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Shanyuanye Guan, Hans A Gray, Anthony G Schache, Julian Feller, Richard de Steiger, Marcus G Pandy
No data are available to describe six-degree-of-freedom (6-DOF) knee-joint kinematics for one complete cycle of overground walking subsequent to total knee arthroplasty (TKA). The aims of this study were firstly, to measure 6-DOF knee-joint kinematics and condylar motion for overground walking following TKA; and secondly, to determine whether such data differed between overground and treadmill gait when participants walked at the same speed during both tasks. A unique mobile biplane X-ray imaging system enabled accurate measurement of 6-DOF TKA knee kinematics during overground walking by simultaneously tracking and imaging the joint...
October 22, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Vajara Wilairatana, Peerasit Sinlapavilawan, Sittisak Honsawek, Noppachart Limpaphayom
BACKGROUND: The aim was to compare serum levels of interleukin-6 (SIL6), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and joint fluid IL-6 (JIL-6) level between total knee arthroplasty (TKA) that used bone cement (BC group) and antibiotic-loaded bone cement (ALBC group). MATERIALS AND METHODS: Thirty-nine patients (40 TKAs) with a mean age of 69.6 years were non-randomly assigned to the BC or ALBC groups. Samples of SIL6, ESR, and CRP were collected at baseline and at 24 h, 72 h, and 4 weeks after surgery...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Nikolaj S Winther, Claus L Jensen, Claus M Jensen, Thomas Lind, Henrik M Schrøder, Gunnar Flivik, Michael M Petersen
BACKGROUND: Regenerex is a novel porous titanium construct with a three-dimensional porous structure and biomechanical characteristics close to that of normal trabecular bone. The aim of this study was to compare this novel construct to a well-proven porous plasma sprayed tibial (PPS) implant after total knee arthroplasty. METHODS: Sixty-one patients scheduled for an uncemented TKA were randomized to receive either a novel highly porous titanium construct Regenerex or the PPS tibial component...
October 18, 2016: Knee
Erhan Şükür, Yusuf Öztürkmen, Yunus Emre Akman, Ahmet Senel, İbrahim Azboy
INTRODUCTION: There is no consensus on the position of the knee joint while performing wound closure after total knee arthroplasty (TKA). Further, there are no studies focusing on the association between early functional outcomes and different wound closure strategies. Therefore, we investigated the effects of tourniquet and knee position during wound closure on early recovery of range of motion (ROM) after primary TKA. To our knowledge, this is the first study to evaluate the influence of both tourniquet and knee position during wound closure in primary TKA...
October 20, 2016: Archives of Orthopaedic and Trauma Surgery
M Moutzouri, N Gleeson, E Billis, E Tsepis, I Panoutsopoulou, J Gliatis
PURPOSE: Despite the high incidence of falls in patients with OA, few studies have explored whether falls risk is affected after patients undergo total knee arthroplasty (TKA). Therefore, the aim of this systematic review was to identify the extent of the effects of TKA on balance and incidence of falls by critically reviewing the available literature. METHODS: A systematic review of published literature sources was conducted up to March 2014. All studies assessing balance and incidence of falls after TKA (without physiotherapeutic intervention) were included...
October 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christian Scheele, Matthias F Pietschmann, Christian Schröder, Thomas Grupp, Melanie Holderied, Volmar Jansson, Peter E Müller
BACKGROUND: Unicompartmental total knee arthroplasty (UKA) is a well-established treatment option for unicondylar osteoarthritis, and generally leads to better functional results than tricompartimental total knee arthroplasty (TKA). However, revision rates of UKAs are reported as being higher; a major reason for this is aseptic loosening of the tibial component due to implant-cement-bone interface fatigue. The objective of this study was to determine the effects of trabecular bone preparation, prior to implantation of tibial UKAs, on morphological and biomechanical outcomes in a cadaver study...
October 16, 2016: Knee
Zhenyang Mao, Bing Yue, You Wang, Mengning Yan, Kerong Dai
BACKGROUND: Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular administration of TXA. This study aimed to evaluate the effects of peri-articular injection of TXA in reducing blood loss after TKA and compare them to those of intra-articular TXA injection...
October 19, 2016: BMC Musculoskeletal Disorders
Morad Chughtai, Anil Bhave, Sabahat Z Khan, Anton Khlopas, Osman Ali, Steven F Harwin, Michael A Mont
The use of a pneumatic unloader brace has been shown in pilot studies to decrease pain and increase muscle strength in patients with knee osteoarthritis (OA). Therefore, we analyzed patients who had knee OA, and either received a pneumatic unloader brace and conventional treatment or conventional treatment alone. Specifically, we assessed: (1) use of pain relieving injections; (2) opioid consumption; and (3) the eventual need for total knee arthroplasty (TKA) in the above-mentioned cohort. We performed an analysis of a longitudinally maintained database of patients from a prospective, randomized, single center study...
October 17, 2016: Journal of Knee Surgery
Anton Khlopas, Michael A Mont, Morad Chughtai, Robert Molloy, Prem N Ramkumar, Steven F Harwin
Revision total knee arthroplasty (TKA) can be challenging in the setting of bone loss. Previously, severe bone loss was managed with impaction grafting and structural allografts; however, these had limited success. Recently, metaphyseal cones have been developed as useful adjuncts with good early outcomes. Presently, there are no published guidelines on how to preoperatively predict the need for metaphyseal cone implantation radiographically. Therefore, the purpose of this study was to evaluate how well preoperative radiographs were able to predict the use of cones in a small series of patients undergoing revision TKA...
