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'Total knee replacement'

Joan Manuel Burdeus González-Solís, Iván Díez-Santacoloma, Albert Isidro Llorens
Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system. A retrospective review was performed on the surgical revision of total knee replacement cases intervened in our center that required an ATT osteotomy from February 2014 to February 2015, and who had a minimum clinical follow-up of 12 months...
October 21, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
B Deng, F Wang, L Yin, C Chen, L Guo, H Chen, X Gong, Y Li, L Yang
OBJECTIVE: To observe the morphological feature of calcified cartilage zone (CCZ) in mild to moderate degeneration of cartilages from patients with knee osteoarthritis (OA), revealing the pattern of CCZ during OA progression and its correlation to the surrounding structures. METHODS: Osteochondral specimens were collected from the center of the lateral tibial plateau of 42 OA patients undergoing total knee replacement. Sections were stained with hematoxylin-eosin and Safranin-O/Fast green...
July 2016: Current Research in Translational Medicine
Philippe P Van Overschelde, David A Fitch
BACKGROUND: Patient dissatisfaction following total knee replacement (TKR) has been reported as high as 24%. Most previous studies have focused on satisfaction for TKR overall, with few reporting satisfaction for specific implant designs. The purpose of this study was to assess patient satisfaction for TKRs performed using a second generation medial-pivot system (EVOLUTION(®), MicroPort Orthopedics Inc., Arlington, TN, USA). METHODS: Of a single surgeon's first 250 consecutive TKRs performed using the subject system, 224 completed a patient satisfaction assessment, the Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, and radiographs at 2 months follow-up...
September 2016: Annals of Translational Medicine
Vikash Kapoor, Daipayan Chatterjee, Sutanu Hazra, Anirban Chatterjee, Parag Garg, Kaustav Debnath, Soham Mandal, Sudipto Sarkar
INTRODUCTION: Patient satisfaction after total knee replacement (TKR) depends on the amount of pain relief and the functional activities achieved. An important criterion of good functional outcome is the amount of flexion achieved and whether the patient can manage high flexion activities. In order to increase the amount of safe flexion, various implant designs have been developed. This study aims to compare the outcome after TKR using two contemporary high flexion knee designs: Sigma CR150 High Flex Knee prosthesis (Depuy, Warsaw, Indiana) and NexGen High Flex Knee prosthesis (Zimmer, Warsaw, Indiana)...
2016: SICOT-J
Qing-Hang Zhang, Andrew Cossey, Jie Tong
Periprosthetic bone strain distributions in some of the typical cases of total knee replacement (TKR) were studied with regard to the selection of material, design and the alignments of tibial components to examine which conditions are more forgiving than the others to stress shielding post a TKR. Four tibial components with two implant designs (cruciate sacrificing and cruciate retaining) and material properties (metal-backed (MB) and all-polyethylene (AP)) were considered in a specimen-specific finite element tibia bone model loaded in a neutral position...
October 10, 2016: Medical Engineering & Physics
Rebecca N Howie, Timothy L Foutz, Curtis C Cathcart, Jeff S Burmeister, Steve C Budsberg
OBJECTIVE: To investigate the relationship between tibiofemoral kinematics before and after total knee replacement (TKR) in vitro. ANIMALS: Eight canine hemipelves. METHODS: A modified Oxford Knee Rig was used to place cadaveric limbs through a range of passive motion allowing the kinematics of the stifle to be evaluated. Four measurements were performed: a control stage, followed by a cranial cruciate transection stage, then following TKR with the musculature intact stage, and finally TKR with removal of limb musculature stage...
October 14, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Robert Gabriel Coumine Riis, Henrik Gudbergsen, Ole Simonsen, Marius Henriksen, Nasir Al-Mashkur, Mikkel Eld, Kristian Kjær Petersen, Olga Kubassova, Anne C Bay Jensen, Janus Damm, Henning Bliddal, Lars Arendt-Nielsen, Mikael Ploug Boesen
OBJECTIVES: To investigate the association between MRI, macroscopic and histological assessments of synovitis in end-stage knee osteoarthritis (KOA). METHODS: Synovitis of end-stage osteoarthritic knees was assessed using non-contrast-enhanced (CE), CE-MRI and dynamic-CE (DCE)-MRI prior to total knee replacement and correlated with microscopic and macroscopic assessments of synovitis obtained intraoperatively. Multiple bivariate correlations were used with a pre-specified threshold of 0...
October 10, 2016: Osteoarthritis and Cartilage
Oriana Ciani, Nicola Antonio Pascarelli, Chiara Giannitti, Mauro Galeazzi, Michela Meregaglia, Giovanni Fattore, Antonella Fioravanti
OBJECTIVE: To perform a cost-effectiveness analysis of mud-bath therapy (MBT) in addition to usual treatment compared to usual treatment alone in patients with bilateral knee osteoarthritis (OA). METHODS: An economic evaluation alongside a randomized controlled trial was conducted. Patients were randomly assigned to receive either a 2 weeks cycle of MBT in addition to their usual treatment or to continue routine care alone. The European Quality-of-Life Questionnaire-5 Dimensions (EQ-5D) questionnaire was administered at baseline, 2 weeks, 3, 6, 9, and 12 months...
