Knee In Patients Research Articles

Influence of Knee Osteoarthritis Severity, Knee Pain, and Depression on Physical Function: A Cross-Sectional Study.

Decreased physical function with increasing life expectancy is a public health concern worldwide. Knee osteoarthritis (KOA) is considered one of the primary illnesses causing decreased physical function. Depression affects decreased physical function and is closely related to knee pain in KOA. However, the effect of these interacting factors on physical function is not clear. We conducted a cross-sectional analysis of the baseline data of 1106 subjects of the 2009 Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). We determined the association between their Timed Up and Go test (TUG) scores and radiographic KOA, knee pain, and depression in a multivariate analysis. Severe knee pain was significantly associated with decreased physical function (the odds ratio [OR] was 2.13, 95% confidence interval [CI]: 1.32-4.89), as was depression (OR 2.64, 95% CI 1.61-4.33). Only Kellgren-Lawrence (KL) grade 4 was significantly associated with decreased physical function in the radiographic KOA severity (OR 6.58, 95% CI 1.75-24.68). Severe knee pain and depression were significantly associated with decreased physical function, but not radiographic KOA severity except for KL grade 4. The limitations of using radiographic KOA severity alone as the indicator of assessment for physical function were suggested. When assessing decreased physical function, the clinical focus tends to be on radiographic KOA severity, but it is important to consider the patient's knee pain and psychological factors.

Guided Growth for Correction of Elevated Tibial Posterior Slope in Pediatric ACL Deficiency: A Case Report.

Fourteen-year-old boy, history of autism presented with bilateral knee instability. Imaging revealed bilateral anterior cruciate ligament (ACL) insufficiency, 20° of posterior tibial slope (PTS) on the right and 18° on the left. A guided growth technique using anterior placed tension band plates was used to correct the PTS. At 22 months, the PTS corrected to 5.5° on the right and 6° on the left. The patient's knee stability improved, and he resumed activities at 30 months. Pediatric ACL insufficiency in the setting of elevated PTS can be successfully corrected with a guided growth technique.

Correction of a Golf Club Deformity of the Femur Using a Computer-Assisted Circular Ring Fixator: A Case Report.

The golf club deformity is the most notable malreduction that occurs after distal femur fracture fixation. This can lead to disruption of the patient's knee biomechanics, arthritis, and functional deterioration. There is a lack of consensus for optimal treatment of these malunions among the orthopaedic community. We present a technique that uses an osteotomy and ring external fixation with computer-assisted deformity correction and retrograde intramedullary nailing to secure correction. Our case shows a potential means to achieve a reliable and objective method of measuring, correcting, and securing the fixation of a golf club deformity.

Rapid bone destruction caused by multidrug-resistant Pseudomonas aeruginosa septic arthritis: A case report.

Infections due to multidrug-resistant (MDR) Pseudomonas aeruginosa are strongly associated with poor outcomes, including prolonged hospitalization and an increased risk of mortality. Antimicrobial options for the treatment of severe infections due to MDR P aeruginosa are quite limited, and treatment remains challenging. A 65-year-old woman presented to our orthopedic clinic with a 3-month history of progressive pain and stiffness in her left knee. Her primary care provider administered a hyaluronic acid injection, which unfortunately resulted in worsening symptoms. Subsequent treatment included a 1-month course of intravenous gentamicin and ceftriaxone, which failed to alleviate her symptoms. MDR P aeruginosa septic arthritis of the knee. The culture isolate was tested for susceptibility to multiple antibiotics. Magnetic resonance imaging evaluations were conducted, showing notable erosive and osteolytic changes around the joint surfaces that had progressed significantly. The patient underwent arthroscopic irrigation and synovectomy. The treatment regimen included a combination of intravenous colistin and piperacillin/tazobactam administered over a 6-week period. Total knee arthroplasty was performed 6 months later without additional antibiotic treatment. Patient's knee condition remained continuously stable without abnormal findings of inflammation. The patient's knee range of motion increased 0 to 125 degrees, her pain almost disappeared, and she was able to maintain activities of daily life. This case underscores the challenges of managing infections with MDR organisms in complex clinical scenarios, emphasizing the need for timely intervention and appropriate antibiotic therapy.

A Modified Triangular Arthroscopic Suture-Based Fixation for Tibial Eminence Fractures: Technique, Outcome and Literature Review.

