scholarly journals Ολική αρθροπλαστική γόνατος GENESIS II - OXINIUM

2020 ◽  
Author(s):  
Ευθύμιος Παπασούλης
Keyword(s):  
Knee Society Score ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Genesis Ii

Η ολική αρθροπλαστική γόνατος είναι μία από τις πιο διαδεδομένες και επιτυχημένες επεμβάσεις στην ορθοπαιδική. Μία από τις σοβαρότερες επιπλοκές της επέμβασης είναι η μηχανική χαλάρωση των προθέσεων εξαιτίας της φθοράς των υλικών που οδηγεί σε ανάγκη αναθεώρησης της αρθροπλαστικής. Η χρήση του οξειδίου του ζιρκονίου συγκεντρώνει τα προτερήματα τόσο μιας μεταλλικής επιφάνειας (ανθεκτικότητα) όσο και μιας κεραμικής επιφάνειας (πολύ χαμηλή τριβή) και για αυτό έχει προταθεί ως ένα υλικό που θα μειώσει τη φθορά των ολικών αρθροπλαστικών. Η παρούσα μελέτη διερευνά τα μακροχρόνια κλινικά αποτελέσματα μιας αρθροπλαστικής γόνατος που φέρει τη συγκεκριμένη ένωση στο μηριαίο πρόθεμά της (OXINIUMΤΜ της εταιρείας Smith & Nephew, Memphis, TN, USA).Συνολικά μελετήθηκαν 261 ολικές αρθροπλαστικές γόνατος που διενεργήθηκαν στο Πανεπιστημιακό Νοσοκομείο Λάρισας σε 245 ασθενείς που έπασχαν από οστεοαρθρίτιδα. Ο συνολικός χρόνος παρακολούθησης ήταν 10 – 15,5 έτη και η μέση τιμή αυτού ήταν 12,3 έτη. Σε όλα τα κλινικά ερωτηματολόγια με τα οποία ελέγχθηκαν οι ασθενείς που συμπεριελήφθησαν στη μελέτη, υπήρξε στατιστικά σημαντική βελτίωση σε σχέση με προεγχειρητικά (p<0,001). Η βελτίωση συνεχίστηκε μέχρι το 2ο ή 3ο μετεγχειρητικό έτος και μετά άρχισε μια σταδιακή μικρού βαθμού επιδείνωση των αποτελεσμάτων. Το αποτέλεσμα όμως παρέμεινε στατιστικά βελτιωμένο σε σχέση με τις προεγχειρητικές τιμές (p<0,01) για όλα τα scores μέχρι και το τέλος της περιόδου παρακολούθησης. Τα κλινικά scores που χρησιμοποιήθηκαν ήταν το Knee Society Score, το Oxford Knee Score, το WOMAC, το KOOS και το EURO-QoL. Tο 90,1% των ασθενών δήλωσε πως η επέμβαση εκπλήρωσε τις προσδοκίες που είχαν για αυτή πριν την επέμβαση. Η παρακολούθηση των ασθενών με ακτινολογικό έλεγχο ανέδειξε την παρουσία ακτινοδιαφανών γραμμών με KSRES >5 μόνο σε μία ασθενή, η οποία παρακολουθήθηκε χωρίς επιδείνωση της ακτινολογικής εικόνας.Η 15ετής επιβίωση της αρθροπλαστικής Genesis II-OXINIUM στην παρούσα μελέτη για άσηπτη χαλάρωση ήταν 98,8% (95% CI: 87,5% - 100,0%), ενώ η 15ετής επιβίωση για αναθεώρηση για οποιοδήποτε λόγο ήταν 98,0% (95% CI: 86,6% - 100,0%). Η 15ετής επιβίωση της αρθροπλαστικής Genesis II-OXINIUM στην παρούσα μελέτη για επανεπέμβαση για οποιοδήποτε λόγο ήταν 95,6% (95% CI: 84,0% - 100,0%), ενώ η 15ετής επιβίωση για το χειρότερο δυνατό σενάριο ήταν 84,9% (95% CI: 73,6% - 92,2%). Το τελικό εύρημα της παρούσας μελέτης είναι πως η χρήση του οξειδωμένου ζιρκονίου ως επιφάνεια της μηριαίας πρόθεσης μιας ολικής αρθροπλαστικής γόνατος – εν προκειμένω της Genesis II – OXINIUM (Smith & Nephew, Memphis, TN, USA) – συνοδεύεται από μακροχρόνια ικανοποιητικά αποτελέσματα τόσο κλινικά όσο και ακτινολογικά, χωρίς να συνοδεύεται από πολλές ή σημαντικές επιπλοκές. Πρόκειται για τη μακροβιότερη και μία από τις μεγαλύτερες σειρές στη βιβλιογραφία αναφορικά με την κλινική αποτελεσματικότητα της χρήσης του οξειδωμένου ζιρκονίου στην ολική αρθροπλαστική γόνατος. Εντούτοις, η παρούσα μελέτη δεν μπόρεσε να αναδείξει αν το υπό έρευνα υλικό είναι ανώτερο των έως τώρα χρησιμοποιούμενων, καθώς δεν ήταν σχεδιασμένη για αυτό το σκοπό. Χρειάζεται να συνεχιστεί η παρακολούθηση όλων των ασθενών με το εν λόγω υλικό για να τεκμηριωθεί η θέση και χρησιμότητα του οξειδωμένου ζιρκονίου στην ορθοπαιδική.

