Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Oct 2016
The C-reactive protein level after total knee arthroplasty is gender specific.
Laboratory diagnostics are part of the routine before and after operations. In all specialist surgical disciplines, including orthopaedic surgery, the acute-phase protein CRP is used to detect inflammatory processes, especially infections. The potential influence of patient gender on the postoperative course of CRP after TKA implantation is still unclear. In order to achieve a more precise evaluation of the complication-free general CRP course after TKA, the objective of the present study is to test the hypothesis that the p.o. course and level of CRP is gender specific in the first 10 days after TKA. ⋯ The present study was able to show, for the first time, that the complication-free course of CRP in the first 10 days after TKA implantation is gender specific. The impact of the finding on diagnostic is that the gender-specific CRP course provides a more precise evaluation of the complication-free course of CRP after TKA. These results have clinical relevance to the interpretation of postoperative CRP values in order to avoid unnecessary investigations such as puncture or surgical care in female and male patients with uncomplicated TKA. Level of evidence Diagnostic study, III.
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Knee Surg Sports Traumatol Arthrosc · Oct 2016
Randomized Controlled TrialLocal infiltration analgesia adds no clinical benefit in pain control to peripheral nerve blocks after total knee arthroplasty.
To evaluate the effect of the local infiltration of analgesics for pain after total knee arthroplasty in patients treated with femoral and sciatic peripheral nerve blocks. The secondary objective was to detect differences in analgesic consumption as well as blood loss after local infiltration of analgesics. ⋯ I.
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Knee Surg Sports Traumatol Arthrosc · Oct 2016
Modified fixations for distal femur fractures following total knee arthroplasty: a biomechanical and clinical relevance study.
Distal femur fractures adjacent to total knee arthroplasty are a rare yet complex problem. Recently, extramedullary locking plate and retrograde intramedullary nail fixations have become popular options, but the complication rates associated with these procedures are 15-20 %. Modified fixations were assessed in an effort to reduce complications from unstable periprosthetic fractures. ⋯ The spiral-blade supplement of retrograde intramedullary nail and locking plate/allograft modified constructs significantly stabilizes the unstable fractured gaps. The locking plate/allograft is recommended for the periprosthetic fractures with deficient bone stock and severe osteoporosis to improve alignment and healing potentials.
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Knee Surg Sports Traumatol Arthrosc · Oct 2016
Patient kinesiophobia affects both recovery time and final outcome after total knee arthroplasty.
To evaluate the effects of kinesiophobia on both phases immediately after surgery and the final results after total knee arthroplasty (TKA). ⋯ IV.
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Knee Surg Sports Traumatol Arthrosc · Oct 2016
Balancing UKA: overstuffing leads to high medial collateral ligament strains.
Balancing unicondylar knee arthroplasty (UKA) is challenging. If not performed properly, it may lead to implant loosening or progression of osteoarthritis in the preserved compartment. This study was aimed to document the biomechanical effects of improper balancing. We hypothesised that overstuffing would lead to more valgus, higher strain in the medial collateral ligament (sMCL), and higher lateral contact force. ⋯ The first two hypotheses were confirmed, but not the latter. This underlines the importance of optimal balancing. Overstuffing should certainly be avoided. Although kinematics is only slightly affected, contact forces and ligament strains are considerably changed and this might be of more clinical importance. It is advisable to use thinner inlays, if stability is not compromised.