Tibial and femoral loosening are major causes for implant failure in total knee arthroplasty. Jefferey (1991) reported a significantly lower rate of loosening when varus or valgus was within 3 degrees of mechanical axis in an eight year follow up. Coulle (Dec1999) reported 48% unacceptable alignment in non-navigated knees and Reed (Aug 2002) reported 35% alignments deviating more than 3 degrees from mechanical axis when navigation was not used. We report our series of 286 navigated knee replacements using the Aesculap Search system (21 cases) and the Aesculap e-motion versions 4.2, 4.3 and 4.4 (265 cases) between April 2003 and December 2012 by the author (A.D) and analysed the correction achieved against the zero mechanical axis. Postoperative measurement of the angles on long length films was done in 23 cases. This matched with the intraoperative corrections achieved as studied using per-operative computer data stored for every case. We continued to use the data stored in the AESCULAP System to correlate the findings in the rest of the cases. The average mechanical axis achieved was 1.3 degrees. All cases had mechanical axes within 3 degrees. We were thus able to achieve a high level of correction of the mechanical axes predictable to achieve better clinical outcomes.
To compare the clinical effectiveness, functional outcome and patient satisfaction following intra articular injection with Synvisc¯ and Hyalgan¯ in patients with osteoarthritis (OA) of the knee. 348 consecutive patients were randomised into two groups to receive either Hylan G-F 20 -Synvisc (n= 181) or Sodium Hyaluronate -Hyalgan (n=167). All patients were prospectively reviewed by independent assessors blinded for the treatment. Knee pain on a VAS were recorded. The functional outcome was assessed using Tegner, UCLA, Oxford knee score and EuroQol-5D scores. VAS was used to quantify patient satisfaction. Mean follow-up was 12 months.Aim
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