scholarly journals A functional comparison of medial pivot and condylar knee designs based on patient outcomes and parameters of gait

2018 ◽  
Vol 100-B (1_Supple_A) ◽  
pp. 76-82 ◽  
Author(s):  
B. Benjamin ◽  
J. R. T. Pietrzak ◽  
J. Tahmassebi ◽  
F. S. Haddad
Keyword(s):  
Statistical Significance ◽  
Oxford Knee Score ◽  
Randomised Study ◽  
Significant Difference ◽  
Medial Pivot ◽  
Stance Time ◽  
Total Knee ◽  
One Year ◽  
Biomechanical Features ◽  
Single Radius

AimsThe outcome of total knee arthroplasty (TKA) is not always satisfactory. The purpose of this study was to identify satisfaction and biomechanical features characterising the gait of patients who had undergone TKA with either an anatomical single radius design or a medial pivot design. We hypothesised that the latter would provide superior function.Patients and MethodsThis is a study of a subset of patients recruited into a prospective randomised study of a single radius design versus a medial pivot design, with a minimum follow-up of one year. Outcome measurements included clinical scores (Knee Society Score (KSS) and Oxford Knee Score (OKS)) and gait analysis using an instrumented treadmill.ResultsThere was no statistically significant difference between the two groups for both the KSS and OKS. There was also no statistical significance in cadence, walking speed, stride length and stance time, peak stride, mid support and push-off forces.ConclusionThis study corroborates a previous study by the same authors that showed equally good results in clinical outcome and gait between the conventional single radius and medial pivot designs under stringent testing conditions. Cite this article: Bone Joint J 2018;(1 Supple A)100-B:76–82.

Venous thromboembolism after total knee arthroplasty is associated with a worse functional outcome at one year

2021 ◽  
Vol 103-B (7) ◽  
pp. 1254-1260
Author(s):  
Lorenzo Calabro ◽  
Nick D. Clement ◽  
Deborah MacDonald ◽  
James T. Patton ◽  
Colin R. Howie ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Venous Thromboembolism ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Significant Independent Predictor ◽  
Total Knee ◽  
Five Dimension ◽  
One Year

Aims The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific functional outcome (Oxford Knee Score (OKS)) one year after total knee arthroplasty (TKA). Secondary aims were to assess whether non-fatal postoperative VTE influences generic health and patient satisfaction at this time. Methods A study of 2,393 TKAs was performed in 2,393 patients. Patient demographics, comorbidities, OKS, EuroQol five-dimension score (EQ-5D), and Forgotten Joint Score (FJS) were collected preoperatively and one year postoperatively. Overall patient satisfaction with their TKA was assessed at one year. Patients with VTE within six months of surgery were identified retrospectively and compared with those without. Results A total of 37 patients (1.5%) suffered a VTE and were significantly more likely to have associated comorbidities of stroke (p = 0.026), vascular disease (p = 0.026), and kidney disease (p = 0.026), but less likely to have diabetes (p = 0.046). In an unadjusted analysis, patients suffering a VTE had a significantly worse postoperative OKS (difference in mean (DIM) 4.8 (95% confidence interval (CI) 1.6 to 8.0); p = 0.004) and EQ-5D (DIM 0.146 (95% CI 0.059 to 0.233); p = 0.001) compared with patients without a VTE. After adjusting for confounding variables VTE remained a significant independent predictor associated with a worse postoperative OKS (DIM -5.4 (95% CI -8.4 to -2.4); p < 0.001), and EQ-5D score (DIM-0.169 (95% CI -0.251 to -0.087); p < 0.001). VTE was not independently associated with overall satisfaction after TKA (odds ratio 0.89 (95% CI 0.35 to 2.07); p = 0.717). Conclusion Patients who had a VTE within six months of their TKA had clinically significantly worse knee-specific outcome (OKS) and general health (EQ-5D) scores one year postoperatively, but the overall satisfaction with their TKA was similar to those patients who did not have a VTE. Cite this article: Bone Joint J 2021;103-B(7):1254–1260.

scholarly journals Composition of raw milk from conventional and organic dairy farming