The Management of Extensive Bone Loss in Primary and Revision Total Knee Replacement

2012 ◽  
Vol 12 (1) ◽  
pp. 32-35
Author(s):  
Silvestris Zebolds ◽  
Valdis Goncars ◽  
Ints Zommers ◽  
Konstantins Kalnberzs
Keyword(s):  
Bone Loss ◽  
Total Knee Replacement ◽  
Knee Society Score ◽  
Oxford Knee Score ◽  
Functional Results ◽  
Knee Score ◽  
Patients Satisfaction ◽  
Satisfaction Rate ◽  
Rotating Hinge ◽  
Total Knee

SummaryIntroduction.Total knee replacement (TKR) is still a challenging procedure for severe gonarthrosis patients. Deformities of knee joint (varus, valgus - more than 30 degrees), insufficiency of collateral ligaments and extensive bone loss could be a difficult problem to solve with standard knee endoprosthesis. Also in cases of revision - TKR the restoration of bone loss and regaining of stability of the joint could be a problem.Aim of the Study.The aim of our study was to analyse the results with Rotating - Hinge prosthesis after severe primary and revision TKR.Materials and Methods.34 patients (27 female, 7 male) were treated with Rotating - Hinge prosthesis during 12 years (first in 1997). Mean age of patients were 69 years. 17 operations were primary total knee arthroplasties and also 17 were revisions of the knee prosthesis. The Oxford Knee score was used for evaluation of patients satisfaction rate. The Knee Society Score was used to get objective functional results. For radiological analysis X-rays of knee joint in two projections were performed.Results.34 Oxford Knee score questionnaires were sent to patients, response we got from 27 patients (79%). Mean result from Oxford Knee score was 32 which is good. The same number of patients (34) were invited for examination using Knee Society score. The response were from 20 patients (59%). Mean result from Knee Society score was 83, which means excellent.Conclusions.Rotating-Hinge prosthesis allows to achieve good and excellent functional results and high patients satisfaction rate after severe primary and revision TKR. The biological age, general health condition, insufficiency of ligaments and previous infection in patients history have to be considered for choosing the tactics for each case.

scholarly journals Correlation of knee society score and oxford knee score in patients with moderate to severe osteoarthritis of the knee

