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Knee surgery

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https://www.readbyqxmd.com/read/29331302/bone-matrix-microdamage-and-vascular-changes-characterize-bone-marrow-lesions-in-the-subchondral-bone-of-knee-osteoarthritis
#1
Dzenita Muratovic, David M Findlay, Flavia M Cicuttini, Anita E Wluka, Yea-Rin Lee, Julia S Kuliwaba
INTRODUCTION: Bone marrow lesions (BMLs) in the subchondral bone in osteoarthritis (OA) are suggested to be multifactorial, although the pathogenic mechanisms are unknown. Bone metabolism and cardiovascular risk factors associate with BML in epidemiologic studies. However, there are no studies at the tissue level investigating the relationship between these processes and BML. The aim of this study was to investigate the relationship between BMLs in the tibial plateau (TP) of knee OA and bone matrix microdamage, osteocyte density and vascular changes...
January 10, 2018: Bone
https://www.readbyqxmd.com/read/29329669/prevalence-and-predictors-of-symptom-resolution-and-functional-restoration-in-the-index-knee-following-knee-arthroplasty-a-longitudinal-study
#2
Daniel L Riddle
OBJECTIVES: To determine the prevalence of a one- to two-year postsurgical pain-free state and pain plus symptom-free state as well as function restoration following knee arthroplasty (KA). A second purpose was to identify predictors of these outcomes. DESIGN: An inception cohort from the Osteoarthritis Initiative (OAI) dataset, a nine-year NIH funded cohort study of persons with or at high risk for knee osteoarthritis was studied. SETTING: Subjects were recruited from the communities of four sites in the Midwest, Eastern and Southeastern United States...
January 9, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29329471/diagnosing-meniscal-pathology-and-understanding-how-to-evaluate-a-postoperative-meniscus-based-on-the-operative-procedure
#3
Monica Tafur, Linda Probyn, Jaskarndip Chahal, Lawrence M White
Magnetic resonance imaging (MRI) represents the preferred noninvasive imaging technique to diagnose meniscal pathology in the pre- and postoperative setting. Furthermore, characterization of meniscal tissue MR properties has been possible by the development of advanced MRI techniques. Suspected meniscal tears are a frequent indication for MRI and the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) classification system has been developed to facilitate accurate and uniform reporting of such meniscal tears...
January 12, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29329145/orthopaedic-management-of-leg-length-discrepancy-in-proteus-syndrome-a-case-series
#4
Molly M Crenshaw, Cara G Goerlich, Lauren E Ivey, Julie C Sapp, Kim M Keppler-Noreuil, Allison C Scott, Leslie G Biesecker, Laura L Tosi
INTRODUCTION: Proteus syndrome (PS) is a rare mosaic disorder comprising asymmetric bony and soft tissue overgrowth leading to significant morbidity. Placement of growth inhibition hardware with subsequent epiphyseal arrest improves leg-length and angular deformities in pediatric patients without PS. The purpose of this study was to review the surgical approach and present outcomes, complications, and recommendations in 8 patients with PS and leg-length discrepancy (LLD). METHODS: We conducted a retrospective chart review of 8 patients with PS whose primary reason for surgery was LLD...
January 11, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29327570/the-detour-procedure-no-more-need-for-conventional-bypass-surgery
#5
Dainis Krievins, Janis Savlovskis, Natalija Ezite, Andrew Hill, Kaspars Kisis, Marcis Gedins, Edgars Zellans, Andrew Holden
BACKGROUND: Long segment occlusive disease in the superficial femoral artery remains a treatment challenge despite advances in open surgical and endovascular approaches. We report initial clinical results of an entirely new procedure to perform femoropopliteal bypass using the DETOUR System to create a stentgraft bypass which originates in the SFA, travels through the femoral vein, and ends in the popliteal artery, bypassing the diseased segment. METHODS: Review the initial results of the first five patients at a single site enrolled in IRB-approved, prospective clinical study using the DETOUR System...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29327559/-combined-surgical-approaches-in-the-treatment-of-complex-tibial-plateau-fractures
#6
Guang-Hua Yuan, Xiao Zheng, Kang Chen
OBJECTIVE: To explore the early clinical efficacy of a posteromedial inverted "L" shape approach combined an assisted antero lateral assisted approach for the treatment of complex fractures of tibial plateau. METHODS: From March 2011 to June 2014, the posteromedial inverted "L" shape approach combined with the antero lateral assisted approach in the treatment of Schatzker type IV, V, VI tibial plateau fracture were performed in 34 cases. There were 23 males and 11 females, ranging in age from18 to 67 years old, averaged 34...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#7
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29326531/medial-pivot-in-total-knee-arthroplasty-literature-review-and-our-first-experience
#8
REVIEW
Luigi Sabatini, Salvatore Risitano, Gennaro Parisi, Ferdinando Tosto, Pier Francesco Indelli, Francesco Atzori, Alessandro Massè
Background: Traditional total knee implants designs, usually, are not able to reproduce the physiological kinematics of the knee, leaving almost 20% of the patients, those who underwent a total knee arthroplasty (TKA), not fully satisfied. Modern inserts are nowadays designed with a fully congruent medial compartment to reproduce the normal medial pivoting biomechanics of the knee. The aim of this article was to evaluate preliminary clinical improvement using the Medial Congruent (MC) insert as specific level of constraint...