2016 ◽  
Vol 32 (2) ◽  
pp. 133-143 ◽  
Author(s):  
Denis Kucevic ◽  
Snezana Trivunovic ◽  
Vladan Bogdanovic ◽  
Ksenija Cobanovic ◽  
Dobrila Jankovic ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Raw Milk ◽  
Farming System ◽  
Dairy Farming ◽  
Milk Samples ◽  
High Statistical Significance ◽  
Significant Difference ◽  
Organic Dairy ◽  
One Year ◽  
The Impact

Possible differences between composition of raw milk due to dairy farming system (organic vs conventional) as well as seasonal variations were investigated. The samples were analysed during one year. A total of 6.782 samples of raw milk were collected (4.496 from organic farming). Dairy farms were located in the northern part of Republic of Serbia (Province of Vojvodina). The principle of analysis of raw milk samples was in accordance with the methodology by midinfrared spectrometry and flow cytometry. The fixed effect of system of farming and season (winter, spring, summer and fall) have shown a high statistical significance (P < 0.01) on all examined milk parameters except fat, total solids and somatic cell count, where the impact was slightly lower (P < 0.05). Significant difference wasn't found in number of bacterial colonies (P > 0.05). Composition of milk is also affected by a number of other factors, therefore it is recommended to involve factors such as nutrition of dairy cows, breed and farm management.

scholarly journals COMPARISON OF HEMOSTASIS WITH TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

2021 ◽  
Vol 29 (4) ◽  
pp. 184-188
Author(s):  
OTÁVIO MONTOVANELLI MONTEIRO ◽  
RODRIGO TURRA PERRONE ◽  
FABRÍCIO NASCIMENTO ALMEIDA ◽  
CID PEREIRA DE MOURA JUNIOR ◽  
SAULO GOMES DE OLIVEIRA ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
Primary Total Knee Arthroplasty ◽  
Joint Surface ◽  
Thromboembolic Events ◽  
Significant Difference ◽  
Total Knee ◽  
Group 3

ABSTRACT Objective: To compare the use of intravenous and topical tranexamic acid (TXA) in unilateral primary total knee arthroplasty (TKA) in relation to blood loss and complications inherent to the medication. Method: Three groups with 14 patients each were constituted, and all of them were operated using the same surgical technique. In Group 1, usual measures for bleeding control were performed. Group 2 patients received TXA topically on the joint surface. In Group 3, intravenous TXA was used. Hemoglobin (HB), hematocrit (HTC), platelets (PLAT), prothrombin time, activated partial thromboplastin time and volume of blood drained observed 24 hours after arthroplasty were compared to the values of tests found before surgery. Results: There was a decrease in the concentration of HB, HTC and PLAT in all groups in relation to the preoperative, however without significant difference. Group 3 had a lower mean volume of drained blood than the other groups, with statistical significance. No adverse effects or thromboembolic events were observed in the groups that received TXA. Conclusion: This study showed superiority in the use of intravenous TXA in decreasing the volume of bleeding, without increasing the risk of thromboembolic events. Level of Evidence I, High quality randomized trial with statistically significant difference or no statistically significant difference but narrow confidence intervals.

scholarly journals Evaluation of Alpha-1 Antitrypsin Level in the Serum of Children With Idiopathic Bronchiectasis

2021 ◽  
Author(s):  
Maryam Babaei ◽  
Zahra Kanannejad ◽  
Soheila Alyasin
Keyword(s):  
Serum Level ◽  
Respiratory Infections ◽  
Statistical Significance ◽  
Clinical Syndrome ◽  
Control Group ◽  
Case Group ◽  
Significant Difference ◽  
Alpha 1 Antitrypsin ◽  
One Year ◽  
And Control

