IS DR YOUTUBE GUIDING OUR PATIENTS WELL ON TOTAL KNEE ARTHROPLASTY? - AN ORTHOPAEDICIAN'S ANALYSIS

2021 ◽  
pp. 26-27
Author(s):  
Sheenam Bansal ◽  
Nikhil Juneja ◽  
Dharam Singh
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Poor Quality ◽  
Educational Quality ◽  
Excellent Quality ◽  
Acceptable Quality ◽  
Quality Grade ◽  
Health Related ◽  
Total Knee

Background: Youtube has a become a popular platform for disseminating health-related information. The objectives of this study was to explore the educational quality of youtube videos pertaining to total knee arthroplasty. Material And Methods: Youtube search was done on 12 April 2021 for TKR related videos by using the following search terms total knee replacement, total knee arthroplasty, TKR, knee replacement. Data from 40 most relevant videos were collected. Quality assessment check list with the scale of 0-10 points were developed to evaluate the video content. On the basis of this, videos were grouped into poor quality (grade 0-3), acceptable quality (grade 4-7) and excellent quality (grade 8-10) respectively. Results: 92.5 % of videos were of poor educational quality (37/40), 7.5% were of acceptable quality (3/40) and none of the video were of excellent quality. Common missing information included discussion of operative complications and implant duration. Conclusion: The current study suggests that youtube is a poor education source for patients concerning knee arthroplasty.

scholarly journals What is a balanced knee replacement?

2018 ◽  
Vol 3 (12) ◽  
pp. 614-619 ◽  
Author(s):  
Lucy C. Walker ◽  
Nick D. Clement ◽  
Kanishka M. Ghosh ◽  
David J. Deehan
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Current Evidence ◽  
Soft Tissue Envelope ◽  
Total Knee ◽  
Uneven Wear ◽  
Definition Of ◽  
Revision Tka

For multifactorial reasons an estimated 20% of patients remain unsatisfied after total knee arthroplasty (TKA). Appropriate tension of the soft tissue envelope encompassing the knee is important in total knee arthroplasty and soft tissue imbalance contributes to several of the foremost reasons for revision TKA, including instability, stiffness and aseptic loosening. There is debate in the literature surrounding the optimum way to achieve balancing of a total knee arthroplasty and there is also a lack of an accepted definition of what a balanced knee replacement is. It may be intuitive to use the native knee as a model for balancing; however, there are many difficulties with translating this into a successful prosthesis. One of the foundations of TKA, as described by Insall, was that although the native knee has more weight transmitted through the medial compartment this was to be avoided in a TKA as it would lead to uneven wear and early failure. There is a focus on achieving symmetrical tension and pressure and subsequent ‘balance’ in TKA, but the evidence from cadaveric studies is that the native knee is not symmetrically balanced. As we are currently trying to design an implant that is not based on its anatomical counterpart, is it possible to create a truly balanced prosthesis or to even to define what that balance is? The authors have reviewed the current evidence surrounding TKA balancing and its relationship with the native knee. Cite this article: EFORT Open Rev 2018;3:614-619. DOI: 10.1302/2058-5241.3.180008.

scholarly journals Is adding intra-articular steroid in total knee arthroplasty cocktail obligatory?

2019 ◽  
Vol 5 (2) ◽  
pp. 260
Author(s):  
Sundar Suriyakumar ◽  
Ganesan G. Ram ◽  
Faraz Ahmed
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Group I ◽  
Total Knee

<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>

scholarly journals Osteoarthritis of the knee joint. Etiology, treatment, rehabilitation (analytical review of the literature)

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 5-11
Author(s):  
Khaled Obeidat ◽  
O.D. Karpinska
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Gait Parameters ◽  
Total Knee ◽  
The Difference ◽  
Knee Pathology

