The mobile-bearing total knee arthroplasty was designed to increase the contact area with the polyethylene bearing, through the functional range of motion, and subsequently decrease the wear rate previously seen in fixed-bearing implants. In the literature there is no clear clinical advantage between the different designs in the short to mid-term follow-up. The purpose of this study was to compare the results between a cruciate retaining mobile-bearing design (SAL II, Sulzer) and two cruciate retaining fixed-bearing designs (AMK, Depuy, and the Genesis II, Smith and Nephew). Ninety patients were randomised to receive either the mobile-bearing or one of the two fixed-bearing designs between 2000 and 2002. Patients were evaluated preoperatively and postoperatively using the WOMAC and the SF-12, both of which are validated scores. One patient was withdrawn due to dementia before three months and eleven patients died. Two patients were revised due to infection (both had received the SAL II). One patient was revised for aseptic loosening and one patient was revised for pain (both had received the Genesis II). Of the 74 patients (77 knees) that remain, they were last seen on average 6.4 years (2–10) after their surgery. Their average age at the surgery was 69.2 years (52–81).Purpose
Method
Unicompartmental versus total knee arthroplasty has been a debated topic for decades. The purpose of this study was to compare the survivorship and clinical outcomes of a large primary total knee arthroplasty versus unicompartmental knee arthroplasty cohort. A consecutive series of 6352 TKAs and 296 UKAs with a minimum of one year follow-up were evaluated. Pre-operative scores, latest scores, and change in clinical outcome scores (KSCRS, SF12, WOMAC) were compared and tested for significance using the students t-test.Purpose
Method
The pros and cons of general anesthesia versus spinal anesthesia in total hip arthroplasty has been a long debated topic. The purpose of this study was to compare the surgical times, blood loss and transfusion requirements between anesthetic types in patients undergoing primary total hip arthroplasty. A consecutive series of 1600 THA procedures with complete preoperative and postoperative data were evaluated. Twenty eight percent of procedures were performed with a general anesthetic (GA), 67% with a spinal anesthetic (SP) and 5% with a combination of the two. Outcomes were compared and tested for significance using the Independent Samples Kruskal Wallis or Pearson Chi-Square analysis.Purpose
Method
The purpose of this study was to compare the outcomes and complications of normal weight, class one obese (BMI=30-34.9 kg/m2) and superobese (BMI≥50 kg/m2) primary total knee replacement (TKR) patients. Between January 1995 and December 2005, 4104 primary TKR were performed in our centre. Patients were stratified for their obesity level according the World Health Organisation (WHO) and current surgical literature classification. Sixty-seven superobese patients (group one) were identified. They were matched with normal weight (group two) and class one obese (group three) primary TKR patients for sex, age, side, preoperative diagnosis, implants used, time since surgery and preoperative SF-12 mental component summary score (MCS). Patient clinical outcomes (WOMAC, SF-12 and Knee Society scores), radiographs, complications, readmissions, and revisions rates were compared for normal BMI, class one obese and superobese patients.Purpose
Method
The patella provides a mechanical advantage to the knee extensor mechanism. Patellectomy, performed for trauma or patellofemoral arthrosis, does not preclude the development of tibiofemoral arthrosis. Total knee arthroplasty is the mainstay of treatment for tibiofemoral arthrosis. The purpose of this study was to evaluate the outcomes of total knee arthoplasty in patients who previously underwent patellectomy. A retrospective analysis was completed on a prospectively collected database to identify all patients who underwent total knee arthroplasty following a previous patellectomy. Sixty-one total knee arthroplasties in 57 patients were identified. Patient demographics as well as functional outcome scores, including WOMAC and Knee Society Scores, were evaluated.Purpose
Method
