Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 450 articles

Articles

Reason for Revision Influences Early Patient Outcomes After Aseptic Knee Revision

Paul Baker MBBS, MSc, FRCS (Trauma & Orthop), Paul Cowling MBBS, MRCS, Steven Kurtz PhD, Simon Jameson MBBS, MRCS, Paul Gregg MD, FRCS (Ed), FRCS, David Deehan MD, MSc, FRCS (Trauma & Orthop)

Revision TKA less consistently produces improvements in clinical function and quality of life when compared with primary TKA. The reasons for this difference are unclear.

Knee Wear Measured in Retrievals: A Polished Tray Reduces Insert Wear

Daniel J. Berry MD, John H. Currier MS, Michael B. Mayor MD, John P. Collier DE

Polyethylene wear is often cited as the cause of failure of TKA. Rotating platform (RP) knees show notable surface damage on the rotating surface raising concerns about increased wear compared to fixed bearing inserts.

Is Unicompartmental Arthroplasty an Acceptable Option for Spontaneous Osteonecrosis of the Knee?

Danilo Bruni MD, Francesco Iacono MD, Giovanni Raspugli MD, Stefano Zaffagnini MD, Maurilio Marcacci MD

The literature suggests survivorship of unicompartmental knee arthroplasties (UKAs) for spontaneous osteonecrosis of the knee ranges from 93% to 97% at 10 to 12 years. However, these data arise from small series (23 to 33 patients), jeopardizing meaningful conclusions.

Drilling Juvenile Osteochondritis Dissecans: Retro- or Transarticular?

Matthew J. Gunton MD, James L. Carey MD, MPH, Colin R. Shaw BSc (Hons), MSc, M. Lucas Murnaghan MD, MEd, FRCSC

Early diagnosis and successful treatment of juvenile osteochondritis dissecans (JOCD) is essential in preventing articular degeneration at a young age. Surgical treatment of stable JOCD lesions failing nonoperative treatment involves retroarticular or transarticular drilling to induce revascularization and healing. Multiple case series report high healing rates and infrequent complications for both retroarticular and transarticular drilling modalities; however, it is unclear from these individual reports whether one mode of drilling provides higher healing rates.

Do Patient-specific Guides Improve Coronal Alignment in Total Knee Arthroplasty?

Ryan M. Nunley MD, Bradley S. Ellison MD, Jinjun Zhu MD, PhD, Erin L. Ruh MS, Stephen M. Howell MD, Robert L. Barrack MD

Coronal alignment may impact clinical outcome and survivorship in TKA. Patient-specific instrumentation has been developed to restore mechanical or kinematic axis and potentially reduce component malpositioning. Although it is clear these instruments add cost, it is unclear whether they improve alignment.

Are Patient-specific Cutting Blocks Cost-effective for Total Knee Arthroplasty?

Ryan M. Nunley MD, Bradley S. Ellison MD, Erin L. Ruh MS, Brandon M. Williams DC, Keith Foreman RN, BS, CNOR, Adrienne D. Ford MPH, Robert L. Barrack MD

Using patient-specific cutting blocks for TKA increases the cost to the hospital for these procedures, but it has been proposed they may reduce operative times and improve implant alignment, which could reduce the need for revision surgery.

Does Using Autograft Bone Chips Achieve Consistent Bone Ingrowth in Primary TKA?

Roy D. Bloebaum PhD, Karyn E. Koller MD, MPH, Bettina M. Willie PhD, Aaron A. Hofmann MD

Cementless fixation remains controversial in TKA due to the challenge of achieving consistent skeletal attachment. Factors predicting durable fixation are not clearly understood, but we presumed bone ingrowth could be enhanced by the quantity of host bone and application of autograft bone chips.

Does Primary or Secondary Chondrocalcinosis Influence Long-term Survivorship of Unicompartmental Arthroplasty?

Philippe Hernigou MD, Walter Pascale MD, Valerio Pascale MD, Yasuhiro Homma MD, Alexandre Poignard MD

Coexistence of degenerative arthritis and calcium pyrophosphate dihydrate (CPPD) crystals (or radiological chondrocalcinosis) with osteoarthritis (OA) of the knees is frequent at the time of arthroplasty. Several studies suggest more rapid clinical and radiographic progression with CPPD than with OA alone. However, it is unclear whether chondrocalcinosis predisposes to higher risks of progression of arthritis in other compartments.

Does Ramosetron Reduce Postoperative Emesis and Pain after TKA?

In Jun Koh MD, Chong Bum Chang MD, Young-Tae Jeon MD, Jung-Hee Ryu MD, Tae Kyun Kim MD

Current pain management protocols involving many anesthetic and analgesic drugs reportedly provide adequate analgesia after TKA. However, control of emetic events associated with the drugs used in current multimodal pain management remains challenging.

A New High-flexion Knee Scoring System to Eliminate the Ceiling Effect

Sang-Eun Na MD, Chul-Won Ha MD, Choong-Hee Lee MD

Various scoring systems document improvement after TKA, but most are associated with a ceiling effect that may fail to distinguish between patients having different levels of knee function after TKA. We therefore developed a new scoring system for patients with higher levels of flexion to eliminate ceiling effects observed with current systems.