Purpose: For unicompartmental knee arthroplasty (UKA), patient selection using correct indications can optimise postsurgical outcomes. The current gold standard for assessing eligibility is with radiographs; however, magnetic resonance imaging (MRI) may allow for more accurate assessments of cartilage damage. This study aimed to evaluate the utility of MRI for preoperative assessment of medial UKA patients by (1) comparing osteoarthritis severity of the medial, lateral and patellofemoral (PF) compartments when assessed using MRI compared with standard radiographs, and (2) investigating associations of these two assessments with postoperative clinical outcomes.
View Article and Find Full Text PDFHypothesis And Background: The incidence of periprosthetic joint infection (PJI) remains high following elbow arthroplasty procedures. The purpose of this study was to investigate whether surgical helmet systems (SHSs) reduce rates of PJI after elbow arthroplasty in a population-based registry study over a consecutive 23-year period. We hypothesized that SHS would reduce the incidence of PJI compared with conventional surgical gowns following elbow arthroplasty surgery.
View Article and Find Full Text PDFCase: Physeal stability in slipped capital femoral epiphysis (SCFE) depends on integrity of the hypertrophic zone. This in turn is affected by imbalance between circulating growth hormones and gonadal hormones. This case describes the occurrence of SCFE in a Māori (indigenous New Zealander) transgender girl, undergoing gender-affirming therapy with a gonadal-releasing hormone analog (GnRHa).
View Article and Find Full Text PDFHypothesis And Background: As the incidence of reverse total shoulder arthroplasty (rTSA) continues to rise, better understanding of the long-term risks and complications is necessary to determine the best choice of implant. The majority (75%) of rTSAs performed in New Zealand use either SMR (Systema Multiplana Randelli; Lima-LTO) or Delta Xtend (DePuy Synthes). The aim of this registry-based study was to compare implant survival, risk of revision, and reasons for revision between the 2 most frequently used rTSA prostheses: SMR and Delta Xtend.
View Article and Find Full Text PDFBackground: The primary objective of this study was to determine the accuracy and precision of component positioning of the ROSA Robotic System for total knee arthroplasty (TKA).
Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analysis systematic review was conducted using 4 electronic databases (MEDLINE, EMBASE, Pubmed, and Cochrane Library) to identify all clinical and radiological studies reporting information about the use and results of the ROSA system. The criteria for inclusion were published research articles evaluating the accuracy of component positioning, learning curve, component alignment, complications, and functional outcomes in adults who underwent robotic-assisted TKA.
Introduction: Arthroscopic procedures for osteoarthritis (OA), in particular arthroscopic meniscectomy, have poorer long-term clinical outcomes compared to those managed non-operatively. In addition, previous arthroscopy is associated with worse outcomes following subsequent total knee arthroplasty (TKA), however there is limited data on the impact on subsequent unicompartmental knee arthroplasty (UKA) outcomes. The aim of the study is to investigate whether patients who had arthroscopy prior to UKA have differences in survivorship or functional outcomes compared to those with no prior arthroscopy.
View Article and Find Full Text PDFCell surface marker expression is one of the criteria for defining human mesenchymal stem or stromal cells (MSC) in vitro. However, it is unclear if expression of markers including CD73 and CD90 reflects the in vivo origin of cultured cells. We evaluated expression of 15 putative MSC markers in primary cultured cells from periosteum and cartilage to determine whether expression of these markers reflects either the differentiation state of cultured cells or the self-renewal of in vivo populations.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
January 2025
Introduction: The key outcome of joint registries is revision events, which inform clinical practice and identify poor-performing implants. Registries record revision events and reasons, but accuracy may be limited by a lack of standardized definitions of revision. Our study aims to assess the accuracy and completeness of unicompartmental knee arthroplasty (UKA) revision and indications reported to the New Zealand Joint Registry (NZJR) with independent clinical review.
View Article and Find Full Text PDFType 2 diabetes is linked with increased incidence and severity of osteoarthritis. The purpose of this study was to determine the effect of extracellular glucose within the normal blood glucose and hyperglycemic range on catabolic enzyme production by chondrocytes isolated from osteoarthritic (OA) and macroscopically normal (MN) human cartilage under oxygenated (18.9% oxygen) and hypoxic (1% oxygen) conditions.
View Article and Find Full Text PDFHypothesis And Background: Recently, the indication of reverse total shoulder arthroplasty (RTSA) has expanded beyond rotator cuff arthropathy to include treatment of complex acute proximal humeral fracture (PHF). Limited previous studies have compared the long-term clinical and functional outcomes of patients undergoing RTSA for PHF vs. elective indications for degenerative conditions.
