Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Randomized Controlled Trial Comparative StudyBetter quadriceps recovery after minimally invasive total knee arthroplasty.
The proponents of minimally invasive total knee arthroplasty (TKA) have reported better functional recovery than conventional TKA. In most of the previous studies, the results were shown with the relatively subjective methods. We investigated the objective results with a dynamometry in this prospective randomized study. It was hypothesized that minimally invasive TKA would have a better and earlier recovery of quadriceps force in terms of the objective numeric data. ⋯ Minimally invasive TKA has benefit in quadriceps recovery at earlier rehabilitation period although catch-up recovery in conventional TKA was accelerated from the postoperative 6 weeks to 3 months. It may support the concept of early return to full activity after minimally invasive TKA, and patients might get back early to normal life.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
ReviewPractical issues for the use of tranexamic acid in total knee arthroplasty: a systematic review.
This systematic review was undertaken to answer three specific questions relating to the clinical values of tranexamic acid (TNA) in total knee arthroplasty (TKA): (1) Whether there are differences in blood-saving effects between the systemic and topical administrations; (2) Whether blood-saving effects of TNA differ by doses and timings of administration; and (3) Whether the use of TNA is safe at all reported doses, timings, and routes of administration with respect to the incidences of symptomatic deep-vein thrombosis (DVT) and pulmonary embolism (PE). ⋯ Surgeons can consider incorporating the use of TNA to their blood-saving protocols in TKA without serious concern of adverse events but need to adopt optimal doses, timings, and routes of TNA administrations.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
UKA closely preserves natural knee kinematics in vitro.
It is assumed that unicondylar knee arthroplasty (UKA) features kinematics close to the natural knee. Clinical studies have also shown functional benefits for UKA. There is to date only little biomechanical data to support or explain these findings. The purpose of this study was to investigate whether UKA is able to preserve natural knee kinematics or not. ⋯ As ligaments, lateral compartment and patellofemoral anatomy are preserved with UKA; the unloaded knee closely resembles native kinematics. The slight kinematic changes that were found under load are probably due to loss of the conforming medial meniscus and to the mismatch in geometry and stiffness introduced by UKA. These patterns resemble those found in knees with significant loss of function of the medial meniscus.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
Randomized Controlled TrialNo difference in blood loss between posterior-cruciate-ligament-retaining and posterior-cruciate-ligament-stabilized total knee arthroplasties.
Posterior-cruciate-ligament-retaining (PCR) and posterior-cruciate-ligament-stabilized (PS) arthroplasties are two major common practices in total knee arthroplasty (TKA). The hypothesis of the present study was that compared with the PCR technique, the PS technique is associated with a higher amount of postoperative blood loss and greater need for blood transfusion in cemented TKA. ⋯ Use of the PS technique during cemented TKA does not appear to influence the amount of perioperative blood loss or the need for postoperative blood transfusion in general. The clinical relevance of this study is that the difference in blood loss between the PCR and PS techniques does not need to be considered by surgeons when performing TKA.
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Knee Surg Sports Traumatol Arthrosc · Aug 2014
The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty.
The aim of this study was to identify the minimal clinically important difference (MCID) in the Oxford knee score (OKS) and Short Form (SF-) 12 score after total knee arthroplasty (TKA). ⋯ The MCID identified for the OKS and SF-12 physical component score after TKA is the best available estimate and can be used to power studies and ensure that a statistical difference is also recognised by a patient.