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Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_8 | Pages 69 - 69
1 May 2016
Jung K Kumar R Lee S Ong A Ahn H Park H
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Introduction

Positive expectations can increase compliance with treatment and realistic expectations may reduce postoperative dissatisfaction. Recently there are articles regarding expectations of patients from their TKA in western literature and only few articles based on Korean populations which don't encompass the whole spectrum of expectations in Korean patients. In all those articles based on pre-operative expectation, results were applied to whole expectation category uniformly not differentially. We aimed to document the pre-operative expectations in Korean patients undergoing total knee replacement using an established survey form and to determine whether expectations were influenced by socio-demographic factors and socio-demographic factors influences expectation items in particular category uniformly or differentially.

Methods

Expectations regarding 19 items in the Knee Replacement Expectation Survey form were investigated in 228 patients scheduled for total knee replacement. The levels and distribution patterns of individual and summated expectation of five expectation categories; relief from pain, baseline activity, high flexion activity, social activity and psychological wellbeing, constructed from the 19 items were assessed. Univariate analyses and Binary logistic regression were performed and analyzed to examine the association of expectations with the socio-demographic factors.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_8 | Pages 70 - 70
1 May 2016
Jung K Kumar R Lee S Ahn H Gondalia V Ong A Park H
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Introduction

Unicompartmental knee arthroplasty (UKA) is becoming an increasingly popular option in single compartment osteoarthritis. As a result, diverse re-operations including revisions to total knee arthroplasty (TKA) has also increase. The objective of this study is to investigate the distribution of causes of re-operations after UKA and to analyze the types of re-operations.

Method

We retrospectively reviewed 691 UKAs performed on 595 patients between January 2003 and December 2011. Except in one case, all UKAs were performed for medial compartment osteoarthritis of the knee. The UKAs were performed in 487 (81.8%) women and 108 (18.2%) men. The mean age at the time of UKA was 61.5 years (47 to 88 years). Mobile-bearing designs were implanted in 627 (90.7%) knees (626- Oxford knee and 1- Scorpio knee) and fixed designs were implanted in 64 (9.3%) knees (42- Tornier and 18- Zimmer). The mean interval between UKA and second operation was 15.4 months (10 days to 10 years) and between second and third operation was 7.7 months (5 weeks to 17 months). In the re-operation group, there were 50 knees (48 patients) with 38 female and 10 male patients.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 536 - 536
1 Sep 2012
Park IS Jung KA Ong A Hwang SH Nam CH Lee DW
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Background

Adequate rotation of femoral component in total knee arthroplasty(TKR) is mandatory for preventing numerous adverse sequelae. The transepicondylar axis has been a well-accepted reference for femoral component rotation in the measured resection technique. In this technique, measured resection is performed referenced off the tibial cut - perpendicular to the tibial mechanical axis with the knee in 90 ° of flexion. However, to the best of our knowledge, it is not known whether this technique apply well to a knee with tibia vara. This study evaluates the reliability of the transepicondylar axis as a rotational landmark in knees with tibia vara.

Methods

We selected 101 osteoarthritis knees in 84 symptomatic patients(mean age: 69.24 ± 5.68) with proximal tibia vara (Group A). Group A was compared with 150 osteoarthritic knees without tibia vara in 122 symptomatic patients (mean age: 69.51 ± 6.01) (Group B). The guide line for selection of all these knees were based on the degree of tibia vara angle (TVA) which was formed by line perpendicular to epiphysis and by anatomical axis of the tibia - all measured in radiographs of the entire lower limb. Magnetic resonance imaging (MRI) axial images with most prominent part of both femoral condyles were used for measurement of transepicondylar axis(TE), anteroposterior axis(AP) and posterior condylar axis(PC).


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_II | Pages 152 - 152
1 Jul 2002
Ioannis M Grigoris P Johnston F Ong A Hamblen DL
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Purpose: To assess the clinical and radiological performance of the Ultima THR.

Material-Methods: Between January 1991 and July 1994, 147 consecutive patients (154 hips) underwent a primary THR using an all-polyethylene cemented cup and the Ultima Ti alloy smooth, collarless, double tapered, straight stem. 65% were females and primary diagnosis was OA or RA in the majority. The average age at operation was 66.4 years. At average follow-up of 76 months, 34 patients (35 hips) were dead and 5 were lost. Patients were annually assessed clinically (HSS) and radiologically. Radiographs were digitized and migration analysis and cup wear was performed using the EBRA method.

Results: There were 9 aseptic failures (5 stems, 1 cup and 3 both components). Cup migration analysis was possible in 106 cases. Migration was detected in 62 of them (18 proximal, 15 medial, and 29 combined). Proximal migration ranged from 0.8 mm-4.0 mm and medial migration from 1.0 mm–3.5 mm. The average cumulative linear cup wear was 0.2 mm. Stem migration analysis was possible in 114 cases. At 2 years, 35 stems subsided less than 1.5 mm. Migration of more than 1.5 mm was observed in 16 stems. Early subsidence of more than 1.5 mm was highly predictive for later revision.

Conclusions: Ti-stems have been criticised for high failure rate but the exact mechanism of loosening is multifactorial. Our revision rate and the low incidence of focal osteolysis, even in the presence of a small degree of stem subsidence, indicate that a smooth double tapered Ti-alloy cemented stem may offer a durable long-term solution.