Stress fractures at tracker after computer navigated total knee replacement are rare. Periprosthetic fracture after Minimally Invasive Plate Osteosynthesis (MIPO) of stress fracture through femoral tracker is unique in orthopaedic literature. We are reporting this unique presentation of periprosthetic fractures after MIPO for stress fracture involving femoral pin site track in computer assisted total knee arthroplasty, treated by reconstruction nail (PFNA). A 75-year old female, who had computer navigated right total knee replacement, was admitted 6 weeks later with increasing pain over distal thigh for 3 weeks without trauma. Prior to onset of pain, she achieved a range of movements of 0–105 degrees. Perioperative radiographs did not suggest obvious osteoporosis, pre-existent benign or malignant lesion, or fracture. Radiographs demonstrated transverse fracture of distal third of femur through pin site track. We fixed the fracture with 11-hole combihole locking plate by MIPO technique. Eight weeks later, she was readmitted with periprosthetic fracture through screw hole at the tip of MIPO Plate and treated by Reconstruction Nail (PFNA), removal of locking screws and refixation of intermediate segment with unicortical locking screws. Then she was protected with plaster cylinder for 4 weeks and hinged brace for 2 months.Background
Methods
Positive expectations can increase compliance with treatment and realistic expectations may reduce postoperative dissatisfaction. Recently there are articles regarding expectations of patients from their TKA in western literature and only few articles based on Korean populations which don't encompass the whole spectrum of expectations in Korean patients. In all those articles based on pre-operative expectation, results were applied to whole expectation category uniformly not differentially. We aimed to document the pre-operative expectations in Korean patients undergoing total knee replacement using an established survey form and to determine whether expectations were influenced by socio-demographic factors and socio-demographic factors influences expectation items in particular category uniformly or differentially. Expectations regarding 19 items in the Knee Replacement Expectation Survey form were investigated in 228 patients scheduled for total knee replacement. The levels and distribution patterns of individual and summated expectation of five expectation categories; relief from pain, baseline activity, high flexion activity, social activity and psychological wellbeing, constructed from the 19 items were assessed. Univariate analyses and Binary logistic regression were performed and analyzed to examine the association of expectations with the socio-demographic factors.Introduction
Methods
Unicompartmental knee arthroplasty (UKA) is becoming an increasingly popular option in single compartment osteoarthritis. As a result, diverse re-operations including revisions to total knee arthroplasty (TKA) has also increase. The objective of this study is to investigate the distribution of causes of re-operations after UKA and to analyze the types of re-operations. We retrospectively reviewed 691 UKAs performed on 595 patients between January 2003 and December 2011. Except in one case, all UKAs were performed for medial compartment osteoarthritis of the knee. The UKAs were performed in 487 (81.8%) women and 108 (18.2%) men. The mean age at the time of UKA was 61.5 years (47 to 88 years). Mobile-bearing designs were implanted in 627 (90.7%) knees (626- Oxford knee and 1- Scorpio knee) and fixed designs were implanted in 64 (9.3%) knees (42- Tornier and 18- Zimmer). The mean interval between UKA and second operation was 15.4 months (10 days to 10 years) and between second and third operation was 7.7 months (5 weeks to 17 months). In the re-operation group, there were 50 knees (48 patients) with 38 female and 10 male patients.Introduction
Method
Significant donor site morbidity (3–61%) has been associated with tri-cortical iliac crest bone graft harvesting and reconstruction of the defect has been shown to reduce it. Chitra-HABG (Chitra-Hydroxyapatite-Bio-active glass ceramic composite) is an indigenously developed ceramic which has been evaluated as a bone graft substitute. To prospectively validate the hypothesis that iliac crest donor site morbidity is a structural issue and reconstructing the crest reduces its incidence. The study also evaluates the efficacy of Chitra - HABG as a material for reconstructing the crest.Introduction
Aim