2021 ◽  
Vol 7 (1) ◽  
pp. 17-23
Author(s):  
Uma Phalswal ◽  
Vandna Pandey ◽  
Ashok Kumar ◽  
Abhay Elhence
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Society Score ◽  
Weight Bearing ◽  
Oxford Knee Score ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Bilateral Knee ◽  
Joint Surfaces ◽  
Massage Treatment ◽  
The Mean

Osteoarthritis (OA) of the knee is a degenerative, non-inflammatory joint condition marked by articular cartilage disintegration and the growth of new bone (osteophytes) at the joint surfaces and borders. It impairs one's ability to function and makes one disabled. It is the most common rheumatic disease. Because the Knee is a weight-bearing joint and a crutch joint, it is the most usually afflicted joint by Osteoarthritis.A Correlational study was conducted to find out the correlation between Knee Society Score (KSS) and Oxford Knee Score (OKS) on 142 Osteoarthritis Knees. Purposive sampling was used to collect data from the Orthopaedics OPD at AIIMS Jodhpur from October to December 2018.On evaluation, the mean age of the patients was 60.19±1.01. Bilateral Knee Osteoarthritis affected about 42% of the patients. Approximately half of the patients were obese. Only 34% of patients had compliance in physiotherapy. Analgesics and massage treatment are used by about 76% of the patients to relieve knee pain. In the Knee Society Score, the majority of the patients (82.4%) had a bad knee condition, with a mean score of 49.07±1.06. In OKS, about half of the patients (46.5%) had Moderate to Severe Knee Osteoarthritis, with a mean score of 22.69±7.09. The correlation coefficient between the Knee Society Score and the Oxford Knee Score is 0.660. As a consequence of the analysis, both scales have almost the same outcome, indicating that they are moderately associated. The Knee Society Score is highly associated with occupation and physiotherapy, whereas the Oxford Knee Score is significantly related to the patients' age alone. According to the study, there is a moderate correlation between the Knee Society Score (KSS) and the Oxford Knee Score (OKS). These scores should be included during the diagnosis of Knee Osteoarthritis for improved patient care.

Similar Outcomes of Two-Stage Revisions for Infection and One-Stage Revisions for Aseptic Revisions of Knee Endoprostheses

2018 ◽  
Vol 32 (09) ◽  
pp. 897-899 ◽  
Author(s):  
Christian Konrads ◽  
Arno Franz ◽  
Maik Hoberg ◽  
Maximilian Rudert
Keyword(s):  
Knee Society Score ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Two Stage ◽  
Revision Knee Arthroplasty ◽  
One Stage ◽  
Sf 36 ◽  
Kujala Score ◽  
Total Knee ◽  
Septic Group

AbstractTwo-stage revision knee arthroplasty using an antibiotic-loaded spacer is the most widely performed procedure for infected knee arthroplasties. The clinical outcome of this type of surgery compared with aseptic joint revision with exchange of tibial and femoral components is still controversial. Therefore, we analyzed clinical outcomes of septic two-stage revisions compared with aseptic one-stage revision total knee arthroplasties (TKAs). In a retrospective study, we assessed 135 consecutive patients who underwent two-stage revision for septic TKA (52 patients) and one-stage aseptic total knee revision arthroplasty (83 patients). The average follow-up was 26.1 months for the aseptic group and 26.5 months for the septic group. For clinical evaluation, we used the Knee Society Score, Oxford Knee Score, Kujala score, Turba score, and the Short Form 36 (SF-36). Postoperative pain level was determined using the visual analog pain scale. The surgeries were performed 51 months (aseptic group) and 24 months (septic group) after primary TKA on average. The main indications for aseptic revision surgeries were instability (40%), aseptic loosening (22.4%), anterior knee pain due to pathologies of the patella (11.8%), or material wear (5.9%). In the clinical outcome, patients achieved 124.8 points in the aseptic group and 105.4 points in the septic group in the Knee Society Score. The Oxford Knee Score revealed 29.9 points for the aseptic group and 33.9 points for the septic group. For the Kujala score, we found 53.2 points in the aseptic group and 48.5 points in the septic group. For the Turba score, we found 8.4 points in the aseptic group and 10.8 points in the septic group. The SF-36 (psychical) showed 52.2 versus 49.5 points and the SF-36 (physical) showed 36.5 versus 35.4 points. Mean level of persisting pain on the visual analog scale was 3.0 (aseptic group) and 3.5 (septic group). Performing septic two-stage or aseptic one-stage tibial and femoral revision knee arthroplasty showed similar clinical outcomes in relation to objective and subjective outcome measures.

