scholarly journals Early Outcomes of Cemented versus Cementless Total Knee Arthroplasty

2019 ◽  
Vol 9 (4) ◽  
pp. 93-98
Author(s):  
Jeffrey Shepherd ◽  
Alexander C.M. Chong ◽  
Robert P. Cusick
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Clinical Score ◽  
Functional Score ◽  
Patient Demographics ◽  
Included Patient ◽  
Significant Difference ◽  
Measured Time ◽  
Total Knee

Introduction. Total knee arthroplasty (TKA) has been provento be very effective for long-term pain relief in the degenerativeknee. Few studies have investigated short-term clinicaland functional outcomes between the cemented and cementlessTKA. The specific aim of this study was to assess the potentialdifference of functional outcomes in the early postoperativeperiod between these two surgical options usingthe Knee Society Score (KSS) and range of motion (ROM). Methods. A total of 164 knees that had undergone TKA by a singlesurgeon at a single institution between 2007 and 2010 were reviewed.Three different TKA prosthetic designs (cruciate retaining(CR), posterior stabilized (PS) and cruciate substituting (CS))were included. Data collection included patient demographics,pre- and post-operative ROM, and pre- and post-operative KSSat each visit (1.5 months, 3 months, and 12 months). Two separateKSS scores were assigned: functional score and clinical score. Results. Sixty-seven knees underwent cemented TKA and 97knees underwent cementless TKA. No significant differencewas recognized in either age or body mass index for thesetwo TKA groups. The cementless group showed a significantearly ROM improvement after 1.5 months post-operative (p <0.05), while the cemented group showed ROM improvementonly after three months post-operative. No significant differencewas detected in terms of KSS between the cemented andcementless TKA groups at each measured time period. Bothgroups showed marked KSS improvement (cemented: 135%,cementless: 125%) after 1.5 months post-operative and theKSS seemed to be stabilized after three months post-operativefor both groups (cemented: p = 0.36; cementless: p = 0.07). Conclusions. There was a significant early ROM improvementfor the cementless TKA group compared to the cementedTKA group, but no statistical significant difference was notedin KSS in the early post-operative period when comparing cementedand cementless TKA groups. The findings provide evidencethat cementless TKA patients can undergo an identicalpost-operative protocol to cemented TKA, without concernsabout implant stability or function. KS J Med 2016;9(4):93-98.

Periprosthetic Infection: Major Cause of Early Failure of Primary and Revision Total Knee Arthroplasty

2018 ◽  
Vol 32 (10) ◽  
pp. 941-946 ◽  
Author(s):  
Dimitrios S. Evangelopoulos ◽  
Sufian S. Ahmad ◽  
Anna M. Krismer ◽  
Christoph E. Albers ◽  
Sven Hoppe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Functional Score ◽  
Extension Deficit ◽  
Primary Tkas ◽  
Significant Difference ◽  
Flexion Extension ◽  
Cause Of Failure ◽  
Total Knee

AbstractRevision total knee arthroplasty (RTKA) represents an effective treatment for failed TKA, but with less favorable outcomes. Considering the technical complexity and economic burden of RTKA procedures, it is mandatory to investigate current mechanisms and predictors for RTKA failure. The objective of this study is to evaluate the survivorship and determine the predominant causes of failure of RTKA. A total of 146 patients undergoing RTKA between 2003 and 2013 were identified from the institutional database. Revision was defined as surgery in which the whole prostheses (inlay and both femoral and tibial components) required exchange. Median follow-up was 6.3 ± 2.7 years (range: 2.2–10). Patient demographics, year of primary implantation, reasons for revision surgery, implant type, pain, knee mobility, systemic or local postoperative complications, and treatment of the complications were recorded and evaluated. Infection was a major cause of failure followed by aseptic loosening, instability, pain, malalignment, and inlay wear. Following RTKA, Knee Society Score (KSS) (knee score and functional score) demonstrated a significant improvement (p < 0.05). No significant difference in flexion, extension deficit, and KSS was detected between aseptic and septic primary TKAs preoperatively and following first RTKA. Reinfection rate of the septic primary TKAs was 5%. Infection was the major cause of a second revision, reaching as high as 50% in all cases. The results of this study support that septic failure of a primary TKA is likely to occur within the first 2 years following implantation. Septic failure of primary TKA does not influence survival of the revision prosthesis.

