scholarly journals Subchondroplasty Bone Substitute Material (BSM) Histological Analysis after Total Knee Arthroplasty: A Case Series

Author(s):  
Brandon Petrone ◽  
◽  
Gary Stone ◽  
James P Gurtowski ◽  
◽  
...  

In our series of 227 patients who underwent prior Subchondroplasty of the knee wiht bone substitute material (BSM) we had the opportunity to review 4 cases which returned for conversion to Total Knee Arthroplasty (TKA). The average time to convert to a TKA was 23.5 months (18-35 months).

2017 ◽  
Vol 31 (01) ◽  
pp. 027-037 ◽  
Author(s):  
Robert Marchand ◽  
Anton Khlopas ◽  
Nipun Sodhi ◽  
Caitlin Condrey ◽  
Nicolas Piuzzi ◽  
...  

AbstractSagittal deformity of the knee is commonly corrected to neutral biomechanical axis (±3 degrees) during total knee arthroplasty (TKA), which is a widely accepted goal. Recent advances in surgical technology have made it possible to accurately plan and fulfill these goals. One of these is robotic-assisted TKA, which has been noted to help increase accuracy and precision of restoring a neutral mechanical axis. While there are data confirming the ability of robotic devices to better correct knee alignment than the manual technique, there is a lack of data concerning the use of the robotic devices in more complex cases, such as those in patients with severe varus or valgus deformity, as well as in flexion contractures. Therefore, the purpose of this case study is to present three cases in which the robotic-assisted TKA device was used to correct a severe varus and severe valgus deformities. Based on this case series, it should be noted that the robotic device can also help correct severe varus/valgus deformities and flexion contractures.


SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 35 ◽  
Author(s):  
Francesco Luceri ◽  
Jacopo Tamini ◽  
Paolo Ferrua ◽  
Damiano Ricci ◽  
Cécile Batailler ◽  
...  

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.


Author(s):  
Bahaa Ali Kornah ◽  
Hesham Mohamed Safwat ◽  
Said K. Abdel-hameed ◽  
Mohamed Abdel-AAl ◽  
Mohamed Abdelaziz ◽  
...  

2014 ◽  
Vol 39 (6) ◽  
pp. 463-469 ◽  
Author(s):  
Camilo Partezani Helito ◽  
Andre Thiago Scandiuzzi de Brito ◽  
Riccardo Gomes Gobbi ◽  
Marco Kawamura Demange ◽  
Luis Eduardo P Tirico ◽  
...  

Background:Patients who undergo transfemoral amputation after infection of a total knee arthroplasty do not have good functional outcomes and have major difficulty walking.Objectives:To evaluate the quality of life and walking ability among patients who underwent amputation and among those who refused to undergo amputation following infection of a total knee arthroplasty.Study design:Retrospective case series.Methods:Patients who received an indication for amputation following an infection of a total knee arthroplasty were evaluated retrospectively. The patients were divided between those who accepted the amputation procedure and those who refused amputation (four amputee vs four non-amputees). Walking ability and quality of life were evaluated using the Short Form–36 questionnaire.Results:The average physical health was 27.4 for the amputees and 31.3 for the non-amputees. The average mental health was 49.9 for the amputees and 47.1 for the non-amputees. In relation to walking ability, only one (25%) of the amputees was able to walk, as opposed to 100% in the non-amputee groups.Conclusion:Twenty-five percent of the amputee patients continued to be able to walk. The functional outcome of non-amputee patients was better, with 100% being able to walk, though with limitations.Clinical relevanceThis is the first study evaluating patients who refused the amputation procedure and remained with the spacer. Despite the fact that this option is not recommended by the medical community, we believe that these data are useful when discussing, with a patient, quality of life after amputation.


2018 ◽  
Vol 26 (3) ◽  
pp. 170-174 ◽  
Author(s):  
IZUMI TANI ◽  
NAOKI NAKANO ◽  
KOJI TAKAYAMA ◽  
KAZUNARI ISHIDA ◽  
RYOSUKE KURODA ◽  
...  

ABSTRACT Objective It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation. Methods Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed. Seven TKAs were performed with navigation (navigation group) and another 7 were performed without navigation (manual group). Clinical and radiographic outcomes were compared before and two years after surgery. Results The mean postoperative Knee Society function score was significantly higher in the navigation group. No significant difference was found in postoperative range of motion and Knee Society knee score. The rate of outliers in radiographic outcomes tended to be lower in the navigation group. Conclusion Better clinical outcomes were achieved in cases in which navigation was used. Computer-assisted navigation is useful in TKA for patients with EAD. Level of Evidence III; Case control study.


2018 ◽  
Vol 12 (1) ◽  
pp. 554-566
Author(s):  
Malcolm R. DeBaun ◽  
Stuart B. Goodman ◽  
David W. Lowenberg

Background and Objective: Persistent periprosthetic joint infection (PJI) is a devastating complication after Total Knee Arthroplasty (TKA). We hypothesize that our novel treatment algorithm utilizing a customized knee spanning recon nail combined with an antibiotic eluting cement spacer improves ambulation status and prevents recurrent PJI in patients with failed TKA and severe bone loss. Methods: In a retrospective case series, 15 consecutive patients who underwent knee arthrodesis after failed ipsilateral TKA secondary to infection from 2004-2017 with at least 1 year of follow-up were enrolled. The average age of patients at the time surgery was 68 (range 50-81) years with an average follow-up of 3.2 (range 1-6) years. Post-surgical ambulation status and eradication of index infection were analyzed as primary outcomes using McNemar’s test for before-and-after study design with p<0.05 for significance. Results: Cement arthrodesis significantly improved ambulation with 67% (10/15) of patients unable to ambulate before arthrodesis and 93% (14/15) of patients able to ambulate at final follow-up (p=0.004). The complication rate was 20% (3/15). There were no periprosthetic fractures. Amongst patients who presented with active PJI, 91% (10/11) had eradication of their index infection final follow-up (p=0.002). Overall prevention of recurrent index infection was 93% (14/15) (p=0.0001). Conclusion: Cement arthrodesis utilizing a custom knee spanning recon nail combined with an antibiotic eluting spacer improves ambulation status and prevents or treats recurrent infection in the majority of patients who have failed total knee arthroplasty.


Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Gaurav Govil ◽  
Lavindra Tomar ◽  
Pawan Dhawan

Abstract Peri-prosthetic patella fracture is the second most common peri-prosthetic fracture after total knee arthroplasty. This report presented the treatment results in 6 patients with peri-prosthetic patella fractures. From January 2015 to February 2019, six patients with peri-prosthetic patella fractures were treated. The mean age at surgery was 64 years (range, 48–72 years). Four patients with displaced fractures were treated surgically, and two patients with non-displaced fractures were treated non-surgically. Outcomes were assessed in terms of motion, functional knee score, and Knee Society score. The mean follow-up period lasted 16 months (range: 12–20 months). The average arc of motion was 110° (range: 80°–130°). The mean functional knee score was 77 (range: 70–87). The mean Knee Society score was 84 (range: 75–89). The non-surgical treatment may be a good choice for non-displaced peri-prosthetic patella fractures. For displaced fractures, surgical treatments yielded good functional outcomes. Level of evidence IVa


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