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

Author(s):  
K. Vijaya Bhaskar Reddy ◽  
N. Brahma Chary ◽  
C. Anil Kumar,

<p class="abstract">Surgical treatment of scaphoid fractures has evolved over the years to include variety of procedures and techniques. However scaphoid middle and distal third fractures fixation with Herbert screw by means of volar approach is a safe and effective method with good functional outcome and union rates. Our study concluded that management of middle and distal third scaphoid fractures with Herbert screw by volar approach gives excellent results in terms of union and recovery to daily activities. The wrist function improvement is more satisfactory, and the incidence of complications is low with this modality of treatment.</p>

2007 ◽  
Vol 81A (4) ◽  
pp. 1005-1010 ◽  
Author(s):  
Yasuo Niki ◽  
Hideo Matsumoto ◽  
Toshiro Otani ◽  
Taisuke Tomatsu ◽  
Yoshiaki Toyama

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sharma Cook-Richardson ◽  
Rasesh Desai

In this case, we will describe a 68-year-old man with combined femoral and tibial bone deformities who underwent robotic arm-assisted total knee arthroplasty (RATKA) to treat his severe osteoarthritis in the setting of extra-articular deformities that altered the native anatomical axis and the kinematics of the deformed extra-articular bony structures which chronically generated a neomechanical axis. The combination of severe osteoarthritis with extra-articular deformities made the RATKA method the best surgical treatment option taking into account altered kinematics of the native joint which conventional jig-based total knee arthroplasty would not have prioritized during bony cuts and implant positioning. The patient underwent successful knee arthroplasty with robotic arm-assisted technology with restoration of the mechanical axis.


2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 108-112
Author(s):  
Cynthia A. Kahlenberg ◽  
Ethan C. Krell ◽  
Thomas P. Sculco ◽  
Jeffrey N. Katz ◽  
Joseph T. Nguyen ◽  
...  

Aims Many patients undergoing total knee arthroplasty (TKA) have severe osteoarthritis (OA) in both knees and may consider either simultaneous or staged bilateral TKA. The implications of simultaneous versus staged bilateral TKA for return to work are not well understood. We hypothesized that employed patients who underwent simultaneous bilateral TKA would have significantly fewer days missed from work compared with the sum of days missed from each operation for patients who underwent staged bilateral TKA. Methods The prospective arthroplasty registry at the Hospital for Special Surgery was used. Baseline characteristics and patient-reported outcome scores were evaluated. We used a linear regression model, adjusting for potential confounding variables including age, sex, preoperative BMI, and type of work (sedentary, moderate, high activity, or strenuous), to analyze time lost from work after simultaneous compared with staged bilateral TKA. Results We identified 152 employed patients who had undergone simultaneous bilateral TKA and 61 who had undergone staged bilateral TKA, and had completed the registry’s return to work questionnaire. The simultaneous group missed a mean of 46.2 days (SD 29.1) compared with the staged group who missed a mean total of 68.0 days of work (SD 46.1) when combining both operations. This difference was statistically significant (p < 0.001). In multivariate mixed regression analysis adjusted for age, sex, BMI, American Society of Anesthesiologists status, and type of work, the simultaneous group missed a mean of 16.9 (SD 5.7) fewer days of work compared with the staged group (95% confidence interval 5.8 to 28.1; p = 0.003). Conclusion Employed patients undergoing simultaneous bilateral TKA missed a mean of 17 fewer days of work as a result of their surgical treatment and rehabilitation compared with those undergoing staged bilateral TKA. This information may be useful to surgeons counselling employed patients with bilateral OA of the knee who are considering surgical treatment. Cite this article: Bone Joint J 2021;103-B(6 Supple A):108–112.


2007 ◽  
Vol 22 (6) ◽  
pp. 62-66 ◽  
Author(s):  
Thomas K. Fehring ◽  
Susan M. Odum ◽  
William L. Griffin ◽  
Thomas H. McCoy ◽  
John L. Masonis

2015 ◽  
Vol 62 (1) ◽  
pp. 49-55
Author(s):  
Predrag Stojiljkovic ◽  
Milorad Mitkovic ◽  
Zoran Golubovic ◽  
Ivan Micic ◽  
Sasa Milenkovic ◽  
...  

