scholarly journals One stage bilateral unicompartmental knee replacement: Similar early clinical outcome with shorter rehabilitation and better resources utilization compared with two stage

2020 ◽  
pp. 221049172097367
Author(s):  
Yan Ho Bruce Tang ◽  
Hok Leung Wong ◽  
Tai Fong Wong
Keyword(s):  
Clinical Outcome ◽  
Knee Replacement ◽  
Operative Time ◽  
Unicompartmental Knee Replacement ◽  
Knee Score ◽  
Two Stage ◽  
One Stage ◽  
Unicompartmental Knee ◽  
Early Results ◽  
The One

Introduction: There are a lot of debates on the advantages and safety profile of one stage bilateral knee arthroplasty. Most of the studies focus on total knee replacement, and it may not be applied directly to unicompartmental knee replacement (UKR). We would like to compare the early results of one and two stage bilateral UKR in our center. Methods: This is a retrospective review of all the bilateral medial UKR done in our center in 2018–2019. Patients’ demographic data, operative time, postoperative blood, length of stay (LOS) and complications were recorded. The number of admissions, pre-operative assessment sessions (PAS), and weeks of post-operative physiotherapy were analyzed. Clinical outcome was measured by Knee society knee score and range of motion (ROM). Results: Our center performed 97 UKR in 2018–2019, with 50 UKR performed in 25 patients, among which 16 received one stage while 9 received two stage bilateral UKR. Both groups had similar mean age, BMI, sex ratio, ASA grading, pre-operative knee score and ROM. Patient in the one stage group required only 1 PAS/admission/operation to treat both knees with a mean LOS of 7.3 days and 7.8 weeks of physiotherapy, while those in the two stage group required 2 PAS/admissions/operations with a mean cumulative LOS of 9.8 days and 14.1 weeks of physiotherapy. The mean cumulative operative time was similar for both groups but the one stage group only required 1 operative session. There was no difference in blood loss and there was no transfusion or complication. The post-operative knee score and ROM at 3 and 6 months were similar for both groups. Conclusion: In suitable patients with bilateral medial OA knee, one stage bilateral UKR offers simliar early clinical outcome with shorter rehabilitation duration but without increasing complications compared with two stage. Resources can therefore be better utilized.

scholarly journals Early Results & Accuracy of the MAKO Robtic Unicompartmental Knee Replacement

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0015
Author(s):  
Anthony GANKO ◽  
William DONNELLY ◽  
Stephen BRENNAN ◽  
Hugh ENGLISH ◽  
Brett HALLIDAY ◽  
...  
Keyword(s):  
Learning Curve ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Unicompartmental Knee Replacement ◽  
Knee Score ◽  
Robotic Technology ◽  
Planning Software ◽  
Unicompartmental Knee ◽  
Early Results ◽  
High Degree

Objectives: To monitor the “learning curve” and assess the accuracy of implantation, safety and early results of a new to Australia, technique for unicompartmental knee replacement Methods: After cadaveric training, the first 50 MAKO unicompartmental replacements, performed by 5 surgeons, were studied. Operative details were recorded including time taken for each step in the surgical procedure. Pre and post operative Knee Society Score (KSS), Oxford knee score (OKS) and WOMAC were recorded. 19 had post-operative CT scans with segmentation using planning software to determine accuracy of implantation compared to plan. Results: In the small number studied there was no evidence of a significant “learning curve” with no significant change in operative times. The procedure proved safe without any failure of technology. At 3 months there was a significant improvement in KSS, WOMAC and OKS. The unicompartmental replacements were inserted with a high degree of accuracy, comparable to other centres and with greater accuracy then reported implantation using “standard” instruments. Conclusion: New robotic technology was able to be introduced safely without a significant learning curve and with satisfactory early results. The technique allowed highly accurate component positioning.

scholarly journals Minimally invasive unicompartmental knee replacement: Midterm clinical outcome

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0176082 ◽  
Author(s):  
Shaoqi Tian ◽  
Jiangjun Liu ◽  
Wanqing Yuan ◽  
Yuanhe Wang ◽  
Chengzhi Ha ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Minimally Invasive ◽  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Unicompartmental Knee

