33,545 results match your criteria Total Knee Arthroplasty


Safety of one-stage bilateral total knee arthroplasty -one surgeon sequential vs. two surgeons simultaneous: a randomized controlled study.

Int Orthop 2020 Jul 10. Epub 2020 Jul 10.

Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv., Fatih, 34093, İstanbul, Turkey.

Purpose: This study aimed to examine the complications by comparing two surgeons simultaneous bilateral total knee arthroplasty (two-surgeon bilateral TKA) to one surgeon sequential bilateral total knee arthroplasty (single-surgeon bilateral TKA).

Methods: Two hundred forty-six participants were prospectively randomized into two groups: two-surgeon bilateral TKA and single-surgeon bilateral TKA. While two surgeons performed simultaneous total knee arthroplasty in the two-surgeon bilateral TKA group, one surgeon performed sequentially in the single-surgeon bilateral TKA group. Read More

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http://dx.doi.org/10.1007/s00264-020-04704-9DOI Listing

Three-step technique for implantation of rotating hinge knee prostheses : Demonstration using the Enduro prosthesis.

Authors:
B Fink D Stefanou

Oper Orthop Traumatol 2020 Jul 10. Epub 2020 Jul 10.

Department of Joint Replacement, General and Rheumatic Orthopaedics, Orthopaedic Clinic Markgröningen gGmbH, Kurt-Lindemann-Weg 10, 71706, Markgröningen, Germany.

Objective: Implantation of an axis-guided knee prosthesis with consideration of the joint line and balanced flexion and extension gap to reduce the mechanical load on the prosthesis axis and to improve the movement of the prosthesis.

Indications: Distinct unilateral instability due to ligament insufficiency in association with knee prostheses. Primary implantation of axis-guided knee prostheses with pronounced axial malalignment (>20-25° valgus or varus malalignment) or/and severe flexion contracture > 40°. Read More

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http://dx.doi.org/10.1007/s00064-020-00672-wDOI Listing

More Severe Radiographic Osteoarthritis Is Associated With Increased Improvement in Patients' Health State Following a Total Knee Arthroplasty.

J Arthroplasty 2020 Jun 17. Epub 2020 Jun 17.

Department of Orthopaedic Surgery, Lovisenberg Diaconal Hospital, Oslo, Norway.

Background: To assess whether preoperative radiological severity of osteoarthritis (OA) is related to the level of improvement in patients' health state measured 1 year after total knee arthroplasty (TKA).

Methods: Radiographic severity of OA was graded using the Kellgren-Lawrence (KL) classification. Two independent observers were blinded to patients' outcome scores. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.025DOI Listing

Meta-analysis in periprosthetic joint infection: a global bibliometric analysis.

J Orthop Surg Res 2020 Jul 10;15(1):251. Epub 2020 Jul 10.

Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Charitéplatz 1, D-10117, Berlin, Germany.

Background: Periprosthetic joint infection (PJI) is the most serious complication of joint replacement surgery. Further comorbidities include bedsore, deep vein thrombosis, reinfection, or even death. An increasing number of researchers are focusing on this challenging complication. Read More

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http://dx.doi.org/10.1186/s13018-020-01757-9DOI Listing

Efficacy and safety of systemic tranexamic acid administration in total knee arthroplasty: A case series.

Int J Surg Case Rep 2020 Jun 22;73:90-94. Epub 2020 Jun 22.

Department of Orthopedic Surgery and Traumatology Saint Georges University Medical Center, Balamand University, P.O. Box 166378, Achrafieh, Beirut, 1100 2807, Lebanon. Electronic address:

Introduction: Total knee arthroplasty (TKA) are associated with significant postoperative blood loss. Tranexamic acid (TXA) is a potent agent with antifibrinolytic activity, that can be administered via the intravenous (IV) and/or topical (intra-articular, IA) route, which can possibly interrupt the cascade of events due to hemostatic irregularities close to the source of bleeding. However, the literature contains scarce scientific evidence related to IV only TXA usage in TKA. Read More

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http://dx.doi.org/10.1016/j.ijscr.2020.06.077DOI Listing

Hip abductor strength and lower limb load on non-operating predicts functional mobility in women patients with total hip arthroplasty.

Am J Phys Med Rehabil 2020 Jul 6. Epub 2020 Jul 6.

Rehabilitation Unit, Kyoto University Hospital, Sakyo-ku, Kyoto, Japan.

Objective: The aim of this study was to identify which aspect of the pre-operative lower limb functions is most likely to affect the functional mobility at 6 months after total hip arthroplasty (THA).

