Clinical evaluation of low cost Indian knee prosthesis in government medical colleges

Background: The clinical and functional outcome of total knee arthroplasty was studied using low cost Indian knee prosthesis called Destiknee by Maxx Company in government medical hospital. The objectives was to do assessment of pain relief, joint mobility and deformity correction post-operatively, pre-operative and post-operative Knee society score comparison.Methods: Patients included were those who underwent primary total knee arthroplasty in Department of Orthopaedics, GMCH Aurangabad from January 2020 to January 2021. Clinical and functional assessment was done using the Knee society score and x-rays at 3, 6 and 12 months intervals.Results: At 1 year follow up of 28 knees, there was an improvement in the average pre-op Knee society score of 53.92 to average post-op score of 86.25 and in the range of motion from 80.42 degree to 127.32 degrees and knee flexion deformity improved from 15.25 degrees to 2.17 degrees, all of which had a p value<0.05 are significant statistically. One diabetic patient with poor glycemic control had superficial infection and one developed minor pulmonary embolism which recovered with medical management. Patients had good satisfaction both in unilateral and bilateral TKA.Conclusions: TKA resulted in significant reduction in knee pain and improvement in the functional ability of patients. The results of this low cost Indian prosthesis in a government rural setup with no laminar airflow with good efficacy and minimal complications are excellent. It was a boon for the rural population suffering from knee pain.

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Short term results of total knee arthroplasty in tertiary rural tier three government medical college and hospital

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20202577 ◽

2020 ◽

Vol 6 (4) ◽

pp. 704

Author(s):

Ansari Muqtadeer Abdul Aziz ◽

Nair Pradeepkumar Sasidharan ◽

Punit S. Malpani

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Womac Score ◽

Government Medical College ◽

X Rays ◽

Medical College ◽

Total Knee

Background: The objective of the study was to assess the clinical and functional outcome of total knee arthroplasty (TKA) using posterior cruciate stabilizing (PS) design in tertiary rural government hospital with limited infrastructure using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and to offer a low cost option and assess post-operative pain relief in rural poor of the society and to compare the WOMAC score pre and post-operatively.Methods: The study was conducted on patients who have undergone primary total knee arthroplasty in Department of Orthopaedics, Government Medical College and Hospital, Aurangabad from December 2018 to December 2019. The patients were assessed using the WOMAC score and X-rays. These evaluations were performed at 3, 6 and 12 months follow up visits.Results: At 1 year follow up of 30 knees, the average pre-op WOMAC score of 79.5 improved to an average post-op score of 42.3. And knee flexion increased from 96.3 degree to 108.5 degrees both of which with a p value <0.0001 are statistically significant. One patient each had wound dehiscence and superficial infection. Patient satisfaction after the procedure was good-both in unilateral and staged bilateral TKA.Conclusions: TKA reduces knee pain significantly and improves the functional ability of the patient. And to be able to do so in a tertiary government rural setup with no laminar airflow and with such great efficacy and minimal complications bodes well for the number of people living in rural areas suffering from knee pain.

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Anterior knee pain following primary total knee arthroplasty

World Journal of Orthopedics ◽

10.5312/wjo.v6.i10.795 ◽

2015 ◽

Vol 6 (10) ◽

pp. 795 ◽

Cited By ~ 21

Author(s):

David Shervin

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Anterior Knee Pain ◽

Primary Total Knee Arthroplasty ◽

Total Knee ◽

Anterior Knee ◽

Primary Total Knee

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The use of the constrained prosthesis in the difficult primary knee arthroplasty

The Moldovan Medical Journal ◽

10.52418/moldovan-med-j.64-5.21.02 ◽

2021 ◽

Vol 64 (5) ◽

pp. 11-15

Author(s):

