scholarly journals Knee Arthroplasty: With or Without Patellar Component?

2015 ◽  
Vol 61 (3) ◽  
pp. 225-228
Author(s):  
Sólyom Árpád ◽  
Király Ildikó ◽  
Benedek Csaba ◽  
Fülöp Csongor ◽  
Nagy Örs ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Pain Management ◽  
Knee Arthroplasty ◽  
Invasive Procedure ◽  
The Other ◽  
Medical Facility ◽  
Irreversible Damage ◽  
Patellar Component ◽  
Less Invasive

AbstractArthroplasty is used when there is irreversible damage to the articular cartilage of the knee. It involves implanting a bicompartimental (femoral and tibial components) or a tricompartimental (femoral, tibial and patellar components) prosthesis. It is a very invasive and costly operation, so our objective was to evaluate the necessity of the patellar component.Material and methods: During our study we’ve included 39 patients: in 27 cases we used tricompartimental prosthesis, while the other 12 received only the bicompartimental components. Patients were evaluated preoperatively and postoperatively using the International Knee Documentation Comitee score. We’ve also compared our results with the results of other published authors.Results: We’ve found that there is little to no difference between the two groups regarding mobility and complication, however patients with bicompartimentalarthroplasty complained of less pain.Conclusion: We’ve found that bicompartimentalarthroplasty – being a less invasive procedure – is better not only in terms of pain management, but there is also less hemorrhaging, shorter intraoperative time is considered, revision is easier and also has financially advantages, both for the patient and for the medical facility.

scholarly journals Influence of Preservation of Normal Knee Contact Stress on Other Compartments with respect to the Tibial Insert Design for Unicompartmental Knee Arthroplasty

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yong-Gon Koh ◽  
Kyoung-Mi Park ◽  
Kyoung-Tak Kang
Keyword(s):  
Articular Cartilage ◽  
Femoral Component ◽  
Contact Stress ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Gait Cycle ◽  
Lateral Meniscus ◽  
The Other ◽  
Loading Conditions ◽  
Tibial Insert

Recent advances in imaging technology and additive manufacturing have led to the introduction of customized unicompartmental knee arthroplasty (UKA) that can potentially improve functional performance due to customized geometries, including customized sagittal and coronal curvature and enhanced bone preservation. The purpose of this study involved evaluating the biomechanical effect of the tibial insert design on the customized medial UKA using computer simulations. We developed sagittal and coronal curvatures in a native knee mimetic femoral component design. We utilized three types of tibial insert design: flat, anatomy mimetic, and conforming design. We evaluated contact stress on the tibial insert and other compartments, including the lateral meniscus and articular cartilage, under gait and squat loading conditions. For the conforming UKA design, the tibial insert and lateral meniscus exhibited the lowest contact stress under stance phase gait cycle. However, for the conforming UKA design, the tibial insert and lateral meniscus exhibited the highest contact stress under swing phase gait cycle. For the flat UKA design, the articular cartilage exhibited the lowest contact stress under gait and squat loading conditions. The anatomy mimetic UKA design exhibited the most normal-like contact stress on the other compartments under gait and squat loading conditions. The results reveal the importance of conformity between the femoral component and the tibial insert in the customized UKA. Based on the results on the femoral component as well as the tibial insert in the customized UKA, the anatomy mimetic design preserves normal knee joint biomechanics and thus may prevent progressive osteoarthritis of the other knee compartments.

