Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 450 articles

Articles

Polyethylene Quality Affects Revision Knee Liner Exchange Survivorship

C. Anderson Engh MD, Nancy L. Parks MS, Gerard A. Engh MD

Options to treat patients with wear or osteolysis include full revision, partial (tibial or femoral) revision, and isolated polyethylene exchange. It is unclear whether one choice is superior to the other. Polyethylene quality reportedly influences the survivorship of primary TKA, but similar reports are not described for revision TKA.

Improved Accuracy of Alignment With Patient-specific Positioning Guides Compared With Manual Instrumentation in TKA

Vincent Y. Ng MD, Jeffrey H. DeClaire MD, Keith R. Berend MD, Bethany C. Gulick RT (R), Adolph V. Lombardi MD

Coronal malalignment occurs frequently in TKA and may affect implant durability and knee function. Designed to improve alignment accuracy and precision, the patient-specific positioning guide is predicated on restoration of the overall mechanical axis and is a multifaceted new tool in achieving traditional goals of TKA.

Restoration of the Distal Femur Impacts Patellar Height in Revision TKA

Saurabh Khakharia MD, Giles R. Scuderi MD

Restoring patellar height is important in revision TKA for normal knee function and kinematics. Alteration in patellar height after revision TKA is associated with inferior extensor mechanism function.

Mark B. Coventry Award: Synovial C-reactive Protein: A Prospective Evaluation of a Molecular Marker for Periprosthetic Knee Joint Infection

Javad Parvizi MD, FRCS, Christina Jacovides BS, Bahar Adeli BA, Kwang Am Jung MD, William J. Hozack MD

C-reactive protein (CRP) serum assays are a standard element of the diagnostic workup for periprosthetic joint infection (PJI). However, because CRP is a marker for systemic inflammation, this test is not specific to PJI.

Residual Varus Alignment does not Compromise Results of TKAs in Patients with Preoperative Varus

Robert A. Magnussen MD, Florent Weppe MD, Guillaume Demey MD, Elvire Servien MD, PhD, Sébastien Lustig MD, PhD

Postoperative varus alignment has been associated with lower IKS scores and increased failure rates. Appropriate positioning of TKA components therefore is a key concern of surgeons. However, obtaining neutral alignment can be challenging in patients with substantial preoperative varus deformity and it is unclear whether residual deformity influences revision rates.

Risk Factors for Peroneal Nerve Injury and Recovery in Knee Dislocation

Christopher J. Peskun MD, Jas Chahal MD, Zvi Y. Steinfeld BSc, Daniel B. Whelan MD

Acute knee dislocation is rare but has a high rate of associated neurovascular injuries and potentially limb-threatening complications. These include the substantial morbidity associated with peroneal nerve injury: neuropathic pain, decreased mobility, and considerably reduced function, which not only impairs patient function but complicates treatment.

Hypesthesia after Anterolateral versus Midline Skin Incision in TKA: A Randomized Study

Jean-Michel Laffosse MD, Anna Potapov MD, Michel Malo MD, Martin Lavigne MD, Pascal-André Vendittoli MD

The anterior midline skin incision in a TKA provides excellent surgical exposure. However, it usually requires sectioning the infrapatellar branch of the saphenous nerve which may be associated with lateral cutaneous hypesthesia and neuroma formation.

Platelet-rich Plasma Does Not Reduce Blood Loss or Pain or Improve Range of Motion After TKA

Timothy M. DiIorio MD, Justin D. Burkholder BS, Robert P. Good MD, Javad Parvizi MD, Peter F. Sharkey MD

Numerous reports suggest the application of platelet-rich plasma (PRP) during TKA may decrease postoperative bleeding. Because excessive bleeding can increase postoperative pain and inflammation, use of PRP also reportedly decreases the need for narcotics and increases speed of recovery after TKA. Because previous investigations of PRP and TKA reflect a weak level of medical evidence, we sought to confirm these findings.

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

Rebecca Avrin Zifchock PhD, Yatin Kirane MBBS, DOrtho, PhD, Howard Hillstrom PhD

Although the severity of knee osteoarthritis (OA) usually is assessed using different measures of joint structure, function, and pain, the relationships between these measures are unclear.

All-Polyethylene Tibial Components in Obese Patients Are Associated With Low Failure at Midterm Followup

David F. Dalury MD, Kimberly K. Tucker MD, Todd C. Kelley MD

In the United States, the obese population has increased markedly over the last four decades, and this trend continues. High patient weight places additional stress on TKA components, which may lead to increased polyethylene wear, osteolysis, radiolucencies, and clinical failure. Metal-backed tibial components and all-polyethylene tibial components in the general population have comparable osteolysis and failure, but it is unclear whether these components yield similar osteolysis and failure in obese patients.