Abstract. Introduction.
Abstract. Introduction. MRI scanning is the establish method of defining intra- and extra-articular diagnoses of patients with non-arthritic
The October 2023
The aim of mechanical alignment in total knee arthroplasty is to align all
The June 2024
Abstract. Introduction. In revision knee arthroplasty, rotating hinge implants (RHK) have been considered to result in higher complication rates and lower survivorship when compared to constrained condylar implants (CCK). The aims of this study were to compare patient reported outcome measures (PROMs), complication rates and survivorship of RHK and CCK used in revision arthroplasty at a single, high volume elective orthopaedic centre with previously validated bespoke database. Methodology. One hundred and eight patients who underwent revision knee arthroplasty with either CCK or RHK and matched our inclusion criteria were identified. EQ5D, Health State and Oxford
Aims. The goal was to evaluate tibiofemoral
Abstract. Introduction.
The December 2022
The February 2024
The February 2023
Abstract. Rehabilitation exercise is critical for patients’ recovery after knee injury or post-surgery. Unfortunately, adherence to exercise is low due to a lack of positive feedback and poor self-motivation. Therefore, it is crucial to monitor their progress and provide supervision. Inertial measurement unit (IMUs) based sensing technology can provide remote patient monitoring functions. However, most current solutions only measure the range of
Aims. Periprosthetic fractures (PPFs) around the
Aims. This study aims to identify the top unanswered research priorities in the field of knee surgery using consensus-based methodology. Methods. Initial research questions were generated using an online survey sent to all 680 members of the British Association for Surgery of the
Abstract. Introduction. We present a case series of patients that underwent
Aims. The aim of this study was to develop and evaluate machine-learning-based computerized adaptive tests (CATs) for the Oxford Hip Score (OHS), Oxford
Abstract. Background. Osteochondral allograft (OCA) transplantation is a clinically and cost-effective option for symptomatic cartilage defects. In 2017 we initiated a program for OCA transplantation for complex chondral and osteochondral defects as a UK tertiary referral centre. Aim. To characterise the complications, re-operation rate, graft survivorship and clinical outcomes of
Aims. This study aimed to investigate the estimated change in primary and revision arthroplasty rate in the Netherlands and Denmark for hips,
Abstract. Introduction. Patient selection is key to the success of medial unicondylar knee arthroplasty (UKA). Progression of arthritis is the most common indication for revision. Various methods of assessing the lateral compartment have been used including stress radiography, radioisotope bone scanning, MRI, and visualisation at the time of surgery. Arthroscopy is another means of assessing the integrity of the lateral compartment. Methods. We used per-operative arthroscopy as a means to confirm suitability for UKA in a consecutive series of 279 Oxford medial UKA. This study reports the long-term results of a previously published cohort of
Abstract. Introduction. Secondary osteonecrosis of the
Abstract. Background. Fracture dislocation of the
Abstract. The Coronavirus pandemic mandated an immediate and dramatic change in the delivery of acute trauma services to minimise face-to-face contact. In our hospital, patients presenting to the Emergency Department with a knee injury and no fracture seen on Xrays were referred to a “Virtual Fracture Clinic” (VFC) where Xrays and clinical notes were reviewed by the duty Trauma and Orthopaedic Consultant the following working day. We present the outcomes of 101 consecutive patients managed through this process and deemed to have a “Soft Tissue
Abstract. Introduction. The aim of this study was to determine the factors affecting return to sport (RTS) and career longevity of elite athletes after microfracture of the
Abstract. Introduction. Traumatic
Abstract. Aims. The primary aim of this study was to evaluate the outcomes of fungal
Abstract. Introduction. The incidence of significant acute chondral injuries with patella dislocation is around 10–15%. It is accepted that chondral procedures should only be performed in the presence of joint stability. Methodology. Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging and complications were recorded. PROMs and patient satisfaction was obtained. Results. 20
Abstract. Introduction. The aim of this study was to determine if elite athletes could return to professional sport after MCL or PLC reconstruction using LARS ligaments and to demonstrate the safety and efficacy of LARS by reporting sport longevity, subsequent surgeries and complications. Methods. A retrospective review of all extra-articular
Abstract. Introduction.