Design: The study subjects included 125 women who underwent THA. Hip flexion and abduction angles, hip abductor and knee extensor strengths, and lower limb load were measured preoperatively. Read More

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http://dx.doi.org/10.1097/PHM.0000000000001523DOI Listing

Periprosthetic Joint Infection with Listeria monocytogenes: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e1900489

1Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.

Case: A 67-year-old immunocompromised woman presented with 2 weeks of atraumatic knee pain 4 months after a primary total knee arthroplasty. The patient had a history of consuming unpasteurized dairy products and horse rearing. The patient underwent a successful irrigation, debridement, polyethylene liner exchange, and adjunct antibiotic therapy for a periprosthetic joint infection (PJI). Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00489DOI Listing

Catastrophic Polyethylene Failure and Fractured Femoral Component in Modern Knee Arthroplasty Design: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e1900552

1Sunnybrook Holland Centre, University of Toronto, Toronto, Canada 2Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences, Toronto, Canada.

Case: We report a 67-year-old gentleman who presented with a painful unstable knee. He had undergone a successful total knee arthroplasty 12 years earlier and was highly functional. He presented with a 10-month history of mild pain, instability, and gait alteration. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00552DOI Listing

Mycobacterium fortuitum Prosthetic Joint Infection After Total Hip Arthroplasty: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0343

1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 2Department of Orthopaedic Surgery, Adult Hip and Knee Reconstruction, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 3Section of Infectious Diseases, Pennsylvania Hospital, Philadelphia, Pennsylvania.

Case: A 57-year-old man presented with a Mycobacterium fortuitum prosthetic joint infection (PJI) after right total hip arthroplasty refractory to the initial revision surgery and cement spacer placement. The patient was subsequently treated with 2-stage total joint arthroplasty revision surgery using an antibiotic-laden spacer customized to include meropenem and delayed reimplantation to allow for prolonged, systemic antimicrobial treatment with multiple antimicrobials, including levofloxacin and linezolid.

Conclusions: There is little evidence to guide practitioners in the diagnosis and treatment of PJI caused by rare, rapidly growing mycobacteria (RGM) such as M. Read More

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http://dx.doi.org/10.2106/JBJS.CC.18.00343DOI Listing

Flexible Intramedullary Nailing in High-Energy Tibial Fractures With Extensive Soft-Tissue Loss: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0030

1Department of Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, South Korea.

Case Report: An 83-year-old woman presented with a high-energy tibial fracture. We treated her with temporary external fixation and delayed flexible intramedullary nailing because of extensive soft-tissue damage and interference from the hardware retained from a previous total knee arthroplasty.

Conclusions: In our opinion, flexible intramedullary nailing is an effective procedure and provides good functional and radiological results in high-energy tibial fractures with extensive soft-tissue loss. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00030DOI Listing

Nonoperative Treatment of a Pathologic Proximal Tibia Fracture in the Setting of Previous Total Knee Arthroplasty: A Case Report.

JBJS Case Connect 2020 Apr-Jun;10(2):e0517

1Department of Orthopaedics and Rehabilitation, University of Iowa Hospital & Clinics, Iowa City, Iowa 2Department of Orthopaedic Surgery, OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.

Case: We present the case of a super obese 51-year-old woman with a pathologic fracture of the proximal tibia in the setting of a previous total knee arthroplasty. Imaging demonstrated an osteolytic lesion distal to the keel and pathologic fracture of the proximal tibia. Nonoperative treatment with a 12-week course of nonweight-bearing resulted in fracture healing and ossification of osteolysis. Read More

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http://dx.doi.org/10.2106/JBJS.CC.19.00517DOI Listing

Why don't patients seek help for chronic post-surgical pain after knee replacement? A qualitative investigation.

Health Expect 2020 Jul 9. Epub 2020 Jul 9.

Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Bristol, UK.

Background: Although many people are satisfied with their outcome after total knee replacement surgery for osteoarthritis, around 20% report chronic post-surgical pain. People are often disappointed and unsure about whether their pain is normal and what can be done about it. Given the high prevalence of long-term post-operative pain after knee replacement, there is potentially a large hidden population with an unaddressed need for care. Read More

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http://dx.doi.org/10.1111/hex.13098DOI Listing

Predictive value of magnetic resonance imaging (MRI) measures for the occurrence of total knee arthroplasty in knee osteoarthritis.

Ann Transl Med 2020 Jun;8(12):772

Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou 510000, China.

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http://dx.doi.org/10.21037/atm.2020.02.174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333097PMC

One-staged surgical management of large-scale skin necrosis after total knee arthroplasty: a case report (CARE-compliant).

