Impact of atrial fibrillation on postoperative outcomes after total knee arthroplasty–A retrospective study

Abstract Background: The argument presupposes that intra-operative soft tissue balance is associated with patient-reported outcome measures after total knee arthroplasty (TKA). Our aim was to assess the association between the extension-to-flexion gap and patients’ reported perception of knee joint function.Methods: This was a retrospective study of 60 cases of primary cruciate-retaining TKAs performed for the treatment of medial-compartment knee osteoarthritis, at a mean follow-up of 2.6 (range, 2.0–5.2) years. Knee perception was evaluated by asking patients whether they considered their knee joint as “natural” (grade I) or “artificial”, with or without restrictions (grades II–V). The following factors were compared between the two groups: age, sex, and the extension-to-flexion gap difference. A multiple logistic regression analysis was used to identify predictive factors of an artificial knee joint perception. A receiver operating characteristic curve analysis was used to identify cut-off values of predictive factors. Result: Compared to a natural knee joint perception (26 knees, 43%), an artificial perception (34 knees, 57%) was associated with a smaller gap difference at the distraction force of 20 lbf (p < .001), 30 lbf (p = .022), and 40 lbf (p = .038), a lower EuroQol 5-Dimension score (p = .029), and self-reported joint health (Knee injury and Osteoarthritis Outcome Score-Joint Replacement [KOOS-JR], p = .032). A gap difference <1.0 mm was a predictive of an artificial perception (odds ratio, 1.63; 95% confidence interval, 1.33–4.54; p < .001). A cut-off gap difference of 0.99 mm at 20 lbf predicted an artificial perception with a sensitivity of 81.5% and a specificity of 87.9%. Post-operative satisfaction (p < .001), KOOS-JR (p < .001), patient’s joint perception (p = .006), pain (p = .015), and EuroQol 5-Dimension (p = .032) differed between the two groups when the gap difference threshold was set to 1.0 mm.Conclusion: Careful balancing of soft tissue during TKA to achieve an extension-to-flexion gap ≥ 1.0 mm can improve patients’ perception of knee joint function and quality of life.

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Results of Robotic-Assisted Versus Manual Total Knee Arthroplasty at 2-Year Follow-up

The Journal of Knee Surgery ◽

10.1055/s-0041-1731349 ◽

2021 ◽

Author(s):

Kevin B. Marchand ◽

Rachel Moody ◽

Laura Y. Scholl ◽

Manoshi Bhowmik-Stoker ◽

Kelly B. Taylor ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Physical Function ◽

Knee Arthroplasty ◽

Postoperative Outcomes ◽

Medical Complications ◽

Womac Pain ◽

Robotic Assisted ◽

Surgical Data ◽

Total Knee

AbstractRobotic-assisted technology has been developed to optimize the consistency and accuracy of bony cuts, implant placements, and knee alignments for total knee arthroplasty (TKA). With recently developed designs, there is a need for the reporting longer than initial patient outcomes. Therefore, the purpose of this study was to compare manual and robotic-assisted TKA at 2-year minimum for: (1) aseptic survivorship; (2) reduced Western Ontario and McMaster Universities Osteoarthritis Index (r-WOMAC) pain, physical function, and total scores; (3) surgical and medical complications; and (4) radiographic assessments for progressive radiolucencies. We compared 80 consecutive cementless robotic-assisted to 80 consecutive cementless manual TKAs. Patient preoperative r-WOMAC and demographics (e.g., age, sex, and body mass index) were not found to be statistically different. Surgical data and medical records were reviewed for aseptic survivorship, medical, and surgical complications. Patients were administered an r-WOMAC survey preoperatively and at 2-year postoperatively. Mean r-WOMAC pain, physical function, and total scores were tabulated and compared using Student's t-tests. Radiographs were reviewed serially throughout patient's postoperative follow-up. A p < 0.05 was considered significant. The aseptic failure rates were 1.25 and 5.0% for the robotic-assisted and manual cohorts, respectively. Patients in the robotic-assisted cohort had significantly improved 2-year postoperative r-WOMAC mean pain (1 ± 2 vs. 2 ± 3 points, p = 0.02), mean physical function (2 ± 3 vs. 4 ± 5 points, p = 0.009), and mean total scores (4 ± 5 vs, 6 ± 7 points, p = 0.009) compared with the manual TKA. Surgical and medical complications were similar in the two cohorts. Only one patient in the manual cohort had progressive radiolucencies on radiographic assessment. Robotic-assisted TKA patients demonstrated improved 2-year postoperative outcomes when compared with manual patients. Further studies could include multiple surgeons and centers to increase the generalizability of these results. The results of this study indicate that patients who undergo robotic-assisted TKA may have improved 2-year postoperative outcomes.