scholarly journals Prospective study of clinical and functional outcome of total knee replacement in osteoarthritic knee

2016 ◽  
Vol 2 (4) ◽  
pp. 240 ◽  
Author(s):  
Rahul V. Kadam ◽  
Sunil Yadav ◽  
Abhay Chhallani ◽  
Chinmoy Sharma
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Tertiary Care ◽  
Clinical Score ◽  
Functional Score ◽  
Postoperative Score ◽  
Total Knee ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Total knee arthroplasty (TKA) is now a reliable treatment for osteoarthritis.  The aim of this study was to study the clinical and functional outcome of total knee arthroplasty using knee society score and to find association between knee functional score and knee clinical score.</p><p class="abstract"><strong>Methods:</strong> We conducted a prospective analysis of 40 cases of osteoarthritis knee patients at a tertiary care centre in Mumbai over a period of two years.  Those patients who underwent total knee arthroplasty were assessed clinically and functionally using knee society score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean preoperative knee clinical score (KCS) was 49.40±13.79 which was increased to a postoperative score of 86.08±5.64 at the end of 6 month. Similarly the mean preoperative knee functional score (KFS) was 32.75±11.79 which was increased to a postoperative score of 84.43±9.59 at the end of 6 month. There was significant increase in KCS and KFC score during follow up at 1, 3 and 6 month interval. There was significant association between knee functional score and knee clinical score at every interval.</p><p><strong>Conclusions:</strong> Total knee arthroplasty improves the functional ability of the patient and the ability of the patient to get back to pre-disease state, which is to have a pain free mobile joint, as reflected by the improvement in the post-op knee clinical score and knee functional score.</p>

scholarly journals Comparative Outcomes of Total Knee Arthroplasty on Physically Active and Passive Patients

2011 ◽  
Vol 54 (2) ◽  
pp. 69-72
Author(s):  
Daniel Waciakowski ◽  
Karel Urban
Keyword(s):  
Physical Activity ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Sedentary Lifestyle ◽  
Active Group ◽  
Functional Score ◽  
Knee Score ◽  
Physically Active ◽  
Significant Difference ◽  
Total Knee

The physical activity of the population is decreasing due to an increase in sedentary lifestyles. The aim of the study was to analyze midterm results of total knee arthroplasty according to the lifelong physical activity of the patients. We evaluated 37 patients (23 women, 14 men), with age average 70.0 years (range 53–87). We divided the patients according to lifelong physical activity. The active group included 11 patients with any history of physical activity and the passive included 26 patients with a sedentary lifestyle. No intergroup differences existed in age, gender or preoperative Knee Score. The active group had a higher postoperative Knee Score 90,5 (±5,0) compared to the passive 87,4 (±5,0). Pain after arthroplasty was experienced significantly more in the active group. Between the active 87,3 (±9,3) and passive 67,5 (±16,7) groups we measured a statistically significant difference in the improvement of Functional Score – ability to walk and climb stairs. Sedentary lifestyle affects the clinical outcomes of total knee arthroplasty. This data is demonstrating that physical activity ameliorate functional postoperative results.

scholarly journals The Effect of Intra- vs. Extramedullary Tibial Guides on the Alignment of Lower Extremity and Functional Outcomes following Total Knee Arthroplasty: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Mohammadreza Razzaghof ◽  
SM Javad Mortazavi ◽  
Alireza Moharrami ◽  
Pouya Tabatabaei Irani ◽  
Abbas Noori
Keyword(s):  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Definitive Treatment ◽  
Normal Ranges ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean

Abstract Background: Total knee arthroplasty (TKA) has been known as a definitive treatment of advanced knee osteoarthritis. Both intra- (IM) and extramedullary (EM) tibial guides have been used to restore the desired extremity alignment. However, controversy exists regarding the superiority of either technique. We aimed to compare their functional outcomes and accuracy in providing neutral alignment after TKA. Methods: In a randomized, double-blinded clinical trial, we studied 98 patients undergoing primary TKA in two groups of IM and EM. We measured the medial proximal tibial angle (MPTA), varus angle (VA), and joint-line convergence angle with normal ranges of 90°±3°, 0-2°, and 0±3°, respectively, on a three-joint alignment view after three months. We also assessed functional outcomes at the last follow-up. Finally, we compared these outcomes between groups. Results: Eighty-four patients (IM=42, EM=42) were included in the final analysis (16 males, 68 females; mean age: 63.9±8.6 years; mean follow-up: 27±2.9 months). The mean postoperative alignment angles showed no significant difference, although MPTA outliers were significantly more frequent in the EM group (26.2% vs. 9.5% in IM, P=0.04). None of the functional outcomes showed a significant difference between groups. However, the mean ROM increase was significantly higher in VAs within ±3° of normal than those outside it (30.8 vs. 27.4, respectively; P=0.039). Conclusions: We conclude that both techniques were not different in terms of the mean alignment angles and functional outcomes. However, fewer MPTA outliers can be seen with IM. A postoperative mechanical axis within ±3° of neutral can result in a more ROM increase after one year. Trial registration: IRCT, IRCT20160809029286N5. Registered 21 April 2020, https://www.irct.ir/trial/46976

scholarly journals Intra-operative peri-articular cocktail injection in inflammatory arthritis patients undergoing total knee arthroplasty

2021 ◽  
Vol 7 (6) ◽  
pp. 1215
Author(s):  
Rohit R. ◽  
U. Thyagarajan ◽  
Raghavendran B. ◽  
Karhik Seetharaman
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Inflammatory Arthritis ◽  
Case Series ◽  
Clinical Score ◽  
Functional Score ◽  
Score Following ◽  
Post Operative Pain ◽  
Total Knee ◽  
The Mean

<p class="abstract"><span lang="EN-US">Pain following TKA is often severe in most patients. The purpose of this case series was to assess the efficiency of intra-operative peri-articular cocktail injection in management of pain following total knee arthroplasty. This case series involves 16 patients with inflammatory arthritis of knee undergoing total knee arthroplasty (TKA). All patients had received peri-articular cocktail of drugs before the implantation of prosthesis with cement. In our study, there was significant improvement of Knee Clinical Score and Knee Functional Score following TKA. The mean KSS score was 37.5 (range: 31-44) improved to 92.5 (range, 86-99) and the functional score improved from 25.5 (range, 18-33) to 76 (range, 72- 80) at 6 months and 93 (range: 90-96) at 12 months. Intraoperative peri-articular injection with 20 ml of 0.5% ropivacaine, 1 ml of ketorolac, 1ml of clonidine and 0.5ml noradrenaline diluted in 20 ml of saline is effective in reducing immediate post-operative pain and thereby improving the overall functional outcome.</span></p>

scholarly journals A study of clinical and functional outcome of primary total knee arthroplasty using posterior cruciate substitute design

2017 ◽  
Vol 3 (3) ◽  
pp. 380
Author(s):  
Radhakrishna A. M. ◽  
Shivananda S. ◽  
Girish S.
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Clinical Score ◽  
Functional Score ◽  
Consecutive Series ◽  
Total Knee ◽  
Primary Total Knee