Ann Transl Med 2020 Jun;8(12):771

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Total knee arthroplasty (TKA) is a common surgical procedure performed in clinical settings. However, postoperative skin necrosis surrounding the incision can be a devastating complication. A large area of black necrotic skin was observed at the incision and anterolateral side of the right knee in a 78-year-old female patient after TKA. Read More

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http://dx.doi.org/10.21037/atm-20-4445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333138PMC

Extensor Mechanism Reconstruction Using Marlex Mesh: Is Postoperative Casting Mandatory?

J Arthroplasty 2020 Jun 18. Epub 2020 Jun 18.

Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.

Background: Extensor mechanism (EM) disruption after total knee arthroplasty is a catastrophic complication. Reconstruction using monofilament polypropylene mesh (Marlex Mesh; CR Bard, Franklin Lakes, NJ) has emerged as the preferred treatment, but reports are limited to the designing institution. This study describes a nondesigner experience and compares 2 postoperative immobilization strategies: long leg cast vs knee immobilizer. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.037DOI Listing

Walking Speed and Maximal Knee Flexion During Gait After Total Knee Arthroplasty: Minimal Clinically Important Improvement Is Not Determinable; Patient Acceptable Symptom State Is Potentially Useful.

J Arthroplasty 2020 May 26. Epub 2020 May 26.

Clinical Research Center, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Clinical Epidemiology, Department of Health and Community Medicine, University Hospitals of Geneva, Geneva, Switzerland.

Background: Total knee arthroplasty (TKA) is the operation of choice in patients with end-stage knee osteoarthritis (OA). Up to 1 in 5 patients still encounter functional limitations after TKA, partly explaining patient dissatisfaction. Which gait ability to target after TKA remains unclear. Read More

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http://dx.doi.org/10.1016/j.arth.2020.05.038DOI Listing

Aggravation of Ankle Varus Incongruency Following Total Knee Replacement Correcting ≥10° of Genu Varum Deformity: A Radiographic Assessment.

J Arthroplasty 2020 Jun 17. Epub 2020 Jun 17.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea.

Background: This study aimed to investigate the change in ankle varus incongruencies following total knee replacement (TKR) in patients with preoperative genu varum deformity of ≥10°.

Methods: The study cohort was composed of patients who underwent TKR in a single institution for knee osteoarthritis with preoperative genu varum deformity of ≥10° and concomitant varus ankle incongruencies. Eight radiographic measurements were evaluated preoperatively and postoperatively: mechanical tibiofemoral angle, mechanical lateral distal femoral angle, medial proximal tibial angle, lateral distal tibial angle, tibial plafond inclination, talar inclination, tibiotalar tilt angle (TTTA), and tibia-mechanical axis angle. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.027DOI Listing

No differences in cost-effectiveness and short-term functional outcomes between cemented and uncemented total knee arthroplasty.

BMC Musculoskelet Disord 2020 Jul 9;21(1):448. Epub 2020 Jul 9.

Department of Orthopaedics, Leiden University Medical Center, Leiden, the Netherlands.

Background: There is an ongoing debate regarding optimal fixation of total knee arthroplasty (TKA), however cost has not been addressed as profoundly. Therefore, the current study primarily aimed to compare costs and cost-effectiveness 1 year after cemented or uncemented TKA. A secondary objective was to compare short-term functional outcomes between both groups. Read More

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http://dx.doi.org/10.1186/s12891-020-03477-xDOI Listing

Impact of comorbidity on the short- and medium-term risk of revision in total hip and knee arthroplasty.

BMC Musculoskelet Disord 2020 Jul 9;21(1):447. Epub 2020 Jul 9.

Agency for Heath Quality and Assessment of Catalonia (AQuAS), Carrer de Roc Boronat, 81, 08005, Barcelona, Spain.

Background: The impact of comorbidity on the risk of revision in patients undergoing Total Knee arthroplasty (TKA) and Total Hip Arthroplasty (THA) is not currently well known. The aim of this study was to analyze the impact of comorbidity on the risk of revision in TKA and THA.

Methods: Patients recorded in the Catalan Arthroplasty Register (RACat) between 01/01/2005 and 31/12/2016 undergoing TKA (n = 49,701) and THA (n = 17,923) caused by osteoarthritis were included. Read More

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http://dx.doi.org/10.1186/s12891-020-03455-3DOI Listing

[Nerve Injuries in Hip and Knee Arthroplasty - Risk Factors, Diagnostic and Therapeutic Approaches].