Vitalie Iacubitchii ◽

◽

Alexandru Betisor ◽

Nicolae Erhan ◽

◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Knee Arthroplasty ◽

Knee Prosthesis ◽

Revision Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Bone Defects ◽

Valgus Knee ◽

Total Knee ◽

Primary Total Knee

Background: The constrained knee prosthesis has the basic indication in revision arthroplasty, but the latest literature reveals that it takes place also in primary total knee arthroplasty in cases of knee osteoarthritis associated with major deformities. Material and methods: Present study is based on the surgical treatment, using the constrained knee prosthesis in the primary total knee arthroplasty, during 2019-2021, of 28 patients with knee osteoarthritis associated with severe deformities in varus or valgus, in the Big Joint Replacement Department, Clinical Hospital of Traumatology and Orthopedics, Chisinau. Results: In this study, the following criteria were evaluated: the type of deformity – valgus (10 cases) and varus (18 cases); the degree of deformation – for varus knees was on average 300 , and for valgus knee – 250 ; bone attrition – 11 cases with bone defects where it was necessary to use augmentations; affected side – in 19 cases the right knee was affected and 9 cases the left one; the women/men ratio was 4/1; the mean age of the patients was 67.5 years; average duration of the intervention – 140 minutes; in 5 cases a lateral para-patellar approach was performed, of which 2 cases with tibial tuberosity osteotomy; complications – 1 case with intra-operative periprosthetic fracture and 2 cases with superficial infections of the operated joints. Conclusions: Osteoarthritis of the knee progresses rapidly, leading to severe deformities, significant bone defects and joint instability, which are indications to use the constrained prosthesis in the primary total knee arthroplasty, long-term follow-up is necessary to obtain the last conclusion, but from this study the constrained knee prosthesis like primary implant for special indication had promising results.

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Mid-Term Results of Two-stage Revision Total Knee Arthroplasty for Infected Total Knee Arthroplasty

Research Institute of Traumatology and Orthopedics ◽

10.52889/1684-9280-2021-1-56-12-18 ◽

2021 ◽

Vol 1 (56) ◽

pp. 12-18

Author(s):

Yasin Koker ◽

◽

Mehmet Yuzugulen ◽

Dogac Karaguven ◽

Burak Akan ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Revision Surgery ◽

Knee Prosthesis ◽

Primary Total Knee Arthroplasty ◽

Treatment Method ◽

Clinical Results ◽

Two Stage ◽

Infected Total Knee Arthroplasty ◽

Total Knee

Introduction. Today, knee arthroplasty is one of the most common surgical procedures. Infection after endoprosthetics is the most dangerous complication in patients who have undergone total knee arthroplasty, which negatively affects the prognosis. Most cases of infection develop within the first 2 years after surgery, and the frequency is 1.5%, and after that it decreases to 0.5%. Material and Method. When a study group of 31 patients (22 female, 9 male) who were diagnosed with infected knee prosthesis and underwent two-stage revision knee prosthesis as a treatment method; the mean age of all patients (31 patients) was 68.78 years. In our study by using the American knee association scoring system; preoperative knee scores of 31 patients who underwent two-stage revision surgery were 35.43 ± 7.14, while this parameter was found to be 83.27 ± 8.89 postoperatively (p <0.01). Conclusion. We believe that two-stage revision surgery is an effective method in the treatment of infection that develops after primary total knee arthroplasty application. Restoration of the joint line in accordance with the anatomical structure will positively affect the clinical results, and the use of a long stem to increase the stability of the prosthesis is appropriate for successful results, especially in the cases with bone defects. Key words: Total Knee Arthroplasty, Two-Stage Revision Surgery, Infected Knee Prosthesis.

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Early Clinical and Radiological Outcomes of the Metaphyseally Fixed Totally Stabilized Knee Prosthesis in Primary Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0039-1683976 ◽

2019 ◽

Vol 33 (07) ◽

pp. 678-684 ◽

Cited By ~ 1

Author(s):

Fahad Hossain ◽

Sujith Konan ◽

Babar Kayani ◽

Christina Kontoghiorghe ◽

Toby Barrack ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Knee Prosthesis ◽

Oxford Knee Score ◽

Primary Total Knee Arthroplasty ◽

Primary Tkas ◽

Total Knee ◽

The Mean ◽

Primary Total Knee

AbstractThe use of valgus–varus constrained (VVC) implant designs in primary total knee arthroplasty (TKA) is considered in situations of severe deformities, bone loss, and inadequate soft tissue balance. It is not known whether the use of such prosthesis designs may predispose to reduced function owing to its constraining design. The components are usually implanted with diaphyseal stem extensions to dissipate the increased forces. The totally stabilized (TS) implant is a contemporary VVC design with metaphyseal fixation only. It has a conforming articulation with increased rotational freedom compared with conventional VVC designs. The aim of this study was to assess whether the use of the contemporary TS implant with its metaphyseally fixed components would be associated with inferior outcomes compared with conventional standard primary posterior stabilized (PS) implants. We reviewed 38 consecutive complex primary TKAs performed using the metaphyseally fixed TS implant and 76 matched patients receiving primary PS TKA, at a minimum follow-up of 24 months. The mean follow-up was 61.1 months (24–102). Only patients with osteoarthritis were included. Clinical outcome was assessed using range of motion (ROM) and Oxford knee score (OKS). Radiographic assessment was performed using the femorotibial angle (FTA) at 6 weeks followed by assessment of bone–implant interface lucencies at final follow-up. There were no major early postoperative complications. The mean postoperative ROM in the TS and PS groups were 114.1 and 112.0, respectively. There was no difference in the mean ROM and OKS between the two groups. The mean FTA for patients in both groups was within 3° of the expected. There was no evidence of progressive lucencies or implant migration at final follow-up. The metaphyseally fixed TS knee design achieves comparable short-term functional outcomes when compared with conventional PS designs in primary knee arthroplasty. Long-term follow-up studies are required to assess survivorship.

