scholarly journals Knee osteoarthritis radiographic progression and associations with pain and function prior to knee arthroplasty: a multicenter comparative cohort study

2015 ◽  
Vol 23 (3) ◽  
pp. 391-396 ◽  
Author(s):  
D.L. Riddle ◽  
W.A. Jiranek
Keyword(s):  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Radiographic Progression ◽  
Comparative Cohort Study ◽  
And Function

scholarly journals Efficacy and mid/long-term survivorship of mobile-bearing unicompartmental knee arthroplasty for medial compartment knee osteoarthritis combined patellofemoral joint arthritis: a prospective cohort study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038448
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Shibao Lu
Keyword(s):  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Prospective Cohort ◽  
Patellofemoral Joint ◽  
Medial Compartment ◽  
Unicompartmental Knee

IntroductionUnicompartmental knee arthroplasty (UKA) is one of the most effective surgical procedures for treating isolated medial compartment knee osteoarthritis. However, previous studies have regarded patellofemoral osteoarthritis as a contraindication for UKA. In contrast, most current research shows that damage to the articular cartilage of the patellofemoral joint, even to the extent of full-thickness cartilage loss, has no influence on the outcome of UKA.Methods and analysisStudy settings: This study is a prospective cohort study that will compare the Forgotten Joint Score and Lonner patellofemoral joint score of patients who have undergone UKA; the patients will be divided into two groups (with and without patellofemoral joint osteoarthritis (PFJOA)). Primary objective: Long-term follow-up will be used to evaluate the effect of the operation on the above-mentioned scores in both the groups. Secondary objective: We will divide the patients from the with PFJOA group into three subgroups according to the localisation of patellofemoral cartilage lesions (medial zone, lateral zone and central zone). We aim to compare knee joint scores among these groups and clarify the impact of different wear sites on clinical efficacy. We will use CT to explore the potential mechanism through which UKA affects patellofemoral joint-related parameters (lateral patellar tilt, lateral patellar shift and tibia tuberosity-trochlear groove distance). We will also record mid-term/long-term post-surgery complications.Ethics and disseminationThis study’s protocol is in accordance with the Declaration of Helsinki. This study was approved by the Ethics Committee of Xuanwu Hospital. The results of this study will be disseminated in international peer-reviewed journals.Trial registration numberChiCTR2000030310.

scholarly journals Knee Arthroplasty in Severe Varus Advanced Knee Osteoarthritis with Proximal Tibia Malunion: a case report

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0005
Author(s):  
Nyoman Aditya Sindunata ◽  
Prettysia Suvarly ◽  
Rio Aditya ◽  
John Butarbutar
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Varus Deformity ◽  
Left Knee ◽  
Tibial Osteotomy ◽  
Posterior Stabilized ◽  
Stem Extension ◽  
Closed Wedge ◽  
And Function

Alignment is crucial for successful knee arthroplasty.1 Tibia malunion will make arthroplasty more challenging. In this case, we present advanced knee osteoarthritis with tibia vara due to malunion that needs corrective osteotomy during knee arthroplasty. Case Presentation: A 70 years old female presented to our office complaining pain in both knees markedly on the left, profoundly felt during walking. She has a history of being hit by motorcycle 15 months ago and left knee was more bent since then. Physical examination of the left knee showed severe varus, mild effusion, tenderness on medial tibial condyle, otherwise normal. Plain radiographs showed advanced bilateral knee osteoarthritis with left proximal tibia malunion. Patient underwent left knee arthroplasty with corrective tibia and fibula osteotomy. Solutions and Outcome: Patient underwent closed wedge tibial osteotomy together with fibula osteotomy followed by knee arthroplasty with posterior-stabilized implant and tibial stem extension in a single surgery. Tibial osteotomy was reinforced using plate and screws. Partial weight bearing was achieved in second postoperative day and discharged on the third day. Patient able to walk with painless left knee after 1 month. Discussion: Severe deformity that causes huge malalignment makes knee arthroplasty difficult. Some methods are available to correct malalignment.1 In this case, the surgeon chose to do closed wedge tibial osteotomy reinforced with plate and screws to correct the proximal tibia malunion. Arthroplasty was done using posterior-stabilized implant and tibial stem extension. Patient shows good result in alignment and function. Conclusion: Correcting the associated deformity is crucial in achieving good alignment in knee arthroplasty. Even in our case of severe genu varus due to proximal tibia malunion, correcting proximal tibia varus deformity prior to knee arthroplasty shows good alignment and function. References: Mullaji AB, Padmanabhan V, Jindal G. Total Knee Arthroplasty for Profound Varus Deformity. 2005;20(5):550–61.

scholarly journals Trajectories of Pain and Function after Primary Hip and Knee Arthroplasty: The ADAPT Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (2) ◽  
pp. e0149306 ◽  
Author(s):  
Erik Lenguerrand ◽  
Vikki Wylde ◽  
Rachael Gooberman-Hill ◽  
Adrian Sayers ◽  
Luke Brunton ◽  
...  
Keyword(s):  
Cohort Study ◽  
Knee Arthroplasty ◽  
Hip And Knee Arthroplasty ◽  
And Function

scholarly journals Total Knee Arthroplasty Improved Locomotive Syndrome in Knee Osteoarthritis Patients: A Prospective Cohort Study Focused on Total Clinical Decision Limits Stage 3