Z Orthop Unfall 2020 Jul 9. Epub 2020 Jul 9.

Iatrogenic nerve injuries are rare complications of total hip and knee arthroplasty, which may cause chronic pain and loss of function, severely affecting the patient's daily activities and quality of life. Nerves "at risk" include the sciatic nerve, the femoral nerve, the lateral femoral cutaneous nerve and the superior gluteal nerve during total hip arthroplasty, and the infrapatellar branch of the saphenous nerve as well as the peroneal nerve during total knee arthroplasty. Multiple procedure-related and patient-related factors have been identified to modify the risk of nerve injury in the course of lower limb joint replacement surgery. Read More

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http://dx.doi.org/10.1055/a-0915-9272DOI Listing

Reoperation Rates following Meniscus Transplantation using the Truven Database.

Arthroscopy 2020 Jul 6. Epub 2020 Jul 6.

Department of Orthopaedic Surgery, Stanford University Medical Center, Palo Alto, California, USA.

Purpose: The purpose of this study was to determine the (1) reoperation rate and (2) 30-day complication rate in a large insurance database.

Methods: The Truven Database was queried for subjects that underwent meniscus allograft transplantation (CPT code 29868) in the outpatient setting with minimal two year follow up. Patients without confirmed laterality and patients that underwent concomitant ligament reconstruction were excluded. Read More

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http://dx.doi.org/10.1016/j.arthro.2020.06.031DOI Listing

A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis.

Musculoskeletal Care 2020 Jul 9. Epub 2020 Jul 9.

Department of Orthopaedics, Leiden University Medical Center (LUMC), Leiden, The Netherlands.

Objective: The purpose of this paper is to revise the 2010 Dutch guideline for physical therapy (PT) in patients with hip or knee osteoarthritis (OA), issued by the Royal Dutch Society for Physical Therapy (KNGF).

Method: This revised guideline was developed according to the Appraisal of Guidelines for Research and Evaluation (AGREE) and Guidelines International Network (G-I-N) standards. A multidisciplinary guideline panel formulated clinical questions based on perceived barriers to current care. Read More

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http://dx.doi.org/10.1002/msc.1492DOI Listing

Why are patients dissatisfied following a total knee replacement? A systematic review.

Int Orthop 2020 Jul 8. Epub 2020 Jul 8.

Department of Trauma and Orthopaedics, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Box 37, Hills Road, Cambridge, CB2 0QQ, UK.

Background: Although total knee replacement (TKR) is an effective intervention for end-stage arthritis of the knee, a significant number of patients remain dissatisfied following this procedure. Our aim was to identify and assess the factors affecting patient satisfaction following a TKR.

Materials And Methods: In accordance with the PRISMA guidelines, two reviewers searched the online databases for literature describing factors affecting patient satisfaction following a TKR. Read More

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http://dx.doi.org/10.1007/s00264-020-04607-9DOI Listing

The effect of rehabilitation education on anxiety in knee replacement patients.

J Educ Health Promot 2020 28;9:115. Epub 2020 May 28.

Department of Medical Surgical Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.

Background: Total knee arthroplasty (TKA) can cause operational anxiety in patients. The purpose of this study was to determine the effects of a hospital rehabilitation program on operational anxiety in patients following TKA.

Materials And Methods: A nonrandomized clinical trial was conducted on 96 patients who were total knee replacement (TKR) candidates in Milad Hospital, Tehran, Iran. Read More

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http://dx.doi.org/10.4103/jehp.jehp_6_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325756PMC

Informed Consent in Patients Undergoing Primary Hip and Knee Arthroplasty: What Do Patients Want to Know?

Cureus 2020 Jun 5;12(6):e8457. Epub 2020 Jun 5.

Trauma and Orthopaedics, Guy's and St Thomas' Hospital, London, GBR.

Introduction The consenting process has been surgeon-focussed traditionally, but there is a recent trend towards making the process more patient and procedure-focussed. The primary aims were to identify the risks considered most important and requiring further discussion by the patients undergoing primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA), as well as to identify the sporting and recreational activities these patients would like to pursue after surgery according to the age group, taking into consideration their values and expectations. The secondary aim is to assess the compliance of the current consenting process with guidelines set out by a governing body in a tertiary referral arthroplasty unit. Read More

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http://dx.doi.org/10.7759/cureus.8457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336667PMC

Clinical and radiographic outcomes with the Nanos™ short-stem hip implant at 24 months: A prospective, single-center study.

J Orthop 2020 Jul-Aug;20:326-331. Epub 2020 Jun 6.

