scholarly journals Measurement For Gap Balancing Technique In Patients Undergoing Total Knee Arthroplasty: A Large Retrospective Observational Study

2021 ◽  
Author(s):  
Zhao Xuequan ◽  
Zhao Bin ◽  
Yao Shuzhang ◽  
Cao Kanduo ◽  
Ren Chongxi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
New Method ◽  
Tibial Osteotomy ◽  
Joint Activity ◽  
Vas Score ◽  
Total Knee ◽  
Hss Score ◽  
Oxford Score

Abstract Background: Many traditional methods are available to prevent unbalance of extension and flexion gap during total knee arthroplasty (TKA), but there are no reports on the use of measurement and positioning method before tibial osteotomy with self-made tools.We designed a self-made tool measuring the location before tibial osteotomy and determined the clinical effect.Methods: The retrospective study included patients who received TKA at our hospital, between January 1, 2012 and December 31, 2015. A new method, named as the measurement and localization before osteotomy with self-made tools, was developed to measure the osteotomy position of the posterior femoral condyle during TKA. They were divided into two groups, one that received the new method (GroupⅠ), and the other that received the traditional method as a control (GroupⅡ). HSS score, Oxford score, VAS score and knee joint activity were evaluated in two groups.Results: One hundred and eighty-seven of 210 eligible patients were included. The function of knee joint in all patients was improved and the pain was obviously relieved. Significant differences were found in the HSS score, Oxford score, VAS score, knee joint activity between two groups at 5-year follow-up (p<0.05).Conclusions: The biomet knee prosthesis was selected for all intraoperative implants. All operations were completed by the same senior surgeon.The use of self-made tools may contribute to improve the balance between flexion and extension gaps as well as the balance between internal and external gaps during TKA, and overcome knee flexion instability.

scholarly journals A New Measurement Technique for Location Before Osteotomy of The Distal Femur in Patients Undergoing Total Knee Arthroplasty

2021 ◽  
Author(s):  
Xuequan Zhao ◽  
Bin Zhao ◽  
Shuzhang Yao ◽  
Kanduo Cao ◽  
Xueliang Hu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
New Method ◽  
Tibial Osteotomy ◽  
Joint Activity ◽  
Vas Score ◽  
Total Knee ◽  
Hss Score ◽  
Oxford Score

Abstract Background Many traditional methods are available to prevent unbalance of extension and flexion gap during total knee arthroplasty (TKA), but there are no reports on the use of measurement and positioning method before tibial osteotomy with self-made tools.We designed a self-made tool measuring the location before tibial osteotomy and determined the clinical effect. Methods The retrospective study included patients who received TKA at our hospital, between January 1, 2012 and December 31, 2015. A new method, named as the measurement and localization before osteotomy with self-made tools (MOST), was developed to measure the osteotomy position of the posterior femoral condyle during TKA. They were divided into two groups, one that received the new method (GroupⅠ), and the other that received the traditional method as a control (GroupⅡ). HSS score, Oxford score, VAS score and knee joint activity were evaluated in two groups. Results One hundred and eighty-seven of 210 eligible patients were included. The function of knee joint in all patients was improved and the pain was obviously relieved. Significant differences were found in the HSS score, Oxford score, VAS score, knee joint activity between two groups at 5-year follow-up (p < 0.05). Conclusions The use of MOST may contribute to improve the balance between flexion and extension gaps as well as the balance between internal and external gaps during TKA, and overcome knee flexion instability.

scholarly journals Two-Stage Total Knee Arthroplasty in the Treatment of Advanced Knee Septic Arthritis: Case Series

2021 ◽  
Author(s):  
Hong Wang ◽  
Yuanjun Teng ◽  
Xingwen Wang ◽  
Shifeng Zhang ◽  
Tianen Xu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Septic Arthritis ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Clinical Severity ◽  
Cement Spacer ◽  
Two Stage ◽  
Total Knee ◽  
Hss Score

Abstract PURPOSE: Septic arthritis (SA) is defined as the joint inflammation secondary to bacterial infection with a potentially fatal condition, but with no established approach treatment currently. Two-stage primary total knee arthroplasty (TKA) with an antibiotic-laden cement spacer has been reported to apply to treat SA of knee effectively in individual cases. We reported our cases aimed to contribute to current information on two-stage TKA in the treatment of advanced SA in knee joint.Methods: We retrospectively screened clinical profiles of eleven patients with SA in knee joint who had two-stage TKA with an antibiotic-laden cement spacer. Information of inflammatory serological markers were summarized and statistic comparisons were done on Hospital for Special Surgery (HSS) score as well as the degree of the range of motion (ROM) between pre-, interval- and post-operation, with significant level of p<0.05.Results: Infection in knee joint was eliminated in all eleven patients by two-stage TKA with an antibiotic-laden cement spacer. CRP took 3.4 ± 1.4 weeks (range, 1-6 weeks) to return to normal level, whilst for ESR was 16.3 ± 3.0 weeks (range, 13-23 weeks). Means of HSS score and ROM degree were significantly increased after both the first and second-stage surgery (p<0.05). HSS score of three timings were not different in age, gender, micro-organism culture results and comorbidities in our study.Conclusions: Two-stage TKA is an effective treatment in SA in knee joint in controlling infection, relieving clinical severity and improving function of keen joint thereafter.Level of evidence IV.

