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Total knee arthroplasty

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https://www.readbyqxmd.com/read/29458202/validity-of-the-intra-operative-measurement-of-stem-anteversion-and-factors-for-the-erroneous-estimation-in-cementless-total-hip-arthroplasty-using-postero-lateral-approach
#1
Y K Lee, J W Kim, T Y Kim, Y C Ha, K H Koo
BACKGROUND: Intra-operative estimation of stem anteversion in total hip arthroplasty (THA) using postero-lateral approach is made by the surgeon's visual assessment, using the tibia as a guide, with the assumption that tibial axis is vertical to the trans-epicondylar axis. However, the accuracy of the intra-operative estimation has rarely been verified with postoperative CT-scans, with controversies regarding these measurements particularly in case of knee osteoarthritis. Therefore we performed a prospective study to: 1) determine the accuracy of the intra-operative measurement and 2) investigate factors affecting the discrepancy between the surgeon's estimation and the real stem anteversion HYPOTHESIS: Intra-operative estimation of stem anteversion correlated with the real stem anteversion on CT scan...
February 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29457404/-perioperative-and-drug-management-of-patients-with-rheumatoid-arthritis-treated-with-joint-replacement
#2
REVIEW
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Jie Shi, Wei Wang, Xiao-le He, Xu-Sheng Li
Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457392/-analysis-on-the-occult-blood-loss-after-unicompartment-knee-arthroplasty
#3
Zhan-Feng Zhang, Ji-Kang Min, Dan Wang, Jian-Ming Zhong, Heng Li
OBJECTIVE: To calculate the volume of occult blood loss after unicompartment knee arthroplasty(UKA), and analyze its influential factors by comparing with total knee arthroplasty. METHODS: A retrospective study of 130 cases from July 2012 to July 2015 were enrolled, of which and 65 cases were UKA, and 65 cases were TKA. In UKA group there were 27 males and 38 females, and the mean age was (62.3±4.3) years old (ranged, 50 to 82 years old). There were 14 cases older than 70 years old, while 51 cases among 50 to 70 years old...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29457342/soft-tissue-balancing-in-total-knee-arthroplasty-using-sensor-guided-assessment-is-there-a-learning-curve
#4
Monther A Gharaibeh, Darren B Chen, Samuel J MacDessi
BACKGROUND: Sensor-guided assessment for soft tissue balance in total knee arthroplasty (TKA) has been reported to improve patient satisfaction and self-reported outcome scores. As more surgeons adopt this technology in TKA, we performed this study to identify if there is a learning curve with its use. METHODS: Analysis of a total of 90 consecutive cases was performed in this study. Initial and final intercompartmental pressure differences were recorded before and after knee ligament balancing...
February 18, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29456980/effect-of-patellar-electrocautery-neurectomy-on-postoperative-pain-among-patients-referred-for-total-knee-arthroplasty
#5
Mehdi Motififard, Khalilollah Nazem, Aida Zarfeshani, Kaveh Zarfeshani
Background: Anterior knee pain is a major problem in total knee arthroplasty (TKA). It is accepted that anterior knee pain (AKP) often contributes to a patellofemoral etiology; however, its etiology or treatment is not understood completely. Disabling pain receptors by electrocautery could theoretically lead to anterior knee area denervation. The present study aimed to evaluate the pain post-patellar denervation (PD) with electrocautery in TKA. Materials and Methods: Clinical results for 92 patients who underwent TKA (58 women, 34 men; mean age 67...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29455938/comparison-of-periarticular-local-infiltration-analgesia-with-femoral-nerve-block-for-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#6
Lu-Kai Zhang, Jian-Xiong Ma, Ming-Jie Kuang, Xin-Long Ma
BACKGROUND: Total knee arthroplasty (TKA) is accompanied by moderate-to-severe postoperative pain. Postoperative pain will hamper functional recovery and lower patients' satisfaction with surgery. Recently, periarticular local infiltration analgesia (LIA) has been widely used in TKA. However, there is no definite answer as to the efficacy and safety of LIA compared with femoral nerve block (FNB). METHOD: Randomized controlled trials about relevant studies were searched from PubMed (1996 to July 2017), Embase (1980 to July 2017), and Cochrane Library (CENTRAL, July 2017)...
January 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29455920/operating-room-traffic-in-total-joint-arthroplasty-identifying-patterns-and-training-the-team-to-keep-the-door-shut
#7
William G Hamilton, Colleen B Balkam, Richard L Purcell, Nancy L Parks, Jill E Holdsworth
BACKGROUND: Surgical site infections after joint arthroplasty are devastating complications and are influenced by patient, surgical, and operating room environmental factors. METHODS: In an effort to reduce the incidence of door openings (DOs) during total joint arthroplasty cases, this prospective observational study consisted of 3 phases. Phase 1 determined the baseline incidence of DOs, followed by installation of a mechanical door counter (phase 2). Finally, an educational seminar was presented to all personnel (phase 3) regarding the implications frequent DOs have on patient and surgical outcomes...
