scholarly journals Observational Study of Total Knee Arthroplasty in Aseptic Revision Surgery: Clinical Results

2020 ◽  
Vol 12 (1) ◽  
pp. 177-183 ◽  
Author(s):  
Gabriel Oliver ◽  
Luis Jaldin ◽  
Eric Camprubí ◽  
Guillermo Cortés
Keyword(s):  
Total Knee Arthroplasty ◽  
Observational Study ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Clinical Results ◽  
Aseptic Revision ◽  
Total Knee

scholarly journals Variation of synovial fluid leucocyte cell count and polymorphonuclear percentage in patients with aseptic revision total knee arthroplasty

2021 ◽  
Vol 2 (8) ◽  
pp. 566-572
Author(s):  
Michael Fuchs ◽  
Felix Kirchhoff ◽  
Heiko Reichel ◽  
Carsten Perka ◽  
Martin Faschingbauer ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Synovial Fluid ◽  
Cell Count ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Joint Infection ◽  
Revision Total Knee Arthroplasty ◽  
Time Points ◽  
Aseptic Revision ◽  
Total Knee

Aims Current guidelines consider analyses of joint aspirates, including leucocyte cell count (LC) and polymorphonuclear percentage (PMN%) as a diagnostic mainstay of periprosthetic joint infection (PJI). It is unclear if these parameters are subject to a certain degree of variability over time. Therefore, the aim of this study was to evaluate the variation of LC and PMN% in patients with aseptic revision total knee arthroplasty (TKA). Methods We conducted a prospective, double-centre study of 40 patients with 40 knee joints. Patients underwent joint aspiration at two different time points with a maximum period of 120 days in between these interventions and without any events such as other joint aspirations or surgeries. The main indications for TKA revision surgery were aseptic implant loosening (n = 24) and joint instability (n = 11). Results Overall, 80 synovial fluid samples of 40 patients were analyzed. The average time period between the joint aspirations was 50 days (SD 32). There was a significantly higher percentage change in LC when compared to PMN% (44.1% (SD 28.6%) vs 27.3% (SD 23.7%); p = 0.003). When applying standard definition criteria, LC counts were found to skip back and forth between the two time points with exceeding the thresholds in up to 20% of cases, which was significantly more compared to PMN% for the European Bone and Joint Infection Society (EBJIS) criteria (p = 0.001), as well as for Musculoskeletal Infection Society (MSIS) (p = 0.029). Conclusion LC and PMN% are subject to considerable variation. According to its higher interindividual variance, LC evaluation might contribute to false-positive or false-negative results in PJI assessment. Single LC testing prior to TKA revision surgery seems to be insufficient to exclude PJI. On the basis of the obtained results, PMN% analyses overrule LC measurements with regard to a conclusive diagnostic algorithm. Cite this article: Bone Jt Open 2021;2(8):566–572.

scholarly journals Mid-Term Results of Two-stage Revision Total Knee Arthroplasty for Infected Total Knee Arthroplasty

2021 ◽  
Vol 1 (56) ◽  
pp. 12-18
Author(s):  
Yasin Koker ◽  
◽  
Mehmet Yuzugulen ◽  
Dogac Karaguven ◽  
Burak Akan ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Knee Prosthesis ◽  
Primary Total Knee Arthroplasty ◽  
Treatment Method ◽  
Clinical Results ◽  
Two Stage ◽  
Infected Total Knee Arthroplasty ◽  
Total Knee

Introduction. Today, knee arthroplasty is one of the most common surgical procedures. Infection after endoprosthetics is the most dangerous complication in patients who have undergone total knee arthroplasty, which negatively affects the prognosis. Most cases of infection develop within the first 2 years after surgery, and the frequency is 1.5%, and after that it decreases to 0.5%. Material and Method. When a study group of 31 patients (22 female, 9 male) who were diagnosed with infected knee prosthesis and underwent two-stage revision knee prosthesis as a treatment method; the mean age of all patients (31 patients) was 68.78 years. In our study by using the American knee association scoring system; preoperative knee scores of 31 patients who underwent two-stage revision surgery were 35.43 ± 7.14, while this parameter was found to be 83.27 ± 8.89 postoperatively (p <0.01). Conclusion. We believe that two-stage revision surgery is an effective method in the treatment of infection that develops after primary total knee arthroplasty application. Restoration of the joint line in accordance with the anatomical structure will positively affect the clinical results, and the use of a long stem to increase the stability of the prosthesis is appropriate for successful results, especially in the cases with bone defects. Key words: Total Knee Arthroplasty, Two-Stage Revision Surgery, Infected Knee Prosthesis.

Cost of Aseptic Revision Total Knee Arthroplasty at a Tertiary Medical Center

2020 ◽  
Author(s):  
John R. Steele ◽  
Sean P. Ryan ◽  
William A. Jiranek ◽  
Samuel S. Wellman ◽  
Michael P. Bolognesi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medical Center ◽  
Revision Total Knee Arthroplasty ◽  
Aseptic Revision ◽  
Total Knee

scholarly journals Slight femoral under-correction versus neutral alignment in total knee arthroplasty with preoperative varus knees: a comparative study

Arthroplasty ◽  
2022 ◽  
Vol 4 (1) ◽  
Author(s):  
Kai Lei ◽  
Li-Ming Liu ◽  
Peng-Fei Yang ◽  
Ran Xiong ◽  
De-Jie Fu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Clinical Results ◽  
Patient Reported Outcome Measures ◽  
Tourniquet Time ◽  
Patient Reported ◽  
Total Knee ◽  
Neutral Alignment

Abstract Background This study aimed to compare the short-term clinical results of slight femoral under-correction with neutral alignment in patients with preoperative varus knees who underwent total knee arthroplasty. Methods The medical records and imaging data were retrospectively collected from patients who had undergone total knee arthroplasty in our hospital from January 2016 to June 2019. All patients had varus knees preoperatively. Upon 1:1 propensity score matching, 256 patients (256 knees) were chosen and divided into a neutral alignment group (n=128) and an under-correction group (n=128). The patients in the neutral group were treated with the neutral alignment. In the under-correction group, the femoral mechanical axis had a 2° under-correction. The operative time, tourniquet time and the length of hospital stay in the two groups were recorded. The postoperative hip-knee-ankle angle, frontal femoral component angle and frontal tibial component angle were measured. Patient-reported outcome measures were also compared. Results The operative time, tourniquet time and the length of hospital stay in the under-correction group were significantly shorter than the neutral alignment group (P<0.05). At the 2-year follow-up, the under-correction group had a larger varus alignment (P<0.05) and a larger frontal femoral component angle (P<0.05), and the frontal tibial component angles of the two groups were comparable. Compared with the neutral alignment group, the slight femoral under-correction group had significantly better patient-reported outcome measures scores (P<0.05). Conclusion For varus knees treated with total knee arthroplasty, alignment with a slight femoral under-correction has advantages over the neutral alignment in terms of the shorter operative time and better short-term clinical results. Level of evidence III

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