Rehabilitation and Pain Management Modalities in Total Knee Arthroplasty

2016 ◽  
Vol 29 (03) ◽  
pp. 179-179 ◽  
Author(s):  
Morad Chughtai ◽  
Randa Elmallah ◽  
Jeffrey Cherian ◽  
Jaydev Mistry ◽  
Steven Harwin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Knee Arthroplasty ◽  
Total Knee

Matched-Pair Analysis of Local Infiltration Analgesia in Total Knee Arthroplasty: Patient Satisfaction and Perioperative Pain Management in 846 Cases

2018 ◽  
Vol 32 (10) ◽  
pp. 953-959 ◽  
Author(s):  
Felix Greimel ◽  
Günther Maderbacher ◽  
Clemens Baier ◽  
Timo Schwarz ◽  
Florian Zeman ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Knee Arthroplasty ◽  
Postoperative Pain Management ◽  
Matched Pair ◽  
Local Infiltration Analgesia ◽  
Replacement Surgery ◽  
Matched Pair Analysis ◽  
Total Knee ◽  
Pair Analysis

AbstractIn the recent past, numerous studies evaluating local infiltration analgesia (LIA) with controversial results have been reported. Efforts have been made to improve patients' outcome regarding operation techniques and material, as well as pain management and anesthetic methods. In this study, postoperative pain management and patient satisfaction were evaluated in patients undergoing total knee replacement surgery with or without intraoperative LIA. Within the context of the “Quality Improvement in Postoperative Pain Management” (QUIPS) project, parameters were collected on the first postoperative day. All patients included in this study underwent primary knee replacement surgery with general anesthesia. Parameters were compared after performing a 1:1 matched-pair analysis within 14 orthopaedic departments. Pain levels and pain management satisfaction were measured using the numerous rating scales, and pain medication use was compared. From 2010 to 2015, 2,789 patients who underwent primary knee arthroplasty with general anesthesia were evaluated within the project, of whom a total of 846 patients could be compared after performing a matched-pair analysis. Pain scores were significantly better in the LIA group (p = 0.019 for activity pain, p = 0.043 for maximum pain, p < 0.001 for minimum pain), but pain management satisfaction was not superior (p = 0.083). Patients with LIA required less opioids in the recovery room (p = 0.048), while nonopioid medication did not differ significantly (p = 0.603). At the ward, 24 hours postoperatively, no significant difference in the use for nonopioids (p = 0.789) could be measured, whereas patients in the LIA group received significantly more opioids (p < 0.001). Although LIA achieved improvement in pain score outcome, and a comparable patient satisfaction level in the immediate postoperative course, the use of LIA in knee arthroplasty, controversially discussed in the current literature, was not able to reduce the need for opioid pain medication in this study.

scholarly journals A Randomised-Controlled Clinical Study Examining the Effect of High-Intensity Laser Therapy (HILT) on the Management of Painful Calcaneal Spur with Plantar Fasciitis

2021 ◽  
Vol 10 (21) ◽  
pp. 4891
Author(s):  
Piotr Tkocz ◽  
Tomasz Matusz ◽  
Łukasz Kosowski ◽  
Karolina Walewicz ◽  
Łukasz Argier ◽  
...  
Keyword(s):  
Pain Management ◽  
High Intensity ◽  
Plantar Fasciitis ◽  
Heel Pain ◽  
The Other ◽  
Control Group ◽  
Study Group ◽  
Calcaneal Spur ◽  
High Intensity Laser ◽  
Intensity Laser

