Which factors affect the ability to kneel following total knee arthroplasty? An outpatient study of 100 postoperative knee replacements

Background: Kneeling is an important activity of daily living, holding social, religious and occupational value. Following total knee replacement (TKR), many patients report they are unable to kneel or have been advised not to kneel. Methods: We observed 100 consecutive knee replacements in 79 patients attending outpatient clinic at a minimum 5 months post-TKR. The patients were asked to fill out a questionnaire detailing whether they were able to kneel prior to their knee replacement and whether they thought they were able to kneel since their knee replacement. The patients were then asked to kneel on a padded examination couch and then onto a pillow on the floor for 15 s. Degree of flexion achievable was also recorded. Results: Of the knees with patella resurfacing, 78.6% were able to kneel compared to only 45.6% knees with native patellae. Two-tailed Fisher’s exact test showed this difference to be statistically significant ( p = 0.001). The χ 2 analysis showed that those patients with an achievable flexion of angle of greater than 100° were significantly more likely to be able to kneel than those with a flexion angle of less than 100° ( p = 0.0148). Comparing posterior cruciate ligament (PCL) retaining against PCL sacrificing implants, there was no statistically significant difference in kneeling ability ( p = 0.541). Conclusion: Kneeling remains an important function in patients undergoing TKR, with patella resurfacing significantly improving the likelihood of a patient being able to kneel.

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Two-stage revision surgery for infected total knee replacements: reasonable function and high success rate with the use of primary knee replacement implants as temporary spacers

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-017-2016-7 ◽

2017 ◽

Vol 28 (1) ◽

pp. 109-115 ◽

Cited By ~ 4

Author(s):

Ben Arthur Marson ◽

Samuel T. Walters ◽

Benjamin V. Bloch ◽

Khosrow Sehat

Keyword(s):

Success Rate ◽

Knee Replacement ◽

Revision Surgery ◽

High Success Rate ◽

Two Stage ◽

Total Knee Replacements ◽

Knee Replacements ◽

Total Knee

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Conservation of posterior cruciate ligament in fixed-bearing total knee replacement

Osteoarthritis of the knee ◽

10.1007/978-2-287-74175-3_31 ◽

2008 ◽

pp. 529-541

Author(s):

J.Y. Nordin ◽

Keyword(s):

Total Knee Replacement ◽

Posterior Cruciate Ligament ◽

Knee Replacement ◽

Cruciate Ligament ◽

Fixed Bearing ◽

Total Knee

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Use of Enoxaparin and Dabigatran for Thrombosis Prevention After Total Knee Replacement

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto20120261-64 ◽

2012 ◽

Vol 19 (2) ◽

pp. 61-64

Author(s):

V. Yu Murylev ◽

Y. A Rukin ◽

P. M Elizarov ◽

A. G Zhuchkov ◽

D. I Terentiev

Keyword(s):

Total Knee Replacement ◽

Enoxaparin Sodium ◽

Knee Replacement ◽

Vena Cava ◽

Preventive Measure ◽

Early Postoperative Period ◽

Peroral Administration ◽

Efficacy And Safety ◽

Significant Difference ◽

Total Knee

Comparative analysis of dabigatran etaxilate and enoxaparin sodium use for prevention of vena cava inferior system thrombosis in patients after total knee replacement in early postoperative period was performed. In 74 patients (1 st group) dabigatran etaxilate and in 127 (2 nd group) enoxaparin sodium was used as a preventive measure. The rate of thrombosis made up 1.35% and 2.4% in the first and second groups, respectively. No significant difference in the volume of perioperative blood loss between the groups was noted. No other hemorrhagic complications were observed. It was shown that in more convenient peroral administration the dabigatran etaxilate efficacy and safety was comparable to enoxaparin sodium.

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Total Knee Replacement With Posterior Cruciate Ligament Retention in Rheumatoid Arthritis

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199712000-00005 ◽

1997 ◽

Vol 345 ◽

pp. 24???28 ◽

Cited By ~ 68

Author(s):

Richard S. Laskin ◽

Hugh M. O??Flynn

Keyword(s):

Rheumatoid Arthritis ◽

Total Knee Replacement ◽

Posterior Cruciate Ligament ◽

Knee Replacement ◽

Cruciate Ligament ◽

Total Knee

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The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01995-x ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Rongguo Yu ◽

Youguang Zhuo ◽

Eryou Feng ◽

Wulian Wang ◽

Wentao Lin ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Total Knee Replacement ◽

Knee Replacement ◽

Continuous Passive Motion ◽

Cochrane Library ◽

Short Term ◽

Significant Difference ◽

Pain Outcomes ◽

Total Knee

Abstract Background A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. Methods A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. Results Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). Conclusions Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.

