scholarly journals Total Knee Arthroplasty for Chronic Anterior Knee Dislocation

2018 ◽  
Vol 11 ◽  
pp. 117954761878288 ◽  
Author(s):  
Mahmoud Jabalameli ◽  
Abolfazl Bagherifard ◽  
Hosseinali Hadi ◽  
Alireza Askari ◽  
Salman Ghaffari
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Dislocation ◽  
Female Patients ◽  
Total Knee ◽  
Anterior Knee

Background: The occurrence of chronic knee dislocation is rare. To the best of our knowledge, total knee arthroplasty for treatment of chronic anterior knee dislocation has not been reported. Method: This report describes 3 cases of chronic anterior knee dislocation treated by total knee arthroplasty. Results: Three female patients with chronic anterior knee dislocation were treated by hinged prosthesis total knee arthroplasty using the Insall rectus snip approach. At a mean of 17 months (range, 12-24 months) of follow-up, all patients showed a painless stable prosthesis and expressed satisfaction with the results. Conclusions: Total knee arthroplasty for chronic anterior knee dislocation is a challenging procedure. The Insall rectus snip approach with quadriceps release and constrained prosthesis is recommended.

scholarly journals Patelloplasty with and without circumpatellar denervation in reducing anterior knee pain in primary total knee arthroplasty: a comparative prospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 270
Author(s):  
Sandeep Kumar Kanugula ◽  
Mallesh Rathod ◽  
Venugopal S. M.
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Intervention Group ◽  
Control Group ◽  
Significant Difference ◽  
Total Knee ◽  
Anterior Knee

<p class="abstract"><strong>Background:</strong> Anterior knee pain (AKP) following total knee arthroplasty (TKA) ­­­­­­is one of the complication which cause dissatisfaction in patients. Incidence estimated to be 4-49%. The aim of our study is to know the efficacy of patelloplasty with circumpatellar denervation with diathermy in reducing AKP in primary TKA.</p><p class="abstract"><strong>Methods:</strong> A total of 130 unilateral TKAs’ are divided into 2 groups. Group I (control) includes 65 patients in which only patelloplasty was done. Group II (intervention) includes 65 patients in which both patelloplasty and circumpatellar denervation with diathermy was done and analysed. Mean follow up period was 18 months. Patients were assessed both preoperatively and postoperatively at final follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> The overall incidence of AKP at follow up (18 months) was 16.9%, with 7.7% in the intervention group and 26.1% in the control group (p&lt;0.05).  Western Ontario and McMaster Universities osteoarthritis index scores were significantly  better in intervention group when compared to control group (28.71±3.948 vs 31.40±3.860). Better results were also found in knee society scores for intervention group compared to control group (166.57±7.941 vs 161.23±11.219); Feller patellar score of  intervention group was significantly better when compared to control group (23.28±2.546 vs 20.69±3.729); the range of knee flexion was similar in both the groups (94.62±12.6 vs 93.54±10.7). In terms of pain referred by the patient at 72 hrs postoperatively, there was statistically significant difference observed according to visual analogue scale.</p><p class="abstract"><strong>Conclusions:</strong> There is statistically significant difference with respect to AKP in patients who have undergone patelloplasty with circumpatellar denervation using diathermy compared with patelloplasty alone.</p><p> </p>

Fat pad excision in total knee arthroplasty does not affect functional outcome or anterior knee pain at 1 year follow-up

2018 ◽  
Vol 5 (1) ◽  
pp. 29-32
Author(s):  
Sameer Rathore ◽  
Nithin Vadlamudi ◽  
Yellati Lvsnr ◽  
A.H. Ashwin Kumar ◽  
Indukuri Viswanatha Reddy ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Fat Pad ◽  
Total Knee ◽  
Anterior Knee

scholarly journals Posterior Dislocation of the Hinge-Post Extension in a Rotating Hinge Total Knee Prosthesis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Givenchy Manzano ◽  
Ran Schwarzkopf
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Knee Dislocation ◽  
Posterior Dislocation ◽  
Rotating Hinge ◽  
History Of ◽  
Total Knee ◽  
Rotating Hinge Knee ◽  
Anterior Knee

The rotating hinge knee prosthesis is a popular intervention in patients lacking stability with highly constrained total knee arthroplasty. Despite improvements in design, nonmechanical and mechanical complications continue to be a problem. Dislocation of the hinge has been widely described, mainly due to the component fracture. Few reports describe isolated dislocation of the rotating stem. We report a case of isolated disengagement of the rotating hinge mechanism, due to severe flexion gap imbalance, leading to subsequent posterior dislocation of the hinge and anterior knee dislocation, in a patient with a history of multiple total knee arthroplasty revisions. This case suggests the importance of the soft tissue balancing, the adequate patellar tracking, and use of a long cylindrical, minimally tapered rotating stem in hinge arthroplasty to minimize hinge dislocation.