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Reply to Letter to the Editor: Impact of Compensated Cirrhosis Etiology on Postoperative Outcomes after Total Knee Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.08.047 ◽

2020 ◽

Vol 35 (12) ◽

pp. 3783-3784

Author(s):

Joshua E. Bell ◽

Brian C. Werner

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Postoperative Outcomes ◽

Compensated Cirrhosis ◽

Letter To The Editor ◽

Total Knee

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Impact of Compensated Cirrhosis Etiology on Postoperative Outcomes Following Total Knee Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2020.07.019 ◽

2021 ◽

Vol 36 (1) ◽

pp. 148-153.e1 ◽

Cited By ~ 1

Author(s):

Joshua E. Bell ◽

Raj Amin ◽

Lawal A. Labaran ◽

Sean B. Sequeira ◽

Sandesh S. Rao ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Postoperative Outcomes ◽

Compensated Cirrhosis ◽

Total Knee

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Revision Total Knee Arthroplasty with Metaphyseal Sleeves without Stem: Short-Term Results

Joints ◽

10.1055/s-0037-1607427 ◽

2017 ◽

Vol 05 (04) ◽

pp. 207-211 ◽

Cited By ~ 13

Author(s):

Giacomo Stefani ◽

Valerio Mattiuzzo ◽

Greta Prestini

Keyword(s):

Total Knee Arthroplasty ◽

Retrospective Study ◽

Knee Arthroplasty ◽

Bone Ingrowth ◽

Womac Score ◽

Revision Total Knee Arthroplasty ◽

X Rays ◽

Short Term ◽

Total Knee ◽

Baseline Values

Purpose The aim of this study was to evaluate the efficacy of revision total knee arthroplasty (TKA) with cementless metaphyseal sleeves without stems either in the femoral or tibial side or in both. Methods In this retrospective study, 51 patients (51 knees) operated in the period 2010 to 2015 met the above-mentioned criteria and were invited to a medical examination including X-rays. Forty-six were available for the study. Mean follow-up was 37 months. Knee Society score (KSS) (objective knee score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and range of motion (ROM) were used as outcome scores and compared with baseline values. X-rays were also examined and compared with postoperative exams to evaluate the presence of loosening, radiolucent lines, and bone ingrowth. Satisfaction of the patients was also investigated using a linear scale from 1 to 10. Results KSS improved from 39 to 77 (p < 0.01); WOMAC score improved from 76 to 41 (p < 0.01). Twenty-four (52%) patients were satisfied, 15 (32%) were partially satisfied, and 7 (16%) were unsatisfied. ROM improved from 93 to 96 degrees (nonsignificant difference). X-rays showed no loosening of the implants, radiolucent lines in 4 patients (3 of them were asymptomatic) and bone ingrowth in 43 out of 46 patients. Conclusion In this short-term retrospective study, the use of sleeves without stem was a safe and effective procedure in revision TKA. We found a significant improvement in clinical results compared with baseline values and no signs of implant loosening. Level of Evidence Level IV, therapeutic case series.

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