Can blood flow restriction therapy improve quality of life and function in dissatisfied knee arthroplasty patients?

Aims: Approximately 10% to 20% of knee arthroplasty patients are not satisfied with the result, while a clear indication for revision surgery might not be present. Therapeutic options for these patients, who often lack adequate quadriceps strength, are limited. Therefore, the primary aim of this study was to evaluate the clinical effect of a novel rehabilitation protocol that combines low-load resistance training (LL-RT) with blood flow restriction (BFR).

Investigating the autoregulation of applied blood flow restriction training pressures in healthy, physically active adults: an intervention study evaluating acute training responses and safety.

Objective: To examine the effects of autoregulated (AUTO) and non-autoregulated (NAUTO) blood flow restriction (BFR) application on adverse effects, performance, cardiovascular and perceptual responses during resistance exercise.

Methods: Fifty-six healthy participants underwent AUTO and NAUTO BFR resistance exercise in a randomised crossover design using a training session with fixed amount of repetitions and a training session until volitional failure. Cardiovascular parameters, rate of perceived effort (RPE), rate of perceived discomfort (RPD) and number of repetitions were investigated after training, while the presence of delayed onset muscle soreness (DOMS) was verified 24 hours post-session.

The learning curve of imageless robot-assisted total knee arthroplasty with standardised laxity testing requires the completion of nine cases, but does not reach time neutrality compared to conventional surgery.

Purpose: The assistance of robot technology is introduced into the operating theatre to improve the precision of a total knee arthroplasty. However, as with all new technology, new technology requires a learning curve to reach adequate proficiency. The primary aim of this study was to identify the learning curve of an imageless robotic system with standardised laxity testing.

Prevention of venous thromboembolism with aspirin following knee surgery: A systematic review and meta-analysis.

Venous thromboembolism (VTE) is a well-known complication following orthopaedic surgery. The incidence of this complication has decreased substantially since the introduction of routine thromboprophylaxis. However, concerns have been raised about increased bleeding complications caused by aggressive thromboprophylaxis.

Return to sport and work after medial open wedge high tibial osteotomy : a case series.

Data on return to work and sport following open wedge high tibial osteotomy (HTO) have been underreported. Furthermore, there is no clear consensus in literature about the postoperative alignment goals following HTO. A retrospective case series was performed to evaluate return to sport and work following open wedge HTO.

The contralateral knee is a good predictor for determining normal knee stability: a cadaveric study.

Purpose: The goal is to evaluate contralateral knee joint laxity and ascertain whether or not contralateral symmetry is observable. Secondary, a validation of a knee laxity testing rig is provided.

Methods: Seven pairs of cadaveric knee specimens have been tested under passive conditions with and without external loads, involving a varus/valgus and an external/internal rotational torque and an anteroposterior shear force.

Efficacy of total knee arthroplasty (TKA) revision surgery depends upon the indication for revision : a systematic review.

The number of revision total knee arthroplasty (TKA) surgeries has increased over the years and it is expected that its number will keep rising. Most frequent reasons for revision are known to be aseptic loosening, infection, instability, periprosthetic frac- ture, arthrofibrosis and component malposition. The influence of the indication for revision on the outcome scores is not fully understood.

Biceps Femoris Compensates for Semitendinosus After Anterior Cruciate Ligament Reconstruction With a Hamstring Autograft: A Muscle Functional Magnetic Resonance Imaging Study in Male Soccer Players.

Background: Rates of reinjury, return to play (RTP) at the preinjury level, and hamstring strain injuries in male soccer players after anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, due to multifactorial causes. Recent insights on intramuscular hamstring coordination revealed the semitendinosus (ST) to be of crucial importance for hamstring functioning, especially during heavy eccentric hamstring loading. Scientific evidence on the consequences of ST tendon harvest for ACLR is scarce and inconsistent.

Conservative treatment of knee osteoarthritis.

Osteoarthritis of the knee causes chronic knee pain, loss of function and disability in the ageing population. When no treatment is applied, a guaranteed onset of symptoms and/or structural damage can be observed in the diseased knee. This work reviewed the different published guidelines, proposing combinations of weight reduction, physical therapy and rehabilitation, self-management education programs and pharmacological treatment.

Muscle loaded stability reflects ligament-based stability in TKA: a cadaveric study.

Purpose: This paper aims at evaluating the effects of muscle load on knee kinematics and stability after TKA and second at evaluating the effect of TKA surgery on knee kinematics and stability; and third, at correlating the stability in passive conditions and the stability in active, muscle loaded conditions.

Methods: Fourteen fresh frozen cadaveric knee specimens were tested under passive and active condition with and without external loads involving a varus/valgus and internal/external rotational torque before and after TKA surgery using two in-house developed and previously validated test setups.

Results: Introduction of muscle force resulted in increased valgus (0.

