Comparable bone penetration between antibiotic-loaded and plain bone cement in total knee arthroplasty.

Introduction: One of the main concerns around the use of antibiotic-loaded bone cement (ALBC) is the potential reduction in the mechanical properties of the cement when antibiotics are admixed. The purpose of this study was to determine whether there is a difference between plain cement and ALBC in terms of radiological intrusion into the bone in total knee arthroplasties (TKAs).

Methods: Prospective randomized study of 80 consecutive patients who underwent TKA.

Antibiotic-loaded bone cement is associated with a reduction of the risk of revision of total knee arthroplasty: Analysis of the Catalan Arthroplasty Register.

Purpose: The purpose of this study was to analyse the impact on peri-prosthetic joint infection (PJI) rate and prosthetic survival using antibiotic-loaded bone cement (ALBC) versus plain cement during total knee arthroplasty (TKA).

Methods: A retrospective cohort study was conducted. The main data source was the Catalan Arthroplasty Register (RACat).

The Use of Erythromycin and Colistin Cement in Total Knee Arthroplasty Does Not Reduce the Incidence of Infection: A Randomized Study in 2,893 Knees With a 9-year Average Follow-Up.

Background: One of the most severe complications of primary total knee arthroplasty (TKA) is prosthetic joint infection. Currently, the use of antibiotic-loaded cement for the prevention of infection is still controversial. The aim of the present study was to evaluate if the use of antibiotic-loaded cement reduces the infection rate in primary TKA in long-term follow-up (more than 5 years average follow-up).

The distal tibiofibular syndesmosis is a reliable landmark for 3° varus tibial resection in total knee arthroplasty: a radiological evaluation on 1296 cases.

Purpose: The purpose of this study was to evaluate the reproducibility and the accuracy of distal tibiofibular syndesmosis (DTFS) as landmark to perform controlled varus tibial resections during total knee arthroplasty (TKA). The hypothesis was that DTFS can be used to perform an accurate 3° varus tibial cut.

Methods: A retrospective analysis on a consecutive series of standard weightbearing full-length anteroposterior views of the lower limbs radiographic images was conducted.

Incidence, functional outcomes and cure rate of hematogenous infection in a 2,498 Total Knee Arthroplasties cohort.

Purpose: The primary aim of the present study is to report the late acute hematogenous (LAH) prosthetic joint infection (PJI) cure rate following Total knee arthroplasty (TKA) treated by means of debridement, antibiotics, and implant retention (DAIR) in a long-term follow-up. The secondary purpose is to report the functional outcomes at that follow-up and to compare them with a non-infected group.

Material And Methods: This study cohort consists of 2,498 TKA performed from September 2005 to April 2010 that had a minimum follow-up of 10 years.

Systematic lateral retinacular release does not reduce anterior knee pain after total knee arthroplasty with patellar resurfacing.

Purpose: The aim of this study was to assess the effect of systematic lateral retinacular release (LRR) on anterior knee pain (AKP), as well as its impact on the functional and radiological outcomes after total knee arthroplasty (TKA) with patellar resurfacing.

Methods: A prospective randomized study was designed. It included patients scheduled for a TKA procedure with patellar resurfacing, who were recruited and randomized into either the LRR group or the non-release group.

Patients lose weight after a total knee arthroplasty: myth or reality?

Background: Obesity is one of most discussed factors when assessing prosthetic knee surgery outcomes. Prior to the procedure, most patients perceive that their excessive weight is secondary to the low level of activity due to limiting knee pain.

Objectives: The main objective of this study was to assess whether patients undergoing total knee arthroplasty (TKA) lose weight after the procedure.

Preoperative muscle thickness influences muscle activation after arthroscopic knee surgery.

Purpose: The aim of this study was to compare the correlation between preoperative quadriceps femoris muscle thickness and postoperative neuromuscular activation and quadriceps femoris strength in patients with and without patellofemoral pain after arthroscopic partial meniscectomy.

Methods: A series of 120 patients were prospectively analysed in a longitudinal cohort study of patients scheduled for arthroscopic partial meniscectomy. The patellofemoral pain group included patients who developed anterior knee pain after surgery while the control group included those who had not done so.

