scholarly journals Corrigendum to ‘Risk Classification for Primary Knee Arthroplasty’ [The Journal of Arthroplasty 24 (2009) 90-95]

2021 ◽  
Author(s):  
Yassir Babiker Al-Arabi ◽  
Sergio Vargas-Prada ◽  
Sandeep Deo
Keyword(s):  
Knee Arthroplasty ◽  
Risk Classification ◽  
Primary Knee Arthroplasty

scholarly journals Public Interest in Knee Pain and Knee Replacement during the SARS-CoV-2 Pandemic in Western Europe

2021 ◽  
Vol 10 (5) ◽  
pp. 1067
Author(s):  
Arne Kienzle ◽  
Lara Biedermann ◽  
Evgeniya Babeyko ◽  
Stephanie Kirschbaum ◽  
Georg Duda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Public Interest ◽  
Western Europe ◽  
Surgical Care ◽  
Number Of Patients ◽  
Primary Knee Arthroplasty ◽  
The Uk

Due to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) pandemic, a large number of elective knee replacement procedures had to be postponed in both early and late 2020 in most western countries including Germany and the UK. It is unknown how public interest and demand for total knee arthroplasties was affected. Public interest in knee pain, knee osteoarthritis and knee arthroplasty in Germany and the UK was investigated using Google Trend Analysis. In addition, we monitored for changes in patient composition in our outpatient department. As of early March in Germany and of late March in the UK, until the lockdown measures, a 50 to 60% decrease in relative search frequency was observed in all categories investigated compared to the beginning of the year. While public interest for knee pain rapidly recovered, decreased interest for knee osteoarthritis and replacement lasted until the easing of measures. Shortly prior to and during the first lockdown mean search frequency for knee replacement was significantly decreased from 39.7% and 36.6 to 26.9% in Germany and from 47.7% and 50.9 to 23.7% in the UK (Germany: p = 0.022 prior to lockdown, p < 0.001 during lockdown; UK: p < 0.0001 prior to and during lockdown). In contrast, mean search frequencies did not differ significantly from each other for any of the investigated time frames during the second half of 2020 in both countries. Similarly, during the first lockdown, the proportion of patients presenting themselves to receive primary knee arthroplasty compared to patients that had already undergone knee replacement declined markedly from 64.7% to 46.9%. In contrast, patient composition changed only marginally during the lockdown measures in late 2020 in both Germany and the UK. We observed a high level of public interest in knee arthroplasty despite the ongoing pandemic. The absence of a lasting decline in interest in primary knee arthroplasty suggests that sufficient symptom reduction cannot be achieved without surgical care for a substantial number of patients.

scholarly journals Evaluation of intraoperative radioscopy on the coronal alignment of the tibial component in primary knee arthroplasty

2015 ◽  
Vol 50 (5) ◽  
pp. 541-545
Author(s):  
Hugo Cobra ◽  
Marcio Bruno Hadid ◽  
Daniel Torres Jácome ◽  
Eduardo Branco de Sousa ◽  
Alan de Paula Mozella ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Tibial Component ◽  
Coronal Alignment ◽  
Primary Knee Arthroplasty

scholarly journals Levobupivacaine in spinal anesthesia for primary knee and hip arthroplasty

2020 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
K. Yu. Ukolov ◽  
V. L. Ayzenberg ◽  
M. V. Kapirina ◽  
M. E. Mikitina
Keyword(s):  
Elderly Patients ◽  
Spinal Anesthesia ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Postoperative Nausea And Vomiting ◽  
Anaesthetic Agents ◽  
Group I ◽  
Primary Knee Arthroplasty ◽  
Group Ii ◽  
Knee And Hip Arthroplasty