Abstract. Introduction. Active, middle-aged patients with symptomatic cartilage or osteochondral defects can find themselves in a treatment gap when they have failed conservative measures but are not yet eligible for conventional arthroplasty. Data from various cohort studies suggests that focal
Abstract. Introduction. Derby technique for posterolateral corner (PLC) reconstruction uses a doubled gracilis autograft to reconstruct the popliteo-fibular ligament (PFL) and a split biceps tendon transfer to reconstruct the lateral collateral ligament (LCL). We report midterm outcomes of a case series who underwent PLC reconstruction. Methodology. A retrospective review of 27 patients who underwent PLC reconstruction from 2012 until 2018 was performed (6 females, 21 males, median age 26). Median time interval from injury to primary procedure was 10 months. Outcomes were recorded as per clinical assessment and outcome scores. Results. All patients had no varus laxity in full
Abstract. Introduction. MCL injuries often occur concurrently with ACL rupture – most noncontact ACL injuries occur in valgus and external rotation (ER) - and conservative MCL treatment leads to increased rate of ACL reconstruction failure. There has been little work developing effective MCL reconstructions. Methods. Cadaveric work measured MCL attachments by digitisation and radiographically, relating them to anatomical landmarks. The isometry of the superficial and deep MCL (sMCL and dMCL) and posterior oblique ligament (POL) was measured using fine sutures led to displacement transducers. Contributions to stability (restraint) were measured in a robotic testing system. Two MCL reconstructions were designed and tested: 3-strand reconstruction (sMCL+dMCL+POL), and 2-strand method (sMCL+dMCL) addressing anteromedial rotatory instability (AMRI). The resulting stability was measured in a kinematics test rig, and compared to the ‘anatomic’ sMCL+POL reconstruction of LaPrade. Results. The sMCL was isometric, centred on the medial epicondyle, and the primary restraint of valgus. The dMCL elongated rapidly in ER, and was the primary restraint of ER near
Introduction. Enhanced pain and rehabilitation protocols have significantly improved patient recovery following primary TKR. Little has been written on how the protocols have affected the revision TKR patient. We report on a matched group of revision and primary TKR patients treated with the identical pain and rehab program. Materials and Methods. 40 aseptic RTKR patients who underwent a full femoral and tibial revision were matched by age, sex, and BMI to a group of patients who underwent a cemented tri-compartmental primary TKR. All revision
Abstract. Introduction. Double-level
Abstract. Background. Little scientific evidence is available regarding the effect of
Abstract. Introduction.
Abstract. Introduction. National BOAST guidelines have been developed to coordinate and improve the standard of care for all patients with problems after knee replacement surgery. Since the inception of these guidelines we wanted to assess the impact of these guidelines on patients and their pathways following their discussions at our weekly revision MDT meetings. Methodology. Trust casenotes programs, PACS software and MDT notes were evaluated over the past 12 months (January 2022 to December 2022) to collect data for all patients with problematic knee replacements. Current in-patients discussed at MDT were excluded. Results. In total 52 patients with problematic
Abstract. Introduction. There are a wide variety of implant brands and types of knee replacement available to surgeons. With time, the options available within many implant brand portfolios has grown, with alternative tibial or femoral components, tibial insert materials or shapes and patella resurfacings. Aim. To investigate the effect of the expansion of implant brand portfolios, and to establish the potential numbers of compatible implant construct combinations. Methods. Hypothetical implant brand portfolios were proposed, and the number of compatible implant construct combinations was calculated. Results. A simple
Abstract. Background. Autologous chondrocyte implantation is a NICE approved intervention however it involves the morbidity of two operations, a prolonged rehabilitation and substantial healthcare costs. This study describes a novel, one-step, bone marrow (BM) derived mesenchymal stem cell (MSC) transplantation technique for treating knee osteochondral lesions and presents our prospective clinical study investigating the success of this technique in 206 lesions over a 5 year period. Methodology. The surgical technique involves harvesting BM from patients’ anterior superior iliac spines, centrifugation to isolate MSCs and seeding into a type 1 collagen scaffold (SyngenitTM Biomatrix). Autologous fibrin glue is used to secure the scaffold into the defect. Inclusion criteria included patients aged 15 – 55 years old with symptomatic osteochondral lesions >1cm2. Exclusion criteria included patients with ligament instability, uncorrected alignment, inflammatory arthropathy and a Body Mass Index >35 kg/m2. Outcome measures included the Modified Cincinnati
Abstract. Patient Reported Outcome Measures (PROMs) can be completed using paper and postal services (pPROMS) or via computer, tablet or smartphone (ePROMs). We have investigated whether there are differences in scores depending on the method of PROMs acquisition for the Oxford
