Worldwide rates of primary and revision total
knee arthroplasty (TKA) are rising due to increased longevity of
the population and the burden of osteoarthritis.
Aims. We have previously reported the mid-term outcomes of
Aims. Stemmed tibial components are frequently used in
Introduction. The primary aim of this study was to describe a baseline comparison of early knee-specific functional outcomes following
Aims. This study aimed to determine outcomes of isolated tibial insert exchange (ITIE) during
Aims. Tibial tubercle osteotomy (TTO) facilitates surgical exposure and protects the extensor mechanism during
The demand for
Aims. Obtaining solid implant fixation is crucial in
Aims. To identify variables independently associated with same-day discharge (SDD) of patients following
Aims. Metal allergy in knee arthroplasty patients is a controversial topic. We aimed to conduct a scoping review to clarify the management of metal allergy in primary and
Aims. The aim of this study was to perform a systematic review and bias evaluation of the current literature to create an overview of risk factors for re-revision following
Aims. The aim of this study was to evaluate medium- to long-term outcomes and complications of the Stanmore Modular Individualised Lower Extremity System (SMILES) rotating hinge implant in
Aims. Tranexamic acid (TXA) is proven to reduce blood loss following total knee arthroplasty (TKA), but there are limited data on the impact of similar dosing regimens in
Aims. Metaphyseal cones with cemented stems are frequently used in
Aims. To map literature on prognostic factors related to outcomes of
Aims. Metaphyseal fixation during
Introduction.
Abstract. Introduction.
Objectives. Preservation of posterior condylar offset (PCO) has been shown to correlate with improved functional results after primary total knee arthroplasty (TKA). Whether this is also the case for
Aims. Metaphyseal tritanium cones can be used to manage the tibial bone loss commonly encountered at
Aims. Both the femoral and tibial component are usually cemented at
Aims. The aim of this study was to measure the effect of hospital case volume on the survival of
Aims. Single-stage
During
Background.
Aim. To improve the challenging treatment of periprosthetic joint infections (PJI), researchers are constantly developing new handling methods and strategies. In patients with PJI after total knee arthroplasty (TKA) and severe local or systemic comorbidities, a two-stage exchange using a temporary antibiotic loaded PMMA-spacer is considered gold standard. This method has undisputed advantages, however, the increased risk of biofilm formation on the spacer surface, bone defects and soft tissue contractions after a six-week spacer interval are severe limitations. Our hypothesis is that a vacuum sealed foam in combination with constant instillation of an antiseptic fluid can address these drawbacks due to a significantly reduced spacer interval. Method. A pilot study was conducted in five PJI cases after TKA with severe comorbidities and/or multiple previous operations to evaluate the feasibility and safety of the proposed method. In the first step, surgical treatment included the explantation of the prosthesis, debridement, and the implantation of the VeraFlo-Dressing foam. The foam is connected to the VAC-Instill-Device via an inflow and an outflow tube. The surgical site is sealed airtight with the VAC-film. During the next 5 days, an antiseptic fluid (Lavasorb® or Taurolidine®) is instilled in a 30-minute interval using the VAC-Instill-Device. The limb is immobilized (no flexion in the knee joint, no weight bearing) for five days. Following that, the second operation is performed in which the VAC-VeraFlo. TM. -Therapy System is explanted and the
Aims. The aim of this study was to evaluate medium-term outcomes and complications of the S-ROM NOILES Rotating Hinge Knee System (DePuy, USA) in
Aims. It has previously been shown that higher-volume hospitals have better outcomes following
Aims. Current guidelines consider analyses of joint aspirates, including leucocyte cell count (LC) and polymorphonuclear percentage (PMN%) as a diagnostic mainstay of periprosthetic joint infection (PJI). It is unclear if these parameters are subject to a certain degree of variability over time. Therefore, the aim of this study was to evaluate the variation of LC and PMN% in patients with aseptic
Aims. Porous metaphyseal cones can be used for fixation in
Background. Joint line, patellar height and posterior condylar offset (PCO) are related to functional outcome such as stability and range of motion after
Little information exists regarding optimal tibial stem usage in
Background. Patellar dislocation is a serious complication leading to patient morbidity following total knee arthroplasty. The cause can be multifactorial. Extensor mechanism imbalance may be present and result from technical errors such as malrotation of the implants. Methods. We performed a retrospective study assessing the outcomes of revision surgery for patellar dislocation in patients with component malrotation in both primary and
Abstract. Objectives. 1. To investigate the effect of
The amount of bone loss due to implant failure, loosening, or osteolysis can vary greatly and can have a major impact on reconstructive options during
Over the last decade, the number of total knee arthroplasty (TKA) has risen over 125%. Numerous studies have established a relationship between obesity and complications in primary TKA. Interestingly, few studies have investigated medical and orthopaedic complications in obese patients undergoing
Introduction. Tranexamic acid (TXA) is proven to reduce blood loss following total knee arthroplasty (TKA), but there are limited data on the impact of similar dosing regimens in
Purpose. The aim of this study was to compare the clinical outcomes of the
Purpose. The aim of this study was to assess the clinical and radiological result of the usage of chip bone graft in non-contained type bone defect in primary or
Background. Subvastus approach for Total Knee Arthropalsty (TKA) allows a faster recovery. It is traditionally not utilized for revision surgeries because of difficulty in exposure of the knee and eversion of the patella. It is considered to have limited indications. We hypothesized that
Introduction. Tibial cones are often utilized in
Aims. Varus-valgus constrained (VVC) implants are often used during
Stems are a crucial part of implant stabilization in
Introduction.
