Aims. The gluteus minimus (GMin) and gluteus medius (GMed) have unique structural and functional segments that may be affected to varying degrees, by
This study aims to determine the proportion of patients with end-stage knee osteoarthritis (OA) possibly suitable for partial (PKA) or combined partial knee arthroplasty (CPKA) according to patterns of full-thickness cartilage loss and anterior cruciate ligament (ACL) status. A cross-sectional analysis of 300 consecutive patients (mean age 69 years (SD 9.5, 44 to 91), mean body mass index (BMI) 30.6 (SD 5.5, 20 to 53), 178 female (59.3%)) undergoing total knee arthroplasty (TKA) for Kellgren-Lawrence grade ≥ 3 knee OA was conducted. The point of maximal tibial bone loss on preoperative lateral radiographs was determined as a percentage of the tibial diameter. At surgery, Lachman’s test and ACL status were recorded. The presence of full-thickness cartilage loss within 16 articular surface regions (two patella, eight femoral, six tibial) was recorded.Aims
Methods
From a prospective, cross-sectional survey of 402 patients who had a total hip (THR) or a total knee (TKR) replacement for idiopathic osteoarthritis (OA) at a major centre, we determined the prevalence of these replacements for idiopathic OA in their 1171 siblings and 376 spouses. Using spouses as controls, the relative risk of THR in siblings was 1.86 (95% CI 0.93 to 3.69). The relative risk for TKR in siblings The increased risks of joint replacement for severe, idiopathic OA which we found in siblings suggest that genetic influences are important in end-stage OA of the hip and knee.
To determine the risk of total knee replacement (TKR) for primary osteoarthritis (OA) associated with overweight/obesity in the Australian population. This population-based study analyzed 191,723 cases of TKR collected by the Australian Orthopaedic Association National Joint Registry and population data from the Australian Bureau of Statistics. The time-trend change in incidence of TKR relating to BMI was assessed between 2015-2018. The influence of obesity on the incidence of TKR in different age and gender groups was determined. The population attributable fraction (PAF) was then calculated to estimate the effect of obesity reduction on TKR incidence. The greatest increase in incidence of TKR was seen in patients from obese class III. The incidence rate ratio for having a TKR for obesity class III was 28.683 at those aged 18-54 years but was 2.029 at those aged >75 years. Females in obesity class III were 1.7 times more likely to undergo TKR compared to similarly classified males. The PAFs of TKR associated with overweight or obesity was 35%, estimating 12,156 cases of TKR attributable to obesity in 2018. The proportion of TKRs could be reduced by 20% if overweight and obese population move down one category. Obesity has resulted in a significant increase in the incidence of TKR in the youngest population in Australia. The impact of obesity is greatest in the young and the female population. Effective strategies to reduce the national obese population could potentially reduce 35% of the TKR, with over 10,000 cases being avoided.
Aims. Treatment of
Aims. Instability is a common cause of failure after total hip arthroplasty. A novel reverse total hip has been developed, with a femoral cup and acetabular ball, creating enhanced mechanical stability. The purpose of this study was to assess the implant fixation using radiostereometric analysis (RSA), and the clinical safety and efficacy of this novel design. Methods. Patients with
Aims. The aim of this study was to investigate the distribution of phenotypes in Asian patients with
Aims. This study reports updates the previously published two-year clinical, functional, and radiological results of a group of patients who underwent transfibular total ankle arthroplasty (TAA), with follow-up extended to a minimum of five years. Methods. We prospectively evaluated 89 patients who underwent transfibular TAA for
Background. It is technically challenging to restore hip rotation center exactly in total hip arthroplasty (THA) for patients with
Introduction. The changes in sagittal spino-pelvic balance from standing to sitting in patients with
Demand for total knee arthroplasty (TKA) is increasing as it remains the gold-standard treatment for
Aims. The aim of this study was to compare a bicruciate-retaining (BCR) total knee arthroplasty (TKA) with a posterior cruciate-retaining (CR) TKA design in terms of kinematics, measured using fluoroscopy and stability as micromotion using radiostereometric analysis (RSA). Methods. A total of 40 patients with
Arthrodesis of the first metatarsophalangeal joint (MTPJ) is the most reliable surgical option, for hallux rigidus from
