The COVID-19 pandemic led to a swift adoption of telehealth in orthopaedic surgery. This study aimed to analyze the satisfaction of patients and surgeons with the rapid expansion of telehealth at this time within the division of adult reconstructive surgery at a major urban academic tertiary hospital. A total of 334 patients underging arthroplasty of the hip or knee who completed a telemedicine visit between 30 March and 30 April 2020 were sent a 14-question survey, scored on a five-point Likert scale. Eight adult reconstructive surgeons who used telemedicine during this time were sent a separate 14-question survey at the end of the study period. Factors influencing patient satisfaction were determined using univariate and multivariate ordinal logistic regression modelling.Aims
Methods
At a time when many surgeons are reluctant to perform a unilateral TKA in the obese patient, little is written on the safety and efficacy of bilateral simultaneous TKA in this same patient population. While these potential benefits are attractive to patients, surgeons may be hesitant to perform bilateral TKA due to the greater physical demand placed on the patient, and a potential increase in postoperative complication. The primary aim of this study was to analyze the impact of obesity on clinical outcomes and complication rates of patients undergoing bilateral TKA under one anesthetic. The clinical outcomes of 133 patients (266 knees) who underwent bilateral TKA between 2013 and 2016 were reviewed. The procedures were performed by three separate surgeons across three major academic institutions. ASA scores, tourniquet time, operative time, blood loss, length of stay, readmission, and postoperative complications were compared between different BMI categories of less than 30 kg/ m2, 30–34.99 kg/ m2, 35–39.99 kg/ m2and above 40 kg/ m2Introduction
Materials and Methods
Component malalignment can be associated with
pain following total knee replacement (TKR). Using MRI, we reviewed
50 patients with painful TKRs and compared them with a group of
16 asymptomatic controls to determine the feasibility of using MRI
in evaluating the rotational alignment of the components. Using
the additional soft-tissue detail provided by this modality, we
also evaluated the extent of synovitis within these two groups.
Angular measurements were based on the femoral transepicondylar
axis and tibial tubercle. Between two observers, there was very
high interobserver agreement in the measurements of all values.
Patients with painful TKRs demonstrated statistically significant
relative internal rotation of the femoral component (p = 0.030).
There was relative internal rotation of the tibial to femoral component
and combined excessive internal rotation of the components in symptomatic
knees, although these results were significant only with one of
the observers (p = 0.031). There was a statistically significant
association between the presence and severity of synovitis and painful
TKR (p <
0.001). MRI is an effective modality in evaluating component rotational
alignment.