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Predicting Persistent Unclear Pain Following Primary Total Knee Arthroplasty

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/15093492.1230507 ◽

2016 ◽

Vol 18 (6) ◽

pp. 527-536 ◽

Cited By ~ 5

Author(s):

Paweł Chodór ◽

Jacek Kruczyński

Keyword(s):

Total Knee Arthroplasty ◽

Knee Pain ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Pain Modulation ◽

Postsurgical Pain ◽

Number Of Patients ◽

Chronic Postsurgical Pain ◽

Total Knee ◽

Primary Total Knee

Chronic post-surgical pain can be a considerable issue for patients undergoing primary total knee arthroplasty. According to the literature, persistent knee pain is experienced by up to 44% of patients. Most studies on total knee arthroplasty (TKA) outcomes have mainly investigated the biomechanics or function of the operated knee, but chronic pain has never been a primary issue. In recent years several possible predictors of chronic postsurgical pain have been investigated and eventually identified. A younger age, female gender, psychological distress, preoperative pain duration and intensity were all reported to influence chronic postoperative pain rates after total knee arthroplasty. Recently, it has also been hypothesized that preoperative signs of centrally driven hyperalgesia and distorted pain modulation may predict persistent knee pain in some patients. Despite the considerable number of patients suffering from chronic postsurgical pain after TKA, available data is scarce, and well controlled prospective studies are lacking. Predictors of chronic postsurgical pain after total knee arthroplasty have yet to be identified. Thus, this article is aimed at reviewing current knowledge on persistent pain after knee arthroplasty.

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Giant Solitary Cyst at the Site of Knee Osteoarthritis: Treatment with a Synthetic Resorbable Bone Graft Substitute and Primary Total Knee Arthroplasty

Case Reports in Orthopedics ◽

10.1155/2018/1693131 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Andreas Thiery ◽

Octavian Tapos ◽

Konstantinos Anagnostakos

Keyword(s):

Total Knee Arthroplasty ◽

Knee Osteoarthritis ◽

Bone Graft ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Bone Graft Substitute ◽

Bone Lesions ◽

X Rays ◽

Total Knee ◽

Primary Total Knee

A 48-year-old male patient presented in our department with knee osteoarthritis and a giant cystic lesion of the lateral femoral condyle. Bone biopsy of the lesion was performed. Histopathological examination confirmed the presence of a solitary bone cyst. The patient was treated by curettage of the cyst, filling with a synthetic resorbable bone graft substitute (Cerament™), and primary, cruciate-retaining total knee arthroplasty. 4 months after surgery, complete osseointegration of the bone graft substitute was evident on X-rays. The use of modern bone graft substitutes might be a novel alternative to other established techniques in the management of large bone lesions, even at the site of primary total knee replacement.

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Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry

Arthritis Research & Therapy ◽

10.1186/ar4091 ◽

2012 ◽

Vol 14 (6) ◽

pp. R248 ◽

Cited By ~ 48

Author(s):

Jasvinder A Singh ◽

David G Lewallen

Keyword(s):

Total Knee Arthroplasty ◽

Cohort Study ◽

Knee Pain ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Joint Registry ◽

Pain Medications ◽

Total Knee ◽

Primary Total Knee

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Bilateral severe heterotopic ossification following primary total knee arthroplasty: a case report in Pakistan

Arthroplasty ◽

10.1186/s42836-020-00057-1 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Faizan Iqbal ◽

Nouman Memon ◽

Syed Shahid Noor ◽

Nasir Ahmed ◽

Muhammad Farhan Sozera ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Heterotopic Ossification ◽

Operative Treatment ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Varus Deformity ◽

X Rays ◽

Total Knee ◽

Primary Total Knee

AbstractThe incidence of unilateral minor heterotopic ossification after primary total knee arthroplasty is still unknown, but bilateral severe heterotopic ossification is rare and has not been reported before. Presented in this report is a 60-year-old female patient who developed bilateral knee pain and stiffness 2 weeks after primary total knee arthroplasty. Her weight was 70 kg and body mass index was 32.2. Preoperatively, she had bilateral varus deformity of both knees. X-rays taken 3 months after surgery revealed bilateral severe heterotopic ossification. The patient had been on non-operative treatment (including anti-inflammatory drugs and physiotherapy). There was a marked improvement 6 months after surgery. This case report showed the non-operative treatment may produce acceptable results for patients with severe bilateral heterotopic ossification after primary total knee arthroplasty, and exerted no influence on the final clinical outcome.

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