We report the natural course of Baker’s cysts following total knee arthroplasty (TKA) at short- and mid-term follow-up. In this prospective case series, 105 TKA patients were included. All patients who received surgery had a diagnosis of primary osteoarthritis and had preoperatively presented with a Baker’s cyst. Sonography and MRI were performed to evaluate the existence and the gross size of the cyst before TKA, and sonography was repeated at a mean follow-up time of 1.0 years (0.8 to 1.3; short-term) and 4.9 years (4.0 to 5.6; mid-term) after TKA. Symptoms potentially attributable to the Baker’s cyst were recorded at each assessment.Aims
Methods
Good clinical outcomes of Total Knee Arthroplasty (TKA) demand the ability to plan a surgery precisely and measure the outcome accurately. In comparison with plain radiograph, CT-based 3D planning offers several advantages. More specifically, CT has the benefits of avoiding errors resulting from magnification and inaccurate patient positioning. Additional benefits include the assessment in the axial plane and the replacement of 2D projections with 3D data. The concern on 3D CT-based planning, however, lies in the increase of radiation dosage to the patients. An alternative is to reconstruct a patient-specific 3D model of the complete lower extremity from 2D X-ray radiographs. This study presents a clinical validation of a novel technology called “3XPlan” which allows for 3D prosthesis planning using 2D X-ray radiographs. After a local institution review board (IRB) approval, 3XPlan was evaluated on 24 patients TKA. Pre-operatively, all the patients underwent a CT scan according to a standard protocol. Image acquisition consisted of three separate short spiral axial scans: 1) ipsilateral hip, 2) affected knee and 3) ipsilateral ankle. All the CT images were segmented to extract 3D surface models of both femur and tibia, which were regarded as the ground truth. Additionally, 2 X-ray images were acquired for each affected leg and were used in 3XPlan to derive patient-specific models of the leg. For 3D models derived from both modalities (CT vs. X-ray), five most relevant anatomical parameters for planning TKA were measured and compared with each other. Except for tibial torsion, the average differences for all other anatomical parameters are smaller than or close to 3 degrees.
It is widely held that most Baker’s cysts resolve after treatment
of the intra-articular knee pathology. The present study aimed to
evaluate the fate of Baker’s cysts and their associated symptoms
after total knee arthroplasty (TKA). In this prospective cohort study, 102 patients with (105 were
included, however three were lost to follow-up) an MRI-verified
Baker’s cyst, primary osteoarthritis and scheduled for TKA were
included. Ultrasound was performed to evaluate the existence and
the gross size of the cyst before and at one year after TKA. Additionally,
associated symptoms of Baker's cyst were recorded pre- and post-operatively.Aims
Patients and Methods
By all developments of new technologies on the improvement of the Total Knee implantation, the discussion about the optimum Alignment is in full way. Besides, is to be considered, that Alignment contains not only static, but also dynamic factors and beside the frontal plan also the sagittal plan as well as in particular the rotation in femur and tibia have a great importance for the outcome after TKR. However, beside the bone alignment, the kapsulo-igamentous structures also play an important role for the results after TKR. If a Varus-Malalignment was valid, in the past the „older” literature described it as a big risk factor for pain, less function and durability. However, in the present literature, we discuss more and more about the optimum Alignment during TKR. In particular, newer publications show no interference of the durability with coronar Alignment also outside from 3 °, also the score results and patient's satisfaction seem to deliver no worse results with slight untercorrection of the varus alignment. Some publications described even better score results and Patient satisfaction with slight untercorrection. Condition for it is probably an exact balancing of the extension and flexion gap. With a new developed instruments it was examined with a tibia and extensions-Gap-First-Technique, to what extent a correction of the AMA opposed after digital planning within from 3 ° in distal femur a balancierung of the extension gap could be reached under avoidance of 3° releases with a varusarthritis oft the knee. 103 directly knee arthroplasties following on each other were selected with Varus-OA without exclusion criteria.Introduction
Material and method
