Patellar resurfacing vs nonresurfacing in primary TKR The reoperation rate due to anterior knee pain, and the patella-femoral complication rate was significantly higher in the resurfacing group. Numerous studies have yielded conflicting results. Track accepted paper Once production of your article has started, you can track the status of your article via Track Your Accepted Article. To use a tourniquet only during cementation or up to wound closure. Continuous passive motion following total knee arthroplasty in people with arthritis.
Continuous passive motion following total knee arthroplasty in people with arthritis. Tourniquet effectively reduced blood and avoided excessive postoperative inflammation and muscle damage. To use or not to use continuous passive motion post-total knee arthroplasty presenting functional assessment results in early recovery. Tai et al[ 20 ]. Indeed, studies have shown that TKA is one of the most rewarding surgical procedures both for patients and surgeons[ 2 ]. To evaluate the early migration, measured by RSA, of cemented knee prosthesis. Patellar resurfacing in primary total knee replacement:
The effect of tourniquet use on hidden blood loss in total knee arthroplasty. Patellar resurfacing in total knee arthroplasty: Yagishita et al[ 13 ] performed a prospective randomized study inwith a minimum follow-up of 5 years, which thfsis 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 topic 2 types of TKA regarding Knee Society Score.
Ji FF L- Editor: Prospective randomized double-blinded study. Ledin et al[ 22 ].
Recent Journal of Arthroplasty Articles – Elsevier
PS TKR superior to CR TKR in weight-bearing maximum flexion and posterior femoral roll-back Kim et al[ 11 ] Prospective randomized trial, comparing ROM and functional outcome in knees receiving either a high-flexion posterior cruciate-retaining or a high-flexion posterior cruciate-substituting TKR No differences among groups Chaudhary et al[ 10 ] Prospective randomized study comparing range of motion of posterior CR vs posterior cruciate-substituting PS TKA No differences among groups Harato et al[ 9 ] Prospective, randomized clinical trial comparing midterm outcomes of posterior CR vs posterior cruciate-substituting PS procedures using the Genesis II TKA No significant difference in knee function, postoperative complications and patient satisfaction.
No difference in anterior knee pain. Type of study Outcome Umrani et al[ 52 ] Prospective randomized trial. 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: A meta-analysis of randomised controlled trials.
Cochrane Database Syst Rev. The role of pain and function in determining patient satisfaction after total knee replacement. Tourniquet effective for reducing intraoperative blood loss but not for reducing the postoperative blood loss and total blood loss.
Common controversies in total knee replacement surgery: Current evidence
We were able to identify 10 studies 5 prospective randomized trials and 5 meta-analysesaiming to answer the question of resurfacing the patella or not. At the same time, it is becoming apparent that a meticulous operative technique, respecting the soft tissue envelope and knowing the principles of alignment and soft tissue balancing, are some of the parameters that might contribute more to achieving the optimal results for the patients.
Grading the evidence through an updated meta-analysis of randomized, controlled trials.
Tourniquet use during cementation only during total knee arthroplasty: Ishii Y, Matsuda Y. Avoidance of patellar eversion improves range of motion after total knee replacement: Total Knee replacement; ROM: A tourniquet was not recommended because it caused significantly increased blood loss, lower free hemoglobin levels, more extensive postoperative swelling, and ecchymosis.
Also, inTarwala et al[ 26 ] in a randomized trial, examined the outcomes of the use of a tourniquet only during cementation and found that it offered bloodless bone for fixation, and did not influence the surgical time, pain, range of knee motion and total blood loss.
Total knee replacement TKR is a widely used operation that has radically improved the quality of life of millions of people during the last few decades.
Therefore, IR should not sell for less than the standalone value, and Timken should not offer more than the with-synergies thesis. Patellar denervation in total knee arthroplasty without patellar resurfacing: No significant difference in knee function, postoperative complications and patient satisfaction.
Recent Journal of Arthroplasty Articles
Enthusiasm Outpaces Science June Thess trial in patients who had undergone cementless TKA. Mid-vastus split with or without patellar tkt vs median parapatellar arthrotomy or a mid-vastus split both without patellar eversion Significantly earlier return of straight leg raise was noted when patellar eversion was avoided Reid et al[ 53 ] Prospective randomized double-blinded study.
Consequently, they recommended this method, claiming that it may restrict the topjcs risks related to prolonged tourniquet use[ 26 ]. Beaupre et al[ 43 ] inperformed a randomized controlled trial, with a follow-up of years, in which they agreed that patellar resurfacing showed no difference with non-resurfacing regarding knee specific outcomes, like pain, stiffness, and function. No statistical differences between 2 groups throughout the follow-up periods in recovery of quadriceps force or power and clinical data.
To use a tourniquet or not Tourniquet restricted total blood loss, but was accompanied with significantly higher rate of hkr complications Tai et al[ 20 ] Prospective randomized trial. In the most recent study, Reid et al[ 53 ] in found that patients who underwent TKR with patella eversion had similar clinical outcome 3 mo and 1 year postoperatively with patients who had TKR with patellar subluxation.
No differences in clinical outcomes.