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The Bone & Joint Journal
Vol. 104-B, Issue 11 | Pages 1202 - 1208
1 Nov 2022
Klasan A Rice DA Kluger MT Borotkanics R McNair PJ Lewis GN Young SW

Aims

Despite new technologies for total knee arthroplasty (TKA), approximately 20% of patients are dissatisfied. A major reason for dissatisfaction and revision surgery after TKA is persistent pain. The radiological grade of osteoarthritis (OA) preoperatively has been investigated as a predictor of the outcome after TKA, with conflicting results. The aim of this study was to determine if there is a difference in the intensity of pain 12 months after TKA in relation to the preoperative radiological grade of OA alone, and the combination of the intensity of preoperative pain and radiological grade of OA.

Methods

The preoperative data of 300 patients who underwent primary TKA were collected, including clinical information (age, sex, preoperative pain), psychological variables (depression, anxiety, pain catastrophizing, anticipated pain), and quantitative sensory testing (temporal summation, pressure pain thresholds, conditioned pain modulation). The preoperative radiological severity of OA was graded according to the Kellgren-Lawrence (KL) classification. Persistent pain in the knee was recorded 12 months postoperatively. Generalized linear models explored differences in postoperative pain according to the KL grade, and combined preoperative pain and KL grade. Relative risk models explored which preoperative variables were associated with the high preoperative pain/low KL grade group.


Orthopaedic Proceedings
Vol. 104-B, Issue SUPP_7 | Pages 15 - 15
1 Jul 2022
Putnis S Klasan A Oshima T Grasso S Neri T Coolican M Fritsch B Parker D
Full Access

Abstract

Introduction

MRI has been increasingly used as an outcome measure and proxy for healing and integration after ACL reconstruction (ACLR). Despite this, it has not yet been established what a steady state graft MRI appearance is.

Methodology

MRI and clinical outcome measures were prospectively taken at 1 and minimum 2 years after hamstring autograft ACLR. MRI graft signal was measured using novel reconstructions both parallel and perpendicular to the graft, with lower signal indicative of better healing and expressed as the signal intensity ratio (SIR), and tunnel apertures analysed.


The Bone & Joint Journal
Vol. 103-B, Issue 6 Supple A | Pages 171 - 176
1 Jun 2021
Klasan A Schermuksnies A Gerber F Bowman M Fuchs-Winkelmann S Heyse TJ

Aims

The management of periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is challenging. The correct antibiotic management remains elusive due to differences in epidemiology and resistance between countries, and reports in the literature. Before the efficacy of surgical treatment is investigated, it is crucial to analyze the bacterial strains causing PJI, especially for patients in whom no organisms are grown.

Methods

A review of all revision TKAs which were undertaken between 2006 and 2018 in a tertiary referral centre was performed, including all those meeting the consensus criteria for PJI, in which organisms were identified. Using a cluster analysis, three chronological time periods were created. We then evaluated the antibiotic resistance of the identified bacteria between these three clusters and the effectiveness of our antibiotic regime.


Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_9 | Pages 8 - 8
1 Oct 2020
Klasan A Bowman M Schermuksnies A Gerber F Malcherczyk D Fuchs-Winkelmann S Heyse TJ
Full Access

Introduction

Management of periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is a challenging task. Antibiotic management remains elusive due to differences in epidemiology and resistance between countries and reports. Increasing resistance of bacteria is a concern. The aim of this study was to investigate the development of antibiotic resistance of main causative bacteria in a single center.

Methods

A retrospective review of all revision TKA between 2006 and 2018 in a tertiary referral center was performed. Included were cases meeting the consensus criteria for PJI with at least two positive cultures. Three chronological groups were created using a two-step cluster analysis.