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"Total knee arthroplasty"

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https://www.readbyqxmd.com/read/28110363/bone-morphotypes-of-the-varus-and-valgus-knee
#1
E Thienpont, P E Schwab, O Cornu, J Bellemans, J Victor
BACKGROUND: Coronal deformity correction with total knee arthroplasty (TKA) is an important feature in the treatment of osteoarthritis (OA). The hypothesis of this study was that bone morphology would be different in varus and valgus deformity, both before osteoarthritis development as well as during and after the disease process of OA. MATERIALS AND METHODS: Retrospective study with measurements on preoperative and postoperative full leg standing radiographs of 96 patients who underwent TKA...
January 21, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28109761/survivorship-of-metaphyseal-sleeves-in-revision-total-knee-arthroplasty
#2
Brian P Chalmers, Nicholas M Desy, Mark W Pagnano, Robert T Trousdale, Michael J Taunton
BACKGROUND: Metaphyseal fixation has promising early results in providing component stability and fixation in revision total knee arthroplasty (TKA). However, there are limited studies on midterm results of metaphyseal sleeves. We analyzed complications, rerevisions, and survivorship free of revision for aseptic loosening of metaphyseal sleeves in revision TKA. METHODS: Two hundred eighty patients with 393 metaphyseal sleeves (144 femoral, 249 tibial) implanted during revision TKA from 2006-2014 were reviewed...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28109759/how-much-does-the-anatomical-tibial-component-improve-the-bony-coverage-in-total-knee-arthroplasty
#3
Cheng Jin, Eun-Kyoo Song, Jatin Prakash, Sung-Kyu Kim, Chee Ken Chan, Jong-Keun Seon
BACKGROUND: Recently, anatomical designs in total knee arthroplasty are introduced to address asymmetry of the resected tibia cutting surface. It is still not well known how much improvement would be achieved in total knee arthroplasty, especially in Asian knees. METHODS: We evaluated the bony coverage of 4 commercially available posterior-stabilized tibial designs (3 symmetrical: NexGen, Attune, and Vega; 1 anatomical: Persona) by measuring uncovered areas over 3 different regions: lateroposterior (LP), medioposterior (MP), and mediolateral (ML) areas...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28109758/the-use-of-electronic-sensor-device-to-augment-ligament-balancing-leads-to-a-lower-rate-of-arthrofibrosis-after-total-knee-arthroplasty
#4
Jeffrey A Geller, Akshay Lakra, Taylor Murtaugh
BACKGROUND: Total knee arthroplasty (TKA) is a highly successful surgery shown to improve quality of life. One of the more common known complications of TKA is early arthrofibrosis requiring manipulation under anesthesia (MUA). This investigation evaluates the incidence of arthrofibrosis before and after the implementation of an electronic sensor device used to assist with ligament balancing. METHODS: Six hundred ninety TKAs performed without sensor use were compared to a cohort of 252 TKAs performed with sensor usage...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28108171/patellar-cut-and-composite-thickness-the-influence-on-postoperative-motion-and-complications-in-total-knee-arthroplasty
#5
William G Hamilton, Deborah J Ammeen, Nancy L Parks, Nitin Goyal, Gerard A Engh, C Anderson Engh
BACKGROUND: Little data exist on the influence of patellar thickness on postoperative motion or complications after total knee arthroplasty (TKA). This study addresses the following questions: Is postoperative motion influenced by change in composite patellar thickness? Is change in patellar thickness associated with more complications? And do more complications occur in the knees with a patellar bone remnant (<12 mm) and a native patellar thickness <18 mm? METHODS: In total, 3655 TKAs were performed by 3 surgeons over a 28-year interval...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28108167/posterior-cruciate-retaining-versus-posterior-stabilized-total-knee-arthroplasty-for-osteoarthritis-with-severe-varus-deformity
#6
Ethem Ayhan Ünkar, Yusuf Öztürkmen, Erhan Şükür, Engin Çarkçı, Murat Mert
OBJECTIVE: The aim of this study was to compare the radiological and functional results of posterior cruciate ligament (PCL) - retaining and posterior-stabilized total knee arthroplasties in patients with severe varus gonarthrosis. METHODS: Medical records of 112 knees of 96 patients who underwent total knee arthroplasty for severe varus (≥15°) were reviewed. PCL-retaining and PCL-stabilizing groups consisted of 58 and 54 knees, respectively. Mean follow-up time was 56...
