scholarly journals Early Experience with a Modern Generation Knee System: Average 2 Years’ Follow-up

2015 ◽  
Vol 5 (4) ◽  
Author(s):  
Thomas Paszicsnyek
Keyword(s):  
Oxford Knee Score ◽  
Knee Score ◽  
Patient Dissatisfaction ◽  
Kaplan Meier ◽  
Ligament Balance ◽  
American Knee Society Score ◽  
Valgus Instability ◽  
Total Knee ◽  
The Mean

Arthritis in the knee is a leading cause of pain and disability with total knee arthroplasty (TKA) often the treatment of choice after failure of more conservative treatments. TKA has been demonstrated to be one of the most successful procedures performed.  However, despite the good long-term survivorship rates, patient satisfaction is still an issue post TKA with over 20% of patients exhibiting patient dissatisfaction most commonly due to anterior knee pain (over 18-28% patients) and mediolateral or varus-valgus instability.  Recent studies have demonstrated that collateral ligament strains are altered post TKA which may lead to laxity and/or tightness of the ligaments resulting in patient discomfort, pain, stiffness and/or instability post TKA.  As a result, it may be beneficial to ensure ligamentous strains after TKA are similar or close to the native situation.  The purpose of this study was to evaluate the clinical and radiographic results of the Unity Knee™ Total Knee System (Corin Ltd, Cirencester, UK), a modern generation, single-radius total knee replacement (TKR) and its accompanying instrumentation which is designed to help maintain proper ligament balance and restore the medial jointline.  A total of 89 knees (89 patients) were implanted with the device in a single surgeon series.  All patients were assessed using the American Knee Society Score (AKSS), the Oxford Knee Score (OKS), and radiographs.  There was 1 revision due to infection and Kaplan-Meier survivorship was 98.9% at 2 years.  The mean AKSS knee score for the total cohort was 87.1 ± 7.98 and the mean Oxford Knee score was 45.89 + 3.69. Radiographic review found no signs of radiographic failure in any of the knees. This study demonstrates good survivorship, clinical, and radiographic results at 2 years for this TKR.

Routine Histopathological Analysis of the Synovium in Patients with Primary Total Knee Arthroplasty

2020 ◽  
Vol 34 (01) ◽  
pp. 115-120
Author(s):  
Ali Utkan ◽  
Emrah Caliskan ◽  
Batuhan Gencer ◽  
Bulent Ozkurt
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Primary Total Knee Arthroplasty ◽  
Histopathological Analysis ◽  
Knee Score ◽  
Total Knee ◽  
The Mean ◽  
Primary Total Knee

AbstractAlthough there are numerous studies about routine histopathological analysis during arthroplasty surgeries, most of them showed that new diagnoses have rarely been obtained as a result. The aim of this study was to evaluate the efficacy of routine pathological analyses of synovia resected during primary total knee arthroplasty in patients with osteoarthritis and its relevance in the treatment process. Of the 47 included patients who were followed up prospectively, 26 patients had clinical and histopathological concordant diagnoses and 21 patients had discrepant diagnoses. Oxford knee score and visual analogue score were performed for all the patients. Kallgren-Lawrence score was used for radiological analyses. The Mann-Whitney U test was used to examine the differences between the abnormally distributed variables. Mean age was 65.9 ± 4.3 years (range, 50–89 years) and mean follow-up time was 19 ± 7.8 months (range, 6–39 months). Grade IV gonarthrosis was found to be statistically lower in the discrepant group (p = 0.046). The mean preoperative Oxford knee score was 16.8 ± 2.3 (range, 2–23) and the mean postoperative Oxford knee score was 44.6 ± 1.8 (range, 27–48; p = 0.016). Postoperative Oxford knee scores and VAS were significantly increased in both the concordant and discrepant groups (p = 0.026 and p = 0.035, p = 0.019 and p = 0.039, respectively). Resection and histopathologic analyses of the hypertrophied and inflamed synovium encountered during primary arthroplasty procedure should be performed. This examination not only could provide crucial information that may influence the postoperative follow-up guidelines but also could help us to expand our knowledge and awareness of rare diseases that might yield osteoarthritis. The level of evidence for the study is level II.

