Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Knee 450 articles


Breakout Session: Gender Disparities in Knee Osteoarthritis and TKA

Mary I. O’Connor MD, Elizabeth Gerken Hooten ScD, MSPH, CPH

Biologically derived (sex-based) and behaviorally influenced (gender-based) disparities exist in knee osteoarthritis and treatment with TKA.

The Surgical Apgar Score in Hip and Knee Arthroplasty

Thomas H. Wuerz MD, MSc, Scott E. Regenbogen MD, MPH, Jesse M. Ehrenfeld MD, Henrik Malchau MD, PhD, Harry E. Rubash MD, Atul A. Gawande MD, MPH, David M. Kent MD, MS

A 10-point Surgical Apgar Score, based on patients’ estimated blood loss, lowest heart rate, and lowest mean arterial pressure during surgery, was developed to rate patients’ outcomes in general and vascular surgery but has not been tested for patients having orthopaedic surgery.

Persistent Hindfoot Valgus Causes Lateral Deviation of Weightbearing Axis after Total Knee Arthroplasty

Arun Mullaji FRCS Ed, MCh Orth, MS Orth, Gautam M. Shetty MS Orth

The weightbearing axis of the limb goes from the pelvis to the ground and includes the hindfoot. However, the influence of hindfoot alignment on mechanical axis and overall limb alignment after TKA is unclear.

Factors Influencing Health-related Quality of Life after TKA in Patients who are Obese

Montserrat Nuñez PhD, Lluis Lozano PhD, Esther Nuñez PhD, Josep-Maria Segur PhD, Sergi Sastre PhD

Although the health-related quality of life (HRQL) for patients who are obese seems to improve after TKA, the magnitude of improvement and the associated factors remain controversial. We previously found body mass index was not associated with changes in HRQL after TKA.

Is Minimally Invasive Total Knee Arthroplasty Associated with Lower Costs Than Traditional TKA?

Jason C. King MD, MPH, Paul A. Manner MD, Daniel L. Stamper PA-C, Douglas C. Schaad PhD, Seth S. Leopold MD

Studies of minimally invasive surgery (MIS) approaches to TKA have shown decreased postoperative pain, earlier return to function, and shorter lengths of stay in the hospital. However, it is unclear whether these differences translate into decreased costs or charges associated with care.

Continuous Infusion of UHMWPE Particles Induces Increased Bone Macrophages and Osteolysis

Pei-Gen Ren DVM, PhD, Afraaz Irani BS, Zhinong Huang MD, PhD, Ting Ma MD, MSc, Sandip Biswal MD, Stuart B. Goodman MD, PhD

Aseptic loosening and periprosthetic osteolysis resulting from wear debris are major complications of total joint arthroplasty. Monocyte/macrophages are the key cells related to osteolysis at the bone-implant interface of joint arthroplasties. Whether the monocyte/macrophages found at the implant interface in the presence of polyethylene particles are locally or systemically derived is unknown.

Effects of a Knee Extension Constraint Brace on Lower Extremity Movements after ACL Reconstruction

Christopher J. Stanley MS, R. Alexander Creighton MD, Michael T. Gross PT, PhD, FAPTA, William E. Garrett MD, PhD, Bing Yu PhD

Patients have high reinjury rates after ACL reconstruction. Small knee flexion angles and large peak posterior ground reaction forces in landing tasks increase ACL loading.

How to Treat A Tibial Post Fracture in Total Knee Arthroplasty?

Paul F. Lachiewicz MD

Posterior-stabilized TKAs, which use a polyethylene tibial post to articulate against a metal femoral cam, are used regularly. Reported complications are related to the patellofemoral articulation or the tibial post-cam mechanism. Fracture of the tibial post is an uncommon but disabling complication after posterior-stabilized TKA that requires operative treatment.

Is the Etiology of Pretibial Cyst Formation After Absorbable Interference Screw Use Related to a Foreign Body Reaction?

Guillem Gonzalez-Lomas MD, Ryan T. Cassilly BS, Fabrizio Remotti MD, William N. Levine MD

Arthroscopically assisted anterior cruciate ligament reconstruction using a bioabsorbable tibial fixation screw is occasionally complicated by pretibial cyst formation. The few case reports describing pretibial cyst formation noted several graft types and fixation techniques, making it difficult to establish one etiology. Some literature suggests cysts form from communication between the joint and pretibial area leading to extravasation of joint fluid, maturing into a cyst. We propose the development of cysts after PLLA screw use may be related to a foreign body reaction.

Modified Hybrid Stem Fixation in Revision TKA is Durable at 2 to 10 Years

Alexander P. Sah MD, Sanjai Shukla MD, Craig J. Della Valle MD, Aaron G. Rosenberg MD, Wayne G. Paprosky MD

Hybrid revision knee component fixation, in which cement is placed in the metaphysis combined with a cementless diaphyseal engaging stem, provides ease of insertion, possibly improved component alignment, and easier removal if required, compared with fully cemented prostheses. The literature suggests the technique has a 2 to 5 year survivorship ranging from 81% to 94%.