ObjectiveTo assess the inter- and intraobserver reproducibility of the original version and different descriptions of the Kellgren and Lawrence classification used in epidemiological studies for osteoarthritis of the knee.MethodsThe study included 72 patients with osteoarthritis of the knee. Three medical members of the Brazilian Society of Knee Surgery were invited to evaluate the images. An intra- and interobserver analysis was conducted, with an interval of one month. The intraobserver agreement was analyzed using the weighted Cohen's Kappa coefficient. The interobserver agreement was analyzed using the Krippendorff alpha coefficient (α).ResultsThe intraobserver assessment indicated conflicting results. In the interobserver analysis, the level of agreement was superficial.ConclusionsThe classification of Kellgren and Lawrence and its variants generated a low reproducibility between observers. The intraobserver analysis showed a lack of uniformity in the use of this classification and its variants, even among experienced observers.
Objective: To present the surgical technique for the He-miCAP-Arthrosurface® system and evaluate our results from this technique for treating primary and/or secondary shoulder osteoarthrosis. Method: Between June 2007 and June 2009, 10 shoulders of 10 patients (nine with primary osteoarthrosis and one with avascular necrosis of the humeral head) underwent surface arthroplasty using the HemiCAP-Arthrosurface® system to correct the problem. The follow-up time ranged from six to 29 months (mean of 17 months). The patients’ ages ranged from 62 to 73 years (mean of 67.5 years). Six patients were female and four patients were male. The patients were followed up weekly for the first month after the surgical procedure and every three months thereafter. The clinic evaluation was done using the criteria of the University of California at Los Angeles (UCLA) and a visual analogue pain scale. Results: All the patients said that they were satisfied with the results from the surgical treatment, with a mean UCLA score of 30 points and a mean analogue pain score of two points. Conclusion: The HemiCAP-Arthrosurface® system for shoulder surgery for a specific group of patients is a technique that preserves the bone stock with good functional and antalgic results.
Objective: To present the surgical technique for the HemiCAP-Arthrosurface ® system and evaluate our results from this technique for treating primary and/or secondary shoulder osteoarthrosis. Method: Between
Objectiveto determine the causes of unicondylar knee arthroplasty failures, as well as identify the implants used and the need of bone grafting in patients undergoing revision UKA in Center of Knee Surgery at the Instituto Nacional de Traumatologia e Ortopedia (INTO) in the period between January 1990 and January 2013.Methodsa retrospective analysis of the medical documentation and imaging, determining the cause of failure of UKA and the time of its occurrence, as well as prosthetic components implanted during the review and the need for bone grafting.Resultsin this study, 27 UKA failures in 26 patients were included. Collapse of one or more components was the main cause of failure, occurring in 33% of patients. Aseptic failure was identified in 30% of cases, progression of osteoarthrosis in 15%, infection and pain 7% each, and osteolysis and polyethylene failure in 4% each. Early failure occurred in 41% of all revisions of UKA and late failure in 59%. 23 patients have undergone revision of UK.Conclusionin 35% of revisions the use of bone grafting was needed in tibial area; in 3 cases we needed allograft from Tissue Bank. We did not use metal increase in any of the revision. In one patient we used implant constraint for instability.
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