Mechanical complications after total knee arthroplasty

Connolly, Patrick; Coombs, Stefan; Schwarzkopf, Ran

doi:10.1080/17434440.2023.2282744

Cited by 4 publications

(3 citation statements)

References 119 publications

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“…This can hinder the patient’s mobility in terms of both passive and active movement, support while walking or resting, and stiffness in the joints. This lack of mobility, consequently, delays the patient’s recovery, affecting the quality of life [ 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

Gómez-Sánchez,

Hernández-Gómez,

Guzmán-Flores

et al. 2024

Clinics and Practice

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This systematic review and meta-analysis aimed to evaluate the analgesic efficacy and adverse effects of celecoxib after total knee arthroplasty. Keywords in the PubMed and Scopus databases were used to find article abstracts. Each included clinical trial was assessed using the Cochrane Collaboration risk of bias tool, and we extracted data on postoperative pain assessment using the Visual Analogue Scale (VAS) at rest, ambulation, and active range of motion, rescue analgesic intake, and adverse effects. Inverse variance tests with mean differences were used to analyze the numerical variables. The Mantel–Haenszel statistical method and the odds ratio were used to evaluate the dichotomous data. According to this qualitative assessment (n = 482), two studies presented conclusions in favor of celecoxib (n = 187), one showed similar results between celecoxib and the placebo (n = 44), and three clinical trials did not draw conclusions as to the effectiveness of celecoxib versus the placebo (n = 251). Moreover, the evaluation of the rescue analgesic intake showed that the patients receiving celecoxib had a lower intake compared to patients receiving a placebo (n = 278, I2 = 82%, p = 0.006, mean difference = −6.89, 95% IC = −11.76 to −2.02). In conclusion, the pooled analysis shows that administration of celecoxib alone results in a decrease in rescue analgesic consumption compared to a placebo after total knee surgery.

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Section: Introductionmentioning

confidence: 99%

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

Gómez-Sánchez,

Hernández-Gómez,

Guzmán-Flores

et al. 2024

Clinics and Practice

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“…The management of pain following TKA is multifaceted, often necessitating a combination of analgesic strategies. 6 Two prevalent approaches in this context are local infiltration anaesthesia (LIA) and femoral nerve block (FNB). 7 LIA entails the direct administration of a combination of anaesthetics, typically including bupivacaine, ropivacaine and lidocaine, to the surgical site.…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of local infiltration anaesthesia versus femoral nerve block in alleviating postoperative wound pain following total knee arthroplasty: A systematic review and meta‐analysis

Yu,

Wu,

Han

et al. 2024

International Wound Journal

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Total knee arthroplasty (TKA) often involves significant postoperative pain, necessitating effective analgesia. This meta‐analysis compares the analgesic efficacy of local infiltration anaesthesia (LIA) and femoral nerve block (FNB) in managing postoperative wound pain following TKA. Adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, this meta‐analysis was structured around the PICO framework, assessing studies that directly compared LIA and FNB in TKA patients. A comprehensive search across PubMed, Embase, Web of Science and the Cochrane Library was conducted without time restrictions. Studies were included based on specific criteria such as participant demographics, study design and outcomes like pain scores and opioid consumption. Quality assessment utilized the Cochrane Collaboration's risk of bias tool. The statistical approach was determined based on heterogeneity, with the choice of fixed‐ or random‐effects models guided by the I2 statistic. Sensitivity analysis and evaluation of publication bias using funnel plots and Egger's linear regression test were also conducted. From an initial pool of 1275 articles, eight studies met the inclusion criteria. These studies conducted in various countries from 2007 to 2016. The meta‐analysis showed no significant difference in resting and movement‐related Visual Analogue Scale scores post‐TKA between the LIA and FNB groups. However, LIA was associated with significantly lower opioid consumption. The quality assessment revealed a low risk of bias in most studies, and the sensitivity analysis confirmed the stability of these findings. There was no significant publication bias detected. Both LIA and FNB are effective in controlling postoperative pain in TKA patients, but LIA offers the advantage of lower opioid consumption. Its simplicity, cost‐effectiveness and opioid‐sparing nature make LIA the recommended choice for postoperative analgesia in knee replacement surgeries.

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“…The mHKA is also used to assess post-operative knee alignments after total knee replacements and is necessary for angular correction surgeries and assessments of the corrections achieved [18]. Knowledge of the mHKA is also helpful in the analysis of the causes of TKA failure and the planning of revision surgery [19]. In addition, advances in digital technology in radiology in the last decade have enabled advantages such as reduced radiation exposure, more efficient image comparisons, variable contrast scales, and ease of storage.…”

Section: Introductionmentioning

confidence: 99%

The Validity and Absolute Reliability of Lower Extremity Angle Values on Full-Leg Standing Radiographs Using the TraumaMeter Software

León-Muñoz,

Hurtado-Avilés,

Moya-Angeler

et al. 2024

Applied Sciences

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To establish classifications and to obtain pre- and post-operative information on patient-specific alignments, it is necessary to measure different angular values accurately and precisely, mainly on weight-bearing, full-length anteroposterior X-rays of the lower limbs (LLRs). This study evaluated angular measurements’ validity and absolute reliability on LLRs with a self-developed, computer-aided measurement system (TraumaMeter v.873). Eight independent observers measured the preoperative mechanical hip-knee-ankle (mHKA) angle of 52 lower extremities (26 cases) in a blinded fashion on three occasions separated by two weeks. We obtained an intra-observer mean bias error (MBE) of 0.40°, a standard deviation (SD) of 0.11°, and a 95% confidence interval (CI) of 0.37°–0.43°. We also obtained an inter-observer MBE of 0.49°, an SD of 0.15°, and a 95% C of 0.45°–0.53°. The intra-observer MBE for the measurement pair between the second and the first measurement round (T2T1) was 0.43°, the SD was 0.13°, and the 95% CI was 0.39°–0.47°; the MBE between the third and the second round (T3T2) was 0.37°, with an SD of 0.10° and a 95% CI of 0.34°–0.40°; and the MBE between the third and the first round (T3T1) was 0.40°, with an SD of 0.10° and a 95% CI of 0.37°–0.43°. The interobserver MBE for the first round of measurements was 0.52°, with an SD of 0.16° and a 95% CI of 0.48°–0.56°; the MBE for the second round was 0.50°, with an SD of 0.15° and a 95% CI of 0.46°–0.54°; and the MBE for the third round was 0.46°, with an SD of 0.14° and a 95% CI of 0.42°–0.50°. There were no statistically significant differences in the inter-observer errors for the three tests. In the case of the intra-observer analysis, there were differences between T2T1 and between T3T2, but these differences were minimal, with no overlaps in the lower or upper values, respectively, of the confidence intervals. These results led us to conclude that the TraumaMeter v.873 software extension for measuring lower-limb angles in LLRs is an accurate tool with low intra- and inter-observer variability.

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Mechanical complications after total knee arthroplasty

Cited by 4 publications

References 119 publications

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

Celecoxib Decreases the Need for Rescue Analgesics after Total Knee Arthroplasty: A Meta-Analysis

Analgesic efficacy of local infiltration anaesthesia versus femoral nerve block in alleviating postoperative wound pain following total knee arthroplasty: A systematic review and meta‐analysis

The Validity and Absolute Reliability of Lower Extremity Angle Values on Full-Leg Standing Radiographs Using the TraumaMeter Software

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