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Partial knee arthroplasty

R H Emerson, O Alnachoukati, J Barrington, K Ennin
AIMS: Approved by the Food and Drug Administration in 2004, the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis (AMOA) in patients with an intact anterior cruciate ligament. This unicompartmental knee arthroplasty (UKA) is relatively new in the United States, and therefore long-term American results are lacking. PATIENTS AND METHODS: This is a single surgeon, retrospective study based on prospectively collected data, analysing a consecutive series of primary UKAs using the Phase III mobile-bearing Oxford Knee and Phase III instrumentation...
October 2016: Bone & Joint Journal
Z C Lum, A V Lombardi, J M Hurst, M J Morris, J B Adams, K R Berend
AIMS: Since redesign of the Oxford phase III mobile-bearing unicompartmental knee arthroplasty (UKA) femoral component to a twin-peg design, there has not been a direct comparison to total knee arthroplasty (TKA). Thus, we explored differences between the two cohorts. PATIENTS AND METHODS: A total of 168 patients (201 knees) underwent medial UKA with the Oxford Partial Knee Twin-Peg. These patients were compared with a randomly selected group of 177 patients (189 knees) with primary Vanguard TKA...
October 2016: Bone & Joint Journal
S Konan, F S Haddad
AIMS: Medial unicompartmental knee arthroplasty (UKA) is associated with successful outcomes in carefully selected patient cohorts. We hypothesised that severity and location of patellofemoral cartilage lesions significantly influences functional outcome after Oxford medial compartmental knee arthroplasty. PATIENTS AND METHODS: We reviewed 100 consecutive UKAs at minimum eight-year follow-up (96 to 132). A single surgeon performed all procedures. Patients were selected based on clinical and plain radiographic assessment...
October 2016: Bone & Joint Journal
Yunus İmren, Süleyman Semih Dedeoğlu, Murat Çakar, Haluk Çabuk, Tahsin Olgun Bayraktar, Hakan Gürbüz
Partial or total resection of the infrapatellar fat pad (IPFP) helps surgeon improve access to lateral tibial plateau for better placement of the knee prosthesis. We aimed to investigate the effect of IPFP excision on clinical and radiologic outcomes including patellar tendon length (PTL), range of motion, and functional scores after total knee arthroplasty (TKA) at 5-year follow-up. We retrospectively evaluated postoperative first X-rays (day 0) and postoperative final 5-year control views of 228 knees in patients with primary osteoarthritis who underwent TKA between September 2006 and December 2009 in our hospital...
September 29, 2016: Journal of Knee Surgery
Joseph M Neal, Francis V Salinas, Daniel S Choi
OBJECTIVE: Local anesthetic-induced myotoxicity occurs consistently in animal models, yet is reported rarely in humans. Herein, we describe 3 sentinel cases of local anesthetic myotoxicity after continuous adductor canal block (ACB). CASE REPORT: Three patients underwent total knee arthroplasty that was managed with subarachnoid block plus ACB induced with 1.5% lidocaine or 1.5% mepivacaine bolus followed by 2% ropivacaine at 8 mL/h. Although initial postoperative recovery was normal, each patient on either postoperative day 1 or 2 developed progressive, profound weakness of the quadriceps muscles...
September 22, 2016: Regional Anesthesia and Pain Medicine
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
Filipe Cabral, Bernardo Sousa-Pinto, Rui Pinto, João Torres
BACKGROUND: Total knee arthroplasty (TKA) is the gold standard procedure for knee osteoarthritis. However, there have been conflicting reports concerning whether TKA is associated with modifications in patellar height. This controversy might be partially explained by the diversity of methods used to measure patellar height. Therefore, we aimed at assessing the reproducibility of 3 radiological indices commonly used to evaluate patellar height-Insall-Salvati (IS), Blackburne-Peel (BP), and Caton-Deschamps (CD) ratios...
