Abnormal reactions to environmental cold have been observed in some patients with Anterior Knee Pain (AKP). The aims of this study were to investigate whether palpation of the knee could classify patients into those with and those without cold knees; whether this classification could be objectively validated using thermal imaging; ...

The correct chest compression technique was emphasised to enhance the result of cardiopulmonary resuscitation in the 2005 guidelines. The present study compared the effects of different bed heights, including a bed at knee height, on the performance of chest compressions. Twenty-four healthcare providers participated in this study. Knee height was ...

STUDY OBJECTIVE: To determine whether intrathecal baclofen is an effective adjunctive agent to decrease acute and chronic postoperative pain after total knee arthroplasty. DESIGN: Prospective, randomized, double-blind controlled trial. SETTING: Operating room and inpatient units of a university hospital. PATIENTS: 60 adult, ASA physical status I, II, and III patients ...

Knee osteoarthritis (OA) is a cause of decline in function and the medial compartment is often affected. Intraarticular injection of hyaluronic acid (HA) is indicated as a symptom modifying treatment with at least 6 months passing between consecutive injection series. The effects of HA injection on gait variables have not ...

Reduction of wear with highly crosslinked polyethylene (HXLPE) has been reported in in vitro and in vivo studies of total hip prostheses. However, use of HXLPE in total knee prostheses is still controversial. The aim of this study was to compare in vivo polyethylene wear particle generation of HXLPE with ...

Patellar resurfacing in total knee arthroplasty remains controversial. This study compared the long-term clinical outcomes of total knee arthroplasties performed with and without the patella resurfaced and is an update of a previous report. Eighty-six patients (118 knees) underwent primary total knee replacement and were randomized into two groups: those ...

BACKGROUND: Multimodal pain-control protocols that include periarticular injections have been reported to decrease pain and improve early outcomes following total knee arthroplasty. While injections containing a corticosteroid have been demonstrated to be safe and effective, we are not aware of any randomized trials in which the specific effect of the ...

Range of motion following total knee arthroplasty (TKA) is a crucial measure of clinical outcome. The purpose of this randomized, controlled study was to determine which factors are predictive of postoperative range of flexion. Fifty-six patients received either a standard or a high-flexion design NexGen Legacy Posterior-Stabilized TKA (Zimmer, Warsaw, ...

A total of 29 consecutive knee joint arthroplasties in 24 patients who underwent previous high tibial osteotomy (HTO) for medial unicompartment osteoarthritis of the knee and followed up for a mean of 97 months were compared with a control group of 28 patients with 29 primary total knee arthroplasty (TKA) ...

A prospective exploratory study of fat emboli in patients undergoing total knee arthroplasty was performed in patients randomly assigned to surgery with computer-assisted navigation or standard technique. Transesophageal echocardiography of the right atrium was recorded for 5 consecutive 1-minute intervals after tourniquet deflation. Emboli were graded on a scale of ...

The purpose of this investigation was to determine whether functional performance and self-report outcomes are related to body mass index (BMI) after total knee arthroplasty (TKA). We hypothesized that higher BMIs would negatively affect functional performance as assessed by the timed up-and-go test, stair climbing test, 6-minute walk test, and ...

The best operative technique for achieving appropriate postoperative alignment following total knee arthroplasty (TKA) remains controversial, with proponents of extramedullary, intramedullary and computer-assisted techniques. One hundred ninety-two consecutive patients undergoing TKA were prospectively evaluated with full-length lower extremity radiographs. Patients underwent cemented TKA using femoral and tibial intramedullary instrumentation. Digital ...

Despite excellent results, there is a lack of prospective studies analysing functional outcome and quality of life after computer-navigated total knee arthroplasty. Fifty-two patients were investigated before and 6 months after surgery with the OrthoPilot navigation system (Aesculap, Germany). We used the SF-36 Health Survey, the visual analog scale (VAS), ...

We compared the results of microfracture in single versus multiple symptomatic articular cartilage defects in the knee in 110 patients with a median age of 38 years (range 15-60). Cases of reoperation of the cartilage defect were classified as failures. Clinical outcome in non-failures was evaluated by the Lysholm score ...

BACKGROUND: Tissue engineering has become available for cartilage repair in clinical practice. HYPOTHESIS: The treatment of full-thickness chondral defects in the knee with a hyaluronan-based scaffold seeded with autologous chondrocytes provides stable improvement of clinical outcome up to 7 years. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifty-three ...

BACKGROUND: Determination of appropriate treatment options for adult osteochondritis dissecans is difficult, as most published papers on surgical osteochondritis dissecans treatment report outcomes in a population consisting of both adult and juvenile patients. PURPOSE: This study examines the outcomes of surgical procedures in patients with adult osteochondritis dissecans. STUDY DESIGN: ...

The in-hospital incidence of pulmonary embolism (PE) in patients undergoing elective joint arthroplasty who receive a minimum of 10 days of dalteparin prophylaxis is reported to be less than 1%. Recent clinical experience raised suspicion that the incidence of PE was significantly higher at our tertiary care institution. It was ...

