Causes of Revision of Total Knee Arthroplasties in a Tertiary Hospital in Brazil.

 To identify the causes of revision of total knee arthroplasty in a referral center in Brazil.  This is a case series, with 80 patients undergoing revision surgery for total knee arthroplasty (RTKA) at a referral center for knee surgery, between August 2019 and November 2021, with a mean age of 69.6 years.

Accuracy of Serological Markers, Synovial Fluid, Microbiological Culture, and Histopathological Examination for Diagnosing Periprosthetic Knee Infection.

 This study assessed the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of serological tests, synovial fluid markers, microbiological tissue culture, and histopathological examination of the periprosthetic membrane in diagnosing periprosthetic knee infection.  This study is prospective, and it includes patients undergoing total knee arthroplasty revision surgery from November 2019 to December 2021. The analysis consisted of serological tests (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], and D-dimer), synovial fluid markers (leukocyte and polymorphonuclear cell counts), periprosthetic tissue culture, and histopathological examination of the periprosthetic membrane of all patients.

Microbiological Profile of Periprosthetic Knee Infections in a Brazilian Unified Health System Hospital Specialized in Highly Complex Orthopedic Surgeries.

 We studied the microbiological profile of periprosthetic knee infections treated in a Brazilian tertiary hospital.  The study included all patients undergoing revision surgery for total knee arthroplasty (RTKA) between November 2019 and December 2021, with a diagnosis of periprosthetic infection confirmed per the 2018 International Consensus Meeting (ICM) criteria.  Sixty-two patients had a periprosthetic joint infection (PJI) per the 2018 ICM criteria.

Midterm Radiographic Results and Reoperations of Tantalum Trabecular Metal Cones in Knee Arthroplasties.

 The management of bone loss represents a challenge in revisions of total knee arthroplasty (rTKA) and in complex primary total knee arthroplasties (TKAs). The purpose of the present study was to evaluate the midterm outcomes (5-year minimum follow-up) of knee reconstructions with tantalum trabecular metal (TM) cones on bone defects Anderson Orthopaedics Research Institute (AORI) 2 and 3.  A retrospective analysis of the medical records of patients operated on between July 2008 and November 2014 was performed, collecting the following data: age, gender, laterality, body mass index, etiology of arthrosis, comorbidities, AORI classification of bone defects, causes for revision, readmissions, reoperations, perioperative and postoperative complications, radiographic signs of osteointegration, and maintenance of the TM support.

EXTENSOR MECHANISM TRANSPLANTATION AFTER KNEE PROSTHESIS: 70-MONTH FOLLOW-UP.

Objective: This article reports the range of motion, failure rate, and complications of patients with extensor mechanism injury after total knee arthroplasty (TKA) treated with extensor mechanism allograft with mid-term follow-up.

Methods: Patients undergoing post-ATJ extensor mechanism transplantation from 2009 to 2018 were retrospectively evaluated. Demographics, the reason for transplantation, elapsed time from arthroplasty to transplantation, related surgical factors, immobilization time, range of motion, transplant failure, and complications were collected.

Cell-free Deoxyribonucleic Acid: A Potential Biomarker of Chronic Periprosthetic Knee Joint Infection.

Background: The correct diagnosis of a chronic periprosthetic joint infection (PJI) is a major challenge in clinical practice, with the "gold standard" for diagnosis yet to be established. Synovial fluid analysis has been proven to be a useful tool for that purpose. Cell-free DNA (cf-DNA) levels have been shown to be increased in several conditions such as cancer, trauma, and sepsis.

Infection after primary total knee arthroplasty: a randomized controlled prospective study of the addition of antibiotics to bone cement.

 The present prospective, randomized and controlled study was conducted with 286 patients submitted to primary total knee arthroplasty (TKA) with the objective of evaluating the efficacy of the addition of antibiotics to bone cement as a way to prevent post arthroplasty infection (PAI).  The patients were randomized into two groups: bone cement without antibiotic (No ATB, = 158) or cement with antibiotic (ATB, = 128), in which 2 g of vancomycin was added to 40 g of cement. The patients were followed up for 24 months after surgery.

Predictive Factors for Blood Transfusion after Total Knee Arthroplasty.

 The present paper aims to (1) verify the incidence and volume of blood transfusion among patients undergoing unilateral cemented total knee arthroplasty (TKA) in a single Brazilian reference center; (2) identify pre and perioperative variables to determine subjects with higher risk (i.e., predictive factors) for blood transfusion within 48 hours following surgery; (3) estimate the risk of blood transfusion during the first 48 hours after the procedure.

Bone Defects in Revision Total Knee Arthroplasty.

The increase in the number of revision total knee arthroplasty surgeries has been observed in recent years, worldwide, for several causes. In the United States, a 601% increase in the number of total knee arthroplasties, between 2005 and 2030, is estimated. Among the enormous challenges of this complex surgery, the adequate treatment of bone defects is essential to obtain satisfactory and lasting results.

Distal femoral cut in total knee arthroplasty in a Brazilian population.

Objective: To determine the ideal angle for making the distal femoral cut in total knee arthroplasty in a Brazilian population.

Methods: Panoramic radiographs of the lower limbs bearing weight from 79 patients (57 women and 22 men) were studied, totaling 107 knees with an indication for total knee arthroplasty. The femoral anatomical axis, femoral mechanical axis and cervical-diaphyseal angle were traced out.

Homologous structural graft for treatment of bone defect during knee revision arthroplasty.

Obtaining stable bone-implant interface, correct alignment of the components, proper balance of soft tissues' tension, maintenance of proper joint interline are fundamental principles for success in surgical revision total knee arthroplasty, which are only obtained with management bone deficiency. However, proper treatment of large defects remains unclear. The aim of this study was to evaluate the clinical and radiographic results of patients that had underwent revision surgery for total knee arthroplasty with use of structural grafts of musculoskeletal tissue bank in the period between January 2002 to December 2010 by the Knee Surgery Center of National Institute of Traumatology and Orthopaedics (INTO).