Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 436 articles


Cylindrical Axis, Not Epicondyles, Approximates Perpendicular to Knee Axes

Clifton W. Hancock MS, MD, Mark J. Winston MD, Joel M. Bach PhD, Bradley S. Davidson PhD, Donald G. Eckhoff MS, MD

The transepicondylar axis (TEA) is often used as a surrogate for the flexion-extension axis, ie, the axis around which the tibia moves in space, because of a belief that both axes lie perpendicular to the mechanical axis. However, studies suggest the cylindrical axis (CA), defined as a line equidistant from contact points on the medial and lateral condylar surfaces from 10to 120flexion, more closely approximates the axis around which the tibia moves in space.

Is Pain After TKA Better with Periarticular Injection or Intrathecal Morphine?

Nattapol Tammachote MD, MSc, Supakit Kanitnate MD, Sudsayam Manuwong MD, Thanasak Yakumpor MD, Phonthakorn Panichkul MD

Postoperative pain after TKA is a major concern to patients. The best technique to control pain is still controversial. Intrathecal morphine or periarticular multimodal drug injection are both commonly used and both appear to provide better pain control than placebo, but it is unclear whether one or the other provides better pain control.

Is There a Gold Standard for TKA Tibial Component Rotational Alignment?

Erin E. Hutter MS, Jeffrey F. Granger MD, Matthew D. Beal MD, Robert A. Siston PhD

Joint function and durability after TKA depends on many factors, but component alignment is particularly important. Although the transepicondylar axis is regarded as the gold standard for rotationally aligning the femoral component, various techniques exist for tibial component rotational alignment. The impact of this variability on joint kinematics and stability is unknown.

What Are the Causes of Revision Total Knee Arthroplasty in Japan?

Yasuhiko Kasahara MD, PhD, Tokifumi Majima MD, PhD, Shoichi Kimura MD, PhD, Osamu Nishiike MD, Jun Uchida MD, PhD

There is limited information regarding the cause of revision TKA in Asia, especially Japan. Owing to differences in patient backgrounds and lifestyles, the modes of TKA failures in Asia may differ from those in Western countries.

Unloader Knee Braces for Osteoarthritis: Do Patients Actually Wear Them?

Emily Squyer MD, Daniel L. Stamper PA-C, Deven T. Hamilton PhD, Janice A. Sabin PhD, Seth S. Leopold MD

Unloader braces are a nonsurgical approach for predominantly unicompartmental knee arthritis. Although noninvasive, braces are expensive and it is unclear whether clinical factors, if any, will predict regular brace use.

Must Bilaterality Be Considered In Statistical Analyses of Total Knee Arthroplasty?

Young Gon Na MD, Yeon Gwi Kang MS, Moon Jong Chang MD, Chong Bum Chang MD, PhD, Tae Kyun Kim MD, PhD

In studies of TKA, treating each knee as an independent case in patients with bilateral TKAs can lead to errors, because patients with bilateral and unilateral TKAs may achieve different levels of function and because the assumption of statistical independence is violated.

Total Knee Arthroplasty in the Elderly: Does Age Affect Pain, Function or Complications?

John W. Kennedy BMSc (Hons), MBChB, Linda Johnston RGN, BN, MSc, Lynda Cochrane PhD, Petros J. Boscainos MD

TKA is one of the most commonly performed procedures in the elderly, yet whether age influences postoperative pain, function, and complication rates is not fully understood for this group. This is because the current literature has limited followup, small sample sizes, and no comparator group.

Tibia Vara Affects the Aspect Ratio of Tibial Resected Surface in Female Japanese Patients Undergoing TKA

Shigeshi Mori MD, Masao Akagi MD, PhD, Shigeki Asada MD, Tetsunao Matsushita MD, Kazuhiko Hashimoto MD

Tibia vara seen in Japanese patients reportedly influences the tibial component alignment when performing TKA. However, it is unclear whether tibia vara affects the component position and size selection.

Can A Modified Robert Jones Bandage After Knee Arthroplasty Reduce Blood Loss? A Prospective Randomized Controlled Trial

Piya Pinsornsak MD, Sukanis Chumchuen MD

A bulky compression dressing (Robert Jones bandage) is commonly used after TKA to reduce blood loss, pain, and swelling. However, it is unclear whether these dressings in fact reduce blood loss.

Proximal Tibial Bone Density Is Preserved After Unicompartmental Knee Arthroplasty

Bradley I. Richmond MBChB, Simon V. Hadlow MBChB, Tim G. Lynskey MBChB, Cameron G. Walker PhD, Jacob T. Munro MBChB

Bone mineral density (BMD) in the proximal tibia decreases after TKA and is believed to be a factor in implant migration and loosening. Unicompartmental knee arthroplasty (UKA) is a less invasive procedure preserving knee compartments unaffected by degeneration. Finite element studies have suggested UKA may preserve BMD and that implants of differing stiffnesses might differentially affect BMD but these notions have not been clinically confirmed.