2018: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29326061/neuropathic-pain-in-end-stage-hip-and-knee-osteoarthritis-differential-associations-with-patient-reported-pain-at-rest-and-pain-on-activity
#9
J D Power, A V Perruccio, R Gandhi, C Veillette, J R Davey, K Syed, N N Mahomed, Y R Rampersaud
OBJECTIVE: We investigated whether pain at rest and pain on activity were differentially associated with neuropathic pain scores in individuals with end-stage hip and knee OA. DESIGN: Study participants were 843 patients with hip or knee OA scheduled for total joint arthroplasty. In pre-surgery questionnaires, measures of socio-demographics, health status, medication use, neuropathic pain (painDETECT), pain at rest and pain on activity (WOMAC pain items), depression (HADS) and pain catastrophizing (PCS) were collected...
January 8, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29325836/interleukin-6-and-leptin-levels-are-associated-with-preoperative-pain-severity-in-patients-with-osteoarthritis-but-not-with-acute-pain-after-total-knee-arthroplasty
#10
Syed Azim, James Nicholson, Mario J Rebecchi, William Galbavy, Tian Feng, Sabeen Rizwan, Ruth A Reinsel, Martin Kaczocha, Helene Benveniste
BACKGROUND: Identifying drivers of pain that can serve as novel drug targets is important for improving perioperative analgesia. Total knee arthroplasty (TKA) is associated with significant postoperative pain. Cytokines contribute to the pathophysiology of osteoarthritis (OA) and associated pain. However, the influence of perioperative cytokine levels after TKA surgery upon postoperative pain remains unexplored. METHODS: We designed a prospective observational study to profile three proinflammatory cytokines, interleukin-6 (IL-6), tumor necrosis factor α (TNFα), and leptin in serum, synovial, and cerebrospinal fluid of TKA patients perioperatively to determine associations between cytokine levels and pain...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29325717/factors-related-to-older-patients-fear-of-falling-during-the-first-mobilization-after-total-knee-replacement-and-total-hip-replacement
#11
Hale Turhan Damar, Ozlem Bilik, Ozgul Karayurt, Figen Erol Ursavas
The aim of this study was to determine fear of falling in the first mobilization and affecting factors in older patients. The study had a descriptive and cross-sectional design. Data were collected in Izmir, Turkey between February 2014 and March 2016. The sample included 204 older patients undergoing joint replacement surgery. Fifty-seven-point four percent and 42.6% of the patients had total hip and knee replacement respectively. 42.2% of the patients had a severe fear of falling when they were first mobilized...
January 8, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29324530/early-results-of-single-plug-autologous-osteochondral-grafting-for-osteochondritis-dissecans-of-the-capitellum-in-adolescents
#12
Donald S Bae, Eitan M Ingall, Patricia E Miller, Katherine Eisenberg
BACKGROUND: Osteochondral autologous transplantation surgery (OATS) has been advocated for unstable osetochondritis dissecans (OCD) lesions of the adolescent capitellum, though limited information is available regarding clinical and radiographic results in North American patients. We hypothesize that single-plug OATS is safe and effective in alleviating pain and restoring function in unstable OCD. METHODS: Twenty-eight patients with unstable OCD treated with single-plug OATS were evaluated...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29324297/longitudinal-joint-loading-in-patients-before-and-up-to-one-year-after-unilateral-total-hip-arthroplasty
#13
Mariska Wesseling, Christophe Meyer, Kristoff Corten, Kaat Desloovere, Ilse Jonkers
Abnormal kinematics and kinetics have been reported in hip osteoarthritis (OA) patients before and after total hip arthroplasty (THA). These changes can affect the loading of the ipsilateral hip, as well as the contralateral hip and knee joint. As it is not clear how hip and knee loading evolves in THA patients during the first year after surgery, the goal of this study is to define how joint loading changes in patients before and at three evaluation times after THA surgery. Musculoskeletal modelling in combination with gait analysis data was used to calculate hip and knee contact forces in 14 patients before and 3-, 6- and 12-months after unilateral THA, as well as in 18 healthy controls...
