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 Predicting Acute Recovery of Physical Function Following Total Knee Joint Arthroplasty. J Arthroplasty. 2013 Jul 25; Authors: Robbins SM, Rastogi R, McLaughlin TL Abstract The objective was to explore predictors of physical function during acute in-patient rehabilitation within a few days after TKA. Physical function status of participants (n = 72) three days after total knee arthroplasty (TKA) was measured using the Timed Up and Go Test (TUG) and the function subscale of the Western Ontario McMaster Universities Index of Osteoarthritis (WOMAC-function). Potential predictors of physical function were measured day one post-TKA. Their relationship with physical function was examined using backward elimination, multiple regression analyses. Older age and increased comorbidity were associated (R(2) = 0.20) with worse TUG times. Increased pain severity was associated (R(2) = 0.08) with worse WOMAC-function scores. Age, comorbidity, and pain severity should be considered when predicting which patients will struggle with acute recovery post-TKA. PMID: 23891055 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23891055?dopt=Abstract

Related Articles Preoperative Patient Characteristics and Outcomes of Total Knee Arthroplasty in a Multiethnic Asian Population Stratified by Ethnicity. J Arthroplasty. 2013 Jul 25; Authors: Jiang L, Bin Abd Razak HR, Chong HC, Tan A Abstract We aim to compare the patient profile and outcomes after TKA between the different racial groups in Singapore. Prospective data were collected from 364 patients who underwent TKA in Singapore General Hospital from January 2006 to May 2010. Patients were stratified according to ethnicity and we compared their preoperative demographic data, Short-Form 36 (SF-36), Oxford Knee (OKS) as well as Knee Society Scores (KSS). Malays were younger (62.0±5.3) at time of surgery (p=0.05) and the body mass index of Chinese (27.9±4.7) was lower than Malay (30.4±5.0) and Indian (31.5±4.5) patients (P<0.005). Malay (40.3±11.0) and Indian (39.2±9.3) patients had less favourable preoperative OKS than Chinese (35.9±7.8) patients (P<0.05). All 3 ethnic groups achieved statistically significant improvements in outcome measures but did not differ significantly between the ethnicities. PMID: 23891052 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23891052?dopt=Abstract

Related Articles Comparison of Outcomes and Survivorship Between Patients of Different Age Groups Following TKA. J Arthroplasty. 2013 Jul 23; Authors: McCalden RW, Robert CE, Howard JL, Naudie DD, McAuley JP, Macdonald SJ Abstract A total of 6275 consecutive TKA patients were divided into three groups based on their age: <55, 55-70 and >70years. There was a statistically significant difference in the change in WOMAC score (32 vs 31 vs 26, P<0.001) and Knee Society Score (78.9 vs 76.0 vs 69.0, P<0.001) favoring the younger populations. However, the revision rate was higher in the younger patients with a Kaplan-Meier survivorship at 5years of 95.5%, 97.2% and 98.1% and at 10years of 92.2%, 95.9% and 97.6%. Infection was the most frequent cause for failure in all groups although aseptic loosening and instability accounted for the increased revision rate in the younger patients. Younger patients may experience slightly better clinical outcomes following TKA but lower survivorship, when compared to older patient populations. PMID: 23890522 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23890522?dopt=Abstract

Related Articles Conflict of Interest in the Assessment of Hyaluronic Acid Injections for Osteoarthritis of the Knee: An Updated Systematic Review. J Arthroplasty. 2013 Jul 23; Authors: Printz JO, Lee JJ, Knesek M, Urquhart AG Abstract The search results of a recent systematic review of prospective, randomized, placebo-controlled trials on hyaluronic acid injections for knee arthritis were updated and reviewed for funding source and qualitative conclusions. Forty-eight studies were identified; 30 (62.5%) were industry funded, and 3 (6.25%) were not. Fifteen (31.3%) studies did not identify a funding source. An association was observed between a reported potential financial conflict of interest of the author and the qualitative conclusion (P=0.018). None of the studies with a reported financial conflict of interest of at least one author had an unfavorable conclusion; 11 (35%) of the 31 studies with no industry-affiliated authors indicated that hyaluronic acid injection for knee osteoarthritis was no more effective than a placebo injection. PMID: 23890521 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23890521?dopt=Abstract

Related Articles Improvement of femoral component size prediction using a C-arm intensifier guide and our established algorithm in unicompartmental knee arthroplasty: A report from a Chinese population. Knee. 2013 Jul 23; Authors: Tu Y, Xue H, Cai M, Ma T, Liu X, Xia Z Abstract BACKGROUND: Unicompartmental knee arthroplasty (UKA) is becoming more widely used with the recent increase in popularity of the use of minimally invasive techniques. However, it is difficult to judge about the femoral component size in UKA using preoperative templating digitally or otherwise. Even when using navigation it is impossible to control the femoral component size. The aim of this study is to develop a better pre- or intra-operative measure that will predict femoral component size. METHODS: Ninety-two UKA cases were studied from June 2007 to December 2011 with a mean 26-month follow-up. We developed an intra-operative C-arm intensifier guide (CAIG) method for determining femoral size instead of pre-operative templating. The accuracy of prediction of both methods was compared from a review of post-operative radiographs. In addition, we summarized all cases and developed a Chinese algorithm to determine the femoral component size pre-operatively.