Department of Orthopaedic Surgery at Diakovere Annastift, Hannover Medical School, Hannover, Germany.

Aim: Short-stem total hip arthroplasty is designed to preserve proximal bone stock in case of eventual revision, potentially benefiting younger and more active patients. This prospective, single-center study assessed the safety and performance of the partially neck-sparing Nanos™ short-stem uncemented prosthesis at 24 months using clinical outcome scores and radiographic results.

Methods: Between April 2011 and February 2015, 52 subjects (mean age, 54. Read More

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http://dx.doi.org/10.1016/j.jor.2020.06.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330422PMC

A Comparison of Neuraxial and General Anesthesia for Thirty-Day Postoperative Outcomes in United States Veterans Undergoing Total Knee Arthroplasty.

J Arthroplasty 2020 Jun 17. Epub 2020 Jun 17.

Department of Surgical Services, John D. Dingell VA Medical Center, Detroit, MI.

Background: The aim of this study is to investigate which anesthetic technique is superior on 30-day outcomes after primary total knee arthroplasty (TKA) in United States veteran patients. To our knowledge, this is the first account from the Veterans Health Administration comparing the effects of different anesthesia modalities in patients undergoing TKA.

Methods: The Veterans Affairs Surgical Quality Improvement Program database was utilized to analyze patients undergoing primary TKA during the period of 2008-2015. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.030DOI Listing

Orthopaedic Surgery Elicits a Systemic Anti-Inflammatory Signature.

J Clin Med 2020 Jul 6;9(7). Epub 2020 Jul 6.

Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198, USA.

Little information is available on the functional activity of leukocytes after arthroplasty or the expansion of populations with immune suppressive properties during the acute post-operative period. Synovial fluid and matched pre- and post-surgical blood samples were collected from total hip and knee arthroplasty patients (THA and TKA, respectively) to examine the impact of surgery on peripheral blood leukocyte frequency, bactericidal activity, and inflammatory mediator expression. For spinal surgeries, inflammatory mediator production by peripheral blood mononuclear cells (PBMCs) pre- and post-surgery was examined. Read More

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http://dx.doi.org/10.3390/jcm9072123DOI Listing

Improved treatment strategies can result in better outcomes following one-stage exchange surgery for MRSA periprosthetic joint infection.

J Med Microbiol 2020 Jul 8. Epub 2020 Jul 8.

Department of Joint Surgery, Helios ENDO-Klinik Hamburg, Holstenstrasse 2, 22767 Hamburg, Germany.

Periprosthetic joint infections caused by methicillin-resistant (MRSA-PJIs) are rare, with only a few studies reporting the treatment outcomes and even fewer reporting outcomes with one-stage exchange. This study aims to analyse the outcomes of one-stage exchange in the management of MRSA-PJIs. Patients with MRSA-PJI of the hip and knee, who were treated with a one-stage exchange between 2001 and 2018 were enrolled in this study. Read More

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http://dx.doi.org/10.1099/jmm.0.001229DOI Listing

Manipulation under Anesthesia for Stiffness of the Knee Joint after Total Knee Replacement.

Arthroplast Today 2020 Sep 28;6(3):470-474. Epub 2020 Jun 28.

The Department of Orthopedic Surgery, Akershus University Hospital, Lørenskog, Norway.

Background: Stiffness of the knee joint is a feared complication after total knee replacement (TKR). An initial noninvasive treatment option is the manipulation of the knee under anesthesia (MUA). The purpose of this study is to evaluate the midterm result of the MUA for joint stiffness after primary TKR. Read More

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http://dx.doi.org/10.1016/j.artd.2020.05.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329891PMC
September 2020

Massive Osteolytic Lesion of the Femur after Total Knee Arthroplasty.

Arthroplast Today 2020 Sep 28;6(3):463-469. Epub 2020 Jun 28.

Orthopaedics Department, Hospital Beatriz Ângelo, Loures, Portugal.

Various failure mechanisms have been identified in total knee arthroplasty (TKA). We hereby present one case of failure, which stands out because of its rapid and destructive progression. We report the case of a 72-year-old Caucasian female patient who developed a large bone osteolytic lesion of the femur after TKA. Read More

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http://dx.doi.org/10.1016/j.artd.2020.05.016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7329907PMC
September 2020

Similar Outcomes After Hospital-Based Same-Day Discharge vs Inpatient Total Hip Arthroplasty.

Arthroplast Today 2020 Sep 28;6(3):451-456. Epub 2020 Jun 28.

NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY, USA.

