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Partial knee replacement

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
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
Jean-Noël Argenson, Sébastien Parratte, Matthieu Ollivier
Often linked to sequelae of a knee injury or knee deformities, gonarthrosis is the most frequent form of osteoarthritis of the limbs. A variety of methods and therapies can be used to treat it. For advanced conditions, treatment may involve partial or total replacement.
August 2016: Revue de L'infirmière
Ben Parkinson, Nicholas Smith, Laura Asplin, Peter Thompson, Tim Spalding
BACKGROUND: Meniscal allograft transplantation (MAT) is performed to improve symptoms and function in patients with a meniscal-deficient compartment of the knee. Numerous studies have shown a consistent improvement in patient-reported outcomes, but high failure rates have been reported by some studies. The typical patients undergoing MAT often have multiple other pathologies that require treatment at the time of surgery. The factors that predict failure of a meniscal allograft within this complex patient group are not clearly defined...
August 2016: Orthopaedic Journal of Sports Medicine
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
Brian T Feeley, Shan Liu, Abigail M Garner, Alan L Zhang, Jan B Pietzsch
BACKGROUND: Meniscal tears are the most common knee condition requiring surgery, and represent a substantial disease burden with clinical and cost implications. The success rates partial meniscectomy and meniscal repair have been studied, but limited information is available investigating their long-term costs and effects. Our objective was to assess the long-term cost-effectiveness of meniscal repair compared to meniscectomy. METHODS: We constructed a decision-analytic Markov disease progression model, using strategy-specific failure rates and treatment-specific probabilities for the development of osteoarthritis (OA) and subsequent knee replacement (TKR)...
August 2016: Knee
J Kloiber, E Goldenitsch, P Ritschl
BACKGROUND: Patellar bone deficiency in revision total knee arthroplasty (TKA) determines the surgical procedure. Different reconstructive and ablative techniques, dependent on the remaining bone stock, are described. INDICATION: The primary patella implant can be retained in up to 50 % of revision situations. Reasons for replacement are aseptic and septic loosening, implant failure, expanding osteolysis, maltracking of the patella and "metal-backed" prosthesis...
May 2016: Der Orthopäde
Rene Verdonk, Henning Madry, Nogah Shabshin, Florian Dirisamer, Giuseppe M Peretti, Nicolas Pujol, Tim Spalding, Peter Verdonk, Romain Seil, Vincenzo Condello, Berardo Di Matteo, Johannes Zellner, Peter Angele
It is widely accepted that partial meniscectomy leads to early onset of osteoarthritis (OA). A strong correlation exists between the amount and location of the resected meniscus and the development of degenerative changes in the knee. On the other hand, osteoarthritic changes of the joint alter the structural and functional integrity of meniscal tissue. These alterations might additionally compromise the limited healing capacity of the meniscus. In young, active patients without cartilage damage, meniscus therapy including partial meniscectomy, meniscus suture, and meniscus replacement has proven beneficial effects in long-term studies...
June 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andreas H Gomoll, Peter Angele, Vincenzo Condello, Vincenzo Madonna, Henning Madry, Pietro Randelli, Nogah Shabshin, Peter Verdonk, Rene Verdonk
Total knee replacement is an accepted standard of care for the treatment of advanced knee osteoarthritis with good results in the vast majority of older patients. The use in younger and more active populations, however, remains controversial due to concerns over activity restrictions, implant survival, and patient satisfaction with the procedure. It is in these younger patient populations that alternatives to arthroplasty are increasingly being explored. Historically, osteotomy was utilized to address unicompartmental pain from degeneration and overload, for example, after meniscectomy...
June 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sylvain Steinmetz, François Bonnomet, Michel Rahme, Philippe Adam, Matthieu Ehlinger
BACKGROUND: Rapidly destructive osteoarthritis of the hip and rapid chondrolysis of the lateral compartment of the knee or the shoulder are rare, but have been previously described in the medical literature. To the best of our knowledge, no case of medial femorotibial compartment chondrolysis after arthroscopy has yet been described. We therefore submit the first case report. CASE PRESENTATION: A 64-year-old white European man presented with right knee pain due to a medial meniscal tear with no other abnormality found on examination or imaging...
2016: Journal of Medical Case Reports
M Keller, E Kurz, O Schmidtlein, G Welsch, C Anders
BACKGROUND: In the treatment of patients with lower extremity injuries, a paradigm shift is taking place: Time-dependent concepts are increasingly being replaced by function-based concepts. METHODS: A function-based Return to Activity Algorithm is presented which contains a level classification (I-IV). Qualitative and subsequent quantitative tests are assigned to every level. Within each level, first the respective qualitative test has to be passed before patients are allowed to perform the corresponding quantitative test...
