Medical advances and an ageing population mean that more people than ever rely on artificial joints. In the past years, shoulder joint replacement has developed rapidly and the numbers of shoulder prostheses implanted increased dramatically. Wear is one of the main contributors to the failure of shoulder implants. It is therefore important to measure the wear properties of the articulating surfaces within the joint Imperial shoulder simulator was designed with six articulating stations and one loaded soak control station for anatomical shoulder system wear simulation. It gives an adduction-abduction (AA) range of-15° to 55°, flexion-extension (FE) range of −90° to 90° and internal external rotation (IER) range of 15° to −90°. The rotations are applied simultaneously to the humeral implants by using stepper motors with integral position encoders. Axial and shear loadings to each glenoid implant were applied using pneumatic cylinders. Force controlled translations were recorded using load cells and LVDTs, and a data acquisition system. Pneumatic cylinders were also installed to work to counterbalance weights during the motion of adduction-abduction. All bearing pairs are within isolated and sealed test chambers to prevent loss of fluid through evaporation, and cross contamination of third body wear (as recommended in F1714-96). The simulator is controlled by LabVIEW program allowing to reproduce shoulder activities of daily living.Background
Materials and Methods
The aim of this study was to compare the accuracy of limb alignment and component positioning after total knee arthroplasty(TKA) performed using fixed or individual distal femoral valgus correction angle(VCA)in valgus knees. One hundred and twenty-four patients were randomised to undergo TKA with either of the clinical baseline, radiological outcomes and subsequent outcome such as knee HSS scores, knee range of motion (ROM) and visual analogue scale (VAS) scores were assessed. Knees in the individual group (n=62) were performed with a tailored VCA. Knees in the fixed group (n=62) were performed utilizing a 4°VCA.Purpose
Materials and Methods
Recently many authors have questioned the role of tourniquets in primary knee arthroplasty (TKA). Meanwhile, whether the use of an intra-articular wound drainage is an advance over the lack of a drain in TKA is controversial in the literature. This study aimed to investigate the efficacy and safety of drainage or not in TKA without a tourniquet. Eighty participants who underwent primary unilateral TKA were prospectively enrolled and were randomized to one of two techniques during surgery without a tourniquet: drainage (Group A) or non-drainage (Group B). Blood loss was monitored perioperatively. The operating time, allogeneic blood transfusion rate, thigh pain, knee pain, limb swelling, clinical outcome as measured by the hospital for special surgery (HSS) score, the ability to straight-leg raise, visual analog scale (VAS) in pain, length of stay and knee active range of motion (ROM) were also recorded. The digital radiographs taken at 6 months postoperatively were assessed for cement mantle thickness and radiolucency using the Knee Society radiographic zones.Purpose
Methods
There is controversial whether synovectomy must be done in primary total knee arthroplasty (TKA). The objectivity of the study was to compare the effect of synovectomy on inflammation and clinical outcomes after surgical treatment of knee osteoarthritis. A total of 240 patients who underwent primary unilateral TKR were randomly divided into a group without (Group A) and with synovectomy (Group B). All operations were performed by the same surgeon and follow-up was for 4 year. Clinical outcomes (including American Knee Society score (AKS), SF-36, and HSS scores) serum inflammatory markers (including interleukin-6 (IL-6), CRP and ESR) and the difference in temperature of the affected knee skin, swelling, ROM, patients VAS satisfaction score and VAS pain score were sequentially evaluated until 4 years after surgery.Purpose
Methods
Previous studies have demonstrated pronounced reduction of sleep quality following major surgery, which may affect postoperative pain and early recovery. This prospective, randomized, controlled trial was designed to evaluate the effect of zolpidem on sleep quality in fast-track total knee arthroplasty (TKA). 180 patients who underwent primary TKA were enrolled in this study and randomized 1:1 to receive either zolpidem (Group A) or placebo (Group B) for 6 days. VAS pain scores (rest, ambulation, flexion, and night), range of motion (ROM), opioid analgesics use, postoperative nausea and vomiting (PONV) and other complication, sleep efficacy and patients VAS satisfaction were recorded postoperatively and at 1, 3, 5 after surgery. Sleep quality was measured using the polysomnography (PSG) and Epworth Sleepiness Scale.Purpose
Methods