Increased posterior translation but similar clinical outcomes using ultracongruent instead of posterior stabilized total knee arthroplasties in a prospective randomized trial.

Purpose: The aim of this study was to compare the posterior tibial translation after ultracongruent (UC) and posterior-stabilized (PS) total knee arthroplasty (TKA) with two different UC with different heights in the anterior lip, and two different PS designs. This study also aimed to compare the range of motion (ROM) and outcomes scores after the use of these TKA models. It was hypothesised less posterior tibial translation after PS than after UC TKA, and less posterior tibial translation with a higher anterior lip in the UC insert than with a lower one.

Adherence to a reliable PJI diagnostic protocol minimizes unsuspected positive cultures rate.

Background: The aim of the present study was to evaluate the incidence of unsuspected PJI when prosthetic revisions are thoroughly evaluated by PJI dedicated orthopedic surgeon before surgery. The hypothesis is that the incidence of unsuspected PJI is reduced by applying this protocol.

Methods: This is a historical cohort study carried out in one university hospital.

Patellofemoral Pain After Arthroscopy: Muscle Atrophy Is Not Everything.

Background: It remains unclear as to why patellofemoral pain (PFP) appears in some patients after knee arthroscopy and what influence the quadriceps muscle has on its onset.

Purpose: To compare muscle thickness, neuromuscular contractility, and quadriceps femoris muscle strength between patients who develop PFP after arthroscopic partial meniscectomy and a control group and to compare functional outcomes between these entities.

Study Design: Cohort study; Level of evidence, 3.

Proximal Tibiofibular Dislocation in Closing-Wedge High Tibial Osteotomy Increases the Risk of Medium and Long-Term Total Knee Replacement.

Proximal tibiofibular dislocation in closing-wedge high tibial osteotomy increases the risk of medium and long-term total knee replacement. : High tibial osteotomy is an effective treatment for medial osteoarthritis in young patients with varus knee. The lateral closing-wedge high tibial osteotomy (CWHTO) may be managed with tibiofibular dislocation (TFJD) or a fibular head osteotomy (FHO).

The technique of cement application has no influence on cement intrusion in total knee arthroplasty: randomized study comparing three different techniques.

Purpose: The aim of the study was to compare the distance of intrusion of the cement into the bone in different areas both in the femur and the tibia in vivo, measured in the radiograph after implanting a total knee arthroplasty (TKA) with three different cement techniques.

Methods: A prospective randomized study of 90 consecutive patients operated on at our institution with a cemented U2 Knee System TKA and medium viscosity Simplex P bone cement. After pulse lavage, the cement was applied on the bone surfaces (group 1), on the implant surfaces (group 2) or both on the bone and the implant surfaces (group 3).

Translation and validation of the new knee society knee scoring system into Spanish: Spanish KSS translation.

Purpose: The aim of the study was to translate and validate the English version of the 'Knee Society Knee Scoring System' developed in 2011 (2011 KSS) into Spanish. This new KSS version considers patient satisfaction and expectations before and after knee arthroplasty. Moreover, the questionnaire allows a better characterization of a younger and more diverse population.

Patellar denervation does not reduce post-operative anterior knee pain after primary total knee arthroplasty with patellar resurfacing.

Purpose: Anterior knee pain (AKP) is a frequent symptom after a total knee arthroplasty (TKA). Patellar denervation (PD) has been put forth as a technique to reduce this pain; however, its effects have not been assessed in combination with patellar resurfacing. The aim of this study is to evaluate the effect of PD on AKP and functional outcomes after TKA with patellar resurfacing.

Proximal Tibiofibular Dislocation in a Closing-Wedge High Tibial Osteotomy Causes Lateral Radiological Gapping of the Knee: A Prospective Randomized Study.

Background: To determine whether a proximal tibiofibular joint dislocation (TFJD) increases lateral compartment gapping more than a fibular head osteotomy (FHO) during a closing-wedge high tibial osteotomy (CWHTO). The second objective was to determine whether lateral compartment gapping affects clinical outcomes.