Background: There has been increasing interest in performing primary hip and knee replacement with same-day discharge (SDD). The purpose of this study is to compare patient-reported outcome (PRO) scores, pain scores, and readmissions in patients who underwent SDD total hip arthroplasty (THA) with those in patients who underwent traditional inpatient THA.

Methods: A retrospective study was conducted on 963 patients who underwent primary THA at our institution between September 2016 and December 2018. Read More

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http://dx.doi.org/10.1016/j.artd.2020.05.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327380PMC
September 2020

Comparison of canine stifle kinematic analysis after two types of total knee arthroplasty: A cadaveric study.

Vet World 2020 May 20;13(5):956-962. Epub 2020 May 20.

Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, 10900, Thailand.

Background And Aim: Osteoarthritis is a common consequence of cranial cruciate ligament rupture (CCLR) in the canine stifle. Total knee replacement is a valuable method for managing end-stage osteoarthritis.

Materials And Methods: Two new designs of total knee replacement implants were fabricated with information from computed tomography scans. Read More

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http://dx.doi.org/10.14202/vetworld.2020.956-962DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311880PMC

Development of an occupational advice intervention for patients undergoing elective hip and knee replacement: a Delphi study.

BMJ Open 2020 Jul 6;10(7):e036191. Epub 2020 Jul 6.

Department of Orthopaedics, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.

Objective: To obtain consensus on the content and delivery of an occupational advice intervention for patients undergoing primary hip and knee replacement surgery. The primary targets for the intervention were (1) patients, carers and employers through the provision of individualised support and information about returning to work and (2) hospital orthopaedic teams through the development of a framework and materials to enable this support and information to be delivered.

Design: Modified Delphi study as part of a wider intervention development study (The Occupational advice for Patients undergoing Arthroplasty of the Lower limb (OPAL) study: Health Technology Assessment Reference 15/28/02) (ISRCTN27426982). Read More

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http://dx.doi.org/10.1136/bmjopen-2019-036191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342851PMC

Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis.

J Arthroplasty 2020 Jun 17. Epub 2020 Jun 17.

Hospital for Special Surgery, New York, NY.

Background: Residual pain is an important cause of patient dissatisfaction after total knee arthroplasty (TKA). A recent study at our institution found that a modern prosthesis was associated with less residual and anterior knee pain at 2-year follow-up when compared to its predecessor. The aim of this study is to evaluate these implants at 5-year follow-up. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.024DOI Listing

Evolving Outcome Measures in Total Knee Arthroplasty: Trends and Utilization Rates Over the Past 15 Years.

J Arthroplasty 2020 Jun 17. Epub 2020 Jun 17.

Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, Ohio.

Background: Patient-reported outcome metrics and reporting are important for demonstrating value associated with total knee arthroplasty (TKA). This review studied the patient-reported outcome utilization trends as reported within the TKA literature over a 15-year period.

Methods: A PubMed search of all manuscripts related to TKA from January 2005 to December 2019 was performed. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.036DOI Listing

Complication Rates and the Benefits of Neuraxial Anesthesia in the Patient With High Comorbidity Burden Undergoing Primary Total Joint Arthroplasty.

J Arthroplasty 2020 Jun 15. Epub 2020 Jun 15.

Department of Anesthesiology, University of California, San Diego, La Jolla, CA; Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA.

Background: The American Society of Anesthesiologists physical status classification 4 (ASA PS 4) comprises patients with "severe systemic disease that is a constant threat to life." The purpose of this study is to conduct a retrospective analysis to report the rate of complications in the ASA PS 4 patients who undergo elective total joint arthroplasty (TJA). In addition, we report whether neuraxial anesthesia is associated with improved outcomes compared to general anesthesia in these patients. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.016DOI Listing

How to choose kinematic or mechanical alignment individually according to preoperative characteristics of patients?

BMC Musculoskelet Disord 2020 Jul 7;21(1):443. Epub 2020 Jul 7.

Department of Orthopaedic Surgery, ZiBo central hospital, 54 Gong Qingtuan West Road, Zhangdian, Zibo, 255036, Shandong, People's Republic of China.

Background: Making decisions in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA).

Methods: We reviewed 296 consecutive patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a computer-assisted navigation from 2016 to 2018 in our prospectively maintained database. Read More

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http://dx.doi.org/10.1186/s12891-020-03472-2DOI Listing

Resuming hip and knee arthroplasty after COVID-19: ethical implications for well-being, safety and the economy.

Hip Int 2020 Jul 7:1120700020941232. Epub 2020 Jul 7.

