scholarly journals 1064 Extra-Articular Tibial Deformity Management in Total Knee Replacement

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S M Choi ◽  
R Kumar ◽  
R Morgan-Jones ◽  
S Agarwal
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Mechanical Axis ◽  
Corrective Osteotomy ◽  
Oxford Knee Score ◽  
Coronal Plane ◽  
Replacement Surgery ◽  
Tibial Resection ◽  
Knee Replacements ◽  
Total Knee

Abstract Aim In knee replacements, restoration of mechanical alignment is essential. Patients with extra-articular deformities (EAD) pose challenges in planning knee replacements. We present a method, based on our experience and review of literature on planning knee replacement surgery, in the presence of extra-articular coronal plane deformity of the tibia. Method Retrospective analysis was made of six patients with EAD of the tibia who underwent knee replacement at our centre. Mechanical axis of the tibia is considered and positioning of the tibia component is planned perpendicular to the mechanical axis of the tibia. The integrity of the collaterals determines the need for correction. Tibial resection >15mm from medial or lateral aspect of the tibia is an indication for corrective osteotomy prior to replacement surgery. The hip knee ankle angle (HKA) was noted. Pre-operative, post-operative clinical score, degree of constraints and post-operative complications were recorded. A post-operative long leg alignment radiograph was obtained. Result All patients had total knee replacement without correction of deformity. Adequate alignment of the limb and restoration of mechanical axis was achieved in all six patients without the need for correction of tibial deformity. All patients had improvement in their HKA angle and Oxford knee score. No re-operations were required, and no complications recorded. Conclusions Our study will help provide guidance on operative planning and decisions making for patients with extra-articular coronal plane tibial deformities.

scholarly journals The Utility of Outcome Measures in Total Knee Replacement Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Michelle M. Dowsey ◽  
Peter F. M. Choong
Keyword(s):  
Total Knee Replacement ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Significant Proportion ◽  
Oxford Knee Score ◽  
High Volume ◽  
Outcome Data ◽  
Knee Oa ◽  
Replacement Surgery ◽  
Total Knee

Total knee replacement (TKR) is the mainstay of treatment for people with end-stage knee OA among suitably “fit” candidates. As a high cost, high volume procedure with a worldwide demand that continues to grow it has become increasingly popular to measure response to surgery. While the majority who undergo TKR report improvements in pain and function following surgery, a significant proportion of patients report dissatisfaction with surgery as a result of ongoing pain or poor function. Poor outcomes of TKR require care that imposes on already overburdened health systems. Accurate and meaningful capture and interpretation of outcome data are imperative for appropriate patient selection, informing those at risk, and for developing strategies to mitigate the risk of poor results and dissatisfaction. The ways in which TKR outcomes are captured and analysed, the level of follow-up, the types of outcome measures used, and the timing of their application vary considerably within the literature. With this in mind, we reviewed four of the most commonly used joint specific outcome measures in TKR. We report on the utility, strengths, and limitations of the Oxford knee score (OKS), knee injury and osteoarthritis outcome score (KOOS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and knee society clinical rating system (KSS).

Participation in Sports After Total Knee Replacement

1998 ◽  
Vol 26 (4) ◽  
pp. 530-535 ◽  
Author(s):  
Neil Bradbury ◽  
David Borton ◽  
Geoff Spoo ◽  
Mervyn J. Cross
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Retrospective Review ◽  
High Impact ◽  
Regular Exercise ◽  
Sports Activity ◽  
Replacement Surgery ◽  
Knee Replacements ◽  
Total Knee

Return to regular sports activity was evaluated in a retrospective review of 160 patients who had undergone total knee replacement surgery by a single surgeon (208 knee replacements). Mean age of the patients was 68 years (range, 27 to 87) at surgery and 73 years (range, 33 to 91) at review at a mean follow-up of 5 years (range, 3 to 7). Seventy-nine patients regularly participated in sports, at least once per week, before surgery, and 51 patients regularly participated in sports after surgery. Only eight patients took up sports after surgery who were not regularly involved in sports in the year before surgery. Patients were more likely to return to low-impact activities such as bowls (29 of 32, or 91%) than to high-impact activities such as tennis (6 of 30, or 20% returned). Forty-three of 56 patients (77%) who had participated in regular exercise in the year before surgery returned to sports. Eighty patients did not participate in sports before surgery and 54 of these had coexisting disease that prevented sports. None of these patients returned to sports.

scholarly journals Microfragmented Adipose Tissue Injection (MFAT) May Be a Solution to the Rationing of Total Knee Replacement: A Prospective, Gender-Bias Mitigated, Reproducible Analysis at Two Years