We analyzed the causes of 113
Introduction. Removal of primary components during
Introduction: Stiffness after primary total knee arthroplasty (TKA) is a severe complication that has been associated with excessive internal rotation of the femoral component. Methods: Between 2001 and 2004, 18 patients with 18 well-fixed, aseptic primary TKA underwent
We identified 148 patients who had undergone a
The amount of bone loss due to implant failure, loosening, or osteolysis can vary greatly and can have a major impact on reconstructive options during
Total knee arthroplasty is a predictable operation. Unfortunately, there is a subset of patients who do not well and require revision surgery. The surgical objective of
Introduction. Presentation of our outcome in implant survival and clinical function using rotating-hinge knee prosthesis in
Introduction. Total knee arthroplasty (TKA) is a proven treatment method for advanced knee arthritis in terms of pain relief, function restoration, and quality-of-life improvement. The TKA use has increased significantly over the past decade and the growing rate is more prominent in Asian countries. Thus, the
Introduction. Modular stems are commonly used to improve fixation in
Aims. The aim of this study was to establish the results of isolated exchange of the tibial polyethylene insert in
Introduction. Even a number of studies have reported clinical outcomes after
We report a consecutive series of 16
Introduction. Porous metaphyseal cones are increasingly used for fixation in
Many surgeons consider
Patella resurfacing in
Following a careful in-depth preoperative plan for
We have previously developed a radiographic technique, the oblique posterior condylar view, for assessment of the posterior aspect of the femoral condyles after total knee arthroplasty. The purpose of this study was to confirm the validity of this radiographic view based upon intra-operative findings at
Summary.
Introduction: Common failure modes of
The use of stems in
Introduction.
Purpose. Most of
Introduction. Previous studies have demonstrated that higher volume hospitals have better outcomes following
There has been speculation as to how the outcome of
Patient satisfaction is not uniform or consistent following
Backgroud:
Aims. Enhanced perioperative protocols have significantly improved patient recovery following primary total knee arthroplasty (TKA). Little has been investigated the effectiveness of these protocols for
Objectives. Initial stability of tibial trays is crucial for long-term success of total knee arthroplasty (TKA) in both primary and revision settings. Rotating platform (RP) designs reduce torque transfer at the tibiofemoral interface. We asked if this reduced torque transfer in RP designs resulted in subsequently reduced micromotion at the cemented fixation interface between the prosthesis component and the adjacent bone. Methods. Composite tibias were implanted with fixed and RP primary and revision tibial trays and biomechanically tested under up to 2.5 kN of axial compression and 10° of external femoral component rotation. Relative micromotion between the implanted tibial tray and the neighbouring bone was quantified using high-precision digital image correlation techniques. Results. Rotational malalignment between femoral and tibial components generated 40% less overall tibial tray micromotion in RP designs than in standard fixed bearing tibial trays. RP trays reduced micromotion by up to 172 µm in axial compression and 84 µm in rotational malalignment models. Conclusions. Reduced torque transfer at the tibiofemoral interface in RP tibial trays reduces relative component micromotion and may aid long-term stability in cases of
Methodology: A retrospective review based on a prospective database was performed on 146 consecutive
Background.
Purpose. Although the use of stems in
Patient function is poorly characterised following
Distal femoral resection in conventional total knee arthroplasty (TKA) utilizes an intramedullary guide to determine coronal alignment, commonly planned for 5° of valgus. However, a standard 5° resection angle may contribute to malalignment in patients with variability in the femoral anatomical and mechanical axis angle. The purpose of the study was to leverage deep learning (DL) to measure the femoral mechanical-anatomical axis angle (FMAA) in a heterogeneous cohort. Patients with full-limb radiographs from the Osteoarthritis Initiative were included. A DL workflow was created to measure the FMAA and validated against human measurements. To reflect potential intramedullary guide placement during manual TKA, two different FMAAs were calculated either using a line approximating the entire diaphyseal shaft, and a line connecting the apex of the femoral intercondylar sulcus to the centre of the diaphysis. The proportion of FMAAs outside a range of 5.0° (SD 2.0°) was calculated for both definitions, and FMAA was compared using univariate analyses across sex, BMI, knee alignment, and femur length.Aims
Methods
Revision TKR is a challenging procedure, especially because most of the standard bony and ligamentous landmarks are lost due to the primary implantation. However, as for primary TKR, restoration of the joint line, adequate limb axis correction and ligamentous stability are considered critical for the short- and long-term outcome of revision TKR. There is no available data about the range of tolerable leg alignment after revision TKR. However, it is logical to assume that the same range than after primary TKR might be accepted, that is ± 3° off the neutral alignment. One might also assume that the conventional instruments, which rely on visual or anatomical alignments or intra- or extramedullary rods, are associated with significant higher variation of the leg axis correction. We used an image-free system (ORTHOPILOT TM, AESCULAP, FRG) for routine implantation of primary TKA. The standard software was used for
Introduction. Patients with solid organ transplant have been shown to have increased risk of complications following TKA compared to non-transplant patients. The risk of AKI in KTx is reported to be as high as 15.6 % and associated with increased morbidity, and length of stay (LOS). Our aim was to determine the incidence of AKI in KTx undergoing primary and
Introduction.
