Objectives. The medially spherical GMK Sphere (Medacta International AG, Castel San Pietro, Switzerland)
Aims. The number of revision total knee arthroplasties (TKA) that are
performed is expected to increase. However, previous reports of
the causes of failure after
Objectives. Malrotation of the femoral component can result in post-operative complications in
Aims. This study investigated the influence of body mass index (BMI)
on the post-operative fall in the level of haemoglobin (Hb), length
of hospital stay (LOS), 30-day re-admission rate, functional outcome
and quality of life, two years after
Aims. The aims of this study were to compare the efficacy and safety
of intra-articular and intravenous (IV) tranexamic acid (TXA) in
controlling perioperative blood loss in total knee arthroplasty
(TKA) using a randomized, double-blinded equivalence trial. Patients and Methods. A total of 182 patients aged between 45 and 75 years undergoing
unilateral
Aims. Our aim was to compare kinematic with mechanical alignment in
total knee arthroplasty (TKA). Patients and Methods. We performed a prospective blinded randomised controlled trial
to compare the functional outcome of patients undergoing
Knee arthroplasty surgery is a highly effective treatment for arthritis and disorders of the knee. There are a wide variety of implant brands and types of knee arthroplasty available to surgeons. As a result of a number of highly publicized failures, arthroplasty surgery is highly regulated in the UK and many other countries through national registries, introduced to monitor implant performance, surgeons, and hospitals. With time, the options available within many brand portfolios have grown, with alternative tibial or femoral components, tibial insert materials, or shapes and patella resurfacings. In this study we have investigated the effect of the expansion of implant brand portfolios and where there may be a lack of transparency around a brand name. We also aimed to establish the potential numbers of compatible implant construct combinations. Hypothetical implant brand portfolios were proposed, and the number of compatible implant construct combinations was calculated.Aims
Methods
The rate of peri-prosthetic infection following
total joint replacement continues to rise, and attempts to curb
this trend have included the use of antibiotic-loaded bone cement
at the time of primary surgery. We have investigated the clinical-
and cost-effectiveness of the use of antibiotic-loaded cement for
primary
The outcome of
We conducted a meta-analysis, including randomised
controlled trials (RCTs) and cohort studies, to examine the effect
of patient-specific instruments (PSI) on radiological outcomes after
total knee replacement (TKR) including: mechanical axis alignment
and malalignment of the femoral and tibial components in the coronal,
sagittal and axial planes, at a threshold of >
3º from neutral.
Relative risks (RR) for malalignment were determined for all studies
and for RCTs and cohort studies separately. Of 325 studies initially identified, 16 met the eligibility criteria,
including eight RCTs and eight cohort studies. There was no significant
difference in the likelihood of mechanical axis malalignment with
PSI versus conventional
Objectives. Unicompartmental knee arthroplasty (UKA) is a potential treatment
for isolated bone on bone osteoarthritis when limited to a single
compartment. The risk for revision of UKA is three times higher
than for
Aims. We wished to compare the clinical outcome, as assessed by questionnaires
and the rate of complications, in
Aims. The aim of this study was to compare the effectiveness of a femoral
nerve block and a periarticular infiltration in the management of
early post-operative pain after
Aims. This non-blinded randomised controlled trial compared the effect
of patient-controlled epidural analgesia (PCEA) versus local
infiltration analgesia (LIA) within an established enhanced recovery
programme on the attainment of discharge criteria and recovery one
year after
Aims. There are two techniques widely used to determine the rotational
alignment of the components in
Objectives. Nylon sutures and skin staples are used commonly in
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
Aims. Adductor canal block (ACB) has emerged as an alternative to femoral nerve block (FNB) for analgesia after
Patient-specific cutting guides (PSCGs) are designed
to improve the accuracy of alignment of
This prospective randomised controlled double-blind
trial compared two types of PFC Sigma