January 5, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29322905/pre-discharge-postoperative-radiographs-after-primary-total-knee-replacement-tradition-or-science
#14
S N Sambandam, V Khanna, G Rohinikumar, V Mounasamy
Consistent evidence exists on the inutility of immediate postoperative radiographs after a total knee replacement (TKR). We hypothesized that eliminating the pre-discharge film would not have any effect on the postoperative patient outcomes. Retrospective analysis of prospectively collected data was performed on 220 knees. Patients undergoing a simple primary TKR operated by 2 surgeons (Surgeon A and B) from January 2013 to July 2015 were divided into 2 groups (Groups 1 and 2 having 112 and 108 knees respectively)...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29322332/evaluation-of-age-dependent-morphometrics-of-the-meniscofemoral-ligaments-in-reference-to-the-posterior-cruciate-ligament-in-routine-mri
#15
Sebastian Röhrich, Franz Kainberger, Lena Hirtler
OBJECTIVES: To quantify the morphological correlation between the posterior cruciate ligament (PCL) and the meniscofemoral ligaments (MFLs), to propose normal ranges for different age populations, and to define guidelines for correct identification and differentiation of MFLs in routine MRI. METHODS: Three hundred forty-two subjects were included retrospectively and subdivided into five age groups. Morphometrics of the PCL and the MFLs were measured on standard MRI in the sagittal, coronal, and axial planes...
January 10, 2018: European Radiology
https://www.readbyqxmd.com/read/29322318/total-knee-arthroplasty-with-unexplained-pain-new-insights-from-kinematics
#16
Célia Planckaert, Gabriel Larose, Pierre Ranger, Marc Lacelle, Alexandre Fuentes, Nicola Hagemeister
INTRODUCTION: Up to 20% of total knee arthroplasty patients remain unsatisfied post-surgery, and a large proportion of them report anterior knee pain. This study aims to verify whether patients who experience anterior knee pain after total knee arthroplasty (TKA) will exhibit kinematic characteristics similar to those associated with patellofemoral syndrome, including in the frontal and transverse planes. MATERIALS AND METHODS: Using four different assessment methods [radiological, patient-reported outcome, musculoskeletal assessment with functional performance testing, and a 3D kinematic assessment during gait], the clinical and 3D knee kinematic profiles of three groups were compared: a painful and an asymptomatic TKA group and a healthy control group...
January 10, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29319718/effects-of-periarticular-injection-on-analgesic-effects-and-nsaid-use-in-total-knee-arthroplasty-and-total-hip-arthroplasty
#17
Wen-Rui Ban, Ery-Ang Zhang, Lei-Feng Lv, Xiao-Qian Dang, Chen Zhang
OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group...
December 2017: Clinics
https://www.readbyqxmd.com/read/29319659/residual-neurological-symptoms-after-peripheral-nerve-blocks-for-pediatric-knee-surgery
#18
Robert J Tamai, Brian T Sullivan, Rushyuan J Lee
BACKGROUND: Peripheral nerve blocks (PNBs) provide excellent pain control and reduce the need for systemic analgesics in orthopaedic surgery. PNBs rarely cause complications; however, a few studies of adults have reported neurological complications during the early postoperative period. We investigated complications associated with the use of PNBs during pediatric knee surgery. METHODS: We reviewed the medical records of all 121 children (aged ≤18 y) who underwent knee surgery by 1 orthopaedic surgeon between October 2014 and September 2016...
January 9, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29318898/path-planning-for-minimally-invasive-knee-surgery-using-a-hybrid-optimization-procedure
#19
Adam Ciszkiewicz, Grzegorz Milewski
The aim of this study was to develop a procedure for medical tool path planning in minimally-invasive knee surgery. The collision-free paths for the tool were obtained using the control locations method with a hybrid optimization strategy. The tool and knee elements were described with surface meshes. The knee model allowed for bones displacement and variable incision size and location. The proposed procedure was proven to be effective in path planning for minimally-invasive surgery. It can serve as a valuable aid in surgery planning and may also be used in systems for autonomous or semi-autonomous knee surgery...
January 10, 2018: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#20
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
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