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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_11 | Pages 11 - 11
1 Oct 2019
Held MB Grosso MJ Gazgalis A Sarpong NO Jennings E Shah RP Cooper HJ Geller JA
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Introduction

Robotic-assisted total knee arthroplasty (TKA) was introduced to improve limb alignment, component positioning, and soft-tissue balance, yet the effect of adoption of this technology has not been established. This study was designed to evaluate whether robotic-assisted TKA leads to improved patient reported outcome measures (PROMs) and patient satisfaction as compared to conventional TKA at 3 and 12 months.

Methods

This IRB-approved single-surgeon retrospective cohort analysis of prospectively collected data compared 113 conventional TKA patients with 145 imageless robotic-assisted TKA patients (Navio™ Surgical System, Smith&Nephew®, Memphis TN). Basic demographic information, intraoperative and postoperative data, and PROMs (SF-P, SF-M, WOMAC pain, WOMAC stiffness, WOMAC Physical Function, KSS) were collected and recorded preoperatively, at 3 months, and at 12 months following surgery. Range of motion (ROM), blood loss, surgical duration, and complication rates between groups were also collected. Continuous measures such as mean difference in PROMs and ROM were compared using unpaired t-tests. Categorical measures such as the percentage of patients with complications were compared using chi-square analysis.


The Bone & Joint Journal
Vol. 101-B, Issue 7_Supple_C | Pages 3 - 9
1 Jul 2019
Shohat N Tarabichi M Tan TL Goswami K Kheir M Malkani AL Shah RP Schwarzkopf R Parvizi J

Aims

The best marker for assessing glycaemic control prior to total knee arthroplasty (TKA) remains unknown. The purpose of this study was to assess the utility of fructosamine compared with glycated haemoglobin (HbA1c) in predicting early complications following TKA, and to determine the threshold above which the risk of complications increased markedly.

Patients and Methods

This prospective multi-institutional study evaluated primary TKA patients from four academic institutions. Patients (both diabetics and non-diabetics) were assessed using fructosamine and HbA1c levels within 30 days of surgery. Complications were assessed for 12 weeks from surgery and included prosthetic joint infection (PJI), wound complication, re-admission, re-operation, and death. The Youden’s index was used to determine the cut-off for fructosamine and HbA1c associated with complications. Two additional cut-offs for HbA1c were examined: 7% and 7.5% and compared with fructosamine as a predictor for complications.


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_12 | Pages 25 - 25
1 Oct 2018
Geller JA Sarpong NO Grosso M Lakra A Jennings E Heller MS Shah RP Cooper HJ
Full Access

Introduction

The success of total knee arthroplasty (TKA) necessitates precise osteotomies and soft tissue balancing to realign the lower extremity to a neutral mechanical axis. While technological advances have facilitated precise osteotomies, soft tissue balancing has traditionally relied mostly on surgeons’ subjective and variable tactile feedback. As soft tissue imbalance accounts for 35% of early TKA revisions in North America, we aimed to compare outcomes when TKA was balanced free-hand versus a sensor-guided balancing device (VERASENSE, OrthoSensor, Inc (Dania, FL)).

Methods

In a randomized-controlled fashion, patients underwent primary TKA soft tissue balancing either free-hand or with VERASENSE (Orthosensor Inc, Dania FL) at our institution beginning January 2018. With VERASENSE, soft-tissue balancing is considered when the pressure difference between the medial and lateral knee compartments was less than 15 pounds. Data regarding patient-reported outcomes, knee range of motion (ROM), pain level, opioid consumption, inpatient ambulation distance, length of stay (LOS), and incidence of arthrofibrosis was collected and analyzed in a two-year minimum follow-up and target patient goal of 120 patients.


The Bone & Joint Journal
Vol. 96-B, Issue 11_Supple_A | Pages 73 - 77
1 Nov 2014
Brown NM Hellman M Haughom BH Shah RP Sporer SM Paprosky WG

A pelvic discontinuity occurs when the superior and inferior parts of the hemi-pelvis are no longer connected, which is difficult to manage when associated with a failed total hip replacement. Chronic pelvic discontinuity is found in 0.9% to 2.1% of hip revision cases with risk factors including severe pelvic bone loss, female gender, prior pelvic radiation and rheumatoid arthritis. Common treatment options include: pelvic plating with allograft, cage reconstruction, custom triflange implants, and porous tantalum implants with modular augments. The optimal technique is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable healing between the two segments. A method of treating pelvic discontinuity using porous tantalum components with a distraction technique that achieves both initial stability and subsequent long-term biological fixation is described.

Cite this article: Bone Joint J 2014;96-B(11 Suppl A):73–7.