We performed a meta-analysis investigating the association between preoperative psychological distress and postoperative pain and function after total knee arthroplasty (TKA). Pubmed/Medline, Embase, PsycINFO, and the Cochrane library were searched for studies on the influence of preoperative psychological distress on postoperative pain and physical function after TKA. Two blinded reviewers screened for eligibility and assessed the risk of bias and the quality of evidence. We used random effects models to pool data for the meta-analysis.Aims
Materials and Methods
Patient-specific instrumentation of total knee arthroplasty (TKA) is a technique permitting the targeting of individual kinematic alignment, but deviation from a neutral mechanical axis may have implications on implant fixation and therefore survivorship. The primary objective of this randomized controlled study was to compare the fixation of tibial components implanted with patient-specific instrumentation targeting kinematic alignment (KA+PSI) A total of 47 patients due to undergo TKA were randomized to KA+PSI (n = 24) or MA+CAS (n = 23). In the KA+PSI group, there were 16 female and eight male patients with a mean age of 64 years (Aims
Patients and Methods
Although knee osteoarthritis (OA) is diagnosed and monitored radiologically, actual full-thickness cartilage loss (FTCL) has rarely been correlated with radiological classification. This study aims to analyze which classification system correlates best with FTCL and to assess their reliability. A prospective study of 300 consecutive patients undergoing unilateral total knee arthroplasty (TKA) for OA (mean age 69 years (44 to 91; standard deviation (SD) 9.5), 178 (59%) female). Two blinded examiners independently graded preoperative radiographs using five common systems: Kellgren-Lawrence (KL); International Knee Documentation Committee (IKDC); Fairbank; Brandt; and Ahlbäck. Interobserver agreement was assessed using the intraclass correlation coefficient (ICC). Intraoperatively, anterior cruciate ligament (ACL) status and the presence of FTCL in 16 regions of interest were recorded. Radiological classification and FTCL were correlated using the Spearman correlation coefficient.Aims
Methods
There has been a significant reduction in unicompartmental knee arthroplasty (UKA) procedures recorded in Australia. This follows several national joint registry studies documenting high UKA revision rates when compared to total knee arthroplasty (TKA). With the recent introduction of robotically assisted UKA procedures, it is hoped that outcomes improve. This study examines the cumulative revision rate of UKA procedures implanted with a newly introduced robotic system and compares the results to one of the best performing non-robotically assisted UKA prostheses, as well as all other non-robotically assisted UKA procedures. Data from the Australian Orthopaedic Association National Joint Arthroplasty Registry (AOANJRR) for all UKA procedures performed for osteoarthritis (OA) between 2015 and 2018 were analyzed. Procedures using the Restoris MCK UKA prosthesis implanted using the Mako Robotic-Arm Assisted System were compared to non-robotically assisted Zimmer Unicompartmental High Flex Knee System (ZUK) UKA, a commonly used UKA with previously reported good outcomes and to all other non-robotically assisted UKA procedures using Cox proportional hazard ratios (HRs) and Kaplan-Meier estimates of survivorship.Aim
Methods
The aim of this study was to evaluate the effects of using a
portable, accelerometer-based surgical navigation system (KneeAlign2)
in total knee arthroplasty (TKA) on the alignment of the femoral
component, and blood loss. A total of 241 consecutive patients with primary osteoarthritis
of the knee were enrolled in this prospective, randomised controlled
study. There were 207 women and 34 men. The mean age of the patients
was 74.0 years (57 to 89). The KneeAlign2 system was used for distal
femoral resection in 121 patients (KA2 group) and a conventional intramedullary
femoral guide was used in 120 patients (IM group).Aims
Patients and Methods
Bone void fillers are increasingly being used for dead space management in arthroplasty revision surgery. The aim of this study was to investigate the influence of calcium sulphate bone void filler (CS-BVF) on the damage and wear of total knee arthroplasty using experimental wear simulation. A total of 18 fixed-bearing U2 total knee arthroplasty system implants (United Orthopedic Corp., Hsinchu, Taiwan) were used. Implants challenged with CS-BVF were compared with new implants (negative controls) and those intentionally scratched with a diamond stylus (positive controls) representative of severe surface damage (n = 6 for each experimental group). Three million cycles (MC) of experimental simulation were carried out to simulate a walking gait cycle. Wear of the ultra-high-molecular-weight polyethylene (UHMWPE) tibial inserts was measured gravimetrically, and damage to articulating surfaces was assessed using profilometry.Objectives
Methods
Aims
Patients and Methods
Altered alignment and biomechanics are thought to contribute to the progression of osteoarthritis (OA) in the native compartments after medial unicompartmental knee arthroplasty (UKA). The aim of this study was to evaluate the bone activity and remodelling in the lateral tibiofemoral and patellofemoral compartment after medial mobile-bearing UKA. In total, 24 patients (nine female, 15 male) with 25 medial Oxford UKAs (13 left, 12 right) were prospectively followed with sequential 99mTc-hydroxymethane diphosphonate single photon emission CT (SPECT)/CT preoperatively and at one and two years postoperatively, along with standard radiographs and clinical outcome scores. The mean patient age was 62 years (40 to 78) and the mean body mass index (BMI) was 29.7 kg/m2 (23.6 to 42.2). Mean osteoblastic activity was evaluated using a tracer localization scheme with volumes of interest (VOIs). Normalized mean tracer values were calculated as the ratio between the mean tracer activity in a VOI and background activity in the femoral diaphysis.Aims
Patients and Methods
