scholarly journals Associations of Urinary Collagen II Neoepitope C2C with Total Knee Replacement Outcomes: Is OA a Systemic Disease in Rapidly Progressive Cases?

2021 ◽  
Vol 12 (1) ◽  
pp. 164
Author(s):  
Liisa Kuhi ◽  
Ann E. Tamm ◽  
Jaanika Kumm ◽  
Kristel Järv ◽  
Aare Märtson ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Systemic Disease ◽  
Performance Tests ◽  
Self Assessment ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Before And After ◽  
Total Knee ◽  
The Individual

The objective of this study was to investigate the dynamics of the urinary collagen type II C-terminal cleavage neoepitope (uC2C) before and after total knee replacement (TKR) in rapid knee OA progressors. C2C in the urine was measured by IBEX-uC2C assay in 86 patients (mean age: 59.9 years) with symptomatic knee OA (kOA) undergoing TKR, assessed before surgery and 3 and 12 months after. The patients’ condition was determined by self-assessment questionnaires, by lower limb performance tests, and by radiography. In the preoperative period, the uC2C level was significantly higher in females than in males, and was associated with the radiographic severity of kOA. A weak correlation between the C2C and knee pain was observed in the whole group and in males, but not in females. The individual dynamics of uC2C after TKR were heterogenic. In general, uC2C increased three months after TKR, but fell to the preoperative level after 12 months. A higher preoperative uC2C implied the tendency to diminish as a result of TKR, and vice versa. TKR did not stop the degradation of Coll2 in the tissues in the majority of cases. The pre-TKR uC2C predicts the postoperative uC2C level. The uC2C dynamic seems to be sex-specific, so it could be considered a prospective pre- and post-TKR biomarker for progressive kOA.

scholarly journals Self-Reported Knee Instability Before and After Total Knee Replacement Surgery

2016 ◽  
Vol 68 (4) ◽  
pp. 463-471 ◽  
Author(s):  
Genevieve Fleeton ◽  
Alison R. Harmer ◽  
Lillias Nairn ◽  
Jack Crosbie ◽  
Lyn March ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Instability ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Before And After ◽  
Total Knee

Thalamic Neurometabolite Alterations in Patients with Knee Osteoarthritis Before and After Total Knee Replacement

2021 ◽  
Vol 22 (5) ◽  
pp. 601
Author(s):  
Akila Weerasekera ◽  
Erin Morrissey ◽  
Minhae Kim ◽  
Atreyi Saha ◽  
Yang Lin ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Before And After ◽  
Total Knee

Evaluation of the relationship of tibiofemoral kinematics before and after total knee replacement in an in vitro model of cranial cruciate deficiency in the dog

2016 ◽  
Vol 29 (06) ◽  
pp. 484-490 ◽  
Author(s):  
Rebecca Howie ◽  
Timothy Foutz ◽  
Curtis Cathcart ◽  
Jeff Burmeister ◽  
Steve Budsberg
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Flexion Extension ◽  
Before And After ◽  
Total Knee ◽  
Tibiofemoral Kinematics ◽  
The Relationship

SummaryObjective: To investigate the relationship between tibiofemoral kinematics before and after total knee replacement (TKR) in vitro.Animals: Eight canine hemipelves.Methods: A modified Oxford Knee Rig was used to place cadaveric limbs through a range of passive motion allowing the kinematics of the stifle to be evaluated. Four measurements were performed: a control stage, followed by a cranial cruciate transection stage, then following TKR with the musculature intact stage, and finally TKR with removal of limb musculature stage. Joint angles and translations of the femur relative to the tibia, including flexion-extension versus adduction-abduction, flexion-extension versus internal-external rotation, as well as flexion-extension versus each translation (cranial-caudal and lateral-medial) were calculated.Results: Significant differences were identified in kinematic data from limbs following TKR implantation as compared to the unaltered stifle. The TKR resulted in significant decreases in external rotation of the stifle during flexion-extension compared to the limb prior to any intervention, as well as increasing the abduction. The TKR significantly increased the caudal translation of the femur relative to the tibia compared to the unaltered limb. When compared with the cranial cruciate ligament-transection stage, TKR significantly decreased the ratio of the external rotation to flexion.Discussion: All three test periods showed significant differences from the unaltered stifle. The TKR did not completely restore the normal kinematics of the stifle.

scholarly journals The Utility of Outcome Measures in Total Knee Replacement Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Michelle M. Dowsey ◽  
Peter F. M. Choong
Keyword(s):  
Total Knee Replacement ◽  
Outcome Measures ◽  
Knee Replacement ◽  
Significant Proportion ◽  
Oxford Knee Score ◽  
High Volume ◽  
Outcome Data ◽  
Knee Oa ◽  
Replacement Surgery ◽  
Total Knee

Total knee replacement (TKR) is the mainstay of treatment for people with end-stage knee OA among suitably “fit” candidates. As a high cost, high volume procedure with a worldwide demand that continues to grow it has become increasingly popular to measure response to surgery. While the majority who undergo TKR report improvements in pain and function following surgery, a significant proportion of patients report dissatisfaction with surgery as a result of ongoing pain or poor function. Poor outcomes of TKR require care that imposes on already overburdened health systems. Accurate and meaningful capture and interpretation of outcome data are imperative for appropriate patient selection, informing those at risk, and for developing strategies to mitigate the risk of poor results and dissatisfaction. The ways in which TKR outcomes are captured and analysed, the level of follow-up, the types of outcome measures used, and the timing of their application vary considerably within the literature. With this in mind, we reviewed four of the most commonly used joint specific outcome measures in TKR. We report on the utility, strengths, and limitations of the Oxford knee score (OKS), knee injury and osteoarthritis outcome score (KOOS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and knee society clinical rating system (KSS).

Thalamic neurometabolite alterations in patients with knee osteoarthritis before and after total knee replacement

Pain ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Akila Weerasekera ◽  
Erin Morrissey ◽  
Minhae Kim ◽  
Atreyi Saha ◽  
Yang Lin ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Before And After ◽  
Total Knee

scholarly journals What are the patient factors that impact on decisions to progress to total knee replacement? A qualitative study involving patients with knee osteoarthritis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031310 ◽  
Author(s):  
Penny O'Brien ◽  
Samantha Bunzli ◽  
Darshini Ayton ◽  
Michelle M Dowsey ◽  
Jane Gunn ◽  
...  
Keyword(s):  
General Practice ◽  
Health Services ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Allied Health ◽  
Operating Conditions ◽  
Patient Factors ◽  
Surgical Interventions ◽  
Knee Oa ◽  
Total Knee

ObjectivesGeneral practitioners (GPs) are often the first health professionals to assess patients with osteoarthritis (OA). Despite clinical guideline recommendations for non-surgical intervention as first-line therapies, the most frequent referral from a GP for a person with knee OA is to an orthopaedic surgeon. The aim of our study was to explore patient factors that impact on the decision to progress to total knee replacement (TKR), including the experience of patients in general practice, their perceptions of their condition, and their access and use of community-based allied health interventions.DesignQualitative investigation using semi-structured interviews. The Candidacy framework was selected as a lens to examine the factors driving healthcare access. Data were analysed using a thematic analysis approach. Codes identified in the data were mapped to the seven Candidacy domains. Themes corresponding to each domain were described.SettingA public hospital in Melbourne, Australia.Participants27 patients with knee OA who were on a waiting list to undergo TKR.ResultsTen themes described factors influencing access and use of non-surgical interventions and decision-making for undergoing TKR: (1) History of knee problems, change in symptoms; (2) Physical and psychosocial functioning (Identification of Candidacy); (3) GP and social networks as information sources, access to care (Navigation); (4) Referral pathways (Permeability of services); (5) Communication of impact (Appearances at health services); (6) GP-Surgeon as the predominant referral pathway (Adjudications); (7) Physical activity as painful; (8) Beliefs about effectiveness of non-surgical interventions (Offers and resistance); (9) Familiarity with local system; and (10) Availability (Operating conditions and local production of Candidacy).ConclusionsUsing the Candidacy framework to analyse patients’ experiences when deciding to progress to TKR highlighted missed opportunities in general practice to orient patients to first try non-surgical interventions. Patients with knee OA also require improved support to navigate allied health services.

scholarly journals Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Meichao Deng ◽  
Yang Hu ◽  
Zhongzu Zhang ◽  
Hongjun Zhang ◽  
Yiming Qu ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Meta Analysis ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Unicondylar Knee Replacement ◽  
Total Knee

Abstract Background Since the optimal surgery for isolated medial knee osteoarthritis (OA) is unclear, this study aimed at comparing the effectiveness of unicondylar knee replacement (UKR) with total knee replacement (TKR) for simple medial knee OA. Methods Literature searches of PubMed, Embase, Web of Science, and the Cochrane Library were searched up to 1th April 2020. Only studies comparing UKR with TKR for isolated medial knee OA were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results A total of 13 articles with 1888 patients were included, among which, 944 and 944 underwent UKR and TKR, respectively. The analyzed postoperative outcomes were mostly within 5 years of follow-up. The meta-analysis showed that UKR improved knee general function (P < 0.00001) and health (P = 0.02), moreover, reduced post-operative pain (P = 0.01) and complications (P < 0.05) more than TKR. There were no significant differences in postoperative revision (P = 0.252), high-activity arthroplasty score (HAAS) (P = 0.307) and Oxford knee score (OKS) (P = 0.15) between the two techniques. Conclusions The patients of UKR could achieve better clinical results than that of TKR, moreover, there were negligible differences between the two techniques in postoperative revision in the early and mid-term follow-up and surgeons should be aware of the important reasons for revision of UKR. Thus, UKR instead of TKR should be performed in patients with late-stage isolated medial knee OA.

Sign in / Sign up

Export Citation Format

Share Document