October 17, 2016: Journal of Knee Surgery
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
October 3, 2016: Anesthesia and Analgesia
Jai Thilak, Melvin J George
BACKGROUND: The correct sizing of the components in both anteroposterior and mediolateral (ML) dimensions is crucial for the success of a total knee arthroplasty (TKA). The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature...
September 2016: Indian Journal of Orthopaedics
Emanuele Maiorano, Bruno Dino Bodini, Francesca Cavaiani, Catia Pelosi, Valerio Sansone
BACKGROUND: To identify variables influencing length of stay (LOS) and short-term functional outcome in patients undergoing total knee arthroplasty (TKA). A secondary aim was to verify the effect of the same variables on blood management and the rate of postoperative infection. METHOD: We retrospectively reviewed 353 patients, 258 females and 85 males, who underwent primary TKA in a single specialist orthopaedic centre. Anamnestic and anthropometric data and the Modified Barthel Index Score (MBI) at admission were recorded, and entered as covariates in four longitudinal regression models, separately carried out for female and male groups...
October 11, 2016: Knee
Kimona Issa, Todd P Pierce, Steven F Harwin, Anthony J Scillia, Anthony Festa, Michael A Mont
BACKGROUND: HIV is prevalent worldwide and numerous patients with this diagnosis ultimately may become candidates for TKA. Although some studies have suggested that complications are more common in patients with HIV who undergo TKA, these studies largely were done before the contemporary era of HIV management; moreover, it is unclear whether patients with HIV achieve lower patient-reported outcome scores or inferior implant survivorship. QUESTIONS/PURPOSES: We asked whether there were any differences in the outcomes of patients with HIV without hemophilia who undergo TKA compared with a matched control cohort in terms of: (1) patient-reported outcomes; (2) implant survivorship; and (3) complication rates...
October 14, 2016: Clinical Orthopaedics and related Research
Jianbing Ma, Weijie Zhang, Shuxin Yao
OBJECTIVE: Total knee arthroplasty (TKA) usually results in postoperative pain. The objective of this meta-analysis was to compare the effectiveness and safety of liposomal bupivacaine (LB) infiltration and femoral nerve block (FNB) for pain control in total knee arthroplasty. METHODS: We systemically searched electronic databases, including Embase (1980-2016.7), MEDLINE (1966-2016.7), PubMed (1966-2016.7), ScienceDirect (1985-2016.7), Web of Science (1950-2016...
October 11, 2016: International Journal of Surgery
Yongcai Chen, Zhuo Chen, Shuo Cui, Zhiyang Li, Zhengjiang Yuan
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss during joint replacements, including total knee arthroplasty (TKA) and total hip arthroplasty (THA). However, there is no final consensus regarding the composition of an optimal administration of TXA regime between topical and systemic (intravenous). The purpose of our study was to compare the efficacy of topical and intravenous (IV) regimen of TXA during TKA and THA. METHODS: Five relevant electronic online databases, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Chinese Biomedical Database were systematically searched in November 2015...
October 2016: Medicine (Baltimore)
Romain Gaillard, Simone Cerciello, Sebastien Lustig, Elvire Servien, Philippe Neyret
PURPOSE: Total knee arthroplasty (TKA) malalignment may result in pain and limited range of motion. The present study assessed the influence of different surgeon's and patient's related factors on the post-operative tibial tray coronal alignment. METHODS: The charts and the x-rays of a continuous prospective series of 1417 TKAs operated upon between 1987 and 2015 were retrospectively reviewed. The long-leg AP views were performed at two months post-op and the tibial mechanical angle of the tibial tray was measured...
October 13, 2016: International Orthopaedics
C Belvedere, A Ensini, M d'Amato, P Barbadoro, A Leardini
PURPOSE: Physiological elongation and orientation of patellar tendon fibres are among the scopes of total knee arthroplasty, but little is known in the three dimensions. The study aims to assess in vitro these variations at the intact and replaced knee, with and without patellar resurfacing. It was hypothesised that fibre patterns differ before and after prosthesis implantation, and between specific prosthesis designs. It was also expected that patellar resurfacing would affect relevant results...
October 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Azim Karim, Luis Pulido, Stephen Incavo
Accelerated physical therapy (PT) protocols are a potential mechanism for achieving early mobilization and safe discharge from hospital after elective primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). We compared 2 groups of patients who underwent elective unilateral THA or TKA-those who started PT the same day (Day 0) and those who started PT the next day (Non-Day 0). The difference in mean (SD) hospital length of stay between the Day 0 and Non-Day 0 groups was not statistically significant for THA patients, 2...
September 2016: American Journal of Orthopedics
Richard D Scott
Total knee arthroplasty (TKA) has evolved into a very successful procedure to relieve pain and improve function in the patient with advanced arthritis. Both short- and long-term outcomes are dependent on optimal surgical technique. In this article, I share a few of the many lessons learned over more than 40 years of experience performing TKA regarding exposure, alignment, bone preparation, correction of deformity, and prosthetic implantation.
September 2016: American Journal of Orthopedics
Ross Alexander Chesham, Sivaramkumar Shanmugam
BACKGROUND: Knee osteoarthritis (OA) is a leading cause of disability in older adults (≥60) in the UK. If nonsurgical management fails and if OA severity becomes too great, knee arthroplasty is a preferred treatment choice. Preoperative physiotherapy is often offered as part of rehabilitation to improve postoperative patient-based outcomes. OBJECTIVES: Systematically review whether preoperative physiotherapy improves postoperative, patient-based outcomes in older adults who have undergone total knee arthroplasty (TKA) and compare study interventions to best-practice guidelines...
October 13, 2016: Physiotherapy Theory and Practice
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