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Medial UKA performed in England and Wales represents seven to 11% of all knee arthroplasty procedures, and is most commonly performed using mobile-bearing designs.Fixed bearing eliminates the risk of bearing dislocation, however some studies have shown higher revision rates for all-polyethylene tibial components compared to those that utilize metal-backed implants. The aim of the study is to analyse...
Pulmonary arterial hypertension (PAH) is defined as pulmonary hypertension (PH) with a pulmonary wedge pressure (PWP) ≤15mmHg; however, some patients with pulmonary venous hypertension (PVH) may have a baseline PWP that is <15mmHg. To identify patients with PVH who would otherwise be classified as having PAH, we measured hemodynamic variables at baseline and after a fluid bolus. The PWP rose to...
Arthrodesis of the knee is an infrequently performed operation perceived by both patient and surgeon to have a poor outcome. This study compares functional outcome of knee arthrodesis following failed primary arthroplasty with that of revision knee arthroplasty in a matched patient group. Outcome was measured using the SF12 and Oxford Knee Score. Twelve patients underwent arthrodesis, of which eight...
In order to investigate whether any single batch of polyethylene inserts was responsible for premature failure of total knee replacements (TKR), we performed a retrospective database review of 1133 consecutive primary Kinemax Plus TKR performed by 2 surgical teams between January 1992 and January 2001 at our institution. Cases re-operated in any way within 5 years of the index arthroplasty were identified,...
The mechanisms of failure for unicompartmental arthroplasty are poorly understood. There is some suggestion that long term ligament degeneration, particularly of the anterior cruciate ligament (ACL), may affect long term survivorship. This study evaluated whether the cruciate mechanism remained functional in the long term (10 years) following UKA.Two separate cohorts of patients who had undergone...
In order to aid patient selection we have analysed the radiological progression of arthritis in the retained compartments following lateral unicompartmental knee replacement (UKR). Patients undergoing lateral UKR (St Georg Sled, Waldemar Link) between 1988 and 1999 were assessed. Radiographs taken post-operatively within 8 weeks and at 5 years were assessed. OA was classified using both the Altman...
Progressive symptomatic tibiofemoral osteoarthritis (OA) following patellofemoral joint replacement (PFJR) may necessitate revision to total knee arthroplasty. This study was designed to quantify this problem in a prospective series of 103 consecutive patients who underwent PFJRs undertaken at our institution.At a mean follow-up of 7.1 years (66–102 months), 14 knees (14%) have been revised, 12 of...
Adolescent anterior knee pain has traditionally been described as running a benign and self-limiting course. Studies more recently have questioned this supposition. This study aimed to assess how many patients who had undergone patellofemoral arthroplasty for isolated patellofemoral arthritis had previously suffered from adolescent anterior knee pain, knee instability and trauma. This group was then...
Background: Failure of knee arthroplasty can lead to significant pain and functional disability. In a small number of patients with fracture, sepsis or massive bone loss they are considered for arthrodesis or above knee amputation. The purpose of this study was to investigate the results and complications of using customised hinged knee replacements in their place. Methods: Since 1993, 30 of the 280...
Failure of a unicompartmental knee replacement (UKR) may be caused by progressive osteoarthritis of the knee and/or failure of the prosthesis. We have examined the fate of the other compartments of the knee by radiological assessment 10 years after operation.A total of 50 UKRs were performed on 45 carefully selected patients between 1989 and 1992. Fifteen patients died, two patients were lost to follow-up...
Unicompartmental knee replacement (UKR) for anteromedial osteoarthritis is a well-established technique. Numerous clinical outcome studies demonstrate good medium and long-term results. The aim of this prospective study was to compare the complications and short-term clinical outcome of the St. Georg Sled, a fixed bearing UKR, with the Oxford mobile bearing UKR. Outcome at 2 years was assessed using...
Polyethylene wear is considered a threat to the long-term survival of unicompartmental knee replacement (UKR). This study aims to determine the linear penetration and volumetric wear associated with a non-congruent commonly used UKR, the St Georg Sled. This prosthesis has a biconvex femoral component which articulates with a flat polyethylene tibial component resulting in point contact.Components...
Patellectomy may in some cases result in persistent pain, weakness and instability of the knee. We report on three patients who had extensor tendon instability and were treated by trochlear resurfacing and extensor tendon realignment. All three cases achieved pain relief and an impressive improvement in knee function.
This study investigates patients' perception of kneeling ability before and at 1 and 2 years after total, unicompartmental knee replacement (UKR) and patellofemoral knee replacement (PFR), for osteoarthritis. Kneeling is an important function of the knee joint required for many daily activities and inability to kneel after knee surgery is a frequent cause of dissatisfaction. Data were prospectively...
Modifications of established implants can result in deleterious effects, as with the Capitol and the matt coated Exeter hips. In 1991 the Kinemax plus modification of the Kinematic knee was introduced in Bristol, the design changes having been made to reduce patello-femoral complications. We carried out a comparative analysis of the prospective recorded data on a consecutive series of 182 total knee...
Introduction: The latest government targets state that by the end of 2005 the maximum waiting time for an outpatient appointment will be 3 months. These recommendations will not only increase the size of the outpatient clinics, but also the resources required thereafter. The purpose of this study was to analyse the outcome of new patient referrals to one knee outpatient service in order to quantify...
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