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Knee surgery

Oren Schwartz, Boris Kanevsky, M A J Sergey Kutikov, Cara H Olsen, Israel Dudkiewicz
Introduction: Attrition from training is associated with substantial financial and personnel loss. There is a plethora of medical literature and research of attrition rates related to initial/phase 1 training (basic combat training); however, the analysis of second phase training (commanders training, consisting of schools that qualify junior commanders and officers for infantry and non-infantry combat units) is limited. The purpose of this study is to perform a comprehensive survey regarding to medical attrition from commanders training in the IDF (Israeli Defense Forces) in order to present the commanders of the IDF a detailed situation report that will serve as an evidence-based platform for future policy planning and implementation...
March 14, 2018: Military Medicine
Alex Han, Alfred C Gellhorn
OBJECTIVE: Knee osteoarthritis (OA) has a significant impact on quality of life (QOL). Although QOL is generally thought to diminish over time, it is unknown if different patient groups demonstrate unique patterns of change in QOL. We sought to identify and characterize QOL trajectories in knee OA. DESIGN: This prospective cohort study included 1013 individuals with symptomatic knee OA from the Osteoarthritis Initiative. We used group-based trajectory modeling to identify distinct temporal patterns of change in the Knee Injury and Osteoarthritis Outcome Score (KOOS) QOL subscale over 8 years...
March 15, 2018: American Journal of Physical Medicine & Rehabilitation
A Kornuijt, D Das, T Sijbesma, L de Vries, W van der Weegen
INTRODUCTION: The etiology of the stiff knee after total knee arthroplasty (TKA) is largely unknown, although excessive scar tissue due to arthrofibrosis is an important reason for a limited range of motion (ROM) after this procedure. Persistent limited ROM after TKA results in poor patient-reported outcomes and is increasingly becoming a more prominent reason for TKA revision surgery. METHODS: A narrative review of current literature on manipulation under anesthesia (MUA) after TKA analyzing etiology and risk factors for stiffness after TKA, effectiveness of MUA and what is known about rehabilitation after MUA...
March 15, 2018: Musculoskeletal Surgery
Susan M Goodman, Vivian P Bykerk, Edward DiCarlo, Ryan W Cummings, Laura T Donlin, Dana E Orange, Annie Hoang, Serene Mirza, Michael McNamara, Kayte Andersen, Susan J Bartlett, Jackie Szymonifka, Mark P Figgie
OBJECTIVE: Rates of total knee arthroplasty (TKA) and total hip arthroplasty (THA) remain high for patients with rheumatoid arthritis (RA), who are at risk of flaring after surgery. We aimed to describe rates, characteristics, and risk factors of RA flare within 6 weeks of THA and TKA. METHODS: Patients with RA were recruited prior to elective THA and TKA surgery and prospectively followed. Clinicians evaluated RA clinical characteristics 0-2 weeks before and 6 weeks after surgery...
March 15, 2018: Journal of Rheumatology
Seung Yeol Lee, Soon-Sun Kwon, Chin Youb Chung, Kyoung Min Lee, Ki Hyuk Sung, Sangwoo Kim, Moon Seok Park
BACKGROUND: Simultaneous motion of the knee and ankle joints is required for many activities including gait. We aimed to evaluate the influence of surgery involving tendons around the knee on ankle motion during gait in the sagittal plane in cerebral palsy patients. METHODS: We included data from 55 limbs in 34 patients with spastic cerebral palsy. Patients were followed up after undergoing only distal hamstring lengthening with or without additional rectus femoris transfer...
March 15, 2018: BMC Musculoskeletal Disorders
Duan Wang, Hui Zhu, Wei-Kun Meng, Hao-Yang Wang, Ze-Yu Luo, Fu-Xing Pei, Qi Li, Zong-Ke Zhou
BACKGROUND: Although randomized controlled trials have confirmed oral tranexamic acid (TXA) can provide similar blood-sparing efficacy compared with intravenous (IV) TXA in total knee arthroplasty (TKA), some concerns do remain about thromboembolic events after such systemic administration. Many studies have confirmed that intra-articular (IA) application of TXA can show similar blood-saving efficacy with minimal levels of systemic absorption compared with IV TXA. However, it remains unclear whether the efficacy and safety of oral TXA administration is equal to or less than that of IA administration in TKA without the use of a tourniquet and drain...