scholarly journals All polyethylene tibia - results of functional and radiological outcome at 5 years follow-up

2020 ◽  
Vol 6 (5) ◽  
pp. 945
Author(s):  
Digen Patel ◽  
Kunal Ajitkumar Shah ◽  
Mohan Madhav Desai ◽  
Swapneel S. Shah
Keyword(s):  
Knee Society Score ◽  
Oxford Knee Score ◽  
X Rays ◽  
Knee Score ◽  
Radiological Outcome ◽  
Component Alignment ◽  
Vas Score ◽  
Significant Difference ◽  
Functional Scores

<p class="abstract"><strong>Background:</strong> Earlier, all-polyethylene tibial (APT) components were the only option available for TKA. APT components improved over years and have shown results similar or superior to MBT components with respect to survivorship and rate of complications. This study aimed to assess the functional and radiological outcome of TKA with APT components with 5 years follow-up.</p><p class="abstract"><strong>Methods:</strong> This longitudinal study was conducted in a tertiary care center in Mumbai in year 2018. All patients who underwent TKA with APT components during the year 2012 were included in the study. Total of 147 knees were operated in 120 patients. Ninty patients (111 knees) followed up at 5 years. Preoperative and postoperative assessment of patients was done for function, pain and radiological outcome. Functional scores used were Knee society score, WOMAC osteoarthritis index, Bristol score and Oxford knee score. Visual analogue scale (VAS) score was used for pain assessment. Pre and postoperative X-rays were done and component alignment angles (α, β, γ and δ) were calculated.<strong></strong></p><p class="abstract"><strong>Results:</strong> Statistically significant difference was found in pre and postoperative values of VAS score, knee society score, WOMAC osteoarthritis index, Bristol score and Oxford knee score (p value &lt;0.001). Component alignment angles were found to be same pre and postoperatively. None of the patients had radiologic evidence of loosening of implants.</p><p class="abstract"><strong>Conclusions:</strong> APT components have good to excellent functional outcome and good radiological outcome at 5 years. They are safe in view of radiologic component migration at 5-year follow-up.</p>

scholarly journals IS iASSIST SUPERIOR TO CONVENTIONAL METHOD IN TOTAL KNEE REPLACEMENT FOR FUNCTIONAL OUTCOMES?PROSPECTIVE OBSERVATIONAL STUDY IN INDIAN POPULATION FOR OXFORD KNEE SCORE, SF 12 AND KNEE SOCIETY SCORE.

2020 ◽  
pp. 13-15
Author(s):  
Sanket Tanpure ◽  
Shweta Tripathi ◽  
Vaibhav Shingade ◽  
Bharat Dhanani ◽  
Darshan Bafna ◽  
...  
Keyword(s):  
Conventional Method ◽  
Knee Society Score ◽  
Short Form ◽  
Oxford Knee Score ◽  
Physical Component Score ◽  
Functional Score ◽  
Knee Score ◽  
Management Protocol ◽  
Significant Difference ◽  
Total Knee