Responsiveness to clinically important change is a key feature of any outcome measure. Throughout Europe, health-related quality of life following total knee arthroplasty (TKA) is routinely measured with EuroQol five-dimension (EQ-5D) questionnaires. The Patient-Reported Outcomes Measurement Information System 10-Question Short-Form (PROMIS-10 Global Health) score is a new general heath outcome tool which is thought to offer greater responsiveness. Our aim was to compare these two tools. We accessed data from a prospective multicentre cohort study in the United Kingdom, which evaluated outcomes following TKA. The median age of the 721 patients was 69.0 years (interquartile range, 63.3 to 74.6). There was an even division of sex, and approximately half were educated to secondary school level. The preoperative EQ-5D, PROMIS-10, and Oxford Knee Scores (OKS) were available and at three, six, and 12 months postoperatively. Internal responsiveness was assessed by standardized response mean (SRM) and effect size (Cohen’s Aims
Patients and Methods
The purpose of this study was to evaluate trends in opioid use
after unicompartmental knee arthroplasty (UKA), to identify predictors
of prolonged use and to compare the rates of opioid use after UKA,
total knee arthroplasty (TKA) and total hip arthroplasty (THA). We identified 4205 patients who had undergone UKA between 2007
and 2015 from the Humana Inc. administrative claims database. Post-operative
opioid use for one year post-operatively was assessed using the
rates of monthly repeat prescription. These were then compared between
patients with and without a specific variable of interest and with
those of patients who had undergone TKA and THA.Aims
Materials and Methods
The aim of this study was to determine if the Oxford Knee and Hip Score (OKHS) can accurately predict when a primary knee or hip referral is deemed nonsurgical We retrospectively reviewed pre-consultation OKHS for all consecutive primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) consultations of a single surgeon over three years. The 1436 knees (1016 patients) and 478 hips (388 patients) included were categorized based on the surgeon’s decision into those offered surgery during the first consultation Aims
Patients and Methods
The primary aim of this study was to assess the rate of patient
satisfaction one year after total knee arthroplasty (TKA) according
to the focus of the question asked. The secondary aims were to identify
independent predictors of patient satisfaction according to the
focus of the question. A retrospective cohort of 2521 patients undergoing a primary
unilateral TKA were identified from an established regional arthroplasty
database. Patient demographics, comorbidities, Western Ontario and
McMaster Universities Osteoarthritis Index (WOMAC) and 12-Item Short-Form
Health Survey (SF-12) scores were collected preoperatively and one
year postoperatively. Patient satisfaction was assessed using four
questions, which focused on overall outcome, activity, work, and
pain. Logistic regression analysis was used to identify independent
preoperative predictors of increased stiffness when adjusting for
confounding variables.Aims
Patients and Methods
The outcome of total knee arthroplasty (TKA) is not always satisfactory.
The purpose of this study was to identify satisfaction and biomechanical
features characterising the gait of patients who had undergone TKA
with either an anatomical single radius design or a medial pivot
design. We hypothesised that the latter would provide superior function. This is a study of a subset of patients recruited into a prospective
randomised study of a single radius design Aims
Patients and Methods
The aim of this study was to evaluate the long-term inducible
displacement of cemented tibial components ten years after total
knee arthroplasty (TKA). A total of 15 patients from a previously reported prospective
trial of fixation using radiostereometric analysis (RSA) were examined
at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine
RSA examinations were acquired at one week, one year, and two years
postoperatively and at final follow-up. Weight-bearing RSA examinations
were also undertaken with the operated lower limb in neutral and
in maximum internal rotation positions. Maximum total point motion
(MTPM) was calculated for the longitudinal and inducible displacement examinations
(supine Aims
Patients and Methods
The aim of this study was to determine if positive Waddell signs
were related to patients’ demographics or to perception of their
quality of life. This prospective cross-sectional study included 479 adult patients
with back pain from a university spine centre. Each completed SF-12
and Oswestry Disability Index (ODI) questionnaires and underwent
standard spinal examinations to elicit Waddell signs. The relationship
between Waddell signs and age, gender, ODI, Mental Component Score
(MCS), and Physical Component Score (PCS) scores was determined.Aims
Patients and Methods
To investigate the risk factors for progression of articular
cartilage damage after anatomical anterior cruciate ligament (ACL)
reconstruction. A total of 174 patients who underwent second-look arthroscopic
evaluation after anatomical ACL reconstruction were enrolled in
this study. The graded condition of the articular cartilage at the
time of ACL reconstruction was compared with that at second-look
arthroscopy. Age, gender, body mass index (BMI), ACL reconstruction
technique, meniscal conditions, and other variables were assessed
by regression analysis as risk factors for progression of damage
to the articular cartilage.Aims
Patients and Methods
The aim of this study was to assess the influence of obesity on the clinical outcomes and survivorship ten years postoperatively in patients who underwent a fixed-bearing unicompartmental knee arthroplasty (UKA). We prospectively followed 184 patients who underwent UKA between 2003 and 2007 for a minimum of ten years. A total of 142 patients with preoperative body mass index (BMI) of < 30 kg/m2 were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2 were in the obese group (five male, 37 female). Pre- and postoperative range of movement (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS), 36-Item Short-Form Health Survey (SF-36), and survivorship were analyzed.Aims
Patients and Methods
To determine whether the findings from a landmark Canadian trial
assessing the optimal management of acute rupture of the Achilles
tendon influenced the practice patterns of orthopaedic surgeons
in Ontario, Canada. Health administrative databases were used to identify Ontario
residents ≥ 18 years of age with an Achilles tendon rupture from
April 2002 to March 2014. The rate of surgical repair (per 100 cases)
was calculated for each calendar quarter. A time-series analysis
was used to determine whether changes in the rate were chronologically
related to the dissemination of results from a landmark trial published
in February 2009. Non-linear spline regression was then used independently
to identify critical time-points of change in the surgical repair
rate to confirm the findings.Aims
Materials and Methods