Bronchiectasis is a clinical syndrome characterized by chronic cough, sputum production, recurrent respiratory infections, and permanent bronchial dilation. The association between the level of alpha-1 antitrypsin (AAT) and bronchiectasis is controversial. In this study, we aimed to investigate this association in children with idiopathic bronchiectasis. The study was conducted on 20 patients with idiopathic bronchiectasis as the case group (mean age 15.9±2.1) and 20 healthy individuals as the control group (mean age 14.9±2.6). Serum AAT level was measured using nephelometric analysis (g/L). Other criteria including sex, parent consanguinity, number of hospitalizations, age of the first symptom were evaluated in both groups related to AAT level. The mean serum level of AAT in the case and control groups were 1.3±0.29; 1.5±0.59, respectively, with statistical significance (P=0.001). There was a significant difference between the two groups in the AAT level distribution, according to AAT normal range (P=0.01). The case group had a more positive attitude toward consanguinity than the control group (66.7% versus 33.3%; P<0.001). The results showed that 80% of patients had the first symptom of disease under one year of age, 6.6% 1-5 years, 6.6% 5-10 years, and 6.6% in more than ten years old. In the case group, 53.3% had a history of medical hospitalization for one time, 26.7% two times, while 20% of the patients had no medical hospitalization. Decreased AAT serum level and high consanguinity rates may be considered as two risk factors for idiopathic bronchiectasis occurrence in children.

scholarly journals Comparison of functional outcome of simultaneous and staged bilateral total knee arthroplasty : systematic review of literature

2021 ◽  
Vol 87 (3) ◽  
pp. 487-493
Author(s):  
Irfan Qadir ◽  
Latif Khan ◽  
Jahanzeb Mazari ◽  
Umair Ahmed ◽  
Atiq uz Zaman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Outcome ◽  
Contemporary Literature ◽  
Oxford Knee Score ◽  
Bilateral Total Knee Arthroplasty ◽  
Significant Difference ◽  
Functional Scores ◽  
Total Knee ◽  
Central Database ◽  
Simultaneous Bilateral Tka

Safety of simultaneous bilateral TKA (simBTKA) and staged BTKA (staBTKA) have been compared in previous systematic reviews but functional outcome remains neglected aspect of the debate. We performed a systematic review of contemporary literature to compare the functional outcome of simBTKA and staBTKA. We searched PubMed/MEDLINE, EMBASE and Cochrane Central Database to identify all articles published between 2000 and July 2020 that evaluated the outcome of patients undergoing BTKA either in simultaneous or staged manner. Ten articles were identified which met the inclusion criteria. Functional outcome was reported in terms of Knee Society score (KSS), range of motion (ROM), Oxford Knee Score (OKS) and Western Ontario and McMaster University score (WOMAC) in seven, five, four and two studies respectively. KSS gained on average 66.6 points (47.5-95.3) for simBTKA and 65.1 points (44.4-97.2) for staBTKA without significant difference between two groups. There was no difference in post-operative ROM (maximum post-operative flexion being 124.4 and 125.1 for simBTKA and staBTKA groups respectively). Mean improvement in OKS ranged from 20 to 32.6 for simBTKA and 21.6 to 33.1 for staBTKA. There was moderate evidence to suggest that both simultaneous BTKA and staged BTKA produce equivalent improvement in functional scores.

scholarly journals Higher treatment effect after total knee arthroplasty is associated with higher patient satisfaction

2020 ◽  
Author(s):  
Jörg Lützner ◽  
Franziska Beyer ◽  
Klaus-Peter Günther ◽  
Jörg Huber
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Treatment Effect ◽  
Treatment Effects ◽  
Oxford Knee Score ◽  
Individual Treatment ◽  
Total Knee ◽  
The Mean ◽  
One Year

Abstract Purpose The aim of this study was to investigate what influence the treatment effect after total knee arthroplasty (TKA) had on patient satisfaction. Methods Prospective registry data of a University-based arthroplasty centre were used. 582 patients with unilateral bicondylar TKA were analyzed. Treatment effect (TE) was deduced from Oxford Knee Score (OKS) before and one year after surgery. Positive values correspond to improved symptoms (maximum 1.0 reflect no symptoms at all) and negative values correspond to deterioration of symptoms. Satisfaction on a visual-analogue scale from 0 to 10 and the willingness to undergo TKA surgery again was assessed one year after surgery. Results The mean OKS improved from 22.1 before to 36.7 one year after TKA. Treatment effects ranged from 1.0 to –0.62 with a mean TE of 0.56. Taking an individual treatment effect of 0.2 as a cut-off between responder and non-responder, a total of 85.8% would be classified as responder after TKA. The mean satisfaction score with the TKA was 8.1. There was a significant correlation between the individual treatment effect and satisfaction after TKA (p < 0.001). The majority of patients (84.5%) would undergo surgery again. Patients not willing to undergo surgery again or those uncertain about this had lower satisfaction scores, a lower treatment effect and were more often female compared to patients who would undergo surgery again. Conclusion Higher individual treatment effects resulted in higher patient satisfaction and willingness to undergo surgery again. However, some patients with a relatively low treatment effect were highly satisfied, which indicates the need for both information. Level of evidence II.

