Are results of total knee arthroplasty for isolated patellofemoral OA as good as for medial compartment OA? A medium-term retrospective comparative study

Background: In Gaza Strip, arthroplasty only performed at our center. This study is to assess the compliance and improve current practices.Methods: Study is based on medical records review of all patients underwent total knee arthroplasty (TKA) between January 2016 and December 2017.Results: Forty eight TKA were performed on 41 patients. Neuraxial anesthesia used in 43 operations (30 spinal, 13 epidural). Tranexamic acid used in 20 operations and those show less frequently decrease in hemoglobin level after surgery and for blood transfusion. Simultaneous bilateral TKA used in one patient. Drain used in 26 operations, 2 of them had infection. No one started physiotherapy at same day surgery, this may be due to repeat doses of Epidural anesthesia, performed surgeries before weekend and using the drain. Delayed physiotherapy is associated with prolong hospitalization and increase suspicion of deep venous tthrombosis. The result from our retrospective comparative study was similar to guidelines.Conclusions: We concluded that there is overall good management of TKA in our hospital according to the best available evidence. We recommend to use the international guidelines like the American Academy of Orthopaedic Surgeons (AAOS) guidelines as a standard guidelines to our Hospital, and increase awareness of our staff to the good practice guidelines. Emphasize the important elements that we have shorten of good practice as listed in the discussion.

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Traction during Total Knee Arthroplasty Leads to a Bone-Conserving Tibial Resection: A Retrospective Comparative Study

International Journal of Orthopaedics ◽

10.17554/j.issn.2311-5106.2020.07.345 ◽

2020 ◽

Vol 7 (3) ◽

pp. 1283-1288

Author(s):

James H M Brown ◽

Keyword(s):

Total Knee Arthroplasty ◽

Comparative Study ◽

Knee Arthroplasty ◽

Tibial Resection ◽

Total Knee ◽

Retrospective Comparative Study

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Over-constrained kinematic of the medial compartment leads to lower clinical outcomes after total knee arthroplasty

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06398-3 ◽

2021 ◽

Author(s):

Nicola Pizza ◽

Stefano Di Paolo ◽

Raffaele Zinno ◽

Giulio Maria Marcheggiani Muccioli ◽

Piero Agostinone ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Clinical Outcomes ◽

Knee Arthroplasty ◽

Motor Task ◽

Medial Compartment ◽

Level Of Evidence ◽

Contact Points ◽

Sit To Stand ◽

Medial Pivot ◽

Total Knee

Abstract Purpose To investigate if postoperative clinical outcomes correlate with specific kinematic patterns after total knee arthroplasty (TKA) surgery. The hypothesis was that the group of patients with higher clinical outcomes would have shown postoperative medial pivot kinematics, while the group of patients with lower clinical outcomes would have not. Methods 52 patients undergoing TKA surgery were prospectively evaluated at least a year of follow-up (13.5 ± 6.8 months) through clinical and functional Knee Society Score (KSS), and kinematically through dynamic radiostereometric analysis (RSA) during a sit-to-stand motor task. Patients received posterior-stabilized TKA design. Based on the result of the KSS, patients were divided into two groups: “KSS > 70 group”, patients with a good-to-excellent score (93.1 ± 6.8 points, n = 44); “KSS < 70 group”, patients with a fair-to-poor score (53.3 ± 18.3 points, n = 8). The anteroposterior (AP) low point (lowest femorotibial contact points) translation of medial and lateral femoral compartments was compared through Student’s t test (p < 0.05). Results Low point AP translation of the medial compartment was significantly lower (p < 0.05) than the lateral one in both the KSS > 70 (6.1 mm ± 4.4 mm vs 10.7 mm ± 4.6 mm) and the KSS < 70 groups (2.7 mm ± 3.5 mm vs 11.0 mm ± 5.6 mm). Furthermore, the AP translation of the lateral femoral compartment was not significantly different (p > 0.05) between the two groups, while the AP translation of the medial femoral compartment was significantly higher for the KSS > 70 group (p = 0.0442). Conclusion In the group of patients with a postoperative KSS < 70, the medial compartment translation was almost one-fourth of the lateral one. Surgeons should be aware that an over-constrained kinematic of the medial compartment might lead to lower clinical outcomes. Level of evidence II.

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