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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXXVII | Pages 39 - 39
1 Sep 2012
Lee MC Lee SM Seong SC Lee S Jang J Lee JK Shim SH
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Summary. UC TKA showed similar anteroposterior translation and more femoral external rotation of earlier onset when compared to PS TKA. Introduction. Recently highly conforming ultracongruent TKA has been reintroduced with improved wear characteristics and lower complications. The purpose of the study was to assess kinematics and clinical outcome of posterior stabilized and ultracongruent rotating-platform mobile bearing TKA. Methods. Ninety patients with primary osteoarthritis of the knee were randomized to undergo computer assisted TKA with PS(n = 45) or UC(n = 45) prostheses and were followed up for a minimum 2 years. The passive kinematic evaluation was performed before and after implantation with a navigation system. Three parameters of tibiofemoral relationship (anterior/posterior translation, varus/valgus alignment and rotation) were recorded from 0° to 120° of flexion. The patients were clinically and radiographically evaluated at final follow-up. Results. Paradoxical anterior translation of the femur was observed from 0° to 70° of flexion in PS(8.7mm) and 0° to 85° in UC knees(10.4mm, p = 0.064). The distance of femoral roll-back was 6.7mm and 5.5mm, but never reached the starting point. Paradoxical internal rotation of the femur was found from 0° to 62° of flexion in PS(9.9°) and 0° to 47° in UC knees(5.6°, p = 0.002). UC knees showed more external rotation of the femur during flexion from 0° to 120°(5.7:11.0, p = 0.048). There was no significant difference in the maximal flexion(123.3°:125.5°, p = 0.366), AKS knee scores(95.9:92.0, p = 0.101), AKS function scores(86.2:82.9, p = 0.435) and WOMAC index scores(13.4:15.9, p = 0.268). There was no progressive radiolucent line or loosening in all knees. Discussion and Conclusion. UC TKA showed similar anteroposterior translation and more femoral external rotation of earlier onset when compared to PS TKA. There was no difference in clinical outcome between two designs. UC TKA showed comparable kinematic and clinical results to PS TKA


The Bone & Joint Journal
Vol. 101-B, Issue 10 | Pages 1285 - 1291
1 Oct 2019
MacKenzie SA Ng RT Snowden G Powell-Bowns MFR Duckworth AD Scott CEH

Aims

Currently, periprosthetic fractures are excluded from the American Society for Bone and Mineral Research (ASBMR) definition of atypical femoral fracture (AFFs). This study aims to report on a series of periprosthetic femoral fractures (PFFs) that otherwise meet the criteria for AFFs. Secondary aims were to identify predictors of periprosthetic atypical femoral fractures (PAFFs) and quantify the complications of treatment.

Patients and Methods

This was a retrospective case control study of consecutive patients with periprosthetic femoral fractures between 2007 and 2017. Two observers identified 16 PAFF cases (mean age 73.9 years (44 to 88), 14 female patients) and 17 typical periprosthetic fractures in patients on bisphosphonate therapy as controls (mean age 80.7 years (60 to 86, 13 female patients). Univariate and multivariate analysis was performed to identify predictors of PAFF. Management and complications were recorded.


The Bone & Joint Journal
Vol. 101-B, Issue 3 | Pages 260 - 265
1 Mar 2019
Lee SH Han SS Yoo BM Kim JW

Aims

The aim of this study was to evaluate the clinical and radiological outcomes of locking plate fixation, with and without an associated fibular strut allograft, for the treatment of displaced proximal humeral fractures in elderly osteoporotic patients.

Patients and Methods

We undertook a retrospective comparison of two methods of fixation, using a locking plate without an associated fibular strut allograft (LP group) and with a fibular allograft (FA group) for the treatment of these fractures. The outcome was assessed for 52 patients in the LP group and 45 in the FA group, with a mean age of 74.3 years (52 to 89), at a mean follow-up of 14.2 months (12 to 19). The clinical results were evaluated using a visual analogue scale (VAS) score for pain, the Constant score, the American Shoulder and Elbow Surgeons (ASES) score, and the range of movement. Radiological results were evaluated using the neck-shaft angle (NSA) and humeral head height (HHH).