In Scotland, the number of primary total knee replacements performed annually has been increasing steadily. The price of the implant is fixed but the length of hospital stay is variable. We prospectively investigated all patients who underwent primary unilateral
We describe the survivorship of the Medial Rotation
The purpose of this study was to investigate
whether a gender-specific high-flexion posterior-stabilised (PS)
total knee replacement (TKR) would offer advantages over a high-flex
PS
Systemic emboli released during
Aims. We conducted a randomised controlled trial to assess the accuracy
of positioning and alignment of the components in total knee arthroplasty
(TKA), comparing those undertaken using standard intramedullary
cutting jigs and those with patient-specific instruments (PSI). Patients and Methods. There were 64 TKAs in the standard group and 69 in the PSI group. The post-operative hip-knee-ankle (HKA) angle and positioning
was investigated using CT scans. Deviation of >
3° from the planned
position was regarded as an outlier. The operating time, Oxford
Knee Scores (OKS) and Short Form-12 (SF-12) scores were recorded. Results. There were 14 HKA-angle outliers (22%) in the standard group
and nine (13%) in the PSI group (p = 0.251). The mean HKA-angle
was 0.5° varus in the standard group and 0.2° varus in the PSI group
(p = 0.492). The accuracy of alignment in the coronal and axial
planes and the proportion of outliers was not different in the two
groups. The femoral component was more flexed (p = 0.035) and there
were significantly more tibial slope outliers (29% versus 13%)
in the PSI group (p = 0.032). Operating time and the median three-month
OKS were similar (p = 0.218 and p = 0.472, respectively). Physical
and mental SF-12 scores were not significantly different at three
months (p = 0.418 and p = 0.267, respectively) or at one year post-operatively
(p = 0.114 and p = 0.569). The median one-year Oxford knee score
was two points higher in the PSI group (p = 0.049). Conclusion. Compared with standard intramedullary jigs, the use of PSI did
not significantly reduce the number of outliers or the mean operating
time, nor did it clinically improve the accuracy of alignment or
the median Oxford Knee Scores. Our data do not support the routine
use of PSI when undertaking
A total of 445 consecutive primary total knee
replacements (TKRs) were followed up prospectively at six and 18 months
and three, six and nine years. Patients were divided into two groups:
non-obese (body mass index (BMI) <
30 kg/m. 2. ) and obese
(BMI ≥ 30 kg/m. 2. ). The obese group was subdivided into
mildly obese (BMI 30 to 35 kg/m. 2. ) and highly obese (BMI ≥ 35
kg/m. 2. ) in order to determine the effects of increasing
obesity on outcome. The clinical data analysed included the Knee
Society score, peri-operative complications and implant survival.
There was no difference in the overall complication rates or implant
survival between the two groups. Obesity appears to have a small but significant adverse effect
on clinical outcome, with highly obese patients showing lower function
scores than non-obese patients. However, significant improvements
in outcome are sustained in all groups nine years after
We suggest that different mechanisms underlie joint pain at rest and on movement in osteoarthritis and that separate assessment of these two features with a visual analogue scale (VAS) offers better information about the likely effect of a
We have compared the time to recovery of isokinetic
quadriceps strength after
In this paper, we will consider the current role
of simultaneous-bilateral
Intra-articular resection of bone with soft-tissue balancing and
The clinical results of bilateral
The long-term success of
There are several methods for evaluating stability
of the joint during
Objectives. A lack of connection between surgeons and patients in evaluating
the outcome of
We evaluated 535 consecutive primary cementless
Metallosis is a rare cause of failure after
Aims. The aims of this study were to determine the proportion of patients
with outlier varus or valgus alignment in kinematically aligned
total knee arthroplasty (TKA), whether those with outlier varus
or valgus alignment have higher forces in the medial or lateral
compartments of the knee than those with in-range alignment and
whether measurements of the alignment of the limb, knee and components
predict compartment forces. Patients and Methods. The intra-operative forces in the medial and lateral compartments
were measured with an instrumented tibial insert in 67 patients
who underwent a kinematically aligned
A series of 100 consecutive osteoarthritic patients was randomised to undergo
We assessed the effect of social deprivation
upon the Oxford knee score (OKS), the Short-Form 12 (SF-12) and patient
satisfaction after