Objective: Considering the difficulty for classifying bone losses the present study was designed to analyze if the AORI classification based on pre-operative radiographies is consistent and reproducible between different orthopedic surgeons. Methods: Six orthopedists specialized in knee surgery were trained for the use of the classification based on radiographic evaluation. All the surgeons individually classified 26 pre operative knee radiographs. Results: There was a moderate (> 50%) matching of the classification in 24 of 26 cases in the femur and 22 of 26 in the tibia. A good matching (> 80%) was present in 12 of 26 cases in the femur and in 7 of 26 cases in the tibia. Conclusion: We observed that the AORI classification presented a moderate radiographic correlation between surgeons. Evidence of level III, Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.
Objective: To evaluate the value of preoperative radiographic evaluations for total knee arthroplasty (TKA) revision. Methods: Thirty-one knees that were operated between 2006 and 2008, in a consecutive series of cases of TKA revision surgery were analyzed retrospectively. The following criteria were evaluated: number of wedges or structured bone grafts used for filling the bone defects; locations of the wedges and bone grafts used; and mean thickness of the polyethylene used. The AORI classification was previously established based on preoperative radiographs, using preestablished criteria. After the analysis, the knees were divided into four groups (I, IIA, IIB and III). Results: The mean number of wedges or grafts used in each knee progressively increased among the groups (group I: 1.33; group IIA: 2; group IIB: 4.33; and group III: 4.83) (P = 0.0012). The commonest locations were medial in the tibia and posteromedial in the femur. There were no statistically significant differences in the thickness of the polyethylene used. Conclusion: The AORI classification for bone defects in the knee, based on preoperative radiographs, showed a correlation with increasing need to use wedges and/or structured grafts in TKA revisions. However, up to 46% of the knees in groups I and IIA presented bone defects of up to 5 mm that were not diagnosed by means of preoperative radiographs.
OBJECTIVE: To show our experience with press-fit cementless stem and metaphyseal fixation
with cement in a selected series of patients who underwent revision total knee
arthroplasty. METHODS: Thirty-four patients (35 knees) underwent revision total knee arthroplasty using
the press-fit technique. Minimum follow-up was one year (mean 2.2 years) with a
maximum length of three years. RESULTS: Of 34 patients, 20 were women and 14 were men. There was one death due to causes
not related to arthroplasty and one patient dropout. There were no cases in which
further review was necessary. Patients who underwent revision had clinical and
functional improvement demonstrated by the results of the KSS, results of the
SF-36 quality of life questionnaire, through gains in range of motion and improved
limb alignment. CONCLUSION: There was postoperative clinical and functional improvement in comparison to the
preoperative status in revision total knee arthroplasty with press-fit cementless
stem. Level of Evidence IV, Case series.
Objective: To evaluate the value of preoperative radiographic evaluations for total knee arthroplasty (TKA) revision. Methods: Thirty-one knees that were operated between 2006 and 2008, in a consecutive series of cases of TKA revision surgery were analyzed retrospectively. The following criteria were evaluated: number of wedges or structured bone grafts used for filling the bone defects; locations of the wedges and bone grafts used; and mean thickness of the polyethylene used. The AORI classification was previously established based on preoperative radiographs, using preestablished criteria. After the analysis, the knees were divided into four groups (I, IIA, IIB and III). Results: The mean number of wedges or grafts used in each knee progressively increased among the groups (group I: 1.33; group IIA: 2; group IIB: 4.33; and group III: 4.83) (P = 0.0012). The commonest locations were medial in the tibia and posteromedial in the femur. There were no statistically significant differences in the thickness of the polyethylene used. Conclusion: The AORI classification for bone defects in the knee, based on preoperative radiographs, showed a correlation with increasing need to use wedges and/or structured grafts in TKA revisions. However, up to 46% of the knees in groups I and IIA presented bone defects of up to 5 mm that were not diagnosed by means of preoperative radiographs.
The purpose of our research consists of studying a new dye which, besides allowing the macroscopic study of small vessels <FONT FACE=Symbol>¾</FONT> following the pioneer research of Salmon(3) <FONT FACE=Symbol>¾</FONT>, permits the radiographic study due to its radiopacity. To do so, ten rats were utilized and their abdominal aorta was catheterized for the injection of the dye towards the periphery, being the flow of the dye observed along the left femoral artery (the right one was cauterized for occlusion). The results of this injection revealed that the dye penetrates well in extremely small vessels and allows dissection without extravasations. Thus, we believe that this dye has the necessary requirements for the study of details of the vascular anatomy.
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