A prospective study was performed to compare the clinical and radiological results of mobile- and fixed-bearing total knee arthroplasty with specific attention to rotational alignment and range of motion. Sixty-one knees were assigned to total knee arthroplasty with either the NexGen LPS Flex fixed-bearing or with the NexGen LPS Flex ...

Valid and reproducible measurements of limb alignment are prerequisites for planning, performing and evaluating TKAs. Although navigation systems have been shown to be reproducible tool for intraoperative TKA alignment measurements, particular doubt has been raised on the correlation with postoperative radiographic measurements. The aim of the present study was to ...

The rotating platform flexion (RPF) Sigma total knee prosthesis (DePuy; Warsaw, Indiana) was designed for maintaining the contact of the condyles with their corresponding tibial plateau throughout the high-flexion range. However, this requires an additional 3-mm bone cut of the posterior condyles. Compared to the conventional design, this modification is ...

AIM: Numerous epidemiological studies have suggested a relationship between knee osteoarthritis and occupational load or, respectively, a kneeling or squatting position at work. Cartilage breakdown was clearly identified as the main mechanism of the osteoarthritic process. This arthroscopic study was aimed to evaluate the relationship between frequency and grade of ...

The non-operative treatment of medial degenerative joint disease of the knee has proven to be difficult due to the underlying deformity and the pathological mechanical loading. Valgus knee bracing offers the possibility to directly address the mechanical deficit. The aim of this study was to analyse whether or not part-time ...

OBJECTIVES: In the literature, radiosynoviorthesis (RSO) has been associated only with a small number of complications. There is a trend towards increasing the use of RSO in diverse indications. After repeatedly observing several complications following RSO, a retrospective evaluation was undertaken to estimate the safety of this method. METHODS: Between ...

Osteonecrosis (ON) in the knee occurs as a localized inflammatory disease in relation to spontaneous or non-traumatic ON. Conservative treatment possibilities are limited, and prognosis appears to be poor; in most cases, ON results in knee arthroplasty. Bisphosphonates are suggested to prevent bone resorption and collapse of necrotic bone. In ...

This study aimed to evaluate the short- and mid-term results of plica excision in patients with mediopatellar plica and associated cartilage degeneration. Seventy-six surgically treated patients with mediopatellar plica and associated cartilage degeneration at medial femoral condyle (MFC) and/or medial pole of patella were included. Patients were evaluated at baseline, ...

Active patients with arthritic malalignment of the knee are difficult to manage. Arthroplasty, unicompartmental or total knee replacement, may not be appropriate in patients who desire to remain highly active. High tibial osteotomy has been recommended for the treatment of varus osteoarthritis to decrease pressure on the damaged medial compartment. ...

We reviewed the rate of revision of unicompartmental knee replacements (UKR) from the New Zealand Joint Registry between 1999 and 2008. There were 4284 UKRs, of which 236 required revision, 205 to a total knee replacement (U2T) and 31 to a further unicompartmental knee replacement (U2U). We used these data ...

PURPOSE: To determine whether patients using a wheeled walker post-total knee replacement (TKR) surgery walk differently prior to hospital discharge and 6 weeks after surgery when compared with patients using a standard walker. METHODS: Fifty-one patients, mean age 67.2 (8.3), seen for TKR were assigned to either a standard walker ...

A prospective study was performed to assess the intra-operative variation in femoral and tibial axis alignment during navigated total knee replacement. The intra-operative initial, trial and final mechanical axis alignments were recorded from the navigation system. The mean variation and correlation coefficient were calculated and analysed. There were 40 patients ...

Minimally invasive surgery (MIS) in total knee arthroplasty (TKA) reportedly yields decreased patient morbidity and a rapid return of function, but how much deformity can be accepted for MIS-TKA remains unclear. This study investigated 238 knees from 218 consecutive patients who underwent MIS-TKA. Patients were divided into groups with tibiofemoral ...

BACKGROUND: Congenital knee dislocation (CDK) is a rare congenital deformity, which often requires surgery for treatment. Little objective data exist characterizing the outcome of patients who require operative treatment for this condition. The purposes of this study were to objectively evaluate the functional, clinical, and gait outcomes of patients who ...

PURPOSE: To compare quality of life, knee function, and physical activity in 33 elderly women with or without early-stage knee osteoarthritis (OA). METHODS: 33 Japanese elderly women (mean age, 66 years) with (n=18) or without (n=15) early-stage knee OA symptoms (knee pain and decreased range of motion [ROM]) were recruited. ...

There has been a resurgence of interest in unicompartmental knee arthroplasty (UKA) for treatment of medial unicompartmental knee osteoarthritis (OA). Improved prosthetic design, minimally invasive surgical techniques, and strict patient selection criteria have resulted in improved survivorship and functional outcomes. A review of orthopedic literature was conducted regarding the advantages ...