<p class="abstract"><strong>Background:</strong> To <span lang="EN-IN">study the clinical and functional outcome in a consecutive series of Total Knee Arthroplasty using Posterior cruciate substituting (PS) design using the Knee Society Score(KSS). The objectives of the study was 1) To assess the improvement in pain relief post-operatively, stability, mobility of the joint and to assess the correction of deformities. 2) To compare the knee clinical score (KCS) pre-operatively and post-operatively. 3) To compare the knee functional score (KFS) pre-operatively and post-operatively. 4) To assess the radiological outcome of total knee arthroplasty. 5) To study the association between the KCS and the KFS.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study was conducted on patients who have undergone Primary total knee replacement, in Department of Orthopaedics, KIMS hospital from June 2014 to February 2017. The patient was assessed clinically, functionally using the Knee Society Score and a radiographic evaluation was done. These evaluations were performed at 6weeks, 12 weeks, 24 weeks and 1year follow up visits</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">At 1 year follow up of 60 knees, the average pre-op knee clinical score and functional score of 24.7 and 41.2 improved to an average post-op score of 89.9 and 87.8 respectively. Knee clinical and functional score grade of excellent to good was seen in 96.7% (58 knees of 60). Significant association was seen between KCS and KFS. 5 patients had delayed wound healing and one patient had deep infection. Alignment of prosthesis was found satisfactory in all patients. Flexion deformity, valgus and varus correction achieved in all the patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Total knee arthroplasty using posterior cruciate substituting designs resulted in excellent relief of pain, range of motion, restoration of function, low prevalence of patellofemoral complications and continues to function well during the follow-up period. Improvement in clinical score correlated significantly with improvement in functional score. Knee society scoring system effective in evaluating clinical, functional and radiological outcomes.</span></p><p> </p>

Tourniquet Use Does Not Affect Pain and Function after Total Knee Arthroplasty: Patient Evaluation According to Pain Threshold

2021 ◽  
Author(s):  
Savaş Çamur ◽  
Serkan Bayram ◽  
Adnan Kara ◽  
Mustafa Faik Seçkin ◽  
Necdet Sağlam ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Pain Threshold ◽  
Early Stage ◽  
Significant Difference ◽  
Total Knee ◽  
Group 2 ◽  
Without Tourniquet ◽  
Group 1

AbstractWe evaluated the effect of using a tourniquet on early-stage pain and 1-year postoperative functional outcomes when patients were divided into two groups according to the pain threshold (PT). Overall, 120 patients who were assessed preoperatively with an algometer were recruited for this prospective, double-blinded, randomized controlled trial. Patients were randomized to undergo total knee arthroplasty (TKA) with a tourniquet (group 1, 60 patients) and without tourniquet (group 2, 60 patients). Primary outcome measures were visual analog scale (VAS) pain scores at 24, 36, and 48 hours postoperatively and functional assessment with Knee Society Score (KSS) test at 1 year postoperatively. No significant differences were observed between groups in terms of gender (49 females and 8 males in group 1 vs. 53 females and 6 males in group 2; p = 0.201) and age (68.9 years in group 1 vs. 68.7 years in group 2; p = 0.811). There was no significant difference between groups in all the VAS and KSS 1 and KSS 2 scores. PT measurements ranged from 2.5 to 11.5 with a mean of 7.69 ± 1.70 and a median of 8. Total 54 patients with a median value of < 8 were defined as the low-PT group, and 62 patients with a median value of ≥ 8 were defined as the high-PT group. When the groups were evaluated according to using the tourniquet, 21 patients were operated on with a tourniquet and 33 patients without it in the low-PT group, while 36 patients were operated on with a tourniquet and 26 patients without it in the high-PT group. There was no significant difference in pain or functional scores between patients when comparing with-tourniquet and without-tourniquet or when comparing the low- and high-PT groups. This showed that the use of a tourniquet during TKA was not associated with either early-stage pain or 1-year postoperative functional outcomes according to algometer evaluation.Level of evidence: Level 1 prospective randomized study.

scholarly journals Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

2015 ◽  
Vol 4 (4) ◽  
pp. 22-26
Author(s):  
Christopher Ironside ◽  
Simon Coffey ◽  
Guy Eslick ◽  
Rami Sorial
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Unicompartmental Knee Arthroplasty ◽  
Functional Outcomes ◽  
Oxford Knee Score ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Subsequent Revision ◽  
Total Knee