Orthopaedic Department, University General Hospital of Larissa, School of Health Sciences, Faculty of Medicine, University of Thessalia, Thessalia, Greece.

Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of the obstacles ahead and realise that the health challenges and economic consequences of the COVID-19 pandemic are potentially devastating. We must also prepare to make difficult ethical decisions about restarting elective hip and knee arthroplasty. Read More

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http://dx.doi.org/10.1177/1120700020941232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345437PMC

Persistent knee pain after uncomplicated total knee arthroplasty secondary to undiagnosed spondylotic myelopathy: a case report.

Spinal Cord Ser Cases 2019 Jul 8;5(1):64. Epub 2019 Jul 8.

Rothman Institute, Philadelphia, PA, USA.

Introduction: Knee osteoarthritis and cervical spondylotic myelopathy are both frequent disorders in the aging patient. Total knee arthroplasty is an increasingly common surgical procedure, with approximately 20% of patients describing persistent knee pain after the procedure, for which it is often difficult to find a cause. We review known reasons for pain after total knee arthroplasty and present a new clinically challenging case of persistent knee pain due to previously undiagnosed cervical spondylotic myelopathy. Read More

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http://dx.doi.org/10.1038/s41394-019-0209-5DOI Listing

Comparison of Tip- Versus Hub-Oscillating Saw Blade Control in a Total Knee Arthroplasty Model.

J Arthroplasty 2020 Jun 15. Epub 2020 Jun 15.

Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington, VT.

Background: Oscillating saws are commonly used for bone preparation in total knee arthroplasty but can cause injury to the posterior neurovascular bundle during tibial resection. Tip-oscillating saw blades are a recent innovation that could improve saw control due to decreased excursion; however, the tactile feedback to the surgeon is different.

Methods: To compare traditional hub and new tip-oscillating saw blades, 16 participants of varying levels of experience were video-recorded during composite tibial bone model resections to measure posterior saw blade plunge. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.019DOI Listing

Periprosthetic Loss of Bone Mineral Density After Cementless Porous Tantalum and Cemented Total Knee Arthroplasties: A Mean of 11-Year Concise Follow-Up of a Previous Report.

J Arthroplasty 2020 Jun 12. Epub 2020 Jun 12.

Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Background: Our previous study showed that the decrease in relative change of bone mineral density (BMD) in the lateral part of the tibia was significantly less in the group treated with the cementless porous tantalum component than in the group treated with the cemented cobalt-chromium tibial component up to 5 years after the operation. However, the long-term benefits of porous tantalum tibial component on BMD have not been proven. The aim of this study was to update a matched cohort study at a minimum of 6 years' follow-up period. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.014DOI Listing

A Validated Forward Solution Dynamics Mathematical Model of the Knee Joint: Can It Be an Effective Alternative for Implant Evaluation?

J Arthroplasty 2020 Jun 14. Epub 2020 Jun 14.

MABE Department, Center for Musculoskeletal Research, University of Tennessee, Knoxville, TN.

Background: Mathematical modeling is among the most common computational tools for assessing total knee arthroplasty (TKA) mechanics of different implant designs and surgical alignments. The main objective of this study is to describe and validate a forward solution mathematical of the knee joint to investigate the effects of TKA design and surgical conditions on TKA outcomes.

Methods: A 12-degree of freedom mathematical model of the human knee was developed. Read More

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http://dx.doi.org/10.1016/j.arth.2020.06.017DOI Listing

Aspirin versus enoxaparin for the initial prevention of venous thromboembolism following elective arthroplasty of the hip or knee: A systematic review and meta-analysis.

Orthop Traumatol Surg Res 2020 Jul 3. Epub 2020 Jul 3.

Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Missenden Road, 2050 Camperdown NSW, Australia; School of Public Health, Institute for Musculoskeletal Health, University of Sydney, King George V building, Missenden Road, 2050 Camperdown NSW, Australia; South Western Sydney Clinical School, Ingham Institute for Applied Medical Research, University of New South Wales, 1,Campbell Street, 2170 Liverpool NSW, Australia.

Background: Aspirin is perceived to be non-inferior to enoxaparin, a low-molecular-weight heparin, for the prevention of venous thromboembolism (VTE) following elective arthroplasty of the hip or knee and is recommended in clinical guidelines internationally. Previous systematic reviews of aspirin as VTE prophylaxis have been limited by the inclusion of heterogenous studies where aspirin is commenced after the initial high-risk postoperative period. The purpose of this systematic review and meta-analysis was to compare the efficacy and associated harms of aspirin and enoxaparin when used as VTE prophylaxis in the initial postoperative period following elective arthroplasty of the hip or knee. Read More

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http://dx.doi.org/10.1016/j.otsr.2020.04.002DOI Listing

One-session bilateral total knee replacement: Late complications and survivorship.

