Surgical Treatment of Flexion Contractures After Total Knee Arthroplasty

AbstractSagittal deformity of the knee is commonly corrected to neutral biomechanical axis (±3 degrees) during total knee arthroplasty (TKA), which is a widely accepted goal. Recent advances in surgical technology have made it possible to accurately plan and fulfill these goals. One of these is robotic-assisted TKA, which has been noted to help increase accuracy and precision of restoring a neutral mechanical axis. While there are data confirming the ability of robotic devices to better correct knee alignment than the manual technique, there is a lack of data concerning the use of the robotic devices in more complex cases, such as those in patients with severe varus or valgus deformity, as well as in flexion contractures. Therefore, the purpose of this case study is to present three cases in which the robotic-assisted TKA device was used to correct a severe varus and severe valgus deformities. Based on this case series, it should be noted that the robotic device can also help correct severe varus/valgus deformities and flexion contractures.

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Robotic Arm-Assisted Total Knee Arthroplasty in the Setting of Combined Extra-articular Deformities of the Femur and Tibia

Case Reports in Orthopedics ◽

10.1155/2020/5489646 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Sharma Cook-Richardson ◽

Rasesh Desai

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Treatment Option ◽

Knee Arthroplasty ◽

Mechanical Axis ◽

Robotic Arm ◽

Implant Positioning ◽

Total Knee ◽

Anatomical Axis ◽

Bone Deformities

In this case, we will describe a 68-year-old man with combined femoral and tibial bone deformities who underwent robotic arm-assisted total knee arthroplasty (RATKA) to treat his severe osteoarthritis in the setting of extra-articular deformities that altered the native anatomical axis and the kinematics of the deformed extra-articular bony structures which chronically generated a neomechanical axis. The combination of severe osteoarthritis with extra-articular deformities made the RATKA method the best surgical treatment option taking into account altered kinematics of the native joint which conventional jig-based total knee arthroplasty would not have prioritized during bony cuts and implant positioning. The patient underwent successful knee arthroplasty with robotic arm-assisted technology with restoration of the mechanical axis.

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Errors in visual estimation of flexion contractures during total knee arthroplasty

World Journal of Orthopedics ◽

10.5312/wjo.v4.i3.120 ◽

2013 ◽

Vol 4 (3) ◽

pp. 120

Author(s):

Cale A Jacobs

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Visual Estimation ◽

Flexion Contractures ◽

Total Knee

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Intra-operative peri-articular cocktail injection in inflammatory arthritis patients undergoing total knee arthroplasty

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20214192 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1220

Author(s):

K. Vijaya Bhaskar Reddy ◽

N. Brahma Chary ◽

C. Anil Kumar,

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Knee Arthroplasty ◽

Inflammatory Arthritis ◽

Daily Activities ◽

Volar Approach ◽

Herbert Screw ◽

Scaphoid Fractures ◽

Total Knee ◽

Wrist Function

<p class="abstract">Surgical treatment of scaphoid fractures has evolved over the years to include variety of procedures and techniques. However scaphoid middle and distal third fractures fixation with Herbert screw by means of volar approach is a safe and effective method with good functional outcome and union rates. Our study concluded that management of middle and distal third scaphoid fractures with Herbert screw by volar approach gives excellent results in terms of union and recovery to daily activities. The wrist function improvement is more satisfactory, and the incidence of complications is low with this modality of treatment.</p>

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Differences in time to return to work among patients undergoing simultaneous versus staged bilateral total knee arthroplasty

The Bone & Joint Journal ◽

10.1302/0301-620x.103b6.bjj-2020-2102.r1 ◽

2021 ◽

Vol 103-B (6 Supple A) ◽

pp. 108-112

Author(s):

Cynthia A. Kahlenberg ◽

Ethan C. Krell ◽

Thomas P. Sculco ◽

Jeffrey N. Katz ◽

Joseph T. Nguyen ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Return To Work ◽

