Gap balanced adjusted mechanical alignment versus measured resection mechanical alignment: a randomised controlled trial.

Introduction: Alignment goals in total knee replacement (TKR) is a topical subject. This study compares the short-term functional outcomes and patient reported outcome measures (PROMs) of two philosophies for knee arthroplasty alignment: measured resection (MR) and an individualised alignment philosophy, with the tibia mechanically aligned and an instrumented gap balancer (GB) to align the femur in both flexion and extension.

Patients And Methods: 94 knees were enrolled in this randomised controlled trial.

Robotic-Assisted Patellofemoral Replacement-Correlation of Preoperative Planning with Intraoperative Implant Position and Early Clinical Experience: A Minimum 2-Year Follow-up.

Patello-femoral arthroplasty (PFA) is successful in a selected group of patients and yields a good functional outcome. Robotic-assisted knee arthroplasty has been shown to provide better implant positioning and alignment. We aim to report our early outcomes and to compare Mako's (Robotic Arm Interactive Orthopaedic System [RIO]) preoperative implant planning position to our intraoperative PFA implant position.

A Randomised Controlled Trial of Local Infiltration Analgesia Versus Femoral Nerve Block for Postoperative Analgesia Following Total Knee Arthroplasty.

Background Total knee replacement is often associated with significant postoperative pain. Although the use of a femoral nerve block is well-established, local infiltration analgesia has gained popularity in recent years. We compared single-shot local infiltration analgesia with a single-shot femoral nerve block for patients undergoing primary total knee arthroplasty.

The Exeter Knee Infection Multi Disciplinary Team approach to managing prosthetic knee infections: A qualitative analysis.

Background: A Knee Infection Multi-Disciplinary Team meeting was established in Exeter. This study was designed to qualitatively evaluate the impact of the MDT on those involved.

Materials And Methods: Semi-structured interviews of all members of the MDT at Exeter were undertaken and analysed using Nvivo software.

Patients' Perception of Bone and Tissue Excision, and the Size and Weight of Prostheses at Total Knee Arthroplasty.

The aim of this study is to ascertain patients' perception of the amount of bone and tissue excision and size and weight of their implanted prostheses at total knee arthroplasty (TKA). To our knowledge, no prior study in the English orthopaedic literature has analyzed these parameters against patient perception of TKA. In a prospective study of eight consecutive TKA (six primary and two single-stage revision TKA procedures) by a single surgeon, patients estimated the weight of their implanted knee.

Apparent Skin Discoloration about the Knee Joint: A Rare Sequela of Metallosis after Total Knee Replacement.

Introduction. Metallosis is a phenomenon most commonly associated with hip replacement. However it can occur in any metallic implant subject to wear.

Periprosthetic fractures in the distal femur following total knee replacement: A review and guide to management.

The management of distal femoral fractures following a total knee replacement can be complex and requires the equipment, perioperative support and surgical skills of both trauma and revision arthroplasty services. Recent advances in implant technology have changed the management options of these difficult fractures. This article describes the options available and discusses the latest evidence.

The use of radiofrequency energy for arthroscopic chondroplasty in the knee.

We present a review of the current literature surrounding the use of radiofrequency energy for arthroscopic chondroplasty in the knee. This review article summarizes basic science, clinical efficacy, and recent advances in the understanding of radiofrequency energy use for the treatment of chondral lesions. Laboratory evidence of increased mechanical stability and decreased release of inflammatory mediators associated with the use of radiofrequency energy chondroplasty is described with clinical evidence of decreased pain and increased functional scores when compared with mechanical chondroplasty.

The value of magnetic resonance imaging in investigating a painful total knee arthroplasty.

This case describes a rare cause of pain around a total knee arthroplasty and highlights the importance of a structured approach to the investigation of these patients. Magnetic resonance imaging provided detailed information about the cause of pain despite the presence of a prosthetic joint, and the pathology, primary non-Hodgkin lymphoma, was treated without the need for further surgical intervention.

Pasteurella abscess in tibial regenerate bone: a case report.

Although superficial pin tract infections during limb lengthening are extremely common, most settle spontaneously or with antibiotics. In contrast, deep infection around pin tracts leading to osteomyelitis and abscess formation is much less frequently observed and may need washout and curettage. We report a case of a 10-year-old boy who presented with latent abscess formation at a tibial lengthening site because of Pasteurella, a rare bacterial cause of infection usually associated with animals.

Hyponatraemia after orthopaedic surgery - a case of pituitary apoplexy.

We describe a case of profound hyponatraemia in a postoperative patient after total hip replacement caused by corticosteroid insufficiency due to a non-functioning pituitary macroadenoma diagnosed by dynamic endocrine tests and radiological imaging. Adopting a multidisciplinary approach, successful diagnosis and management lead to a complete recovery without any long-term sequelae.

A technical innovation for improving identification of the trackers by the LED cameras in navigation-assisted total knee arthroplasty.

Objective: To reduce the operating time in computer-assisted navigated total knee replacement (TKR), by improving communication between the infrared camera and the trackers placed on the patient.

Materials And Methods: The innovation involves placing a routinely used laser pointer on top of the camera, so that the infrared cameras focus precisely on the trackers located on the knee to be operated on. A prospective randomized study was performed involving 40 patients divided into two groups, A and B.