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Orthopaedic Proceedings
Vol. 105-B, Issue SUPP_13 | Pages 4 - 4
7 Aug 2023
Khaleeq T Saeed AZ Ahmed U Ajula R Boutefnouchet T D'Alessandro P Malik S
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Abstract

Customised individually made implants(CIM) total knee arthroplasty(TKA) are custom-made to better fit patients native anatomy and aim to improve outcomes which can be variable with conventional off-the-shelf(OTS).

A systematic review and meta-analysis was conducted searching the MEDLINE and Embase databases. Studies reporting on patient reported outcome measures, clinical or radiological outcomes were included.

23 studies satisfied the search criteria (case-control studies14, case series8, cross-sectional studies1). There were 2,856(CIM) and 1,877(OTS) implants. The overall revision-rate was higher in CIM 5.9%vs3.7%OTS [OR 1.46(95% CI 0.82–2.62)]. MUA was higher in the CIM group 2.2%vs.1.1%OTS [OR 2.95(95% CI 0.95–9.13)] and overall complications rate was also higher in the CIM group 5% vs. 4.5%OTS [OR 1.45(95% CI 0.53–3.96)]. LOS was significantly shorter in the CIM group 2.9 days vs. 3.5 days [MD −0.51(95% CI −0.82–0.20)]. Pooled analysis for KSS showed no difference between CIM and OTS groups(Knee=90.5 vs. 90.6 [MD-0.27,(95% CI −4.27–3.73)] and Function=86.1 vs. 90.6[MD 1.51 (95% CI −3.69–6.70)] component of the scores. There was no significant difference in post-operative ROM between CIM and OTS groups 117.3° vs. 115.0° [MD 0.02,(95% CI −1.70–1.74)].

CIM TKAs has theoretical benefits over OTS TKAs however in this review they were associated with higher complication, MUA and revision rates with no difference in outcome scores and no improvement in target alignment. The findings of this review does not support the use of CIM over OTS prosthesis in total knee arthroplasty.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 75 - 75
1 Jul 2022
Aujla R Malik S Dalgleish S Raymond A D'Alessandro P
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Abstract

Introduction

Meniscal repair is an accepted surgical option for meniscal tears. However, there remains trepidation with regard to offering such surgery to older patients. We aim to evaluate the outcomes in these such patients.

Methodology

A single surgeons log was used to identify patients who underwent meniscal repair and were over the age of 40. Patients having concurrent anterior cruciate ligament reconstructions were excluded. Demographic data, surgical data and outcomes (pain visual analogue score (VAS); single assessment numerical evaluation (SANE) and knee injury and osteoarthritis outcome joint replacement (KOOS Jr) score) were collected prospectively. Final outcomes were collected between 6–12 months following surgery.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 97 - 97
1 Jul 2022
Khalefa MA Aujla R Aslam N D'Alessandro P Malik SS
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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 primary aim of this review was to assess all complications of QT in adult population.

Methodology

A systematic review of the literature was conducted on in accordance with the PRISMA guidelines using the online databases Medline and EMBASE. Clinical studies or reporting on soft tissue QT were included and appraised using the Methodological Index for Non-Randomized Studies (MINORS) tool.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 44 - 44
1 Jul 2022
Aujla R Scanlon J Raymond A Ebert J Lam L Gohill S D'Alessandro P
Full Access

Abstract

Introduction

The incidence of significant acute chondral injuries with patella dislocation is around 10–15%. It is accepted that chondral procedures should only be performed in the presence of joint stability.

Methodology

Patients were identified from surgeon/hospital logs. Patient demographics, lesion size and location, surgical procedure, patient reported outcome measures, post-operative MR imaging and complications were recorded. PROMs and patient satisfaction was obtained.