February 15, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29455244/rotation-of-intramedullary-alignment-rods-affects-distal-femoral-cutting-plane-in-total-knee-arthroplasty
#8
Günther Maderbacher, Jan Matussek, Armin Keshmiri, Felix Greimel, Clemens Baier, Joachim Grifka, Hermann Maderbacher
PURPOSE: Intramedullary rods are widely used to align the distal femoral cut in total knee arthroplasty. We hypothesised that both coronal (varus/valgus) and sagittal (extension/flexion) cutting plane are affected by rotational changes of intramedullary femoral alignment guides. METHODS: Distal femoral cuts using intramedullary alignment rods were simulated by means of a computer-aided engineering software in 4°, 6°, 8°, 10°, and 12° of valgus in relation to the femoral anatomical axis and 4° extension, neutral, as well as 4°, 8°, and 12° of flexion in relation to the femoral mechanical axis...
February 17, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29454601/cross-linked-polyethylene-does-not-reduce-wear-in-total-knee-arthroplasty
#9
S Lasurt-Bachs, P Torner, F Maculé, E Prats, F Menéndez-García, J Ríos-Guillermo, A Torrents
AIM: To compare two different types of inserts: Ultra-high molecular weight polyethylene (UHMWPE) and cross-linked polyethylene with a quantitative and qualitative study of polyethylene wear particles in synovial fluid 3 years after total knee arthroplasty. MATERIAL AND METHODS: A prospective, randomized, controlled cohort study with blinded evaluation was carried out on 25 patients undergoing staged bilateral total knee replacement, 6 months apart. Knee arthrocentesis was performed on 12 patients 3 years after surgery, and the polyethylene particles were analyzed...
February 14, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29454556/validity-and-responsiveness-of-the-two-minute-walk-test-for-measuring-functional-recovery-after-total-knee-arthroplasty
#10
Aasis Unnanuntana, Pakpoom Ruangsomboon, Worawut Keesukpunt
BACKGROUND: The 2-minute walk test (2mwt) is a performance-based test that evaluates functional recovery after total knee arthroplasty (TKA). This study evaluated its validity compared with the modified Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), modified Knee Score, Numerical Pain Rating Scale, and Timed Up and Go test, and its responsiveness in assessing functional recovery in TKA patients. METHODS: This prospective cohort study included 162 patients undergoing primary TKA between 2013 and 2015...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29453487/significant-differences-between-manufacturer-and-surgeon-in-the-accuracy-of-final-component-size-prediction-with-ct-based-patient-specific-instrumentation-for-total-knee-arthroplasty
#11
Davide Cucchi, Alessandra Menon, Riccardo Compagnoni, Paolo Ferrua, Chiara Fossati, Pietro Randelli
PURPOSE: Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) may improve component sizing. Little has been reported about accuracy of the default plan created by the manufacturer, especially for CT-based PSI. The goal of this study was to evaluate the reliability of this plan and the impact of the surgeon's changes on the final accuracy of the guide sizes. METHODS: Forty-five patients eligible for primary TKA were prospectively enrolled. The planned implant sizes were prospectively recorded from the initial manufacturer's proposal and from the final plan adjusted in light of the surgeon's evaluation; these two sizes where then compared to the actually implanted sizes...
February 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29452974/-running-two-rooms-does-not-compromise-outcomes-or-patient-safety-in-joint-arthroplasty
#12
William G Hamilton, Henry Ho, Nancy L Parks, Alexander V Strait, Robert H Hopper, James F McDonald, Nitin Goyal, Kevin B Fricka, C Anderson Engh
BACKGROUND: Scrutiny from the federal government and the media regarding the safety of 1 surgeon doing cases in 2 operating rooms (ORs) on the same day, prompted us to examine our own institutional data. Over the past 11 years, surgeons at our facility have operated consecutively in 1 OR on a given day or used 2 alternating ORs. This study compares these cases with a focus on revisions and complications in both groups. METHODS: Six surgeons performed a total of 16,916 primary hip and knee arthroplasties from 2006-2016...
January 31, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29452296/development-and-persistence-of-suspected-neuropathic-pain-after-total-knee-arthroplasty-in-individuals-with-osteoarthritis
#13
Matthew Fitzsimmons, Eloise Carr, Linda Woodhouse, Geoff P Bostick
BACKGROUND: Despite the effectiveness of total knee arthroplasty (TKA) for osteoarthritis (OA), up to 20% will report knee pain 1-year after surgery. One possible reason is the development of neuropathic pain before or after TKA. OBJECTIVE: To longitudinally describe suspected neuropathic pain in patients pre- and post-TKA and to explore relationships between pre-TKA suspected neuropathic pain and post-TKA outcomes. DESIGN: Prospective observational study...