Minimally invasive lateral unicompartmental knee replacement: Early results from an independent center using the Oxford fixed lateral prosthesis

The Knee ◽  
2020 ◽  
Vol 27 (1) ◽  
pp. 235-241 ◽  
Author(s):  
Tilman Walker ◽  
Mustafa Hariri ◽  
Johannes Eckert ◽  
Benjamin Panzram ◽  
Tobias Reiner ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Unicompartmental Knee ◽  
Early Results

scholarly journals Cementless Oxford Medial Unicompartmental Knee Replacement—Clinical and Radiological Results of 228 Knees with a Minimum 2-Year Follow-Up

2020 ◽  
Vol 9 (5) ◽  
pp. 1476 ◽  
Author(s):  
Benjamin Panzram ◽  
Mira Mandery ◽  
Tobias Reiner ◽  
Tobias Gotterbarm ◽  
Marcus Schiltenwolf ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Knee Replacement ◽  
Survival Rates ◽  
Unicompartmental Knee Replacement ◽  
Radiolucent Lines ◽  
Implant Positioning ◽  
Radiological Results ◽  
Unicompartmental Knee ◽  
Clinical And Radiological Results

(1) Background: Studies show several advantages of unicompartmental knee replacement (UKR) over total knee replacements (TKR), whereas registry based revision rates of UKR are significantly higher than for TKA. Registry data report lower revision rates for cementless UKR compared to cemented UKR. The aim of this study was to assess clinical and radiological results of cementless Oxford UKR (OUKR) in an independent cohort. (2) Methods: This retrospective cohort study examines a consecutive series of 228 cementless OUKR. Clinical outcome was measured using functional scores (Oxford Knee Score (OKS), American Knee Society Score (AKSS), Hannover Functional Ability Questionnaire for Osteoarthritis (FFbH-OA), range of motion (ROM)), pain and satisfaction. Radiographs were analyzed regarding the incidence of radiolucent lines (RL), implant positioning, and their possible impact on clinical outcome. (3) Results: At a mean follow-up of 37.1 months, the two and three year revision free survival-rates were 97.5% and 96.9%. Reasons for revision surgery were progression of osteoarthritis, inlay dislocation and pain. All clinical outcome scores showed a significant improvement from pre- to postoperative. The incidence of RL around the implant was highest within the first year postoperatively (36%), and decreased (5%) within the second year. Their presence was not correlated with inferior clinical outcome. Implant positioning showed no influence on clinical outcome. (4) Conclusion: Cementless OUKR showed excellent clinical outcome and survival rates, with reliable osteointegration. Neither the incidence of radiolucent lines nor implant positioning were associated with inferior clinical outcome.

scholarly journals Staged Revision with Antibiotic Spacers for Infected Hindfeet vs One-Stage Revision Using an Ilizarov Ringfixator: What’s Better?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0020
Author(s):  
Rebecca Hartmann ◽  
Florian Grubhofer ◽  
Stephan Wirth
Keyword(s):  
Clinical Outcome ◽  
Infection Control ◽  
Cement Spacer ◽  
Two Stage ◽  
Aofas Score ◽  
Musculoskeletal Infection ◽  
Knee Amputation ◽  
One Stage ◽  
Successful Infection ◽  
The One