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Nima Heidari ◽  
Tiffanie-Marie Borg ◽  
Stefano Olgiati ◽  
Mark Slevin ◽  
Alessandro Danovi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adipose Tissue ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Ageing Population ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee

Background. Knee osteoarthritis (KOA) is a significant cause of disability in a globally ageing population. Knee replacement surgery has been shown to improve function and quality of life. Access to this intervention can be limited for a number of reasons including rationing of care, lack of healthcare provision in austere environments, and more recently, due to the cessation of elective orthopaedic care as a result of the COVID pandemic. Referral for knee replacement surgery is often guided by the patient’s Oxford Knee Score (OKS). Recent therapies including treatment with microfragmented adipose tissue (MFAT) have emerged as alternatives to relieve pain and improve function in such patients. Method. We identified all patients with KOA Kellgren-Lawrence grade 3 and 4 in our dataset of patients treated with a single injection of MFAT and applied published OKS thresholds for referral for TKR to separate them into 3 cohorts according to their functional impairment. 220 patients (95 females, 125 males) with KOA were given one MFAT injection. The function (OKS) and quality of life (EuroQol-5) prior to and 24 months after therapy were compared. Results. MFAT injection provided a statistically significant improvement in the quality of life (EQ-5D) at 24 months in patients with a baseline OKS of 39 or less ( p value: <0.001) as well as those with OKS of 27 or less who are deemed suitable for a knee replacement ( p value: <0.001). Conclusion. MFAT injection improves quality of life in patients with KOA who are deemed suitable for the knee replacement. MFAT is a low-morbidity alternative biological treatment and can delay the need for total knee replacement in suitable patients.

scholarly journals Self-Reported Knee Instability Before and After Total Knee Replacement Surgery

2016 ◽  
Vol 68 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Genevieve Fleeton ◽  
Alison R. Harmer ◽  
Lillias Nairn ◽  
Jack Crosbie ◽  
Lyn March ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Instability ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Before And After ◽  
Total Knee

scholarly journals Comparison of 2 Analgesia Modalities in Total Knee Replacement Surgery: Is There an Effect on Knee Function Rehabilitation?

2017 ◽  
Vol 23 ◽  
pp. 3019-3025 ◽  
Author(s):  
Janis Zinkus ◽  
Lina Mockutė ◽  
Arūnas Gelmanas ◽  
Ramūnas Tamošiūnas ◽  
Arūnas Vertelis ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Function ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

scholarly journals Autologous blood transfusion in total knee replacement surgery

2013 ◽  
Vol 70 (3) ◽  
pp. 274-278 ◽  
Author(s):  
Mirka Lukic-Sarkanovic ◽  
Ljiljana Gvozdenovic ◽  
Dragan Savic ◽  
Miroslav Ilic ◽  
Gordana Jovanovic
Keyword(s):  
Blood Transfusion ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Autologous Blood ◽  
Allogeneic Blood ◽  
Autologous Blood Transfusion ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Total Knee

Background/Aim. Total knee replacement (TKR) surgery is one of the most frequent and the most extensive procedures in orthopedic surgery, accompanied with some serious complications. Perioperative blood loss is one of the most serious losses, so it is vital to recognize and treat such losses properly. Autologous blood transfusion is the only true alternative for the allogeneic blood. The aim of this study was to to examine if autologous blood transfusion reduces usage of allogenic blood in total knee replacement surgery, as well as to examine possible effect of autologous blood transfusion on postoperative complications, recovery and hospital stay of patients after total knee replacement surgery. Methods. During the controlled, prospective, randomised study we compared two groups of patients (n = 112) with total prosthesis implanted in their knee. The group I consisted of the patients who received the transfusion of other people?s (allogeneic) blood (n = 57) and the group II of the patients whose blood was collected postoperatively and then given them [their own (autologous) blood] (n = 55). The transfusion trigger for both groups was hemoglobin level of 85 g/L. Results. In the group of patients whose blood was collected perioperatively only 9 (0.9%) of the patients received transfusion of allogeneic blood, as opposed to the control group in which 98.24% of the patients received the transfusion of allogeneic blood (p ? 0.01). The patients whose blood was collected stayed in hospital for 6.18 days, while the patients of the control group stayed 7.67 days (p < 0.01). Conclusion. Autologous blood transfusion is a very effective method for reducing consumption of allogenic blood and thus, indirectly for reducing all complications related to allogenic blood transfusion. There is also a positive influence on postoperative recovery after total knee replacement surgery due to the reduction of hospital stay, and indirectly on the reduction of hospital costs.

Sign in / Sign up

Export Citation Format

Share Document