The COVID-19 pandemic has led to unprecedented times worldwide. From lockdowns to masks now being part of our everyday routine, to the halting of elective surgeries, the virus has touched everyone and every part of our personal and professional lives. Perhaps, now more than ever, our ability to adapt, change and persevere is critical to our survival. This year's closed meeting of The
Abstract. Introduction. The
Abstract. Introduction. Coronal plane alignment of the
Abstract. Introduction. Historic MCL reconstruction techniques focused on the superficial MCL to restore valgus stability while overlooking tibial external rotation and the deep MCL. This study assessed the ability of a contemporary medial collateral ligament (MCL) reconstruction and a deep MCL (dMCL) reconstruction to restore rotational and valgus
Background. Secondary osteonecrosis of the
Introduction. Medial pivoting motion of the
Abstract. Introduction. Risk factors for osteoarthritis include raised BMI and female gender. Whether these two factors influenced synovial gene expression was investigated using a triangulation and modelling strategy which generated 12 datasets of gene expression in synovial tissue from three
Abstract. Introduction. COMPOSE describes the demographics, fracture characteristics, management and associated outcomes of
Introduction. Septic arthritis of the native
Aims. Joint registries classify all further arthroplasty procedures to a
Abstract. Introduction. In 2020, the National Hip Fracture Database (NHFD) was extended to capture data from patients with periprosthetic femoral fractures (PPFF) with plans to include these patients in Best Practice Tarif. We aimed to describe the epidemiology of PPFF in England and Wales, with a particular focus on fractures occurring around the femoral component of knee prostheses. Methodology. This population-based observational cohort study utilised open-access data available from the NHFD. Patients aged over 60, admitted to an acute hospital in England or Wales with a PPFF, within the period 1st January 2020 to 31st December 2020 were included. The primary outcome was the incidence of PPFF in England and Wales. The secondary outcome was the treatment received. Results. We identified 2606 patients with PPFF from 135 hospitals. Of these, a total of 578 fractures occurred around the femoral component of a knee implant. These were classified as Vancouver A (epicondylar, n=77), B (involving implant/cement, n=166) and C (proximal to implant/cement, n=335). Internal fixation was the most employed treatment, used in 352 cases. Revision arthroplasty was performed in 80 cases, and 100 were managed non-operatively. Only 28% of operated PPFF went to theatre within 36 hours but nearly 90% had orthogeriatrician review within 72 hours. Conclusion. Eighty six percent of patients with PPFF were treated with non-revision surgery and would not be recorded in the National Joint Registry. In response, we support calls for the prioritisation of further research into the prevention and management of PPFF around the
Abstract. Introduction. Persistent medial laxity increases the risk of failure for ACL reconstruction. To address this, multiple reconstruction techniques have been created. To date, no single strand reconstruction constructs have been able to restore both valgus and rotational stability. In response to this, a novel single strand Short Isometric Construct (SIC) MCL reconstruction was developed. Methods. Eight fresh-frozen cadaveric specimens were tested in three states: 1) intact 2) after sMCL and dMCL transection, and 3) after SIC MCL reconstruction. In each state, four loading conditions were applied at varying flexion angles: 90N anterior drawer, 5Nm tibial external rotation torque, 8Nm valgus torque, and combined 90N anterior drawer plus 5Nm tibial external rotation torque. Results. Transection of the sMCL and dMCL resulted in increased laxity with external rotation torque, valgus torque, and combined anterior drawer plus external rotation. SIC MCL reconstruction restored external rotation and valgus stability to intact levels throughout all degrees of flexion. In the combined test SIC MCL reconstruction also restored stability to intact levels for both anterior distraction and external rotation throughout the range of motion. No significant differences were noted between intact and SIC reconstruction. Conclusion. The single-limb short isometric construct (SIC) MCL reconstruction restored native valgus and rotatory stability to a sMCL- and dMCL-deficient
Classifying trochlear dysplasia (TD) is useful to determine the treatment options for patients suffering from patellofemoral instability (PFI). There is no consensus on which classification system is more reliable and reproducible for the purpose of guiding clinicians’ management of PFI. There are also concerns about the validity of the Dejour Classification (DJC), which is the most widely used classification for TD, having only a fair reliability score. The Oswestry-Bristol Classification (OBC) is a recently proposed system of classification of TD, and the authors report a fair-to-good interobserver agreement and good-to-excellent intraobserver agreement in the assessment of TD. The aim of this study was to compare the reliability and reproducibility of these two classifications. In all, six assessors (four consultants and two registrars) independently evaluated 100 axial MRIs of the patellofemoral joint (PFJ) for TD and classified them according to OBC and DJC. These assessments were again repeated by all raters after four weeks. The inter- and intraobserver reliability scores were calculated using Cohen’s kappa and Cronbach’s α.Aims
