Age-adjusted Charlson comorbidity index as a novel guideline for patient selection between unilateral versus bilateral simultaneous total knee arthroplasty.

Purpose: The aim of this study was to validate the age-adjusted Charlson comorbidity index as a clinical practice guideline for patient selection between unilateral total knee arthroplasty (UTKA) and bilateral simultaneous total knee arthroplasty (BSTKA).

Methods: A consecutive series of 1016 patients undergoing UTKA (402 patients) or BSTKA (614 patients) was analysed. The age-adjusted Charlson comorbidity index (ACCI) was measured for all the patients and graded as low (0-2 score), moderate (3-4 score) and high risk (≥ 5 score).

Options and limitations of implant constraint.

With an ever-increasing number of revisions, the surgeons will be faced with the dilemma of choosing the right implant for the revision knee. The soft tissue viability governs the choice of an implant at the time of revision. The selection ranges from the cruciate-retaining to the rotating/fixed hinge implants.

A prospective comparative study of local infiltration versus adductor block versus combined use of the two techniques following knee arthroplasty.

Background: Pain management after total knee arthroplasty (TKA) is important as acute postoperative pain can affect patient's ability to walk and participate in rehabilitation required for good functional outcome. This is achieved by effective intra-operative and post-operative analgesia to facilitate early recovery. Adductor canal block (ACB) and local infiltration analgesia (LIA) are analgesic regimens and commonly used for effective post-operative analgesia after TKA.

Prosthetic knee joint infection due to .

Infected total knee arthroplasty (TKA) due to is very rare with only three such cases described in literature. Only one case was managed successfully, however, with a prolonged course of anti tubercular therapy. In this case report, we present an elderly lady with infected TKA after 2 years of the primary procedure.

Impact of Charlson indices and comorbid conditions on complication risk in bilateral simultaneous total knee arthroplasty.

Background: The purpose of this study was to evaluate the influence of Charlson indices and comorbid conditions on the risk of perioperative complications in bilateral simultaneous total knee arthroplasty (BSTKA).

Methods: In our retrospective analysis, 556 patients including 133 males and 423 females (mean age 65.8years), who had undergone bilateral simultaneous total knee arthroplasty between 2011 and 2014 were included.

Management of distal femoral periprosthetic fractures by distal femoral locking plate: A retrospective study.

Background: Management of periprosthetic supracondylar femoral fractures is difficult. Osteoporosis, comminution and bone loss, compromise stability with delayed mobility and poor functional outcomes. Open reduction and internal fixation (ORIF) with anatomic distal femoral (DF) locking plate permits early mobilization.

Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly.

Background: Cemented hip arthroplasty is an established treatment for femoral neck fracture in the mobile elderly. Cement pressurization raises intramedullary pressure and may lead to fat embolization, resulting in fatal bone cement implantation syndrome, particularly in patients with multiple comorbidities. The cementless stem technique may reduce this mortality risk but it is technically demanding and needs precise planning and execution.

Unicompartmental knee arthroplasty for tricompartment osteoarthritis in octogenarians.

Background: Unicompartmental knee arthroplasty (UKA) is specifically indicated in isolated unicompartmental arthritis with competent ligaments. Recent series of UKA for unicompartmental arthritis have shown good function, persistence of pain relief, and nearly 90% survivorship at 15 years, even in knees that would perhaps not be considered good indications for UKA today. The perioperative morbidity of UKA is less than total knee arthroplasty.

Extensively coated revision stems in proximally deficient femur: early results in 15 patients.

Background: Hip replacement following failed internal fixation (dynamic hip screw for intertrochanteric fractures) or previous hip arthroplasty presents a major surgical challenge. Proximal fitting revision stems do not achieve adequate fixation. Distal fixation with long-stemmed extensively coated cementless implants (like the Solution system) affords a suitable solution.

Prosthetic replacement in femoral neck fracture in the elderly: results and review of the literature.

Background: Intracapsular fractures of the proximal femur account for a major share of fractures in the elderly. The primary goal of treatment is to return the patient to his or her pre-fracture functional status. There are multiple internal fixation options (screws, dynamic hip screw plate or blade plates) and hemi and total hip arthroplasty.