Total knee arthroplasty (TKA) is a very successful procedure. The alignment in TKA has been identified as being of importance to prevent early implant failure and patient dissatisfaction. Our hypothesis was that patients with a preoperative varus deformation remaining in a slight varus alignment as their natural alignment after TKA will have superior clinical results compared with patients who are restored in neutral alignment. A total of 115 patients were corrected from varus to neutral (varus-neutral) and in 33 patients a preoperative varus alignment was kept in varus (varus). Standardized preoperative and postoperative full-length hip-knee-ankle radiographs under full weight-bearing conditions were performed in all patients. The patients' knees were categorized preoperatively and postoperatively based on the angle between mechanical femoral axis and mechanical tibial axis. Knees with alignment between ± 3 degrees were categorized as neutrally aligned, whereas alignment within ≤ -3 degrees was categorized as varus. The Knee Injury Osteoarthritis Outcome Score (KOOS) and Oxford Knee Score were determined retrospectively. The varus group scored significantly better in total KOOS ( < 0.05) compared with the varus-neutral group. Also, a trend was visible in the Oxford Knee Score but this was not significant ( > 0.05). This trend was even more evident in varus knees which were slightly undercorrected. The results support the assumption that leaving a residual varus alignment after TKA leads to better functional outcomes in TKA for patients with preoperative varus osteoarthritis.
Femoroacetabular regularization in hip impingement is currently performed by means of trochanter osteotomy and hip dislocation or more recently by means of hip arthroscopy. We present a novel alternative through a unique mini-invasive anterior approach. Our first series consisted of 35 hips (32 patients) with a mean follow-up of 29.2 months. Range of motion (ROM) and clinical scores were evaluated preoperatively at six weeks, three months, six months and one-year follow-up (FU). Impingement test was negative in 33 out of 35 cases six weeks after surgery. Mean hospitalisation time was 2.6 days (2-5 days). Mean improvement in internal rotation was 23 degrees (p=0.006) and 21 degrees in flexion (p=0.011). There was a significant improvement in hip score according to the Merle d'Aubign evaluation (13.8 points preoperative vs. 16.9 at one-year visit) (p=0.017). No Trendelenburg, heterotopic calcifications or osteonecrosis were observed. Complications related to the femorocutaneous nerve appeared in six cases (17.1%) although all but one were neuroapraxia and disappeared before one year. Mean rehabilitation time was 4.4 weeks. We conclude that the anterior surgical approach for the treatment of femoroacetabular impingement enables early resumption of sport while accuracy in bone resection is maintained.
Femoroacetabular regularization in hip impingement is currently performed by means of trochanter osteotomy and hip dislocation or more recently by means of hip arthroscopy. We present a novel alternative through a unique mini-invasive anterior approach. Our first series consisted of 35 hips (32 patients) with a mean follow-up of 29.2 months. Range of motion (ROM) and clinical scores were evaluated preoperatively at six weeks, three months, six months and one-year follow-up (FU). Impingement test was negative in 33 out of 35 cases six weeks after surgery. Mean hospitalisation time was 2.6 days (2-5 days). Mean improvement in internal rotation was 23 degrees (p=0.006) and 21 degrees in flexion (p=0.011). There was a significant improvement in hip score according to the Merle d'Aubign evaluation (13.8 points preoperative vs. 16.9 at one-year visit) (p=0.017). No Trendelenburg, heterotopic calcifications or osteonecrosis were observed. Complications related to the femorocutaneous nerve appeared in six cases (17.1%) although all but one were neuroapraxia and disappeared before one year. Mean rehabilitation time was 4.4 weeks. We conclude that the anterior surgical approach for the treatment of femoroacetabular impingement enables early resumption of sport while accuracy in bone resection is maintained.
Our analysis shows that our low early reinfection rate (6.45%) is within statistical expectation. Furthermore, we have showed that there is evidence to suggest that the rate of successful outcomes in one-stage revision arthroplasties, at least at the hip, is not different from the rate of two-stage revision arthroplasties and that the difference may be interpreted as stochastic deviation (p=0.264494). According to existing studies, an analogy to knee arthroplasties can be assumed. We demonstrated that one-stage revision is an adequate therapeutic option if patients are carefully selected and under the supervision of an experienced surgeon.
Surgical repair of degenerative tears of the anterior tibial tendon leads to very good functional results and high patient satisfaction.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.