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Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2019/1652901 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Han Wang ◽

Ziming Liu ◽

Yuwan Li ◽

Yihang Peng ◽

Wei Xu ◽

...

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Meta Analysis ◽

Cruciate Ligament Reconstruction ◽

Significant Difference ◽

Anterior Cruciate ◽

Postoperative Knee

Purpose. This is a systematic review and meta-analysis of current evidence that aims at comparing the clinical outcomes of remnant-preserving anterior cruciate ligament reconstruction (ACLR) and standard ACLR. Methods. A systematic review of randomized controlled studies and cohort studies comparing remnant-preserving ACLR with standard ACLR with a minimum level of evidence of II was performed. Studies were included by strict inclusion and exclusion criteria. Extracted data were summarized as preoperative conditions, postoperative clinical outcomes, and postoperative complications. When feasible, meta-analysis was performed with RevMan5.3 software. Study methodological quality was evaluated with the modified Coleman methodology score (CMS). Results. Eleven studies (n = 466 remnant-preserving and n = 536 standard) met the inclusion criteria. The mean modified CMS for all included studies was 85.8 (range: 77–92 on a 100-point scale). In total, 466 patients underwent remnant-preserving ACLR by 3 different procedures: standard ACLR plus tibial remnant tensioning (n = 283), selective-bundle augmentation (n = 49), and standard ACLR plus tibial remnant sparing (n = 134). Remnant-preserving ACLR provided a superior outcome of postoperative knee anterior stability (WMD = −0.42, 95% CI, −0.66, −0.17; P<0.01) and Lysholm score (WMD = 2.01, 95% CI, 0.53 to 3.50; P<0.01). There was no significant difference between the two groups with respect to second-look arthroscopy (OR = 1.38, 95% CI, 0.53, 3.62; P=0.51), complications (OR = 1.24 95% CI, 0.76, 2.02; P=0.39), International Knee Documentation Committee (IKDC) subject scores, IKDC grades, Lachman test, and pivot-shift test. Summary/conclusion. Remnant-preserving ACLR promotes similar graft synovial coverage and revascularization to standard ACLR. Equivalent or superior postoperative knee stability and clinical scores were observed for remnant-preserving ACLR compared with standard ACLR. No significant difference in the total complication rate between the groups was evident.

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Platypnoea–orthodeoxia after left total knee replacement

BMJ Case Reports ◽

10.1136/bcr-2019-230771 ◽

2019 ◽

Vol 12 (10) ◽

pp. e230771

Author(s):

Taha Almufti ◽

Franz Eversheim ◽

Brett Johnson ◽

Gabriel Ayonmigbesimi Akra

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Unusual Case ◽

Medical Intervention ◽

Colour Doppler ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Significant Difference ◽

Severe Hypoxaemia ◽

Total Knee

Platypnoea–orthodeoxia syndrome (POS) is a rare disorder characterised by both dyspnoea (platypnoea) and arterial desaturation (orthodeoxia) in the upright position, with improvement in the supine position. We report an unusual case in which an 82-year-old woman developed severe hypoxaemia with POS after left total knee replacement. A significant difference in alveolar–arterial blood gas oxygen tension was demonstrated, and hypoxaemia failed to respond to 100% oxygen supply. A patent foramen ovale with a right-to-left shunt was evident on transoesophageal echocardiogram employing colour Doppler and agitated normal saline studies. Interestingly, the patient’s symptoms resolved within 6 months with ongoing chest physiotherapy, without surgical or medical intervention.

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Enhanced patella tracking in rotating platform total knee replacements, friend or foe? A case of iliotibial band impingement by rotating polyethylene insert

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1177/2210491719859594 ◽

2019 ◽

Vol 26 (2) ◽

pp. 99-104

Author(s):

Michelle Kar Lam Li ◽

Lawrence Chun Man Lau ◽

Yuk Wah Hung ◽

Ka Bon Kwok ◽

Alexander Pak Hin Chan ◽

...

Keyword(s):

Total Knee Replacement ◽

Knee Replacement ◽

Knee Kinematics ◽

Iliotibial Band ◽

Polyethylene Insert ◽

Rotating Platform ◽

Total Knee Replacements ◽

Knee Replacements ◽

Total Knee ◽

Patella Tracking

Rotating platform total knee replacement implants have been marketed to allow more precise approximation of normal knee kinematics and enhance patella tracking. At liberty of rotation, the distinct mobile polyethylene insert design does have its pitfalls in spite of purported merits. We report a case of lateral knee pain following rotating platform total knee replacement, attributable to iliotibial band impingement by the rotating polyethylene insert. Prompt treatment via arthroscopic release circumvented a traumatic and costly revision procedure.

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