The Functional Outcome of Total Knee Replacement in Young Patients: A 10-Year Matched Case Control Study

Wood, Alexander; Keenan, A.; Arthur, C.; Aitken, Stuart A.; Walmsley, P; Brenkel, Ivan J.

doi:10.4236/ojo.2013.32024

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…Spinal anesthesia and sedation was the most common type of anesthesia used with the majority of patients staying around a week. While this corroborates with previous figures [6,[15][16][17], a contradictory result [18] is that there was no association between any of the parameters studied and length of stay.…”

Section: Resultssupporting

confidence: 91%

Total Hip and Knee Replacement in Eastern Libya: A Post-Conflict Case Series

Elzwai¹,

Elhnid²,

Bodalal³

et al. 2014

Int. J. Stats. Med. Res.

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Background: Total knee replacement (TKR) and total hip replacement (THR) are effective procedures for alleviating pain and improving hip and knee function. Literature has not covered the experience of developing countries with arthroplasty-especially in an unstable post-conflict setting. Methods: Patient records were obtained from a major surgical center in Benghazi where total joint arthroplasties (TJA) are performed for a period of twenty months and key parameters were analyzed. The patients were followed up on an outpatient basis at regular time intervals (one week, one month, three months and six months) and any complications were documented. Results: A total of 135 total knee (81.5%, n=110) and total hip (18.5%, n=25) replacements were done in Benghazi mostly on elderly (mean age=60.2 years) females (72.2%, n=100). The most common causative pathology in both groups was osteoarthritis (80.6%, n=108). The most common complication was superficial infection (4.4%, n=6) by Staph aureus. The Harris Hip Score and Knee Society Score were used to determine the functional outcomes of THR and TKR respectively-both showing high values. The Short form 36 (SF36) health survey was carried out to assess the patients' satisfaction levels. For all the axes, the obtained score was over 80%. Discussions: THR and TKR are major orthopedic surgeries that constitute an advancement in the treatment of chronic joint pain. Most of the demographic features of our patients match up well with previous literature-with certain exceptions. There was no difference in thromboembolic incidence between the group of patients who received LMWH and those who simply started early mobilization and physiotherapy. Despite a number of hindrances faced by the hospital due to the conflict (i.e. funding limitations and drug shortages), a low rate of complications was maintained. No thromboembolic incidents or mortalities occurred. Conclusions: Libyan surgeons have had a good experience with TJA and patients have been satisfied with the outcomes.

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Section: Resultssupporting

confidence: 91%

Total Hip and Knee Replacement in Eastern Libya: A Post-Conflict Case Series

Elzwai¹,

Elhnid²,

Bodalal³

et al. 2014

Int. J. Stats. Med. Res.

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“…We present the first early clinical, radiological and patient reported results for the PFCSCC TKA. We have previously reported on the medium-to long-term follow up of the PFC Sigma TKA [9][10][11][12][13]. The design of the PFC Sigma Cobalt Chrome TKA incorporates a number of minor modifications from the PFC Sigma TKA and these initial results show that at three years post-operatively, the prosthesis survival rate stands at 97.6% with revision for any reason and 99.6% with revision for aseptic failure.…”

Section: Discussionmentioning

confidence: 99%

PFC Sigma Cobalt-Chrome Total Knee Replacement: Early Outcomes Demonstrate No Significant Early Failures at the Three-Year Mark

Wood¹,

McIlwain²,

Arthur³

et al. 2014

OJO

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The PFC Sigma Cobalt Chrome Sigma (PFCSCC) was introduced in 2006, and represents further development of the PFC Sigma design aiming at reducing the problem of backside wear. To ensure that there were no significant early failures following the introduction of this knee system to our hospital in 2006, we prospectively identified all patients undergoing TKA with the PFCSCC over a one-year period. Clinical and demographic patient data, American Knee Society scores, Oxford Knee scores, SF-12 scores and radiographic data were recorded pre-operatively and at three-year post surgery. 233 patients underwent 249 primary knee arthroplasties with the PFCSCC. Seven patients (eight TKAs) died before the last review and eight cases were lost to follow up. Mean age was 66.7 (range 34-80) with 47.6% male. Mean follow-up days were 1109 (range 741 to 1591). 5 (2.2%) were revised for infection with 1 revised for pain. The 3-year survival rate was 97.6% and 99.6% for aseptic failure. AKS 46.2 (0-95) was preoperatively 88.3 (17-100) with 3 years P < 0.001. OKS 39.0 (22-53) was preoperatively 22.6 (12-53) with 3 years P < 0.001. 17 of the 219 who had x-rays (8%) had radiolucent zones on x-ray. Our results demonstrate a good early aseptic survivorship of the PFCSCC at three years of 99.6%, combined with a good functional and objective improvement in our patients in three years.

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“…Some specialist centres have reported survivorship between 87 to 99% in young patients undergoing a cemented total knee replacement at a medium-term follow up between 6 to 14 years [ 80 – 82 ]. In a case matched series it was also suggested that younger patients achieve similar results from TKA, in terms of pain and function, which are comparable and even superior to older patients when matched for ASA, diagnosis, and BMI [ 83 ]. Therefore, a younger age should not preclude patients from having a total knee replacement although in cemented components there still remains general anxiety about the osteolysis and loosening as a result of wear debris from the perceived multiple cyclical loading.…”

Section: Total Knee Replacementsmentioning

confidence: 99%

A Review on the Management of Hip and Knee Osteoarthritis

Wood

Brock

Heil

et al. 2013

International Journal of Chronic Diseases

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Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips. We review the current concepts with regard to the disease process and risk factors for developing hip and knee osteoarthritis. We then explore the nonsurgical management of osteoarthritis as well as the operative management of hip and knee arthritis. We discuss the indications for surgical treatment of hip and knee arthritis, looking in particular at the controversies affecting young and obese patients in both hip and knee replacements. Patient and implant related outcomes along with survivorships are addressed as well as the experiences and controversies described in national joint registries.

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The Functional Outcome of Total Knee Replacement in Young Patients: A 10-Year Matched Case Control Study

Cited by 9 publications

References 12 publications

Total Hip and Knee Replacement in Eastern Libya: A Post-Conflict Case Series

Total Hip and Knee Replacement in Eastern Libya: A Post-Conflict Case Series

PFC Sigma Cobalt-Chrome Total Knee Replacement: Early Outcomes Demonstrate No Significant Early Failures at the Three-Year Mark

A Review on the Management of Hip and Knee Osteoarthritis

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