March 15, 2018: BMC Musculoskeletal Disorders
Daniel L Riddle, Mark P Jensen, Dennis Ang, James Slover, Robert Perera, Levent Dumenci
BACKGROUND: Pain-coping strategies and appraisals are responses to the pain experience. They can influence patient-reported and physical performance outcome measures in a variety of disorders, but the associations between a comprehensive profile of pain-coping responses and preoperative pain/function and physical performance measures in patients scheduled for knee arthroplasty have not been examined. Patients with moderate to high pain catastrophizing (a pain appraisal approach associated with an exaggerated focus on the threat value of pain) may represent an excellent study population in which to address this knowledge gap...
April 2018: Clinical Orthopaedics and related Research
Kurt P Spindler, Laura J Huston, Kevin M Chagin, Michael W Kattan, Emily K Reinke, Annunziato Amendola, Jack T Andrish, Robert H Brophy, Charles L Cox, Warren R Dunn, David C Flanigan, Morgan H Jones, Christopher C Kaeding, Robert A Magnussen, Robert G Marx, Matthew J Matava, Eric C McCarty, Richard D Parker, Angela D Pedroza, Armando F Vidal, Michelle L Wolcott, Brian R Wolf, Rick W Wright
BACKGROUND: The long-term prognosis and risk factors for quality of life and disability after anterior cruciate ligament (ACL) reconstruction remain unknown. Hypothesis/Purpose: Our objective was to identify patient-reported outcomes and patient-specific risk factors from a large prospective cohort at a minimum 10-year follow-up after ACL reconstruction. We hypothesized that meniscus and articular cartilage injuries, revision ACL reconstruction, subsequent knee surgery, and certain demographic characteristics would be significant risk factors for inferior outcomes at 10 years...
March 2018: American Journal of Sports Medicine
William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
March 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Jacqueline Murphy, Mark G Pritchard, Lok Yin Cheng, Roshni Janarthanan, José Leal
INTRODUCTION: Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways...
March 14, 2018: BMJ Open
Zhi-Sen Gao, Yong-Gang Zhou, Yin-Qiao Du, Shang Piao, Jing-Yang Sun, Ya-Wen Peng, Wen-Ming Wu
OBJECTIVE: To investigate the risk factors for the failure in treating periprosthetic infection of coagulase-negative staphylococci by two-stage revision. METHODS: From January 2005 to June 2015, 57 patients with periprosthetic hip and knee joint infection of coagulase-negative staphylococcus by two-stage revision were retrospectively reviewed with an average age of (61.3±11.9) years old. According to the drug resistance of methicillin, the patients were divided into methicillin sensitive group(MSCoN) and methicillin resistance(MRCoN) group, 25 cases in MSCoN group(9 knees and 16 hips) included 12 males and 13 females, 32 cases in MRCoN group(11 knees and 21 hips) included 14 males and 18 females...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Felix Stief, André Schmidt, Stefan van Drongelen, Katharina Lenarz, Dara Froemel, Timur Tarhan, Frederick Lutz, Andrea Meurer
A total hip replacement (THR) is a common and routine procedure to reduce pain and restore normal activity. Gait analysis can provide insights into functional characteristics and dynamic joint loading situation not identifiable by clinical examination or static radiographic measures. The present prospective longitudinal study tested whether two years after surgery a THR would restore dynamic loading of the knee and hip joints in the frontal plane to normal. Instrumented gait analysis was performed shortly before surgery and approximately two years after THR on 15 unilateral hip osteoarthritis patients...
March 14, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Firooz Salami, Julia Wagner, Stefan van Drongelen, Matthias C M Klotz, Thomas Dreher, Sebastian I Wolf, Mirjam Niklasch
AIM: Flexed knee gait can be treated with distal femoral extension osteotomy (DFEO) and additional patellar tendon advancement (PTA) in children with cerebral palsy (CP). This study assesses changes in hamstring muscle tendon length (MTL) and velocity after DFEO (+PTA). METHOD: Nineteen children (mean age 13y [standard deviation 3y] at surgery) with CP and flexed knee gait who were treated with DFEO (15 limbs) or DFEO+PTA (10 limbs) were retrospectively included in this study...