Introduction Computer assistance can be valuable in positioning of knee prostheses when the bone interface is in the form of bone graft. The efficacy of this technique can be checked using the Perth CT Protocol for knee prosthesis alignment. Methods Fourteen patients are presented who had an allograft
This study evaluated the effect of prosthetic patellar resurfacing on outcome of
Introduction: Chronic stiffness is an uncommon complication of total knee arthroplasty (TKA) with reports in the literature citing an incidence of 1–5%. Surgical options to manage this debilitating condition include manipulation under anaesthesia (MUA) and arthrolysis; there is concern regarding revision surgery given the potential for stiffness recurrence. Methods: Patients undergoing
The number of revision knee arthroplasties performed is projected to rise dramatically in the coming years. Primary knee arthroplasties are also being performed in younger patients increasing the likelihood of multiple revision procedures. Reconstruction can be challenging with bone stock deficiencies and ligament incompetence. The aim of this study was to present our results of
The aim of this study was to measure the effect of hospital case-volume on the survival of
Periprosthetic joint infection (PJI) occurs in approximately 1% to 2% of total knee arthroplasties (TKA) presenting multiple challenges, such as difficulty in diagnosis, technical complexity, and financial costs. Two-stage exchange is the gold standard for treating PJI but emerging evidence suggests 'two-in-one' single-stage revision as an alternative, delivering comparable outcomes, reduced morbidity, and cost-effectiveness. This study investigates five-year results of modified single-stage revision for treatment of PJI following TKA with bone loss. Patients were identified from prospective data on all TKA patients with PJI following the primary procedure. Inclusion criteria were: revision for PJI with bone loss requiring reconstruction, and a minimum five years’ follow-up. Patients were followed up for recurrent infection and assessment of function. Tools used to assess function were Oxford Knee Score (OKS) and American Knee Society Score (AKSS).Aims
Methods
Introduction: Management of bone loss during
Introduction. Previous fluoroscopy studies have been conducted on numerous primary-type TKA, but minimal in vivo data has been documented for subjects implanted with
Aims. The aim of this study was to compare the outcome of revision
total knee arthroplasty (TKA) with and without proximalisation of
the tibial tubercle in patients with a failed primary TKA who have
pseudo patella baja. Patients and Methods. All revision TKAs, performed between January 2008 and November
2013 at a tertiary referral University Orthopaedic Department were
retrospectively reviewed. Pseudo patella baja was defined using
the modified Insall-Salvati and the Blackburne-Peel ratios. A proximalisation
of the tibial tubercle was performed in 13 patients with pseudo
patella baja who were matched with a control group of 13 patients
for gender, age, height, weight, body mass index, length of surgery
and Blackburne-Peel ratio. Outcome was assessed two years post-operatively
using the Knee Society Score (KSS). Results. The increase in KSS was significantly higher in the osteotomy
group compared with the control group. The outcome was statistically
better in patients in whom proximalisation of >
1 cm had been achieved
compared with those in whom the proximalisation was <
1 cm. Conclusion. In this retrospective case-control study, a proximal transfer
of the tibial tubercle at
Abstract. Introduction.
There has been speculation as to whether the outcome of
Constrained condylar knee (CCK) prosthesis offers an implant option for complex
By 1998, 10 patients had undergone 12
Aim: To present the experience of a highly specialized total knee arthroplasty revision center with the use of femoral and tibial components with modular press-fit offset stem extensions. Methods: Intramedullary press-fit offset stem extensions were developed to offer an additional option when doing a
Purpose of the study:
Recent projections expect the number of revision knee replacements performed to grow from 38,000 in 2005 to 270,000 by the year 2030. 1. Although the results of primary total knee arthroplasty are well documented, with overall implant survivorship at 15 years greater than 95%. 2. the results of revision procedures are not as well known. What if the revision TKR fails and what is the prevalence of failure of revision TKRs, the complications and re-operation rates? There are various studies which has either exclusively dealt with the causes or outcomes of revision with a particular prosthesis and survivorship analysis. The effectiveness of
Background.
INTRODUCTION. Porous metal bone fillers are frequently used to manage bony defects encountered in