Category: Hindfoot Introduction/Purpose: The treatment of hindfeet infections with a two-stage revision surgery using an antibiotic-loaded cement spacer is an established treatment strategy. If the soft tissue situation is critical or if patients do have severe comorbidities, the use of a one-stage procedure, using an Ilizarov ringfixator to perform the arthrodesis is also an option. We wanted to compare the outcome of patients who either received the two-stage revision or the one-stage procedure. The purpose of the study was to determine the likelihood of infection control and radiological consolidation of the arthrodesis after either two-stage or one-stage revision in patients with hindfoot infection, as defined by the Musculoskeletal Infection Society PJI criteria. The postoperative AOFAS score was used to measure the clinical outcome. Methods: Between 1995 and 2015, we treated 12 patients with a two-stage procedure using an antibiotic-loaded cement spacer, followed by antibiotic therapy. The second stage consisted of a hindfoot arthrodesis. Of those, 7 were available for review at a minimum of 24 months. 3 were excluded because they were deceased (due to old age). Two moved abroad, leaving 7 patients for analysis. During the same time period we treated 13 patients with a one-stage hindfoot arthrodesis using an Ilizarov ringfixator. Of those, 10 were available for review at a minimum of 24 months. 2 were excluded because they were deceased due to old age, leaving 10 patients for analysis. The primary outcome included the proportion of patients achieving infection control, defined as the absence of the Musculoskeletal Infection Society PJI criteria. Radiological consolidation on standard foot X-rays was also determined. The clinical outcome was assessed with the AOFAS hindfoot score. Results: Successful infection control in the two-stage revision group was achieved in 6 out of 7 patients (86%). One patient achieved infection control only after a below-knee amputation. The mean AOFAS score at the latest follow-up was 75. Radiological consolidation was achieved in 70% (5 out of 7, with one patient needing an amputation for infection control). In the Ilizarov-group, successful infection control was achieved in 9 out of 10 patients (90%). One patient achieved infection control only after a below-knee amputation. The mean AOFAS score at the latest follow-up was 70. Radiological consolidation was achieved in 80% (8 out of 10, with one patient needing an amputation for infection control). Conclusion: A one-stage arthrodesis using an Ilizarov ringfixator for infection control in infected hindfeet leads to comparable infection control and radiological consolidation as the established two-stage procedure with an antibiotic-loaded cement spacer. The clinical outcome, measured by the AOFAS hindfoot score, is also comparable in both groups. The one-stage procedure using an Ilizarov ringfixator should therefore be considered as a treatment option, when soft tissues or comorbidities do not allow a two-stage procedure. It is an option to avoid a below-knee amputation in those patients.

EARLY RESULTS OF FIXED BEARING UNICOMPARTMENTAL KNEE REPLACEMENT DESIGNED FOR THE LATERAL COMPARTMENT

The Knee ◽  
2020 ◽  
Vol 27 ◽  
pp. S4-S5
Author(s):  
S. Asadollahi ◽  
F.R. Thomson ◽  
H.A. Wilson ◽  
R.M. Middleton ◽  
C. Jenkins ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Lateral Compartment ◽  
Unicompartmental Knee Replacement ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Early Results

scholarly journals 589 Early Results of Single Anaesthetic Bilateral Fixed Bearing Cemented Medial Unicompartmental Knee Replacement

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Roy ◽  
M Kiran ◽  
N Atwal ◽  
Ha Gosal
Keyword(s):  
Knee Replacement ◽  
Unicompartmental Knee Replacement ◽  
Functional Score ◽  
Fixed Bearing ◽  
Unicompartmental Knee ◽  
Early Results ◽  
Functional Scores ◽  
Surgical Data ◽  
The Mean

Abstract Introduction Unicompartmental knee replacement (UKR) results in less morbidity, early mobilisation, and better PROMs in appropriately selected patients. There has been a steady increase in the number of fixed bearing UKRs in the NJR. We present the early results of single anaesthetic bilateral fixed bearing cemented medial UKR. Method All patients undergoing bilateral UKR using the ZUK prosthesis (LIMA, UK) under a single anaesthetic between March 2013 and March 2019 were included in this study. Demographic data, surgical data, change in haemoglobin after surgery and occurrence of complications were prospectively recorded in the hospital database. Pre-op and follow-up Oxford knee scores were recorded. Statistical analysis was performed using SPSS 25.0 (IBM, USA) and paired t-test was used to analyse improvement in functional score. Results Nine patients were included in this study. The mean age was 53.2years (range 43-71 years). There were 2 females and 7 males. A significant improvement in Oxford knee score from a mean of 37.2 to 53.6(p < 0.01) was seen. The mean drop in Hb was 4.1mg/dl. The mean follow up was 28 months (range 12-76 months). Conclusions There was good improvement in functional scores without any significant drop in Hb. Therefore, it is a safe and beneficial procedure.