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Shigeaki Miyazaki ◽  
Saori Yoshinaga ◽  
Kurumi Tsuruta ◽  
Amy Hombu ◽  
Yoshinori Fujii ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Motor Function ◽  
Knee Arthroplasty ◽  
Clinical Decision ◽  
Step Test ◽  
Locomotive Syndrome ◽  
Improvement Rate ◽  
Total Knee

Purpose. The purpose of this study is to investigate the treatment efficacy of total knee arthroplasty (TKA) on locomotive syndrome (LS) focusing on total clinical decision limit (CDL) stage 3 leading to revealing the motor function indicators that can predict LS improvement in knee osteoarthritis patients who had received TKA. Methods. This prospective cohort study was conducted in 47 patients evaluated as total CDL stage 3 before TKA who received primary TKA on the operated side and were diagnosed with Kellgren-Lawrence grade 2, 3, or 4 knee osteoarthritis on the nonoperated side. LS was evaluated using stand-up test, two-step test, and 25-Question Geriatric Locomotive Function Scale. In addition, the motor function indicators which could predict the LS improvement were examined. All assessments were conducted before TKA and three months after TKA. Results. Of the 47 subjects who were evaluated to be in total CDL stage 3 before TKA, 13 patients (27.7%) were determined to show improvements in total CDL. From the result of the decision tree analysis, when the CDL of the two-step test before TKA was 1 or less, the improvement rate was 83.3%. Even if the CDL of the two-step test before TKA was higher than 1 and if the 3 m-Timed Up and Go test (3m-TUG) before TKA was 9.6 or less, the improvement rate was 50%. Conclusions. As of three months after surgery, TKA can improve LS in about 30% of knee osteoarthritis patients. A two-step test before TKA and 3m-TUG before TKA can be used as motor function indicators to predict LS improvement. This study provides useful information for setting the goal for rehabilitation prior to surgery.

scholarly journals Intra-Articular Injections Prior to Total Knee Arthroplasty Do Not Increase the Risk of Periprosthetic Joint Infection: A Prospective Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 330
Author(s):  
Jérôme Grondin ◽  
Pierre Menu ◽  
Benoit Métayer ◽  
Vincent Crenn ◽  
Marc Dauty ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Knee Osteoarthritis ◽  
Prospective Cohort Study ◽  
Knee Arthroplasty ◽  
Prospective Cohort ◽  
Therapeutic Option ◽  
Joint Infection ◽  
Significant Risk ◽  
Total Knee

Periprosthetic joint infections (PJI) occur in 0.5 to 2.8% of total knee arthroplasties (TKA) and expose them to an increase of morbidity and mortality. TKA are mainly performed after failure of non-surgical management of knee osteoarthritis, which frequently includes intra-articular injections of corticosteroids or hyaluronic acid. Concerning the potential impact of intra-articular injections on TKA infection, literature provides a low level of evidence because of the retrospective design of the studies and their contradictory results. In this prospective cohort study, we included patients after a total knee arthroplasty, at the time of their admission in a rehabilitation center, and we excluded patients with any prior knee surgery. 304 patients were included. Mean follow-up was 24.9 months, and incidence proportion of PJI was 2.6%. After multivariate logistic regression, male was the only significant risk factor of PJI (OR = 19.6; p = 0.006). The incidence of PJI did not differ between patients who received prior intra-articular injections and others, especially regarding injections in the last 6 months before surgery. The use of intra-articular injection remains a valid therapeutic option in the management of knee osteoarthritis, and a TKA could still be discussed.

Differences in Baseline Joint Moments and Muscle Activation Patterns Associated With Knee Osteoarthritis Progression When Defined Using a Clinical Versus a Structural Outcome

2020 ◽  
Vol 36 (1) ◽  
pp. 39-51 ◽  
Author(s):  
Kerry E. Costello ◽  
Janie L. Astephen Wilson ◽  
William D. Stanish ◽  
Nathan Urquhart ◽  
Cheryl L. Hubley-Kozey
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Muscle Activation ◽  
Radiographic Progression ◽  
Principal Component ◽  
Rectus Femoris ◽  
Muscle Activation Patterns ◽  
Osteoarthritis Progression ◽  
Total Knee

Both structural and clinical changes can signify knee osteoarthritis progression; however, these changes are not always concurrent. A better understanding of mechanical factors associated with progression and whether they differ for structural versus clinical outcomes could lead to improved conservative management. This study examined baseline gait differences between progression and no progression groups defined at an average of 7-year follow-up using 2 different outcomes indicative of knee osteoarthritis progression: radiographic medial joint space narrowing and total knee arthroplasty. Of 49 individuals with knee osteoarthritis who underwent baseline gait analysis, 32 progressed and 17 did not progress using the radiographic outcome, while 13 progressed and 36 did not progress using the arthroplasty outcome. Key knee moment and electromyography waveform features were extracted using principal component analysis, and confidence intervals were used to examine between-group differences in these metrics. Those who progressed using the arthroplasty outcome had prolonged rectus femoris and lateral hamstrings muscle activation compared with the no arthroplasty group. Those with radiographic progression had greater mid-stance internal knee rotation moments compared with the no radiographic progression group. These results provide preliminary evidence for the role of prolonged muscle activation in total knee arthroplasty, while radiographic changes may be related to loading magnitude.

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