We investigated serum prolidase activity and oxidative/antioxidative status in patients with knee osteoarthritis (OA) and evaluated its relationships with radiographic severity and clinical parameters. The study population consisted of 137 patients with knee OA and 134 healthy volunteers. The severity of knee OA was classified according to the Kellgren-Lawrence criteria. Each patient was also evaluated clinically according to the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Serum prolidase activity was measured spectrophotometrically. Oxidative status was assessed by measuring serum lipid hydroperoxide (LOOH) and total oxidative status (TOS). Antioxidative status was assessed by measuring serum-free sulfhydryl groups (-SH = total thiol) and total antioxidant capacity (TAC). Oxidative stress index (OSI) was calculated. Serum prolidase activity was significantly lower in the knee OA group than in the control group (p < 0.001). The serum prolidase activities decreased with the severity of knee OA. Furthermore, serum LOOH, TOS, and OSI levels of the knee OA group were significantly higher than those of the controls (p < 0.001 for all), whereas TAC and -SH levels did not differ between the two groups (p > 0.05). In a multiple regression analysis, WOMAC score was independently associated with serum prolidase activity (β = -0.340, p < 0.001). Decreased serum prolidase activity and elevated LOOH, TOS, and OSI levels may be associated with knee OA, and serum prolidase activity may be a useful adjunctive indicator of the progression of knee OA in follow-up.

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Background: Successful results have been reported in association with the use of a rotating-hinge prosthesis for primary total knee arthroplasty (TKA). The objective of the present study was to identify risk factors for aseptic loosening in patients who underwent primary TKA with rotating-hinge knee prostheses. Methods: The records of 1,235 patients who underwent primary TKA with a rotating-hinge prosthesis at our center were evaluated. A total of 125 patients who underwent revision were further evaluated according to the inclusion and exclusion criteria, and 33 patients who underwent revision because of aseptic loosening were then compared with a group of 30 patients who did not require revision surgery. All data, including radiographic measurements, were obtained from records prior to the primary TKA. Results: On the basis of our review of demographic, anthropometric, clinical, surgical, and radiographic findings, we found that higher body mass index (BMI) was associated with revision. The majority of patients with aseptic loosening had loosening of the femoral component. Furthermore, the inner femoral diameter at 20 cm proximal to the knee joint (on both anteroposterior and lateral images) was found to be predictive of revision among those with aseptic loosening. Receiver operating characteristic curve analysis showed that an inner diameter of the femur of >19 mm on anteroposterior images had a sensitivity of 91% and specificity of 87% for predicting the need for revision surgery in patients with aseptic loosening. Conclusions: This is one of few studies that has focused on determining risk factors for the failure of rotating-hinge prostheses following TKA surgery. Our findings indicate that a novel variable, the inner (diaphyseal) diameter of the femur at the point 20 cm proximal to the knee joint, is an extremely reliable predictor of revision surgery in patients with aseptic loosening. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Oblique incision with less risk of nerve damage is better for graft harvesting. Area of hypaesthesia gradually reduces with time and even recover totally. As a possible complication, nerve injury and its benign prognosis should be explained to the patient before surgery.

Body composition assessed using BIA might be associated with knee OA, and be a noninvasive tool for diagnosis of knee OA. However, body composition may not be predictive of the progression of knee OA.