The Knee
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Prior literature suggests that opioid use prior to primary arthroplasty procedures results in increased risk for complication. Despite this, it is unknown whether preoperative opioid use increases risk following revision TKA. The purpose of this study was to examine this relationship. ⋯ Preoperative opioid use preceding revision TKA is common and is associated with complications following surgery. An opioid holiday appears to provide risk reduction and suggests that opioid use may be a modifiable risk factor.
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Unicompartmental knee arthroplasty (UKA) accounts for 8.9% of knee arthroplasty procedures in England, Wales and Northern Ireland. Fixed bearing UKA designs have shown favourable survivorship in registries when compared with mobile bearings but some studies suggest poor survival of all-polyethylene fixed tibial bearings. This study analyses long-term follow-up of patients with a medial fixed all-polyethylene tibial bearing UKA and reports survivorship and 10-year clinical outcomes. ⋯ Medial fixed all-polyethylene tibial bearing UKA demonstrates acceptable long-term survivorship and patient outcomes. It appears to be a suitable option for the treatment of medial compartment OA, particularly in older patients.
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The aim of this study was to compare the functional outcomes and recurrence rate of infection between patients who underwent arthroscopic surgery and two-stage total knee arthroplasty (TKA) for infected arthritic knees. ⋯ Considering infection control and functional outcomes, two-stage TKA using ACS can be an effective alternative treatment for patients with infected arthritic knees.
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Medial compartment stability is important in total knee arthroplasty. The medial stabilizing technique (MST) has been proposed to achieve medial stability without excessive medial soft tissue release in total knee arthroplasty. Herein, we compare the MST and the gap-balancing technique (GBT) in navigated total knee arthroplasty. ⋯ The MST could avoid knee joint line changes and might increase postoperative range of motion. Although the MST permitted a discrepancy between medial and lateral gaps, no patients felt knee instability. The MST might improve the results of total knee arthroplasty.