With the advent of newer diagnostic imaging tools, the reported prevalence of acute pulmonary embolism (PE) following total hip (THA) and total knee (TKA) arthroplasty appears to be increasing. However, the true prevalence and clinical relevance of these events are unclear. Our study was designed to evaluate the results of routine multi-detector computed tomography (MDCT) in this patient population in the early postoperative period. We prospectively performed MDCT scans on 48 consecutive THA/TKA patients on the first postoperative day in 2009. Patients underwent routine postoperative care and data were collected regarding the development of symptoms such as tachycardia, fever, chest pain, or shortness of breath. Scans were kept blinded and read at the end of study recruitment for the diagnosis of acute PE.Purpose
Method
Although total knee replacement (TKR) has a high reported success rate, the pain relief and functional improvement after surgery varies. We asked what is the prevalence of patients showing no clinically significant improvement 1-year after TKR, and what are the patient level factors that may predict this outcome. We reviewed primary TKR registry data that were collected from two academic hospitals: the Toronto Western Hospital (TWH) and the Henderson Hospital(HH) in Ontario. Relevant covariates including demographic data, body mass index, and comorbidity were recorded. Knee joint pain and functional status were assessed at baseline and at 1-year follow-up with the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Oxford knee score (OKS) to measure the change using the minimal clinically important difference (MCID). Logistic regression modeling was used to identify the predictors of interest.Purpose
Method
Total knee arthroplasty (TKA) is the preferred treatment for those with end stage osteoarthritis (OA) and severe functional limitations. With the demographic transition in society, TKA is being offered to a younger patient population. Younger patients are generally more active requiring an increased range of motion, and place greater physiological demands on the prosthesis than typical older patients. The mobile bearing (MB) total knee prosthesis has theoretically been designed to meet these demands. We conducted a meta-analysis and systematic review of randomized controlled trials comparing outcomes of MB and fixed bearing (FB) TKA. After testing for publication bias and heterogeneity, the data were aggregated by fixed effects modelling. Our searches identified 14 studies for reporting our primary outcome of Knee Society Scores (KSS). We also pooled data for post-operative range of motion (ROM) and Hospital for Special Surgery scores (HSS).Purpose
Method