Introduction: Unicompartmental knee arthroplasty (UKA) can be used to treat medial compartment osteoarthritis of the knee. Some of these knees will eventually fail, and need to be revised. There is controversy about using UKA in younger patients as a definitive procedure or as a means to delay total knee arthroplasty (TKA) because the outcomes of subsequent revision surgery may be inferior to a primary TKA. Methods: We retrospectively reviewed a series of 46 revision TKA patients following failed UKA (UKA revisions) using functional outcomes questionnaires and compared the results with a cohort of age and gender matched primary TKA patients. Our hypothesis was that UKA revision surgery would be inferior to primary TKA surgery. Results: Data was collected on 33 knees after a mean follow-up period of five years. There was no significant difference in the Oxford Knee Score (33.7 vs 37.1, p = 0.09) or the Western Ontario and MacMasters Universities Arthritis Index (WOMAC) (24.8 vs. 19.1, p = 0.22). A subgroup analysis demonstrated that UKAs, which fail early, are more likely to produce an inferior outcome following revision surgery than those that survive more than five years. Discussion: We conclude that UKA can be used effectively in appropriately selected patients, as the functional outcome of their subsequent revision to TKA is not significantly inferior to a primary TKA.Keywords: unicompartmental knee arthroplasty, revision knee arthroplasty

The influence of prior arthroscopy on subsequent total knee arthroplasty: the comparison in the same patient

2020 ◽  
Author(s):  
rui shen ◽  
Chuan HU ◽  
Cai-lin Wang ◽  
Kui-shuai XU ◽  
Yuan-he Wang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
Clinical Score ◽  
Functional Score ◽  
Continuous Variables ◽  
Chi Square ◽  
Group A ◽  
Total Knee ◽  
Group B

Abstract Background: To explore whether prior arthroscopic knee surgery affects future total knee arthroplasty or not Methods : A total of 36 patients with prior arthroscopy who underwent total knee arthroplasty in the department of orthopedics, affiliated hospital of Qingdao University from September 2013 to July 2017 were collected. We defined the knee with a prior arthroscopy history as group A, and the other side as group B. Using Kolmogorov-Smirnov test to test normality of continuous variables, and the chi-square test was applied to compare the rate of reoperation and complication between two groups. For all statistical comparisons, P<0.05 was considered significant. Results: There was no statistical significance in postoperative Knee Society clinical score and functional score between group A and group B, as well as ROM, FJS, VAS scores and local complications Conclusion : There were no statistically significant differences in postoperative functional recovery and complications in patients who underwent total knee arthroplasty with prior knee arthroscopy.

Effects of the Use of Tourniquet in Total Knee Arthroplasty on the Clinical and Functional Outcomes with 5 Years of Follow-up: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Sherwan A. Hamawandi ◽  
Hazhar I. Amin ◽  
Ameer K. Al-Humairi
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Functional Outcomes ◽  
Controlled Trial ◽  
Thigh Pain ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Total Knee

AbstractThe use of tourniquet in total knee arthroplasty (TKA) had a lot of controversies with no clear agreement about the advantages and disadvantages of tourniquet. This study aims to show the effects of tourniquet use in TKA on the functional and clinical outcomes with follow-up of 5 years. This is a randomized, double-blind, and single-center study of 101 patients who were treated by TKA and divided randomly into two groups. Tourniquet was used in group A and was not used in group B. Both groups were assessed by Knee Society score (KSS), knee injury and osteoarthritis outcome score (KOOS), visual analogue scale (VAS) score for thigh pain, and postoperative complications. Both groups were followed up for 5 years. The group of no tourniquet showed significant better functional outcomes measured by KSS at postoperative periods of 2 weeks (p = 0.001), 6 weeks (p = 0.006), and 3 months (p = 0.034), and KOOS at postoperative periods of 2 weeks (p = 0.001), 6 weeks (p =0.001), and 3 months (p = 0.016). However, there was no significant difference in long-term follow-up of 5 years. There were significantly better results with use of tourniquet regarding surgeon's visualization during surgery, less operative time, and less calculated blood loss, while significantly better results with no use of tourniquet were reported regarding less hospital stay, less postoperative analgesic consumption, and less postoperative thigh pain measured by VAS score at postoperative periods of day 1 (p = 0.001), day 5 (p = 0.001), 2 weeks (p = 0.001), and 6 weeks (p = 0.001). Regarding postoperative blood transfusion and clinical deep venous thrombosis, there was no significant difference between use of tourniquet or not. The evidence presented in this level-1 randomized controlled trial suggests that no use of tourniquet in TKA can improve functional outcomes in early postoperative period with no significant difference on functional outcome at 5 years of follow-up.

Sign in / Sign up

Export Citation Format

Share Document