scholarly journals A study on functional outcome of posterior cruciate ligament substituted total knee arthroplasty

Author(s):  
K. Vijaya Bhaskar Reddy ◽  
N. Brahma Chary ◽  
Birru Sumanth

<p class="abstract"><strong>Background: </strong>Total knee replacement surgery is considered as a treatment of choice in patients with advanced arthritis, especially in patients where conservative treatment has been failed. Total knee replacement gives good pain relief, functional improvement of knee and correction of deformity.</p><p class="abstract"><strong>Methods:</strong> This is study of 39 patients following total knee arthroplasty, who were operated between August 2017 and March 2020 at MNR Medical College and Hospital, Sangareddy. They were followed up for a minimum period of 1 year and evaluated using oxford knee scoring system. Oxford knee score is designed specifically for measuring outcomes in knee arthroplasty. There were 14 right knees, 10 left knees, 15 bilateral knees.</p><p class="abstract"><strong>Results: </strong>There was a significant functional improvement of knee in patients and we had achieved excellent results, out of 39 patients and 4 patients had post op suprapatellar fullness, which was relieved with medications for 3 weeks and 2 patients (2 knees) without no signs of immediate post-operative period, developed infection after 6 months followed which underwent staged revision total knee replacement. The outcome categories based on oxford knee scoring system: excellent (40-48), good (30-39), fair (20-29) and poor (0-19).</p><p class="abstract"><strong>Conclusions: </strong>It is difficult to balance the knee with retention of posterior cruciate ligament, whereas posterior cruciate ligament substituting total knee replacement gives reproducible and good results, hence it is the preferred mode of management.</p>

2020 ◽  
Vol 13 (5) ◽  
pp. 956-962
Author(s):  
Chaiyakorn Thitiyanaporn ◽  
Nattapon Chantarapanich ◽  
Somchai Sompaisarnsilp ◽  
Naris Thengchaisri

Background and Aim: Osteoarthritis is a common consequence of cranial cruciate ligament rupture (CCLR) in the canine stifle. Total knee replacement is a valuable method for managing end-stage osteoarthritis. Materials and Methods: Two new designs of total knee replacement implants were fabricated with information from computed tomography scans. Canine hind limbs of cadavers were tested with a biomechanical testing machine with C-arm fluoroscopy. The four groups tested were as follows: Intact stifles (INTACT), CCLR, total knee arthroplasty (TKA) with a peg on top of the tibial component (TKAP), and TKA with no peg on top of the tibial component (TKAN). Extension, flexion, adduction, abduction, internal rotation, external rotation, cranial translation, caudal translation, and range of motion were measured. Results: The cranial translation of the tibia relative to the femur increased significantly after cutting off the cranial cruciate ligament. After arthroplasty, adduction/abduction and cranial/caudal translation within the TKAN group was increased compared with the intact stifle group. In the TKAP group, only adduction was greater than it was in the intact stifle group. Conclusion: The design of the prosthesis used for the TKAP group was more appropriate for total knee replacement in dogs than the design of the prosthesis for the TKAN group.


Author(s):  
Matthew T. Brown ◽  
Jagmeet S. Bhamra ◽  
J. Palmer ◽  
A. Olivier ◽  
Panagiotis D. Gikas ◽  
...  

Author(s):  
Sundar Suriyakumar ◽  
Ganesan G. Ram ◽  
Faraz Ahmed

<p class="abstract"><strong>Background:</strong> The patients can undergo total knee replacement surgery either under general anaesthesia, combined spinal and epidural anaesthesia, nerve root block, spinal combined with intra-articular knee cocktail. There is an ongoing debate amongst Arthroplasty surgeons whether to include steroid in the cocktail or not. The aim of this study is to assess whether there is an added benefit of including steroid in the intraarticular mixture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Sri Ramachandra Institute of Higher education, Chennai between December 2017 to December 2018. The study was conducted in the Arthroplasty unit, Department of Orthopaedics. SRIHER ethics committee clearance was obtained prior to the start of the study. The inclusion criteria were patients who underwent total knee replacement surgery under combined spinal and intra-articular knee cocktail. Patients were divided into two groups based on the use of steroid in the intra-articular mixture. Patients were evaluated using Visual analogue scale, opioids usage as primary endpoint while any joint infection within six months of the surgery and knee society score at 1 month and 6 months as the secondary endpoint.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean visual analogue score for the 0 pod for the group I and group II were 2.3 and 2.4 respectively. There was no case of infection in both groups.</p><p class="abstract"><strong>Conclusions:</strong> There is no fringe benefit of adding steroid to the knee cocktail. So it is not obligatory to add steroid in intra-articular total knee arthroplasty cocktail.</p>


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