Introduction. Spinal anesthesia is widely used in major orthopedic. Primary hip and knee arthroplasty are major surgical procedures associated with significant potential morbidity in elderly patients. This increases requirement to surgical and anesthetic procedures. Some studies provide evidence that levobupivacaine when used as an alternative to bupivacaine in spinal anesthesia is less cardiotoxic and neurotoxic. Aim: To compare the efficacy and safety of these two spinal anaesthetic agents in elderly patients undergoing primary hip or knee replacement. Patients and methods. The study included 90 patients performed arthroplasty with spinal anesthesia. I group patients received spinal anesthesia bupivacaine 0,5%, II group patients received intrathecal levobupicavaine 0.5%. Group I (n=60), 22 (37%) underwent primary hip arthroplasty, and 38 (63%) patients that underwent primary knee arthroplasty with mean age (65,4 + 6,5). Group II (n=30), 18 (60%) patients that underwent primary total hip arthroplasty and 12 (40%) patients that underwent primary knee arthroplasty with mean age (65,5 + 8,1). Anesthesia algorithm did not differ for both groups. Results. Vital parameters and adverse effects in relation to spinal anesthesia were observed. Decrease of heart rate was more significant in group II. Blood pressure parameters were comparable to both groups though, 10% of Group I patients received infusion of norepinephrine for treatment of hypotension. The two groups were comparable with glucose and lactate variations as well as the duration of analgesia and postoperative nausea and vomiting. No postoperative delirium was noted in both groups. Conclusion. Spinal anesthesia with levobupivacaine is more safe for elderly patients undergoing knee and hip arthroplasty.

Revision knee arthroplasty with replacement of part of femoral diaphysis with the modular endosystem AMT in a patient with inhibitory hemophilia B

2020 ◽  
Author(s):  
Г.В. Мишин ◽  
В.Ю. Зоренко ◽  
Е.Е. Карпов ◽  
Н.В. Садыкова ◽  
М.С. Сампиев ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Hemophilia B ◽  
Femoral Diaphysis ◽  
Orthopedic Treatment ◽  
Complete Replacement ◽  
Revision Knee Arthroplasty ◽  
Leading Role ◽  
Primary Knee Arthroplasty ◽  
Considerable Length

Представлен случай использования модульной эндосистемы АМТ при ревизионном эндопротезировании коленного сустава у больного с ингибиторной формой гемофилии В. Эндопротезирование суставов у больных гемофилией занимает ведущую роль в оперативном ортопедическом лечении гемофилической артропатии. Хирургические вмешательства у пациентов с гемофилией связаны с высоким риском кровотечения и инфекции и проводятся на фоне заместительной гемостатической терапии. Выживаемость первичных эндопротезов коленного сустава у пациентов с гемофилией составляет около 80% при сроке наблюдения 10 лет. Тем не менее встречаются случаи, когда использование эпифизарных эндопротезов невозможно технически в связи с недостаточным массивом костной ткани. В таких случаях может потребоваться замещение дефекта костной ткани на значительном протяжении. Использование модульных эндопротезов позволяет частично или полностью замещать дефекты костей. В современной литературе описаны лишь единичные случаи использования модульных эндопротезов у больных гемофилией. Представлен клинический случай успешного применения модульного эндопротеза АМТ коленного сустава у больного с ингибиторной формой гемофилии В. The case is presented of modular endosystem AMT use in revision knee arthroplasty in a patient with an inhibitory form of hemophilia B. Arthroplasty in patients with hemophilia plays a leading role in the surgical orthopedic treatment of hemophilic arthropathy. Surgical treatment in patients with hemophilia is associated with a high risk of bleeding and infection, and is performed in conjunction with hemostatic therapy. The survival rate of primary knee arthroplasty in patients with hemophilia is about 80% with a follow-up period of 10 years. Nevertheless, there are cases when epiphyseal endoprostheses use is technically impossible, due to insufficient bone tissue. In these cases, it may be necessary to replace the bone defect over a considerable length. The use of modular endoprostheses allows partial or complete replacement of bone defects. Only a few cases of modular endoprostheses use in patients with hemophilia are described in the modern literature. The article presents a clinical case of successful application of a modular knee replacement AMT in a patient with an inhibitory form of hemophilia B.

Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

2021 ◽  
Author(s):  
Veena Graff ◽  
Justin T. Clapp ◽  
Sarah J. Heins ◽  
Jamison J. Chung ◽  
Madhavi Muralidharan ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Shared Decision ◽  
Structured Interviews ◽  
Primary Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how patients should participate in decisions. Evaluating the feasibility and desirability of carrying out shared decision-making in anesthesia requires better understanding of preoperative conversations. The objective of this qualitative study was to characterize how preoperative consultations for primary knee arthroplasty arrived at decisions about primary anesthesia. Methods This focused ethnography was performed at a U.S. academic medical center. The authors audio-recorded consultations of 36 primary knee arthroplasty patients with eight anesthesiologists. Patients and anesthesiologists also participated in semi-structured interviews. Consultation and interview transcripts were coded in an iterative process to develop an explanation of how anesthesiologists and patients made decisions about primary anesthesia. Results The authors found variation across accounts of anesthesiologists and patients as to whether the consultation was a collaborative decision-making scenario or simply meant to inform patients. Consultations displayed a number of decision-making patterns, from the anesthesiologist not disclosing options to the anesthesiologist strictly adhering to a position of equipoise; however, most consultations fell between these poles, with the anesthesiologist presenting options, recommending one, and persuading hesitant patients to accept it. Anesthesiologists made patients feel more comfortable with their proposed approach through extensive comparisons to more familiar experiences. Conclusions Anesthesia consultations are multifaceted encounters that serve several functions. In some cases, the involvement of patients in determining the anesthetic approach might not be the most important of these functions. Broad consideration should be given to both the applicability and feasibility of shared decision-making in anesthesia consultation. The potential benefits of interventions designed to enhance patient involvement in decision-making should be weighed against their potential to pull anesthesiologists’ attention away from important humanistic aspects of communication such as decreasing patients’ anxiety. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Mid-term results of impaction bone grafting in tibial bone defects in complex primary knee arthroplasty for severe varus deformity

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 2
Author(s):  
Yashwant Singh Tanwar ◽  
Yatinder Kharbanda ◽  
Harsh Bhargava ◽  
Kulbhushan Attri ◽  
Anoop Bandil
Keyword(s):  
Knee Arthroplasty ◽  
Bone Grafting ◽  
Primary Total Knee Arthroplasty ◽  
Varus Deformity ◽  
Womac Score ◽  
Bone Defects ◽  
Impaction Bone Grafting ◽  
Tibial Condyle ◽  
Primary Knee Arthroplasty ◽  
The Many

Introduction: Bone defects are a challenging problem encountered occasionally during primary knee arthroplasty. These defects should be meticulously addressed so as to avoid malalignment and premature loosening and failure. Out of the many options available to deal with these defects, impaction bone grafting provides a more biological solution, which is especially important in case of primary knees. Materials and methods: A retrospective analysis was done and patients with severe varus deformity of more than 20 degrees who had undergone primary knee arthroplasty with impaction bone grafting of the tibial condyle defect were followed up. Results: Between 2008 and 2014, out of the 1124 patients who underwent primary total knee arthroplasty, only 26 knees in 23 patients met the inclusion criteria. The amount of varus deformity ranged from 20 to 35 degrees. Follow-up ranged from 3 to 8 years with an average of 6 years. The average pre-operative Knee Society Score (KSS) and Western Ontario McMaster Universities (WOMAC) score were 24.2 and 78, respectively. There were significant improvements in the post-op scores, with the average KSS being 90.2 and the WOMAC being 38. Conclusion: Impaction bone grafting provides an invaluable option to the orthopedic surgeon for managing bone defects, especially in case of primary knee arthroplasty as it reconstitutes the bone stock.

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