The Knee
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Comparative Study
Changes in bone mineral density of the distal femur after total knee arthroplasty: a 7-year DEXA follow-up comparing results between obese and nonobese patients.
Periprosthetic femoral bone mineral density (BMD, g/cm2) decreases after total knee arthroplasty (TKA) as a result of the stress-shielding phenomenon. It is not known whether obesity has an effect on this phenomenon or not. The aim of this study was to assess long-term periprosthetic BMD changes after TKA and compare whether there is a difference between obese and nonobese patients. ⋯ Periprosthetic bone loss around the femoral component continued for up to 7 years postoperatively. The loss of bone density was not associated with any negative clinical outcome in this study, but periprosthetic bone loss was of a smaller quantity in the obese which is probably due to higher weight induced stresses on bone.
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There are a limited number of studies related to quality of life and functional outcome after revision total knee arthroplasty (TKA). The present study aimed to identify predictors of functional outcome after revision TKA for aseptic failure. ⋯ Level II.
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The aim of the present study was to evaluate an isometric maximal voluntary contraction (MVC) force of the leg extensor muscles and its relationship with knee joint loading during gait prior and after total knee arthroplasty (TKA). ⋯ III (correlational study).
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Comparative Study
Does malrotation of components correlate with patient dissatisfaction following secondary patellar resurfacing?
The aim of our study was to identify whether there was any correlation between the outcome of secondary patellar resurfacing and malrotation of either the femoral or tibial component. ⋯ Level of Evidence III.
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Periprosthetic distal femur fracture after total knee arthroplasty due to the stress-shielding phenomenon is a challenging problem. Retrograde intramedullary nail (RIMN) or locking plate (LP) fixation with/without a strut allograft has been clinically used via less invasive stabilization surgery (LISS) for the treatment of these periprosthetic fractures. However, their biomechanical differences in construct stability and implant stress have not been extensively studied, especially for the osteoporotic femur. ⋯ The LP/allograft construct significantly stabilizes the fracture gap, reduces the implant stress, and serves as the recommended fixation for periprosthetic distal femur fracture.