Two-Stage Procedure for the Quantitative Determination of Autoprothrombin III Concentration and Some Applications

1967 ◽  
Vol 18 (01/02) ◽  
pp. 198-210 ◽  
Author(s):  
Ronald S Reno ◽  
Walter H Seegers
Keyword(s):  
Prothrombin Time ◽  
Factor Vii ◽  
Two Stage ◽  
Pronounced Increase ◽  
One Stage ◽  
Assay Procedure ◽  
Bovine Plasma ◽  
The One ◽  
Autoprothrombin C

SummaryA two-stage assay procedure was developed for the determination of the autoprothrombin C titre which can be developed from prothrombin or autoprothrombin III containing solutions. The proenzyme is activated by Russell’s viper venom and the autoprothrombin C activity that appears is measured by its ability to shorten the partial thromboplastin time of bovine plasma.Using the assay, the autoprothrombin C titre was determined in the plasma of several species, as well as the percentage of it remaining in the serum from blood clotted in glass test tubes. Much autoprothrombin III remains in human serum. With sufficient thromboplastin it was completely utilized. Plasma from selected patients with coagulation disorders was assayed and only Stuart plasma was abnormal. In so-called factor VII, IX, and P.T.A. deficiency the autoprothrombin C titre and thrombin titre that could be developed was normal. In one case (prethrombin irregularity) practically no thrombin titre developed but the amount of autoprothrombin C which generated was in the normal range.Dogs were treated with Dicumarol and the autoprothrombin C titre that could be developed from their plasmas decreased until only traces could be detected. This coincided with a lowering of the thrombin titre that could be developed and a prolongation of the one-stage prothrombin time. While the Dicumarol was acting, the dogs were given an infusion of purified bovine prothrombin and the levels of autoprothrombin C, thrombin and one-stage prothrombin time were followed for several hours. The tests became normal immediately after the infusion and then went back to preinfusion levels over a period of 24 hrs.In other dogs the effect of Dicumarol was reversed by giving vitamin K1 intravenously. The effect of the vitamin was noticed as early as 20 min after administration.In response to vitamin K the most pronounced increase was with that portion of the prothrombin molecule which yields thrombin. The proportion of that protein with respect to the precursor of autoprothrombin C increased during the first hour and then started to go down and after 3 hrs was equal to the proportion normally found in plasma.

Standardization of Factor VIII – IV. Establishment of the 3rd International Standard for Factor VIII: C Concentrate

1983 ◽  
Vol 50 (03) ◽  
pp. 697-702 ◽  
Author(s):  
T W Barrowcliffe ◽  
A D Curtis ◽  
D P Thomas
Keyword(s):  
Factor Viii ◽  
High Purity ◽  
Collaborative Study ◽  
World Health ◽  
Current Standard ◽  
Two Stage ◽  
International Standard ◽  
One Stage ◽  
The One ◽  
Health Organization

SummaryAn international collaborative study was carried out to establish a replacement for the current (2nd) international standard for Factor VIII: C, concentrate. Twenty-six laboratories took part, of which 17 performed one-stage assays, three performed two-stage assays and six used both methods. The proposed new standard, an intermediate purity concentrate, was assayed against the current standard, against a high-purity concentrate and against an International Reference Plasma, coded 80/511, previously calibrated against fresh normal plasma.Assays of the proposed new standard against the current standard gave a mean potency of 3.89 iu/ampoule, with good agreement between laboratories and between one-stage and two- stage assays. There was also no difference between assay methods in the comparison of high-purity and intermediate purity concentrates. In the comparison of the proposed standard with the plasma reference preparation, the overall mean potency was 4.03 iu/ampoule, but there were substantial differences between laboratories, and the two-stage method gave significantly higher results than the one stage method. Of the technical variables in the one-stage method, only the activation time with one reagent appeared to have any influence on the results of this comparison of concentrate against plasma.Accelerated degradation studies showed that the proposed standard is very stable. With the agreement of the participants, the material, in ampoules coded 80/556, has been established by the World Health Organization as the 3rd International Standard for Factor VIII :C, Concentrate, with an assigned potency of 3.9 iu/ampoule.

Sign in / Sign up

Export Citation Format

Share Document