Soft-tissue penetration of the oscillating saw during tibial resection in total knee arthroplasty.

Aims: Inadvertent soft tissue damage caused by the oscillating saw during total knee arthroplasty (TKA) occurs when the sawblade passes beyond the bony boundaries into the soft tissue. The primary objective of this study is to assess the risk of inadvertent soft tissue damage during jig-based TKA by evaluating the excursion of the oscillating saw past the bony boundaries. The second objective is the investigation of the relation between this excursion and the surgeon's experience level.

How should we evaluate robotics in the operating theatre?

The application of robotics in the operating theatre for knee arthroplasty remains controversial. As with all new technology, the introduction of new systems might be associated with a learning curve. However, guidelines on how to assess the introduction of robotics in the operating theatre are lacking.

Correction to: Surgeon experience with dynamic intraligamentary stabilization does not influence risk of failure.

The original version of this article unfortunately contains mistake in Table 4.

Surgeon experience with dynamic intraligamentary stabilization does not influence risk of failure.

Purpose: Studies on dynamic intraligamentary stabilization (DIS) of acute anterior cruciate ligament (ACL) ruptures reported failure rates similar to those of conventional ACL reconstruction. This study aimed to determine whether surgeon experience with DIS is associated with revision rates or patient-reported outcomes. The hypothesis was that more experienced surgeons achieved better outcomes following DIS due to substantial learning curve.

How does lower leg alignment differ between soccer players, other athletes, and non-athletic controls?

Purpose: The influence of type and intensity of sports during growth on knee alignment was investigated. The second aim was to ascertain whether the distal femur or proximal tibia contribute most to knee alignment. Also, the influence of field position and leg dominancy on knee alignment in soccer players was audited.

A New Prediction Model for Patient Satisfaction After Total Knee Arthroplasty.

Background: Total knee arthroplasty (TKA) is a proven and cost-effective treatment for osteoarthritis. Despite the good to excellent long-term results, some patients remain dissatisfied. Our study aimed at establishing a predictive model to aid patient selection and decision-making in TKA.

3D printed guides for controlled alignment in biomechanics tests.

The bone-machine interface is a vital first step for biomechanical testing. It remains challenging to restore the original alignment of the specimen with respect to the test setup. To overcome this issue, we developed a methodology based on virtual planning and 3D printing.

Total knee arthroplasty at 15-17 years: does implant design affect outcome?

Purpose: A study was conducted to compare minimum 15-year survivorship and outcome of the Genesis I and II implants for total knee arthroplasty (TKA).

Methods: We retrospectively reviewed 245 consecutive TKA implanted between January 1995 and October 1997. Genesis I was implanted in 156 knees and Genesis II in 89 knees.

The influence of freezing on the tensile strength of tendon grafts : a biomechanical study.

We investigated the influence of freezing on the tensile strength of fresh frozen tendon grafts. The biomechanical characteristics of tendons that are less commonly used in knee surgery (tibialis anterior, tibialis posterior, peroneus longus and medial and lateral half of Achilles tendons) were compared to those of a semitendinosus and gracilis graft harvested from the same 10 multi-organ donors. All right side tendons constituted the study group and were frozen at -80 degrees C and thawed at room temperature 5 times.

Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial.

Background: Recently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial.

Questions/purposes: We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG.

Complex total knee arthroplasty using resection prostheses at mid-term follow-up.

Complex primary or revision TKA may require the use of a resection type prosthesis to address major bone loss and soft tissue deficiencies. The aim of this retrospective study is to evaluate the clinical and radiographic outcomes of salvage knee reconstructions in a larger cohort and longer follow-up than previously reported. We therefore present the results of 66 cases treated with the Finn/OSS knee system with an average follow-up of 5 years (range 2-12).

Are clinical photographs appropriate to determine the maximal range of motion of the knee?

Goniometry is a commonly used method for the clinical assessment of range of motion (ROM) of the knee. A digital photograph of the knee in maximal flexion and extension could provide a more objective way to assess the ROM. The aim of our study was to investigate the reliability of the use of digital photographs as a method for measuring the ROM of the knee.

Posterior dislocation in total knee replacement: a price for deep flexion?

Introduction: Post-cam dislocation in TKA is a rare complication after posterior stabilized TKA.

Purpose: Four cases of posterior dislocation of the tibia relative to the femur are described in one current posterior stabilized design.

Conclusion: Specific design features in one contemporary high flexion TKA design contribute to high dislocation rates.

Avoidance of patellar eversion improves range of motion after total knee replacement: a prospective randomized study.

Minimally invasive surgery has recently been introduced in TKA surgery. The purpose of this study was to evaluate the effect of eversion of the patella, on safety and functional result after TKA. In a prospective, randomised, double blinded trial, 60 patients were divided in two groups: group A underwent TKA through a standard medial parapatellar arthrotomy, with patellar eversion.