Calcaneal spur and plantar fasciitis are the most common causes of plantar heel pain. There are many effective physical modalities for treating this musculoskeletal disorder. So far, the are no clear recommendations confirming the clinical utility of high-intensity laser therapy (HILT) in the management of painful calcaneal spur with plantar fasciitis. This study aimed to evaluate the effectiveness of HILT in pain management in patients with calcaneal spur and plantar fasciitis. A group of 65 patients was assessed for eligibility based on the CONSORT guidelines. This study was prospectively registered in the Australian New Zealand Clinical Trial Registry platform (registration number ACTRN12618000744257, 3 May 2018). The main eligibility criteria were: cancer, pregnancy, electronic and metal implants, acute infections, impaired blood coagulation, cardiac arrhythmias, taking analgesic or anti-inflammatory medications, non-experience of heel pain, or presence of other painful foot conditions. Finally, 60 patients were randomly assigned into two groups: study group (n = 30, mean age 59.9 ± 10.1), treated with HILT (7 W, 149.9 J/cm2, 1064 nm, 4496 J, 12 min), and placebo-controlled group (n = 30, mean age 60.4 ± 11.9), treated with sham HILT therapy. Both groups received ultrasound treatments (0.8 W/cm2, 1 MHz frequency, 100% load factor, 5 min). Treatment procedures were performed once a day, five times per week for three weeks (total of 15 treatment sessions). Study outcomes focused on pain intensity and were assessed before (M1) and after (M2) the treatment as well as after 4 (M3) and 12 (M4) weeks using the Visual Analogue Scale (VAS) and the Laitinen Pain Scale (LPS). According to VAS, a statistically significant decrease in the study group was observed between M1 and M2 by 3.5 pts, M1 and M3 by 3.7 pts, and M1 and M4 by 3.2 pts (p < 0.001). On the other hand, the control group showed a statistically significant decrease (p < 0.001) between M1 and M2 by 3.0 pts, M1 and M3 by 3.4 pts, and M1 and M4 by 3.2 pts. According to LPS, a statistically significant decrease in the study group was observed between M1 and M2 by 3.9 pts, M1 and M3 by 4.2 pts, and M1 and M4 by 4.0 pts (p < 0.001). On the other hand, the control group showed a statistically significant decrease between M1 and M2 by 3.2 pts (p = 0.002), M1 and M3 by 4.0 pts (p < 0.001), and M1 and M4 by 3.9 pts (p < 0.001). However, there were no statistically significant differences between the groups in VAS and LPS (p > 0.05). In conclusion, the HILT does not appear to be more effective in pain management of patients with calcaneal spurs and plantar fasciitis than the conservative standard physiotherapeutic procedures.

scholarly journals Estimation of differences in selected indices of vibroacoustic signals between healthy and osteoarthritic patellofemoral joints as a potential non-invasive diagnostic tool

2021 ◽  
Vol 2130 (1) ◽  
pp. 012009
Author(s):  
R Karpiński ◽  
P Krakowski ◽  
J Jonak ◽  
A Machrowska ◽  
M Maciejewski ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Invasive Procedure ◽  
Superficial Layer ◽  
Degenerative Changes ◽  
Joint Disease ◽  
Control Group ◽  
Kinetic Chain ◽  
Non Invasive ◽  
Joint Surfaces ◽  
Vibroacoustic Signals

Abstract Osteoarthritis (OA) is currently the most generic form of joint disease. It is a complex process in which degenerative changes occur in the articular cartilage [AC], subchondral bone, and synovial membrane and can lead to permanent joint failure. The primary and most commonly used method of diagnosing degenerative changes is classic radiography. Magnetic resonance imaging (MRI) may be used to assess the extent of damage to joint surfaces, but this method is limited by the availability of specialised equipment and the excessive cost of the examination. Arthroscopy, an invasive procedure, is considered the “gold standard” in joint diagnosis. The occurrence of degenerative changes is closely related to the friction and lubrication processes within the joint. The main causes of osteoarthritis are a change or lack of synovial fluid, deformation of the joint bones, local damage to the articular cartilage, and a change in the mechanical properties of the articular cartilage due to water loss from the damaged superficial layer. An alternative, non-invasive method that allows for a delicate assessment of the condition of moving joints is vibroarthrography (VAG). The analysis of vibroacoustic signals generated by moving joint surfaces has an immense potential in the non-invasive assessment of the degree of damage to articular cartilage, meniscus and ligaments and the general diagnosis of degenerative diseases. The purpose of this study is to analyse and statistically compare the basic characteristics of vibroacoustic signals recorded with a CM-01B contact microphone placed on the patella for motion in the 90°–0°–90° range in a closed kinetic chain (CKC) in a control group (HC) and a group of patients diagnosed with osteoarthritis (OA), qualified for the knee alloplasty.

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