The Knee
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Quadriceps and hamstrings weakness and co-activation are present following total knee arthroplasty (TKA) and may impair functional performance. How surgery and post-operative rehabilitation influence muscle activation during walking early after surgery is unclear. ⋯ Muscle strength, co-activation, and timing differed between patients and controls before and early after surgery. Rehabilitation to improve strength and muscle activation seems imperative to restore proper muscle firing patterns early after surgery.
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Review Meta Analysis Comparative Study
Comparison of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled and prospective cohort trials.
There has been much debate and controversy about the optimal regimen of tranexamic acid in primary total knee arthroplasty. The purpose of this study was to undertake a meta-analysis to compare the efficacy of topical and intravenous regimen of tranexamic acid in primary total knee arthroplasty. ⋯ II.
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There have been no studies evaluating the clinical results after repair of a radial tear in the posterior horn of the lateral meniscus (PHLM) using the FasT-Fix system. This study was undertaken to evaluate the clinical outcomes after repair of a radial tear in the PHLM using the FasT-Fix system in conjunction with anterior cruciate ligament (ACL) reconstruction. ⋯ Case series, Level IV.
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A recent proposed modification in surgical technique in total knee arthroplasty (TKA) has been the introduction of the "kinematically aligned" TKA, in which the angle and level of the posterior joint line of the femoral component and joint line of the tibial component are aligned to those of the "normal," pre-arthritic knee. The purpose of this study was to establish the relationship of the posterior femoral axis of the "kinematically aligned" total knee arthroplasty (TKA) to the traditional axes used to set femoral component rotation. ⋯ Using a kinematically aligned surgical technique internally rotates the posterior femoral axis relative to the transepicondylar axis, which significantly differs from current alignment instrument targets.
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Randomized Controlled Trial
The limited use of a tourniquet during total knee arthroplasty: a randomized controlled trial.
Total knee arthroplasty (TKA) is commonly performed using a tourniquet. However, some studies have reported that several complications were associated with the use of a tourniquet in TKA. In this study we investigate whether the limited use of a tourniquet in TKA would reduce complications and facilitate postoperative recovery. ⋯ Level I (Therapeutic).