Between 1969 and 1971 20 prototypes of the Stanmore total knee prosthesis were used to replace severely arthritic knees in 18 patients. Seven patients died before the final follow-up and one had to have her leg amputated because of deep infection; in none of these patients had the prosthesis become loose. Ten patients (11 knees) were reviewed at least 10 years after operation. There was no significant clinical deterioration in 7 of these 11 surviving knees when the results at one year were compared with those at 10 years.
One hundred and three sequential Stanmore knee replacements were reviewed retrospectively on two occasions with a maximal follow-up period of nine years three months. This knee prosthesis, which is hinged, was successful in alleviating pain, stabilising an unstable knee and modestly increasing the arc of flexion. Walking capacity was increased and flexion contractures were reduced. There were seven cases of infection and four of fracture around the prosthesis. All these proved difficult to treat and two knees with both fracture and infection needed amputation. Eight knees were revised for aseptic loosening and a further 14 were found to have radiological signs of loosening. The results have been analysed by the methods advocated by Tew and Waugh and give a cumulative success rate of 80 per cent at seven years, provided success is judged solely by whether the prosthesis is still in situ. The role of the Stanmore knee as a primary arthroplasty is discussed.
Aims. The patient-acceptable symptom state (PASS) is a level of wellbeing, which is measured by the patient. The aim of this study was to determine if the proportion of patients who achieved an acceptable level of function (PASS) after medial unicompartmental knee arthroplasty (UKA) was different based on the status of the anterior cruciate ligament (ACL) at the time of surgery. Methods. A total of 114 patients who underwent UKA for isolated medial osteoarthritis (OA) of the knee were included in the study. Their mean age was 65 years (SD 10). No patient underwent a bilateral procedure. Those who had undergone ACL reconstruction during the previous five years were excluded. The Knee injury Osteoarthritis Outcome Score Activities of Daily Living (KOOS ADL) function score was used as the primary outcome measure with a PASS of 87.5, as described for
Aims. The aim of this study was to determine the risk of tibial eminence avulsion intraoperatively for bi-unicondylar knee arthroplasty (Bi-UKA), with consideration of the effect of implant positioning, overstuffing, and sex, compared to the risk for isolated medial unicondylar knee arthroplasty (UKA-M) and bicruciate-retaining
Aims.
We performed a prospective study of 54 patients (76 knees) who underwent Osteonics series 3000 cruciate-retaining cementless total knee arthroplasty between December 1990 and June 1993. Five patients (seven knees) were lost to follow-up (90.7% completion). One patient required revision at 10.5 years after operation. The rate of survival was 100% at ten years and 96.7% at 13 years. The mean ten-year knee and function scores were 79 and 59 respectively. Both were significantly better than the pre-operative scores. The range of movement also improved. Although a radiolucent line around the tibial component enlarged in six knees (20.7%) at ten years, the clinical outcome was generally good. In a patient who died after 5.5 years, post-mortem examination of the knee showed no bony ingrowth into the tibial component. Despite poor bony ingrowth, press-fit fixation was satisfactory and good results can be obtained with this cementless, cruciate-retaining prosthesis.
Aims. Revision total knee arthroplasty (rTKA) is a technically challenging and costly procedure. It is well-documented that primary TKA (pTKA) have better survivorship than rTKA; however, we were unable to identify any studies explicitly investigating previous rTKA as a risk factor for failure following rTKA. The purpose of this study is to compare the outcomes following rTKA between patients undergoing index rTKA and those who had been previously revised. Methods. This retrospective, observational study reviewed patients who underwent unilateral, aseptic rTKA at an academic orthopaedic speciality hospital between June 2011 and April 2020 with > one-year of follow-up. Patients were dichotomized based on whether this was their first revision procedure or not. Patient demographics, surgical factors, postoperative outcomes, and re-revision rates were compared between the groups. Results. A total of 663 cases were identified (486 index rTKAs and 177 multiply revised TKAs). There were no differences in demographics, rTKA type, or indication for revision. Multiply revised patients had significantly longer rTKA operative times (p < 0.001), and were more likely to be discharged to an acute rehabilitation centre (6.2% vs 4.5%) or skilled nursing facility (29.9% vs 17.5%; p = 0.003). Patients who had been multiply revised were also significantly more likely to have subsequent reoperation (18.1% vs 9.5%; p = 0.004) and re-revision (27.1% vs 18.1%; p = 0.013). The number of previous revisions did not correlate with the number of subsequent reoperations (r = 0.038; p = 0.670) or re-revisions (r = −0.102; p = 0.251). Conclusion. Multiply revised
Aims. This study aimed to compare the effect of antibiotic-loaded bone cement (ALBC) versus plain bone cement (PBC) on revision rates for periprosthetic joint infection (PJI) and all-cause revisions following primary elective total hip arthroplasty (THA) and
Aims. The aims of this study were to evaluate wear on the surface of cobalt-chromium (CoCr) femoral components used in
Aims. Treatment outcomes for methicillin-resistant Staphylococcus aureus (MRSA) periprosthetic joint infection (PJI) using systemic vancomycin and antibacterial cement spacers during two-stage revision arthroplasty remain unsatisfactory. This study explored the efficacy and safety of intra-articular vancomycin injections for PJI control after debridement and cement spacer implantation in a rat model. Methods.
Aims. Cementless total knee arthroplasty (TKA) offers the potential for strong biological fixation compared with cemented
Arterial complications occurring in association with knee replacement surgery are rare, even though most patients having this operation are elderly and therefore more likely to have peripheral vascular disease. We report a patient who developed an arterial complication during the course of a knee replacement operation, as well as the results of a survey of Fellows of the Australian Orthopaedic Association. Recommendations to minimise this serious complication are proposed.