Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 443 articles


Patient Activity After TKA Depends on Patient-specific Parameters

Cornelia Lützner Dipl-Päd, Stephan Kirschner Dr med, PD, Jörg Lützner Dr med, PD

Most patients expect an improvement of walking ability and an increase in activity levels after TKA. Unfortunately, few studies report qualitative and quantitative activity improvements after TKA.

Infrapatellar Saphenous Neuralgia After TKA Can Be Improved With Ultrasound-guided Local Treatments

Steven Clendenen MD, Roy Greengrass MD, Joseph Whalen MD, PhD, Mary I. O’Connor MD

Current opinion suggests that in some patients, chronic pain after total knee arthroplasty (TKA) has a neuropathic origin. Injury to the infrapatellar branch of the saphenous nerve (IPSN) has been implicated as a cause of medial knee pain; however, local treatments for this condition remain controversial.

Does Advanced Cryotherapy Reduce Pain and Narcotic Consumption After Knee Arthroplasty?

Emmanuel Thienpont MD, MBA

Cryotherapy has been used to enhance recovery after orthopaedic surgery. Several cooling devices are available but few can guarantee a fixed temperature during a prolonged time and therefore have been criticized. The arrival of new advanced cryotherapy devices made it possible to test the effect of prolonged cooling on rehabilitation after joint replacement.

Systematic Review of Patient-specific Instrumentation in Total Knee Arthroplasty: New but Not Improved

Adam Sassoon MD, Denis Nam MD, Ryan Nunley MD, Robert Barrack MD

Patient-specific cutting blocks have been touted as a more efficient and reliable means of achieving neutral mechanical alignment during TKA with the proposed downstream effect of improved clinical outcomes. However, it is not clear to what degree published studies support these assumptions.

Correlation of Knee and Hindfoot Deformities in Advanced Knee OA: Compensatory Hindfoot Alignment and Where It Occurs

Adam A. Norton BA, John J. Callaghan MD, Annunziato Amendola MD, Phinit Phisitkul MD, Siwadol Wongsak MD, Steve S. Liu MD, Catherine Fruehling-Wall BA

Many patients undergoing TKA have both knee and ankle pathology, and it seems likely that some compensatory changes occur at each joint in response to deformity at the other. However, it is not fully understood how the foot and ankle compensate for a given varus or valgus deformity of the knee.

Is the All-arthroscopic Tibial Inlay Double-bundle PCL Reconstruction a Viable Option in Multiligament Knee Injuries?

Alexander E. Weber MD, Benjamin Bissell MD, Edward M. Wojtys MD, Jon K. Sekiya MD

All-arthroscopic tibial inlay double-bundle (DB) posterior cruciate ligament (PCL) reconstruction avoids an open dissection and the “killer turn” while maintaining the advantage of an anatomic graft. However, clinical data on the viability of this surgical technique in multiligamentous knee injuries are lacking.

What Are the Economic Consequences of Unplanned Readmissions After TKA?

R. Carter Clement MD, MBA, Michael M. Kheir BS, Peter B. Derman MD, MBA, David N. Flynn MD, MBA, Rebecca M. Speck PhD, L. Scott Levin MD, FACS, Lee A. Fleisher MD

In 2009, the Center for Medicare & Medicaid Services (CMS) began penalizing hospitals with high rates of 30-day readmissions after hospitalizations for certain conditions. This policy will expand to include TKA in 2015.

How Do Knee Implants Perform Past the Second Decade? Nineteen- to 25-year Followup of the Press-fit Condylar Design TKA

Shantanu Patil MD, Julie C. McCauley MPHc, Pamela Pulido BSN, Clifford W. Colwell MD

At 14- to 17-year followup, we reported successful outcomes of the Press-fit Condylar total knee arthroplasty (TKA) system in 160 TKAs performed between 1986 and 1989. However, there are few published reports on TKA survivorship and patient function that include patients evaluated into the third decade after surgery.

How Precise Is Computer-navigated Gap Assessment in TKA?

James B. Stiehl MD, David A. Heck MD

Methods to improve gap balancing in total knee arthroplasty (TKA) include the development of calibrated distractors and various devices to determine the distances of the gaps. However, few studies have validated the accuracy or precision of computer navigation to determine these measurements, especially gaps created after bone cuts have been made; doing so would be important, because optimal surgical technique relies on appropriate gap spacing.

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Tilman Pfitzner MD, Matthew P. Abdel MD, Philipp Roth MD, Carsten Perka MD, Hagen Hommel MD

Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery.