Instability in ACL deficient knees can lead to medial compartment osteoarthritis. The risk of developing significant OA is 5x higher in knees with ACL deficiency. In associated Varus, there is quicker progression of the medial OA along with a varus thrust exerting strain on the ACL graft. The simultaneous valgus HTO and ACL reconstruction decompresses the medial tibiofemoral joint, corrects the mechanical-axis and reduces strain on the graft. Outcomes for this simultaneous procedure are still unclear in literature and we attempt evaluating its functional outcome. This Panel study was performed using data from 2019 to 2022 on 21 patients who had ACL insufficiency with Varus or medial OA and underwent a simultaneous Opening-wedge HTO with Arthroscopic ACL reconstruction. The mean follow-up was 2 years. The patients were evaluated with IKDC and Lysholm scores, Lachman test and ROM pre and post-operatively. The HKA was compared pre and post-operatively and the complications were evaluated. The progression of OA was evaluated with serial radiographs post-operatively.Introduction
Methods
During TKR it is mandatory to achieve perfect soft tissue balance and component alignment. It is necessary to access all tight structures for proper releases. We aim to analyze the results of Trivector arthrotomy approach for TKRs. It is a retrospective study of 1050 cases between 2010-2020. All cases were performed by a single surgeon. Approach includes dividing distal 30% of vastus medialis along with medial retinaculum - 1cm medial to patella and patellar tendon distally up to Tibial tuberosity and raised as a single flap.Introduction & Aim
Methods
The use of All-Poly Tibia has been in practice since the early 1970's. Recently due to the reports on wear and osteolysis in other articulations, this component has generated significant interest. In the current study we aim to report early medium-term results of All-poly Tibial components in elderly (>70 years) patients. Study of 455 cases done between 2005-2020. All the cases were performed by a single surgeon. All-Poly Tibial component implantations were performed using Standard mechanical jigs and the same posterior-stabilized implant was used for all cases.Introduction & Aim
Method
Mechanical alignment (MA) in total knee arthroplasty (TKA), although considered the gold standard, reportedly has up to 25% of patients expressing post-operative dissatisfaction. Biomechanical outcomes following kinematic alignment (KA) in TKA, developed to restore native joint alignment, remain unclear. Without a clear consensus for the optimal alignment strategy during TKA, the purpose of this study was to conduct a paired biomechanical comparison of MA and KA in TKA by experimentally quantifying joint laxity and medial collateral ligament (MCL) strain. 14 bilateral native fresh-frozen cadaveric lower limbs underwent medially-stabilised TKA (GMK Sphere, Medacta, Switzerland) using computed CT-based subject-specific guides, with KA and MA performed on left and right legs, respectively. Each specimen was subjected to sensor-controlled mediolateral laxity tests. A handheld force sensor (Mark-10, USA) was used to generate an abduction-adduction moment of 10Nm at the knee at fixed flexion angles (0°, 30°, 60°, 90°). A digital image correlation system was used to compute the strain on the superficial medial collateral ligament. A six-camera optical motion capture system (Vicon MX+, UK) was used to acquire kinematics using a pre-defined CT-based anatomical coordinate system. A linear mixed model and Tukey's posthoc test were performed to compare native, KA and MA conditions (p<0.05). Unlike MA, medial joint laxity in KA was similar to the native condition; however, no significant difference was found at any flexion angle (p>0.08). Likewise, KA was comparable with the native condition for lateral joint laxity, except at 30°, and no statistical difference was observed. Although joint laxity in MA seemed lower than the native condition, this difference was significant only for 30° flexion (p=0.01). Both KA and MA exhibited smaller MCL strain at 0° and 30°; however, all conditions were similar at 60° and 90°. Medial and lateral joint laxity seemed to have been restored better following KA than MA; however, KA did not outperform MA in MCL strain, especially after mid-flexion. Although this study provides only preliminary indications regarding the optimal alignment strategy to restore native kinematics following TKA, further research in postoperative joint biomechanics for load bearing conditions is warranted.
Dynamic stabilisation system for the spine relies on titanium screw purchase within the pedicle. Decision on osteointegration is important especially when the patient becomes symptomatic following initial good outcome. From our cohort of 420 Dynesys patients, over all incidence of screw loosening was 17%. Only 35% were symptomatic.
Seven observers composed of two expert orthopaedic spine consultant surgeons and one spine expert consultant radiologist and four Specialist Registrars in orthopaedics and radiology. Data gathered were distributed and presented in tables in the form of descriptive statistics. The evaluation of interobserver agreement was performed by obtaining a Kappa (K) index. For continuous variables comparison, the t test was employed, with a significance level of 0.05.
We are planning to evaluate a 3D computer reconstruction model based on 2 X-ray views at 45 degree angle to each other which might be sensitive to detect screw loosening.
Dynamic stabilisation system for the spine relies on titanium screw purchase within the pedicle. Decision on osteointegration is important especially when the patient becomes symptomatic following initial good outcome. From our cohort of 420 Dynesys patients, over all incidence of screw loosening was 17%. Only 35% were symptomatic.
Seven observers composed of two expert orthopaedic spine consultant surgeons and one spine expert consultant radiologist and four Specialist Registrars in orthopaedics and radiology. Data gathered were distributed and presented in tables in the form of descriptive statistics. The evaluation of interobserver agreement was performed by obtaining a Kappa (K) index. For continuous variables comparison, the t test was employed, with a significance level of 0.05.
We are planning to evaluate a 3D computer reconstruction model based on 2 X-ray views at 45 degree angle to each other which might be sensitive to detect screw loosening.
