Aims. The use of high tibial osteotomy (HTO) to delay
Aims. The primary aim of this study was to compare the postoperative systemic inflammatory response in conventional jig-based
Aims. Loosening of components after
Aims. No predictive model has been published to forecast operating time for
Aims.
Aims. Blood transfusion and postoperative anaemia are complications of
Aims. The aims of this study were to investigate the ability to kneel after
Aims. This study aims to determine the rate of and risk factors for
Aims. Access to
Aims. In-hospital length of stay (LOS) and discharge dispositions following arthroplasty could act as surrogate measures for improvement in patient pathways, and have major cost saving implications for healthcare providers. With the ever-growing adoption of robotic technology in arthroplasty, it is imperative to evaluate its impact on LOS. The objectives of this study were to compare LOS and discharge dispositions following robotic arm-assisted
Aims. The success of
Aims. Mid-level constraint designs for
Aims. Despite new technologies for
Aims. The aim of this study was to compare a bicruciate-retaining (BCR)
Aims. Intraoperative pressure sensors allow surgeons to quantify soft-tissue balance during
Limb alignment in
Aims. Social determinants of health (SDOHs) may contribute to the total cost of care (TCOC) for patients undergoing
Aims. We aimed to assess the reliability and validity of OpenPose, a posture estimation algorithm, for measurement of knee range of motion after
Aims. Many surgeons choose to perform
Aims. Patients with a deformity of the hindfoot present a particular challenge when performing
Aims. The aim of this study was to investigate the distribution of phenotypes in Asian patients with end-stage osteoarthritis (OA) and assess whether the phenotype affected the clinical outcome and survival of mechanically aligned
Aims. It is unknown whether gap laxities measured in robotic arm-assisted
Aims. Recent
Aims. The primary aim of this study was to compare the migration of the femoral and tibial components of the cementless rotating platform Attune and Low Contact Stress (LCS)
Aims.
Aims. Although
Aims. This study aimed to investigate the relationship between changes in patellar height and clinical outcomes at a mean follow-up of 7.7 years (5 to 10) after fixed-bearing posterior-stabilized total knee arthroplasty (PS-TKA). Methods. We retrospectively evaluated knee radiographs of 165 knees, which underwent fixed-bearing PS-TKA with patella resurfacing. The incidence of patella baja and changes in patellar height over a minimum of five years of follow-up were determined using Insall-Salvati ratio (ISR) measurement. We examined whether patella baja (ISR < 0.8) at final follow-up affected clinical outcomes, knee joint range of motion (ROM), and Knee Society Score (KSS). We also assessed inter- and intrarater reliability of ISR measurements and focused on the relationship between patellar height reduction beyond measurement error and clinical outcomes. Results. The ISR gradually decreased over five years after
Aims. The objective of this study was to compare the two-year migration pattern and clinical outcomes of a
Aims. The tibial component of
Aims. While mechanical alignment (MA) is the traditional technique in
Aims. The removal of the cruciate ligaments in
Aims. Modern
Aims. Alternative alignment concepts, including kinematic and restricted kinematic, have been introduced to help improve clinical outcomes following
Aims. Robotic-assisted
Aims. This study aims to investigate the effects of posterior tibial slope (PTS) on knee kinematics involved in the post-cam mechanism in bi-cruciate stabilized (BCS)
Aims. Vitamin E-infused highly cross-linked polyethylene (E1) has recently been introduced in
Aims. Arthrodesis is rarely used as a salvage procedure for patients with a chronically infected
Aims. Unicompartmental knee arthroplasty (UKA) provides improved early functional outcomes and less postoperative morbidity and pain compared with
Aims. The aims of this study were: 1) to describe extended restricted kinematic alignment (E-rKA), a novel alignment strategy during robotic-assisted
Aims. Between 15% and 20% of patients remain dissatisfied following
Aims. Although bone cement is the primary mode of fixation in
Aims. We report the natural course of Baker’s cysts following
Aims. The primary aim of this study was to compare the knee-specific functional outcome of patellofemoral arthroplasty with
Aims. There is little literature about
Aims. The aim of this study was to characterize the factors leading to transfemoral amputation after
Aims. For many designs of