January 17, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28107366/comparative-analysis-of-direct-hospital-care-costs-between-aseptic-and-two-stage-septic-knee-revision
#7
Richard Kasch, Sebastian Merk, Grit Assmann, Andreas Lahm, Matthias Napp, Harry Merk, Steffen Flessa
BACKGROUND: The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available...
2017: PloS One
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#8
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
January 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28106354/adding-dexmedetomidine-to-ropivacaine-for-femoral-nerve-block-inhibit-local-inflammatory-response
#9
Jing Li, Hanghui Wang, Buhuai Dong, Jianbing Ma, Xucai Wu
BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective α2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA). METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study...
January 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28103911/comparison-of-the-effectiveness-and-safety-of-topical-versus-intravenous-tranexamic-acid-in-primary-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#10
Tao-Ping Chen, Yu-Min Chen, Jian-Bao Jiao, Yun-Fei Wang, Li-Gang Qian, Zhao Guo, Zheng Ma, Cui-Yu Han, Tong-Huan Shi
BACKGROUND: This study aims to compare the effectiveness and safety of topical versus intravenous tranexamic acid (TXA) in reducing blood loss in primary total knee arthroplasty (TKA). METHODS: PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database and China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled studies (RCTs) that compared topical versus intravenous TXA in terms of reducing blood loss during TKA from their inception to September 2015...
January 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28102160/assessment-of-selected-factors-influencing-the-development-of-stiffness-after-total-knee-arthroplasty
#11
Jakub Oberbek, Marek Synder
BACKGROUND: Surgical treatment of idiopathic degenerative disease of the knee joint with total arthroplasty is aimed at reducing concomitant pain and improving the limited range of motion. This paper aims to assess the influence of pain intensity and range of motion on the presence of knee joint stiffness after primary total arthroplasty. MATERIAL AND METHODS: 59 male and female patients were divided into two groups based on the presence (G1) or absence (G2) of stiffness in the operated knee joint at 3 months post-operatively...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28100411/comparison-of-mid-term-results-between-conversion-total-knee-arthroplasties-following-closed-wedge-high-tibial-osteotomy-and-primary-total-knee-arthroplasties-a-matched-pair-study-including-patellar-symptom-and-position
#12
Dae Kyung Bae, Sang Jun Song, Cheol Hee Park, Hu Liang, Jung Kwon Bae
BACKGROUND: The purpose of this study was to compare mid-term clinical and radiographic results of conversion total knee arthroplasties (TKA) following a closed-wedge high tibial osteotomy (HTO) and primary TKAs. METHODS: A total of 32 conversion TKAs (29 patients) were compared with a matched control group of patients who had undergone primary TKA. The clinical results were evaluated using the Knee Society Knee and Function score, the Western Ontario and McMaster Universities score, patella score, and range of motion (ROM)...
January 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28099301/unicompartmental-knee-arthroplasty-provides-higher-activity-and-durability-than-valgus-producing-proximal-tibial-osteotomy-at-5-to-7-years
#13
Aaron J Krych, Patrick Reardon, Paul Sousa, Ayoosh Pareek, Michael Stuart, Mark Pagnano
BACKGROUND: The cases of patients with medial compartment osteoarthritis who were ≤55 years old and had a proximal tibial osteotomy (PTO) or medial unicompartmental knee arthroplasty (UKA) were compared. Outcomes included postoperative activity level, function, and survivorship free of revision to total knee arthroplasty. METHODS: Between 1998 and 2013, data were available for 240 patients between 18 and 55 years old with medial compartment arthritis and varus malalignment who were treated either with PTO (57 patients) or with UKA (183 patients)...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28099297/sedentary-behavior-cadence-and-physical-activity-outcomes-after-knee-arthroplasty
#14
Sandra C Webber, Shaelyn M Strachan, Navjot S Pachu
PURPOSE: This study comprehensively examined sedentary behaviour and physical activity patterns in people with severe knee osteoarthritis awaiting total knee arthroplasty (TKA) and in individuals after TKA. METHODS: Pre-operative (n=32, mean ± SD = 69.9 ± 5.3 yr) and one-year post-operative participants with TKA (n=38, 67.9 ± 7.3 yr) wore ActiGraph GT3X+ activity monitors for 6.8 ± 0.6 days. Total sedentary time, time in long sedentary bouts (≥ 30 min) and physical activity outcomes (steps, time in moderate-to-vigorous physical activity [MVPA], cadence) were examined...
