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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 308 - 308
1 Mar 2013
Jenkins D Rodriguez J Ranawat A Alexiades M Deshmukh A Rathod P McHugh M
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Introduction

Patellar mobilisation methods used during total knee arthroplasty (TKA) have been debated in the literature, with some proponents of minimally invasive TKA suggesting that laterally retracting, rather than everting the patella may be beneficial. It was our hypothesis that by using randomised, prospective, blinded study methods, there would be no significant difference in clinical outcome measures based solely on eversion of the patella during total knee arthroplasty.

Methods

After an a priori power analysis was done, 120 primary total knee replacements indicated for degenerative joint disease were included in the study and randomised to one of two patella exposure techniques: lateral retraction or eversion. Short-term outcomes were evaluated during hospitalisation and included time to return of straight leg raise (SLR), ambulation distance, and length of hospital stay. Long-term outcome values were evaluated pre-operatively, at 6 weeks, 3 months, and 1 year post-operatively, and included leg extension strength measured by dynamometer, knee range of motion (ROM), Visual Analog Scale (VAS) pain before and after knee motion, circumferential thigh measurements, and SF-36 Physical and Mental Component Scores (PCS, MCS). All collaborating investigators were blinded to each other's data. Surgical techniques and perioperative arthroplasty management protocols were those routinely and currently used during total knee replacement surgery at our institution.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 246 - 246
1 Jun 2012
Deshmukh A Orishimo K Kremenic I McHugh M Nicholas S Rodriguez J Thakur R
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Introduction

Although Total Knee Arthroplasty (TKA) has been shown to correct abnormal frontal plane knee biomechanics, little is known about this effect beyond 6 months. The purpose of this study was to compare sequentially the knee adduction moment during level-walking before and after TKA in varus knees. We hypothesized that adduction moment would diminish after TKA proportionate to the tibio-femoral realignment in degrees.

Methods

Fifteen patients (17 TKA's) with varus knees were prospectively enrolled and gait analysis performed prior to, 6 months and 1 year following TKA. Reflective markers were placed on the lower extremity and motion data collected using six infrared cameras (Qtrac, Qualysis). Ground reaction forces were recorded with a multicomponent force plate (Kistler). A repeated-measures ANOVA was used to compare changes in the peak adduction moment and peak dynamic varus angle over time.