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Related Articles The effects of femoral external derotational osteotomy on frontal plane alignment. Knee Surg Sports Traumatol Arthrosc. 2013 Jul 26; Authors: Nelitz M, Wehner T, Steiner M, Dürselen L, Lippacher S Abstract PURPOSE: Femoral osteotomies are the preferred treatment in significant torsional deformity of the femur. The influence of torsional osteotomies on frontal plane alignment is poorly understood. Therefore, the aim of the present study was to evaluate the effects of external derotational osteotomies on proximal, mid-shaft and distal levels onto frontal plane alignment. METHODS: The effect of rotation around the anatomical axis of the femur on frontal plane alignment was determined with a 3D computer model, created from CT data of a right human cadaver femur. Virtual torsional osteotomies of 10°, 20° and 30° were performed at proximal, mid-shaft and distal levels under five antecurvatum angles of the femur. The change of the frontal plane alignment was expressed by the mechanical lateral femoral angle.

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Related Articles Why are Total Knee Arthroplasties Being Revised? J Arthroplasty. 2013 Jul 22; Authors: Dalury DF, Pomeroy DL, Gorab RS, Adams MJ Abstract Despite technical improvements, revision rates for total knee arthroplasties (TKAs) remain high. Our goal was to report the reason(s) for revision TKA in a large, current, multicenter series and compare those reasons with previously published reasons. We retrospectively identified 820 consecutive revision TKAs (693 patients, 2000-2012) from our 3 centers and recorded the primary reason for the revision. The top seven reasons for the revision were aseptic loosening (23.1%), infection (18.4%), polyethylene wear (18.1%), instability (17.7%), pain/stiffness (9.3%), osteolysis (4.5%), and malposition/malalignment (2.9%). Comparison with previously published reasons showed fewer TKA revisions for polyethylene wear, osteolysis, instability, and malalignment. These changes may represent improvements in surgical technique and implants. PMID: 23886410 [PubMed - as supplied by publisher]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23886410?dopt=Abstract

Related Articles Revision of Unicompartmental Arthroplasty to Total Knee Arthroplasty: Not Always a Slam Dunk! J Arthroplasty. 2013 Jul 22; Authors: Sierra RJ, Kassel CA, Wetters NG, Berend KR, Della Valle CJ, Lombardi AV Abstract OBJECTIVE: As the number of UKA performed in the world continues to increase, so will the number of failures. A better understanding of the outcomes after revision UKAto TKA is warranted. The objective of this study is to report the outcomes of modern UKA revised to TKA in three US centers. METHODS: A total of 175 revisions of medial UKA in 168 patients (81 males, 87 females; average age of 66years) performed from 1995 to 2009 in three institutions and with a minimum of 2-year clinical follow-up were reviewed. Individual joint registries and chart reviews were performed to collect data regarding reasons for revision, type of implants used, and re-revision rates.

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Related Articles Does Adding Antibiotics to Cement Reduce the Need for Early Revision in Total Knee Arthroplasty? Clin Orthop Relat Res. 2013 Jul 25; Authors: Bohm E, Zhu N, Gu J, de Guia N, Linton C, Anderson T, Paton D, Dunbar M Abstract BACKGROUND: There is considerable debate about whether antibiotic-loaded bone cement should be used for fixation of TKAs. While antibiotics offer the theoretical benefit of lowering early revision due to infection, they may weaken the cement and thus increase the likelihood of aseptic loosening, perhaps resulting in a higher revision rate. QUESTIONS/PURPOSES: We (1) compared the frequency of early knee revision arthroplasty in patients treated with antibiotic-loaded or non-antibiotic-loaded cement for initial fixation, (2) determined effects of age, sex, comorbidities, and surgeons' antibiotic-loaded cement usage patterns on revision rate, and (3) compared causes of revision (aseptic or septic) between groups. METHODS: Our study sample was taken from the Canadian Joint Replacement Registry and Canada's Hospital Morbidity Database and included cemented TKAs performed between April 1, 2003, and March 31, 2008, including 20,016 TKAs inserted with non-antibiotic-loaded cement and 16,665 inserted with antibiotic-loaded cement. Chi-square test was used to compare the frequency of early revisions between groups. Cox regression modeling was used to determine whether revision rate would change by age, sex, comorbidities,

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Related Articles Trabecular Metal in Total Knee Arthroplasty Associated with Higher Knee Scores: A Randomized Controlled Trial. Clin Orthop Relat Res. 2013 Jul 25; Authors: Fernandez-Fairen M, Hernández-Vaquero D, Murcia A, Torres A, Llopis R Abstract BACKGROUND: Porous tantalum is an option of cementless fixation for TKA, but there is no randomized comparison with a cemented implant in a mid-term followup. QUESTIONS/PURPOSES: We asked whether a tibial component fixed by a porous tantalum system might achieve (1) better clinical outcome as reflected by the Knee Society Score (KSS) and WOMAC Osteoarthritis Index, (2) fewer complications and reoperations, and (3) improved radiographic results with respect to aseptic loosening compared with a conventional cemented implant. METHODS: We randomized 145 patients into two groups, either a porous tantalum cementless tibial component group (Group 1) or cemented conventional tibial component in posterior cruciate retaining TKA group (Group 2). Patients were evaluated preoperatively and 15 days, 6 months, and 5 years after surgery, using the KSS and the WOMAC index. Complications, reoperations, and radiographic failures were tallied.

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