See yesterday’s most popular searches here. Resurfacing versus nonresurfacing the patella in total knee arthroplasty: Patellar eversion or not mid-vastus approach No statistical differences between 2 groups throughout the follow-up periods in recovery of quadriceps force or power and clinical data Arnout et al[ 51 ] Prospective randomized study. These conflicting results are an indication that larger and better conducted high quality trials are needed in order to gain more secure answers. Furthermore, the authors did not note differences in the parameters of postoperative pain, knee motion, and wound-related complications between the groups and came to an important secondary finding: Posterior cruciate-retaining versus posterior stabilized total knee arthroplasty: Total knee arthroplasty TKA is a widely used operation that has radically improved the quality of life of millions of people suffering from symptomatic knee OA during the last decades[ 2 ].
Predicting dissatisfaction following total knee replacement: Prospective randomized controlled trial. Furthermore, Arnout et al[ 51 ] in , in a prospective randomized study, concluded that patellar dislocation without eversion improved the active and passive range of knee motion up to 1 year postoperatively and recommended this procedure as safe. Thus, we tried to shed some light into these controversies, by extracting from the literature high quality papers that have as an object the answer to the previously reported questions. We have tried to extract the best and most up-to-date evidence available regarding some of the most debatable aspects of TKR surgery regarding the everyday surgical technique of thousands of orthopedic surgeons around the world.
Patellar eversion during TKR surgery has traditionally been used to facilitate exposure and component positioning. Patellar resurfacing vs nonresurfacing Patellar resurfacing reduce the risk of reoperation after TKR.
A meta-analysis and systematic review. In a minimum follow-up of 7 years, the authors did not find a difference between the 2 methods regarding pain, radiographic findings, and functional knee scores, but recommended patellar reshaping, because it retained sufficient patellar bone stock and could easily be converted to patellar replacement in the case of recurrent anterior knee pain[ 46 ].
Common controversies in total knee replacement surgery: Current evidence
J Bone Joint Surg Br. No statistically significant difference in flexion, edema or drainage, function, or pain between groups 3 mo post-surgery.
Predictors of osteoporosis in patients with fragility fractures. The postoperative knee swelling persisted longer in the CPM group He et al[ tir ] Meta-analysis of randomized trials Cochrane.
To use a tourniquet or not Tourniquet restricted total blood loss, but was accompanied with significantly higher rate of minor complications Tai et al[ 20 ] Prospective randomized trial. Verra et al[ 15 ]. No differences between the groups regarding postoperative pain or complications. Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the genesis ii prosthesis.
Search for dissertations about: “thesis on total knee replacement”
To use a tourniquet during operation or not? These are specially timed for wr Intrafocal pinning of radial neck fracture in tppics Announcement Scroller No data available!
Patellar reshaping vs resurfacing in TKR. Yagishita et al[ 13 ] performed a prospective randomized study inwith a minimum follow-up of 5 years, which indicated that posterior-stabilized prosthesis showed better results in postoperative knee motion, posterior knee pain at passive flexion and patient satisfaction, but no significant difference was found between the 2 types of TKA regarding Knee Society Score.
Tourniquet application only during cement fixation or continually.
: THESIS ON TOTAL KNEE REPLACEMENT
No difference in anterior knee pain. It has been estimated that, bythe demand for primary TKA is projected to increase to 3. Open in a separate window. Type of study Outcome Verra et al[ 15 ] Meta-analysis of randomized and quasi-randomized controlled trials, thesls retention with sacrifice of the PCL in primary TKR No clinically relevant differences found. Patellar resurfacing vs nonresurfacing in primary TKR.
Alkire et al[ 32 ]. Surgical treatment is still controversial. Timing of tourniquet release in knee arthroplasty. Weak evidence that CPM reduces the need for manipulation under anesthesia Alkire et al[ 32 ] Prospective randomized study. We have tried to extract the best and most up-to-date evidence available regarding some of the most debatable aspects of TKR surgery regarding the everyday surgical technique of thousands of orthopedic surgeons around the world.
Prospective randomized trial, comparing in vivo kinematics, range of motion, and functional outcomes in patients who received either a high-flexion cruciate retaining or a high-flexion cruciate substituting TKR. To the extent that this ratio can be driven lower, more value will be created.
Lower tourniquet cuff pressure reduces postoperative wound complications after total knee arthroplasty: Lensenn et al[ 31 ].
The sole difference lies in the treatment of the cost savings and the integration costs. This is a huge number, considering the world population, and it is expected to increase as the population ages[ 1 ]. To use a tourniquet or not Tourniquet effective for reducing intraoperative blood loss but not for reducing the postoperative blood loss and total blood loss Olivecrona et al[ 24 ] Randomized controlled trial.
More recently, inBreeman et al[ 39 ] in a randomized controlled trial with a 5-year follow-up, found that this method did not have a significant impact on functional outcomes, reoperation rate, and total healthcare cost.