Study of the difference in outcomes between two treatment modalities of the patella in total knee replacement

2012 ◽  
Author(s):  
N Shaath
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Treatment Modalities ◽  
Total Knee ◽  
The Difference

scholarly journals Lived Experiences of Clients with Total Knee Replacement Residing in Kathmandu

2019 ◽  
Vol 2 (1) ◽  
pp. 60-69
Author(s):  
Suvekshya Silwal ◽  
Bimala Kumari Sah ◽  
Lal Kumari Gurung ◽  
Kapil Amgain
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Lived Experiences ◽  
Real Life ◽  
University Teaching ◽  
Treatment Modalities ◽  
Personal Perspective ◽  
Standing Up ◽  
Total Knee ◽  
Health Counselling

Introduction: Total Knee Replacement (TKR) is an increasingly common treatment for severe knee osteoarthritis and the main indication is pain. Subjective factors affect the way in which individuals express their real-life experiences thus, this study aimed in bringing to the fore the personal perspective and interpretation of clients with (TKR). The objective of this study was to explore the lived experiences of clients with total knee replacement. Methodology: Phenomenological qualitative research design was used where participants were selected from hospital record of Tribhuwan University Teaching Hospital and Nepal Orthopedic Hospital of Kathmandu. Based on the lived phenomenon, similar sharing of experiences from seven among nine participants with the in-depth interview was obtained. The data was collected for 2 months period where data analysis went simultaneously to reveal the concepts. Then the interview was transcribed manually following the thematic analysis phases of Gibson. Results: The results indicated that most (5/7) expressed their ability to walk independently. Four clients (4/7) reported they could perform household chores and had no difficulty travelling in vehicles. Despite those positive results, all respondents (7/7) after TKR faced difficulties sitting down and the majority (6/7) faced difficulty climbing stairs. Four had difficulty in standing up and lying. Three had queries about the treatment process; swelling of lower legs and life of the implant. Conclusion: The emerged five themes: impact of the treatment regimen, mobility issues, treatment modalities, supportive environment and inadequate health counselling revealed that although there is mixed result of treatment outcome, all respondents are satisfied as they got rid of the continued severe knee pain; hence, the respondents are following some safety and precaution measures for the better outcome. Adequate health counselling emphasizing in the rehabilitation programmes after TKR should be prioritized.

scholarly journals OUTCOMES OF MULTIMODAL COCKTAIL VS TRANEXAMIC ACID ON POST OPERATIVE PAIN AND BLOOD LOSS IN TOTAL KNEE REPLACEMENT PATIENTS: A PROSPECTIVE RANDOMIZED STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Suhail Malhotra ◽  
Parminder Kaur
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Pain Score ◽  
Knee Replacement ◽  
Control Group ◽  
Total Knee ◽  
The Mean ◽  
The Difference

Background: Osteoarthritis is the most common form of arthritis and a leading cause of disability. Total knee replacement (TKR) is one of the most effective surgical procedures, providing improvement in function and relief of pain for the majority of patients. Intra-articular tranexamic acid [TXA] and multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine) are commonly used drugs which help to reduce postoperative bleeding and pain respectively, improving outcome of surgery. Objective: To compare the postoperative blood loss and pain with or without Intra-articular tranexamic acid and multimodal cocktail respectively in patients undergoing total knee replacement Material and Methods: A total of 96 patients of either gender presenting to Orthopaedics department of Government Medical College, Amritsar, with knee osteoarthritis and planned to undergo total knee replacement were enrolled. Patients were divided into 3 groups. Group A being the control group was not given tranexamic acid [TXA] but only standard drugs for anesthesia. Group B patients were given 3gm intra-articular injection of tranexamic acid. Group C patients were given a multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine. TKR was done and patients were followed-up for 72 hours. Blood loss and pain score after every 24 hours for 72 hours were noted. Intra-articular injections were given just before wound closure. Results: The mean age of patients in control group was 48.92±13.22years, in TXA group was 52.31±14.69 years and in cocktail group was 50.22±9.63years. The male to female ratio was 11:21, 14:18 and 10:22 in three groups respectively. The total blood loss during first 72 hours was 1030.1±177.27ml in control group, 453.7±80.4ml in TXA group while 607.7±122.5ml in cocktail group. The difference was significant in all three groups and also between TXA and cocktail group (p<0.05). The mean postoperative pain score during first 72 hours was 4.4±2.3in control group, 2.4±1.5 in TXA group while 1.8±1.0in cocktail group. The difference was significant in all three groups (p<0.05) but insignificant between TXA and cocktail group (p>0.05). Conclusion: Results showed that intra-articular injection of TXA is beneficial in reducing blood loss and postoperative pain in comparison to control group. While pain was better controlled with the multimodal cocktail compared to TXA group and control group. Keywords: Post-operative blood loss, Intra-articular injection, tranexamic acid, cocktail, total knee replacement