The results of knee arthrodesis with dedicated modular intramedullary nail as a limb salvage procedure in infection complications of knee arthroplasty

2020 ◽  
Vol 86 (2) ◽  
pp. 33-38
Author(s):  
Marcin Para ◽  
◽  
Paweł Bartosz ◽  
Maciej Kogut ◽  
Gracjan Suchodolski ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Intramedullary Nail ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Knee Arthrodesis ◽  
Bone Contact ◽  
Total Knee ◽  
The Mean

Introduction. Complications after arthroplasty often result in irreversible disability. In some cases, for the extremity to be salvaged, permanent knee joint arthrodesis is a last-chance procedure. Modular implant design simplifies surgical technique and knee arthrodesis without bone-on-bone contact, immediately provides full weight bearing and restores limb length and alignment. Puropose. The aim of this article was to perform a clinical evaluation of patients after knee arthrodesis with a dedicated modular intramedullary nail without bone-on-bone contact after a failed infected total knee arthroplasty. Methods. Between 2017 and 2021, 17 patients were treated with knee arthrodesis with a modular nail after a septic complication of total knee arthroplasty. Clinical evaluation of 15 patients was obtained during a follow-up visit, including: the pain severity using the Visual Analog Scale (VAS), physical function using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Score, gait independence, and the shortening of the affected limb in relation to the other one. Results. The mean follow-up duration was 1.4 years. The group included 11 women and 4 men with an average of 69.3 (57–84) years. All nails were cemented. There was one recurrence of infection. The mean VAS pain score was 2.73, also 4 patients felt no pain at all. The average functional score on the WOMAC scale was 36.4 (14–60) and for the Oxford Knee Score was 26.5 (15–41). Each patient achieved an independent gait. All patients reported the necessity of use of crutches outside home. The average limb shortening was 2.05 cm (0.5–3.0). In addition, 14 of the 15 patients positively evaluated the procedure results and if they had to, they would again decide on this form of treatment. During follow-up, no complication or problems with implants used were observed. Conclusions. Knee arthrodesis with modular nail offers an acceptable functional result and gives a chance of salvaging a limb in complex septic complications of TKA.

Long-term trends in the Oxford knee score following total knee replacement

2013 ◽  
Vol 95-B (1) ◽  
pp. 45-51 ◽  
Author(s):  
D. P. Williams ◽  
C. M. Blakey ◽  
S. G. Hadfield ◽  
D. W. Murray ◽  
A. J. Price ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Knee Score ◽  
Score Following ◽  
Long Term Trends ◽  
Total Knee

The long-term impact of preoperative psychological distress on functional outcomes, quality of life, and patient satisfaction after total knee arthroplasty

2020 ◽  
Vol 102-B (7) ◽  
pp. 845-851 ◽  
Author(s):  
Graham S. Goh ◽  
Ming Han Lincoln Liow ◽  
You Wei Adriel Tay ◽  
Jerry Yongqiang Chen ◽  
Sheng Xu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Psychological Distress ◽  
Functional Outcomes ◽  
Knee Score ◽  
Sf 36 ◽  
Total Knee

Aims While patients with psychological distress have poorer short-term outcomes after total knee arthroplasty (TKA), their longer-term function is unknown. We aimed to 1) assess the influence of preoperative mental health status on long-term functional outcomes, quality of life, and patient satisfaction; and 2) analyze the change in mental health after TKA, in a cohort of patients with no history of mental health disorder, with a minimum of ten years’ follow-up. Methods Prospectively collected data of 122 patients undergoing primary unilateral TKA in 2006 were reviewed. Patients were assessed pre- and postoperatively at two and ten years using the Knee Society Knee Score (KSKS) and Function Score (KSFS); Oxford Knee Score (OKS); and the Mental (MCS) and Physical Component Summary (PCS) which were derived from the 36-Item Short-Form Health Survey questionnaire (SF-36). Patients were stratified into those with psychological distress (MCS < 50, n = 51) and those without (MCS ≥ 50, n = 71). Multiple regression was used to control for age, sex, BMI, Charlson Comorbidity Index (CCI), and baseline scores. The rate of expectation fulfilment and satisfaction was compared between patients with low and high MCS. Results There was no difference in the mean KSKS, KSFS, OKS, and SF-36 PCS at two years or ten years after TKA. Equal proportions of patients in each group attained the minimal clinically important difference for each score. Psychologically distressed patients had a comparable rate of satisfaction (91.8% (47/51) vs 97.1% (69/71); p = 0.193) and fulfilment of expectations (89.8% vs 97.1%; p = 0.094). The proportion of distressed patients declined from 41.8% preoperatively to 29.8% at final follow-up (p = 0.021), and their mean SF-36 MCS improved by 10.4 points (p < 0.001). Conclusion Patients with poor mental health undergoing TKA may experience long-term improvements in function and quality of life that are comparable to those experienced by their non-distressed counterparts. These patients also achieved a similar rate of satisfaction and expectation fulfilment. Undergoing TKA was associated with improvements in mental health in distressed patients, although this effect may be due to residual confounding. Cite this article: Bone Joint J 2020;102-B(7):845–851.

