Patients undergoing revisions for total knee replacement malposition are younger and more often female: An analysis of data from the Dutch Arthroplasty register.

Background: The proportion of patients who are dissatisfied with the outcome following total knee replacement (TKR) is high. Malalignment is considered a probable cause for persistent pain, but whether this reason for revision could be the result of specific patient characteristics remains unclear. Therefore, we aim to assess whether specific patient characteristics are associated with revision for symptomatic TKR malalignment.

Prospective, observational study to evaluate the relation between patient-reported outcomes and component rotation in total knee replacement: protocol for the CRACK study.

Introduction: Total knee replacement (TKR) for osteoarthritis results in a satisfactory outcome in the majority of patients, although up to one in five patients may be dissatisfied with the outcome. Persistent pain is a main contributor to patient dissatisfaction, and femoral and tibial component malrotation have been identified as a potential cause for both persistent pain and patellofemoral problems. Based on the assumption that component malrotation is the causative factor for persistent pain, early revision for patients with symptomatic malrotated components has been advocated in the literature.

Patellar tendon shortening following patellofemoral joint replacement.

Purpose: Patellar tendon shortening may occur following patellofemoral joint replacement (PFJR). We hypothesized that patellar tendon shortening results in unfavourable patient-reported outcomes (PROs). The aim of this study was to determine the effect of patellar tendon shortening following PFJR on PROs.

Femoral component rotation in patellofemoral joint replacement.

Background: Clinical outcomes in patellofemoral joint replacement may be related to femoral component rotation. Assessment of rotational alignment is however difficult as patients with isolated patellofemoral osteoarthritis often have trochlear dysplasia. The use of the medial malleolus as a landmark to guide rotation has been suggested.

Preoperative characteristics of working-age patients undergoing total knee arthroplasty.

Objective: Total Knee Arthroplasty (TKA) is performed more in working-age (<65 years) patients. Until now, research in this patient population has been conducted mainly among retired (≥65 years) patients. Aim of this study was therefore to describe demographic, physical, psychological and social characteristics of working TKA patients and to subsequently compare these characteristics with retired TKA patients and the general population.

Patient Satisfaction and Functional Outcomes Following Secondary Patellar Resurfacing.

When secondary patellar resurfacing is performed, a uniformly and widely used scoring system that is validated for anterior knee pain caused by a retropatellar degeneration will give more insight into the results of this procedure. The cause of anterior knee pain following total knee arthroplasty (TKA) is not always related to the patella itself. Other causes have been identified, such as an insufficient posterior cruciate ligament in the case of a posterior cruciate-retaining TKA or an internally rotated femoral and/or tibial component.

Survival, clinical and radiological outcome of the Zweymüller SL/Bicon-Plus total hip arthroplasty: a 15-year follow-up study.

Aim: The primary aim of this study is to analyse the long-term results of the third generation of the "Zweymüller" total hip arthroplasty (THA) comprising the SL-Plus Stem and the Bicon-Plus cup.

Methods: We evaluated 208 patients with a SL/Bicon-Plus primary THA (218 hips). Survival analysis was performed with a follow-up of 13 to 15 years.

Femoral component rotation in patellofemoral joint replacement: a study protocol for a prospective observational study.

Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. The short and mid-term outcomes are related to malposition and unexplained pain. Whether external rotation of the femoral component in isolated patellofemoral joint replacement is required is unclear.

Secondary patellar resurfacing following total knee arthroplasty : A cohort study in fifty eight knees with a mean follow-up of thirty one months.

Purpose: If anterior knee pain (AKP) emerges or persists following total knee arthroplasty (TKA), secondary patellar resurfacing (SPR) may offer relief of AKP. The purpose of our study was to evaluate the mid-term clinical outcomes after secondary patellar resurfacing for persistent AKP. Secondary objectives were to correlate surgical outcomes with clinical and radiological parameters including 99 m-technetium bone scintigraphy.

Overstuffing in total knee replacement: no effect on clinical outcomes or anterior knee pain.

Purpose: With total knee replacement (TKR), correct sizing and rotational alignment are essential for good clinical outcomes. Overstuffing may result in loss of flexion and adversely affect the outcome of TKR. The purpose of this study was to correlate overstuffing with patient reported clinical outcomes and anterior knee pain (AKP).

HUMeral shaft fractures: measuring recovery after operative versus non-operative treatment (HUMMER): a multicenter comparative observational study.

Background: Fractures of the humeral shaft are associated with a profound temporary (and in the elderly sometimes even permanent) impairment of independence and quality of life. These fractures can be treated operatively or non-operatively, but the optimal tailored treatment is an unresolved problem. As no high-quality comparative randomized or observational studies are available, a recent Cochrane review concluded there is no evidence of sufficient scientific quality available to inform the decision to operate or not.

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature.

Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethylene wear rate than cemented acetabular components in total hip arthroplasty. We performed a systematic review of the peer-reviewed literature, comparing the wear rate in uncemented and cemented acetabular components in total hip arthroplasty.

Determinants of anterior knee pain following total knee replacement: a systematic review.

Purpose: Anterior knee pain (AKP) following total knee replacement (TKR) is both prevalent and clinically relevant. The purpose of this study was to systematically review the peer-reviewed literature, and to identify and assess the different modifiable and non-modifiable determinants that may be associated with the development of AKP in patients following primary TKR.

Methods: A systematic computerized database search (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Google Scholar) was performed in January 2012.

Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study.

Background: Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal femoral bone mineral density after patellofemoral joint replacement.

A dutch survey on circumpatellar electrocautery in total knee arthroplasty.

Introduction: Anterior knee pain following total knee arthroplasty is estimated to occur in 4-49% of patients. Some orthopedic surgeons use circumpatellar electrocautery (diathermy) to reduce the prevalence of postsurgical anterior knee pain; however, the extent of its use is unknown.

Materials And Methodology: In April 2009, a postal questionnaire was sent to all 98 departments of orthopedic surgery in The Netherlands.

Distal femoral bone mineral density decreases following patellofemoral arthroplasty: 1-year follow-up study of 14 patients.

Background: The bone mineral density (BMD) of the distal femur decreases by 16-36% within one year after total knee arthroplasty (TKA) because of the femoral component's stress-shielding effect. The aim of this prospective study was to determine the quantitative change from the baseline BMD in the distal femur 1 year after patellofemoral arthroplasty using dual-energy X-ray absorptiometry (DXA).

Methods: Between December 2007 and December 2008, 14 patients had patellofemoral arthroplasty for isolated patellofemoral osteoarthritis.

Isolated patellofemoral osteoarthritis.

Background And Purpose: The optimal treatment for isolated patellofemoral osteoarthritis is unclear at present. We systematically reviewed the highest level of available evidence on the nonoperative and operative treatment of isolated patellofemoral osteoarthritis to develop an evidenced-based discussion of treatment options.

Methods: A systematic computerized database search (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE (PubMed), and EMBASE) was performed in March 2009.

Patellofemoral arthroplasty for symptomatic nonunion after trochlear osteotomy for patellar instability: a case report.

Introduction: Patients with patellofemoral instability with trochlear dysplasia may be treated with trochlear osteotomy.

Case Presentation: We present a patient with patellofemoral instability treated with trochlear osteotomy. The procedure resulted in nonunion with painful bony impingement and isolated patellofemoral osteoarthritis.

Long-term outcomes of patellofemoral arthroplasty.

The purpose of this study was to correlate the long-term survival of patellofemoral arthroplasty with primary diagnosis, age, sex, and body mass index. One hundred eighty-five consecutive Richards type II patellofemoral arthroplasties were performed in 161 patients with isolated patellofemoral osteoarthritis. Diagnoses included primary patellofemoral osteoarthritis, posttraumatic patellofemoral osteoarthritis, and patellofemoral osteoarthritis with a previous realignment procedure for patellar subluxation or trochlear dysplasia.

Dissociation of mobile-bearing patellar component in low contact stress patellofemoral arthroplasty, its mechanism and management: two case reports.

Introduction: Isolated patellofemoral osteoarthritis can be treated with patellofemoral arthroplasty.

Case Presentation: We present two cases of isolated patellofemoral osteoarthritis treated with Low Contact Stress patellofemoral arthroplasty; in both cases the polyethylene mobile-bearing of the patellar component dissociated from the metal backing. One patient had a revision to a Richards patellofemoral prosthesis, and in the second patient the arthroplasty was converted to a total knee prosthesis because of clinically important femorotibial osteoarthritis.

Conversion of patellofemoral arthroplasty to total knee arthroplasty: A matched case-control study of 13 patients.

Background And Purpose: The long-term outcome of patellofemoral arthroplasty is related to progression of femorotibial osteoarthritis with need for conversion to total knee arthroplasty. We investigated whether prior patellofemoral arthroplasty compromises the results of total knee arthroplasty.

Methods: 13 patients who had had 14 Richards type II patellofemoral arthroplasties converted to total knee arthroplasty because of femorotibial osteoarthritis, were individually matched to a control group of 13 patients with 14 primary total knee arthroplasties.

Anterior cervical interbody fusion with a titanium box cage: early radiological assessment of fusion and subsidence.

Background Context: The use of stand-alone cervical interbody cages in anterior cervical discectomy with fusion (ACDF) has become popular, but high subsidence rates have been reported in the literature.

Purpose: The authors present short-term radiological results of a titanium box cage with regard to fusion and subsidence. Reliable fusion and lack of subsidence may influence long-term clinical results.