Aims. Anterior cruciate ligament (ACL) and multiligament knee (MLK) injuries increase the risk of development of knee osteoarthritis and eventual need for
Aims. Postoperative range of movement (ROM) is an important measure of successful and satisfying
Aims. The primary aim of this study was to assess whether pain in the contralateral knee had a clinically significant influence on the outcome of
Objectives. The use of the haptically bounded saw blades in robotic-assisted
Aims. The purpose of this study was to determine the impact of the removal of
Aims. The aim of this study was to assess the effect of posterior cruciate ligament (PCL) resection on flexion-extension gaps, mediolateral soft-tissue laxity, fixed flexion deformity (FFD), and limb alignment during posterior-stabilized (PS)
Aims. With an ageing population of patients who are infected with hepatitis C virus (HCV), the demand for
Aims. The aim of this study was to analyze the true costs associated with preoperative CT scans performed for robotic-assisted
Aims. This study aimed to evaluate the association between the sagittal alignment of the femoral component in
Objectives. Little biomechanical information is available about kinematically aligned (KA)
Advances in polyethylene (PE) in total hip arthroplasty
have led to interest and increased use of highly crosslinked PE
(HXLPE) in
Aims. It is unknown whether kinematic alignment (KA) objectively improves knee balance in
Aims. Patellofemoral problems are a common complication of
Aims. The purpose of the present study was to compare patient-specific instrumentation (PSI) and conventional surgical instrumentation (CSI) for
Aims. A retrospective study was conducted to measure short-term in vivo linear and volumetric wear of polyethylene (PE) inserts in 101
Aims. There are comparatively few randomized studies evaluating knee arthroplasty prostheses, and fewer still that report longer-term functional outcomes. The aim of this study was to evaluate mid-term outcomes of an existing implant trial cohort to document changing patient function over time following
Objectives. Malalignment of the tibial component could influence the long-term survival of a
Aims. The primary aim of this study was to assess the rate of patient
satisfaction one year after
Aims. Our intention was to investigate if the highly porous biological fixation surfaces of a new 3D-printed
Aims. The best marker for assessing glycaemic control prior to
We explored the literature surrounding whether
allergy and hypersensitivity has a clinical basis for implant selection
in
Aims. A significant percentage of patients remain dissatisfied after
Aims. The results of irrigation and debridement with component retention (IDCR) in the treatment of acutely infected
Aims. The primary aim of this study was to assess whether patient satisfaction
one year after
Aims. The aim of this study was to assess the effectiveness of perioperative essential amino acid (EAA) supplementation to prevent rectus femoris muscle atrophy and facilitate early recovery of function after
Aims. Patient-specific instrumentation of
Aims. The aim of this study was to evaluate the effects of using a
portable, accelerometer-based surgical navigation system (KneeAlign2)
in
Aims. This study investigated the influence of body mass index (BMI)
on patients’ function and quality of life ten years after total
knee arthroplasty (TKA). Patients and Methods. A total of 126 patients who underwent unilateral TKA in 2006
were prospectively included in this retrospective study. They were
categorized into two groups based on BMI: < 30 kg/m. 2. (control)
and ≥ 30 kg/m. 2. (obese). Functional outcome was assessed
using the Knee Society Function Score (KSFS), Knee Society Knee
Score (KSKS), and Oxford Knee Score (OKS). Quality of life was assessed
using the Physical (PCS) and Mental Component Scores (MCS) of the 36-Item
Short-Form Health Survey. Results. Patients in the obese group underwent
Objectives. Tranexamic acid (TXA) is an antifibrinolytic agent used as a blood-sparing technique in
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
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
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
The aim of this study was to determine the general postoperative opioid consumption and rate of appropriate disposal of excess opioid prescriptions in patients undergoing primary unilateral total knee arthroplasty (TKA). In total, 112 patients undergoing surgery with one of eight arthroplasty surgeons at a single specialty hospital were prospectively enrolled. Three patients were excluded for undergoing secondary procedures within six weeks. Daily pain levels and opioid consumption, quantity, and disposal patterns for leftover medications were collected for six weeks following surgery using a text-messaging platform.Aims
Patients and Methods
This review summarises the opinions and conclusions
reached from a symposium on infected
The aim of this study was to find anatomical
landmarks for rotational alignment of the tibial component in total knee
replacement (TKR) in a CT-based study. Pre-operative CT scanning
was performed on 94 South Korean patients (nine men, 85 women, 188
knees) with osteoarthritis of the knee joint prior to
Our objective is to describe our early and mid-term results with the use of a new simple primary knee prosthesis as an articulating spacer in planned two-stage management for infected knee arthroplasty. As a second objective, we compared outcomes between the group with a retained first stage and those with a complete two-stage revision. We included 47 patients (48 knees) with positive criteria for infection, with a minimum two-year follow-up, in which a two-stage approach with an articulating spacer with new implants was used. Patients with infection control, and a stable and functional knee were allowed to retain the initial first-stage components. Outcomes recorded included: infection control rate, reoperations, final range of motion (ROM), and quality of life assessment (QoL) including Western Ontario and McMaster Universities osteoarthritis index, Knee Injury and Osteoarthritis Outcome Score, Oxford Knee Score, 12-Item Short-Form Health Survey questionnaire, and University of California Los Angeles (UCLA) activity score and satisfaction score. These outcomes were evaluated and compared to additional cohorts of patients with retained first-stage interventions and those with a complete two-stage revision. Mean follow-up was 3.7 years (2.0 to 6.5).Aims
Methods
The aim of this study was to investigate the incidence of knee arthroplasty and arthroscopy following patellar fractures, and to compare this with an age- and gender-matched group without a prior patellar fracture. A national matched cohort study based on the Danish National Patient Register including all citizens of Denmark (approximately 5.3 million) was undertaken. A total of 6096 patients who sustained a patellar fracture in Denmark between 1 January 1996 and 31 December 2000 were included. The median age of these patients was 50.6 years (interquartile range (IQR) 28.5 to 68.9); 49.1% were women. Patients were followed-up until 31 December 2015, with regard to treatment with knee arthroplasty and/or knee arthroscopy.Aims
Patients and Methods
We performed a CT-based computer simulation study
to determine how the relationship between any inbuilt posterior
slope in the proximal tibial osteotomy and cutting jig rotational
orientation errors affect tibial component alignment in total knee
replacement. Four different posterior slopes (3°, 5°, 7° and 10°),
each with a rotational error of 5°, 10°, 15°, 20°, 25° or 30°, were
simulated. Tibial cutting block malalignment of 20° of external
rotation can produce varus malalignment of 2.4° and 3.5° with a
7° and a 10° sloped cutting jig, respectively. Care must be taken in
orientating the cutting jig in the sagittal plane when making a
posterior sloped proximal tibial osteotomy in
In a randomised controlled pragmatic trial we
investigated whether local infiltration analgesia would result in earlier
readiness for discharge from hospital after total knee replacement
(TKR) than patient-controlled epidural analgesia (PCEA) plus femoral
nerve block. A total of 45 patients with a mean age of 65 years
(49 to 81) received a local infiltration with a peri-articular injection
of bupivacaine, morphine and methylprednisolone, as well as adjuvant
analgesics. In 45 PCEA+femoral nerve blockade patients with a mean
age of 67 years (50 to 84), analgesia included a bupivacaine nerve
block, bupivacaine/hydromorphone PCEA, and adjuvant analgesics.
The mean time until ready for discharge was 3.2 days (1 to 14) in
the local infiltration group and 3.2 days (1.8 to 7.0) in the PCEA+femoral
nerve blockade group. The mean pain scores for patients receiving
local infiltration were higher when walking (p = 0.0084), but there
were no statistically significant differences at rest. The mean
opioid consumption was higher in those receiving local infiltration. The choice between these two analgesic pathways should not be
made on the basis of time to discharge after surgery. Most secondary
outcomes were similar, but PCEA+femoral nerve blockade patients
had lower pain scores when walking and during continuous passive
movement. If PCEA+femoral nerve blockade is not readily available, local
infiltration provides similar length of stay and similar pain scores
at rest following