Comparison of Muscle Recovery Following Bi-cruciate Substituting versus Posterior Stabilized Total Knee Arthroplasty in the Asian Population

2017 ◽  
Vol 30 (07) ◽  
pp. 725-729 ◽  
Author(s):  
Akihito Takubo ◽  
Keinosuke Ryu ◽  
Yasuaki Tokuhashi ◽  
Takanori Iriuchishima
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Society Score ◽  
Muscle Power ◽  
Asian Population ◽  
Clinical Score ◽  
Posterior Stabilized ◽  
Function Score ◽  
Muscle Recovery ◽  
Significant Difference ◽  
Total Knee

AbstractThe purpose of this study was to compare muscle recovery in the lower extremities following the newly developed bi-cruciate substituting (BCS) to posterior stabilized (PS) total knee arthroplasty (TKA) in the Asian population. Forty-one knees in 41 patients undergoing BCS-TKA (41 female, average age: 71 ± 8.8) and 34 knees in 34 patients undergoing PS-TKA (33 female, average age: 73 ± 7.2) were included in this study. The maximum isometric power of the quadriceps and hamstring muscles was measured preoperatively, and at 1, 3, 6, and 12 months after surgery using a handheld dynamometer. Postoperative muscle recovery was calculated regarding preoperative muscle power as 100%. Pre- and postoperative range of knee motion, femorotibial angle, and clinical scores (Knee Society score and function score) were also compared. No significant difference in sex, age, preoperative quadriceps, or preoperative hamstring power was observed between the BCS and PS-TKA groups. When regarding the preoperative muscle power as 100%, quadriceps power at 1, 3, 6, and 12 months following BCS-TKA was 61.2 ± 22%, 86.3 ± 28.3%, 97 ± 27.4%, and 112.4 ± 30.8%, respectively. Quadriceps power at 1, 3, 6, and 12 months following PS-TKA was 72.4 ± 20.8%, 84 ± 16.9%, 95 ± 20.7%, and 110.8 ± 27%, respectively. Hamstring power at 1, 3, 6, and 12 months following BCS-TKA was 96.3 ± 30%, 111.4 ± 35%, 120 ± 37%, and 125 ± 31%, respectively. Hamstring power at 1, 3, 6, and 12 months following PS-TKA was 95 ± 25%, 112.4 ± 27%, 117 ± 38.5%, and 120.4 ± 18.5%, respectively. No significant difference in muscle power recovery was observed at 3 (p = 0.995), 6 (p = 0.944), and 12 (p = 0.917) months after surgery between the two groups. No significant difference of the clinical score was observed between the groups (Knee Society score: p = 0.479, function score: p = 0.342). No significant difference in muscle recovery and clinical score were observed between the BCS and PS-TKA groups. Longer follow-up is needed for the evaluation of efficacy of BCS-TKA in the Asian populations.

Prospective randomized trial of standard versus highly crosslinked tibial polyethylene in primary posterior-stabilized total knee arthroplasty

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 33-39 ◽  
Author(s):  
P. F. Lachiewicz ◽  
J. A. O’Dell
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Randomized Study ◽  
Posterior Stabilized ◽  
Function Score ◽  
Score Change ◽  
Osteolytic Lesions ◽  
Significant Difference ◽  
Total Knee

Aims There is insufficient evidence to recommend the use of alternative polyethylene bearings in modular, fixed-bearing total knee arthroplasty (TKA). The purpose of this study was to compare standard polyethylene (SP) and highly crosslinked polyethylene (XLP) tibial liners in posterior-stabilized TKA, with osteolysis as the primary outcome and clinical results and the rate of re-operation as the secondary outcomes. Patients and Methods This is a single-surgeon, prospective randomized study involving one design of modular posterior-stabilized TKA. An analysis of 122 TKAs with an SP compression moulded liner and 123 with an XLP liner was performed, with a mean follow-up of six years (2 to 11). Patients were evaluated clinically using the Knee Society score, Lower Extremity Activity Score (LEAS), and the presence of an effusion, and standard radiographs were assessed for radiolucent lines and osteolytic lesions. Results Osteolysis was present in four TKAs (3.3%) in the SP group, and no knees in the XLP group (p = 0.06). There were no significant differences between the Knee Society total score, change in total score, knee function score, change in function score, LEAS, and change in LEAS in the two groups. There was a significant difference in the presence of an effusion (10/122 with SP liners, 1/123 with XLP liners; p = 0.02). There was no significant difference in the rate of re-operation between the two groups (p = 0.36). There were no complications related to the XLP liner. Conclusion At this length of follow-up, there were no advantages and no complications related to the use of this XLP tibial liner. The presence of effusion and small osteolytic lesions was more frequent with SP than XLP liners, but of unknown clinical significance. Cite this article: Bone Joint J 2019;101-B(7 Supple C):33–39

scholarly journals Prospective study of clinical and functional outcome of total knee replacement in osteoarthritic knee

