Aims. The aim of this study was to examine whether tourniquet use can improve perioperative blood loss, early function recovery, and pain after primary total knee arthroplasty (TKA) in the setting of multiple-dose intravenous tranexamic acid. Methods. This was a prospective, randomized clinical trial including 180 patients undergoing TKA with multiple doses of intravenous tranexamic acid. One group was treated with a tourniquet during the entire procedure, the second group received a tourniquet during cementing, and the third group did not receive a tourniquet. All patients received the same protocol of intravenous tranexamic acid (20 mg/kg) before skin incision, and three and six hours later (10 mg/kg). The primary outcome measure was perioperative blood loss. Secondary outcome measures were creatine kinase (CK), CRP, interleukin-6 (IL-6), visual analogue scale (VAS) pain score, limb swelling ratio, quadriceps strength, straight leg raising, range of motion (ROM), American
Objectives. A lack of connection between surgeons and patients in evaluating
the outcome of total knee arthroplasty (TKA) has led to the search
for the ideal patient-reported outcome measure (PROM) to evaluate
these procedures. We hypothesised that the desired psychometric properties
of the ideal outcome tool have not been uniformly addressed in studies describing
TKA PROMS. Methods. A systematic review was conducted investigating one or more facets
of patient-reported scores for measuring primary TKA outcome. Studies
were analysed by study design, subject demographics, surgical technique,
and follow-up adequacy, with the ‘gold standard’ of psychometric
properties being systematic development, validity, reliability,
and responsiveness. Results. A total of 38 articles reported outcomes from 47 different PROMS
to 85 541 subjects at 26.3 months (standard deviation 30.8) post-operatively.
Of the 38, eight developed new scores, 20 evaluated existing scores,
and ten were cross-cultural adaptation of existing scores. Only
six of 38 surveyed studies acknowledged all ‘gold standard’ psychometric
properties. The most commonly studied PROMS were the Oxford Knee
Score, New
Objectives. The objective of this study was to compare the early migration
characteristics and functional outcome of the Triathlon cemented
knee prosthesis with its predecessor, the Duracon cemented knee
prosthesis (both Stryker). Methods. A total 60 patients were prospectively randomised and tibial
component migration was measured by radiostereometric analysis (RSA)
at three months, one year and two years; clinical outcome was measured
by the American
A functional anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) has been assumed to be required for patients undergoing unicompartmental knee arthroplasty (UKA). However, this assumption has not been thoroughly tested. Therefore, this study aimed to assess the biomechanical effects exerted by cruciate ligament-deficient knees with medial UKAs regarding different posterior tibial slopes. ACL- or PCL-deficient models with posterior tibial slopes of 1°, 3°, 5°, 7°, and 9° were developed and compared to intact models. The kinematics and contact stresses on the tibiofemoral joint were evaluated under gait cycle loading conditions.Aims
Methods
To identify the responsiveness, minimal clinically important difference (MCID), minimal clinical important change (MIC), and patient-acceptable symptom state (PASS) thresholds in the 36-item Short Form Health Survey questionnaire (SF-36) (v2) for each of the eight dimensions and the total score following total knee arthroplasty (TKA). There were 3,321 patients undergoing primary TKA with preoperative and one-year postoperative SF-36 scores. At one-year patients were asked how satisfied they were and “How much did the knee arthroplasty surgery improve the quality of your life?”, which was graded as: great, moderate, little (n = 277), none (n = 98), or worse.Aims
Methods
This study aims to investigate the effects of posterior tibial slope (PTS) on knee kinematics involved in the post-cam mechanism in bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) using computer simulation. In total, 11 different PTS (0° to 10°) values were simulated to evaluate the effect of PTS on anterior post-cam contact conditions and knee kinematics in BCS TKA during weight-bearing stair climbing (from 86° to 6° of knee flexion). Knee kinematics were expressed as the lowest points of the medial and lateral femoral condyles on the surface of the tibial insert, and the anteroposterior translation of the femoral component relative to the tibial insert.Aims
Methods
This systematic review and meta-analysis was conducted to determine
the mid- to long-term clinical outcomes for a medial-pivot total
knee replacement (TKR) system. The objectives were to synthesise
available survivorship, Knee Society Scores (KSS), and reasons for
revision for this system. A systematic search was conducted of two online databases to
identify sources of survivorship, KSS, and reasons for revision.
Survivorship results were compared with values in the National Joint
Registry of England, Wales, and Northern Ireland (NJR).Objectives
Methods
The purpose of this study was to examine the effect of posterior
cruciate ligament (PCL) retention, PCL recession, and PCL excision
during cruciate-retaining total knee replacement. A total of 3018 anatomic graduated component total knee replacements
were examined; 1846 of these retained the PCL, 455 PCLs were partially
recessed, and in 717 the PCL was completely excised from the back
of the tibia.Objectives
Methods