Methods: A prospective randomized clinical study was carried out that included 18 patients in Group 1 (FHO) and 18 in Group 2 (TFJD).

Limb length discrepancy after total knee arthroplasty may contribute to suboptimal functional results.

Purpose: Limb length discrepancy (LLD) has been related to inferior outcomes after total hip arthroplasty (THA), but few studies have dealt with the LLD in primary total knee arthroplasty (TKA). The aims of the study were to examine the incidence of LLD after TKA and how it can influence in the outcomes scores.

Methods: We analysed preoperative, postoperative and changes in LLD in 460 patients who underwent a unilateral primary TKA.

Barbed Sutures in Total Knee Arthroplasty: Are They Really Useful? A Randomized Controlled Trial.

Bidirectional barbed sutures (BBSs) have recently been investigated in total knee arthroplasty (TKA). The contrasting results from the scarce literature suggest that BBSs are safe, save time and money, and give results comparable to traditional sutures. The purpose of the study is to test the real effect of BBSs on closure time in TKA and assess the functional results as well as the complications related to them.

Pressure algometry is a suitable tool to assess anterior knee pain in osteoarthritic patients.

Purpose: Anterior knee pain is a frequent symptom in the osteoarthritic knee. Its intensity has been classically evaluated by the visual analogic score (VAS). The main objective of the study was to assess whether pressure algometry (PA) can be used as a reliable tool to quantify anterior pain in the osteoarthritic knee.

Contamination occurs during ACL graft harvesting and manipulation, but it can be easily eradicated.

Purpose: Why anterior cruciate ligament (ACL) autograft soaking in a 5 mg/ml vancomycin solution decreases the rate of infection has not been well-explained. One hypothesis is that grafts can be contaminated during harvesting and vancomycin eradicates the bacteria. The purpose of the present study is to assess how the vancomycin solution acts against ACL graft contamination during graft harvesting and preparation.

Depressed patients feel more pain in the short term after total knee arthroplasty.

Purpose: The hypothesis of this study was that depressive patients feel more pain in the immediate TKA postoperative period in comparison with non-depressed patients.

Methods: The diagnosis of depression was made with the Geriatric Depression Scale Short Form. The Visual Analogic Score (VAS) was registered each 8 h during the first 3 days.

Superficial wound infection does not cause inferior clinical outcome after TKA.

Purpose: Superficial wound infections do not lead to chronic prosthetic joint infection. Therefore, it has been hypothesized that a superficial infection of a surgical wound following a successfully treated TKA does not lead to a lower functional outcome at long-term follow-up. This may be due to early diagnosis and proper treatment without interrupting the rehabilitation programme.

Local infiltration analgesia adds no clinical benefit in pain control to peripheral nerve blocks after total knee arthroplasty.

Purpose: To evaluate the effect of the local infiltration of analgesics for pain after total knee arthroplasty in patients treated with femoral and sciatic peripheral nerve blocks. The secondary objective was to detect differences in analgesic consumption as well as blood loss after local infiltration of analgesics.

Methods: Prospective randomized double-blinded study in patients who underwent a TKA for knee osteoarthritis under spinal anesthesia and treated with femoral and sciatic nerve blocks.

Does Obesity Influence on the Functional Outcomes of a Total Knee Arthroplasty?

Background: The objective of this study was to compare the total knee arthroplasty (TKA) functional outcomes and quality of life of obese and non-obese patients.

Methods: Prospective comparative study, including all patients underwent TKA in a single centre. Patients were divided into three groups: Group 1 (Gr.

A new score assessing the surgical wound of a TKA and its relation with pain, infection and functional outcome.

Intra-osseous pin sites used in Computer Navigated knee Arthroplasty are known to cause complications including infection, neurovascular The aim of this study was to describe a new score to evaluate the clinical aspect of the TKA surgical wound and to correlate it with postoperative pain, infection and functional outcome at 1 year of follow-up. This score, ranging from 0 to 10, assessed 5 parameters; swelling, haematoma, erythema, blood drainage and blisters. One hundred fifty-nine consecutive TKA were prospectively evaluated.