scholarly journals How much improvement can satisfy patients? Exploring patients’ satisfaction 3 years after total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiao Yu Fan ◽  
Jin Hui Ma ◽  
Xinjie Wu ◽  
Xin Xu ◽  
Lijun Shi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Minimal Clinically Important Difference ◽  
Important Change ◽  
Score Change ◽  
Patients Satisfaction ◽  
Clinically Important Difference ◽  
Total Knee ◽  
Hss Score ◽  
Varus Angle

Abstract Background Despite the innovations in total knee arthroplasty (TKA), there is still a subset of patients who do not acquire significant relief or expected satisfaction after primary TKA. However, this subgroup of patients still gains improvements more or less in terms of objective or quantified assessments after the procedure. The purpose of our study is to explore the factors that correlate with patients’ satisfaction and identify minimal clinically important difference (MCID) and minimum important change (MIC) in clinical parameters. Methods We conducted a retrospective study of 161 patients diagnosed with osteoarthritis who underwent unilateral total knee arthroplasty from January 2017 to December 2017. We collected the following parameters: body mass index (BMI), duration of disease, education level, depression state, preoperative flexion contracture angle of knee, HSS scores, 11-point NRS scores, and radiological parameters (preoperative minimal joint space width and varus angle of knee). The satisfaction was graded by self-reported scores in percentage (0–100). Results We revealed that 80.8% of patients were satisfied 3 years overall after primary TKA. HSS score change, NRS-Walking score change, age, and pre-mJSW showed significant difference between satisfied and dissatisfied group. The varus angle change revealed statistical significance according to the levels of satisfaction. Simple linear regression identified the MCID for HSS score to be 5.41 and for the NRS-Walking to be 1.24. The receiver operating characteristics (ROC) curve identified the MIC for HSS score to be 25.5 and for the NRS-Walking score to be 6.5. Conclusions In summary, we identified several factors that correlated with patients’ satisfaction independently after TKA in a long term. In addition, we revealed the minimal clinically important difference (MCID) and minimum important change (MIC) for HSS and NRS score in these patients.

Unicompartmental knee arthroplasty versus High tibial osteotomy in treatment of isolated medial compartment Osteoarthritis of knee: A Systematic Review and MetaAnalysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim Mostafa El-Ganzoury ◽  
Zeiad Mohamed Zakaria ◽  
Ahmed Elsayed ◽  
Abd Ellah Elwarwary
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
High Tibial Osteotomy ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Meta Analysis ◽  
Medial Compartment ◽  
Tibial Osteotomy ◽  
Medial Compartment Osteoarthritis ◽  
Total Knee

Abstract Background Several surgical procedures have been mentioned to treat medial compartment osteoarthritis (OA), as total knee arthroplasty (TKA), unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO). Objectives The aim of the study is a systematic review & meta analysis conducted to compare the outcomes between UKA & HTO in different types of patients diagnosed as an isolated medial compartment OA who treated with UKA or HTO and statistically compare between their results of pain, range of motion, complications, and i ncidence of revision to TKA using studies published between 2009 to 2019 from any country. Patients and Methods The review will be restricted to Randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of HTO versus UKA of isolated medial compartment osteoarthritis patients, articles published in English &published during 2009 to 2019. Results About 150 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 60 articles were found. By applications of all inclusion and exclusion criteria, only 12 articles were fit to undergo this meta-analysis. Conclusion In conclusion, there were no significant differences in the pain score, knee score, complication rate and revision rate to TKA between HTO and UKA, while the HTO group manifested superior ROM compared to the UKA group. So, HTO may be convenient for patients with high activity requirements. Over time, both groups exhibited increased revision rates with the deteriorated clinical outcomes. Therefore when deciding on a therapeutic plan, the ability to revise these failed choices of treatment to a total knee arthroplasty should be a major consideration. This may assist surgeons in their choice. Based on the findings of current meta-analysis, it appears that the two groups have the same efficiency and safety in the treatment of medial knee OA.

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