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Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_9 | Pages 53 - 53
1 Oct 2020
Larson D Rosenberg J Lawlor M Garvin KL Hartman C Lyden E Konigsberg B
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Introduction

Revision total knee arthroplasty (TKA) is becoming increasingly common in the United States as the population ages and larger numbers of primary TKA are performed in younger individuals. Cemented or uncemented tibial stems are frequently used in revision cases. Decreased clinical outcomes and patient satisfaction have been described for revision TKA. This study aims to determine if the presence of overall pain and tibial pain at the end of the stem differs between cemented and uncemented tibial stems in revision TKA.

Methods

This was a retrospective cohort study comparing patients who underwent revision TKA utilizing cemented or uncemented tibial stems in a 15-year period at a single institution with at least two-year follow-up. Exclusion criteria included age under 18, isolated revisions of the femoral component or polyethylene exchanges, lack of preoperative or postoperative imaging, insufficient operative or implant records available for electronic chart review, revision procedures performed at outside facilities, patients who were deceased at the time of survey administration, refusal to participate in the study, and failure to return the mailed survey or respond to a telephone follow-up questionnaire. Radiographic analysis included calculation of the percentage of the tibial canal filled with the implant, as well as measurement of the diameter of the tibial stem. Radiographs were also reviewed for evidence of cavitary defects, pedestal formation, radiolucent lines, and periprosthetic fractures. Mailed surveys addressing overall pain, tibial pain, and satisfaction were analyzed using Fisher's exact test and the independent sample t-test. Logistic regression was used to adjust for age, gender, and preoperative bone loss.


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 268 - 268
1 Sep 2005
Verzin EJ Lawlor M McKeever O Henderson SA
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Introduction: The Orthopaedic Leg Trolley (OLT) is an alternative to crutches in the management of patients treated non-weight bearing. Advantages of the OLT include ease of use and the avoidance of problems such as painful hands and axillae, thus promoting greater mobility and facilitating early discharge. It also leaves the hands free for other purposes. The aim of this study was to investigate the benefit of the OLT following major elective foot and ankle surgery, using a questionnaire.

Methods: A prospective clinical audit was conducted on thirty patients undergoing elective foot and ankle surgery. Post-operatively, each patient was provided with an OLT. A questionnaire, measuring patient experience and satisfaction, was administered after the period of non-weight bearing.

Results: There were 13 males and 17 females, mean age 56 years, range 22 to 81 years. All patients had undergone major hindfoot reconstruction, and many had significant co-morbidities which rendered routine crutch use difficult. The mean duration of use was 4 weeks. After one week’s use, 80 of patients reported having no difficulty; 13.3% had slight difficulty; 6.7% had great difficulty; and no patients found the OLT impossible. All patients had used crutches pre-operatively: 76.7% rated the OLT as being easier to use than crutches; 13.3% felt that it was the same; and 10% reported that crutches were easier to use. Overall 53.3% rated the OLT as “invaluable”; 36.6% as being “very helpful”; 6.7% as being “quite helpful”; and 3.3% as being “not at all helpful”.

Conclusion: This study shows that the OLT is a useful alternative to crutches. It is particularly helpful in the rehabilitation of patients who are treated non-weight bearing following major foot and ankle surgery and have significant co-morbidities making crutch use difficult.