Supracondylar periprosthetic femoral fractures after total knee arthroplasty are very rare, but very difficult to treat. They occur most often as a result of low energy trauma (slips and fall) in older patients with present osteoporosis and periprosthetic osteolysis. The treatment of these fractures is very difficult due to reduced biological capacity for healing in most cases. Surgical treatment of these fractures is accompanied by severe complications (prolonged healing, nonunion and disintegration osteosintets material) in 25 to 70% of the cases. The aim of this paper is to present the treatment of supracondylar femur fractures after total knee arthroplasty in men aged 72 with selfdynamisable internal fixator Mitkovic. Surgical treatment of fracture performed on the six day after the injury with minimally invasive surgical technique through two incisions. Verticalization and walking with crutches with non-weight-bearing started the first postoperative day. Patient discharged from hospital fifth postoperative day. Full weight-bearing on the operated leg is allowed after 6 weeks. The patient started a stationary physical therapy 6 weeks after surgery. Postoperative follow-up was 10 months. The fractures healed with an excellent functional result. Application of selfdynamisable internal fixator Mitkovic with minimally invasive technique in the treatment of these complex fractures provides excellent biomechanical conditions for healing.


2019 ◽  
Vol 2 (2) ◽  
pp. 102-107
Author(s):  
Ioana Creţu ◽  
Mihai Bojincă ◽  
Mihaela Milicescu ◽  
Teodora Şerban ◽  
Bogdan Creţu ◽  
...  

AbstractTotal joint arthroplasty (TJA) including total hip arthroplasty (THA) and total knee arthroplasty (TKA) are performed for patients with primary osteoarthritis (OA). Also, there are patients who undergo TJA for management of inflammatory arthritis (IA), including patients with rheumatoid arthritis (RA), Spondyloarthritis (SPA) including ankylosing spondylitis (AS) and psoriatic arthritis (PSA) and systemic lupus erythematosus (SLE).The purpose of this review was to evaluate the current knowledge about the risk of complications after TJA in patients with IA and perioperative management of antirheumatic drugs.THA and TKA are orthopedic surgeries that help patients with arthritis restore function, mobility and reduce pain. Patients with inflammatory arthritis have systemic disorders that cause a high rate of complications associated with the surgery.Patients with inflammatory arthritis, including RA, SPA, and SLE who need TJA have a higher risk of developing complications compared to patients with OA.Information about cardiovascular risk factors and other comorbidities is important to better control and reduce the risk of postoperative complications.AbbreviationsTJA = total joint arthroplasty, THA = total hip arthroplasty, TKA = total knee arthroplasty, OA = osteoarthritis, SPA = spondyloarthritis, IA = inflammatory arthritis, RA = rheumatoid arthritis, AS = ankylosing spondylitis, PSA = psoriatic arthritis, SLE = systemic lupus erythematosus, DMARDs = Disease-modifying antirheumatic drugs, PJI = prosthetic joint infection, VTE = venous thromboembolism, HCQ = hydroxychloroquine, SSZ = sulfasalazine, TNF = tumor necrosis factor, GS = corticosteroids.


Author(s):  
Rohit R. ◽  
U. Thyagarajan ◽  
Raghavendran B. ◽  
Karhik Seetharaman

<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>


2011 ◽  
Vol 18 (1) ◽  
pp. 16-21
Author(s):  
R M Tikhilov ◽  
Aleksandr Yur'evich Kochish ◽  
L A Rodomanova ◽  
D I Kutyanov ◽  
A O Afanas'ev ◽  
...  

Results of surgical treatment of 19 patients in whom total knee replacement was performed in combination with various reconstructive microsurgical operations were analyzed. It was shown that application of microsurgical technologies provided new potentialities in total knee arthroplasty first of all in atypical and complicated cases. Advantages of step-by-step treatment presupposing firstly the restoration of integument in the knee joint region followed by its total arthroplasty were revealed.


2020 ◽  
Vol 35 (10) ◽  
pp. 3010-3030
Author(s):  
Renate List ◽  
Pascal Schütz ◽  
Michi Angst ◽  
Lynn Ellenberger ◽  
Katrin Dätwyler ◽  
...  

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