2016 ◽  
Vol 2 (4) ◽  
pp. 240 ◽  
Author(s):  
Rahul V. Kadam ◽  
Sunil Yadav ◽  
Abhay Chhallani ◽  
Chinmoy Sharma
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Tertiary Care ◽  
Clinical Score ◽  
Functional Score ◽  
Postoperative Score ◽  
Total Knee ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Total knee arthroplasty (TKA) is now a reliable treatment for osteoarthritis.  The aim of this study was to study the clinical and functional outcome of total knee arthroplasty using knee society score and to find association between knee functional score and knee clinical score.</p><p class="abstract"><strong>Methods:</strong> We conducted a prospective analysis of 40 cases of osteoarthritis knee patients at a tertiary care centre in Mumbai over a period of two years.  Those patients who underwent total knee arthroplasty were assessed clinically and functionally using knee society score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean preoperative knee clinical score (KCS) was 49.40±13.79 which was increased to a postoperative score of 86.08±5.64 at the end of 6 month. Similarly the mean preoperative knee functional score (KFS) was 32.75±11.79 which was increased to a postoperative score of 84.43±9.59 at the end of 6 month. There was significant increase in KCS and KFC score during follow up at 1, 3 and 6 month interval. There was significant association between knee functional score and knee clinical score at every interval.</p><p><strong>Conclusions:</strong> Total knee arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op knee clinical score and knee functional score.</p>

scholarly journals A study of clinical and functional outcome of primary total knee arthroplasty using posterior cruciate substitute design

2017 ◽  
Vol 3 (3) ◽  
pp. 380
Author(s):  
Radhakrishna A. M. ◽  
Shivananda S. ◽  
Girish S.
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Clinical Score ◽  
Functional Score ◽  
Consecutive Series ◽  
Total Knee ◽  
Primary Total Knee

<p class="abstract"><strong>Background:</strong> To <span lang="EN-IN">study the clinical and functional outcome in a consecutive series of Total Knee Arthroplasty using Posterior cruciate substituting (PS) design using the Knee Society Score(KSS). The objectives of the study was 1) To assess the improvement in pain relief post-operatively, stability, mobility of the joint and to assess the correction of deformities. 2) To compare the knee clinical score (KCS) pre-operatively and post-operatively. 3) To compare the knee functional score (KFS) pre-operatively and post-operatively. 4) To assess the radiological outcome of total knee arthroplasty. 5) To study the association between the KCS and the KFS.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study was conducted on patients who have undergone Primary total knee replacement, in Department of Orthopaedics, KIMS hospital from June 2014 to February 2017. The patient was assessed clinically, functionally using the Knee Society Score and a radiographic evaluation was done. These evaluations were performed at 6weeks, 12 weeks, 24 weeks and 1year follow up visits</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">At 1 year follow up of 60 knees, the average pre-op knee clinical score and functional score of 24.7 and 41.2 improved to an average post-op score of 89.9 and 87.8 respectively. Knee clinical and functional score grade of excellent to good was seen in 96.7% (58 knees of 60). Significant association was seen between KCS and KFS. 5 patients had delayed wound healing and one patient had deep infection. Alignment of prosthesis was found satisfactory in all patients. Flexion deformity, valgus and varus correction achieved in all the patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Total knee arthroplasty using posterior cruciate substituting designs resulted in excellent relief of pain, range of motion, restoration of function, low prevalence of patellofemoral complications and continues to function well during the follow-up period. Improvement in clinical score correlated significantly with improvement in functional score. Knee society scoring system effective in evaluating clinical, functional and radiological outcomes.</span></p><p> </p>

scholarly journals Comparative study on mid- and long-term clinical effects of medial pivot prosthesis and posterior-stabilized prosthesis after total knee arthroplasty

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Weipeng Shi ◽  
Yaping Jiang ◽  
Changyao Wang ◽  
Haining Zhang ◽  
Yingzhen Wang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Complications ◽  
Knee Arthroplasty ◽  
Chinese Patients ◽  
Clinical Effects ◽  
Posterior Stabilized ◽  
Significant Difference ◽  
Medial Pivot ◽  
Total Knee