Complete Anterior Knee Dislocation 16 Years After Cruciate-retaining Total Knee Arthroplasty

Orthopedics ◽  
2012 ◽  
Vol 35 (4) ◽  
pp. e585-e588 ◽  
Author(s):  
Yusuke Sato ◽  
Masahiko Saito ◽  
Ryuichiro Akagi ◽  
Masahiko Suzuki ◽  
Tatsuya Kobayashi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Dislocation ◽  
Cruciate Retaining ◽  
Total Knee ◽  
Anterior Knee

Comparison between Mid-Term Results of Total Knee Arthroplasty with Single-Radius versus Multiple-Radii Posterior-Stabilized Prostheses

2020 ◽  
Author(s):  
Zhenyu Luo ◽  
Kai Zhou ◽  
Haoyang Wang ◽  
Fuxing Pei ◽  
Zongke Zhou
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Short Form ◽  
Posterior Stabilized ◽  
Total Knee ◽  
Anterior Knee ◽  
Single Radius

AbstractSingle-radius (SR) prostheses and multiple-radii (MR) prostheses have different theoretical advantages; however, few comparative studies have been reported. The aim of the study was to compare mid-term clinical, radiological, and survival outcomes of SR and MR posterior-stabilized prostheses in total knee arthroplasty (TKA). Two hundred consecutive patients who underwent TKA between January 2012 and July 2013 were enrolled in the SR group (100 patients) and an MR group (100 patients), with a minimum follow-up of 5 years. Functional, radiological, satisfaction, and survival rates were evaluated. There was a significantly higher range of motion (ROM) in the SR group than in the MR group (flexion, 123.65 ± 10.12 degrees vs. 115.52 ± 10.03 degrees, p < 0.001). Quadriceps strength (3.05 ± 0.43 vs. 2.68 ± 0.58 kg, p = 0.025) and chair test results (80 [93.02%] vs. 69 [83.13%], p = 0.027) were better in the SR group than in the MR group. The SR group also had significantly less anterior knee pain (6 [6.98%] vs. 15 [18.07%], p < 0.05) and a better satisfaction rate than those in the MR group. No significant differences were observed in clinical scale scores such as Hospital for Special Surgery (HSS), Knee Society Score (KSS), and Short-Form 12 (SF-12), radiological results in terms of component position and radiolucent lines. The Kaplan–Meier survival curve estimates at 5 years were not significantly different (96.91% [95% confidence interval [CI]: 93.5–99.5%] vs. 94.86% [95% CI: 90.6–98.6%], p = 0.4696). The SR prosthesis design was better than that of the MR in terms of ROM, reduced anterior knee pain, contributions to better recovery of the extension mechanism, and higher satisfaction rates. The SR had similar results in clinical scales such as HSS, KSS, SF-12, radiological, or survival results to MR prostheses. More accurate measurements and longer-term follow-up are required.

scholarly journals Traumatic anterior knee dislocation after total knee arthroplasty

2016 ◽  
Vol 2 (3) ◽  
pp. 97-99 ◽  
Author(s):  
Richard S. Ahn ◽  
Matthew J. Brown ◽  
Mario D. Santilli
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Dislocation ◽  
Total Knee ◽  
Anterior Knee

scholarly journals Influence of femoral implant design modification on anterior knee pain and patellar crepitus in patients who underwent total knee arthroplasty without patella resurfacing

2019 ◽  
Author(s):  
Yifan Huang ◽  
Yuhang Gao ◽  
Lu Ding ◽  
Bo Liu ◽  
Jianguo Liu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Implant Design ◽  
Control Group ◽  
Study Group ◽  
Design Modification ◽  
Total Knee ◽  
Anterior Knee

