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https://www.readbyqxmd.com/read/28723917/evidence-base-and-practice-variation-in-acute-care-processes-for-knee-and-hip-arthroplasty-surgeries
#1
Marcel Mayer, Justine Naylor, Ian Harris, Helen Badge, Sam Adie, Kathryn Mills, Joseph Descallar
BACKGROUND: Lack of evidence contributes to unnecessary variation in treatment costs and outcomes. This study aimed to identify from interventions historically used for total knee or hip arthroplasty (TKA, THA): i) if routine use is supported by high-level evidence; ii) whether surgeon use aligns with the evidence. METHODS: Part 1: Systematic search of electronic library databases for systematic reviews and practice guidelines concerning seven acute-care interventions...
2017: PloS One
https://www.readbyqxmd.com/read/28723749/effects-of-sealing-the-intramedullary-femoral-canal-in-total-knee-arthroplasty-a-randomized-study
#2
Xu Li, Xiang-Bei Qi, Xue Han, Wei Wang, Jian-Ning Liu, Ji-Chao Guo, Zhi-Yong Li
BACKGROUND: This study investigates the clinical effects of sealing the femoral canal by intramedullary alignment instrumentation in total knee arthroplasty (TKA). METHODS: One hundred twenty consecutive patients with knee osteoarthritis, who underwent unilateral TKA, were enrolled in the study and equally randomized into 2 groups: the sealing group and the control group. In the sealing group, the femoral canal was sealed with autogenous bone and cement using intramedullary alignment instrumentation, while the femoral hole was left open for patients in the control group...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721498/functional-outcome-of-intra-articular-tibial-plateau-fractures-the-impact-of-posterior-column-fractures
#3
Juriaan van den Berg, Maike Reul, Menno Nunes Cardozo, Anastasiya Starovoyt, Eric Geusens, Stefaan Nijs, Harm Hoekstra
ABASTRACT: INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. METHODS: A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted...
July 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28721459/measurement-of-lower-limb-alignment-there-are-within-person-differences-between-weight-bearing-and-non-weight-bearing-measurement-modalities
#4
Daphne A L Schoenmakers, Peter Z Feczko, Bert Boonen, Martijn G M Schotanus, Nanne P Kort, Pieter J Emans
PURPOSE: Previous studies have compared weight-bearing mechanical leg axis (MLA) measurements to non-weight-bearing measurement modalities. Most of these studies compared mean or median values and did not analyse within-person differences between measurements. This study evaluates the within-person agreement of MLA measurements between weight-bearing full-length radiographs (FLR) and non-weight-bearing measurement modalities (computer-assisted surgery (CAS) navigation or MRI). MATERIALS AND METHODS: Two independent observers measured the MLA on pre- and postoperative weight-bearing FLR in 168 patients...
July 18, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28716681/mri-magic-angle-effect-in-femorotibial-cartilages-of-the-red-kangaroo
#5
Tonima S Ali, Namal Thibbotuwawa, YuanTong Gu, Konstantin I Momot
OBJECTIVE: Kangaroo knee cartilages are robust tissues that can support knee flexion and endure high levels of compressive stress. This study aimed to develop a detailed understanding of the collagen architecture in kangaroo knee cartilages and thus obtain insights into the biophysical basis of their function. DESIGN: Cylindrical/square plugs from femoral and tibial hyaline cartilage and tibial fibrocartilage were excised from the knees of three adult red kangaroos...
July 14, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28712026/posterior-cruciate-ligament-is-twisted-and-flat-structure-new-prospective-on-anatomical-morphology
#6
Tomohiro Kato, Robert Śmigielski, Yunshen Ge, Urszula Zdanowicz, Bogdan Ciszek, Mitsuo Ochi
PURPOSE: This cadaveric study aimed to elucidate PCL morphology by observing the anatomical relationship with other structures and the fibre layers of the PCL in cross section for remnant preserving PCL reconstruction. METHODS: Seventeen fresh-frozen cadaveric knees were studied, using the clock-face method to analyse the anatomical relationship between the PCL and Humphrey's ligament. The width and thickness of the PCL, Humphrey's and Wrisberg's ligaments were measured...
July 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28702380/patient-specific-instrumentation-in-total-knee-arthroplasty-should-we-adopt-it
#7
REVIEW
Ana Sofia Teles Rodrigues, Manuel António Pereira Gutierres
Total knee arthroplasty (TKA) is a surgical procedure of paramount relevance that restores a substantial degree of function in arthritic knees. Increased consideration has been given to the influence of limb alignment on longevity after TKA, as errors in component placement can be associated with inferior function and compromised long-term performance. Consequently, numerous studies comparing patient-specific instrumentation (PSI) to standard instruments (SI) have been published. Patient-specific approaches use preoperative imaging to create specific materials for each patient's anatomy and were designed to achieve a higher rate of success in TKA, causing the entire procedure to be more efficient and cost-effective...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28701006/how-accurate-is-intraoperative-alignment-measurement-with-a-navigation-system-in-primary-total-knee-arthroplasty
#8
Xaver Feichtinger, Paul Kolbitsch, Roland Kocijan, Andreas Baierl, Alexander Giurea
No abstract text is available yet for this article.
