Arthroscopic Debridement of the Posterior Compartment of the Knee after Total Knee Arthroplasty

Ohishi, Tsuyoshi; Fujita, Tomotada; Suzuki, Daisuke; Yamamoto, Keiji; Ushirozako, Hiroki; Matsuyama, Yukihiro

doi:10.1155/2014/568417

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…63 These prostheses are generally considered the gold standard for clinical effect assessment after knee replacement. 64 The PS design achieves a greater postoperative ROM in patients with high functional demands 65,[69][70][71][72] and was selected as the comparator in the present study. In this study, the MP prosthesis achieved excellent postoperative performance compared with a traditional prosthesis in a clinical application, indicating that its design is also suitable for Chinese patients.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients

Yuan

Zhang

et al. 2019

J Knee Surg

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There is an unmet need for a prosthesis designed according to the anatomical parameters of the Chinese population. This study aims to compare the use of a medial pivot (MP) implant or posterior cruciate ligament (PCL) substitution (posterior-stabilized [PS]) prosthesis for unilateral total knee arthroplasty (TKA) in a Chinese population. The medical records of patients undergoing unilateral TKA with an MP implant (Group A) or a PS prosthesis (Group B) at our institution between January 2010 and December 2011 were retrospectively reviewed. Patients were followed up for 5 years. Preoperatively and at the December 2016 postoperative follow-up, the Hospital for Special Surgery scoring system (HSS knee score) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were measured to evaluate TKA outcomes. This study included 49 patients in Group A and 51 in Group B. As of December 2016, there were no significant differences in the preoperative/postoperative changes in any category of the HSS knee score or WOMAC score between the groups. There were no postoperative complications in either group during the 5-year follow-up. There were no periprosthetic infections or need for revision surgery. One patient in Group A experienced aching and a small amount of effusion in the articular cavity that was attributed to overexertion. In conclusion, there were no significant differences in midterm outcomes in Chinese patients receiving an MP implant or a PS prosthesis for unilateral TKA. These data suggest that the MP and PCL substitution design are safe and effective for unilateral TKA in China.

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Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients

Yuan

Zhang

et al. 2019

J Knee Surg

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“…7a). 40 Another alternative to perform the technique is the ‘back and forth’ technique described by Louisia et al, 41 in which the arthroscope is introduced through the posteromedial portal and pushed until it touches the septum and is then replaced by a blunt obturator to perforate the septum. The obturator is pushed from the medial to the lateral side of the posterolateral compartment and a cutaneous incision is made in the obturator tip (Fig.…”

Section: Periprosthetic Infectionmentioning

confidence: 99%

Arthroscopic treatment of total knee arthroplasty complications

Encinas-Ullán¹,

Rodríguez-Merchán²

2019

EFORT Open Reviews

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The most frequent indications for arthroscopy in patients with total knee arthroplasty (TKA) are soft-tissue impingement, arthrofibrosis (knee stiffness), periprosthetic infection and removal of free bodies or cement fragments. When performing a knee arthroscopy in a patient with a symptomatic TKA, look for possible free/retained bone or cement fragments, which can be anywhere in the joint. Patellar tracking should be evaluated and soft-tissue impingement under the patella or between the femoral and tibial prosthetic components should be ruled out. Current data suggest that knee arthroscopy is an effective procedure for the treatment of some patients with symptomatic TKA. The approximate rates of therapeutic success vary according to the problem in question: 85% in soft-tissue impingement; 90% in arthrofibrosis; and 55% in periprosthetic infections. More clinical studies are needed to determine which patients with symptomatic TKA can be the best candidates for knee arthroscopy. Cite this article: EFORT Open Rev 2019;4:33-43. DOI: 10.1302/2058-5241.4.180035.

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Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

Ohishi

Takahashi

Suzuki

et al. 2015

WJO

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Arthroscopic surgery of the posterior compartment of the knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.

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Arthroscopic Debridement of the Posterior Compartment of the Knee after Total Knee Arthroplasty

Cited by 3 publications

References 17 publications

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients

Total Knee Arthroplasty Using a Medial Pivot or Posterior Cruciate-Stabilizing Prosthesis in Chinese Patients

Arthroscopic treatment of total knee arthroplasty complications

Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

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