Functional outcome of single stage bilateral total knee replacement measured using oxford knee score

2019 ◽  
Vol 6 (2) ◽  
pp. 94-97 ◽  
Author(s):  
Krishnamoorthy Shriram ◽  
A.B. Govindaraj ◽  
A.N. Vivek ◽  
Sohanlal VijayKumar ◽  
M. Anand
Keyword(s):  
Total Knee Replacement ◽  
Functional Outcome ◽  
Knee Replacement ◽  
Oxford Knee Score ◽  
Single Stage ◽  
Knee Score ◽  
Total Knee ◽  
Bilateral Total Knee Replacement

CLINICAL AND RADIOLOGICAL RESULTS OF TOTAL KNEE REPLACEMENT USING PATIENT-SPECIFIC POSITIONING GUIDES WITH AT LEAST 5 YEARS OF FOLLOW-UP

2020 ◽  
pp. 2050020
Author(s):  
Xabier Foruria ◽  
Jesús Moreta ◽  
Carlos Jaramillo ◽  
Ane Anton ◽  
Isidoro Calvo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Knee Score ◽  
Conventional Instrumentation ◽  
Total Knee ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Coronal Malalignment

Objective: Patient-specific positioning guides have been designed to improve precision in total knee arthroplasty. The aim of this study is to evaluate the medium-term clinical and radiological outcomes with magnetic resonance imaging-based patient-specific positioning guides. Material and methods: We retrospectively reviewed patients from two centers treated with total knee arthroplasty performed with patient-specific positioning guides. We enrolled patients operated on between January 2011 and December 2013, with a minimum follow-up of 5 years. Preoperative and postoperative hip knee angle (HKA) and position of each component in the coronal plane were assessed. Overall malalignment was defined as an outlier of more than [Formula: see text] from the neutral mechanical axis and specific malalignment as when any component showed more than [Formula: see text] of deviation. Clinical outcomes were evaluated using the Hospital for Special Surgery (HSS) knee Score. Results: This study included 68 patients with a mean age of 72 years. The mean postoperative alignment (HKA) was [Formula: see text] and 26.5% of patients showed coronal malalignment [Formula: see text]. Regarding femoral components, 19.1% showed specific malalignment [Formula: see text], while 11.7% of tibial components were classified as outliers. The mean HSS Knee Score at final follow up was 89.2. Patients whose implants were mechanically aligned did not obtain better functional outcomes ([Formula: see text]). Conclusion: In our series, the use of patient-specific positioning guides resulted in a range of mechanical malalignment, similar to conventional instrumentation results reported in the literature.

scholarly journals Is constraint implant with metaphyseal sleeve a viable option for revision TKR with preoperative coronal plane instability and bone defect?

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092631
Author(s):  
Mun Chun Lai ◽  
Jerry Yongqiang Chen ◽  
Ming Han Lincoln Liow ◽  
Darren Keng Jin Tay ◽  
Ngai Nung Lo ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Bone Defect ◽  
Oxford Knee Score ◽  
Joint Line ◽  
Coronal Plane ◽  
Knee Score ◽  
Viable Option ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Total Knee

Background: Metaphyseal sleeves have been used as metaphyseal filling implants to address bone loss during revision total knee replacements (TKRs). This study aims to compare the 2-year clinical and radiological outcomes of constraint implant with bone defect and constraint implant without or minimal bone defect in revisions TKR with preoperative coronal plane instability. Materials and Methods: Seventeen cases of constraint implants with metaphyseal sleeve matched paired with 34 cases of constrained condylar knee (CCK) prosthesis. Age, gender, body mass index and aetiology for revision surgery were recorded. Clinical outcome measures included Knee Society Knee Score (KSKS), Knee Society Function Score (KSFS), Oxford Knee Score (OKS), physical component summary (PCS) and mental component summary (MCS). Radiological outcome measures included joint line changes, hip–knee–ankle angle (HKA), coronal femoral angle (CFA) and coronal tibial angle (CTA). Result: Patients in sleeve group showed significant improvement in KSKS, KSFS and OKS (38 ± 7, 35 ± 6 and 20 ± 2 points, respectively, p < 0.001), while they were 19 ± 3 and 6 ± 2 points for PCS and MCS, respectively ( p < 0.001 and p = 0.021). These postoperative scores after surgery were similar between the two groups at 6 months and 2 years. The sleeve provides comparable result in joint line restoration; the postoperative HKA, CFA and CTA were all comparable between the two groups. Conclusion: Metaphyseal sleeve with constraint implant is a viable option for revision TKR with preoperative coronal plane instability and significant bone defect. It is able to achieve similar clinical outcomes and joint line restoration compared to CCK prosthesis at 2-year follow-up.

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