View Article and Find Full Text PDFObjectives: The prevalence and severity of knee osteoarthritis (OA) are greater in females than males. The purpose of this study was to determine whether there is an underlying difference in the biology of OA chondrocytes between males and females.
Methods: Chondrocytes were obtained following knee arthroplasty from male and female patients with primary OA.
The periosteum plays a crucial role in bone healing and is an important source of skeletal stem and progenitor cells. Recent studies in mice indicate that diverse populations of skeletal progenitors contribute to growth, homeostasis and healing. Information about the in vivo identity and diversity of skeletal stem and progenitor cells in different compartments of the adult human skeleton is limited.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
October 2023
Purpose: Osteoarthritis (OA) is associated with inflammation, and residual inflammation may influence outcomes following knee arthroplasty. This may be more relevant for patients undergoing unicompartmental knee arthroplasty (UKA) due to larger remaining areas of native tissue. This study aimed to: (1) characterise inflammatory profiles for medial UKA patients and (2) investigate whether inflammation markers are associated with post-operative outcomes.
View Article and Find Full Text PDFExpression of key transcriptional regulators is altered in chondrocytes in osteoarthritis (OA). This contributes to an increase in production of cartilage-catabolizing enzymes such as MMP13 and ADAMTS5. RCOR1 and RCOR2, binding partners for the transcriptional repressor REST, have previously been found to be downregulated in OA chondrocytes although their function in chondrocytes is unclear.
View Article and Find Full Text PDFWe hypothesized that a combined growth factor hydrogel would improve chronic rotator cuff tear healing in a rat and sheep model. Insulin-like growth factor 1, transforming growth factor β1, and parathyroid hormone were combined into a tyraminated poly-vinyl-alcohol (PVA-Tyr) hydrogel and applied directly at the enthesis. In total, 30 Sprague-Dawley rats and 16 Romney ewes underwent unilateral rotator cuff tenotomy and then delayed repairs were performed after 3-4 weeks.
View Article and Find Full Text PDFProsthetic joint infection (PJI) is a rare but devastating complication of joint arthroplasty. Biofilm formation around the prosthesis confers tolerance to antibiotics so that treatment is challenging. Most animal models of PJI use planktonic bacteria to establish the infection which fails to reproduce the pathology of chronic infection.
View Article and Find Full Text PDFPurpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA.
View Article and Find Full Text PDFBackground: Long-term survivorship and accurate characterization of revision reasons in unicompartmental knee arthroplasty (UKA) are limited by a lack of long-term data and standardized definitions of revision. The aim of this study was to identify survivorship, risk factors, and reasons for revision in a large cohort of medial UKAs with long-term follow-up (up to 20 years).
Methods: Patient, implant, and revision details for 2,015 primary medial UKAs (mean follow-up, 8 years) were recorded following systematic clinical and radiographic review.
Aim: This study aimed to assess the impact of COVID-19 on orthopaedic practice in New Zealand, with a focus on training and mental health.
Methods: An online survey was sent to the 385 consultant orthopaedic surgeons and registrars in New Zealand registered with the New Zealand Orthopaedic Association (NZOA). The survey consisted of 27 questions relating to demographics, the effects of COVID-19 on orthopaedic departments, on training, on mental health and the utilisation of telehealth and online teaching.
Background: The aim of this study was to define outcomes after total knee arthroplasty (TKA) in lymphoedema and lipoedema patients managed by a multidisciplinary team and daily compression bandaging.
Methods: A retrospective study was performed in a single centre. Between 2007 and 2018, 36 TKA procedures were performed on 28 consecutive patients with a diagnosis of lymphoedema and lipoedema.
Purpose: The introduction of robotics for total knee arthroplasty (TKA) into the operating theatre is often associated with a learning curve and is potentially associated with additional complications. The purpose of this study was to determine the learning curve of robotic-assisted (RA) TKA within a multi-surgeon team.
Methods: This prospective cohort study included 83 consecutive conventional jig-based TKAs compared with 53 RA TKAs using the Robotic Surgical Assistant (ROSA) system (Zimmer Biomet, Warsaw, Indiana, USA) for knee osteoarthritis performed by three high-volume (> 100 TKA per year) orthopaedic surgeons.
Hypothesis And Background: Traumatic rotator cuff injuries can be a leading cause of prolonged shoulder pain and disability and contribute to significant morbidity and health care costs. Previous studies have shown evidence of sociodemographic disparities with these injuries. The purpose of this nationwide study was to better understand these disparities based on ethnicity, sex, and socioeconomic status, in order to inform future health care strategies.
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