Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 2013
Have bilateral total knee arthroplasties become safer? A population-based trend analysis.
Studies suggest a trend in the selection of younger and healthier individuals to undergo bilateral TKAs in an attempt to diminish the incidence of complications. It remains unclear whether this development has reduced overall perioperative morbidity and mortality. ⋯ Although a decreased incidence was seen for some major complications, others either remained unchanged or had an increased incidence when adjusted for length of stay. Future interventions should focus on reducing perioperative risk to improve patient safety.
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Clin. Orthop. Relat. Res. · Jan 2013
Which factors increase risk of malalignment of the hip-knee-ankle axis in TKA?
Computer navigation has improved accuracy and reduced the percentage of alignment outliers in TKA. However, the characteristics of outliers and the risk factors for limb malalignment after TKA are still unclear. ⋯ The presence of preoperative radiographic risk factors should alert the surgeon to increased chance of malalignment and every measure should be undertaken in such at-risk knees to ensure proper limb and component alignment and soft tissue balance.
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Clin. Orthop. Relat. Res. · Jan 2013
Postoperative alignment and ROM affect patient satisfaction after TKA.
Patient satisfaction has increasingly been recognized as an important measure after total knee arthroplasty (TKA). However, we do not know yet how and why the patients are satisfied or dissatisfied with TKA. ⋯ Most patients did not report symptoms, but they experienced difficulty with activities of daily living after TKA. Patient satisfaction is difficult to measure, but avoiding varus alignment and achieving better ROM appear to be important for increasing satisfaction and meeting expectations.
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Clin. Orthop. Relat. Res. · Jan 2013
Is posterior synovial plica excision necessary for refractory lateral epicondylitis of the elbow?
Arthroscopic treatments for lateral epicondylitis including débridement of the extensor carpi radialis brevis (ECRB) origin (Baker technique) or resection of the radiocapitellar synovial plica reportedly improve symptoms. However the etiology of the disease and the role of the plica remain unclear. ⋯ The addition of débridement of the posterior synovial fold did not appear to enhance either pain relief or function compared with the classic Baker technique without decortication.
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Clin. Orthop. Relat. Res. · Jan 2013
Is pain and dissatisfaction after TKA related to early-grade preoperative osteoarthritis?
There is growing evidence to suggest many patients experience pain and dissatisfaction after TKA. The relationship between preoperative osteoarthritis (OA) severity and postoperative pain and dissatisfaction after TKA has not been established. ⋯ A high percentage of patients referred for unexplained pain after TKA had early-grade osteoarthritis preoperatively. Patients undergoing TKA for less than Grade 3 or 4 OA should be informed that they may be at higher risk for persistent pain and dissatisfaction.