In total knee arthroplasty (TKA), the correct positioning of the components is a key element to obtain good functionality and durability of the implant. The use of computer-assisted surgery (CAS) in TKA ensure excellent limb alignment, components orientation and ligament balancing; however, it is still unclear whether this translates to better mid- to long-term clinical and functional outcomes. We present our clinical, functional and radiological results in a case series of two hundred implants at a medium follow up of 2.5 years. Between March 2008 and January 2013 we performed 200 computer navigated TKAs in 180 patients. The average age of the patients was 64 years. The average BMI was 28 kg/m2. In all cases we implanted a posterior stabilised, fixed bearing TKA and adopted a protocol of pre- and intra-operative administration of tranexamic acid. We never performed patellar prosthesis. A radiographic assessment was made to all patients with pre- and post-surgery X-ray in the antero-posterior, lateral and axial-patella projection. Coronal plane alignment was measured by standard weight-bearing anteroposterior radiographs including the femoral head, knee and ankle. Computed tomography (CT) with artifact reduction was also carried out to evaluate axial or rotational femoral and tibial alignment. Clinical and functional evaluations were effected on the basis of the Knee Society Scoring System (KSS) and Tegner activity level score. Blood loss and reduction in haemoglobin were considered too. The medium follow-up was 2.5 years (minimum 1 year; maximum 5 years).Introduction
Material and Methods
Pes planus is a complex syndrome whose origin can be quite different. Knowledge of the causes is essential for optimal treatment. Clinical and radiographic examinations are the basis for a correct diagnosis. Arthroreisis of the sub-astragalic joint, extrasenotarsum, represents the gold standard for surgical correction of idiopathic pes planus in childhood. The rate of excellent and good results has been 98% in the authors’ experience. We conclude that the arthroreisis of the sub-astragalic joint is an easy, fast and efficacious operation in the management of idiopathic pes planus.
In acquired knee deformations the usefulness of arthroscopy is strictly correlated with the degree of axial defomation and cartilaginous degeneration. The authors comparatively consider two groups of patients (the first one Albach I and II and the second one Albach III and IV) treated with arthroscopic débridement (washing and curettage), in relation to the joint’s degeneration stage. A minimum 6-month follow-up, using KSKSS grading revealed satisfactory medium-term results.
