Primary total knee arthroplasty is the treatment for end-stage arthritis of the knee; in the last years, it is becoming more common and reliable, due to technical and implant improvement. With larger implant rates, the overall complications will increase and pain is the most common sign of implant failure. Pain can be related to a lot of different clinical findings, and the surgeon has to be aware of the various etiologies that can lead to failure. Pain does not always mean revision, and the patient has to be fully evaluated to have a correct diagnosis; if surgery is performed for the wrong reason, this will surely lead to a failure. In this paper, the authors revised the more common causes of failure that can have a painful onset proposing an approach for diagnosis and treatment.
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http://dx.doi.org/10.1007/s12178-015-9296-5 | DOI Listing |
J Arthroplasty
January 2025
Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Redwood City, California, USA. Electronic address:
Background: Current guidelines recommend shared decision-making in the treatment of hip and knee osteoarthritis, but the impact of individual treatment decisions on patient satisfaction scores is unknown. We hypothesized that clinic Press Ganey satisfaction ratings would be higher for patients who later underwent arthroplasty than patients who did not have surgery.
Methods: Press Ganey satisfaction surveys were obtained from all patient visits at a single academic institution's arthroplasty clinic from 2010 to 2018.
J Arthroplasty
January 2025
Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 E 70th Street, New York, NY, 10021.
Introduction: Robotic-assisted total knee arthroplasty (TKA) platforms require tibial and femoral pins to support rigidly fixed navigation arrays. These pins can be placed inside or outside the primary incision. We sought to compare 90-day complication rates between three different pin configurations: all-outside, intra-incisional femur/extra-incisional tibia, and all-inside.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Introduction: The two-stage surgical protocols used for the treatment of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) are associated with marked patient morbidity. As such, alternatives such as durable "1.5-stage" spacer constructs have gained popularity.
View Article and Find Full Text PDFJ Knee Surg
January 2025
Department of Orthopaedics, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia.
Traditional research on total knee arthroplasty (TKA) relies on preoperative patient-reported outcome measures (PROMs) to predict postoperative satisfaction. We aim to identify distinct patient phenotypes among TKA candidates, and investigate their correlations with patient characteristics. Between 2017 and 2021, patients with primary knee cases at a metropolitan public hospital were enrolled in a clinical quality registry.
View Article and Find Full Text PDFSemin Thromb Hemost
January 2025
of Medicine, Universita degli Studi di Padova Scuola di Medicina e Chirurgia, Padova, Italy.
Anti-platelet factor 4 (PF4) antibody-mediated disorders are a heterogenous group of diseases characterized by the presence of highly pathogenic immunoglobulins G directed against PF4 and/or PF4/heparin complexes. These antibodies are able to activate platelets, neutrophils and monocytes, thus resulting in thrombocytopenia and a hypercoagulable state. Five different forms of anti-PF4 antibody-mediated disorders have been identified: i) classic heparin-induced thrombocytopenia (cHIT) mediated by heparin and certain polyanionic drugs; ii) autoimmune HIT (aHIT) characterized by the presence of anti-PFA/polyanion antibodies that can strongly activate platelets even in the absence of heparin; iii) spontaneous HIT (spHIT) characterized by thrombocytopenia and thrombosis without proximate exposure to heparin, with two subtypes: (a) post-total knee arthroplasty, and cardiac surgery using cardiopulmonary bypass or extracorporeal membrane oxygenation, and (b) post-infections; iv) vaccine-induced immune thrombotic thrombocytopenia (VITT) characterized by thrombocytopenia, arterial and venous thrombosis, or secondary hemorrhage after receiving adenoviral vector vaccines for COVID-19; v) VITT-like disorders triggered by adenoviral infections.
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