Approximately 10% to 20% of knee arthroplasty patients are not satisfied with the result, while a clear indication for revision surgery might not be present. Therapeutic options for these patients, who often lack adequate quadriceps strength, are limited. Therefore, the primary aim of this study was to evaluate the clinical effect of a novel rehabilitation protocol that combines low-load resistance training (LL-RT) with blood flow restriction (BFR). Between May 2022 and March 2024, we enrolled 45 dissatisfied knee arthroplasty patients who lacked any clear indication for revision to this prospective cohort study. All patients were at least six months post-surgery and had undergone conventional physiotherapy previously. The patients participated in a supervised LL-RT combined with BFR in 18 sessions. Primary assessments included the following patient-reported outcome measures (PROMs): Knee injury and Osteoarthritis Outcome Score (KOOS); Knee Society Score: satisfaction (KSSs); the EuroQol five-dimension five-level questionnaire (EQ-5D-5L); and the pain catastrophizing scale (PCS). Functionality was assessed using the six-minute walk Test (6MWT) and the 30-second chair stand test (30CST). Follow-up timepoints were at baseline, six weeks, three months, and six months after the start.Aims
Methods
Recently a new version of the Knee Society Knee Scoring System has been developed, adapted to the lifestyle and activities of contemporary patients with a Total Knee Arthroplasty (TKA). It is subdivided into 4 domains including an Objective Knee Score, a Satisfaction Score, an Expectations Score and a Functional Activity Score. Before this scale can be used in non-English speaking populations, it has to be translated and validated for specific populations. The aim of this study was to translate and validate the New Knee Society Knee Scoring System (new KSS) for Dutch speaking populations. A Dutch translation of the New KSS was established using a forward-backward translation protocol. 137 patients undergoing TKA were asked to complete the Dutch translation of the New KSS as well as the Dutch WOMAC, Dutch KOOS and the Dutch SF12. To determine the test-retest reliability, 53 patients were asked to fill out a second questionnaire with one-week interval. We tested the test-retest reliability of the subjective domains of the New KSS by assessing the intra-class coefficient and the Pearson correlation coefficient between the first and second questionnaires. Systematic differences between the first and second questionnaires were investigated with T-tests and non-parametric statistics. Internal consistency of the Dutch new KSS was evaluated with Cronbach's alpha. The construct validity of the Dutch New KSS was determined by comparing it to the Dutch WOMAC, Dutch KOOS and Dutch SF12 using Pearson correlation coefficients. Content validity was assessed by examining the distribution and the floor and ceiling effects of the Dutch version of the new KSS.Background:
Materials and Methods:
The number of young patients undergoing total knee arthroplasty is rapidly increasing. Long-term follow-up of modern type implants is needed to provide a benchmark of implant longevity for these patients. Between January 1995 and October 1997, 245 consecutive total knee arthroplasties were performed in 217 patients by a single surgeon. In 156 knees, the Genesis I implant was used, and in 89 knees the Genesis II implant was used. Mean age at surgery was 69.3 years for the Genesis I cohort and 66 years for the Genesis II (p = 0.016). At 15 to 17 years, cumulative survivorship was calculated using Kaplan-Meier statistics whilst outcomes were rated with the ‘Knee society score’ and with the ‘Knee Injury and Osteoarthritis Outcome Score’. Radiological assessment included coronal alignment measured on full leg standing X-rays, and analysis of radiolucent lines and polyethylene thickness on AP, Lateral and Axial X-rays, positioned under fluoroscopic control.Background:
Methods:
Outcomes of revision TKA are inferior to primary TKA. Early failures were mainly caused by infection, instability, malalignment. Grouping revision TKA’s to etiology of failure did not lead to significant differences in outcomes. Significant better outcomes were reported for late revisions, patients with older age at revision surgery and partial knee replacement. Survivorship analysis was significally better for late than for early revisions.