To evaluate the short-term outcome of osteochondritis dissecans (OCD) treated with mosaic osteochondral autograft transplantation (OAT), 7 male patients (mean age 33.4) with 8 OCD lesions on the lateral border of the medial femoral condyle were prospectively followed. Patients were evaluated by the International Knee Documention Committee (IKDC) score and ...

BACKGROUND AND PURPOSE: In Sweden, surgery for knee osteoarthritis (OA) in patients younger than 55 years of age has doubled during the last 10 years. We evaluated the use of 3 surgical alternatives: high tibial osteotomy (HTO), unicompartmental arthroplasty (UKA), and total knee arthroplasty (TKA). We also examined the outcome, ...

PURPOSE: To identify initial symptoms of osteosarcoma around the knee joint. METHODS: Records of 19 men and 11 women aged 9 to 34 (mean, 17) years with osteosarcoma around the knee joint were reviewed. Each patient was interviewed (for a mean of 1.5 hours), and a detailed history of symptom ...

Periprosthetic osteolysis is an increasingly prevalent complication of TKA. To reduce the polyethylene wear and periprosthetic osteolysis, particularly in young patients, the design of the contemporary fixed-bearing TKAs has been modified and mobile-bearing TKAs have been introduced. We asked whether the prevalence of osteolysis would be less in well-functioning mobile-bearing ...

BACKGROUND: Although equinus is more common in cerebral palsy (CP), the prevalence of calcaneal gait (CG) has been reported at more than 30% among patients with CP, even in the absence of prior surgical intervention. The goal of this study was to identify patient characteristics predictive of the development of ...

OBJECTIVE: To examine whether a multidisciplinary rehabilitation programme can improve functional recovery and quality of life and reduce the use of rehabilitation services compared with conventional care one year after total knee arthroplasty. DESIGN: Prospective, randomized, non-blinded, controlled trial. SETTING: An outpatient centre-based setting. SUBJECTS: Eighty-six patients who were scheduled ...

This study aimed to determine the efficacy of PEMF (pulsed electromagnetic field) treatment in experimental osteochondral defect healing in a rabbit model. The study was conducted on 12 New Zealand white rabbits. Six rabbits formed the study group and six rabbits the control group. The right knee joints of all ...

The purpose of this study was to evaluate the effectiveness of software advancements in improving total knee component positioning and limb alignment when using computer-aided navigation. A single total joint fellowship-trained surgeon performed unilateral total knee arthroplasty on 315 patients using conventional techniques or with assistance from computer navigation software. ...

INTRODUCTION: Ligament balancing is an established surgical technique in total knee arthroplasty with good clinical results. A similar technique for unicondylar knee arthroplasty was developed. The aim of this study was to asses the outcomes of a unicondylar knee replacement implanted with a ligament tensor. MATERIALS AND METHODS: A prospective ...

The Bi-Surface Knee System (Japan Medical Material, Kyoto, Japan), which has a unique ball-and-socket joint and whose femoral component is made from alumina ceramic, was designed to improve deep knee flexion and long-term durability after total knee arthroplasty. The purpose of this study was to review the clinical results of ...

A bilateral total knee prosthesis procedure can be performed simultaneously in patients with bilateral gonarthrosis. The purpose of this study was to evaluate the differences in component alignment between the simultaneous bilateral TKA and unilateral TKA. A total of 20 patients out of 40 underwent simultaneous bilateral TKA, whereas 20 ...

This study investigated the effects of the histone deacetylase (HDAC) inhibitor trichostatin A (TSA) on cartilage degradation in an experimental model of osteoarthritis (OA). Thirty-two male New Zealand rabbits underwent unilateral anterior cruciate ligament transection (ACLT) on left knee joints to induce OA and were randomly divided into two groups ...

Concerns have been raised regarding minimally invasive surgery (MIS) and its possible effect on postoperative functional recovery, complications, and survival rate after TKA. We specifically asked whether MIS TKA would be associated with (1) increased operative time, (2) reduced blood loss, (3) shortened hospital stay, (4) faster recovery of ROM, ...

In the current study, we evaluated changes in the patellofemoral joint indices in 49 knees from 39 patients (11 men and 28 women with a median age of 64 years; range 53-79) who had undergone an opening wedge high tibial osteotomy (OWHTO). Osteoarthritis had been diagnosed in 39 knees and ...

We hypothesized that changes in patellar thickness following patellar resurfacing affect patellar tilt in total knee arthroplasty (TKA) patients. The study enrolled 272 TKAs and categorized them into four groups according to change in patellar thickness: (A) thinner by 1 mm or more, (B) equal or thinner by less than ...

