Knee Replacement Arthroplasty (Subscribe)  

Questions/purposes We therefore determined if (1) the timeframe for return to driving, as determined by attainment of preoperative braking levels, would be shorter after contemporary right TKA than that reported previously for a traditional TKA; and (2) gender or age influence recovery of baseline response time.
Results All patients...

Questions/purposes We asked whether newer, modular distal femoral components had improved survivorship compared with older, custom-casted designs.
Conclusions Cemented modular rotating-hinge distal femoral endoprostheses demonstrated improved survivorship compared with custom-casted implants during this three-decade experience. Patients with low-grade disease and long-term survivors of high-grade localized disease should expect at least one or more...

Questions/purposes - (1) How long do proximal tibial endoprostheses last? (2) What is the typical long-term functional result after proximal tibial replacement? And (3) what are the short- and long-term complications associated with endoprosthetic reconstruction of the proximal tibia, particularly with respect to the soft tissue reconstruction?
Conclusions - Cemented endoprosthetic...

Study Objectives. To compare opioid requirements in opioid-tolerant and opioid-naïve patients after total knee arthroplasty, and to compare pain scores, sedation scores, and adverse effects between the groups.
Conclusion. After total knee arthroplasty, patients tolerant to opioids required significantly more opioids in the PACU and up to 48 hours after discharge...

Conclusion. When managed early, patients complicated with CRPS after TKA have a similar prognosis to patients with uncomplicated TKA.Complex regional pain syndrome complicating total knee arthroplasty
AWR Burns, DA Parker, MRJ Coolican, K Rajaratnam Journal of Orthopaedic Surgery 2006;14(3):280-3 full text

Total knee replacement has become an acceptable method of treating severe arthritis of the knee. The operative procedure must be performed with precise skill and accuracy. Meticulous alignment of the prosthetic components can reduce many of the complications.
Fine attention to general operating technique with adroit handling of tissues and efficient...

We sought to evaluate whether a fluoroscopic computer-assisted minimally invasive UKA procedure would improve the accuracy and precision in the placement of the femoral component in the coronal and sagittal planes compared with conventional surgery.
Conclusion: We cannot justify the additional expense and complexity imposed by fluoroscopic navigation despite the observed improvements in alignment precision. Improved...

Many of the factors associated with an increased incidence of postoperative Patellar Crepitus such as shortened patellar tendon length, use of smaller patellar components, decreased patellar composite thickness, and increased posterior femoral condylar offset may all increase quadriceps tendon contact forces against the superior aspect of the intercondylar box, increasing...

Intrathecal (IT) morphine provides excellent post-operative analgesia, but causes multiple side effects including nausea and vomiting (PONV), pruritus and respiratory depression, particularly at higher doses. The lowest effective dose of spinal morphine in patients undergoing total knee arthroplasty is not known.
We evaluated the analgesic efficacy and side effect profile of...

Questions/purposes We evaluated the diagnostic performance of four common laboratory tests, the synovial white blood cell count, differential, C-reactive protein, and erythrocyte sedimentation rate to detect infection in the first 6 weeks after primary TKA.
Conclusions With a cutoff of 27,800 cells/μL, synovial white blood cell count predicted infection...

Abstract No preferred test for diagnosis of periprosthetic joint infection exists, and the algorithm for the workup of patients suspected of infection remains unclear. The work group evaluated the available literature to determine the role of each diagnostic modality and devise a practical algorithm that allows physicians to reach diagnosis...

Clinical Follow up and survivorship analysis from the Royal Orthopaedic Hospital, Stanmore, UK Full Text JBJS B 69: 2; 276

The goal of this prospective, randomized, blinded trial was to determine if ligament balancing techniques for rotating platform TKA affect postoperative knee kinematics. Sixteen patients with unilateral rotating platform TKA consented to participate in this institutional review board approved study. Eight patients were randomly selected to receive ligament balancing with...

Surgical Technique Monograph
This publication sets forth procedural highlights for using Howmedica devices and instruments. It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments when and as required. The surgeon can refer...

Routine thromboprophylaxis following elective hip and knee replacement surgery remains a controversial topic. No one disputes that patients undergoing these surgical procedures are at risk for deep vein thrombosis. The combination of stasis, endothelial wall injury and hypercoagulability are almost routine following this type of hip and knee surgery. It...