Damaged articular cartilage has limited capacity for self-repair. Autologous chondrocyte implantation using a characterized cell therapy product results in significantly better early structural repair as compared with microfracture in patients with symptomatic joint surface defects of the femoral condyles of the knee. To evaluate clinical outcome at 36 months after ...

BACKGROUND: There is no consensus about the optimal time for weightbearing activities after matrix-associated autologous chondrocyte implantation (MACI) of the femoral condyle. HYPOTHESIS: A comprehensive protocol after MACI on the femoral condyle with accelerated weightbearing leads to a better functional and radiographic outcome compared with the same comprehensive protocol with ...

It is debatable whether high-flexion (HF) total knee arthroplasty (TKA) designs will improve postoperative flexion and function or will diminish the need for manipulation under anaesthesia (MUA). We retrospectively analysed range of motion (ROM), flexion, Knee Society Score (KSS), and rate of MUA in a consecutive group of patients who ...

The purposes of this study were to investigate the mode of failure and survivorship of an independently performed series of medial Oxford unicompartmental knee arthroplasties. The study included 43 knees in 40 patients with a mean follow-up of 14.88 years: 13 knees (11 patients) had revision surgery (30%), and ten ...

Platelet-rich plasma (PRP) is a natural concentrate of autologous blood growth factors experimented in different fields of medicine in order to test its potential to enhance tissue regeneration. The aim of our study is to explore this novel approach to treat degenerative lesions of articular cartilage of the knee. One ...

The aim of this study is to evaluate the effect of religious practice on the prevalence, severity, and patterns of knee osteoarthritis (OA) in a Thai elderly population with the same ethnicity and culture but different religions. A house-to-house survey was conducted in two subdistricts of Phranakhon Sri Ayutthaya province ...

Arthrofibrosis is a relatively common complication after total knee arthroplasty that negatively affects function and quality of life. Static progressive stretching is a technique that has shown promising results in the treatment of contractures of the elbow, ankle, wrist and knee. This study evaluated a static progressive stretching device as ...

Recovery room radiographs (RRR) are routinely performed after total knee arthroplasty (TKA). This study investigates the utility of these radiographs. Twenty four arthroplasty surgeons were surveyed to rank the value of RRRs. Since RRRs were primarily valued for educational purposes, we examined the ability of 49 orthopaedic trainees to determine ...

A case of bilateral knee pain and compromised function in an adolescent tennis player caused by symptomatic fenestrated bucket handle medial plicae is presented. Arthroscopic resection relieved all symptoms. The patient returned to competitive tennis and was without complaint at 12 month (left knee) and 18 month (right knee) follow-up.

The objective was to evaluate the functional performance over a 2-year period following autologous chondrocyte implantation (ACI) in an open knee procedure compared to microfracture. Objective functional outcome was studied as secondary analysis in a subgroup of patients, in a randomized clinical trial, with concealed allocation and independent evaluators. Sixty-seven ...

The concept of minimally invasive total knee arthroplasty surgery evolved to reduce quadriceps muscle strength loss and improve clinical outcome following total knee replacement. We performed a systematic review of the published literature on Minimally Invasive Total Knee Arthroplasty (MITKA) and analyzed the reported surgical outcomes. Twenty-eight studies published from ...

A systematic review of randomized, controlled, prospective clinical studies is described (8 trials; N = 1674 patients), with > 100 patients in each, which evaluated functional outcomes with hylan G-F 20 in secondary analyses. Hylan G-F 20 significantly improved Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function versus ...

The objective of this article was to evaluate the effect of the change of posterior condylar offset to range of motion (ROM) and clinical results after computer-assisted cruciate-retaining mobile-bearing total knee arthroplasty (TKA). A total of 111 knees underwent cruciate-retaining mobile-bearing TKAs under computer-assisted navigation from January 2005 to September ...

BACKGROUND: Most authorities recognize minimally invasive unicompartmental knee arthroplasty (UKA) as technically demanding with concerns regarding loss of implantation accuracy. We have previously reported on the potential inaccuracy of femoral intramedullary guides in UKA leading to poor component positioning. Our 3-dimensional analysis of alignment error showed that a short, narrow ...

Patients with posterior medial meniscal detachment, as determined at knee arthroscopy, were evaluated retrospectively. Mean follow-up was 5.3 years for 8 men and 20 women (30 knees; mean age, 57 years). Most patients had acute onset of pain with a minor specific incident. Seventeen patients were obese, 9 were overweight, ...

BACKGROUND: Congenital dislocation of the knee is a rare condition for which the treatment is difficult and remains controversial. For severe cases associated with neuromuscular disorders treatment has usually consisted of extensive surgical reconstruction. The purpose of this study is to assess the short-term results of a new method of ...

This study compared the results of total knee arthroplasty (TKA) in patients with stiff knees and patients with good preoperative range of motion. Results following TKA were compared in 30 patients (52 knees) with severely degenerated knees with preoperative range of motion < 50 degrees (group 1) and 30 patients ...

