Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 433 articles

Articles

Can Preoperative Patient-reported Outcome Measures Be Used to Predict Meaningful Improvement in Function After TKA?

Jonathan L. Berliner MD, Dane J. Brodke BA, Vanessa Chan MPH, Nelson F. SooHoo MD, Kevin J. Bozic MD, MBA

Despite the overall effectiveness of total knee arthroplasty (TKA), a subset of patients do not experience expected improvements in pain, physical function, and quality of life as documented by patient-reported outcome measures (PROMs), which assess a patient’s physical and emotional health and pain. It is therefore important to develop preoperative tools capable of identifying patients unlikely to improve by a clinically important margin after surgery.

Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Knee Arthroplasty?

Bhaveen H. Kapadia MD, Peter L. Zhou BA, Julio J. Jauregui MD, Michael A. Mont MD

Many preventive methodologies seek to reduce the risk of surgical site infections after total knee arthroplasty (TKA), including the use of preoperative chlorhexidine baths and cloths. Although we have demonstrated in previous studies that this may be an efficacious method for infection prevention, our study was underpowered and we therefore set out to evaluate this with a larger sample size.

The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA?

Nicholas A. Bedard MD, Andrew J. Pugely MD, Jacob M. Elkins MD, PhD, Kyle R. Duchman MD, Robert W. Westermann MD, Steve S. Liu MD, Yubo Gao PhD, John J. Callaghan MD

Infection after total knee arthroplasty (TKA) can result in disastrous consequences. Previous research regarding injections and risk of TKA infection have produced conflicting results and in general have been limited by small cohort size.

How Does Wear Rate Compare in Well-functioning Total Hip and Knee Replacements? A Postmortem Polyethylene Liner Study

Robin Pourzal PhD, Christopher B. Knowlton BS, Deborah J. Hall BS, Michel P. Laurent PhD, Robert M. Urban, Markus A. Wimmer PhD

The longevity of total hip (THR) and knee replacements (TKR) that used historical bearing materials of gamma-in-air sterilized UHMWPE was affected more by osteolysis in THRs than in TKRs, although osteolysis remains a concern in TKRs. Therefore, the study of polyethylene wear is still of interest for the knee, particularly because few studies have investigated volumetric material loss in tibial knee inserts. For this study, a unique collection of autopsy-retrieved TKR and THR components that were well-functioning at the time of retrieval was used to compare volumetric wear differences between hip and knee polyethylene components made from identical material.

Pain Control and Functional Milestones in Total Knee Arthroplasty: Liposomal Bupivacaine versus Femoral Nerve Block

Stephen Yu MD, Alessandra Szulc MA, Sharon Walton MD, Joseph Bosco MD, Richard Iorio MD

Although pain management after total knee arthroplasty (TKA) affects rehabilitation, length of stay, and functional outcomes, pain management for patients undergoing TKA has yet to be standardized. Femoral nerve blocks (FNBs) are commonly used as an adjunct; however, these can result in transient quadriceps weakness and have been associated with in-hospital falls. Periarticular infiltration of liposomal bupivacaine has been recently introduced as a long-acting analgesic that can be administered without affecting motor function.

Antibiotic-tolerant Staphylococcus aureus Biofilm Persists on Arthroplasty Materials

Kenneth L. Urish MD, PhD, Peter W. DeMuth BS, Brian W. Kwan PhD, David W. Craft PhD, Dongzhu Ma PhD, Hani Haider PhD, Rocky S. Tuan PhD, Thomas K. Wood PhD, Charles M. Davis MD

The continued presence of biofilm may be one cause of the high risk of failure observed with irrigation and débridement with component retention in acute periprosthetic joint infection (PJI). There is a poor understanding of the role of biofilm antibiotic tolerance in PJI.

Validation of the KOOS, JR: A Short-form Knee Arthroplasty Outcomes Survey

Stephen Lyman PhD, Yuo-Yu Lee MS, Patricia D. Franklin MD, MBA, MPH, Wenjun Li PhD, Michael B. Cross MD, Douglas E. Padgett MD

Medicare is rapidly moving toward using patient-reported outcome measures (PROMs) for outcomes assessment and justification of orthopaedic and other procedures. Numerous measures have been developed to study knee osteoarthritis (OA); however, many of these surveys are long, disruptive to clinic flow, and result in incomplete data capture and/or low followup rates. The Knee injury and Osteoarthritis Outcome (KOOS) physical function short-form (KOOS-PS), while shorter, ignores pain, which is a primary concern of patients with advanced knee OA.

Synovial Cytokines and the MSIS Criteria Are Not Useful for Determining Infection Resolution After Periprosthetic Joint Infection Explantation

Salvatore J. Frangiamore MD, Marcelo B. P. Siqueira MD, Anas Saleh MD, Thomas Daly MD, Carlos A. Higuera MD, Wael K. Barsoum MD

Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure.

What Is the Frequency of Noise Generation in Modern Knee Arthroplasty and Is It Associated With Residual Symptoms?

Denis Nam MD, MSc, Toby Barrack BA, Ryan M. Nunley MD, Robert L. Barrack MD

Prior investigations have recognized the presence of patient-perceived noise generation after total knee arthroplasty (TKA). However, questions remain regarding its overall frequency after both TKA and unicompartmental knee arthroplasty (UKA) as well as with respect to its association with demographic and prosthesis-related factors and its association with patient-reported outcomes.

What Factors Influence the Success of Medial Gastrocnemius Flaps in the Treatment of Infected TKAs?

Matthew W. Tetreault MD, Craig J. Della Valle MD, Daniel D. Bohl MD, MPH, Sameer J. Lodha MD, Debdut Biswas MD, Robert W. Wysocki MD

Soft tissue defects after TKA are a potentially devastating complication. Medial gastrocnemius flaps occasionally are used to provide soft tissue coverage, most commonly with a periprosthetic joint infection.