Objectives: To identify the incidence and characteristics of chronic post-surgical pain (CPSP) following total knee arthroplasty and determine peri-operative influencing factors.
Methods: A representative, retrospective random sample was taken of patients who underwent total knee arthroplasty in the South Infirmary University Hospital Cork for an 18-month period. Two hundred fourteen patient charts were reviewed out of a total of 507 charts for that period to provide a 90% confidence interval.
Results: The incidence of CPSP in an Irish population 6 months after total knee arthroplasty was found to be 36.5%. The following factors were found to be statistically significant with respect to the incidence of CPSP: female sex, lack of multimodal analgesia (consisting of paracetamol, NSAID, and opioids), general anaesthesia, and lower Oxford Knee Scores at 6 months post-surgery. Age, the knee operated on, ASA grade, or greatest acuity pain, were not found to be statistically significant factors in the development of CPSP.
Conclusions: CPSP is common after total knee arthroplasty with an incidence of 36.5% at 6 months post procedure. Female sex, lack of multimodal analgesia, and lower Oxford Knee Scores were associated with increased CPSP.
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http://dx.doi.org/10.1007/s11845-024-03817-z | DOI Listing |
J Med Ultrason (2001)
January 2025
Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyamahigashicho, Hirakata, Osaka, 573-1136, Japan.
Purpose: Knee pain is a characteristic symptom of early-stage knee osteoarthritis. Recently, the association between knee symptoms and infrapatellar fat pad (IFP) degeneration has garnered attention. This study aimed to clarify the association between ultrasound-derived size and echo intensity (EI) in the IFP and knee symptoms.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Background: Complete blood cell count-based ratios (CBRs), including the neutrophil-lymphocyte ratio (NLR) and monocyte-lymphocyte ratio (MLR), are inflammatory markers associated with postoperative morbidity. Given the link between the surgical stress response and complications after total joint arthroplasty (TJA), this study aimed to evaluate whether higher preoperative CBR values predict greater postoperative benefits associated with dexamethasone utilization.
Methods: The Premier Healthcare Database was queried for adult patients who underwent primary, elective total hip or knee arthroplasty (THA or TKA).
J Bone Joint Surg Am
January 2025
Department of Bone and Joint Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People's Republic of China.
Background: Early knee effusion is a common phenomenon after total knee arthroplasty (TKA), with potential clinical implications. Unlike traditional alloy knee prostheses, the polyetheretherketone (PEEK) knee system has radiographic transparency on magnetic resonance (MR) scans, which allows analysis of prosthetic knee effusion. We aimed to identify the distribution and volume of knee effusion after TKA with the PEEK prosthesis with use of MR imaging and to analyze whether dynamic changes in effusion were correlated with serum inflammatory marker changes and knee function recovery.
View Article and Find Full Text PDFJ Bone Joint Surg Am
January 2025
Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY.
Background: Antiseptic solutions are commonly utilized during total joint arthroplasty (TJA) to prevent and treat periprosthetic joint infection (PJI). The purpose of this study was to investigate which antiseptic solution is most effective against methicillin-sensitive Staphylococcus aureus (MSSA) and Escherichia coli biofilms established in vitro on orthopaedic surfaces commonly utilized in total knee arthroplasty: cobalt-chromium (CC), oxidized zirconium (OxZr), and polymethylmethacrylate (PMMA).
Methods: MSSA and E.
Arch Orthop Trauma Surg
January 2025
Department of Public Health, Orthopedic Unit, "Federico II" University, Naples, Italy.
Background: Two-stage revision in infected total knee arthroplasty increases the risk of blood loss and the need for transfusion. The present study aimed to test the hemostatic efficacy of a bipolar sealer to reduce blood loss and transfusion requirements after the first stage in patients affected by peri-prosthetic knee infections.
Methods: Twenty-four patients undergoing 2-stage arthroplasty for infected TKA using a bipolar sealer (Haemodiss, Kylix, Naples, IT) were compared with 24 patients of a historical control group in which conventional electrocautery was used.
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