Abstract. Introduction. Articular cartilage degradation is a defining feature of osteoarthritis. Synovium is a reactive tissue with synovial villae, neoangiogenesis and intimal hyperplasia common to many joint pathologies. The consequences of cartilage debris in osteoarthritis impacting the synovial intima is not well understood. We analysed the immunohistology of synovium from 16 patients with osteoarthritis and 17 patients undergoing knee surgery for non-arthritic pathologies. This data was integrated with imaging and functional scores to correlate synovitis in osteoarthritis. Methodology. Formalin-fixed paraffin embedded synovial biopsy sections were cut in serial sequence and processed for routine staining (H&E or CD3, CD68, CD20, Vimentin, vWF and PCNA IHC) using standardised Dako monoclonal mouse anti-human antibodies. Digital images scanned at x20 were evaluated for fragments of cartilage and aggregates of inflammatory cells. Clinical data (gender, BMI, KL grade, WOMAC & SF-12 scores) was aligned with histopathological data. Results. Cartilage fragments were seen in the synovial intimal layer from
Aims. Total knee arthroplasty (TKA) may provoke ankle symptoms. The aim of this study was to validate the impact of the preoperative mechanical tibiofemoral angle (mTFA), the talar tilt (TT) on ankle symptoms after TKA, and assess changes in the range of motion (ROM) of the subtalar joint, foot posture, and ankle laxity. Methods. Patients who underwent TKA from September 2020 to September 2021 were prospectively included. Inclusion criteria were primary
Objectives. The aim of this study was to investigate the structural integrity of torn and non-torn human acetabular labral tissue. Methods. A total of 47 human labral specimens were obtained from a biobank. These included 22 torn specimens and 25 control specimens from patients undergoing total hip arthroplasty with macroscopically normal labra. The specimens underwent dynamic shear analysis using a rheometer to measure storage modulus, as an indicator of structural integrity. Results. There was a significant difference in the storage modulus between torn (mean modulus = 2144.08 Pa) and non-torn (3178.1 Pa) labra (p = 0.0001). Conclusion. The acetabular labrum of young patients with a tear has significantly reduced structural integrity compared with a non-torn labrum in older patients with
Total hip replacement (THR) for
Introduction. The degree of cartilage degeneration assessed intraoperatively may not be sufficient as a criterion for patellar resurfacing in total knee arthroplasty (TKA). However, single-photon emission tomography/computed tomography (SPECT/CT) is useful for detecting osteoarthritic involvement deeper in the subchondral bone. The purpose of the study was to determine whether SPECT/CT reflected the cartilage lesion underneath the patella in patients with
Aims. The aim of this study was to observe the implications of withholding total joint arthroplasty (TJA) in morbidly obese patients. Patients and Methods. A total of 289 morbidly obese patients with
Aims. Despite advances in the treatment of paediatric hip disease, adolescent and young adult patients can develop early onset
Introduction. Patients undergoing total knee arthroplasty (TKA) with
Background. Total hip arthroplasty (THA) has been and continues to be the gold standard for treatment of
Total hip replacements (THRs) provide pain relief and improved function to thousands of patients suffering from
Introduction and Objective. Total joint replacement (TJR) is indicated for patients with
Spinopelvic mobility describes the change in lumbar lordosis and pelvic tilt from standing to sitting position. For 1° of posterior pelvic tilt, functional cup anteversion increases by 0.75° after total hip arthroplasty (THA). Thus, spinopelvic mobility is of high clinical relevance regarding the risk of implant impingement and dislocation. Our study aimed to 1) determine the proportion of OA-patients with stiff, normal or hypermobile spino-pelvic mobility and 2) to identify clinical or static standing radiographic parameters predicting spinopelvic mobility. This prospective diagnostic cohort study followed 122 consecutive patients with
While total joint replacement (TJR) is considered as an effective intervention to relieve pain and restore joint function for
Objectives. Numerous complications following total knee replacement (TKR)
relate to the patellofemoral (PF) joint, including pain and patellar
maltracking, yet the options for in vivo imaging
of the PF joint are limited, especially after TKR. We propose a
novel sequential biplane radiological method that permits accurate
tracking of the PF and tibiofemoral (TF) joints throughout the range
of movement under weightbearing, and test it in knees pre- and post-arthroplasty. Methods. A total of three knees with
The goals of a total knee arthroplasty include approximation of the function of a normal knee and achievement of balance post-surgery. Accurate bone preparation and the preservation of natural ligaments along with a functional knee design, holds the potential to provide a method of restoring close to normal function. Although conventional knee arthroplasty is considered a successful intervention for