Methods
Aims. The aim of this study was to describe and compare joint-specific and generic health-related quality of life outcomes of the first versus second
Introduction. One of the main considerations in the revision TKR setting is deciding on the level of constraint to be utilized once the bone defects have been reconstructed. There is a fear that employing a maximally constrained insert could compromise long term results. We report on a consecutive series of full tibial and femoral component revisions all treated with a maximally conforming insert and followed for a minimum of 5 years. Materials and Methods. The study group consisted of 76 consecutive revision TKR in 76 patients where both the femur and the tibia were revised. 4 patients died and 6 were lost to follow up. Final cohort had an average age of 70 years, average BMI of 31 and there were 39 males in the group. Average time to revision was 7 years (range 1–10 years) and the reasons for revision included infection in 28, aseptic loosening 26, osteolysis and poly wear in 9 and 13 other. All were treated with the same revision system and an identical maximally conforming tibial rotating platform insert and followed for an average of 7 years (range 5–14 years). Results. one patient required additional surgery during the study period for a patella fracture. There were no manipulations. Average
The extended wait that most patients are now experiencing for hip and knee arthroplasty has raised questions about whether reliance on waiting time as the primary driver for prioritization is ethical, and if other additional factors should be included in determining surgical priority. Our Prioritization of THose aWaiting hip and knee ArthroplastY (PATHWAY) project will explore which perioperative factors are important to consider when prioritizing those on the waiting list for hip and knee arthroplasty, and how these factors should be weighted. The final product will include a weighted benefit score that can be used to aid in surgical prioritization for those awaiting elective primary hip and knee arthroplasty. There will be two linked work packages focusing on opinion from key stakeholders (patients and surgeons). First, an online modified Delphi process to determine a consensus set of factors that should be involved in patient prioritization. This will be performed using standard Delphi methodology consisting of multiple rounds where following initial individual rating there is feedback, discussion, and further recommendations undertaken towards eventual consensus. The second stage will then consist of a Discrete Choice Experiment (DCE) to allow for priority setting of the factors derived from the Delphi through elicitation of weighted benefit scores. The DCE consists of several choice tasks designed to elicit stakeholder preference regarding included attributes (factors).Aims
Methods
Symptomatic osteochondritis dissecans (OCD) and traumatic osteochondral fractures (OCF) are treated with fixation with either metal or bioabsorbable device. We performed a comparative review of patients with OCD and traumatic OCF stabilised with Bio-Compression screws which are headless absorbable compression screws. Our aim was to determine whether there was a difference in outcomes between presentations. Retrospective single-centre cohort study of all patients with OCD and OCF treated with Bio-Compression screw between July 2017 and September 2022. All patients followed up until discharge with satisfactory clinical outcome. Primary outcome was return to theatre for ongoing pain or mechanical symptoms. Secondary outcome was evidence of fixation failure on follow-up MRI scan.Abstract
Introduction
Methods
The December 2015
Introduction. Diagnosing acute postoperative periprosthetic joint infections (PJIs) after primary total knee arthroplasties (TKAs) remains difficult. Published diagnostic thresholds for ESR, CRP, and synovial fluid analysis have not been replicated. We aimed to validate the optimal cutoffs for detecting acute postoperative PJIs in a large series of primary TKAs. Methods. We retrospectively identified 27,066 primary TKAs performed between 2000–2019. Within 12 weeks, 171
Aims. The primary aim of this study was to assess whether the postoperative Oxford
Objectives. Whilst gait speed is variable between healthy and injured adults, the extent to which speed alone alters the 3D in vivo
This multi-centre randomised controlled trial evaluated the clinical and cost effectiveness of liposomal bupivacaine for pain and recovery following knee replacement. 533patients undergoing primary knee replacement were randomised to receive either liposomal bupivacaine (266mg) plus bupivacaine hydrochloride (100mg) or control (bupivacaine hydrochloride 100mg), administered at the surgical site. The co-primary outcomes were pain visual analogue score (VAS) area under the curve (AUC) 6 to 72hours and the Quality of Recovery 40 (QoR-40) score at 72hours.Abstract
