Tibial polyethylene post fractures at ten-years in a bicruciate stabilised (BCS) total knee arthroplasty design.

Introduction: This short paper reports a potential emerging mode of failure in three patients with a bicruciate stabilised (BCS) total knee arthroplasty.

Methods: Three patients presented to our institution with late instability ten years after undergoing total knee arthroplasty (Journey BCS) and were asymptomatic up to this point. Retrieval analysis was performed by an external body commissioned by the NHS and all three cases were reported to the UK Medicines and Healthcare Products Regulatory Agency (MHRA).

Fifteen-year survival analysis of an oxidised zirconium total knee arthroplasty.

Background: Early studies have found Oxidised Zirconium (OxZr-Nb) total knee arthroplasties to have a low incidence of failure in young, high demand patients. Theoretically this is because they are low friction and hard wearing. However, there are a paucity of studies reporting on the outcome of these implants beyond ten years.

Short-Term functional comparison of three total knee arthroplasties-Journey II, Genesis II and Profix.

Aim Of The Study: To compare the outcomes of three knee arthroplasty design philosophies and surface tribology.• A zirconium-surfaced, bicruciate-stabilised implant designed to mimic kinematic movement and improve flexion and outcomes;• A cobalt-chrome surfaced, multi-radius design with built-in femoral external rotation to aid balancing and patella tracking through a deeper trochlea groove;• A zirconium-surfaced, single-radius implant designed on surface conformity, particularly within the patello-femoral joint.

Methods: 313 knee replacements - 103 103 and 107 - were statistically assessed at a minimum of 2 years using WOMAC, Oxford and SF-12 scores, and range of movement.

Cartilage debris and osteoarthritis risk factors influence gene expression in the synovium in end stage osteoarthritis.

Background: Gene expression in healthy synovium remains poorly characterised. Thus, synovial functional activity changes associated with osteoarthritis (OA) are difficult to define. This study sought to identify differentially expressed genes (DEG) of end-stage OA and assess the influence of OA risk factors on these DEG.

Histopathological dataset and demographic details of synovial tissues from patients with end-stage osteoarthritis, soft tissue and traumatic injuries of the knee.

Degradation of articular cartilage is the defining feature of end-stage osteoarthritis (OA) with osteophytes, subchondral sclerosis, malalignment and joint space narrowing being additional indicators of advanced disease. Obesity, older age and female gender are OA risk factors. Differing degrees of synovitis are observed in OA, soft tissue and traumatic injuries of the knee.

The impact of COVID-19 on foot and ankle surgery in a major trauma centre.

Introduction And Aims: COVID-19 has had a significant impact on orthopaedic surgery globally. This paper aims to evaluate the impact of COVID-19 on foot and ankle trauma in a major trauma centre.

Methods: A retrospective observational study of prospectively collected data was performed.

The Journey Bicruciate Knee Replacement: Design Modifications Yield Better Early Functional Results and Reduce Complications.

The Journey-I total knee replacement was designed to improve knee kinematics but had several complications including early dislocation. The Journey-II modification was introduced to reduce these while maintaining high function. To assess whether the modified Journey-II prosthesis has succeeded in its designers aims, we undertook an observational study of prospectively recorded data to analyze and compare the two knees.

The Medium-Term Survival Analysis of an All-Polyethylene Tibia in a Single-Series Cohort of Over 1000 Knees.

Background: Total knee arthroplasty is a successful elective orthopedic procedure with an increasing number being undertaken. Original knee arthroplasties used an all-polyethylene tibia; however, with concerns over tibial loosening, the trend moved toward the metal-backed variety. Modern designs providing more conformity and changes in manufacturing of the polyethylene make it an equivalent but cheaper option.

Validity of the International Prostate Symptoms Score in predicting urinary retention after joint replacement.

Postoperative urinary retention necessitating catheterization after major lower limb arthroplasty surgery adds to the patients' postoperative discomfort and increases the risk of urinary tract infection with potential risk of transient bacteraemia and seeding of infection to prosthetic joints. Preoperative evaluation of patients with lower urinary tract symptoms may help to identify at-risk patients and the International Prostate Symptoms Score (IPSS) has been used as a screening tool to quantify the severity of symptoms in males. A prospective cohort of 303 patients undergoing total hip or knee arthroplasty was evaluated using the IPSS.

Manipulation under anaesthetic following total knee arthroplasty: Predicting stiffness and outcome.

Purpose: A stiff total knee replacement can severely limit a patient's post-operative function, but there remain few prospective trials identifying those patients at risk, nor the efficacy of manipulation. We analysed our prospectively collected database to assess predictors of stiffness and outcomes following manipulation.

Methods: Using prospectively collected knee arthroplasty data, including preoperative and post-operative range of knee movement, SF-12 (physical and mental) and The Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores, patients requiring manipulation were compared to a matched group of patients not requiring manipulation, with a detailed statistical analysis undertaken to assess potential risk factors and the post-manipulation outcome.

Mid- to long-term survivorship of oxidised zirconium total knee replacements performed in patients under 50years of age.

Background: Oxidised zirconium has the wear properties of ceramic with the breakage resistance of metal. This results in less wear and is of benefit to younger, higher demand patients. We report the short- to mid-term survival of 103 Profix zirconium total knee replacements performed in patients under 50years of age at time of surgery.

Five year survival analysis of an oxidised zirconium total knee arthroplasty.

Background: Zirconium total knee arthroplasties theoretically have a low incidence of failure as they are low friction, hard wearing and hypoallergenic. We report the five year survival of 213 Profix zirconium total knee arthroplasties with a conforming all polyethylene tibial component.

Methods: Data was collected prospectively and multiple strict end points were used.

Ten-year survival analysis of the PFC total knee arthroplasty--a surgeon's first 99 replacements.

Ninety-seven patients with 99 total knee arthroplasties were operated on by a surgeon in the first 3 years of his surgical career. Complete survival data were available for all 99 knees. The cases were reviewed at a minimum of 10 years after their initial operation, but as 37 patients had died before reaching 10 years, the average follow-up was 8 years 8 months with a maximum of 12 years 4 months.