The Journal of arthroplasty
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Multicenter Study
Knee range of motion after total knee arthroplasty: how important is this as an outcome measure?
We investigated the relationship of knee range of motion (ROM) and function in a prospective, observational study of primary total knee arthroplasty (TKA). Preoperative and 12-month data were collected on 684 patients, including knee ROM, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function questionnaire scores, patient satisfaction, and perceived improvement in quality of life (QOL). ⋯ In linear regression models, WOMAC pain and function scores at 12 months were both correlates of patient satisfaction and perceived improvement in QOL (standardized beta>3.5; P<.0001), but knee flexion was not. For assessment of these outcomes, WOMAC function appears to be more important than knee flexion.
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Review Case Reports
Insufficiency subchondral fracture of the femoral head: report of 4 cases and review of the literature.
Insufficiency subchondral fractures are nontraumatic flattened lesions in the superolateral area of the femoral head, occurring in healthy adults. These lesions were recently described and are an infrequent cause of acute hip pain. ⋯ The etiology and the natural history of these rare lesions remain to be elucidated. These lesions should be differentiated from osteonecrosis and transient osteoporosis, because treatment and prognosis may differ.
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This study evaluated the mortality after total knee and hip arthroplasties by a single surgeon in a medium-volume university referral practice. For 610 knee arthroplasties, the in-hospital mortality rate was 0.16%, and overall, 2 patients (0.33%) died within the first 90 days. ⋯ For 1,108 total hip arthroplasties, the early in-hospital mortality rate was 0.18%, and overall 5 patients (0.45%) died within the first 90 days. For the entire group of arthroplasties, the overall mortality at 1 year and 2 years was significantly less (both P <.05) than the number of expected deaths in the general population.