Changes in posterior tibial slope (PTS) and patellar height (PH) following proximal tibial osteotomies have been a recent focus for knee surgeons. Increased PTS and decreased PH following medial opening wedge high tibial osteotomy (MOWHTO) have been repeatedly reported in the literature. However, this has been disputed in more recent biomechanical studies. A total of 62 cases who underwent MOWHTO were included. Surgery was performed using a dedicated step-by-step protocol focusing on the risks of unintentional slope changes. Clinically, all patients were evaluated preoperatively and at 2 years follow-up with the KOOS scores and UCLA physical activity scale. Preoperative and postoperative radiographic lower limb alignment parameters were measured on full-length lower limb radiographs, including (HKA), (MPTA), (mLDFA), proximal posterior tibial angle (PPTA), (JLCA) and(JLO). PH measurements were assessed on radiographs.Abstract
Introduction
Methodology
Introduction. In the setting of periprosthetic joint infection, the complete removal of implants and cement can be challenging with well-fixed, cemented implants about the knee. This can get especially complex in the setting of long cemented femoral stems.
Periprosthetic joint infection (PJI) is a challenging complication of any arthroplasty procedure. We reviewed our use of static antibiotic-loaded cement spacers (ABLCSs) for staged management of PJI where segmental bone loss, ligamentous instability, or soft-tissue defects necessitate a static construct. We reviewed factors contributing to their failure and techniques to avoid these complications when using ABLCSs in this context. A retrospective analysis was conducted of 94 patients undergoing first-stage revision of an infected knee prosthesis between September 2007 and January 2020 at a single institution. Radiographs and clinical records were used to assess and classify the incidence and causes of static spacer failure. Of the 94 cases, there were 19 primary total knee arthroplasties (TKAs), ten revision TKAs (varus-valgus constraint), 20 hinged TKAs, one arthrodesis (nail), one failed spacer (performed elsewhere), 21 distal femoral endoprosthetic arthroplasties, and 22 proximal tibial arthroplasties.Aims
Methods
We have investigated the benefits of patient
specific instrument guides, applied to osteotomies around the knee. Single,
dual and triple planar osteotomies were performed on tibias or femurs
in 14 subjects. In all patients, a detailed pre-operative plan was
prepared based upon full leg standing radiographic and CT scan information.
The planned level of the osteotomy and open wedge resection was
relayed to the surgery by virtue of a patient specific guide developed
from the images. The mean deviation between the planned wedge angle
and the executed wedge angle was 0° (-1 to 1, Cite this article:
Previous studies from single centres or single-surgeon
series report good early and mid-term results for high tibial osteotomy
(HTO) in the treatment of osteoarthritis of the knee. However, the
survivorship of HTO at a national level is unknown. This registry-based
study included 3195 high HTOs performed between 1987 and 2008. Kaplan-Meier analysis
revealed an overall survivorship of 89% (95% confidence interval
(CI) 88 to 90) at five years and 73% (95% CI 72 to 75) at ten years,
when conversion to total knee replacement was taken as the endpoint.
Females and patients aged >
50 years had worse survivorship than
males or patients aged ≤ 50 years (hazard ratio (HR) 1.26 (95% CI
1.11 to 1.43) and HR 1.41 (95% CI 1.23 to 1.64), respectively).
The survivorship of HTOs performed between 1998 to 2008 was worse
than for those performed between 1987 and 1997.