July 12, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28698929/favourable-alignment-outcomes-with-mri-based-patient-specific-instruments-in-total-knee-arthroplasty
#9
REVIEW
Martijn G M Schotanus, Elke Thijs, Marion Heijmans, Rein Vos, Nanne P Kort
PURPOSE: Patient-specific instruments (PSIs) are already in relatively common use, and their post-operative radiographic results are equal to those for total knee arthroplasty (TKA) with conventional instrumentation. PSI use requires a preoperative MRI scan, CT scan, or a combination of MRI and a long-leg standing radiograph. However, there is no consensus as to which of these modalities, MRI or CT, is the preferred imaging modality when performing TKA with PSIs. METHODS: This systematic literature review and meta-analysis studied the differences in alignment outliers between CT- and MRI-based PSI for TKA...
July 11, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28695183/a-randomized-controlled-trial-to-compare-component-placement-in-navigated-total-knee-arthroplasty-using-original-and-streamlined-registration-processes
#10
Nadia C Sciberras, Mohammed Almustafa, Benjamin R K Smith, David J Allen, Frederic Picard, Angela H Deakin
BACKGROUND: This randomized controlled trial validated a redesigned version of navigated total knee arthroplasty software with a streamlined registration (Smart) against the previous version (Classic). The objectives were to determine if Smart software had the same accuracy of component positioning and whether registration and operative time were reduced. METHODS: A total of 220 patients were recruited and had a navigated total knee arthroplasty performed. With the exception of the software, all patients had the same perioperative care...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28692365/robotic-surgery-in-hip-and-knee-arthroplasty
#11
Sujith Konan, Carla Maden, Alex Robbins
This article provides an overview of current use of robotics in hip and knee arthroplasty. Several studies have reported radiographic improvements in joint alignment using robotic-assisted arthroplasty surgery. The economic case made for introducing robotics in joint arthroplasty largely focuses on the hypothesis of reduced hospital stay and reduction in the rate of revisions. This awaits robust data from long-term studies along with the documentation of clinical benefits that will follow the larger implementation of robotic-assisted surgery...
July 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28684111/frontal-alignment-in-total-knee-arthroplasty-comparative-study-between-radiographic-measurement-and-surgical-navigation
#12
D Hernandez-Vaquero, A Noriega-Fernandez, A Suarez-Vazquez, S Roncero-Gonzalez, A A Sierra-Pereira, L Gil-Martinez, J M Fernandez-Carreira
OBJECTIVE: To establish the concordance between angulation of the femoro-tibial mechanical axis measured with x-rays and surgical navigation in both the pre and postoperative period after a total knee arthroplasty (TKA) was implanted. MATERIAL AND METHOD: Pre and postoperative measurements were analyzed in 88 TKA of the same model and all performed with the same surgical navigation system. The mechanical frontal angle (MFA) and femoro-tibial anatomic angle were measured before and after the TKA...
July 3, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28683980/midterm-survivorship-and-complications-of-total-knee-arthroplasty-in-patients-with-dwarfism
#13
Timothy L Tan, Michael M Kheir, Ronuk Modi, Chi-Lung Chen, Hongyi Shao, Antonia F Chen
BACKGROUND: Dwarfism is associated with skeletal dysplasias and joint deformities that frequently result in osteoarthritis requiring treatment with total knee arthroplasty (TKA). These surgeries can be challenging because of alignment deformities, poor bone stock, and smaller components. This study aims to compare TKA implant survivorship and complications between dwarf and nondwarf patients. METHODS: A retrospective case-control study was performed from 1997-2014 evaluating 115 TKAs in patients under the height threshold of 147...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28669859/effect-of-the-upper-instrumented-vertebral-level-upper-vs-lower-thoracic-spine-on-gait-ability-after-corrective-surgery-for-adult-spinal-deformity
#14
Mitsuru Yagi, Nobuyuki Fujita, Osahiko Tsuji, Narihiro Nagoshi, Yoshiyuki Yato, Takashi Asazuma, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND CONTEXT: The relationship between gait pattern and the level of upper instrumented vertebra (UIV) in surgically treated patients with adult spinal deformity (ASD) has not been fully documented. PURPOSE: To assess the effect of UIV level for the gait pattern in ASD STUDY DESIGN/SETTING: Prospective case series. PATIENT SAMPLE: Thirty surgically treated consecutive female ASD with lumbosacral fusion (age 67.0±8.4 years; body mass index (BMI) 22...
