scholarly journals Clinical and Radiological Changes of Ankle in Knee Osteoarthritis With Varus After Total Knee Arthroplasty: A Systematic Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhiwei Feng ◽  
Ming Ma ◽  
Yaobin Wang ◽  
Chenfei Yang ◽  
Zhongcheng Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Ankle Joint ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Cochrane Library ◽  
Total Knee ◽  
Radiological Changes ◽  
The Impact

Background: Arthritis with severe varus deformity remains a challenge in total knee arthroplasty (TKA). Until recently, surgeons aimed at a neutral lower limb alignment when performing a TKA. However, the impact of TKA on the ankle joint has been ignored. Therefore, we conducted a systematic review to assess the clinical and radiological changes in the ankle joint after TKA on knees with severe varus deformity.Methods: A systematic search was conducted in four English (PubMed, Embase, Cochrane Library, and Web of Science) and four Chinese (CBM, VIP, CNKI, and Wan Fang Database) databases. Screening of literature and extraction of data were independently performed by two researchers. The modified methodological index for non-randomized studies (MINORS) was used to assess the quality.Results: A total of eight studies were eligible, namely, four prospective and four retrospective studies. TKA resulted in a negative clinical effect in the ankle joint in patients with ankle osteoarthritis. Seven studies reported changes in the mechanical tibiofemoral angle, and four studies reported radiological changes in the hindfoot. The mean score of the MINORS was 9.8 out of eight (9–11).Conclusion: As a result of the correction of the knee osteoarthritis with severe varus deformity following mechanically aligned TKA, the radiological malalignment of the ankle joint was improved. However, some patients experience increased ankle pain after undergoing TKA, especially, if there was a residual knee varus deformity, a stiff hindfoot with varus deformity, or ankle arthritis.

scholarly journals Impact of Smoking on the Incidence and Postoperative Complications of Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Cohort Studies

2021 ◽  
Author(s):  
Yuqi He ◽  
Mohamed Omar ◽  
Xiaoyuan Feng ◽  
Claudia Neunaber ◽  
Michael Jagodzinski
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Postoperative Complications ◽  
Cohort Studies ◽  
Knee Arthroplasty ◽  
Surgical Complications ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Total Knee ◽  
The Impact

Osteoarthritis and rheumatoid arthritis are the most ubiquitous joint disorders which cause tremendous loss of life quality and impose an economic burden on society. At present, the treatment options for these two diseases comprise non-operative and surgical treatments, amongst those total knee arthroplasties (TKA). Various studies have recognized smoking as a significant risk factor for postoperative complications. Therefore, the purpose of this study was to examine the impact of smoking on the incidence and postoperative complications after a total knee arthroplasty by a systematic review and meta-analysis. The research was performed using PUBMED, Cochrane Library and EMBASE, extracting data from thirteen suitable studies and incorporating 2,109,482 patients. Cohort studies evaluating the impact of smoking on TKA with sufficient data were included for the study, and cohort studies without a proper control group and complete data were excluded. A fixed-effects or random-effects model was used to measure the pooled risk ratio (RR) or hazard ratio (HR) with 95% confidence interval (CI). Compared to non-smokers, smokers had a significantly lower incidence of TKA (p<0.01). However, smokers had a higher incidence of total complications (p=0.01), surgical complications (p<0.01), pneumonia (p<0.01) and revision surgery (p=0.01). No significant difference in the risk of blood transfusion (p=0.42), deep vein thrombosis (p=0.31), pulmonary embolism (p=0.34), urinary tract infection (p=0.46) or mortality (p=0.39) was found between smokers and non-smokers. In conclusion, the study indicated that tobacco has two diametrically opposite effects on TKA patients: 1. Tobacco increases the incidence of surgical complications, pneumonia and revision after TKA; 2. It decreases the overall risk of being a candidate for TKA.

Alignment of the hindfoot in total knee arthroplasty: a systematic review of clinical and radiological outcomes

2021 ◽  
Vol 103-B (1) ◽  
pp. 87-97
Author(s):  
Arne Burssens ◽  
Dries De Roos ◽  
Alexej Barg ◽  
Matt J. Welck ◽  
Nicola Krähenbühl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
English Language ◽  
Case Reports ◽  
Varus Deformity ◽  
Cochrane Library ◽  
Hindfoot Alignment ◽  
Total Knee ◽  
Hindfoot Deformity

