Acute Total Knee Replacement in Rheumatoid Arthritis Patients with Proximal Tibial Fractures: A Case Series

2020 ◽  
Author(s):  
Fardin Mirzatolooei ◽  
Ali Tabrizi ◽  
Mir Bahram Safari ◽  
Seyed Amir Mahlisha Kazemi Shishavan
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Case Series ◽  
Normal Activity ◽  
Tibial Fractures ◽  
Proximal Tibial Fractures ◽  
Total Knee ◽  
The Mean ◽  
And Function

AbstractManagement of proximal tibial fractures is a challenging issue in patients with rheumatoid arthritis (RA). In the present study, we aimed to describe our experience of acute total knee replacement in RA patients.This case series included 11 RA patients with simultaneous insufficiency fractures of the proximal tibia, who were treated by acute total knee replacement. Midterm functional results, severity of pain, Hospital for Special Surgery (HSS), and Knee Society Score (KSS) parameters were evaluated in this study. The patients were followed up for 24 months.Eleven women with proximal tibial fractures and history of RA (mean age: 54.3 ± 4.7 years) were enrolled in this study. The mean score of Tegner activity scale was 2.2 ± 1.4 preoperatively, which significantly improved to 4.3 ± 1.4 postoperatively (p < 0.001). The two sections of KSS (knee and function section) averaged 88.7 ± 5.4 and 59.4 ± 8.2, respectively. There wasn't poor outcome and excellent result was in knee section 54.5% and function section 36.3% based on KSS. The mean score of pain severity during normal activity before fracture was 65.2 ± 12.3, which significantly reduced to 35.5 ± 11.3 in the final follow-up (p = 0.02). The score of HSS scale improved from 42 (range: 16–58) in the preoperative stage to 78 (range: 72–91) after surgery (p < 0.001). In the 6-month follow-up, deep vein thrombosis was reported in two patients. The time required to return to normal activity was 5.5 ± 2.3 months.Based on the findings, total knee replacement therapy in patients with RA and proximal tibial fractures produced excellent clinical outcomes, which led to rapid return to normal activity. This is a Level IV, therapeutic study.

Kniegelenksendoprothetik bei hämophiler Arthropathie

2010 ◽  
Vol 30 (S 01) ◽  
pp. S104-S106
Author(s):  
W. Miesbach ◽  
L. M. Sahner ◽  
A. Kurth ◽  
B. Habermann
Keyword(s):  
Quality Of Life ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Society Score ◽  
Normal Population ◽  
Knee Function ◽  
Total Knee ◽  
The Mean

Summary Purpose Purpose of this retrospective study was to evaluate our own results after total knee replacement in patients with haemophilia. Patients, material, method: 30 patients with haemophilia who underwent total knee replacement between 1987 and 2005 were included. We used the clinical and radiological Knee Society Score. Furthermore, the Petterson and the Arnold and Hilgartner score were applied. Results: The mean age at the time of surgery was 43.2 (27–66). At the time of follow- up examination the mean age was 51.6 (30–82) years. The mean follow-up was 7.1 (2–20) years. Preoperative, he mean Arnold and Hilgartner score was 4.17 (± 0.59) and the mean Petterson-Score was 9 ± 2.29. Compared to the preoperative deficiency in knee function (KSS-Score 88.17 ± 33.58) an improvement with 166.67 (± 22.73) points was seen. 1 patient showed an aseptic loosening after 11 years. Discussion: Total knee replacement in patients with haemophilia improves knee function and quality of life. The results of our study represent results in earlier published studies. Compared to a non-haemo-philic normal population the rate of perioper-ative complications was not increased.

scholarly journals Early assessment of patient perception of outcome in total knee replacement

Joints ◽  
2014 ◽  
Vol 02 (02) ◽  
pp. 71-75 ◽  
Author(s):  
Filippo Boniforti ◽  
Antonio Macaione ◽  
Stefano Gagliardi ◽  
Francesco Giangrasso ◽  
Davide Di Marzo ◽  
...  
Keyword(s):  
Health Status ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Case Series ◽  
Early Period ◽  
Patient Perception ◽  
Early Assessment ◽  
Total Knee

