The Knee
-
The analysis of the different operative reconstructions of patellar tendon ruptures has not been reported. A critical review of the existing literature was performed to identify the different operative techniques and the post-operative outcomes in acute, chronic and post-total knee arthroplasty (TKA) patellar tendon rupture repairs. ⋯ Acute surgical repair of a patellar tendon rupture using augmented primary repair is associated with the best post-operative outcomes. In chronic and post-TKA repair, autogeneous grafts produce best post-operative outcomes. Immediate post-operative mobilisation should be considered in all repairs. Future papers reporting on patellar operative repairs should have a standardised scoring method of functional outcome to allow more comprehensive comparison and evaluation.
-
Multicenter Study
How accurate are orthopedic surgeons in diagnosing periprosthetic joint infection after total knee arthroplasty?: A multicenter study.
The lack of standardized diagnostic criteria for periprosthetic joint infection (PJI) poses a challenge to accurate diagnosis of PJI. Recently, the Musculoskeletal Infection Society (MSIS) proposed diagnostic criteria for PJI. However, it is not known how well these proposed criteria accommodate real clinical scenarios. We determined what proportion of patients satisfied the MSIS criteria, and if MSIS criteria were not met, what other rationales were used to diagnose PJI. ⋯ The diagnosis of PJI was based on clinical suspicion in approximately one-third of cases. In this series, joint aspiration or histological analysis was not performed in a large number of patients. Thus, surgeons should perform joint fluid and histologic analysis to assure the accuracy of PJI diagnosis.
-
The purpose of this study is to elucidate how the rotational malalignment of prosthesis after total knee arthroplasty affects the rotational kinematics in a weight-bearing condition. ⋯ Rotational alignment of the tibial component affects the kinematic rotation of the replaced knee during a weight-bearing condition even though using a low-restricting designed surface, and the AP axis can be a reliable reference in determining rotational alignment for the tibial component.
-
Control of perioperative blood loss is important in total knee arthroplasty (TKA), especially cementless or hybrid TKA. There is increasing interest in the use of tranexamic acid (TXA) for this purpose, however, studies to date have mainly evaluated the effects of various TXA administration regimens on patients who have undergone cemented TKA. We sought to determine (1) whether administration of TXA reduces blood loss after hybrid TKA, and (2) whether an autologous blood reinfusion system is necessary in TKA patients who are treated with TXA. ⋯ Level II.