Aims Patients with a deformity of the hindfoot present a particular challenge when performing total knee arthroplasty (TKA). The literature contains little information about the relationship between TKA and hindfoot alignment. This systematic review aimed to determine from both clinical and radiological studies whether TKA would alter a preoperative hindfoot deformity and whether the outcome of TKA is affected by the presence of a postoperative hindfoot deformity. Methods A systematic literature search was performed in the databases PubMed, EMBASE, Cochrane Library, and Web of Science. Search terms consisted of “total knee arthroplasty/replacement” combined with “hindfoot/ankle alignment”. Inclusion criteria were all English language studies analyzing the association between TKA and the alignment of the hindfoot, including the clinical or radiological outcomes. Exclusion criteria consisted of TKA performed with a concomitant extra-articular osteotomy and case reports or expert opinions. An assessment of quality was conducted using the modified Methodological Index for Non-Randomized Studies (MINORS). The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42019106980). Results A total of 17 studies were found to be eligible for review. They included six prospective and ten retrospective studies, and one case-control study. The effects of TKA showed a clinical improvement in the hindfoot deformity in three studies, but did not if there was osteoarthritis (OA) of the ankle (one study) or a persistent deformity of the knee (one study). The radiological alignment of the hindfoot corrected in 11 studies, but did not in the presence of a rigid hindfoot varus deformity (in two studies). The effects of a hindfoot deformity on TKA included a clinical association with instability of the knee in one study, and a shift in the radiological weightbearing axis in two studies. The mean MINORS score was 9.4 out of 16 (7 to 12). Conclusion TKA improves both the function and alignment of the hindfoot in patients with a preoperative deformity of the hindfoot. This may not apply if there is a persistent deformity of the knee, a rigid hindfoot varus deformity, or OA of the ankle. Moreover, a persistent deformity of the hindfoot may adversely affect the stability and longevity of a TKA. These findings should be interpreted with caution due to the moderate methodological quality of the studies which were included. Therefore, further prospective studies are needed in order to determine at which stage correction of a hindfoot deformity is required to optimize the outcome of a TKA. Cite this article: Bone Joint J 2021;103-B(1):87–97.

scholarly journals Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: A systematic review and best evidence synthesis

2018 ◽  
Vol 15 (3) ◽  
pp. 903-908 ◽  
Author(s):  
Giorgio di Laura Frattura ◽  
Giuseppe Filardo ◽  
Dario Giunchi ◽  
Augusto Fusco ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Evidence Synthesis ◽  
Best Evidence Synthesis ◽  
Risk Of Falls ◽  
Total Knee

Sedentary Behavior in Patients With Knee Osteoarthritis Before and After Total Knee Arthroplasty: A Systematic Review

2018 ◽  
Vol 26 (4) ◽  
pp. 671-681 ◽  
Author(s):  
Emmanuel Frimpong ◽  
Joanne A. McVeigh ◽  
Rebecca M. Meiring
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Sedentary Behavior ◽  
Knee Arthroplasty ◽  
Risk Of Bias ◽  
Before And After ◽  
Total Knee ◽  
Appraisal Tool

Objective:The objective of this systematic review is to integrate the available evidence on changes in sedentary behavior (SB) in patients with knee osteoarthritis after total knee arthroplasty (TKA).Methods:A systematic literature search from January 2002 to October 31, 2017, was performed for studies assessing objectively and/or subjectively measured SB following TKA. The Scottish Intercollegiate Guidelines Network Methodology appraisal tool was used to critically appraise the methodological quality of the included studies.Results:Ten studies reporting on SB with a total of 1,028 participants were included in the review. Three studies reported changes in SB with two showing a reduction in SB and one (with high risk of bias) an increase in SB after TKA. Seven studies showed no change in SB following TKA.Conclusion:Currently, there is insufficient evidence which suggests that SB time improves following TKA. Detailed assessments of SB after TKA are needed.

scholarly journals Femoral quadriceps neuromuscular electrical stimulation after total knee arthroplasty: a systematic review

2015 ◽  
Vol 14 (1) ◽  
pp. 77-98 ◽  
Author(s):  
Helena Bruna Bettoni Volpato ◽  
Paulo Szego ◽  
Mario Lenza ◽  
Silvia Lefone Milan ◽  
Claudia Talerman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Electrical Stimulation ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Randomized Clinical Trials ◽  
Neuromuscular Electrical Stimulation ◽  
Cochrane Library ◽  
Significant Difference ◽  
Total Knee

Abstract The purpose of this study was to evaluate the effects of neuromuscular electrical stimulation in patients submitted to total knee arthroplasty. This was a systematic review with no language or publication status restriction. Our search was made in Cochrane Library, MEDLINE, Embase and LILACS. Randomized or quasi-randomized clinical trials evaluating neuromuscular electrical stimulation after total knee arthroplasty were included. Four studies with moderate risk of bias and low statistical power were included, totalizing 376 participants. There was no statistically significant difference in knee function, pain and range of motion during 12 month follow-up. This review concluded that neuromuscular electrical stimulation was less effective than traditional rehabilitation in function, muscular strength and range of motion. However, this technique was useful for quadriceps activation during the first days after surgery.

Sign in / Sign up

Export Citation Format

Share Document