Total joint arthroplasty (TJA) is often utilized to improve pain and dysfunction associated with
Total joint arthroplasty (TJA) is often utilized to improve pain and dysfunction associated with
Limited strong data exists in current literature comparing the 90-day morbidity and mortality following general or spinal anesthetic in patients who underwent total hip or knee arthroplasty, especially between matched cohorts. Because of this, there continues to be an ongoing debate regarding the risks and benefits of using general versus spinal anesthetic for patients undergoing elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) for
The aim of this retrospective cohort study was
to identify any difference in femoral offset as measured on pre-operative
anteroposterior (AP) radiographs of the pelvis, AP radiographs of
the hip and corresponding CT scans in a consecutive series of 100
patients with primary
Introduction. Total hip arthroplasty (THA) is a highly successful procedure achieving excellent clinical outcomes beyond 10 years post-surgery. With exception of periprosthetic infection, dislocation is the most common cause of failure in THA. A novel reverse total hip (RTH) replacement has been developed to address dislocation through reversal of the typical THA articulation in which a femoral cup and acetabular ball interlock at the extremes of motion to enhance mechanical stability in all planes. The purpose of this study was to assess the safety and efficacy of this novel RTH in a series of 22 patients and to monitor implant fixation using radiostereometric analysis (RSA). Methods. Twenty two patients with
Not all degenerative knees need a total knee replacement. Over the last few decades we have shifted our surgical treatment of
Introduction. A total knee arthroplasty (TKA) is the standard of care treatment for
Successful nonarthroplasty solutions for the treatment of osteonecrosis of the femoral head continued to be sought. However, no definitive nonarthroplasty solutions have to date been found. Hence, even in the best of hands a large number of patients with osteonecrosis end up with debilitating
Knee osteoarthritis (OA) is a progressive and debilitating condition that is estimated to account for over 80% of the osteoarthritis burden. In cases of
Knee osteoarthritis (OA) is a debilitating and progressive condition that accounts for over 80% of the total osteoarthritis burden. Surgical intervention is the suitable option in
Purpose. To update current surgical management of knee osteoarthritis. Methods. A literature review was done using standard keyword search. Articles were scrutinized by the investigators to ensure relevancy to the purpose of this review. Summary of the review. Arthroscopy, osteotomy and arthroplasty are three major techniques for knee osteoarthritis. Arthroscopy is more and more common as it is diagnostically and therapeutically useful, especially for patients with painful osteoarthritis with mechanical symptoms. Recently, arthroscopic techniques to treat subchondral bone marrow lesions associated with knee osteoarthritis have been developed. Osteotomy is a technique that preserves the natural biomechanics of the joint and reestablishes joint alignment. Its accuracy has been improved with the advancement of computer-assisted surgery. Arthroplasty includes Unicompartmental knee arthroplasty (UKA) and Total knee arthroplasty (TKA). In UKA, patient selection is a key factor for good outcomes, which can be enhanced with newer implant designs and robotic technology. TKA is the mainstay technique for
Background. The indication of unicompartmental knee arthroplasty (UKA) for
A prospective randomized trial on 128 patients with
We performed a systematic review and meta-analysis
of modern total ankle replacements (TARs) to determine the survivorship,
outcome, complications, radiological findings and range of movement,
in patients with
Introduction. Total knee arthroplasty (TKA) is an excellent treatment for
Total hip arthroplasty (THA) is one of the preferable solutions for regaining ambulatory activity for patients with
The number of hip arthroplasty procedures has steadily increased in the United States over the last decade [Wolford, et. al, 2015]. This trend will continue as this treatment is the most effective approach in relieving pain, improving mobility, reducing fall risk and improving the quality of life in patients with
Hip arthroplasty is commonly used as the final treatment approach for patients experiencing
INTRODUCTION. Total knee arthroplasty (TKA) is an effective technique to treat
Introduction. A total knee replacement is a proven cost-effective treatment for
Hip resurfacing arthroplasty is emerging as an increasingly popular, conservative option for the treatment of