Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Sep 2011
ReviewHip replacement in the athlete: is there a role?
Sport and total hip arthroplasty (THA) have been regarded by many as being mutually exclusive. The primary indication for hip arthroplasty has always been pain. With advances in the technology surrounding hip replacement surgery and increasing patient expectations of what THA can offer, there is a growing demand for hip replacement with the aim of returning to sporting activity. The aim of this review article is to report the advances in hip replacement surgery that aim to make the procedure more suitable for the sporting individual and to summarise the literature on the subject of returning to sports after THA.
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Knee Surg Sports Traumatol Arthrosc · Sep 2011
Review Comparative StudyWhat are the factors of residual pain after uncomplicated TKA?
Residual pain during activities of daily living and/or at rest is a major cause of a patient's dissatisfaction after total knee arthroplasty (TKA). The management of a painful TKA, which has no obvious clinical or radiological explanation, requires further investigation with more sensitive imaging modalities (CT scan and bone scan) and hematological tests. It is often challenging for the physician to determine what level of pain warrants these more complex and expensive medical examinations. A precise knowledge of the natural history of postoperative pain following TKA is therefore of fundamental importance. ⋯ The identification of these high-risk patients is critical so that a surgeon can provide detailed preoperative education in order to give these patients a realistic expectation of their possible satisfaction following TKA.
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Knee Surg Sports Traumatol Arthrosc · Sep 2011
Comparative StudyExpectation, satisfaction and clinical outcome of patients after total knee arthroplasty.
There is a well-known difference between patients expectation, satisfaction and the measured clinical outcome in total knee arthroplasty (TKA). It has been hypothesized that higher expectation prior to surgery and higher satisfaction will show better clinical outcome according to well-established scoring systems, frequently used for assessment after TKA. ⋯ This study has shown that patient satisfaction correlates well with the clinical outcome according to the KSS, WOMAC and SF-36. The indication for TKA should consider the general health, emotional role and knee function of the patients as well in order to predict patient's outcome.
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Knee Surg Sports Traumatol Arthrosc · Sep 2011
Comparative StudyTreatment of periprosthetic femoral fractures of the knee.
We report a continuous series of periprosthetic femoral fractures after knee arthroplasty treated with a locking plate. We hypothesize that minimally invasive surgery and immediate weight-bearing improve functional recovery. ⋯ Osteosynthesis with a minimally invasive bridge-plating technique is effective in the treatment of periprosthetic, distal femoral fractures without component loosening. Immediate full weight-bearing is possible if certain rules are respected. The surgical management presented herein is beneficial for these challenging fractures, and it may help reduce the complication rate and improve functional outcome.
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Knee Surg Sports Traumatol Arthrosc · Sep 2011
Comparative StudyThe effect of femoral component rotation on the kinematics of the tibiofemoral and patellofemoral joints after total knee arthroplasty.
Complications after total knee arthroplasty (TKA) often involve the patellofemoral joint, and problems with patellar maltracking or lateral instability have sometimes been addressed by external rotation of the femoral component. This work sought to measure the changes of knee kinematics caused by TKA and then to optimise the restoration of both the patellofemoral and tibiofemoral joint kinematics, by variation of femoral component internal-external rotation. ⋯ It was concluded that femoral rotation alone could not restore all aspects of both patellar and tibial kinematics to normal with this specific implant. The clinical relevance of this is that it appears to be inadvisable to reposition the femoral component, in an attempt to improve patellar tracking, if that repositioning may then cause abnormal tibiofemoral kinematics. Further, the pattern of patellar tracking, with the type of TKA used in this study, could not be adjusted to normal by femoral component rotation.