January 17, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28097422/novel-alignment-measurement-technique-for-total-knee-arthroplasty-using-patient-specific-instrumentation
#15
Kazumasa Yamamura, Yukihide Minoda, Shigekazu Mizokawa, Yoichi Ohta, Ryo Sugama, Suguru Nakamura, Hideki Ueyama, Hiroaki Nakamura
INTRODUCTION: This study was designed to evaluate the true accuracy of patient specific instrumentation (PSI) for total knee arthroplasty (TKA) using a new 3D measurement method. MATERIALS AND METHODS: Consecutive 21 patients (30 knees) who underwent TKA using computed tomography (CT)-based PSI were retrospectively evaluated. Mean patient age was 69.2 years (62 to 77). The postoperative three-dimensional (3D) CT image were superimposed onto the preoperative 3D CT plan and measured the absolute difference in the prosthetic alignment using six parameters: coronal, sagittal, and axial alignment of the femoral and tibial prostheses...
January 17, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28096578/the-effect-of-pregabalin-and-s-ketamine-in-total-knee-arthroplasty-patients-a-randomized-trial
#16
Lajla Kadic, Frank G van Haren, Oliver Wilder-Smith, Jorgen Bruhn, Jacques J Driessen, Maarten C de Waal Malefijt
BACKGROUND AND AIMS: Pain reduction is important for rehabilitation after total knee arthroplasty. Intra- and peri-articular infiltration with local anesthetics may be an alternative to commonly used locoregional techniques. Adding pregabalin orally and s-ketamine intravenously may further reduce postoperative pain. MATERIAL AND METHODS: This prospective, randomized, double-blind, placebo-controlled study compared two methods of perioperative analgesia. Control patients received a standardized multimodal postoperative analgesic regime of paracetamol, diclofenac, and piritramide-patient-controlled analgesia, including ropivacaine knee infiltration during surgery...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28094763/measuring-the-effect-of-femoral-malrotation-on-knee-joint-biomechanics-for-total-knee-arthroplasty-using-computational-simulation
#17
K-T Kang, Y-G Koh, J Son, O-R Kwon, C Baek, S H Jung, K K Park
OBJECTIVES: Malrotation of the femoral component can result in post-operative complications in total knee arthroplasty (TKA), including patellar maltracking. Therefore, we used computational simulation to investigate the influence of femoral malrotation on contact stresses on the polyethylene (PE) insert and on the patellar button as well as on the forces on the collateral ligaments. MATERIALS AND METHODS: Validated finite element (FE) models, for internal and external malrotations from 0° to 10° with regard to the neutral position, were developed to evaluate the effect of malrotation on the femoral component in TKA...
November 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/28093635/different-intraoperative-kinematics-stability-and-range-of-motion-between-cruciate-substituting-ultracongruent-and-posterior-stabilized-total-knee-arthroplasty
#18
Hagen Fritzsche, Franziska Beyer, Anne Postler, Jörg Lützner
PURPOSE: The aim of this study was the comparison of intraoperative kinematics, stability, and range of motion (ROM) between the native osteoarthritic knee and cruciate-substituting fixed-bearing total knee arthroplasty (TKA) using both an ultracongruent (UC) and a posterior-stabilized (PS) insert design in the same patient. We hypothesized less knee flexion and less antero-posterior stability in the UC TKA. METHODS: Intraoperative measurements of kinematics, stability, and ROM were performed in 40 patients before soft-tissue release and bone cuts, and after implantation of the final femoral and tibial implants with both a UC insert and a PS insert...
January 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28089667/periprosthetic-fractures-of-the-distal-femur-after-total-knee-arthroplasty-plate-versus-nail-fixation
#19
REVIEW
Sara Shippee Wallace, Daniel Bechtold, Adam Sassoon
: The incidence of periprosthetic fractures about a TKA is increasing. Traditionally these fractures are classified by their location and prosthesis integrity. In the setting of a supracondyar fracture about a well-fixed prosthesis, both plate and nail fixation of the fracture present themselves as options, each with unique benefits and pitfalls. Through review and discussion of the literature, we aim to describe some of the patient, fracture, and implant related factors that should be considered when planning fixation of periprosthetic fractures about a TKA...
January 12, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#20
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
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