The Knee Joint: Surgical Techniques and Strategies

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This study will compare two different surgical methods used in total knee replacement with the Unity Total Knee Replacement System.

The Knee Joint: Surgical Techniques and Strategies

The study will evaluate these two methods based on patients' ability to perform various tasks prior to surgery and at 4 time points during the first 12 months after surgery. This study will be conducted at a single centre. The study has two treatment groups. One group of 50 knees approximately 50 subjects will have a surgical method that uses mechanical alignment alignment based on how the leg and knee joint move to determine the proper position of the knee replacement device.

Subjects will be randomly assigned to one of the two groups. Clinical and functional tests will be conducted pre-operatively and at 6 weeks, 3 months, 6 months and 12 months to determine overall knee function. In addition, a CT scan will be completed pre-operatively and at 6 weeks to assess changes in alignment.

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FDA Resources. Arms and Interventions. Patients in this arm will have the Unity Total Knee Replacement System implanted using a surgical technique that utilizes anatomic alignment via ligament balancing with the tibial cut perpendicular to the tibial anatomic axis. Outcome Measures. The test measures the length of time the subject can stand on their operative leg. The test measures the length of distance a subject can walk in 6 minutes at a pace that does not cause them to become short of breath.

Surgical Techniques and Strategies

The test measures the length of time it takes a subject to climb up a stair block and down the other side. The subject is asked to stand on a Wii Fit balance board while the "Deep breathing" exercise in the Yoga section is selected. The subject is asked to kneel on a mat on the floor and then rise to a standing position. The subject is asked to walk on a level treadmill at a comfortable walking speed. The subject is asked to walk from one end to the other on a specialized track topped with fist-sized pebbles. CT scan will be done to assess the following anatomical items: Medial joint line position Overall limb alignment Joint obliquity Rotation.

Power of knee flexion via peak torque of quads measured on a digital myometer.

How to Know When It’s Time for a Total Knee Replacement | Rothman Orthopaedic Institute

A questionnaire about your ability to perform daily functions. A questionnaire to assess your ability to perform activities of different difficulty levels. A questionnaire to assess your health and well-being. A questionnaire to assess your satisfaction with your knee implant. Downloaded times. Published online 1 October Published in print 1 October We use cookies to give you the best experience on our website.

To find out more about how we use cookies and how to change your settings, see our Privacy Policy. Submit a Letter to the Editor about this article. Abstract Total knee arthroplasty TKA is a major orthopaedic intervention. The incidence of knee arthroplasty for primary osteoarthritis grows rapidly among baby boomers: a population-based study in Finland.

Arthritis Rheum ;— The incremental hospital cost and length-of-stay associated with treating adverse events among Medicare beneficiaries undergoing TKA. J Arthroplasty ;— Why still in hospital after fast-track hip and knee arthroplasty? Acta Orthop ;— Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop ;— Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway.

Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients. Preoperative risk stratification and risk reduction for total joint reconstruction: AAOS exhibit selection. Knee Surg Relat Res ;— Fast-track knee arthroplasty -- status and future challenges.

Knee ;20 suppl 1 :S29—S Role of preoperative anemia for risk of transfusion and postoperative morbidity in fast-track hip and knee arthroplasty. Transfusion ;— Lower blood loss after unicompartmental than total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc Epub ahead of print PMID: The impact of an algorithm-guided management of preoperative anemia in perioperative hemoglobin level and transfusion of major orthopedic surgery patients.

Anemia ; Perioperative anemia management in colorectal cancer patients: a pragmatic approach. World J Gastroenterol ;— Preoperative anemia increases postoperative complications and mortality following total joint arthroplasty.

The constraints on day-case total knee arthroplasty: the fastest fast track

Risk factors for venous thromboembolism of total hip arthroplasty and total knee arthroplasty: a systematic review of evidences in ten years. BMC Musculoskelet Disord ; Thromboprophylaxis only during hospitalisation in fast-track hip and knee arthroplasty, a prospective cohort study. BMJ Open ; Cost-effective prophylaxis against venous thromboembolism after total joint arthroplasty: warfarin versus aspirin. Symptomatic pulmonary embolus after joint arthroplasty: stratification of risk factors. Clin Orthop Relat Res ;— High level of residual symptoms in young patients after total knee arthroplasty.