Background: The iASSIST (Zimmer) system is an accelerometer base navigation tool use for total knee arthroplasty (TKA) which guides surgeon to take bone cuts during surgery. The purpose of this study was to compare the functional outcome between accelerometer base iASSIST system and the conventional system. Method: A prospective study between two groups of 28 patients (14 iASSIST and 14 conventional) of primary osteoarthritis of the knee who underwent TKA using Zimmer iASSIST ™ or conventional method from January 2018 to December 2019. A single surgeon performs whole operations with the same instrumentation and same surgical approach. Pre-operative and postoperative management protocol are same for both groups. Preoperative oxford knee score, SF12 and Knee society score was taken 1 week prior to surgery and postoperative scores was taken 3 weeks after surgery. Results: There was no difference between the two groups for age, height and weight (p > 0.05). No significant difference was observed in SF 12(Physical and mental score),OKS and knee score preoperatively and postoperatively . Significant difference was observed in knee society functional score preoperatively and postoperatively between 2 groups but no significant difference was observed in difference of score. Significant correlation observed in preoperative short form(SF)12 physical component score (PCS) and preoperative oxford knee score. Conclusion: Our study concludes that despite being a useful guidance tool during TKA, iASSIST does not show any difference in functional and satisfaction outcomes when compared with the conventional method.

Does the Oxford Knee Score Complement, Concur, or Contradict the American Knee Society Score?

2011 ◽  
Vol 26 (5) ◽  
pp. 714-720 ◽  
Author(s):  
Krishna I.A. Reddy ◽  
Linda R. Johnston ◽  
Weijie Wang ◽  
Rami J. Abboud
Keyword(s):  
Knee Society Score ◽  
Oxford Knee Score ◽  
Knee Score ◽  
American Knee Society Score

scholarly journals A comparison between laterally wedged insoles and ankle-foot orthoses for the treatment of medial osteoarthritis of the knee: A randomized cross-over trial

2021 ◽  
pp. 026921552199363
Author(s):  
Martin Schwarze ◽  
Leonie P Bartsch ◽  
Julia Block ◽  
Merkur Alimusaj ◽  
Ayham Jaber ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Oxford Knee Score ◽  
Knee Adduction Moment ◽  
Osteoarthritis Of The Knee ◽  
Knee Score ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Patient Reported ◽  
Angular Impulse

Objective: To compare biomechanical and clinical outcome of laterally wedged insoles (LWI) and an ankle-foot orthosis (AFO) in patients with medial knee osteoarthritis. Design: Single-centre, block-randomized, cross-over controlled trial. Setting: Outpatient clinic. Subjects: About 39 patients with symptomatic medial knee osteoarthritis. Interventions: Patients started with either LWI or AFO, determined randomly, and six weeks later changed to the alternative. Main measures: Change in the 1st maximum of external knee adduction moment (eKAM) was assessed with gait analysis. Additional outcomes were other kinetic and kinematic changes and the patient-reported outcomes EQ-5D-5L, Oxford Knee Score (OKS), American Knee Society Clinical Rating System (AKSS), Hannover Functional Ability Questionnaire – Osteoarthritis and knee pain. Results: Mean age (SD) of the study population was 58 (8) years, mean BMI 30 (5). Both aids significantly improved OKS (LWI P = 0.003, AFO P = 0.001), AKSS Knee Score (LWI P = 0.01, AFO P = 0.004) and EQ-5D-5L Index (LWI P = 0.001, AFO P = 0.002). AFO reduced the 1st maximum of eKAM by 18% ( P < 0.001). The LWI reduced both maxima by 6% ( P = 0.02, P = 0.03). Both AFO and LWI reduced the knee adduction angular impulse (KAAI) by 11% ( P < 0.001) and 5% ( P = 0.05) respectively. The eKAM (1st maximum) and KAAI reduction was significantly larger with AFO than with LWI ( P = 0.001, P = 0.004). Conclusions: AFO reduces medial knee load more than LWI. Nevertheless, no clinical superiority of either of the two aids could be shown.

Sign in / Sign up

Export Citation Format

Share Document