Search

Four major approaches to total knee arthroplasty (TKA) exist: standard parapatellar, subvastus, midvastus, and mini-parapatellar. Research has shown that there may be some benefit to patients when minimally invasive approaches are employed. However, research has not shown whether the minimally invasive approaches are beneficial for restoring patients' gait when compared against those of healthy age-matched subjects. This study has compared the effect of the four surgical approaches using computer navigation on recovery of gait at 2, 4, and 6 months. Although some statistically significant differences exist among surgical approaches at specific points of the gait cycle, results demonstrate that no approach is superior to another in restoring patients' gait across the entire gait cycle., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Minimally invasive total knee arthroplasty (TKA) aims to enhance functional recovery and minimize trauma to the knee extensor mechanism through quadriceps sparing techniques. Few have studied the effect of TKA surgical approach on activities of daily living. Stand-to-sit-down (STSD) and sit-to-stand-up (STSU) activities are challenging for patients in constrained scenarios where upper body support is limited. In this study, 60 subjects diagnosed with primary osteoarthritis undergoing TKA were randomized to receive the standard parapatellar (SP) or mini-parapatellar (MP) surgical approach performed using computer navigation. All received identical postoperative orders, hospitalization, and physical therapy. Before surgery and at 2, 4, and 6 months postoperatively, the STSD and STSU kinetics and kinematics showed differences for both groups in comparison with controls, but the two were essentially indistinguishable throughout all time points., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Electrical stimulation and interferential current are commonly used modalities in the physical rehabilitation of patients who have undergone joint arthroplasty surgery. Sparse data are available in the literature regarding potential complications from using these modalities. We report on a patient who underwent a unicompartmental knee arthroplasty with a subsequent full-thickness skin burn over the metal implant after electrical stimulation and interferential current modalities in physical therapy.

Lymphedema is a relatively common disorder; wound and vascular complications after orthopaedic surgery are assumed, but not previously shown, to be higher in this population. We reviewed the outcome and complications of knee arthroplasty in patients with lymphedema, documented by physical examination at their preoperative medical assessment. This was a retrospective analysis of prospectively collected data compiled on all patients having knee arthroplasty at our institution. Eighty-three knee replacements were implanted in 63 patients. Patients were followed up for a minimum of 2 years, with a mean followup of 58 months (range, 24-228 months). No patients were lost to followup. We noted significant improvement in the Knee Society score from a preoperative mean of 47 points (range, 16-75 points) to a postoperative mean of 87 points (range, 53-100 points). The knee functional score also improved significantly from a preoperative mean of 36 points (range, 0-80 points), to a postoperative mean of 59 points (range, 0-100 points). The total complication rate was 31%, with 10 superficial wound infections (12%), six deep infections (7%), and three deep venous thromboses (3.6%). We concluded that although knee arthroplasty can be successful in reducing pain and improving function in patients with lymphedema, the complication rate is greater than that seen in patients without this diagnosis.