The journal of knee surgery
-
Multicenter Study
Adverse effects of increased body mass index and weight on survivorship of total knee arthroplasty and subsequent outcomes of revision TKA.
To investigate the effects of increased weight and body mass index (BMI) on total knee arthroplasty (TKA) survivorship and on functional outcomes and quality of life following revision TKA, a prospective cohort study of 291 consecutive revision TKA patients was performed. Average patient BMI was 32.3 +/- 7.7, and 57% of patients were obese (BMI > or = 30). The obese group was not significantly different from the nonobese group regarding reasons for prosthesis failure; however, they were more likely to experience certain comorbidities. ⋯ In regression analysis, BMI was a significant predictor of Short Form-36, WOMAC difficulty of function, and KSS. Weight and BMI have deleterious effects on the longevity of primary TKA and functional and quality of life outcomes following revision TKA. These findings indicate a need for more effective management of these patients.
-
Isolated anterior cruciate ligament (ACL) reconstruction may provide long-term symptom relief and improved function in patients with medial knee arthrosis and ACL-deficiency, while delaying or possibly eliminating the need for further surgical intervention. Fifty-three patients who had medial unicompartmental arthrosis and chronic ACL-deficient knees underwent ACL reconstruction alone. Subjective evaluation at mean 10 years postoperatively indicated statistically significant improvement compared to preoperative evaluation and better scores for patients who obtained normal knee range of motion. ⋯ Isolated ACL reconstruction provides long-term symptomatic pain relief, increased activity, and improved function. Anterior cruciate ligament reconstruction can effectively provide stability to the ACL-deficient knee with degenerative medial arthrosis without compromising range of motion or strength. Obtaining and maintaining full range of motion equal to the normal knee is important for the optimal result.
-
The purpose of this study was to evaluate the blood levels of patients preparing for total knee arthroplasty (TKA) who were enrolled in a preoperative autologous donation program. The charts and hospital records of 70 consecutive patients who underwent primary unilateral TKA between 2000 and 2002 were retrospectively reviewed. Study participants were instructed to donate one unit of blood approximately 4 weeks prior to surgery. ⋯ Postoperatively, the mean hemoglobin concentration in the recovery room was 11.6 g/dL and dropped to a nadir of 10.8 g/dL on postoperative day 3. Overall, 91% of patients required autologous blood transfusion following TKA but no patients required allogeneic blood transfusions. Preoperative autologous donation was associated with a decrease in preoperative hemoglobin levels and with a high rate of autologous transfusion based on clinical symptoms of postoperative anemia.