Mechanical thromboembolic prophylaxis with risk stratification in total knee arthroplasty. A mobile compression device for thrombosis prevention in hip and knee arthroplasty. Quadriceps arthrogenic muscle inhibition neural mechanisms and treatment perspecties. Semin Arthritis Rheum ;— The effectiveness of minimally invasive total knee arthroplasty to preserve quadriceps strength: a randomized controlled trial. Knee ;— The feasibility and perioperative complications of outpatient knee arthroplasty.

Faster quadriceps recovery with the far medial subvastus approach in minimally invasive total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc ;— Tourniquet versus no tourniquet on knee-extension strength early after fast-track total knee arthroplasty; a randomized controlled trial.


Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty. Pre-operative interventions non-surgical and non-pharmacological for patients with hip or knee osteoarthritis awaiting joint replacement surgery--a systematic review and meta-analysis. Osteoarthritis Cartilage ;— J Arthroplasty ;S Role of patient characteristics for fast-track hip and knee arthroplasty.

Br J Anaesth ;— J Am Geriatr Soc ;— Avoiding readmissions-support systems required after discharge to continue rapid recovery? An evidence-based review of enhanced recovery interventions in knee replacement surgery. Ann R Coll Surg Engl ;— Pre-operative patient education reduces length of stay after knee joint arthroplasty.

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Which outcomes related to regional anesthesia are most important for orthopedic surgery patients? Anesthesiol Clin ;— Total intravenous general anaesthesia vs. Acta Anaesthesiol Scand ;— Predictive factors of postoperative pain after day-case surgery. Clin J Pain ;— The anatomy and biomechanics of the medial collateral ligament and posteromedial corner of the knee.

Clinical basis: Epidemiology, risk factors, mechanisms of injury, and prevention of ligament injuries of the knee. ACL rupture in children: Anatomical and biological bases, outcome of ACL deficient knee in childhood: Strategy, operative technique, results, and complications. Definition and diagnosis of posterior cruciate ligament injury and algorithm of treatment. One or two bundles? Arthroscopic reconstruction of the posterior cruciate ligament using double-bundle and tibial-inlay technique. Combined injuries to the posterior cruciate ligament and medial collateral ligament of the knee.

Fixed bearing unicompartmental knee prosthesis: Results, complications, and technical considerations. Conservation of posterior cruciate ligament in fixed-bearing total knee replacement. Pre-operative imaging techniques in primary total knee replacement: Role for computed tomography. JavaScript is currently disabled, this site works much better if you enable JavaScript in your browser. Medicine Orthopedics.

Free Preview. Presentation includes images, tables and algorithms Gives residents all the basic concepts and historical roots of the modern techniques and senior surgeons the keys to analyze the most recent techniques see more benefits. Buy eBook. Buy Hardcover. Buy Softcover. Rent the eBook. FAQ Policy. About this book Pushed by the progress of biology, technology and biomechanics, knee surgery has dramatically evolved in the last decades.

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Show all. Table of contents chapters Table of contents chapters The menisci: Anatomy, healing response, and biomechanics Pages Amendola, A. The cruciate ligaments: Anatomy, biology, and biomechanics Pages Scheffler, S. The anatomy and biomechanics of the medial collateral ligament and posteromedial corner of the knee Pages Amis, A. The lateral collateral ligament and posterolateral corner Pages Griffith, C.

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  8. Basic science of ligament healing Pages Tohyama, H. Clinical basis: Epidemiology, risk factors, mechanisms of injury, and prevention of ligament injuries of the knee Pages Hewett, T. Classification of knee laxities Pages Piedade, S. Scoring the knee Pages Heyworth, B. Arthroscopic meniscectomy Pages Panisset, J. Meniscal sutures Pages Wilmes, P.