The Knee
-
Clinical Trial
Knee proprioception following ACL reconstruction; a prospective trial comparing hamstrings with bone-patellar tendon-bone autograft.
We prospectively studied knee proprioception following ACL reconstruction in 40 patients (34 men and six women; mean age 31 years). The patients were allocated into two equal groups; group A underwent reconstruction using hamstrings autograft, and group B underwent reconstruction using bone-patellar tendon-bone autograft. Proprioception was assessed in flexion and extension by the joint position sense (JPS) at 15°, 45° and 75°, and time threshold to detection of passive motion (TTDPM) at 15° and 45°, preoperatively and at 3, 6 and 12 months postoperatively. ⋯ No statistical difference was found between the ACL-operated and the contralateral knees in TTDPM 15° at 6 and 12 months, nor regarding TTDPM 45° at 3, 6 and 12 months, in group A. No statistical difference was found in JPS and TTDPM between the two grafts, at any time period. Knee proprioception returned to normal with ACL reconstruction at 6 months postoperatively, without any statistically significant difference between the autografts used.
-
Comparative Study
The prevalence of cognitive dysfunction after conventional and computer-assisted total knee replacement.
Post operative cognitive dysfunction (POCD) is common following lower limb arthroplasty. The prevalence varies from 41-75% at 7 days to 18-45% at 3 months post operatively. The wide range of prevalence is due to inconsistencies in defining and quantifying POCD. ⋯ The cause is undoubtedly multi-factorial; however we have demonstrated that procedure time may be a contributing factor. Our results suggest that using an intra-medullary femoral jig has no effect on POCD. Further research into the cognitive effects following TKR with and without a tourniquet would be of benefit.
-
Case Reports
Medial patellofemoral ligament reconstruction for subluxating patellofemoral arthroplasty.
Patellofemoral joint (PFJ) arthroplasty has become a successful operation for patellofemoral osteoarthritis. The post-operative complication of patella subluxation is uncommon. We report the stabilisation of a subluxating patella following PFJ arthroplasty using autogenous hamstring tendons. Medial patellofemoral ligament reconstruction may be considered a method of stabilising a subluxating patellofemoral replacement in patients for whom revision arthroplasty is not recommended.