scholarly journals SURGICAL TREATMENT OF THE KNEE JOINT CONTRACTURES AFTER TOTAL KNEE ARTHOPLASTY

2020 ◽  
Author(s):  
Alexander Akhpashev ◽  
Leonid Brizhan ◽  
Aleksander Artemiev ◽  
Mikhail Bolotnikov ◽  
Aleksander Shipulin ◽  
...  
Keyword(s):  
Knee Joint ◽  
Revision Arthroplasty ◽  
Open Arthrolysis ◽  
Joint Contractures ◽  
Arthroscopic Arthrolysis ◽  
Surgical Access ◽  
Joint Revision ◽  
Total Knee ◽  
Comparison Of The Results ◽  
Group 1

Background: The development of contractures after total knee replacement is most often associated with arthrofibrosis and makes up 1.3% - 5.7% of the total number of cases of joint replacement. Conservative treatment is ineffective. Arthrolysis is pathogenetically substantiated (arthroscopic or open). Aims: assessment of the effectiveness of arthrolysis as a method of treating knee joint contractures after arthroplasty, comparison of the results of arthroscopic and open arthrolysis, analysis of complications. Materials and methods: Compare two groups. In group 1, 57 patients underwent arthroscopic arthrolysis. In group 2, 54 patients underwent open arthrolysis. The operations were performed from 2015 to 2019, the observation period ranged from one year to three years. As criteria for the result of treatment, KSS data were used (general and functional assessment of the knee joint), as well as separately the amplitude of movements in the joint before surgery and at different times after it. Results: One of the results of this work was the optimization of arthroscopic arthrolysis technique. Improved surgical access and joint revision sequence. According to the KSS scale and range of motion, the best results were obtained in group 1. Especially important is the lesser number of complications in comparison with the 2nd group requiring repeated interventions, including revision arthroplasty. In the 1st group of such cases there were 3 (5.3%), in the 2nd group - 7 (13.0%). Conclusions: Arthroscopic arthrolysis is a less traumatic and more effective treatment for arthritis of the knee. It seems appropriate to gradually displace open arthrolysis by arthroscopic.

scholarly journals Peculiarities of Drainage after Total Knee Arthroplasty

2016 ◽  
Vol 23 (4) ◽  
pp. 16-21
Author(s):  
G. M Kavalerskiy ◽  
S. M Smetanin ◽  
A. D Chenskiy ◽  
A. A Gritsyuk ◽  
A. V Lychagin
Keyword(s):  
Knee Joint ◽  
Large Diameter ◽  
Small Diameter ◽  
Treatment Results ◽  
Group 4 ◽  
Tube Removal ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Treatment results for 65 patients were analyzed depending on the approach to the knee joint drainage after arthroplasty. Active drainage was performed using two large-diameter tubes (group 1, n=16), one large-diameter tube (group 2, n=20), one small-diameter tube (group 3, n=15). In group 4 (n=14), no drainage was performed. Hemoglobin level, knee joint circumference at the level upper patellar pole, volume of drainage discharge and the number of days for exudation via contraperture after drainage tube removal (groups 1-3), pain intensity by visual analog scale, terms of wound gluing and sutures removal, frequency of hemotransfusion were assessed. Statistically significant expediency of active drainage with 1 large-diameter tube and pleats was proved. Without drainage a statistically significant lower decline in hemoglobin levels on 3rd and 5th postoperative days was observed but the terms for wound edges adhesion and the period of knee edema increased.

scholarly journals Peculiarities of Drainage after Total Knee Arthroplasty

2016 ◽  
pp. 16-21 ◽  
Author(s):  
G. M. Kavalerskiy ◽  
S. M. Smetanin ◽  
A. D. Chenskiy ◽  
A. A. Gritsyuk ◽  
A. V. Lychagin
Keyword(s):  
Knee Joint ◽  
Large Diameter ◽  
Small Diameter ◽  
Treatment Results ◽  
Group 4 ◽  
Tube Removal ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Treatment results for 65 patients were analyzed depending on the approach to the knee joint drainage after arthroplasty. Active drainage was performed using two large-diameter tubes (group 1, n=16), one large-diameter tube (group 2, n=20), one small-diameter tube (group 3, n=15). In group 4 (n=14), no drainage was performed. Hemoglobin level, knee joint circumference at the level upper patellar pole, volume of drainage discharge and the number of days for exudation via contraperture after drainage tube removal (groups 1-3), pain intensity by visual analog scale, terms of wound gluing and sutures removal, frequency of hemotransfusion were assessed. Statistically significant expediency of active drainage with 1 large-diameter tube and pleats was proved. Without drainage a statistically significant lower decline in hemoglobin levels on 3rd and 5th postoperative days was observed but the terms for wound edges adhesion and the period of knee edema increased.

