Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jun 2018
Higher physical activity and lower pain levels before surgery predict non-improvement of knee pain 1 year after TKA.
The purpose of this study was to describe patterns of pain during the first year following total knee arthroplasty (TKA) and evaluate pre- and postoperative factors associated with pain and patient satisfaction at 1 year. It was hypothesized that more severe preoperative pain would be associated with more residual pain and lower patient satisfaction 1 year after surgery. ⋯ Prognostic study, Level II.
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Knee Surg Sports Traumatol Arthrosc · Jun 2018
Increased in vivo patellofemoral loading after total knee arthroplasty in resurfaced patellae.
The primary purpose of the study was to investigate if and how patellar bone tracer uptake (BTU) distribution in SPECT/CT is influenced by patellar resurfacing and the position of femoral and tibial TKA component position. ⋯ Based on the findings of the present study, patellar resurfacing is related to significantly higher BTU in the anterior parts of the patella and lower clinical outcomes. In light of these results, routine patellar resurfacing as part of a primary TKA might be reevaluated. SPECT/CT enables a precise localization of the BTU and might be considered as the ideal imaging modality for evaluation and investigate of patellofemoral disorders after TKA.
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Knee Surg Sports Traumatol Arthrosc · Jun 2018
Revision of partial knee to total knee arthroplasty with use of patient-specific instruments results in acceptable femoral rotation.
Patient-specific instruments (PSI) were initially developed for the alignment of both total knee- (TKA) and partial knee arthroplasty (PKA). We hypothesize that CT-based PSI for PKA-to-TKA revision surgery can restore biomechanical limb alignment and prosthetic component positioning in vivo as calculated pre-operatively, resulting in a limited percentages of outliers. ⋯ Prospective cohort study, Level II.
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Knee Surg Sports Traumatol Arthrosc · May 2018
Randomized Controlled TrialTwo doses of low-dose perioperative dexamethasone improve the clinical outcome after total knee arthroplasty: a randomized controlled study.
To study the clinical effect and safety of two doses of low-dose perioperative dexamethasone on pain and recovery after total knee arthroplasty. Methods A total of 108 patients were included in this randomized, double-blinded, placebo-controlled study. They received two doses of 10 mg IV dexamethasone (group Dexa) or IV isotonic saline (group Placebo). ⋯ Conclusions Administering two doses of low-dose perioperative dexamethasone for patients receiving total knee arthroplasty reduces postoperative CRP and IL-6 levels, provides additional analgesic effect, and reduces the PONV incidence and postoperative fatigue, without increasing the risk of early surgical wound infection and gastrointestinal haemorrhage. So two doses of low-dose perioperative dexamethasone are effective and safe for patients receiving TKA to decrease the inflammatory response, prevent PONV, relieve postoperative pain and fatigue, and enhance recovery. Level of evidence I.
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Knee Surg Sports Traumatol Arthrosc · May 2018
Ten-year patient-reported outcomes following total and minimally invasive unicompartmental knee arthroplasty: a propensity score-matched cohort analysis.
For patients with medial compartment arthritis who have failed non-operative treatment, either a total knee arthroplasty (TKA) or a unicompartmental knee arthroplasty (UKA) can be undertaken. This analysis considers how the choice between UKA and TKA affects long-term patient-reported outcome measures (PROMs). ⋯ II.