July 21, 2016: Journal of Arthroplasty
Bo Zhang, Cheng-Kung Cheng, Tie-Bing Qu, Yong Hai, Yuan Lin, Jiang Pan, Zhi-Wei Wang, Liang Wen
OBJECTIVE: Whether the entire posterior cruciate ligament (PCL) should be retained during cruciate-retaining total knee arthroplasty (CR TKA) is controversial. The goal of this study was to compare the early clinical outcomes of partial versus intact PCL-retaining TKA. METHODS: Ninety-two patients who had undergone unilateral CR TKA from March 2012 to June 2013 were enrolled in this study. Forty-six of these patients were randomly selected to undergo intact PCL-retaining TKA (intact group), whereas the remaining 46 patients underwent tibial osteotomy together with anterolateral bundle and bone island resection (partial group)...
August 2016: Orthopaedic Surgery
Shabnam Pejhan, Eric Bohm, Jan-Mels Brandt, Urs Wyss
Although total knee arthroplasty is generally a successful operation, many studies have shown that it results in significant alterations in the kinematics of the joint, which cause limitations in performing the activities of daily living. This study aimed to define the design features for a customized surface-guided total knee replacement and to evaluate the kinematic outcomes. Magnetic resonance imaging data of the knee joint are used to generate the design features as they relate to the functionality of the implant...
October 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Nader Naouar, Hamdi Kaziz, Thabet Mouelhi, Karim Bouattour, Mohamed Mseddi, Mohamed Laziz Ben Ayeche
BACKGROUND: The treatment of isolated internal tibiofemoral knee osteoarthritis on young and active patients is controversial. This treatment can be a high tibial osteotomy or a joint replacement that can be a partial unicompartmental knee arthroplasty (UKA) or total knee replacement (TKR). The aim of our study is the long-term evaluation of functional outcome of partial unicompartmental knee arthroplasty (UKA) in elderly patients under than 60 years. METHODS: This is a retrospective study of 25 unicompartmental knee arthroplasties in 22 patients, collected between1993 and 2003 whose age was less than 60 years...
January 2016: La Tunisie Médicale
Stefaan Van Onsem, Catherine Van Der Straeten, Nele Arnout, Patrick Deprez, Geert Van Damme, Jan Victor
BACKGROUND: Total knee arthroplasty (TKA) is a proven and cost-effective treatment for osteoarthritis. Despite the good to excellent long-term results, some patients remain dissatisfied. Our study aimed at establishing a predictive model to aid patient selection and decision-making in TKA. METHODS: Using data from our prospective arthroplasty outcome database, 113 patients were included. Preoperatively and postoperatively, the patients completed 107 questions in 5 questionnaires: Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, Pain Catastrophizing Scale, Euroqol questionnaire, and Knee Scoring System...
July 14, 2016: Journal of Arthroplasty
Jason A Boyd, Ian M Gradisar
Several orthopedic registries have described the incidence of total knee arthroplasty (TKA) in patients who have undergone knee arthroscopy. Patient risk factors may play a role in the conversion rate from knee arthroscopy to TKA. This study quantifies the incidence of conversion of knee arthroscopy to TKA from a US mixed-payer database and describes some common patient risk factors for conversion. The medical records of more than 50 million patients who were treated between 1998 and 2014 were mined with a commercially available software platform...
July 25, 2016: Orthopedics
Julie L Shaner, Ammar R Karim, David S Casper, Christopher J Ball, Eric M Padegimas, Jess H Lonner
BACKGROUND: While partial knee arthroplasty (PKA) is increasingly performed on an outpatient basis, many surgeons still admit patients overnight and obtain laboratory studies on the first postoperative day. The purpose of this study was to investigate the utility and cost effectiveness of routine postoperative laboratory studies after PKA. METHODS: This is a retrospective review of 322 consecutive unilateral or bilateral simultaneous PKAs (unicompartmental, patellofemoral, and modular bicompartmental knee arthroplasty) performed by a single surgeon...
May 31, 2016: Journal of Arthroplasty
William Pedraza, Johannes Beckmann, Constantin Mayer, Frieder Mauch, Jochen Huth, Raymond Best
PURPOSE: Rotational alignment of prosthetic components after total knee arthroplasty (TKA) is predominantly monitored with computer tomography (CT), for example by relating the anatomical transepicondylar axis (a-TEA) of the native femur to the posterior bicondylar axis of the prosthetic component (PBCA). The purpose of the present study was to portray a reliable, novel plain radiographic method that likewise enables the evaluation of rotational positioning of prosthetic components in TKA...
