The Knee
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Patellar malalignment is thought to be an etiological factor with respect to the development of patellofemoral pain. Although previous studies have suggested that the geometry of the femoral trochlea and the height of the patella play an important role in determining patellar alignment, no investigation has systematically examined these relationships during weight bearing. The aim of this study was to determine whether patellar height and/or trochlear geometry predicts patellar alignment (lateral patellar displacement and lateral patellar tilt) during weight bearing. ⋯ Level III.
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Comparative Study
Patellar resurfacing versus no resurfacing in two-stage revision of infected total knee arthroplasty.
Cartilage debridement and staged reimplantation are the most common treatments for infected total knee arthroplasty (TKA). Very few studies have focused on the management of primarily non-resurfaced patellae in infected TKA. The purpose of this study was to compare the outcomes of patellar resurfacing and non-resurfacing in two-stage revision of infected TKA. ⋯ Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Comparative Study
Oxidative stress and inflammatory responses following an acute bout of isokinetic exercise in obese women with knee osteoarthritis.
Obesity is associated with osteoarthritis and it is accompanied by chronic inflammation and elevated oxidative stress. Strengthening-type exercise is used in knee osteoarthritis (KOA) rehabilitation. This study determined how acute isokinetic exercise influences inflammatory responses of obese middle-aged women with KOA. ⋯ Isokinetic exercise produces minimal inflammation and pain in knee osteoarthritis patients, could be performed every 48h during rehabilitation, and up-regulates patients' antioxidant system.
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Review Meta Analysis Comparative Study
Does cruciate-retaining total knee arthroplasty enhance knee flexion in Western and East Asian patient populations? A meta-analysis.
This study analyzed the published data to examine if CR TKAs can enhance the flexion and functional outcomes of the knee in the Western and East Asian populations using a meta-analysis approach. ⋯ The meta-analysis indicated that contemporary CR TKAs have not been shown to enhance post-operative flexion capability in the Western and East Asian. The extension angles of the knee and the knee scores were significantly improved in both populations.
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Despite the excellent total knee arthroplasty (TKA) results reported using traditional outcome measures, dissatisfaction rates of up to 30% are reported following surgery. Although several preoperative factors have been identified as possible predictors of satisfaction, there is conflicting evidence. Identification of dissatisfaction in the early postoperative assessment may therefore be an alternative consideration. ⋯ Dissatisfaction following TKA is associated with worse outcomes as early as 3months following surgery, with minimal further improvement subsequently achieved at 12-months. Early postoperative assessment following TKA should therefore be considered, including clinical assessment, to identify those patients at risk of dissatisfaction.