March 2016: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
J Beckmann, A Steinert, C Zilkens, A Zeh, C Schnurr, M Schmitt-Sody, M Gebauer
Knee arthroplasty is a successful standard procedure in orthopedic surgery; however, approximately 20 % of patients are dissatisfied with the clinical results as they suffer pain and can no longer achieve the presurgery level of activity. According to the literature the reasons are inexact fitting of the prosthesis or too few anatomically formed implants resulting in less physiological kinematics of the knee joint. Reducing the number of dissatisfied patients and the corresponding number of revisions is an important goal considering the increasing need for artificial joints...
April 2016: Der Orthopäde
Qing-Hang Zhang, Andrew Cossey, Jie Tong
Cementation is one of the main fixation methods used in joint replacement surgeries such as Total Knee Replacement (TKR). This work was prompted by a recent retrieval study, which shows losses up to 75% of the bone stock at the bone-cement interface ten years post TKR. It aims to examine the effects of cementation on the stress shielding of the interfacing bone, when the influence of an implant is removed. A micromechanics finite element study of a generic bone-cement interface is presented here, where bone elements in the partially and the fully interdigitated regions were evaluated under selected load cases...
April 2016: Medical Engineering & Physics
E Meier, K Gelse, K Trieb, M Pachowsky, F F Hennig, A Mauerer
BACKGROUND: The aim of the study was to evaluate the safety and efficacy of a novel metal-free ceramic total knee replacement system. METHODS: Thirty-eight primary total knee arthroplasties (TKAs) were performed on 34 patients using the metal-free BPK-S ceramic total knee replacement system with both the femoral and tibial components of an alumina/zirconia ceramic composite. The clinical outcome was evaluated pre- and postoperatively at 3 (n = 32 TKA) and 12 months (n = 32 TKA) using the Knee Society Score (KSS), the Oxford Knee Score and the EQ-5D...
2016: Journal of Orthopaedic Surgery and Research
Allison J Rao, Brandon J Erickson, Gregory L Cvetanovich, Adam B Yanke, Bernard R Bach, Brian J Cole
Meniscal tears are the most common knee injury, and partial meniscectomies are the most common orthopaedic surgical procedure. The injured meniscus has an impaired ability to distribute load and resist tibial translation. Partial or complete loss of the meniscus promotes early development of chondromalacia and osteoarthritis. The primary goal of treatment for meniscus-deficient knees is to provide symptomatic relief, ideally to delay advanced joint space narrowing, and ultimately, joint replacement. Surgical treatments, including meniscal allograft transplantation (MAT), high tibial osteotomy (HTO), and distal femoral osteotomy (DFO), are options that attempt to decrease the loads on the articular cartilage of the meniscus-deficient compartment by replacing meniscal tissue or altering joint alignment...
October 2015: Orthopaedic Journal of Sports Medicine
Simon Frostick
Pharmacological and mechanical thromboprophylaxis reduces the risk of venous thromboembolism (VTE) in patients undergoing total knee/hip replacement (TKR/THR). Nurses play a key role in VTE prevention through clinical care, before and after discharge from hospital, and patient education. Conventional pharmacological agents for VTE prophylaxis include low molecular weight heparins (LMWHs) and fondaparinux. However, parenteral administration, increased bleeding risk, and patient/physician non-adherence to treatment and guidelines, are important limitations...
January 14, 2016: British Journal of Nursing: BJN
H G Pandit, S Campi, T W Hamilton, O D Dada, S Pollalis, C Jenkins, C A F Dodd, D W Murray
PURPOSE: Cementless unicompartmental knee replacement (UKR) was introduced to address some of the problems that can occur following cemented UKR. The aim of this study was to report the 5-year experience of the first 512 medial cementless Oxford UKR implanted by two surgeons for the recommended indications. METHODS: The first consecutive 512 cementless Phase 3 Oxford UKRs implanted by two surgeons for the recommended indications between June 2004 and October 2013 were prospectively identified and followed up independently...
November 26, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Alfred J Tria, Giles R Scuderi
Minimally invasive surgery (MIS) for arthroplasty of the knee began with surgery for unicondylar knee arthroplasty (UKA). Partial knee replacements were designed in the 1970s and were amenable to a more limited exposure. In the 1990s Repicci popularized the MIS for UKA. Surgeons began to apply his concepts to total knee arthroplasty. Four MIS surgical techniques were developed: quadriceps sparing, mini-mid vastus, mini-subvastus, and mini-medial parapatellar. The quadriceps sparing technique is the most limited one and is also the most difficult...
November 18, 2015: World Journal of Orthopedics
Etienne Cavaignac, Regis Pailhé, Nicolas Reina, Jérôme Murgier, Jean Michel Laffosse, Philippe Chiron, Pascal Swider
PURPOSE: The purpose of this study was to determine whether a four-strand gracilis-only construct possesses the biomechanical properties needed to act as an anterior cruciate ligament (ACL) reconstruction graft. METHODS: This was a pilot study with 32 cadaver specimens. The biomechanical properties of three types of grafts were determined using validated tensile testing methods: patellar tendon (BTB), both hamstring tendons together (GST4) and gracilis alone (G4)...
August 2016: International Orthopaedics
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