scholarly journals Sagittal radius of curvature, trochlea design and ultracongruent insert in total knee arthroplasty

2019 ◽  
Vol 4 (8) ◽  
pp. 519-524 ◽  
Author(s):  
Jimmy Wui Guan Ng ◽  
Benjamin V. Bloch ◽  
Peter J. James
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Radius Of Curvature ◽  
Ultracongruent Insert ◽  
Medial Pivot ◽  
Total Knee ◽  
Quadriceps Function ◽  
Single Radius

Multi radius (MR) total knee arthroplasty (TKA) has been associated with mid-flexion instability. Single radius (SR) TKA may provide better anteroposterior stability through single flexion axis and biomechanical advantage for quadriceps function. Medial pivot (MP) TKA and gradually reducing (GR) radius TKA produce better knee kinematics. Clinical outcomes are equivalent for SR, MR and MP TKA. Short-term studies have shown better clinical outcomes and kinematics for GR TKA. Thinner and narrow anterior flange, deeper trochlea groove and more anatomical trochlea design reduces patellofemoral complications in TKA Ultracongruent inserts provide comparable clinical outcomes to posterior-stabilized TKA and cruciate retaining TKA.Cite this article: EFORT Open Rev 2019;4:519-524. DOI: 10.1302/2058-5241.4.180083

Event Rate for Patients with Atrial Fibrillation with and without Low Molecular Weight Heparin Bridging.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 916-916
Author(s):  
Henny Heisler Billett ◽  
Eileen M. Madsen ◽  
Emily Giannattasio
Keyword(s):  
Atrial Fibrillation ◽  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Index Date ◽  
Event Rate ◽  
Statistical Significance ◽  
Low Molecular Weight ◽  
Significant Difference ◽  
Hemorrhagic Risk ◽  
One Year

Abstract The benefit of ’bridging’ atrial fibrillation patients with low molecular weight heparin until their INRs are at therapeutic levels with coumadin is unclear. Using a replicative hospital database available for IRB approved protocols and quality control analyses, we compared a cohort of patients over 65 years of age discharged with a diagnosis of atrial fibrillation (index date) who had been bridged (n=201) with a cohort of patients over 65 years of age who were not bridged on discharge but who achieved a therapeutic INR within 30 days of coumadin initiation (nonbridged and early INR, NB-E, n=1376). Log rank Mantel Haenszel two group comparisons were used to test for differences in time to event rate for admission for CVA, admission for hemorrhage, and number of laboratory INRs in therapeutic range (NLTR). The incidence of CVA admissions in the bridged group at 15, 30, 60, 90, 180 and 365 days was 0%, 0%, 0%, 0%, 0.5% and 1.2% whereas for the NB-E it was 0.1%, 0.3%, 0.8%, 1.3%, 1.8% and 2.8%. This difference did not reach statistical significance (p=0.19). No difference was noted in the time to admission for hemorrhage (3.5% at day 15, remaining unchanged at 30, 60 and 90 days for the bridged patients vs. 1.0%, 1.9%, 3.1% and 4.2% for NB-E patients, p=0.67). When NLTR were expressed as dichotomous variables (INR&lt;1.9=bad, 2–3.5=good, 3.6–20=bad) and assessed for one year from index date, there was no significant difference (good = 55.3% NLTR for bridged vs. 52.3% for NB-E). When either of these groups were compared to patients with AF who did not achieve therapeutic INRs until after 30 days (but less than one year, NB-L, n=2061), there was a difference in the incidence of admissions for CVA that was significant (0.2%, 0.7%, 1.1%, 1.2%, 2.5% and 4.8% at day 15, 30, 60, 90, 180, 365, p=0.025 vs. bridged, and p=0.048 vs. NB-E), NLTR (45.2%), but not in the incidence of admission for hemorrhage at 90 days (0.7%, 1.4%, 2.6% and 3.9% at 15, 30, 60 and 90 days). Because no risk factors prompting the decision to bridge patients were examined, the non-significant decreased incidence of CVA admissions in bridged patients may be important, since it may be that patients who were bridged were at higher risk for stroke than those who were not bridged (early or late). Future randomized trials with risk group stratification will be necessary to elucidate this but these data demonstrate there is no significant additional hemorrhagic risk for patients with atrial fibrillation who are bridged with low molecular weight heparin and suggest a potential benefit to early effective anticoagulation.