OBJECTIVES: To study the difference in clinical and radiological outcomes between imageless computer-navigated and the conventional technique for performing total knee arthroplasty. DESIGN: Prospective case-control study. SETTING: University teaching hospital, Hong Kong. PATIENTS: Forty-seven patients with imageless computer-navigated total knee arthroplasty were matched with 47 patients with total knee arthroplasty ...

Unicompartmental knee arthroplasty (UKA) is specifically indicated in isolated unicompartmental arthritis with competent ligaments. Recent series of UKA for unicompartmental arthritis have shown good function, persistence of pain relief, and nearly 90% survivorship at 15 years, even in knees that would perhaps not be considered good indications for UKA today. ...

The anatomical and morphological differences and high-flexion daily activities in the Asian population have since ever prompted for development of customized knee replacement systems. INDUS knee system has advantages both of high-flex designs and is developed by keeping the anatomical variations of the native population in mind. The purpose of ...

The purpose of this study was to analyze the clinical results of patients who underwent navigation-assisted cruciate ligament retention-type mobile-bearing total knee arthroplasty (TKA) according to joint line changes. From September 2004 to January 2006, cruciate ligament retention-type mobile-bearing TKAs were performed using a navigation system (OrthoPilot; B. Braun Aesculap, ...

Fibroarthrosis following knee injury or synovial disease is characterized by the presence of dense adhesions filling the entire joint cavity and the fibrotic involvement of periarticular structures. In this particular subset of knee stiffness, both the open and the arthroscopic treatment may fail not addressing all pathology. The aim of ...

Controversy exists regarding the clinical and radiological differences in outcomes between fixed- and mobile-bearing total knee replacements (TKR). The aim of this study was to compare these two TKR designs using a meta-analysis of the electronic databases MEDLINE, EMBASE, CINAHL and AMED in addition to a review of unpublished material. ...

Since 1969 corrective osteotomy has been performed at our institute in young patients (under 40 years) with bowlegs, knock knees and flexion or rotational deformities around the knee. Fifty-seven knees (29 left, 28 right) of 45 patients (19 boys, 26 girls) were followed-up for a period ranging from 30 to ...

The purported advantages of mobile-bearing knee include increased survivorship and restoration of more natural knee kinematics compared to a standard fixed-bearing design. To evaluate these claims, an extensive review of the available literature was undertaken. We compared survivorship and clinical function, including patient preference. We found no difference in survivorship ...

We performed a retrospective clinical and radiographic evaluation of 83 nonconsecutive patients operated in our institute between February 1996 and March 2003 with a mean follow-up of 60 months to assess the efficiency of unicompartmental knee replacement (UKR) performed with a minimally invasive technique. The aim of this study was ...

Autologous chondrocyte implantation (ACI) is widely used to treat symptomatic articular cartilage injury of the knee. Fibrin ACI is a new tissue-engineering technique for the treatment of full-thickness articular cartilage defects, in which autologous chondrocytes are inserted into a three-dimensional scaffold provided by fibrin gel. The objective of this study ...

INTRODUCTION: Deformity correction by Illizarov method in haemophilic patients is a rare phenomenon. AIM: To correct the bilateral knee deformity by Illizarov in one sitting. MATERIALS AND METHODS: Patient had fixed flexion deformity (100 degrees ) of both knees; posterior skin webs, posterior subluxation, wasting of quadriceps and <1% level ...

Although total knee replacement (TKR) has been proven a very successful treatment modality for the end-stage knee osteoarthritis (OA) in obese patients, the rehabilitation period often is long and painful. Minimal invasive surgery (MIS) has gained much attention in TKR promising fast and less painful recovery. However, little is known ...

INTRODUCTION: A previous study demonstrated that performing a total knee arthroplasty through a lateral approach including anterior tibial tuberosity (ATT) osteotomy (refixed in its original position) presented numerous advantages: correcting the preoperative patella lateral tilt and improving postoperative patella tracking. We hypothesized that these improvements in patella centering were, at ...

Anterior knee pain following primary total knee arthroplasty is common and can be difficult to treat satisfactorily. We reviewed 28 consecutive patients (29 knees) who underwent secondary resurfacing of the patella for persistent anterior knee pain and report on the results. Mean follow-up was 28 months (range 12-61) with no ...

The study evaluated the subjective functional outcome following total knee arthroplasty (TKA) in participants who underwent hydrotherapy (HT) six months after discharge from a rehabilitation unit. A total of 70 subjects, 12 of which were lost at follow-up, were randomly assigned to either a conventional gym treatment (N=30) or HT ...

OBJECTIVE: To compare the effects of an acute stretching intervention on knee extension range of motion, passive resistive torque and stiffness in subjects with osteoarthritis of the knee, and to compare these variables with subjects without osteoarthritis. DESIGN: Cross-sectional experimental study. SETTING: Human performance laboratory. PARTICIPANTS: A total of 55 ...