Publications by authors named "N J Bottomley"
Article Synopsis
- There is limited research on the optimal indications for lateral unicompartmental knee arthroplasty (UKA), in contrast to the more established guidelines for medial UKA, due to differences in anatomy, osteoarthritis types, movement patterns, and surgical techniques.
- A systematic review examined 38 cohort studies to identify common indications and contraindications for lateral UKA, reporting that it is mainly performed for primary lateral osteoarthritis and identifying key contraindications.
- While some agreement on indications was found, the study indicates there is no strong consensus on the best practices for lateral UKA, highlighting the need for clearer, evidence-based guidelines in future research.
Article Synopsis
- MRI scans are being used more frequently to assess knee osteoarthritis and plan for unicompartmental knee arthroplasty (UKA), especially since many patients have scans prior to seeing their surgeons.
- The study analyzed 100 knees with specific criteria to evaluate cartilage damage, osteophytes, meniscal issues, and ACL status, with decisions for UKA based on surgical inspections rather than MRI alone.
- Findings showed significant cartilage loss in the medial compartment, varying conditions of the ACL, and some osteophyte presence, stressing that while MRI confirms bone-on-bone disease, further understanding of additional findings is necessary for better patient outcomes.
Article Synopsis
- Anterior cruciate ligament (ACL) injuries in the knee often lead to decreased activity levels and a higher risk of osteoarthritis, and there’s a lack of clear guidelines for managing these injuries either through surgery or rehabilitation.
- This study aimed to compare the effectiveness and cost of surgical ACL reconstruction without prior rehab against a rehabilitation approach before surgery for patients with non-acute ACL injuries and symptoms of instability.
- Conducted across 29 NHS orthopedic units in the UK, the trial tracked key outcomes like knee function and patient satisfaction over 18 months in 316 participants.
Article Synopsis
- Anterior cruciate ligament (ACL) ruptures can severely affect knee stability, leading researchers to compare reconstructive surgery and non-surgical rehabilitation in patients with persistent instability symptoms.
- A randomized controlled trial involved 316 patients across 29 UK NHS orthopedic units, with participants split into surgical and rehabilitation groups, primarily assessing outcomes using the Knee Injury and Osteoarthritis Outcome Score-4 at 18 months.
- Results showed that the surgical group had a higher average KOOS4 score (73.0) compared to the rehabilitation group (64.6), indicating that surgery may be more effective; however, many patients in the rehabilitation group later opted for surgery.
Background: Isolated lateral compartment knee arthritis is less prevalent than medial. While the reported results of medial unicompartmental knee replacement (UKR) have been good and comparable to total knee replacement, the results of lateral UKR have been mixed. We present the short-term results and survivorship of a fixed-bearing UKR designed specifically for the lateral compartment.
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