BACKGROUND: Tai chi (TC) is proposed as a potential option for the management of osteoarthritis (OA), however, its beneficial effect on patients with knee OA has not been convincing. OBJECTIVES: To evaluate the effect of a 24-week TC program on physical functions in older Chinese women with knee OA. METHODS: ...

BACKGROUND: The goal of the study was to compare surgical approaches to the knee joint (anterior-medial approach--midvastus type and anterior-medial--midpatellar type) and assess their influence on post-operative range of motion, muscle strength, pain intensity and the rate of progress of rehabilitation in patients with different degrees of knee joint function. ...

BACKGROUND: Total knee arthroplasty can involve substantial blood loss. We prospectively studied a consecutive series of patients undergoing primary total knee arthroplasty to assess the influence of femoral cementing on perioperative blood loss. We hypothesized that an uncemented femoral component is a risk factor for bleeding. METHODS: A semiconstrained posterior ...

We analysed data from the Oxford hip and knee questionnaires collected by the New Zealand Joint Registry at six months and five years after joint replacement, to determine if there was any relationship between the scores and the risk of early revision. Logistic regression of the six-month scores indicated that ...

Equalized rectangular extension and flexion gaps are considered desirable to ensure proper kinematics in total knee arthroplasty (TKA). We compared soft tissue balancing in TKAs performed using navigation-assisted gap-balancing (60 knees) and conventional measured resection (56 knees). The outlier of soft tissue balancing was defined as a gap difference >3 ...

BACKGROUND AND PURPOSE: Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identified variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients ...

There is a high volume of unmet needs for knee arthroplasty in the population despite the increase in surgery rates. Given the long waiting times to have a knee arthroplasty, some governments have proposed prioritization systems for patients on waiting lists based on their level of need. We therefore estimated ...

BACKGROUND: The mini-subvastus and the mini-midvastus approaches are among the most common alternatives to the medial parapatellar approach for total knee arthroplasty. The purpose of this study was to compare the early clinical outcomes of these two approaches. METHODS: In this prospective, randomized study of fifty-one patients who underwent bilateral ...

We present a technical note on 2 patients with post-traumatic symptomatic hyperextension of the knee treated with a new arthroscopic technique. Both patients were of similar ages with similar injuries resulting in an excess of hyperextension at the knee with resulting instability and pain. Both patients had not improved with ...

Recurrent hemarthrosis following total knee replacement is relatively uncommon and can result from causes that may not always be easy to diagnose. We report three patients with late-onset recurrent hemarthrosis following total knee replacement due to synovial hypertrophy and impingement, which were successfully treated by embolization.

BACKGROUND: There is controversial evidence regarding whether foot orthoses or knee braces improve pain and function or correct malalignment in selected patients with osteoarthritis (OA) of the medial knee compartment. However, insoles are safe and less costly than knee bracing if they relieve pain or improve function. QUESTIONS/PURPOSES: We therefore ...

BACKGROUND: Patient age, radiographic severity of osteoarthritis (OA), and severity of symptoms are typically considered as the three key factors in selecting the osteoarthritic patients for total knee arthroplasty (TKA). The purpose of this study was to evaluate the associations between the three selection criteria and the postoperative outcomes including ...

We analyzed alignment of 300 knees, divided equally into groups according to total knee arthroplasty technique: Conventional, CAS-Early (computer-assisted surgery during the surgeon's learning curve), and CAS-Late (after experience with CAS). With the margin of error for alignment of the mechanical axis and femoral and tibial components each within ±3°, ...

This paper described a less invasive surgical technique that was performed for treatment of elderly patients with isolated patellofemoral (PF) osteoarthritis (OA) associated with patellar malalignment, although their tibiofemoral joints are minimally osteoarthritic. Two hundred and thirty-four knees in 126 consecutive elderly patients (average, 72yrs) diagnosed with combined disorders were ...

AIM: The aim of this study was to evaluate the efficacy of two different autotransfusion methods in total knee replacement (TKR) performed without tourniquet, in comparison to allogeneic blood transfusion (ABT) only. METHOD: In a comparative study, 248 patients with knee osteoarthritis were randomized in three groups: in control Group ...

Varus malalignment after total knee replacement is mentioned to be a major risk factor for postoperative pain and functional impairments. This wide spread opinion is based on the historical data derived from implantations performed in the late 1970s and early 1980s. We tested the hypothesis whether significant varus malalignment leads ...

OBJECTIVE: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. DESIGN: Prospective, parallel group design. SETTING: Orthopaedic University Medical Centre. PATIENTS: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional ...

The purpose of this study was to determine if the cartilage from loose osteochondral fragments remains viable. Five patients with OCD of the knee who had undergone surgical treatment (arthroscopic reduction and internal fixation of the loose body) were included. The average age of patients was 13 years (range 10-14 ...

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