Introduction
Methodology
Synovitis impacts osteoarthritis symptomatology and progression. The transcription factors controlling synovial gene expression have not been described. This study analyses gene expression in synovium samples from 16 patients with osteoarthritis with 9 undergoing arthroscopic and 8 knee trauma surgery for non-arthritic pathologies. Intra-operative synovial biopsies were immersed in RNAlater at 4oC before storage at -80oC. Total RNA was extracted using RNAeasy. After purification, RT-PCR and quality assessment, cDNA was applied to Affymetrix Clariom D microarray gene chips. Bioinformatics analyses were performed. Linear models were prepared in limma with gender and BMI factors incorporated sequentially for each pathology comparison, generating 12 models of probes differentially expressed at FDR p<0.05 and Bayes number, B>0. Data analysis of differently expressed genes utilized Ingenuity Pathway Analysis and Cytoscape with Cluego and Cytohubba plug-ins.Abstract
Introduction
Methodology
Introduction. In total knee arthroplasty (TKA), tibial insert thickness is determined intraoperatively by applying forces that generate varus-valgus moments at the
With respect to survivorship following total knee arthroplasty (TKA), joint registries consistently demonstrate higher revision rates for both sexes in those less than 55 years. The current study analyses the survivorship of 500 cementless TKAs performed in this age group in a high-volume primary joint unit where cementless TKA has traditionally been used for the majority of patients. This was a retrospective review of 500 consecutive TKAs performed in patients under the age of 55 between March 1994 and April 2017. The primary outcome measure for the study was all-cause revision. Secondary outcome measures included clinical, functional and radiological outcomes.Abstract
Introduction
Methods
A lipohaemarthrosis seen on Horizontal beam lateral X-ray in acute knee injury is often considered predictive of an intra-articular fracture requiring further urgent imaging. We retrospectively searched a five-year X-ray database for the term “lipohaemarthrosis”. We excluded cases if the report concluded “no lipohaemarthrosis” or “lipohaemarthrosis” AND “fracture”. All remaining cases were reviewed by an Orthopaedic Consultant with a special interest in knee injuries (AD) blinded to the report. X-rays were excluded if a fracture was seen, established osteoarthritic change was present, a pre-existing arthroplasty present or no lipohaemarthrosis present. Remaining cases were then studied for any subsequent Radiological or Orthopaedic surgical procedures.Abstract
Introduction
Methodology
Introduction. Pitting damage on implants has been reported and attributed to use of electrocautery. This study aimed to distinguish how different TKA bearing surfaces are susceptible to this type of damage and whether surgeons were aware that this damage can occur. Methods. A survey was sent to Hip and
Introduction. While
In-situ assessment of collateral ligaments strain could be key to improving total knee arthroplasty outcomes by improving the ability of surgeons to properly balance the
The February 2015
Aims. The aim of this study was to investigate differences in pain,
range of movement function and satisfaction at three months and
one year after total knee arthroplasty (TKA) in patients with an
oblique pattern of kinematic graph of the
Aims. Intra-articular . 90. Yttrium (. 90. Y) is an adjunct
to surgical treatment by synovectomy for patients with diffuse-type tenosynovial
giant-cell tumour (dtTGCT) of the
The December 2014
Cryocompression therapy after knee surgery is widely utilised for post-operative rehabilitation. Skin temperature should be reduced to 10–15°C to maximise the therapeutic benefits while avoiding risks of adverse events. Some cryocompression devices offer control over the temperature of the ice-water circulated through a cuff. The degree to which this corresponds to the achieved skin temperature during a treatment is unknown. 30 healthy participants volunteered for this prospective randomised crossover trial involving the use of a cryocompression device. Each underwent a 30-minute test in all of five conditions: A, B, C, D and Control. Conditions corresponded to device temperature settings of 6, 8, 10, 12°C and no ice-water circulation, respectively. Skin temperature was measured prior to the cuff being applied, then every 5 minutes during a test.Abstract
Introduction
Methods
The October 2014
The August 2014
The December 2012
The rate of day-case total knee replacement (TKR) in the UK is currently ~0.5%. Reducing length of stay improves efficiency, increases operative throughput and tackles the rising demand for joint replacement surgery and the COVID-19 related backlog. We report safe delivery of day-case TKR in an NHS Trust via inpatient wards, with no additional resources. Day-case TKRs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six-months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction.Abstract
Introduction
Methodology
Aims. The aim of this consensus was to develop a definition of post-operative
fibrosis of the
The December 2013
The February 2013
The October 2015