scholarly journals Benchmarking total knee replacement constructs using noninferiority analysis: the New Zealand joint registry study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
MC Wyatt ◽  
CF Frampton ◽  
MR Whitehouse ◽  
KC Deere ◽  
A Sayers ◽  
...  
Keyword(s):  
At Risk ◽  
New Zealand ◽  
Relative Risk ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Survival Function ◽  
Joint Registry ◽  
Kaplan Meier ◽  
Total Knee ◽  
The Difference

Abstract Background The aim of this study was to compare the relative performance of total knee replacement constructs and discern if there is variability in performance in currently commonly used prostheses in the New Zealand Joint Registry (NZJR) using a noninferiority analysis. Methods All patients who underwent a primary total knee replacement (TKR) registered in the NZJR between 1st January 1999 to June 2020 were identified. Using a noninferiority analysis, the performance of total knee replacement prostheses were compared with the best performing contemporary construct. Construct all-cause revision rate was estimated using the 1-Kaplan Meier survival function method to estimate net failure. The difference in all-cause revision rates between the contemporary benchmark and all other constructs was tested. Results In total 110 183 TKR were recorded and 25 constructs (102 717 procedures) had > 500 procedures at risk at 3 years post-primary of which 5 were inferior by at least 20 % relative risk of which, one was inferior by at least 100 % relative risk. 14 constructs were identified with > 500 procedures at risk at 10 years with 5 inferior by at least 20 %, of which 2 were inferior by > 100 % relative risk. Conclusions We discerned that there is great variability in construct performance and at all time points, greater than 25 % of constructs are inferior to the best performing construct by at least 20 %. These results can help inform patients, clinicians and health care funders when considering TKR surgery.

MORPHOMETRICAL COMPARISON BETWEEN THE RESECTED SURFACES IN OSTEOARTHRITIC KNEES AND POROUS-COATED ANATOMIC KNEE PROSTHESIS

2000 ◽  
Vol 04 (01) ◽  
pp. 39-46 ◽  
Author(s):  
Chun-Hsiung Huang ◽  
Cheng-Kung Cheng ◽  
Jiann-Jong Liau ◽  
Ye-Ming Lee
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Tibial Plateau ◽  
Knee Prosthesis ◽  
Femoral Condyle ◽  
Design Parameters ◽  
Good Match ◽  
Total Knee ◽  
The Difference ◽  
Important Design

In total knee replacement, a good match of the prosthesis to bone is very important. Most knees that require total knee replacement are deformed. However, most of the design parameters of knee prosthesis were based on the normal knee. In this series, the dimensions of the resected surfaces in 77 osteoarthritic knees were measured intraoperatively and compared with the corresponding surfaces of the porous-coated anatomic (PCA) (Howmedica, Rutherford, NJ, USA) knee prosthesis. The results showed that the medial femoral condyle was wider than the lateral femoral condyle (p < 0.05) in the resected surfaces. The intercondylar notch of the resected femur was wider than that of the prosthesis (p < 0.05). In the resected tibial plateau, the ratio of the anteroposterior length to the mediolateral width was larger than that of the prosthesis (p < 0.05). The length and width of the resected patella were greater than those of the implant (p < 0.05). According to the difference in morphometrical parameters between the resected surfaces and the knee prosthesis, we suggest that the dimensions of the resected surfaces of the osteoarthritic knee should be important design parameters in total knee prosthesis.

Total knee replacement in an amputee patient: A case report

2000 ◽  
Vol 81 (6) ◽  
pp. 824-826 ◽  
Author(s):  
Paul F. Pasquina ◽  
Erik Dahl
Keyword(s):  
Case Report ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee
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