Orthop Traumatol Surg Res 2020 Jul 3. Epub 2020 Jul 3.

Institut Universitaire Locomoteur et du sport, Hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06000 Nice, France. Electronic address:

Introduction: The early morbidity and mortality of one-session bilateral total knee arthroplasty (1-session BTKA) has been reported in the medical literature. However, there is less information about the long-term clinical impact of this strategy. The aim of this study was to report on the late complications (>90 days), clinical outcomes (KOOS and new KSS) along with the survivorship of 1-session BTKA. Read More

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http://dx.doi.org/10.1016/j.otsr.2020.02.017DOI Listing

Elongation Patterns of the Posterior Cruciate Ligament after Total Knee Arthroplasty.

J Clin Med 2020 Jul 2;9(7). Epub 2020 Jul 2.

Institute for Biomechanics, ETH Zurich, 8093 Zurich, Switzerland.

This study aimed to understand the ability of fixed-bearing posterior cruciate ligament (PCL)-retaining implants to maintain functionality of the PCL in vivo. To achieve this, elongation of the PCL was examined in six subjects with good clinical and functional outcomes using 3D kinematics reconstructed from video-fluoroscopy, together with multibody modelling of the knee. Here, length-change patterns of the ligament bundles were tracked throughout complete cycles of level walking and stair descent. Read More

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http://dx.doi.org/10.3390/jcm9072078DOI Listing

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery-A Systematic Review and Meta-Analysis.

Life (Basel) 2020 Jun 25;10(6). Epub 2020 Jun 25.

Department of Orthopaedics and Trauma Surgery, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, Poland.

In recent years, the interest in biological treatment of knee lesions has increased, especially the application of platelet-rich plasma is of particular note. The number of articles evaluating platelet-rich plasma (PRP) efficacy in the recovery of knee disorders and during knee surgery has exponentially increased over the last decade. A systematic review with meta-analyses was performed by assessing selected studies of local PRP injections to the knee joint. Read More

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http://dx.doi.org/10.3390/life10060094DOI Listing

Autologous Biologic Treatment with Fat, Bone Marrow Aspirate and Platelet Rich Plasma Is an Effective Alternative to Total Knee Arthroplasty for Patients with Moderate Knee Arthrosis.

Medicines (Basel) 2020 Jun 25;7(6). Epub 2020 Jun 25.

Illinois Sportsmedicine and Orthopaedic Centers, Glenview, IL 60025, USA.

Osteoarthrosis (OA) of the knee afflicts millions worldwide. Total Knee Arthroplasty (TKA) is common, but associated with substantial cost and morbidity. Prior studies of intra-articular injection of fat, bone marrow aspirate (BMA), and platelet rich plasma (PRP) have shown clinical benefit. Read More

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http://dx.doi.org/10.3390/medicines7060037DOI Listing

Mesenchymal Stromal Cell-Based Therapy-An Alternative to Arthroplasty for the Treatment of Osteoarthritis? A State of the Art Review of Clinical Trials.

J Clin Med 2020 Jun 30;9(7). Epub 2020 Jun 30.

Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.

Osteoarthritis (OA) is the most common degenerative joint disorder worldwide and to date no regenerative treatment has been established in clinical practice. This review evaluates the current literature on the clinical translation of mesenchymal stromal cell (MSC)-based therapy in OA management with a focus on safety, outcomes and procedural specifics. PubMed, Cochrane Library and clinicaltrials. Read More

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http://dx.doi.org/10.3390/jcm9072062DOI Listing

The Relationship of Transepicondylar Width with the Distal and Posterior Femoral Condyles and Its Clinical Implications: A Three-Dimensional Study.

J Knee Surg 2020 Jul 6. Epub 2020 Jul 6.

Department of Orthopaedic Surgery, National Orthopaedic Center of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Background:  Restoration of the anatomical joint line, while important for clinical outcomes, is difficult to achieve in revision total knee arthroplasty (rTKA) due to distal femoral bone loss. The objective of this study was to determine a reliable method of restoring the anatomical joint line and posterior condylar offset in the setting of rTKA based on three-dimensional (3D) reconstruction of computed tomography (CT) images of the distal femur.

Methods:  CT scans of 50 lower limbs were analyzed. Read More

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http://dx.doi.org/10.1055/s-0040-1713733DOI Listing