Recovery after unilateral knee replacement due to severe osteoarthritis and progression in the contralateral knee: a randomised clinical trial comparing daily 2000 IU versus 800 IU vitamin D.

Objective: To test whether daily high-dose vitamin D improves recovery after unilateral total knee replacement.

Methods: Data come from a 24-month randomised, double-blind clinical trial. Adults aged 60 and older undergoing unilateral joint replacement due to severe knee osteoarthritis were 6-8 weeks after surgery randomly assigned to receive daily high-dose (2000 IU) or standard-dose (800 IU) vitamin D.

The use of the Core Outcome Measures Index (COMI) in patients undergoing total knee replacement.

Background: The Core Outcome Measure Index (COMI) is a very short outcome instrument used in spine patients. The aim of this study was to examine the utility of a knee version of the COMI in patients undergoing total knee arthroplasty (TKA) by assessing the reproducibility, construct and discriminant validity, and responsiveness.

Methods: Preoperatively, 224 patients completed the Oxford Knee Score (OKS), EuroQoL (EQ-5D) and the COMI-Knee; 189 (84) % also completed the questionnaires at follow-up and 73 patients completed preoperatively the COMI-knee twice.

A titanium plasma-sprayed cup with and without hydroxyapatite-coating: a randomised radiostereometric study of stability and osseointegration.

We present a prospective, two-centre radiostereometric analysis (RSA) regarding the stability of a flattened pole titanium press-fit cup (EP-FIT PLUS), and whether additional hydroxyapatite coating leads to faster bone ingrowth into the porous coating. Forty-two postmenopausal female patients (44 hips) undergoing total hip arthroplasty for primary osteoarthritis, selected to avoid hormonal factors influencing bone metabolism, were randomised to receive this cup with a titanium-plasma-sprayed surface with or without an additional hydroxyapatite coating. RSA was used to measure cup translation and rotation along three cardinal axes with respect to the host bone at the following time points: immediately postoperatively, at 6 weeks, and at 3, 6, 12, and 24 months.

The effect of femoral component rotation on the five-year outcome of cemented mobile bearing total knee arthroplasty.

Purpose: Performing total knee replacement, accurate alignment and neutral rotation of the femoral component are widely believed to be crucial for the ultimate success. Contrary to absolute bone referenced alignment, using a ligament balancing technique does not automatically rotate the femoral component parallel to the transepicondylar axis. In this context we established the hypothesis that rotational alignment of the femoral component parallel to the transepicondylar axis (0° ± 3°) results in better outcome than alignment outside of this range.

Five-year results of the Innex total knee arthroplasty system.

The clinical and radiographic results of 174 female and 86 male Innex (Zimmer, Warsaw, Indiana) mobile bearing total knee arthroplasty systems (245 patients) were evaluated, with particular emphasis on gender-related differences at five-year follow-up. Pre-operative Knee Society (KS) function and total scores were lower in women than in men. All KS scores showed a significant improvement at follow-up, but women still obtained lower KS function scores than men.

Reconstruction of severe uncontained bone defects in revision total knee arthroplasty in a patient with rheumatoid arthritis.

We report on a 54-year-old rheumatoid arthritic female patient with uncontained type-III tibial and femoral bone defects at the time of revision total knee arthroplasty (TKA). The knee was reconstructed using a structural distal femoral allograft and a stemmed, semi-constrained knee prosthesis. We achieved the re-alignment of a severe preoperative valgus deformity of 40 degrees.