Total Knee Arthroplasty after Previous Ipsilateral Hip Arthroplasty Showed Lower Clinical Outcomes and Higher Leg Length Discrepancy Perception

2020 ◽  
Author(s):  
Han-Jun Lee ◽  
Seong Hwan Kim ◽  
Nicolas Pujol ◽  
Yong-Beom Park
Keyword(s):  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Leg Length ◽  
Function Score ◽  
Patient’S Satisfaction ◽  
Length Discrepancy ◽  
Total Knee ◽  
Group 2 ◽  
Ks Function ◽  
Group 1

AbstractThe purpose of this study is to compare perception of leg length discrepancy (LLD) and clinical results of total knee arthroplasties (TKA) in patients with or without previous ipsilateral hip arthroplasty. Between 2008 and 2015, navigation-assisted TKA was performed in 43 patients with previous hip arthroplasty after hip fracture. After 1:3 propensity score matching was performed, 108 patients of primary navigation-assisted TKA (group 1) and 36 patients with hip arthroplasty (group 2) were included. Knee Society (KS) scores, Western Ontario and McMaster Universities Index (WOMAC) scores, and patients' satisfaction including perception of LLD were evaluated. Radiographic evaluation included mechanical axis, component position, and LLD. Logistic regression analysis was performed to find the factors that affect the clinical outcomes. No significant differences in radiologic and clinical evaluations, except for KS function score, patient's satisfaction and LLD (p< 0.001), were detected between the groups. LLD and its perception were significantly higher in group 2 (1.8 ± 3.4 mm in group 1 and 9.7 ± 4.1 mm in group 2, p = 0.000). Risk factors for the low KS function score were found as LLD (odds ratio [OR]: 1.403, p = 0.008) and previous hip arthroplasty itself (OR: 15.755, p = 0.002), but much higher OR was found in previous hip arthroplasty. Although the outcomes of TKA in patients with ipsilateral hip arthroplasty are comparable to those of primary TKA, LLD was high and patient's satisfaction and functional outcomes were low in patients with previous ipsilateral hip arthroplasty. Care should be taken when considering TKA in patients with previous hip arthroplasty. This is a Level III, case control study.

Wrist Arthrolysis: A Systematic Review of Open and Arthroscopic Techniques

2021 ◽  
Author(s):  
Marco Guidi ◽  
Riccardo Luchetti ◽  
Inga Besmens ◽  
Esin Rothenfluh ◽  
Maurizio Calcagni
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Systematic Literature Search ◽  
Viable Option ◽  
Level Of Evidence ◽  
Open Arthrolysis ◽  
Arthroscopic Arthrolysis ◽  
Radiocarpal Joint ◽  
Post Traumatic ◽  
Wrist Stiffness

Abstract Background Wrist arthrolysis is a viable option in wrist stiffness and can be performed via open or arthroscopic techniques. Purpose The aim of the study is to describe and evaluate the available techniques of open and arthroscopic arthrolysis of the radiocarpal joint and the distal radio ulnar joint (DRUJ) in posttraumatic wrist stiffness. Methods A systematic literature search was performed in PubMed to identify studies reporting on open and arthroscopic wrist arthrolysis. Key words included “open wrist arthrolysis,” “arthroscopic wrist arthrolysis,” “post-traumatic wrist stiffness,” and “DRUJ arthrolysis.” Data were extracted independently by a pair of reviewers. Results Overall, 637 studies were identified; 13 additional articles were found through previous publications (total 650 articles). A total of 612 records resulted after duplicates was removed. Fourteen studies were selected and only eight respected the inclusions criteria. One study focused on volar open arthrolysis and four studies on arthroscopic arthrolysis of the radiocarpal joint; two studies reported on open arthrolysis and two studies on arthroscopic DRUJ arthrolysis. Range of motion following open and arthroscopic wrist arthrolysis improved in all studies. Conclusion Both arthroscopic and open arthrolysis can lead to similar and satisfactory results in radiocarpal joint and DRUJ stiffness.. Level of Evidence This is a level 3a study.

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