July 22, 2016: International Orthopaedics
S Campi, H G Pandit, C A F Dodd, D W Murray
PURPOSE: The aim of this study was to evaluate clinical outcome, failures, implant survival, and complications encountered with cementless fixation in unicompartmental knee arthroplasty (UKA). METHODS: A systematic review of the literature on cementless fixation in UKA was performed according to the PRISMA guidelines. The following database was comprehensively searched: PubMed, Cochrane, Medline, CINAHL, Embase, and Google Scholar. The keywords "unicompartmental", "unicondylar", "partial knee arthroplasty", and "UKA" were combined with each of the keyword "uncemented", "cementless" and "survival", "complications", and "outcome"...
July 19, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Aad Dhollander, Peter Verdonk, René Verdonk
BACKGROUND: A biodegradable polyurethane scaffold was designed to fulfill a challenging clinical need in the treatment of patients with painful, irreparable partial meniscal defects. HYPOTHESIS: The use of an acellular polyurethane scaffold for new tissue generation in irreparable, partial meniscal defects provides both midterm pain relief and improved functionality. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 44 patients with irreparable, partial meniscal defects (29 medial and 15 lateral) were implanted with a polyurethane scaffold in a prospective, single-arm proof-of-principle study with a minimum 5-year follow-up...
July 18, 2016: American Journal of Sports Medicine
Michiel P Peters, Peter Z Feczko, Karel Tsang, Bert van Rietbergen, Chris J Arts, Peter J Emans
BACKGROUND: Historically it has been suggested that noise-induced hearing loss (NIHL) affects approximately 50% of the orthopedic surgery personnel. This noise may be partially caused by the use of powered saw systems that are used to make the bone cuts. The first goal was to quantify and compare the noise emission of these different saw systems during total knee arthroplasty (TKA) surgery. A second goal was to estimate the occupational NIHL risk for the orthopedic surgery personnel in TKA surgery by quantifying the total daily noise emission spectrum during TKA surgery and to compare this to the Dutch Occupational Health Organization guidelines...
May 27, 2016: Journal of Arthroplasty
Keun-Churl Chun, Seok-Hyun Kweon, Ki-Joon Jeong, Kwang-Mee Kim, Churl-Hong Chun
BACKGROUND: This study was conducted to assess the clinical and radiological results of total knee arthroplasty (TKA) with an allogeneic bone graft using varus-valgus constrained (VVC) prostheses in knees with severe bone defects and unstable neuropathy. METHODS: This study included 20 knees of 16 patients who underwent TKA between August 2001 and January 2006 due to unstable knees with severe bone destruction resulting from neuropathic arthritis. At the time of surgery, the mean age of the patients was 56 years...
June 3, 2016: Journal of Arthroplasty
Roy H Lan, Atul F Kamath
BACKGROUND: Initiatives led by the American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons (AAHKS) have indicated a number of clinical risk factors associated with total joint arthroplasty that might reflect the complexity of contemporary hip and knee care. This study sought to examine the prevalence of specific International Classification of Diseases, Ninth Revision (ICD-9), coding with respect to an AAHKS-endorsed list of comorbidity codes. METHODS: An administrative data set from an academic arthroplasty referral center was analyzed in an attempt to measure the prevalence of clinical risk factors (ICD-9) endorsed by AAHKS...
May 31, 2016: Journal of Arthroplasty
G Filardo, G Merli, A Roffi, T Marcacci, F Berti Ceroni, D Raboni, B Bortolotti, E Kon, M Marcacci
PURPOSE: To evaluate the effects of kinesiophobia on the outcomes of total knee arthroplasty (TKA), and to investigate whether kinesiophobia represents an independent factor influencing the surgery success or whether the observed effects are driven by other physical or psychological aspects such as anxiety and depression. METHODS: Two hundred patients were evaluated prospectively (mean age 65.7 ± 9.1 years, 134 women and 66 men) at 12 months after TKA. Kinesiophobia was assessed with the Tampa Scale for kinesiophobia (TSK: Activity Avoidance-TSK1 and Harm-TSK2 subscales); anxiety and depression were assessed with STAI and BDI, respectively, and preoperative pain and function, sex, age, BMI, education level, number of painful joints and years of symptoms' duration before surgery were documented as well...
June 21, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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