Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jul 2011
Review Meta AnalysisTourniquet use in total knee arthroplasty: a meta-analysis.
The use of an intraoperative tourniquet for total knee arthroplasty (TKA) is a common practice. However, the effectiveness and safety are still questionable. A systematic review was conducted to examine that whether using a tourniquet in TKA was effective without increasing the risk of complications. ⋯ The current evidence suggested that using tourniquet in TKA may save time but may not reduce the blood loss. Due to the higher risks of thromboembolic complications, we should use a tourniquet in TKA with caution.
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Knee Surg Sports Traumatol Arthrosc · Jul 2011
Clinical TrialThe impact of a rectangular or trapezoidal flexion gap on the femoral component rotation in TKA.
The influence of soft tissue balancing on femoral component rotation in the gap technique remains unclear. The present study therefore compared the reliability of femoral component rotation determined by rectangular and trapezoidal gaps in total knee arthroplasty (TKA) using a navigation-assisted gap-balancing technique. The study also determined the correlation between femoral component rotation and gap measurement. ⋯ In the gap technique, the rotation of the femoral component is affected more by the flexion gap than by the extension gap. However, neither the trapezoidal nor rectangular flexion gap influenced femoral component rotation.
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Knee Surg Sports Traumatol Arthrosc · Jul 2011
Comparative StudyAxial and torsional stability of an improved single-plane and a new bi-plane osteotomy technique for supracondylar femur osteotomies.
An important disadvantage of the standard medial closing-wedge distal femur osteotomy for lateral compartment osteoarthritis of the knee is the immediate effects on the extensor mechanism function. Therefore, a novel bi-plane osteotomy technique was developed. The stability and stiffness of this newly developed technique and a modification of the proximal screw configuration were tested in a composite femur model and compared to the standard single-plane technique. Research question was if the new bi-plane technique and/or modified screw configuration would improve the stability and stiffness of the construct. ⋯ In replicate femurs, the new bi-plane technique improved axial stability, but in contrast to what was theorized, decreased torsional stability, compared to the single-plane technique. The addition of a bi-cortical screw proximally improved stability under axial loading, but not torsion. Further clinical testing will have to prove if early full weight bearing using the new bi-plane technique is possible.
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Knee Surg Sports Traumatol Arthrosc · Jun 2011
Comparative StudyClinical and radiographic outcomes of minimally invasive total knee arthroplasty through a lateral approach.
With increasing confidence and surgical experience, minimally invasive surgery (MIS) in total knee arthroplasty (TKA) is now being applied to more complicated cases. The present study assessed the feasibility of MIS-TKA using a lateral approach for valgus knees. ⋯ From the perspectives of postoperative pain, clinical scores, radiographic accuracy, and postoperative complication rate, lateral MIS-TKA achieved comparable or superior results to medial MIS-TKA. This technique may offer a promising technical option that can be utilized for most patients with valgus knee deformity.
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Knee Surg Sports Traumatol Arthrosc · Jun 2011
Comparative StudyEfficient strategy for controlling postoperative hemorrhage in total knee arthroplasty.
The objective of the present study was to compare the intraoperative use of tranexamic acid (TNA) plus intra-articular diluted-epinephrine (DEP) with preoperative autologous blood donations and transfusions in reducing an allogeneic blood transfusion (ABT) in primary unilateral total knee arthroplasty (TKA). ⋯ The results of the study showed that the TNA plus DEP combination exerted a comparable effect with preoperative autologous blood transfusion in avoiding ABTs in unilateral primary TKA. Considering several problems of preoperative autologous blood donation, the use of TNA plus DEP is recommended. In addition, it is highly possible that allogeneic blood transfusions can be avoided for patients with preoperative Hb values≥10.5 using the method described in this study, and the need for preoperative autologous blood donations can be decreased.