The purpose of this study in to investigate the role of infrapatellar fat pad on primary total knee arthroplasty. We evaluated 100 patients who had been undergone TKA from August 2002 to July 2003, with open box posterior substituting femoral component implant (Scorpio PS Knee™). The study was performed prospectively and randomly allocated. We divided two groups. Group 1 (50 knees) was preserved infrapatellar fat pad and repaired fad at wound closure. Group 2 (50 knees) was excised infrapatellar fat pad as possible and repaired only joint capsule. We analyzed and compared clinical results of Knee Society knee (KS) score, function score, patellar score and Insall-Salvati ratio in both groups. The complications of each group were evaluated. Patients were followed up for mean 40 months(17~52 months). Mean KS score was 91.9 (91.94±5.58) in Group 1 and 90.9(90.92±6.38) in Group 2. Mean function score was 81.6(81.64±13.18) in Group 1 and 83.7(83.79±17.71) in Group 2. Mean patellar score was 29.9(29.89±9.10) in Group 1 and 27.9(27.90±1.80) in Group 2. And mean patellar height as Insall-Salvati ratio was 1.19(1.19±0.17) in Group 1 and 1.23(1.23±0.11) in Group 2. The differences between the Group 1 and Group 2 in all of index were statistically insignificant. In complications, 2 cases of recurrent hemarthrosis were observed in Group 1 patients. We concluded The difference of clinical outcomes whether infrapatellar fat pad was excised or not were statistically insignificant. However, preservation of infrapatellar fat pad on open boxed PS TKA showed unique complications such as recurrent hemarthrosis which might be caused by fat pad adhesion to intercondylar notch. We propose that infrapatellar fat pad on primary PS TKA with open box design would like to be excised for prevention of unique complications.
INTRODUCTION. Femur is one of the bones in humans that exhibit ethnic, racial, and gender difference. Several basic and clinical studies were conducted to explore these variations. Clinical anthropological studies have dealt with the compatibility of femoral prostheses and osteosythesis and materials with the femur. If there is a misalignment between the
Objectives. To evaluate the clinical and radiographic outcomes of total knee arthroplasty using Vega® Knee System (B Braun-Aesculap, Tuttlingen, Germany) [Fig. 1] designed to allow high flexion by shortening the length of posterior condylar flange of femoral component after at least 2 year and to assess the occurrence of periprosthetic osteolysis and loosening at final follow-up. Materials and Methods. Of the patients who underwent total knee arthroplasty using Vega® Knee System between April 2011 and May 2013, 40 patients (46 knees) were enrolled. The mean age of the patients at the time of surgery was 72.3 years and the mean follow-up period was 29.4 months. Clinical parameters, including Knee Society Knee score, Knee Society Function score, maximal flexion and range of motion were evaluated. Relationship between postoperative maximal flexion and radiographic factors including the posterior tibial slope, the femoral condylar offset and the change of the posterior flange length of femoral condyle was analyzed. Also, the occurrence of periprosthetic osteolysis and loosening was assessed. Results. The mean preoperative flexion contracture was 4.3° which was reduced to 1.1° at the final follow-up (P < 0.05). The mean preoperative maximal flexion was 121.6° which was increased to 132.7° at the final follow-up (P < 0.05). The mean preoperative range of motion was 122.8° which was increased to 130.5° at the final follow-up (P < 0.05). The mean preoperative knee score and function score were 54.2 and 46.1. At the final follow-up, the mean knee score and function score were improved to 90.2 and 78.6 (P < 0.05). The post operative posterior tibial slope, femoral condylar offset and the change of the posterior flange length of femoral condyle showed no significant relationship with the postoperative maximal flexion angle. (posterior tibial slope; R=0.241, p=0.94 / femoral condylar offset; R=−0.271, p=0.167 / posterior flange; R=−0.074, p=0.623). The periprosthetic osteolysis of the femoral component occurred in two cases, but loosening did not occur at the final follow-up. Conclusions.
Introduction. Revision
Periprosthetic fractures around Total Knee Arthroplasty are potentially devastating complication to both the patients and the surgeons. The reported prevalence of supracondylar femoral fractures following Total Knee Replacement has ranged from 0.3 to 2.5 percent. The complication rates of various treatment modalities reported in literature varies from 25 to 70 percent. Aim: The purpose of this study is to evaluate the outcome of Antegrade Nailing and Wire fixation in Supra-condylar femoral periprosthetic fractures. Material &
Methods: Seven patients who sustained complex distal femoral fractures above Total Knee Arthroplasty all treated by New technique of Ante-grade intramedullary Nailing and intramedullary bi-wire fixation through greater trochanteric approach without opening the distal femur were retrospectively evaluated. Results: All the patients demonstrated uncomplicated postoperative follow-ups and returned to weight bearing between 2 and 3 months. The average age of patient was 70 (55–90) years. All fractures healed in a satisfactory alignment in average duration of 12.6 weeks. There was no wound infection, loss of reduction or implant failure. The average range of movement of knee was 86 degrees. Conclusion: The Antegrade Nail with Wires is a simple &
effective method of treating displaced periprosthetic fractures proximal to
Arthrodesis is used most commonly as a salvage procedure for failed total knee arthroplasty (TKA). For successful arthrodesis, a stable fusion technique and acceptable limb mechanical alignment are needed. Although the use of intramedullary alignment rods might be helpful in terms of achieving an acceptable limb mechanical axis, fat embolism and intramedullary dissemination of an infection or reactivation of latent infection might occur in failed TKA cases. However, computer-assisted surgery allows precise cuts to be made without breaching medullary cavities. Here, the authors describe a case of knee arthrodesis performed by computer navigation and the Ilizarov method in a patient with a past history of infection. A 45-year-old man visited our hospital with failed
Patellar maltracking after
Fungal periprosthetic joint infections (fPJIs) are rare complications, constituting only 1% of all PJIs. Neither a uniform definition for fPJI has been established, nor a standardized treatment regimen. Compared to bacterial PJI, there is little evidence for fPJI in the literature with divergent results. Hence, we implemented a novel treatment algorithm based on three-stage revision arthroplasty, with local and systemic antifungal therapy to optimize treatment for fPJI. From 2015 to 2018, a total of 18 patients with fPJI were included in a prospective, single-centre study (DKRS-ID 00020409). The diagnosis of PJI is based on the European Bone and Joint Infection Society definition of periprosthetic joint infections. The baseline parameters (age, sex, and BMI) and additional data (previous surgeries, pathogen spectrum, and Charlson Comorbidity Index) were recorded. A therapy protocol with three-stage revision, including a scheduled spacer exchange, was implemented. Systemic antifungal medication was administered throughout the entire treatment period and continued for six months after reimplantation. A minimum follow-up of 24 months was defined.Aims
Methods