Purpose: the aim of the present study was to measure patient perception in the early period after knee replacement surgery and to correlate health status with the surgery-related outcome. Methods: thirty-eight consecutive patients who underwent total knee replacement were evaluated before surgery; at the time Radiographic evaluation was used to assess limb alignment and the Oxford Knee Score (OKS) to assess objective outcome. Health outcome was measured with the three-level version of the EuroQol – five dimension (EQ-5D-3L) selfadministered questionnaire, a standardized instrument used to measure patient’s perception of health status. Evaluation was performed before surgery, at discharge from hospital, and six weeks after surgery. Results: the mean overall EQ-5D-3L scores were 10.23 before surgery, 8.34 at discharge from the hospital, and 6.52 at six weeks. The overall EQ-5D-3L score before surgery was greater than 8 points in 31 of the 38 patients, ranging from 5 to 8 points in 21 of the 38 patients at the discharge and greater than 8 points in six of the 38 patients six weeks after surgery. Patients with scores of over 8 points at six weeks also scored more than 10 points on the discharge assessment. Conclusions: analysis of early patient reports of performance after TKR showed marked changes in the level of satisfaction during the first six weeks after surgery. An EQ-5D-3L score of 8 or more at follow-up should be considered a sign that the patient has not achieved satisfaction and, accordingly, should be studied in the context of a personalized follow-up schedule in order to identify as soon as possible the causes of impairment. Level of Evidence: Level IV, prognostic case series.

Manipulation under anaesthesia post total knee replacement: Long term follow up

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 329-331 ◽  
Author(s):  
David Yeoh ◽  
Nick Nicolaou ◽  
Richard Goddard ◽  
Henry Willmott ◽  
Kim Miles ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Long Term Follow Up ◽  
Manipulation Under Anaesthesia ◽  
Total Knee

scholarly journals Over 5-Year Follow-up of Total Knee Replacement with the Okayama University Type(Mark II).

1991 ◽  
Vol 40 (1) ◽  
pp. 55-58
Author(s):  
Eiji Kawaguchi ◽  
Tetuya Hirano ◽  
Kunihiko Tomoda ◽  
Kenichi Yamashiro ◽  
Kiminori Sakamoto ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee

DOES NAVIGATION TOTAL KNEE REPLACEMENT REALLY MAKE A DIFFERENCE?

2013 ◽  
Vol 16 (02) ◽  
pp. 1350007
Author(s):  
P. Motwani ◽  
A. Jariwala ◽  
N. Valentine
Keyword(s):  
Total Knee Replacement ◽  
Tibial Component ◽  
Sagittal Plane ◽  
Computer Navigation ◽  
Component Alignment ◽  
Tibial Component Alignment ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean

Background: Computer Navigation in Total Knee Replacement (TKR) has completed more than a decade since its inception. From that time, numerous studies have been done to see its effect on the variables of surgery and its outcome. Some studies have shown that it is definitely beneficial while others have negated its superiority over conventional techniques. This is an early outcome study on the results of navigation TKR in terms of alignment and clinical outcome at three years post-operatively. Methods: In the present study, 128 patients who had undergone navigation TKR (128 TKR) between January 2006 and November 2009 were included. The navigation system used was orthoPilot®. Patients were assessed post-operatively at one and three year using knee society score (KSS) and knee function score (KFS). All patients completed one year follow-up and 55 patients completed three year follow-up. From 128 patients, 40 navigated TKR patients operated between November 2007 and 2009 and were compared with 40 patients operated by conventional TKR operated between July 2007 and December 2008. Results: The mean KSS at 1 year post-operatively was 85.60 and at 3 years was 85.87. The mean KFS at 1 year post-operatively was 69.30 and at 3 years was 68.00. There was no statistically significant difference between navigation TKR and conventional TKR in terms of anatomical femoro-tibial alignment, femoral component alignment in coronal and sagittal plane and tibial component alignment in coronal plane. However, there was statistically significant difference between tibial component alignment in sagittal plane (p = 0.000) between both the groups. Conclusion: Computer navigation TKR affords a possibility to place both the femoral and tibial component very precisely without the risk of any greater axis deviation from ideal value. It helps in reducing the outliers in alignment of the limb and that of component and that improves the overall implant survival for a long time post-operatively.

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