Failure to Resurface the Patella during Total Knee Arthroplasty May Result in More Knee Pain and Secondary Surgery

2005 ◽  
Vol &NA; (438) ◽  
pp. 191-196 ◽  
Author(s):  
Javad Parvizi ◽  
Venkat R Rapuri ◽  
Khaled J Saleh ◽  
Michael A Kuskowski ◽  
Peter F Sharkey ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Secondary Surgery ◽  
Total Knee

scholarly journals A Dutch Survey on Circumpatellar Electrocautery in Total Knee Arthroplasty

2010 ◽  
Vol 4 (1) ◽  
pp. 201-203 ◽  
Author(s):  
Hans-Peter W. van Jonbergen ◽  
Alexander F.W. Barnaart ◽  
Cees C.P.M. Verheyen
Keyword(s):  
Total Knee Arthroplasty ◽  
The Netherlands ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Patellar Resurfacing ◽  
Orthopedic Surgeons ◽  
Unicompartmental Knee Arthroplasties ◽  
Total Knee ◽  
Anterior Knee

Introduction: Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown. Materials and Methodology: In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands. The questions focused on the frequency of total knee arthroplasties, patellar resurfacing, and the use of circumpatellar electrocautery. Results: The response rate was 92%. A total of 18,876 TKAs, 2,096 unicompartmental knee arthroplasties, and 215 patellofemoral arthroplasties are performed yearly in The Netherlands by the responding orthopedic surgeons. Of the orthopedic surgeons performing TKA, 13% always use patellar resurfacing in total knee arthroplasty for osteoarthritis, 49% use selective patellar resurfacing, and 38% never use it. Fifty-six percent of orthopedic surgeons use circumpatellar electrocautery when not resurfacing the patella, and 32% use electrocautery when resurfacing the patella. Conclusion: There is no consensus among Dutch orthopedic surgeons on the use of patellar resurfacing or circumpatellar electrocautery in total knee replacement performed for osteoarthritis. A prospective clinical trial is currently underway to fully evaluate the effect of circumpatellar electrocautery on the prevalence of anterior knee pain following total knee arthroplasty.

Selective Denervation for Persistent Knee Pain After Total Knee Arthroplasty: A Report of 50 Cases

2017 ◽  
Vol 32 (3) ◽  
pp. 968-973 ◽  
Author(s):  
Shao-Min Shi ◽  
David W. Meister ◽  
Kelly C. Graner ◽  
James T. Ninomiya
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Total Knee

Radiographs are not sufficient for evaluation of component fit in subtle knee pain after total knee arthroplasty

2020 ◽  
Vol 28 (6) ◽  
pp. 2015-2022
Author(s):  
Mehmet Emin Simsek ◽  
Safa Gursoy ◽  
Mustafa Akkaya ◽  
M. I. Safa Kapicioglu ◽  
Murat Bozkurt
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Variability in Recommendations for Total Knee Arthroplasty Among Rheumatologists and Orthopedic Surgeons

2013 ◽  
Vol 41 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Liana Fraenkel ◽  
Lisa Suter ◽  
Lawrence Weis ◽  
Gillian A. Hawker
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Employment Status ◽  
Functional Limitations ◽  
Knee Oa ◽  
Orthopedic Surgeons ◽  
Physician Characteristics ◽  
Academic Settings ◽  
Total Knee

Objective.The most rapidly growing population of patients undergoing total knee arthroplasty (TKA) is under the age of 65. The objective of our study was to gain insight into the factors influencing physicians’ recommendations for persons in this age group with moderate osteoarthritis (OA).Methods.Rheumatologists and orthopedic surgeons attending national meetings were asked to complete a survey including a standardized scenario of a 62-year-old person with knee OA who has moderate knee pain limiting strenuous activity despite medical management. We used an experimental 2 × 2 × 2 design to examine the effects of sex, employment status, and severity of radiographic OA on physicians’ recommendations. Each physician was asked to rate a single scenario.Results.The percentage of physicians recommending TKA varied from 30% to 55% for scenarios describing a patient with mild radiographic OA, and from 39% to 71% for scenarios describing a patient with moderate radiographic OA. Surgeons were less likely to recommend TKA for women compared to men of the same age, employment status, symptom severity, and functional status, and radiographs. Rheumatologists practicing in academic settings were more likely to recommend TKA compared to those practicing in nonacademic settings, and American surgeons were more likely to recommend TKA compared to their European counterparts.Conclusion.Orthopedic surgeons and rheumatologists vary significantly in their recommendations for patients with moderate knee pain and functional limitations. Both patient and physician characteristics influence physicians’ recommendations, and rheumatologists and orthopedic surgeons display different patterns of decision making.

Pseudomeniscus following total knee arthroplasty as a cause of persistent knee pain

1997 ◽  
Vol 12 (1) ◽  
pp. 114-118 ◽  
Author(s):  
David M. Scher ◽  
J.Cletus Paumier ◽  
Paul E. Di Cesare
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Fatigue failure of the femoral component of a total knee arthroplasty: a case report and review of the literature

2020 ◽  
Author(s):  
W Greeff ◽  
RDV Greeff ◽  
CT Frey ◽  
V Singh
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Case Report ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Pain ◽  
Fatigue Failure ◽  
Knee Arthroplasty ◽  
English Literature ◽  
Total Knee

ABSTRACT INTRODUCTION: Reports of fatigue failure of the femoral component of a total knee arthroplasty (TKA) is scanty in the literature. As a result, there are no clearly defined risk factors to aid us in predicting fatigue failure of an implant. Furthermore, these patients may present with non-specific knee pain, which may or may not be well tolerated, depending on the stability of the implant. We report a case of fatigue failure of a poorly cemented femoral component of a TKA in a 72-year-old female, approximately seven years after the initial surgery CASE REPORT: A 72-year-old female presented to our tertiary level arthroplasty unit with new-onset knee pain approximately seven years after undergoing a TKA at our unit. She reported hearing a crack six months earlier, while standing up from a seated position. She had initially presented to her local clinic, but the pathology was missed. She received revision surgery at our institution and was doing well at early follow-up. DISCUSSION: We reviewed the literature on fatigue failure of femoral components in TKA in an attempt to define risk factors. We also summarised all cases of femoral component fatigue failure in the English literature. CONCLUSION: Although femoral component fatigue failure in TKA is rare, the majority of cases have attributed the failure to poor surgical technique. Despite this, certain implants have been failing more often than others, and proposed mechanisms for this exist. Orthopaedic surgeons need to be aware of which implant designs are prone to failure, as well as how meticulous surgical technique can reduce the chances of fatigue failure. Level of evidence: Level 5 Keywords: femoral component, total knee arthroplasty, fatigue failure, stress fracture

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