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There have been no published reports detailing the clinical performance of the Vario Knee System (VKS) total knee arthroplasty (TKA) since its introduction in 2001. The current study was therefore undertaken to provide 5-year clinical and radiographic follow-up data for this implant. Over a 24-month period, 146 VKS TKAs were performed in 131 patients (mean age, 69years). Prospective data and radiographs...
Injury to the anterior cruciate ligament (ACL) is associated with increased risk of osteoarthritis and subsequent need for total knee arthroplasty (TKA). The impact of prior ACL reconstruction on TKA has been rarely studied. Twenty-two patients undergoing TKA, with a mean of 26years following ACL reconstruction, were compared to a matched control group. Tibial exposure was more difficult in the study...
Excision of the eroded lateral patellar facet has been suggested as an acceptable treatment for short-term pain reduction in patients with isolated patellofemoral osteoarthritis. The outcome of this procedure at long-term is however not known. We therefore reviewed the results of 155 consecutive patients (168 knees) treated at our institution with lateral facetectomy at an average follow up of 10...
Altered kinematics following ACL-reconstruction may be a cause of post-traumatic osteoarthritis. T 1ρ MRI is a technique that detects early cartilage matrix degeneration. Our study aimed to evaluate kinematics following ACL-reconstruction, cartilage health (using T 1ρ MRI), and assess whether altered kinematics following ACL-reconstruction are associated with early cartilage degeneration...
Patients with anterior cruciate ligament (ACL) deficiency may have increased failure rates with UKA as a result of abnormal contact stresses and altered knee kinematics. Variations in the slope of the tibial component in UKA may alter tibiofemoral translation, and affect outcomes. This cadaveric study evaluated tibiofemoral translation during the Lachman and pivot shift tests after changing the slope...
The evidence linking body mass index (BMI) to severe OA shows a strong association in the knee. There are limited data exploring the effect of BMI on the risk of joint arthroplasty in a healthy population with long periods of follow up. We compared the self-reported BMI at age 20, measured BMI at baseline, year 5 and year 10 with the year 19 risk of total knee arthroplasty (TKA) in a well-described,...
Neglected rupture of the patellar tendon is rare but becomes more difficult to repair the longer it is left untreated. The most common rupture sites are the inferior pole of the patella and distal insertion. Proximal retraction of the patella and extensor mechanism adhesions makes the treatment more difficult than acute tendon rupture. We report two patients with neglected patellar tendon rupture...
The aim of this study was to evaluate a new collagen–GAG–calcium phosphate biphasic scaffold for the repair of surgically created osteochondral defects in goats. Comparison of morphological, histological and mechanical performance of the repair tissue was made with defects repaired using a synthetic polymer scaffold. Defects were created in the medial femoral condyle (MFC) and lateral trochlear sulcus...
Knee injuries are highly prevalent in athletic populations, particularly among female athletes. Many of these injuries occur during landing from a jump. Various comprehensive knee injury prevention programs have been developed to date. However, there is a need to determine which components of these programs contribute directly to changes in knee biomechanics. Therefore, the purpose of this study was...
There is no ideal treatment for younger patients with medial knee osteoarthritis (OA) and varus malalignment. We have investigated the first case series of combined neutralising high tibial osteotomy (HTO) and Matrix-induced Autologous Chondrocyte Implantation (MACI) with MRI. Treatment goals were clinical improvement and delay of arthroplasty.Between 2002 and 2005 18 patients (Mean age 47years) underwent...
We report the first case of the assessment and treatment of a spontaneous patellar fracture in a patient with Goltz syndrome—a rare dermal hypoplasia. This case illustrates the non-straightforward presentation of a spontaneous patellar fracture in seemingly osteoporotic bone stock further complicated by the inability to rule out osteomyelitis. In this confusing presentation, a high index of suspicion...
The current rate of day-case anterior cruciate ligament reconstruction (ACLR) in the UK remains low. Although specialised care pathways with standard operating procedures (SOPs) have been effective in reducing length of stay following some surgical procedures, this has not been previously reported for ACLR. We evaluate the effectiveness of SOPs for establishing day-case ACLR in a specialist unit.Fifty...
The purpose of the study was analysis of leg alignment and tibial slope comparing intramedullary versus extramedullary tibial instrumentation in the Genesis II MIS-TKA (Smith & Nephew, Memphis, USA).A prospective randomized study was performed according to the CONSORT guidelines. All patients (56 patients) for MIS-TKA were included, if the pre-operative standing long leg X-ray demonstrated the...
Stiffness is a known complication following total knee arthroplasty. Multiple options are available to address this problem but revision TKA has been reported to be an effective treatment especially in the presence of technical issues such as oversized or loose components. However, it is not clearly known what factors may affect the outcome of revision TKA for stiffness. The purpose of this study...
Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients...
Recent reports suggest good outcome results following unicompartmental knee replacement (UKR). However, a number of authors have commented on the problem of osseous defects requiring technically difficult revision surgery. We reviewed clinical outcomes following revision total knee replacement (TKR) for failed UKR and analysed the reasons for failure and the technical aspects of the revision surgery...
The use of highly conforming polyethylene inlays in total knee arthroplasty (TKA) provides improved anteroposterior stability.The aim of this fluoroscopic study was to investigate the in vivo kinematics during unloaded and loaded active extension with a highly conforming inlay and a flat inlay after cruciate retaining (CR) total knee arthroplasty (TKA).Thirty one patients (50 knees) received a fixed-bearing...
Knee arthroplasty provides not only pain relief but also an improvement in function and range of movement. Limited joint mobility is a common complication of diabetes mellitus. We therefore examined functional outcome post total knee arthroplasty in a cohort of subjects with (n=367) and a cohort matched for age, sex, BMI and functional movement at baseline, without diabetes mellitus (n=367). Participants...
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