Knee Arthroplasty ◽

Patient Reported Outcome ◽

Simultaneous Group ◽

Patient Reported ◽

Total Knee ◽

American Society ◽

Simultaneous Bilateral Tka

Aims Many patients undergoing total knee arthroplasty (TKA) have severe osteoarthritis (OA) in both knees and may consider either simultaneous or staged bilateral TKA. The implications of simultaneous versus staged bilateral TKA for return to work are not well understood. We hypothesized that employed patients who underwent simultaneous bilateral TKA would have significantly fewer days missed from work compared with the sum of days missed from each operation for patients who underwent staged bilateral TKA. Methods The prospective arthroplasty registry at the Hospital for Special Surgery was used. Baseline characteristics and patient-reported outcome scores were evaluated. We used a linear regression model, adjusting for potential confounding variables including age, sex, preoperative BMI, and type of work (sedentary, moderate, high activity, or strenuous), to analyze time lost from work after simultaneous compared with staged bilateral TKA. Results We identified 152 employed patients who had undergone simultaneous bilateral TKA and 61 who had undergone staged bilateral TKA, and had completed the registry’s return to work questionnaire. The simultaneous group missed a mean of 46.2 days (SD 29.1) compared with the staged group who missed a mean total of 68.0 days of work (SD 46.1) when combining both operations. This difference was statistically significant (p < 0.001). In multivariate mixed regression analysis adjusted for age, sex, BMI, American Society of Anesthesiologists status, and type of work, the simultaneous group missed a mean of 16.9 (SD 5.7) fewer days of work compared with the staged group (95% confidence interval 5.8 to 28.1; p = 0.003). Conclusion Employed patients undergoing simultaneous bilateral TKA missed a mean of 17 fewer days of work as a result of their surgical treatment and rehabilitation compared with those undergoing staged bilateral TKA. This information may be useful to surgeons counselling employed patients with bilateral OA of the knee who are considering surgical treatment. Cite this article: Bone Joint J 2021;103-B(6 Supple A):108–112.

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Selfdynamisable internal fixator Mitkovic in treatment of periprosthetic supracondylar femoral fracture after total knee arthroplasty

Acta chirurgica iugoslavica ◽

10.2298/aci1501049s ◽

2015 ◽

Vol 62 (1) ◽

pp. 49-55

Author(s):

Predrag Stojiljkovic ◽

Milorad Mitkovic ◽

Zoran Golubovic ◽

Ivan Micic ◽

Sasa Milenkovic ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Minimally Invasive ◽

Knee Arthroplasty ◽

Weight Bearing ◽

Internal Fixator ◽

Full Weight Bearing ◽

Invasive Technique ◽

Femur Fractures ◽

Total Knee

Supracondylar periprosthetic femoral fractures after total knee arthroplasty are very rare, but very difficult to treat. They occur most often as a result of low energy trauma (slips and fall) in older patients with present osteoporosis and periprosthetic osteolysis. The treatment of these fractures is very difficult due to reduced biological capacity for healing in most cases. Surgical treatment of these fractures is accompanied by severe complications (prolonged healing, nonunion and disintegration osteosintets material) in 25 to 70% of the cases. The aim of this paper is to present the treatment of supracondylar femur fractures after total knee arthroplasty in men aged 72 with selfdynamisable internal fixator Mitkovic. Surgical treatment of fracture performed on the six day after the injury with minimally invasive surgical technique through two incisions. Verticalization and walking with crutches with non-weight-bearing started the first postoperative day. Patient discharged from hospital fifth postoperative day. Full weight-bearing on the operated leg is allowed after 6 weeks. The patient started a stationary physical therapy 6 weeks after surgery. Postoperative follow-up was 10 months. The fractures healed with an excellent functional result. Application of selfdynamisable internal fixator Mitkovic with minimally invasive technique in the treatment of these complex fractures provides excellent biomechanical conditions for healing.

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Use of Reconstructive Microsurgery Technologies in Complicated Knee Joint Arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto201118116-21 ◽

2011 ◽

Vol 18 (1) ◽

pp. 16-21

Author(s):

R M Tikhilov ◽

Aleksandr Yur'evich Kochish ◽

L A Rodomanova ◽

D I Kutyanov ◽

A O Afanas'ev ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Surgical Treatment ◽

Knee Joint ◽

Total Knee Replacement ◽

Knee Arthroplasty ◽

Joint Arthroplasty ◽

Joint Region ◽

Total Arthroplasty ◽

Reconstructive Microsurgery ◽

Total Knee

Results of surgical treatment of 19 patients in whom total knee replacement was performed in combination with various reconstructive microsurgical operations were analyzed. It was shown that application of microsurgical technologies provided new potentialities in total knee arthroplasty first of all in atypical and complicated cases. Advantages of step-by-step treatment presupposing firstly the restoration of integument in the knee joint region followed by its total arthroplasty were revealed.

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