Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Oct 2008
Randomized Controlled TrialMinimal invasive and computer assisted total knee replacement compared with the conventional technique: a prospective, randomised trial.
Minimal invasive surgery (MIS) in total knee replacement (TKR) has been favoured by several authors and the industry and is asked for by the patients. Computer assisted surgery (CAS) is proposed to support the surgeon in terms of postoperative leg alignment and implant orientation. To prove the hypothesis that MIS in TKR fastens early rehabilitation compared to the standard approach and that CAS-MIS in TKR improves accuracy in implant position compared to the freehand MIS and freehand standard technique, we performed a prospective, randomised short-term trial which was approved by the local ethic committee. ⋯ The clinical relevance of our results is that the benefit of the minimal invasive approach in TKR is still not proven and navigation improves postoperative accuracy of leg alignment and component orientation. Our study shows that for the group of patients included there is no statistically significant difference in early rehabilitation between MIS and the conventional approach based on the Knee Society and WOMAC Score. Using the CAS technique restoration of leg axis was more accurate.
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Knee Surg Sports Traumatol Arthrosc · Oct 2008
Case ReportsLateral ankle fracture with missed proximal tibiofibular joint instability (Maisonneuve injury).
We present a case of a soccer player who sustained a lateral ankle fracture and the associated proximal anterolateral tibiofibular joint instability (Maisonneuve injury) was overlooked. After a non-contact injury the (incomplete) diagnosis of a lateral malleolar fracture (type Weber B, AO 44-B1) was made and the patient was surgically treated with open reduction and internal fixation including a distal syndesmosis screw. ⋯ This case report emphasizes the importance of precise clinical examination for detection of a proximal tibiofibular joint instability. Restoration of a well functioning and stable proximal tibiofibular joint may be difficult to achieve in previously operated and missed instabilities.
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Knee Surg Sports Traumatol Arthrosc · Oct 2008
Comparative StudyParticipation in sporting activities following knee replacement: total versus unicompartmental.
Few studies have been published assessing patients sporting activity after total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA). Common concerns of patients undergoing TKA or UKA are whether they can continue with sporting activities after surgery. This study compares the sporting activity of TKA and UKA patients preoperatively and postoperatively. ⋯ A large proportion of patients in the TKA group did not return to sport which their surgeon would have expected them to including golf and bowls. Patients in the UKA group also took part in more sporting sessions and for a longer period of time than patients in the TKA group. Moreover, patients undergoing UKA also returned to sport more quickly than patients undergoing TKA.