According to epidemiological studies, osteoarthritis accounts for 10–12 % of all cases of musculoskeletal diseases. In the general structure of knee pathology, degenerative diseases make up 57.8 %. The urgency of the problems of gonarthrosis is due to not only its widespread prevalence, but also the high risk of developing knee dysfunction, accompanied by a significant reduction in the quality of life of patients and often leading to partial or permanent disability of patients. Gonarthrosis has significant gender features. Women account for about 70 % of the number of patients, while men had this disease almost 2 times less often, but other data indicate that the incidence of gonarthrosis in men under 60 years of age is higher, and in women it begins to increase after 65 years. Knee replacement is a leading method in the treatment of knee osteoarthritis stages III–IV. The tendency towards an increase in the total number of surgeries leads to an increase in the frequency of complications and unsatisfactory results: according to some authors, from 3.3 to 13.2 % of patients complain of knee replacement outcomes. Studies of long-term complaints after arthroplasty have shown that in addition to pain reduction, some patients had an increase in varus angle when bending the knee while walking but they didn’t mark an improvement in gait parameters compared to preoperative examination. After unilateral total knee arthroplasty, the load patterns of the frontal plane in the operated knee remain pathological in the long run. After knee arthroplasty, there is muscle weakness, and studies have shown changes in all muscles of the lower extremity. Weakening of some muscles led to compensatory strengthening of others. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low efficiency. Many studies have studied motor activity of patients after total knee arthroplasty in recent years. Not only gait features, but also movements of the pelvis, trunk and upper extremities are studied. Modern methods of diagnosing spatial oscillations of the body when walking have shown that disorders of body movements — excessive hand movements, pelvic loosening, asymmetrical flexion of the knee joints, etc., after arthroplasty are preserved in patients and restore slowly, and some disorders remain forever. Conclusions. Knee arthroplasty relieves pain, improves quality of life, but according to many authors, patients complain of incomplete restoration of the functionality of the prosthetic limb. According to the researchers, the main cause for incomplete reco-very of gait parameters is the difference in the frontal angles of the knee joint flexion and the difference in the length of the steps. Special training exercises can reduce the asymmetry of the steps, but it is difficult to completely restore the symmetry of the steps within 2 years. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low effectiveness.

Health-Related Quality of Life in Total Hip and Total Knee Arthroplasty

2004 ◽  
Vol 86 (5) ◽  
pp. 963-974 ◽  
Author(s):  
Olivier Ethgen ◽  
Olivier Bruyère ◽  
Florent Richy ◽  
Charles Dardennes ◽  
Jean-Yves Reginster
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Health Related Quality ◽  
Total Hip ◽  
Related Quality ◽  
Health Related ◽  
Total Knee

EARLY POSTOPERATIVE QUADRICEPS POWER, MOTION RANGE, AND ANALGESIA EVALUATION FOLLOWING KNEE REPLACEMENT AFTER FEMORAL OR ADDUCTOR BLOCK: RANDOMIZED CONTROLLED STUDY

2020 ◽  
Vol 23 (03) ◽  
pp. 2050006
Author(s):  
Mahmoud Fahmy
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Pain Control ◽  
Femoral Nerve ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Group A ◽  
Total Knee

Purpose: Evaluate the reliability of the early functional recovery and postoperative pain control using adductor canal block (ACB) compared with that using femoral nerve block (FNB) in patients undergoing total knee replacement (TKR). Patients and Methods: A total of 80 patients scheduled for TKR were randomly and blindly distributed into two groups (40 patients each). Group A received ACB and group F received FNB. The early quadriceps strength, range of motion and pain control were assessed after surgery during the first 48[Formula: see text]h. Results: Patients in group F had significantly less quadriceps power postoperatively than those in group A. There were no significant differences between the two studied groups as regard ambulation, range of motion and pain estimation. Conclusion: Since both blocks have comparable analgesic effect and opioid consumption rates, the increased quadriceps muscle strength and ability to ambulate on the first postoperative day is the driving factor in selecting the ACB. With the findings discussed in our study and in literature, an ACB is a viable option in place of a FNB in patients undergoing a total knee arthroplasty. Additional large participant randomized controlled studies should be conducted to further discover the benefits of an ACB in patients undergoing a total knee arthroplasty.

scholarly journals Bicompartmental Knee Arthroplasty (BKA) in comparison to unicompartmental (UKA), Patellofemoral (PFA) ans total knee arthroplasty (TKA) – Early Clinical Results

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Johannes Holz ◽  
Stefan Schneider ◽  
Ansgar Ilg ◽  
Rene Kaiser
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Clinical Results ◽  
Single Center ◽  
Patient Reported ◽  
Total Knee ◽  
Bicompartmental Arthroplasty