October 9, 2016: Arthritis Care & Research
Yaxia Zhang, Michael Joyce, Jean Schils, Thomas W Bauer
Sarcoidosis is a systemic inflammatory disorder characterized by non-caseating granulomas, predominantly involving lung, mediastinal lymph nodes and other organs. Synovium involvement is infrequent, and as far as we know, involvement of a periprosthetic membrane has not been reported in the English literature. Intra-articular diffuse tenosynovial giant cell tumor ("conventional diffuse pigmented villonodular synovitis") is an uncommon, locally aggressive neoplasm with few previous case reports in which it arose in periprosthetic tissues after knee arthroplasty...
October 7, 2016: Skeletal Radiology
Bayan Ghalimah, Amre Hamdi
INTRODUCTION: Infection poses a substantial challenge after joint replacement. CASE PRESENTATION: We report a 53-year-old female with multiple co-morbidities, who underwent unilateral total knee arthroplasty. Her postoperative course was complicated by acute cholecystitis necessitating cholecystectomy. CONCLUSION: In patients who require joint replacement surgery, careful and detailed preoperative assessment is important to identify those at risk for this complication in order to provide timely treatment...
April 2016: Journal of Orthopaedic Case Reports
Karim Masmoudi, Yamen Grissa, Sofien Benzarti, Hassen Cheikhrouhou, Zied Mensi
INTRODUCTION: Periprosthetic patellar fracture after total knee arthroplasty (TKA) is a rare complication. Their management can be very challenging with unpredictable results. Literature analysis showed few articles about this complication, but no publication has described the management of open patella fracture around total knee arthroplasty. CASE PRESENTATION: We report a unique case of an open patellar fracture above a total knee arthroplasty, sustained by a 56-year-old female patient...
April 2016: Journal of Orthopaedic Case Reports
M D Crema, F W Roemer, L Li, R C Alexander, I P Chessell, A D Dudley, R Karlsten, L B Rosen, A Guermazi
OBJECTIVE: To compare different semiquantitative and quantitative methods using both non-enhanced and gadolinium-enhanced magnetic resonance imaging (MRI) techniques for the assessment of synovitis in knee osteoarthritis (OA). METHODS: Knees with end-stage clinical OA in patients undergoing total knee replacement surgery were included in this cross-sectional study. MRI was performed on all knees. Standard non-enhanced and gadolinium-enhanced sequences were acquired...
September 30, 2016: Osteoarthritis and Cartilage
Raveendhara R Bannuru, Christopher R Brodie, Matthew C Sullivan, Timothy E McAlindon
OBJECTIVE: Though there is no consensus on its efficacy, knee osteoarthritis is symptomatically managed with intra-articular hyaluronic acid (IAHA). Recent reports suggest that IAHA may delay the need for total knee replacement, with the magnitude of delay proportional to the number of injection series. However, the safety of repeated injection series is reported to vary between commercial products. This report describes a systematic review of safety data on repeated treatment courses of SUPARTZ...
October 2016: Cartilage
S Singh, S Reddy, Raj Shrivastva
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
September 29, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Dennis Hamacher, Margit Rudolf, Christoph Lohmann, Lutz Schega
BACKGROUND: Pain has disruptive effects on cognitive functions leading to a decreased capability to multi task. This might be the reason why pain is a fall risk factor in dual-task situations. This study aims to relate a decrease/increase in pain severity with a decrease/increase in dual-task costs of gait variability, which is associated with fall risk, in patients with osteoarthritis prior to and 6-8weeks after total knee replacement. METHODS: We assessed the variability of minimum toe clearance in normal walking and dual-task walking in 36 patients (14 male and 22 female participants; age=mean 64...
September 22, 2016: Clinical Biomechanics
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
Mohammed Shaath, Mohamed Sukeik, Saadallah Mortada, Sean Masterson
Compartment syndrome is a rare complication of total knee replacement (TKR) surgery that needs prompt diagnosis and treatment as it may be associated with high morbidity and mortality. We have found very few reports in the literature describing compartment syndrome after TKRs and therefore, present a relevant case which occurred in the immediate postoperative phase and was treated with fasciotomy and subsequent operations to close the soft tissue defects.
September 18, 2016: World Journal of Orthopedics
Amaia Ormaza, Jesús Moreta, Javier Mosquera, Oskar Sáez de Ugarte, José Luis Martinez-de Los Mozos
Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh...
September 19, 2016: Orthopedics
Thomas Kurien, Robert Kerslake, Brett Haywood, Richard G Pearson, Brigitte E Scammell
We present our case report using a novel metal artefact reduction magnetic resonance imaging (MRI) sequence to observe resolution of subchondral bone marrow lesions (BMLs), which are strongly associated with pain, in a patient after total knee replacement surgery. Large BMLs were seen preoperatively on the 3-Tesla MRI scans in a patient with severe end stage OA awaiting total knee replacement surgery. Twelve months after surgery, using a novel metal artefact reduction MRI sequence, we were able to visualize the bone-prosthesis interface and found complete resection and resolution of these BMLs...
2016: Case Reports in Orthopedics
C-D Liao, Y-C Huang, Y-S Chiu, T-H Liou
OBJECTIVE: Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. PARTICIPANTS AND SETTING: A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review...
May 9, 2016: Physiotherapy
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