March 14, 2018: Developmental Medicine and Child Neurology
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Natalie C Rollick, Devin B Lemmex, Yohei Ono, Carol R Reno, David A Hart, Ian Ky Lo, Gail M Thornton
Background: When considering the "joint as an organ", the tissues in a joint act as complementary components of an organ, and the "set point" is the cellular activity for homeostasis of the joint tissues. Even in the absence of injury, joint tissues have adaptive responses to processes, like aging and menopause, which result in changes to the set point. Purpose: The purpose of this study in a preclinical model was to investigate age-related and menopause-related changes in knee-joint tissues with the hypothesis that tissues will change in unique ways that reflect their differing contributions to maintaining joint function (as measured by joint laxity) and the differing processes of aging and menopause...
2018: Clinical Interventions in Aging
R J Cong, J F Liu, Y Jiang, Duolikun Dilixiati, X D Hou, L P Zheng
Objective: To explore the influence of the lower extremity abnormal alignment and the joint surface, and to explore the surgical skills. Methods: Twenty-two cases of tibial plateau Schatzker Ⅵ fracture internal fixation failure revision from January 2012 to January 2017 in Department of Orthopedics, Shanghai 10(th) Hospital.One year follow-up after initial surgery to make sure of failure.Three-dimensional CT scan, radiography, infection index, gait analysis, knee joint ROM, femur tibia angle, tibial plateau tibial shaft angle and posterior slope if tibial plateau were observed...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Thomas James Ryan, Rhys Holyoak, Ruan Vlok, Thomas Melhuish, Anthony Hodge, Matthew Binks, Glenn Hurtado, Leigh White
The infiltration of local anesthetic has been shown to reduce postoperative pain in knee arthroscopy. Several studies have shown that the addition of agents such as magnesium and nonsteroidal antiinflammatory drugs (NSAIDs) result in an increased time to first analgesia and overall reduction in pain. The aim of this systematic review and meta-analysis was to determine whether the addition of an α-2 agonist (A2A) to intra-articular local anesthetic, results in a reduction in postoperative pain. Four major databases were systematically searched for relevant randomized controlled trials (RCTs) up to July 2017...
March 13, 2018: Journal of Knee Surgery
Takahiro Ogura, Tim Bryant, Brian A Mosier, Tom Minas
BACKGROUND: Treating bipolar chondral lesions in the tibiofemoral (TF) compartment with cartilage repair procedures is challenging, and a suitable treatment remains unclear. PURPOSE: To evaluate clinical outcomes after autologous chondrocyte implantation (ACI) for the treatment of bipolar chondral lesions in the TF compartment. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We evaluated 57 patients who underwent ACI for the treatment of symptomatic bipolar chondral lesions in the TF compartment by a single surgeon between October 1995 and June 2014...
March 1, 2018: American Journal of Sports Medicine
Kevin Taliaferro, Alexander Crawford, Justin Jabara, Jonathan Lynch, Edward Jung, Raimonds Zvirbulis, Trevor Banka
BACKGROUND: Intraarticular steroid injections are a common first-line therapy for severe osteoarthritis, which affects an estimated 27 million people in the United States. Although topical, oral, intranasal, and inhalational steroids are known to increase intraocular pressure in some patients, the effect of intraarticular steroid injections on intraocular pressure has not been investigated, to the best of our knowledge. If elevated intraocular pressure is sustained for long periods of time or is of sufficient magnitude acutely, permanent loss of the visual field can occur...
March 9, 2018: Clinical Orthopaedics and related Research
Jian Huang, Peng Zhang, Dawei Wang
Coagulation changes after total knee arthroplasty (TKA) can provide evidence for optimization of timing of perioperative anticoagulation medicine. To evaluate the changes, 50 patients with knee osteoarthritis or rheumatoid arthritis were recruited for the study and underwent thrombelastography tests pre-, 6 hours, 12 hours, and 24 hours after TKA surgery and Doppler ultrasound examination 20 to 24 hours after surgery. The results have shown prolonged clotting time ( R value) at 6 and 12 hours, while shortened at 24 hours...
January 30, 2018: Journal of Knee Surgery
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