scholarly journals Quality of life and functional outcome after single-radius and multi-radius total knee arthroplasty

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879241 ◽  
Author(s):  
Merrill Lee ◽  
Jerry Yongqiang Chen ◽  
Hao Ying ◽  
Pang Hee Nee ◽  
Darren Keng Jin Tay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
T Test ◽  
Significant Difference ◽  
Patient Groups ◽  
Total Knee ◽  
Single Radius

Purpose: The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome. Methods: One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012. A propensity score matching algorithm was used to select 103 MR TKAs performed during the same period. Preoperative and postoperative variables such as standardized knee and quality of life scores were captured prospectively and then analyzed via both the Student’s t-test and paired t-test to look for statistically significant differences between the SR and MR patient groups. Results: At 2 years postoperatively, there was no statistically significant difference between the SR and MR patient populations in knee extension, Oxford Knee Score, Knee Society Clinical Rating Scores, and the Physical Component Summary of the Short Form 36 Health Survey (SF-36). There was a statistically significant difference between the two patient groups in postoperative knee flexion in favor of the MR design ( p = 0.011). Conclusion: While an SR femoral implant design has several theoretical biomechanical advantages, postoperative standardized KSCs and quality of life scores in this single-surgeon series do not show a clear advantage of one design over the other. Level of evidence: III.

scholarly journals Intervention Effects of the Health Promotion Programme “Join the Healthy Boat” on Objectively Assessed Sedentary Time in Primary School Children in Germany

2020 ◽  
Vol 17 (23) ◽  
pp. 9029
Author(s):  
Susanne Kobel ◽  
Jens Dreyhaupt ◽  
Olivia Wartha ◽  
Sarah Kettner ◽  
Belinda Hoffmann ◽  
...  
Keyword(s):  
Screen Time ◽  
Primary School Children ◽  
Control Group ◽  
Health Promotion Programme ◽  
Randomised Study ◽  
Targeted Interventions ◽  
Promotion Programme ◽  
Significant Difference ◽  
One Year

Sedentary behaviour (SB) in children is related to negative health consequences that can track into adulthood. The programme “Join the Healthy Boat” promotes reduced screen time and a less sedentary lifestyle in schoolchildren. This study investigated the effects of the programme on children’s SB. For one year, teachers delivered the programme. A total of 231 children (7.0 ± 0.6 years) participated in the cluster-randomised study; there were 154 one year later at follow-up. Children’s SB was assessed using multi-sensor accelerometery, screen time via parental questionnaire. Effects were analysed using (linear) mixed effects regression models. At baseline, children spent 211 (±89) min daily in SB, at follow-up 259 (±109) min/day with no significant difference between the intervention (IG) and control group (CG). SB was higher during weekends (p < 0.01, for CG and IG). However, at follow-up, daily screen time decreased in IG (screen time of >1 h/day: baseline: 33.3% vs. 27.4%; follow-up: 41.2% vs. 27.5%, for CG and IG, respectively). This multi-dimensional, low-threshold intervention for one year does not seem to achieve a significant reduction in children’s SB, although screen time decreased in IG. Therefore, it should be considered that screen time cannot be the key contributor to SB and should not solely be used for changing children’s SB. However, if screen time is targeted, interventions should promote the replacement of screen time with active alternatives.

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