February 13, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/29451685/a-quantitative-lc-msms-method-for-determination-of-edoxaban-a-xa-inhibitor-and-its-pharmacokinetic-application-in-patients-after-total-knee-arthroplasty
#14
Kazuhiko Hanada, Shin-Ichi Matsumoto, Soichi Shibata, Hajime Matsubara, Yasunori Tsukimura, Harumi Takahashi
Edoxaban was extracted from human plasma by simple protein precipitation with acetonitrile, followed by quantitative determination using a liquid chromatography-mass spectrometry method. The recoveries of edoxaban and the internal standard (ticlopidine) from human plasma were higher than 85%, and the within- and between-day coefficients of variation were within 15%. The limit of quantification in human plasma was 1 ng/mL. The concentration of edoxaban in blood decreased at room temperature, but remained unchanged for 1 week at 4°C...
February 16, 2018: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/29450640/incidence-of-perioperative-complications-in-total-hip-and-knee-arthroplasty-in-patients-with-parkinson-disease
#15
Tankamani Sharma, Wolfgang Hönle, René Handschu, Werner Adler, Tarun Goyal, Alexander Schuh
INTRODUCTION: The aim of this study is to evaluate the difference in perioperative complication rate in total hip, bipolar hemiarthroplasties and total knee arthroplasty in patients with Parkinson disease in trauma and elective surgery in our Musculoskeletal Center during a period of 10 years. MATERIAL AND METHOD: Between 2006 and 2016, 45 bipolar hemiarthroplasties in trauma surgery, 15 total knee and 19 total hip arthroplasties in patients with Parkinson's disease were performed...
February 15, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29448880/migration-and-clinical-outcome-of-mobile-bearing-versus-fixed-bearing-single-radius-total-knee-arthroplasty
#16
Koen T Van Hamersveld, Perla J Marang-Van De Mheen, Huub J L Van Der Heide, Henrica M J Van Der Linden-Van Der Zwaag, Edward R Valstar, Rob G H H Nelissen
Background and purpose - Mobile-bearing total knee prostheses (TKPs) were developed in the 1970s in an attempt to increase function and improve implant longevity. However, modern fixed-bearing designs like the single-radius TKP may provide similar advantages. We compared tibial component migration measured with radiostereometric analysis (RSA) and clinical outcome of otherwise similarly designed cemented fixed-bearing and mobile-bearing single-radius TKPs. Patients and methods - RSA measurements and clinical scores were assessed in 46 randomized patients at baseline, 6 months, 1 year, and annually thereafter up to 6 years postoperatively...
February 16, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29448081/medial-tilting-of-the-joint-line-in-posterior-stabilized-total-knee-arthroplasty-increases-contact-force-and-stress
#17
Yoshihisa Tanaka, Shinichiro Nakamura, Shinichi Kuriyama, Kohei Nishitani, Hiromu Ito, Moritoshi Furu, Mutsumi Watanabe, Shuichi Matsuda
BACKGROUND: Kinematically aligned total knee arthroplasty is based on the concept to represent the premorbid joint alignment with cruciate-retaining implants, characterized by medial tilt and internal rotation. However, kinematic and kinetic effects of kinematically aligned total knee arthroplasty with posterior-stabilized implants is unknown. The purpose of this study was to examine the effect of medial tilting of the joint line with posterior-stabilized implants. METHODS: A mechanical alignment model, and medial tilt 3° and 5° models were constructed...
February 9, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29444666/analysis-of-total-knee-arthroplasty-revision-causes
#18
Anne Postler, Cornelia Lützner, Franziska Beyer, Eric Tille, Jörg Lützner
BACKGROUND: The number of revision Total Knee Arthroplasty (TKA) is rising in many countries. The aim of this study was the prospective assessment of the underlying causes leading to revision TKA in a tertiary care hospital and the comparison of those reasons with previously published data. METHODS: In this study patients who had revision TKA between 2010 and 2015 were prospectively included. Revision causes were categorized using all available information from patients' records including preoperative diagnostics, intraoperative findings as well as the results of the periprosthetic tissue analysis...
February 14, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29444542/kinematically-aligned-total-knee-arthroplasty-or-mechanically-aligned-total-knee-arthroplasty
#19
Tsuneari Takahashi, Juned Ansari, Hemant G Pandit
Kinematically aligned total knee arthroplasty (KATKA) was developed to more anatomically align the knee prosthesis to restore the native alignment of the knee and promote physiological kinematics. Even though there are concerns with implant survival, and follow-up at 10 years or more after KATKA has not been reported, there is a negligible incidence of failure of a tibial component at 2 to 9 years. Early clinical results with this technique are encouraging and demonstrate better functional outcomes compared with mechanically aligned TKA (MATKA)...
February 14, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29439922/increased-precision-of-coronal-plane-outcomes-in-robotic-assisted-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#20
REVIEW
Ashim Mannan, James Vun, Christopher Lodge, Alistair Eyre-Brook, Simon Jones
BACKGROUND: Inaccuracy of component alignment in total knee arthroplasty adversely impacts outcomes. Robotic systems improve translation of pre-operative planning to intra-operative steps, theoretically resulting in greater accuracy and precision. In this study we systematically review literature data of alignment outcomes and apply meta-analysis methods to assess whether robotic-assisted knee arthroplasty provides superior outcomes when compared to conventional knee prostheses. METHODS: A PRISMA compliant search comparing alignment outcomes in robotic vs conventional knee arthroplasty was performed...
February 10, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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