scholarly journals Patient-Specific CT-Based Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty: A Prospective Randomized Controlled Study on Clinical Outcomes and In-Hospital Data

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Andrzej Kotela ◽  
Jacek Lorkowski ◽  
Marek Kucharzewski ◽  
Magdalena Wilk-Frańczuk ◽  
Zbigniew Śliwiński ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Controlled Study ◽  
Patient Specific ◽  
Control Group ◽  
Hospital Data ◽  
Randomized Controlled ◽  
Conventional Instrumentation ◽  
Total Knee

Total knee arthroplasty (TKA) is a frequently performed procedure in orthopaedic surgery. Recently, patient-specific instrumentation was introduced to facilitate correct positioning of implants. The aim of this study was to compare the early clinical results of TKA performed with patient-specific CT-based instrumentation and conventional technique. A prospective, randomized controlled trial on 112 patients was performed between January 2011 and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients who received the Signature CT-based implant positioning system, and the control group consisted of 60 patients with conventional instrumentation. Clinical outcomes were evaluated with the KSS scale, WOMAC scale, and VAS scales to assess knee pain severity and patient satisfaction with the surgery. Specified in-hospital data were recorded. Patients were followed up for 12 months. At one year after surgery, there were no statistically significant differences between groups with respect to clinical outcomes and in-hospital data, including operative time, blood loss, hospital length of stay, intraoperative observations, and postoperative complications. Further high-quality investigations of various patient-specific systems and longer follow-up may be helpful in assessing their utility for TKA.

scholarly journals AQUACEL® Ag Surgical Dressing Reduces Surgical Site Infection and Improves Patient Satisfaction in Minimally Invasive Total Knee Arthroplasty: A Prospective, Randomized, Controlled Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Feng-Chih Kuo ◽  
Bradley Chen ◽  
Mel S. Lee ◽  
Shih-Hsiang Yen ◽  
Jun-Wen Wang
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Minimally Invasive ◽  
Knee Arthroplasty ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Site Infection ◽  
Randomized Controlled ◽  
Total Knee

The use of modern surgical dressings to prevent wound complications and surgical site infection (SSI) after minimally invasive total knee arthroplasty (MIS-TKA) is lacking. In a prospective, randomized, controlled study, 240 patients were randomized to receive either AQUACEL Ag Surgical dressing (study group) or a standard dressing (control group) after MIS-TKA. The primary outcome was wound complication (SSI and blister). The secondary outcomes were wear time and number of dressing changes in the hospital and patient satisfaction (pain, comfort, and ease of use). In the intention-to-treat analysis, there was a significant reduction in the incidence of superficial SSI (0.8%, 95% CI∶ 0.00–2.48) in the study group compared to 8.3% (95% CI∶ 3.32–13.3) in the control group (p=0.01). There were no differences in blister and deep/organ-space SSIs between the two groups. Multivariate analysis revealed that AQUACEL Ag Surgical dressing was an independent risk factor for reduction of SSI (odds ratio: 0.07, 95% CI: 0.01–0.58, p=0.01). The study group had longer wear time (5.2±0.7 versus 1.7±0.4 days, p<0.0001) and lower number of dressing changes (1.0±0.2 versus 3.6±1.3 times, p<0.0001). Increased patient satisfaction (p<0.0001) was also noted in the study group. AQUACEL Ag Surgical dressing is an ideal dressing to provide wound care efficacy, patient satisfaction, reduction of SSI, and cost-effectiveness following MIS-TKA.

Effect of Acupressure and Abdominal Massage on Constipation in Patients with Total Knee Arthroplasty: A Randomized Controlled Study

2021 ◽  
pp. 105477382110339
Author(s):  
Mahinur Durmuş İskender ◽  
Nurcan Çalışkan
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Controlled Study ◽  
Control Group ◽  
Randomized Controlled ◽  
Massage Group ◽  
Total Knee ◽  
Abdominal Massage ◽  
Group Control Group

This study was a randomized controlled trial aimed to compare the effects of acupressure and abdominal massage on constipation development for patients with TKA. The patients were randomly assigned to each group: control group ( n = 31), acupressure group ( n = 30), and abdominal massage group ( n = 30). The finding showed that the severity of constipation and straining stool consistency of the groups in which acupressure and abdominal massage was applied are significantly better than the control group ( p < .05). When the first defecation times of the groups are analyzed, it is seen that the patients to whom acupressure and abdominal massage are applied defecate significantly earlier than the control group ( p < .05). It has been concluded that safe non-invasive acupressure and abdominal massage that can be easily applied by health professions, healthy individuals, and patients is effective on patients with total knee arthroplasty for the prevention of constipation.

Temperature-Controlled Continuous Cold Flow Device after Total Knee Arthroplasty: A Randomized Controlled Trial Study

2016 ◽  
Vol 30 (07) ◽  
pp. 675-681 ◽  
Author(s):  
Alberto Ruffilli ◽  
Francesco Traina ◽  
Isabella Corneti ◽  
Domenico Fenga ◽  
Sandro Giannini ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Postoperative Treatment ◽  
Controlled Study ◽  
Control Group ◽  
Cold Flow ◽  
Randomized Controlled ◽  
Flow Device ◽  
Total Knee

Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany). Twenty-six patients represented the control group, treated with crushed ice packs. All the patients shared the same analgesic strategy and the same rehabilitation protocol. Pain, analgesic consumption, active knee range of motion, drain output, transfusion requirement, and total blood loss were evaluated at different follow-ups (postoperative first, third, and seventh days). The two groups were homogenous for preoperative and intraoperative features. The groups showed no statistically significant differences in all the evaluated parameters. A modest reduction of knee volume was evident after 7 days from surgery (trend). No differences in blood loss were noticed. Continuous cold flow device in the acute postoperative setting after TKA did not show superiority in reducing edema, pain, and blood loss, compared with traditional icing regimen. Thus, due to the costs, it should be reserved to selected cases.

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

2020 ◽  
Author(s):  
Omer Ayik ◽  
Mehmet Demirel ◽  
Fevzi Birisik ◽  
Ali Ersen ◽  
Halil I. Balci ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Peak Torque ◽  
Thigh Muscle ◽  
Controlled Study ◽  
Total Work ◽  
Isokinetic Muscle Strength ◽  
Total Knee

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

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