Aims. Medial unicompartmental knee arthroplasty (mUKA) is an advised treatment for anteromedial knee osteoarthritis. While long-term survival after mUKA is well described, reported incidences of short-term
Aims. The aim of this study was to estimate the incremental use of resources, costs, and quality of life outcomes associated with
Abstract. Introduction. There is increasing adoption of robotic
Aims. This study aims to determine difference in annual rate of early-onset (≤ 90 days) deep
Aims. Treatment of end-stage anteromedial osteoarthritis (AMOA) of the knee is commonly approached using one of two
Abstract. Introduction. Osteotomy is a recognised
Abstract. INTRODUCTION. Geniculate nerve blocks (GNB) and ablation (GNA) are increasing in popularity as strategies for the management of knee pain in patients unsuitable for
Aims. Outcomes of current operative treatments for arthrofibrosis after total knee arthroplasty (TKA) are not consistently positive or predictable. Pharmacological in vivo studies have focused mostly on prevention of arthrofibrosis. This study used a rabbit model to evaluate intra-articular (IA) effects of celecoxib in treating contracted knees alone, or in combination with capsular release. Methods. A total of 24 rabbits underwent contracture-forming surgery with knee immobilization followed by remobilization surgery at eight weeks. At remobilization, one cohort underwent capsular release (n = 12), while the other cohort did not (n = 12). Both groups were divided into two subcohorts (n = 6 each) – one receiving IA injections of celecoxib, and the other receiving injections of vehicle solution (injections every day for two weeks after remobilization). Passive extension angle (PEA) was assessed in live rabbits at 10, 16, and 24 weeks, and disarticulated limbs were analyzed for capsular stiffness at 24 weeks. Results. IA celecoxib resulted in greater mean PEA at ten weeks (69.6° (SD 4.6) vs 45.2° (SD 9.6), p = 0.004), 16 weeks (109.8° (SD 24.2) vs 60.9° (SD10.9), p = 0.004), and 24 weeks (101.0° (SD 8.0) vs 66.3° (SD 5.8), p = 0.004). Capsular stiffness was significantly reduced with IA celecoxib (2.72 Newton per cm (N·cm)/° (SD 1.04), p = 0.008), capsular release (2.41 N·cm/° (SD 0.80), p = 0.008), and capsular release combined with IA celecoxib (3.56 N·cm/° (SD 0.99), p = 0.018) relative to IA vehicle (6.09 N·cm/° (SD 1.64)). Conclusion. IA injections of a celecoxib led to significant improvements in passive extension angles, with reduced capsular stiffness, when administered to rabbit knees with established experimental contracture. Celecoxib was superior to
Abstract. Introduction. 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. Methodology. 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. Results. There was a significant change in the coronal plane alignment; the mMPTA changed from 84.38° to 90.39°, and the HKA changed from 172.19° to 180.15° (Both P < 0.0001). There was no significant change in the PTS as evidenced by a postoperative PPTA of 80.56 ° from a preoperative of 80.36°. And no significant change in the PH with all the indices; preoperative Caton Deschamps, Insall Salvati, and Schröter indices measured 0.95, 1.03, and 1.56, respectively. In comparison to postoperative measures of 0.93, 1.03, and 1.54, respectively. Conclusion. MOWHTO does not change the PTS or PH when accurate preoperative planning and precise intraoperative freehand technique are adopted. Involuntary modification of these anatomic parameters should be considered
Abstract. INTRODUCTION. COVID-19 reduced availability of cross-sectional imaging, prompting the need to clinically justify pre-operative computed tomography (CT) in tibial plateau fractures (TPF). The study purpose was to establish to what extent does a CT alter the pre-operative plan in TPF compared to radiographs. There is a current paucity of evidence assessing its impact on
Aims. The aim of this study was to identify risk factors for prosthetic
joint infection (PJI) following total knee arthroplasty (TKA). . Patients and Methods. The New Zealand Joint Registry database was analysed, using revision
surgery for PJI at six and 12 months after surgery as primary outcome
measures. Statistical associations between revision for infection,
with common and definable
Intro/Purpose. Lateral partial knee replacement is indicated as an alternative to total knee replacement for isolated end stage lateral compartment degenerative joint disease. The purpose of this study is to report the
Patient-reported outcome measures (PROMs) are
increasingly being used to assess functional outcome and patient satisfaction.
They provide a framework for comparisons between
Introduction. In recent years, online patient portals have been developed to offer the potential of an enhanced recovery experience. By offering videos, communication tools and patient-reported outcomes collection, online portals encourage patient's engagement in their care. In the total joint arthroplasty population, portals may also offer online physical therapy, allowing TJA patients to reach functional goals while reducing costs. Although technology may offer the potential of an enhanced recovery experience, disparities may exist between the comfort level of use and communication preferences of different patient populations. Our study aimed to analyze the utilization of an internet based patient portal, and quantify the impact of usage on patient reported outcome measures. Methods. 4,458 patients who underwent TJA across 8 major academic centers within one healthcare system were analyzed. Patients who scheduled surgery were registered for the online portal by the
We report the results of a prospective study of the
Aim. To compare minimally invasive (MIS) and standard
The aim of this study was to evaluate the risk
factors for dislocation of the bearing after a mobile-bearing Oxford medial
unicompartmental knee replacement (UKR) and to test the hypothesis
that
A prospective study of 276 TKA's performed in patients with valgus knee deformity ≥ 10° using a Modified
Mesenchymal stem cells (MSCs) have several properties that may support their use as an early treatment option for osteoarthritis (OA). This study investigated the role of multiple injections of allogeneic bone marrow-derived stem cells (BMSCs) to alleviate the progression of osteoarthritic changes in the various structures of the mature rabbit knee in an anterior cruciate ligament (ACL)-deficient OA model. Two months after bilateral section of the ACL of Japanese white rabbits aged nine months or more, either phosphate buffered saline (PBS) or 1 x 106 MSCs were injected into the knee joint in single or three consecutive doses. After two months, the articular cartilage and meniscus were assessed macroscopically, histologically, and immunohistochemically using collagen I and II.Aim
Materials and Methods
Instability in flexion after total knee replacement
(TKR) typically occurs as a result of mismatched flexion and extension
gaps. The goals of this study were to identify factors leading to
instability in flexion, the degree of correction, determined radiologically,
required at revision surgery, and the subsequent clinical outcomes.
Between 2000 and 2010, 60 TKRs in 60 patients underwent revision
for instability in flexion associated with well-fixed components.
There were 33 women (55%) and 27 men (45%); their mean age was 65
years (43 to 82). Radiological measurements and the Knee Society
score (KSS) were used to assess outcome after revision surgery.
The mean follow-up was 3.6 years (2 to 9.8). Decreased condylar
offset (p <
0.001), distalisation of the joint line (p <
0.001)
and increased posterior tibial slope (p <
0.001) contributed
to instability in flexion and required correction at revision to regain
stability. The combined mean correction of posterior condylar offset
and joint line resection was 9.5 mm, and a mean of 5° of posterior
tibial slope was removed. At the most recent follow-up, there was
a significant improvement in the mean KSS for the knee and function
(both p <
0.001), no patient reported instability and no patient
underwent further surgery for instability. The following step-wise approach is recommended: reduction of
tibial slope, correction of malalignment, and improvement of condylar
offset. Additional joint line elevation is needed if the above steps
do not equalise the flexion and extension gaps. Cite this article: