Knee

Latest journal articles about knee arthroplasty and reconstruction from Journal of Arthroplasty, Knee Surgery, Sports Traumatology, Arthroscopy, Knee, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Tantalum cones for major osteolysis in revision knee replacement. Bone Joint J. 2013 Aug 1;95-B(8):1069-1074 Authors: Rao BM, Kamal TT, Vafaye J, Moss M Abstract

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Related Articles Obesity has no adverse effect on the outcome of unicompartmental knee replacement at a minimum follow-up of seven years. Bone Joint J. 2013 Aug 1;95-B(8):1064-1068 Authors: Cavaignac E, Lafontan V, Reina N, Pailhé R, Warmy M, Laffosse JM, Chiron P Abstract

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Related Articles Is there reduced polyethylene wear and longer survival when using a mobile-bearing design in total knee replacement?: A meta-analysis of randomised and non-randomised controlled trials. Bone Joint J. 2013 Aug 1;95-B(8):1057-1063 Authors: Zeng Y, Shen B, Yang J, Zhou ZK, Kang PD, Pei FX Abstract The purpose of this study was to undertake a meta-analysis to determine whether there is lower polyethylene wear and longer survival when using mobile-bearing implants in total knee replacement when compared with fixed-bearing implants. Of 975 papers identified, 34 trials were eligible for data extraction and meta-analysis comprising 4754 patients (6861 knees). We found no statistically significant differences between the two designs in terms of the incidence of radiolucent lines, osteolysis, aseptic loosening or survival. There is thus currently no evidence to suggest that the use of mobile-bearing designs reduce polyethylene wear and prolong survival after total knee replacement. Cite this article: Bone Joint J 2013;95-B:1057-63. PMID: 23908420 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23908420?dopt=Abstract

Related Articles The Oxford Unicompartmental Knee Fails at a High Rate in a High-volume Knee Practice. Clin Orthop Relat Res. 2013 Aug 2; Authors: Schroer WC, Barnes CL, Diesfeld P, Lemarr A, Ingrassia R, Morton DJ, Reedy M Abstract BACKGROUND: The Oxford knee is a unicompartmental implant featuring a mobile-bearing polyethylene component with excellent long-term survivorship results reported by the implant developers and early adopters. By contrast, other studies have reported higher revision rates in large academic practices and in national registries. Registry data have shown increased failure with this implant especially by lower-volume surgeons and institutions. QUESTIONS/PURPOSES: In the setting of a high-volume knee arthroplasty practice, we sought to determine (1) the failure rate of the Oxford unicompartmental knee implant using a failure definition for aseptic loosening that combined clinical features, plain radiographs, and scintigraphy, and (2) whether increased experience with this implant would decrease failure rate, if there is a learning curve effect.

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Related Articles A Prospective Double-Blind Placebo Controlled Trial of Topical Tranexamic Acid in Total Knee Arthroplasty. J Arthroplasty. 2013 Jul 29; Authors: Georgiadis AG, Muh SJ, Silverton CD, Weir RM, Laker MW Abstract Tranexamic acid (TNA) reduces postoperative blood loss in general and obstetrical surgery but there is limited orthopaedic literature regarding its use in the topical setting. To study the effect of topical TNA after primary total knee arthroplasty (TKA), 101 patients were randomized to topical administration of 2.0g TNA in 75mL of normal saline (50 patients) or placebo (51 patients). Operative technique, drug administration, and venous thromboembolism prophylaxis were standardized. All patients underwent screening ultrasound of the operative extremity. Total blood loss was lower in the TNA group (940.2±327.1mL) than the placebo group (1293.1±532.7mL)(P<0.001), and four patients in the placebo group and none in the TNA group received postoperative transfusion (P=0.118). We recommend administration of topical TNA in primary TKA in healthy patients to decrease perioperative blood loss. PMID: 23906869 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23906869?dopt=Abstract

Related Articles Analysis of Tibial Component Rotation Following Total Knee Arthroplasty Using 3D High Definition Computed Tomography. J Arthroplasty. 2013 Jul 29; Authors: Roper GE, Bloemke AD, Roberts CC, Spangehl MJ, Clarke HD Abstract Malrotation of the tibial component is associated with poor outcomes after total knee arthroplasty, yet the definition and evaluation of this problem remain controversial. Contributing factors to this controversy include inconsistent and cumbersome methods for measuring rotation, based upon transposed measurements from multiple computed tomography images. We developed and tested the reliability of a new, simple method for measuring tibial component rotation based upon a single, three-dimensional high definition, axial computed tomography image. Sixty individual knees after total knee arthroplasty were evaluated. The intra-reliability and inter-reliability both exceeded 0.9 whether the tibial component was made of titanium, cobalt-chrome or all-polyethylene. Based upon these findings we suggest that this technique be used for evaluating tibial component rotation in future studies. PMID: 23906867 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23906867?dopt=Abstract

Related Articles Does Vitamin D Improve Osteoarthritis of the Knee: A Randomized Controlled Pilot Trial. Clin Orthop Relat Res. 2013 Aug 1; Authors: Sanghi D, Mishra A, Sharma AC, Singh A, Natu SM, Agarwal S, Srivastava RN Abstract BACKGROUND: Animal, epidemiologic, and human clinical studies suggest a putative role for vitamin D in osteoarthritis (OA). Inadequate sunlight exposure and lower serum levels of 25(OH)D appear in some reports to be associated with an increased risk for progression of knee OA. QUESTIONS/PURPOSES: We asked whether treatment with vitamin D would (1) reduce knee pain (WOMAC and VAS), (2) improve function (WOMAC), and (3) change levels of relevant biochemical markers in patients with knee OA with vitamin D insufficiency. METHODS: This randomized controlled pilot trial prospectively enrolled 107 patients with knee OA with vitamin D insufficiency (25(OH)D ≤ 50 nmol/L) to receive oral vitamin D or placebo. The primary outcome measures were pain and function, and the secondary were biochemical markers. At baseline, the two groups were comparable. The patients were followed for 1 year. RESULTS: At 12 months, knee pain had decreased in the vitamin D group by mean -0.26 (95% CI, -2.82 to -1.43) on VAS and -0.55 (95% CI, -0.07 to 1.02) on the WOMAC, whereas in the placebo group, it increased by mean 0.13 (95% CI, -0.03 to 0.29) on the VAS and 1.16 (95% CI, 0.82 to 1.49) on the WOMAC (effect size = 0.37 and

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Related Articles Total knee arthroplasty with patient-specific instruments improves function and restores limb alignment in patients with extra-articular deformity. Knee. 2013 Jul 27; Authors: Thienpont E, Paternostre F, Pietsch M, Hafez M, Howell S Abstract BACKGROUND: Restoring function and alignment when treating knee arthritis with a total knee arthroplasty (TKA) in patients who have an extra-articular deformity (EAD) from a malunion or with retained femoral hardware is a challenge. The normal anatomical landmarks are hard to find and difficult to use to obtain correct alignment. The procedure will be further challenged by angular deformity of the femur or tibia. A retrospective study was performed on a case series of patients with EAD or obliteration of the canal treated with patient-specific instruments (PSI). METHODS: A multicenter retrospective review of 10 patients with multiplanar deformities in which the knee components were aligned with patient-specific instruments was performed. Outcome and alignment were studied.

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Related Articles Range of motion and function are not affected by increased post constraint in patients undergoing posterior stabilized total knee arthroplasty. Knee. 2013 Jul 27; Authors: King BR, Gladnick BP, Lee YY, Lyman S, Della Valle AG Abstract BACKGROUND: Constrained primary total knee arthroplasty (TKA) can provide stability in the face of incompetent collateral structures or irreconcilable flexion-extension imbalances. However, little is known about its effect on overall knee range of motion (ROM). This study determines whether TKA with increased constraint affects postoperative ROM. METHODS: Patients undergoing primary TKA using either posterior stabilized (PS) or constrained condylar knee (CCK) inserts were match-paired based on body mass index, preoperative ROM, and direction and severity of the coronal deformity, yielding 68 pairs. ROM and Knee Society Score (KSS) were obtained preoperatively and at 6weeks, 4months, and 1year. RESULTS: When the 68 matched pairs were considered, all outcome variables related to ROM between the PS and CCK groups at each of the postoperative intervals were similar. Additionally, both the individual items and combined scores of the KSS were similar between groups at all time points. CONCLUSIONS: We demonstrate that the use of increased constraint does not affect ROM, relief of pain, or function after TKA.

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