The June 2012
The August 2012
The purpose of this study was to evaluate the
effect of various non-operative modalities of treatment (transcutaneous
electrical nerve stimulation (TENS); neuromuscular electrical stimulation
(NMES); insoles and bracing) on the pain of osteoarthritis (OA)
of the
The August 2015
Osteochondritis Dissecans (OCD) is a condition
for which the aetiology remains unknown. It affects subchondral bone
and secondarily its overlying cartilage and is mostly found in the
knee. It can occur in adults, but is generally identified when growth
remains, when it is referred to as juvenile OCD. As the condition
progresses, the affected subchondral bone separates from adjacent
healthy bone, and can lead to demarcation and separation of its associated
articular cartilage. Any symptoms which arise relate to the stage
of the disease. Early disease without separation of the lesion results
in pain. Separation of the lesion leads to mechanical symptoms and
swelling and, in advanced cases, the formation of loose bodies. Early identification of OCD is essential as untreated OCD can
lead to the premature degeneration of the joint, whereas appropriate
treatment can halt the disease process and lead to healing. Establishing
the stability of the lesion is a key part of providing the correct
treatment. Stable lesions, particularly in juvenile patients, have
greater propensity to heal with non-surgical treatment, whereas
unstable or displaced lesions usually require surgical management. This article discusses the aetiology, clinical presentation and
prognosis of OCD in the
Introduction. Total knee arthroplasty (TKA) femoral components are known to wear and roughen with clinical use, and reaction to metal is a well-documented complication of TKA. Ceramic materials are resistant to wear and corrosion, but the surface wear of ceramic femoral components in TKA has not been reported. This study measured the changes in roughness and mass lost from cobalt-chromium (CoCr) femoral components tested in a
Background. Pseudotumor or high grade ALVAL (aseptic lymphocyte-dominated vasculitis-associated lesion) development around total hip replacements secondary to local metal debris generation – especially in the setting of metal-on-metal bearings – is a well-recognised histopathologic phenomenon. Recent work has suggested a strong genetic correlation with an individual's risk of such lesion development following metal exposure. Emerging data have highlighted a similar potential concern around total knee replacements (TKRs), particularly with increasing construct modularity. To date, the body-of-knowledge pertaining to TKR-associated ALVALs has largely been limited to individual case reports or small retrospective case series’, with no large-scale investigation looking at this potential complication. This study sought to establish the preliminary prevalence of pseudotumor or high grade ALVAL formation seen at the revision of primary TKRs and to establish the correlation between histologic ALVAL grade and patient-reported functional outcomes. Methods. Findings of 1263 consecutive patients undergoing revision knee surgery, at a high-volume referral center, were reviewed. 161 cases of active infection were excluded. Complete histopathology reports were subsequently available for 321 (29.1%) non-infective cases. Each case was independently histologically-classified using a previously validated scoring system reflecting ALVAL grade. Post-operative patient-reported outcomes measures (PROMs) were available for 134 patients (41.7%), allowing direct correlation between functional performance and the established histopathology results. Results. In total, 23 high grade lesions were identified, including 5 distinct pseudotumors, representing 7.2% (23/321) of the cohort. When compared by histologic grade, Jonkeere-Terpstra testing yielded P-values of 0.02 and 0.03 for the Oxford
The June 2014
The April 2014
Given the growing prevalence of obesity around
the world and its association with osteoarthritis of the
Background. The purpose of this multi-center, randomized clinical trial was to compare static and articulating spacers in the treatment of PJI complicating total knee arthroplasty TKA. Methods. 68 Patients treated with two-stage exchange arthroplasty were randomized to either a static (32 patients) or an articulating (36 patients) spacer. A power analysis determined that 28 patients per group were necessary to detect a 13º difference in range of motion between groups. Six patients were excluded after randomization, six died, and seven were lost to follow-up prior to two years. Results. Patients in the static group had a hospital length of stay that was one day greater than the articulating group (6.1 vs. 5.1 days; p=0.032); no other differences were noted perioperatively. At a mean 3.5 years (range, 2.0 to 6.4 years), 49 patients were available for evaluation. Mean motion arc in the articulating group was 113.0º compared to 100.2º in the static group (p=0.001). The mean
The February 2014
Several emerging reports suggest an important involvement of the hindfoot alignment in the outcome of
Individuals with multi-compartment knee osteoarthritis (KOA) frequently experience challenges in activities of daily living (ADL) such as stair ambulation. The Levitation “Tri-Compartment Offloader” (TCO)