New technology using magnetic resonance imaging (MRI) allows the surgeon to place total knee replacement components into each patient's pre-arthritic natural alignment. This study evaluated the initial intraoperative experience using this technique. Twenty-one patients had a sagittal MRI of their arthritic knee to determine component placement for a total knee replacement. Cutting guides were machined to control all intraoperative cuts. Intra-operative events were recorded and these knees were compared to a matching cohort of the senior surgeon's previous 30 conventional total knee replacements. Post-operative scanograms were obtained from each patient and coronal alignment was compared to previous studies using conventional and computer-assisted techniques. There were no intra-operative or acute postoperative complications. There were no differences in blood loss and there was a mean decrease in operative time of 14% compared to a cohort of patients with conventional knee replacements. The average deviation from the mechanical axis was 1.2°of varus, which was comparable to previously reported conventional and computer-assisted techniques. Custom-fit total knee replacement appeared to be a safe procedure for uncomplicated cases of osteoarthritis.
This study compared the rates of anterior knee pain and functional outcomes between resurfaced patellas and non-resurfaced patellas with a circumpatellar denervation. One hundred ten patients who underwent patellar resurfacing or a circumpatellar denervation were evaluated for knee pain and functional outcomes at a minimum of 2 years after total knee arthroplasty. There were no significant differences between the 2 groups regarding Knee Society Scores, anterior knee pain scores, or visual analog scale scores. The groups had similar incidences of anterior knee pain. Most patients reported no to mild effect of anterior knee pain on daily living. Patients in each group reported increased pain with kneeling, squatting, and departing an automobile. Similar proportions of patients were disappointed with their overall outcomes in each group. Circumpatellar denervation and patellar resurfacing during total knee arthroplasty lead to similar incidences of anterior knee pain. [Orthopedics. 2016; 39(5):e1019-e1023.].
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.