June 29, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28663394/external-rotation-of-the-femoral-component-increases-asymmetry-of-the-posterior-condyles
#15
M P Bonnin, M Saffarini, L Nover, J van der Maas, C Haeberle, G Hannink, J Victor
AIMS: The morphometry of the distal femur was largely studied to improve bone-implant fit in total knee arthroplasty (TKA), but little is known about the asymmetry of the posterior condyles. This study aimed to investigate the dimensions of the posterior condyles and the influence of externally rotating the femoral component on potential prosthetic overhang or under-coverage. PATIENTS AND METHODS: We analysed the shape of 110 arthritic knees at the time of primary TKA using pre-operative CT scans...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28660000/coronal-knee-alignment-40-years-after-total-meniscectomy-in-adolescents-a-prospective-cohort-study
#16
I P Pengas, W Nash, Wasim Khan, A Assiotis, J Banks, M J McNicholas
INTRODUCTION: Meniscectomies result in altered knee biomechanics and increase contact forces on the operated knee joint. METHODS: We assessed coronal knee alignment in relation to radiological osteoarthritis grading, clinical range of movement and patient reported outcome measures 40 years after total open meniscectomies in adolescence. Thirty eight knees (30 patients) that underwent total open meniscectomy were assessed on standardised weight-bearing anteroposterior radiographs for deviation from 'physiological valgus angle' in either direction (magnitude of malalignment)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28657568/metal-hypersensitivity-after-knee-arthroplasty-fact-or-fiction
#17
Massimo Innocenti, Berti Vieri, Tommaso Melani, Tommaso Paoli, Christian Carulli
BACKGROUND AND AIM OF THE WORK: Hypersensitivity to metals in the general population has an incidence of about 15%, and in rising also for the higher number of joint replacements in the last decades. Total Knee Arthroplasty (TKA) represents the most performed orthopaedic procedure during last years, and it seems to be particularly associated with sensitization after surgery. On the other hand, there is a rising amount of patients with painful but well implanted and functioning TKAs: in certain cases, after the exclusion of the most frequent causes of failure, a condition of hypersensitivity may be found, and a revision with anallergic implants is mandatory...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657565/robotic-arm-assisted-partial-knee-arthroplasty-a-single-centre-experience
#18
Andrea Marcovigi, Francesco Zambianchi, Dario Sandoni, Elisa Rivi, Fabio Catani
BACKGROUND AND AIM OF THE WORK: UKA has proven to be an effective surgical procedure, but its survivorship is still negatively affected by inaccuracy in component component positioning, implant and limb alignment. Robotic surgery has been introduced in order to minimize such technical errors. The aim of the present paper was to evaluate clinical and surgical outcomes after a 3 years' experience of robotic assisted UKA with the Mako Robotic Arm. METHODS: Seventy-three patients undergoing  UKA with robotic instrumentation (65 medial UKAs, 8 lateral UKAs) and with a clinical follow-up of 3 -37 months were included in the present study...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657564/computer-assisted-total-knee-arthroplasty-a-real-navigation-to-better-results
#19
Paolo Di Benedetto, Enrico Daniele Di Benedetto, Michele Mario Buttironi, Alessandro Beltrame, Renato Gissoni, Vanni Cainero, Araldo Causero
BACKGROUND AND AIM OF THE WORK: Computer assisted surgery in knee replacement is still in discussion, but majority of papers affirm an increase of the accuracy in alignment. Aim of our study is to evaluate the accuracy of mechanical axis, the posterior tibial slope and the femoral component rotation with navigation, x-ray and CT data. METHODS: We have analysed 145 patients who underwent total knee arthroplasty between January 2012 and December 2014. We have checked each patient at 6, 12 and 24 months of follow-up...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657562/patient-specific-instrumentation-in-total-knee-arthroplasty
#20
Andrea Colombelli, Alberto Belluati, Yousef Rizqallah, Giovanni Guerra, Carlo Busatto
BACKGROUND AND AIM OF THE WORK: The international literature and analysis of the prosthetic registers highlight a significant relationship between the alignment of the components and the survival of prosthetic implants of the knee. The patient specific instrumentation (PSI) technology exploits the data obtained with the MRN for the production of cutting blocks (CB) useful to a TKA. Revisiting the recent international literature, comparing the results of the conventional method and PSI, numerous studies confirm a statistically significant difference of inliers (± 3 degrees) for HKA...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
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