Abstract Objective The purpose of this study was to explore the mid-and long-term clinical effects of Chinese patients with medial pivot (MP) prosthesis and posterior-stabilized (PS) prosthesis after total knee arthroplasty (TKA), to provide a reference for the recommendation of clinical prostheses. Methods A retrospective analysis of 802 patients who received TKA was performed from June 2010 to December 2013. A total of 432 patients received a MP prosthesis (MP group) and 375 patients received a PS prosthesis (PS group). Postoperative range of motion (ROM), clinical scores including the knee scoring system (KSS), the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), the forgotten joint score (FJS), and postoperative complications were compared between the two groups. Results A total of 527 patients were followed up, including 290 in the MP group and 237 in the PS group. Both groups achieved satisfactory results in terms of KSS score, WOMAC score, and postoperative ROM, which were significantly improved compared with those before surgery, but the difference between the groups was not statistically significant (P > 0.05). The FJS scores of the MP group and the PS group were satisfactory and no significant difference was observed (P = 0.426). Postoperative complications occurred in 5 and 11 patients in the MP group and PS group, respectively. Conclusion The clinical results of TKA with MP or PS in Chinese patients at mid- and long-term are encouraging, and no significant differences were observed between the two types of prostheses. Studies have also shown that both prostheses are safe for Chinese patients.

Early Aseptic Loosening with Increased Presence and Severity of Backside Burnishing in the Optetrak Logic Posterior-Stabilized Total Knee Arthroplasty Femoral Component

2021 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
David A. Iacobelli ◽  
Lisa Torres ◽  
Carolena Rojas Marcos ◽  
Allina A. Nocon ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Significant Difference ◽  
Group A ◽  
Total Knee ◽  
Group B ◽  
Severe Degree

AbstractConcerns persist that the Optetrak Logic posterior-stabilized (PS) total knee arthroplasty (TKA) femoral component might correlate with early failures due to aseptic loosening. The primary aim of this study was to examine if the use of the Optetrak Logic PS femoral component is associated with early (<5 years) and more extensive aseptic loosening compared with other PS femoral components. This is a single-institution retrieval analysis and revision registry study (based on prospectively collected data) of 27 failed primary PS TKA patients with loose femoral components that underwent revision TKAs between 2016 and 2019. Patients were stratified by components type: Group A (n = 16) received the Optetrak Logic PS femoral component, while Group B (n = 11) received other PS femoral components. Burnishing (macroscopic polishing of the component's backside) was observed and graded as a marker for relative motion at the cement-implant interface. No significant differences were found between the two groups regarding the baseline demographic, radiographic, and clinical characteristics. Mean length of implantation for Group A (3.8 ± 2.9 years) was significantly shorter (p < 0.001) than that of Group B (12.0 ± 6.7 years). A significant difference (p = 0.009) was found in presence of backside femoral burnishing between Group A (15 of 16 patients; 93.8%) and group B (5 of 11 patients; 45.6%). Furthermore, we found a significant difference (p < 0.001) in the severity of burnishing between Group A (13 of 16 patients with severe degree of burnishing; 81.3%) and Group B (1 of 11 patients with severe degree of burnishing; 9.1%). In contrast to Group B, a distinctive macroscopic pattern found in Logic retrieved femoral components (Group A) was the total absence of cement in the backside surface. The use of the Optetrak Logic PS TKA femoral component was associated with early aseptic loosening and increased presence and severity of backside burnishing with early cement-implant interface debonding compared with other commercially available types of PS TKA femoral components. The earlier failure rate with this implant is of concern.

scholarly journals Clinical and functional outcome of total knee replacement in patients with osteoarthritis: a prospective study

2017 ◽  
Vol 3 (6) ◽  
pp. 1148
Author(s):  
Umang Shihora ◽  
Bimal Modi
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Medical Science ◽  
Clinical Score ◽  
Functional Score ◽  
Postoperative Score ◽  
Total Knee ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Total knee arthroplasty (TKA) is now a reliable treatment for osteoarthritis. The aim of this study was to study the clinical and functional outcome of total knee arthroplasty using knee society score and to find association between knee functional score and knee clinical score.</p><p class="abstract"><strong>Methods:</strong> Present study was performed in 40 cases of knee patients at department of orthopedics, Gujarat Adani institute of osteoarthritis medical science, Bhuj, Kutch, Gujarat from January 2014 to February 2015. Those patients who underwent total knee arthroplasty were assessed clinically and functionally using knee society score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean preoperative knee clinical score (KCS) was 49.40±13.79 which was increased to a postoperative score of 86.08±5.64 at the end of 6 month. Similarly the mean preoperative knee functional score (KFS) was 32.75±11.79 which was increased to a postoperative score of 84.43±9.59 at the end of 6 month. There was significant increase in KCS and KFC score during follow up at 1, 3 and 6 month interval. There was significant association between knee functional score and knee clinical score at every interval.</p><p><strong>Conclusions:</strong> Total knee arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op knee clinical score and knee functional score.</p>

scholarly journals Early Outcomes of Cemented versus Cementless Total Knee Arthroplasty

