Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 443 articles


Low Risk of Thromboembolic Complications With Tranexamic Acid After Primary Total Hip and Knee Arthroplasty

Blake P. Gillette MD, Lori J. DeSimone PA, Robert T. Trousdale MD, Mark W. Pagnano MD, Rafael J. Sierra MD

The use of antifibrinolytic medications in hip and knee arthroplasty reduces intraoperative blood loss and decreases transfusion rates postoperatively. Tranexamic acid (TXA) specifically has not been associated with increased thromboembolic (TE) complications, but concerns remain about the risk of symptomatic TE events, particularly when less aggressive chemical prophylaxis methods such as aspirin alone are chosen.

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

James H. Hui FRCS, MD, Xiafei Ren PhD, Mohd Hassan Afizah MSc, Kerm Sin Chian PhD, Antonios G. Mikos PhD

Management of osteochondritis dissecans remains a challenge. Use of oligo[poly(ethylene glycol)fumarate] (OPF) hydrogel scaffold alone has been reported in osteochondral defect repair in small animal models. However, preclinical evaluation of usage of this scaffold alone as a treatment strategy is limited.

The John Insall Award: No Benefit of Minimally Invasive TKA on Gait and Strength Outcomes: A Randomized Controlled Trial

Julien Wegrzyn MD, PhD, Sebastien Parratte MD, PhD, Krista Coleman-Wood PhD, PT, Kenton R. Kaufman PhD, PE, Mark W. Pagnano MD

While some clinical reports suggest minimally invasive surgical (MIS) techniques improve recovery and reduce pain in the first months after TKA, it is unclear whether it improves gait and thigh muscle strength.

Discordance in TKA Expectations Between Patients and Surgeons

Hassan M. K. Ghomrawi PhD, MPH, Carol A. Mancuso MD, Geoffrey H. Westrich MD, Robert G. Marx MD, MSc, Alvin I. Mushlin MD, ScM

Aligning patient and surgeon expectations preoperatively may lead to better postoperative medical and rehabilitation compliance and therefore improve outcomes and increase satisfaction.

High Infection Control Rate and Function After Routine One-stage Exchange for Chronically Infected TKA

Jean-Yves Jenny MD, Bruno Barbe MD, Jeannot Gaudias MD, Cyril Boeri MD, Jean-Noël Argenson MD

Many surgeons consider two-stage exchange the gold standard for treating chronic infection after TKA. One-stage exchange is an alternative for infection control and might provide better knee function, but the rates of infection control and levels of function are unclear.

Higher Cefazolin Concentrations with Intraosseous Regional Prophylaxis in TKA

Simon W. Young FRACS, Mei Zhang PhD, Joshua T. Freeman FRCPA, Kelly G. Vince MD, Brendan Coleman FRACS

Prophylactic antibiotics reduce the risk of deep infection after primary TKA. However, conventional systemic dosing may not provide adequate tissue concentrations against more resistant organisms such as coagulase-negative staphylococci. Regional intravenous administration of antibiotics after tourniquet inflation achieves far higher tissue concentrations but requires foot vein cannulation. The intraosseous route may offer a rapid and reliable method of regional administration.

Aseptic Tibial Debonding as a Cause of Early Failure in a Modern Total Knee Arthroplasty Design

Diren Arsoy MD, Mark W. Pagnano MD, David G. Lewallen MD, Arlen D. Hanssen MD, Rafael J. Sierra MD

We observed isolated tibial component debonding from the cement in one modern primary TKA design (NexGen LPS 3° tibial tray; Zimmer, Warsaw, IN, USA). This failure mechanism is sparsely reported in the literature.

Is Pain and Dissatisfaction After TKA Related to Early-grade Preoperative Osteoarthritis?

Gregory G. Polkowski MD, Erin L. Ruh MS, Toby N. Barrack, Ryan M. Nunley MD, Robert L. Barrack MD

There is growing evidence to suggest many patients experience pain and dissatisfaction after TKA. The relationship between preoperative osteoarthritis (OA) severity and postoperative pain and dissatisfaction after TKA has not been established.

Voriconazole Is Delivered From Antifungal-Loaded Bone Cement

Ryan B. Miller MD, Alex C. McLaren MD, Christine Pauken PhD, Henry D. Clarke MD, Ryan McLemore PhD

Local delivery of antifungals is an important modality in managing orthopaedic fungal infection. Voriconazole is a powder antifungal suitable for addition to bone cement that is released from bone cement but the mechanical properties of antimicrobial-loaded bone cement (ALBC) made with voriconazole are unknown.

The 2012 ABJS Nicolas Andry Award: The Sequence of Prevention: A Systematic Approach to Prevent Anterior Cruciate Ligament Injury

Timothy E. Hewett PhD, Gregory D. Myer PhD, Kevin R. Ford PhD, Mark V. Paterno PhD, PT, Carmen E. Quatman MD, PhD

ACL injuries are common, often devastating injuries that lead to short-term disability and long-term sequelae, many of which lack effective treatment, such as osteoarthritis. Therefore, prevention of ACL injury is currently the only effective intervention for these life-altering sequelae, while much of the literature has a rehabilitative focus.