Aims and Objectives: The purpose was to evaluate the clinical outcomes of patients with knee osteoarthritis treated with bicompartmental arthroplasty (BKA) in comparison to unicompartmental (UKA), patellofemoral (PFA) and total knee arthroplasty (TKA) in a single center. Materials and Methods: This is a prospective study analyzing a consecutive series of 396 patients from two surgeons in a single center. In 191 men and 205 women either partial or total knee replacement were performed. Their mean age at surgery was 63±6,85 years and mean BMI 29,55±5,00 kg/m2. In 238 patients UKA, in 125 TKA, in 21 PFA and in 11 patients BKA was performed. Implants were cemented and made of cobalt chrome in partial knee and zirconium oxide in total knee replacement. Demographics and patient reported outcomes (VAS, KOOS, Oxford Knee Score (OKS)) were collected preoperatively and 3,6 and 12 months postoperatively. A total of 202 patients have thus far completed the 12 months follow-up time point. Results: All mean KOOS and OKS scores improved significantly 1 year after surgery (p<0.05). Mean preoperative aggregated KOOS improved from 49,0±14,1 to 74,3±17,8 in UKA, from 44,1±12,9 to 67,5±9,4 in PFA, from 46,1±15,1 to 71,0±14,8 in TKA and from 45,7±13,8 to 72,6±9,7 in BKA (p<0.05). Mean preoperative aggregated OKS improved from 25,1±7,6) to 38,5±9,7 in UKA, from 23,0±7,6 to 36,8±3,8 in PFA, from 23,4±8,2 to 37,3±8,1 in TKA and from 22,9±9,6 to 37,0±1,5 in BKA (p<0.05). The mean pain level (VAS)decreased from pre-treatment to 12 months after surgery in UKA from 5,5 to 1,6, in PFA from 6,1 to 2,5, in TKA from 6,0 to 1,9 and in BKA from 6,6 to 2,6. One patient (0.4%) underwent revision (at 3 month for inlay dislocation). Conclusion: This study shows excellent early clinical results of patients treated with unicompartmental, bicompartmental and total knee arthroplasty. Adherence to strict indications lead to a significant improvement of patient reported outcomes and a low revision rate one year postoperatively. The reported results for BKA are comparable to those of patients treated with unicompartmental arthroplasty. We conclude that bicompartmental arthroplasty is a safe and reliable surgery for patients with bicompartmental osteoarthritis.

scholarly journals Total knee arthroplasty after distal femoral osteotomy: a systematic review and current concepts

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 35 ◽  
Author(s):  
Francesco Luceri ◽  
Jacopo Tamini ◽  
Paolo Ferrua ◽  
Damiano Ricci ◽  
Cécile Batailler ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Randomized Clinical Trials ◽  
Case Series ◽  
Femoral Osteotomy ◽  
Long Term Results ◽  
Radiographic Evaluation ◽  
Distal Femoral Osteotomy ◽  
Total Knee

Introduction: Distal Femoral Osteotomy (DFO) is a common procedure for correcting lower limb valgus deformity and lateral compartment overload. Low 20-year survivorship rate was reported with a consequent need for total knee arthroplasty (TKA). This study aims to review literature and to analyse the influence of a previous distal femoral osteotomy on outcomes of patients undergoing TKA. Methods: A systematic literature review was performed in PubMed/Medline and Embase in May 2020. Papers were selected based on the following criteria: patient with a previous distal femoral osteotomy; total knee replacement; Pre- and Postoperative outcomes; surgical outcomes: clinical scores, range of motion, radiographic evaluation and revisions for any cause; case series, retrospective studies, observational studies, open-label studies, randomized clinical trials; systematic reviews and meta-analyses were included to extract primitive studies. Results: 306 articles were found, of which five papers were considered eligible for this review. In every study included, postoperative clinical outcomes (Knee Society Score or Hospital for Special Surgery score) statistically improved from the preoperative. Complications were not uncommon; implant survivorship at the available follow-up seems to be similar to primary TKA, although being too short to draw any conclusions. Conclusions: Limited and highly heterogeneous evidence is currently available on the influence of DFO on outcomes after TKA. Knee replacement improves clinical middle-term outcomes in patients with previous distal femoral osteotomy. In this complex surgery, the use of technical tips and tricks could help surgeons to obtain an accurate knee balancing and better long-term results.

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