2019 ◽  
Vol 9 (4) ◽  
pp. 93-98
Author(s):  
Jeffrey Shepherd ◽  
Alexander C.M. Chong ◽  
Robert P. Cusick
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Clinical Score ◽  
Functional Score ◽  
Patient Demographics ◽  
Included Patient ◽  
Significant Difference ◽  
Measured Time ◽  
Total Knee

Introduction. Total knee arthroplasty (TKA) has been provento be very effective for long-term pain relief in the degenerativeknee. Few studies have investigated short-term clinicaland functional outcomes between the cemented and cementlessTKA. The specific aim of this study was to assess the potentialdifference of functional outcomes in the early postoperativeperiod between these two surgical options usingthe Knee Society Score (KSS) and range of motion (ROM). Methods. A total of 164 knees that had undergone TKA by a singlesurgeon at a single institution between 2007 and 2010 were reviewed.Three different TKA prosthetic designs (cruciate retaining(CR), posterior stabilized (PS) and cruciate substituting (CS))were included. Data collection included patient demographics,pre- and post-operative ROM, and pre- and post-operative KSSat each visit (1.5 months, 3 months, and 12 months). Two separateKSS scores were assigned: functional score and clinical score. Results. Sixty-seven knees underwent cemented TKA and 97knees underwent cementless TKA. No significant differencewas recognized in either age or body mass index for thesetwo TKA groups. The cementless group showed a significantearly ROM improvement after 1.5 months post-operative (p <0.05), while the cemented group showed ROM improvementonly after three months post-operative. No significant differencewas detected in terms of KSS between the cemented andcementless TKA groups at each measured time period. Bothgroups showed marked KSS improvement (cemented: 135%,cementless: 125%) after 1.5 months post-operative and theKSS seemed to be stabilized after three months post-operativefor both groups (cemented: p = 0.36; cementless: p = 0.07). Conclusions. There was a significant early ROM improvementfor the cementless TKA group compared to the cementedTKA group, but no statistical significant difference was notedin KSS in the early post-operative period when comparing cementedand cementless TKA groups. The findings provide evidencethat cementless TKA patients can undergo an identicalpost-operative protocol to cemented TKA, without concernsabout implant stability or function. KS J Med 2016;9(4):93-98.

scholarly journals Outcome after total knee arthroplasty with or without patellar resurfacing

2021 ◽  
Author(s):  
M. Shahbaz Siddiqui ◽  
Vivek Kumar Parsurampuriya ◽  
Neeraj Kumar ◽  
Sumedh Kumar
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Visual Analogue Score ◽  
Patellar Resurfacing ◽  
Rest Pain ◽  
Randomised Study ◽  
Significant Difference ◽  
Functional Scores ◽  
Total Knee

<p><strong>Background: </strong>Patellar resurfacing in total knee arthroplasty has had its defenders and detractors. There seems to be a great difference in patellar resurfacing between countries and patellar resurfacing is still controversial. Some surgeons resurface the patella routinely, others not at all, and a third group prefers selective resurfacing. Therefore, in this prospective and randomised study, we compared the outcome after total knee arthroplasty with or without patellar resurfacing.</p><p><strong>Methods: </strong>In this study 50 cases (100 knees) were selected and each case was followed up for 2 years. In each case, one knee was operated by TKA with patellar resurfacing and the other by TKA with patellar non-resurfacing. Patients were followed-up for a period of 2 years and clinical and functional outcome of both knees was measured and compared by the help of knee society score (KSS) and VAS score.</p><p><strong>Results: </strong>There was statistically significant difference between the patellar resurfacing and non-resurfacing group with regard to knee society score, pain score and visual analogue score (VAS), with the patellar resurfacing having better scores. There was no significant difference in the functional scores between the 2 groups. Range of motion was complication rate was comparable in both the groups. However, there was no case of reoperation nor was there any complication related to the patellar implant. </p><p><strong>Conclusions:</strong> Patellar resurfacing in TKA leads to less post-operative persisting knee pain, and also leads to better outcome in terms of walking without pain, using stairs without pain and rest pain as compared to TKA without patellar resurfacing.</p>

scholarly journals The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial

2021 ◽  
Vol 12 ◽  
pp. 215145932199663
Author(s):  
Mustafa Kaçmaz ◽  
Zeynep Yüksel Turhan
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Nerve Block ◽  
Knee Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Adductor Canal Block ◽  
Adductor Canal ◽  
Significant Difference ◽  
Total Knee

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.

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