Introduction

Computer Assisted Total Knee Arthroplasty (CATKA) has proven benefits of achieving reproducible and accurate component alignment with outcomes comparable to conventional jig based TKR. Optical trackers are required for assessment of alignment and are fixed via bone pins. This technique does present its own unique complications including fracture and infection at the pin- sites. We report our experience of a single surgeon series performing CATKA.

Introduction

Computer assisted total knee replacement (CATKR) has been shown to give reproducible and accurate alignment of the mechanical axis. The benefits of the reproducible technique has been demonstrated in literature but there is little evidence of benefits in training junior surgeons in a clinical setting. We show our experience of CATKR performed by junior staff under supervision by the senior author, looking at component alignment and patient reported outcome measures.

Introduction

Minimally invasive Computer Assisted Total Knee Arthroplasty (MICATKA) has benefits of reduced blood loss, shorter hospital stay, improved post-operative quadriceps function and enhanced post-operative recovery. Our study looked into these factors to compare if there was a significant difference when compared to conventional Computer Assisted Total Knee Arthroplasty (CATKA).

Introduction

Unicondylar knee replacement (UKR) surgery is proven long term results in its benefit in medial compartment OA. However, its results are sensitive to component alignment with poor alignment leading to early failure. The advent of computer navigation has resulted in improved mechanical alignment, but little has been published on the outcomes of navigated UKR surgery. We present the results of 253 consecutive Computer Assisted UKR's performed by a single surgeon.

Introduction

It is now widely accepted that acute knee dislocations should be managed operatively. Most published studies are from outside the UK and from major trauma or specialist centres. The aim of the study is to report the functional outcomes of all patients presenting with an acute knee dislocation at our institution all of whom were surgically managed. The results were then compared to other published series. The hypothesis being that there would be no significant difference in the functional outcome scores between the groups.

Introduction

It is now widely accepted that acute knee dislocations should be managed operatively. Most published studies are from outside the UK and from major trauma or specialist centres. The aim of the study is to report the functional outcomes of all patients presenting with an acute knee dislocation at our institution all of whom were surgically managed. The results were then compared to other published series. The hypothesis being that there would be no significant difference in the functional outcome scores between the groups.

Introduction: Studies have shown Near Infrared Spectroscopy (NIRS) as being an effective tool in measuring oxygenation non-invasively in tissues. More recently it has been used in clinical settings to assess circulatory and metabolic abnormalities, however, clinical studies in bone are lacking.

Materials and Methods: Ten able-bodied (AB) (5 men and 5 women; age, 23-40 years) and ten spinal cord injured (SCI) (complete cord transection above T10, 5 men and 5 women; age 19–38) participants were matched by age, gender, skin pigmentation and studied.

A spectrometer measured between 498-1000nm, at 0.2Hz , using glass optodes (2mm diameter). Five minutes of resting readings, followed by 3 minutes of below knee arterial occlusion and then 6 minutes post-occlusion were made. The second study, started with 5 minutes of resting readings, vibration loading for 3 minutes at 30 Hz with acceleration of 3g and 6 minutes post-vibration was then conducted.

Results: NIRS showed changes in blood parameters during the hyperemic response (avg. 97% increase in Hb from baseline, p< 0.0001). Able-bodied subjects had significantly quicker (p=0.01) capacity for Hb to return to baseline. There was a significant difference (p=0.001) in the time to peak for Hb following arterial occlusion in the SCI group, 16.6 seconds (sd 4.3), and 10.1 seconds (sd 1.7) in the able bodied.

Conclusion: Our findings suggest that there is a reduction in the bone’s ability to restore oxygenated blood in SCI participants compared to the AB participants. Future studies looking at changes in bone following a range of vibration amplitudes and frequencies in the SCI group should be considered using NIRS in order to optimize potential clinical benefits.