Aims. The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following
Abstract. Introduction. The study aims were to demonstrate rates, level, and time taken to RTP in elite sports after ACL reconstruction (ACL-R) and compare football and rugby. Methods. A retrospective review of a consecutive series of ACL-R between 2005 and 2019 was undertaken. Patients were included if they were elite athletes and were a minimum of 2 years post
Aims. Intra-articular administration of antibiotics during primary total knee arthroplasty (TKA) may represent a safe, cost-effective strategy to reduce the risk of acute periprosthetic joint infection (PJI). Vancomycin with an aminoglycoside provides antimicrobial cover for most organisms isolated from acute PJI after TKA. However, the intra-articular doses required to achieve sustained therapeutic intra-articular levels while remaining below toxic serum levels is unknown. The purpose of this study is to determine the intra-articular and serum levels of vancomycin and tobramycin over the first 24 hours postoperatively after intra-articular administration in
Abstract. Introduction. Anterior cruciate ligament reconstruction (ACLR) can be performed with a number of different autografts including all soft tissue quadriceps autograft. (QT). QT has several advantages including decreased donor site morbidity, reduced anterior knee pain and comparable revision rates compared to other autografts. The
Abstract. Introduction. Cementless fixation of Oxford Unicompartmental Knee Replacements (UKRs) is an alternative to cemented fixation, however, it is unknown whether cementless fixation is as good long-term. This study aimed to compare
Abstract. Introduction. Anxiety and depression are risk factors for poor outcome following knee replacement surgery. The aim of this study was to investigate the prevalence of anxiety and depression before and after
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
Aims. Our objective is to describe our early and mid-term results with the use of a new simple
Aims. Antibiotic-loaded bone cements (ALBCs) may offer early protection against the formation of bacterial biofilm after joint arthroplasty. Use in hip arthroplasty is widely accepted, but there is a lack of evidence in total knee arthroplasty (TKA). The objective of this study was to evaluate the use of ALBC in a large population of TKA patients. Materials and Methods. Data from the National Joint Registry (NJR) of England and Wales were obtained for all
Introduction. Enhanced pain and rehabilitation protocols have significantly improved patient recovery following primary TKR. Little has been written on how the protocols have affected the revision TKR patient. We report on a matched group of revision and primary TKR patients treated with the identical pain and rehab program. Materials and Methods. 40 aseptic RTKR patients who underwent a full femoral and tibial revision were matched by age, sex, and BMI to a group of patients who underwent a cemented tri-compartmental primary TKR. All revision knees had uncemented stemmed femurs and tibias. All 40 patients had either a metaphyseal sleeve on either the femur or tibia or both. Patients in both groups were treated with an identical post op pain protocol (Spinal anesthetic, local infiltrative analgesia and multimodal oral pain management along with rapid rehabilitation). All patients were mobilized on POD1 and allowed weight bearing as tolerated. Patients were followed for a minimum of 1 year. KSS at 6 weeks and 1 year were recorded for both groups. Results. There was no significant difference in length of stay between the RTKR and the primary TKR (1.2 days versus 1.1 days). Average oral morphine equivalents used during the hospitalization was 38 for the RTKR and 42 for the
It is increasingly evident that synovium may play a larger role in the aetiology of osteoarthritis. We compared gene expression in whole tissue synovial biopsies from end-stage knee osteoarthritis and knee trauma patients with that of their paired explant cultures to determine how accurately cultured cells represent holistic synovial function. Synovial tissue biopsies were taken from 16 arthroplasty patients and 8 tibial plateau fracture patients with no osteoarthritis. Pairs of whole tissue fragments were either immediately immersed in RNAlater Stabilisation Solution at 4o C before transfer to -80o C storage until RNA extraction; or weighed, minced and cultured at 500mg tissues/5ml media in a humidified incubator at 37oC, 5% CO2. After sub-culturing total RNA was extracted using RNAeasy Plus Mini Kit with gDNA removal. Following RT-PCR and quality assessment, cDNA was applied to Affymetrix Clariom D microarray gene chips. Bioinformatics analyses were performed.Abstract
Introduction
Methodology
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
Background. The evaluation and management of outcomes risk has become an essential element of a modern total joint replacement program. Our multidisciplinary team designed an evidence-based tool to address modifiable risk factors for adverse outcomes after
Aims. The practice of alternating operating theatres has long been used to reduce surgeon idle time between cases. However, concerns have been raised as to the safety of this practice. We assessed the payments and outcomes of total knee arthroplasty (TKA) performed during overlapping and nonoverlapping days, also comparing the total number of the surgeon’s cases and the total time spent in the operating theatre per day. Materials and Methods. A retrospective analysis was performed on the Centers for Medicare & Medicaid Services (CMS) Limited Data Set (LDS) on all
The use of hinged implants in
Purpose of the study. To determine the effectiveness, complications and side effects of Rivaroxaban when used for extended thromboprophylaxis in patients undergoing
The purpose is to determine the non-inferiority of a smartphone-based exercise educational care management system after primary knee arthroplasty compared with a traditional in-person physiotherapy rehabilitation model. A multicentre prospective randomized controlled trial was conducted evaluating the use of a smartphone-based care management system for primary total knee arthroplasty (TKA) and partial knee arthroplasty (PKA). Patients in the control group (n = 244) received the respective institution’s standard of care with formal physiotherapy. The treatment group (n = 208) were provided a smartwatch and smartphone application. Early outcomes assessed included 90-day knee range of movement, EuroQoL five-dimension five-level score, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) score, 30-day single leg stance (SLS) time, Time up and Go (TUG) time, and need for manipulation under anaesthesia (MUA).Aims
Methods
We studied a series of Endo-Modell(r) rotating hinge knee replacements (RHKRs) to determine indications, implant survival and complication rates. Case notes were audited for a consecutive series of 129 implants performed between 08/12/2002 and 30/01/2009. Indication for use of RHKR was complex
We analysed at a mean follow-up of 7.25 years the clinical and radiological outcome of 117 patients (125 knees) who had undergone a
Patients with skeletal dysplasia are prone to
developing advanced osteoarthritis of the knee requiring total knee replacement
(TKR) at a younger age than the general population. TKR in this
unique group of patients is a technically demanding procedure owing
to the deformity, flexion contracture, generalised hypotonia and ligamentous
laxity. We retrospectively reviewed the outcome of 11 TKRs performed
in eight patients with skeletal dysplasia at our institution using
the Stanmore Modular Individualised Lower Extremity System (SMILES)
custom-made rotating-hinge TKR. There were three men and five women
with mean age of 57 years (41 to 79). Patients were followed clinically
and radiologically for a mean of seven years (3 to 11.5). The mean
Knee Society clinical and function scores improved from 24 (14 to
36) and 20 (5 to 40) pre-operatively, respectively, to 68 (28 to
80) and 50 (22 to 74), respectively, at final follow-up. Four complications
were recorded, including a patellar fracture following a fall, a
tibial peri-prosthetic fracture, persistent anterior knee pain,
and aseptic loosening of a femoral component requiring revision.
Our results demonstrate that custom