Abstract Background: The incidence of dissatisfaction that due to multiple factors especially anterior knee pain (AKP) and patellar crepitus after total knee arthroplasty (TKA) are still required concern. Improvements of femoral component in traditional prosthesis could reduce the incidence of these complications in TKA with patella resurfacing. This study aimed to explore whether TKA without patella resurfacing benefit from this femoral implant design modification in the aspects of AKP and patellar crepitus.Methods: Sixty-two patients (85 knees) using the modern prosthesis and 62 age-matched and sex-matched patients (90 knees) using the traditional prosthesis were enrolled in this study. The incidences of AKP and patellar crepitus, Knee Society Scores were recorded. Statistical analyses were accomplished to determine if there were differences between the two groups. Results: The incidence of AKP was significantly lower in the study group compared with those in the control group at 3-month and 1-year follow-up (4.7% vs. 13.3%, p = 0.048; 3.5% vs. 13.3%, p = 0.021, respectively). The incidence of patellar crepitus was significantly lower in the study group compared with those in the control group at 3-month and 1-year follow-up (34.4% vs. 15.3%, p = 0.004; 28.9% vs. 10.6% at 1 year, p = 0.002, respectively). There was no significant difference in Knee Society Scores between two groups.Conclusion: The results showed that TKA without patella resurfacing benefited from this femoral implant design modification in the aspects of AKP and patellar crepitus. This study may provide meaningful information for surgeons who use the modern prosthesis and selectively not resurfacing the patella in their patients.

scholarly journals Patelloplasty in total knee arthroplasty with circumpatellar denervation versus without denervation – a randomized prospective study

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
S. R. K. Deekshith ◽  
K. J. Reddy ◽  
R. Raviteja
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Kujala Score ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean ◽  
Anterior Knee

Abstract Introduction Anterior knee pain is one of the major problems in total knee arthroplasty (TKA) and is often etiologically associated with a patellofemoral parts etiology. There is no consensus as to etiology or treatment. Denervation of the patella by electrocautery and patelloplasty along with removal of osteophytes have been used for treatment of anterior knee pain in TKA. The purpose of our study was to compare, in terms of the anterior knee pain and clinical outcomes of patelloplasty in total knee arthroplasty (TKA), patellar denervation by electrocautery and non-patellar-denervation treatment in a 2 year follow-up. Materials and methods This study was conducted in a total of 108 patients, who underwent TKA at our institution between June 2015 and December 2016. Patients age 55 to 80 years, who are suffering from osteoarthritis, rheumatoid arthritis of knee were included in this study. Patients were randomly allocated into patelloplasty with denervation group and non-denervation group. The denervation of the patella was done in electrocautery group using a monopolar coagulation diathermy set to 50 W. (Valleylab Inc., Boulder, CO). Postoperatively, patients were assessed at regular intervals of 3, 6, 9, 12, 24 months. To assess patient outcomes, we used questionnaires to determine the Knee Society score (KSS - knee and function scores), a specific patellofemoral pain questionnaire (Kujala score) range of motion (ROM) and a visual analogue scale (VAS) to assess anterior knee pain. Results The data obtained were analyzed using SPSS version 17.0. Continuous variables were expressed as mean ± SD. Of the 108 patients, 9 patients were lost to follow-up. Among the remaining 99 patients, 50 were included in denervation group and 49 in non-denervation group. In our study, there was no statistically significant difference in Mean KUJALA score preoperatively (p > 0.05). Postoperatively, the mean KUJALA score was significantly higher in denervation group at 3, 6, 9, 12, 24 months of follow-up when compared to TKR with no denervation (p < 0.05). There was no statistically significant difference in Mean VAS score preoperatively (p > 0.05). However, 6, 12 and 24 months after the operation, the mean VAS score was significantly lower in denervation group. There was no statistically significant difference in Mean KSS score preoperatively and postoperatively (p > 0.05). The mean ROM was significantly higher in denervation group than in the group of TKR with no denervation (p < 0.05). Conclusion In our study, less postoperative anterior knee pain, increased range of motion, significantly lower VAS scores were seen in the denervation group compared with non-denervation group. Circumferential denervation of patella during primary TKA along with patellar resurfacing is a safe procedure that improves patient satisfaction, decreases anterior knee pain and improves range of flexion in the postoperative period and at postoperative follow-ups.

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