Objectives: Tibial eminence fractures account for 2% to 5% of all knee injuries. Low-grade fractures, such as Type I, are typically treated conservatively, whereas high-grade fractures, such as Types III and IV, usually require surgical intervention. This paper describes a modified surgical arthroscopic technique, which employs pull-through triangle suture fixation for Type II and Type III arthroscopic intercondylar eminence avulsion fractures. In addition, we examined the efficacy and complication rate compared to the existing literature. Methods: Data were prospectively collected for knee arthroscopy surgeries and retrospectively analyzed with a minimum two-year follow-up. Twenty-three consecutive adults underwent arthroscopic treatment of displaced intercondylar Type II and Type III eminence fractures, as evidenced by clinical examination and imaging studies between May/2008 and May/2021. The patient's knee evaluation was performed using clinical symptoms and physical examination, along with International Knee Documentation Committee (IKDC) questionnaire and Tegner Activity Score. Compared to the literature, post-hoc power was calculated based on the mean Tegner Activity Score in our analysis. Results: fifteen females and eight males (mean age 33.9 years, range 19-56 years) were enrolled. The average postoperative follow-up was 35.4 months (27-53). The post-hoc power was 95% confidence in terms of the Tegner Activity Score. The mean ± standard deviation postoperative Tegner Activity Score was 8.2 ± 1.7 (6.8-10.0). Fifteen patients were classified as IKDC A (normal), six as IKDC B (nearly normal), and two as IKDC C (abnormal). The mean IKDC subjective score was 72.7 ± 23 (23-100). Twenty-four patients achieved normal flexion degrees compared with the unaffected side, while one patient achieved a flexion of only 0-90°. The group's mean flexion range of motion was 123 ± 16° (90-150°). Conclusion: This study presents a modified surgical arthroscopic suture fixation technique for tibial eminence fractures. The procedure is relatively simple and requires no more than basic arthroscopy equipment. The clinical and radiographic results indicate that this technique is safe, efficient, enables early initiation of rehabilitation, and has a lower complication rate in a variety of aspects compared with other fixation techniques used for tibial eminence fractures.

Functional and Symptomatic Improvements Based on the Femoral Tunnel Drilling Technique in Anterior Cruciate Ligament (ACL) Reconstruction.

The current literature comparing femoral tunnel techniques often reports on short-term outcomes after anterior cruciate ligament reconstruction (ACLR), but only a few studies have analyzed long-term outcomes. In addition, many studies have compared transtibial to anteromedial portal techniques without differentiating whether rigid or flexible reaming is used, making it difficult to infer how the techniques truly compare to one another. This study aimed to detect differences in patient-reported outcome scores in those treated with three different femoral tunnel drilling techniques. This study is a prospective cohort study. Of 650 patients treated for anterior cruciate ligament (ACL) injuries with ACLR, 350 were 5+ years out from surgery. Of these patients, 111 completed patient-reported outcome surveys (PROs). The Kruskal-Wallis H test was used to detect differences between patients treated with either of the three femoral tunnel drilling techniques: transtibial (TT), anteromedial portal with rigid reaming (AMP-RR), or anteromedial portal with flexible reaming (AMP-FR). Bonferroni correction was applied to the p-values to reduce the risk of making a type 1 error. No differences were found between the three groups in demographics or postoperative PROs. However, there was a significant change between pre-surgery and post-surgery PROs. TT, when compared to AMP-RR, had a greater increase in satisfaction and greater improvement in a patient's ability to go up and down the stairs from pre-surgery to post-surgery. AMP-FR, when compared to TT, had greater improvement of the patient's knee stiffness/swelling. AMP-FR, when compared to AMP-RR, had greater improvement in knee pain during stairs and the ability to go down the stairs. No differences in return to sport, additional procedures on the affected knee (meniscal surgeries or cyclops lesion excisions), or revision surgery rates were found. Overall, postoperative PROs did not show statistically significant differences between the three femoral tunnel drilling techniques. Differences, however, were identified in the responses to specific questions on PRO surveys, which may have otherwise been overlooked. It is important to recognize the differences between TT, AMP-RR, and AMP-FR in the improvement of stair climbing and swelling/stiffness as these likely directly affect a patient's satisfaction from pre-ACLR to post-ACLR.

Methods of alignment in total knee arthroplasty, systematic review.

Although total knee arthroplasty (TKA) is a very frequent surgery, one in five patients is not completely satisfied. Mechanical alignment (MA) is the most popular technique for implanting TKA. However, to improve clinical outcomes, new techniques that aim to rebuild the native alignment of the knee have been developed. The aim of this study is to perform a systematic review of the available clinical trials and observational studies comparing clinical and radiological outcomes of different methods of alignment (kinematic, anatomic, functional) to MA. A systematic review is performed comparing results of patient reported outcome measures (PROMs) questionnaires (WOMAC, OKS, KSS, KOOS, FJS), radiological angles (HKA, mLDFA, MPTA, JLOA, femoral rotation and tibial slope) and range of motion (ROM). Kinematic and functional alignment show a slight tendency to obtain better PROMs compared to mechanical alignment. Complication rates were not significantly different between groups. Nevertheless, these results are not consistent in every study. Anatomic alignment showed no significant differences compared to mechanical alignment. Kinematic alignment is an equal or slightly better alternative than mechanical alignment for patients included in this study. However, the difference between methods does not seem to be enough to explain the high percentage of dissatisfied patients. Studies implementing lax inclusion and exclusion criteria would be needed to resemble conditions of patients assisted in daily surgical practice. It would be interesting to study patient's knee phenotypes, to notice if any method of alignment is significantly better for any constitutional deviation.

Translation and Linguistic Validation of the Patient's Knee Implant Performance (PKIP) into Japanese.

The patient's knee implant performance (PKIP) is a patient-reported outcome measure, developed in the USA in English that evaluates knee functional performance before and after primary total knee arthroplasty (TKA). The PKIP assesses the level of satisfaction, confidence, and stability, while performing various activities, as well as the need for changing ways of doing activities. It comprises 24 items. The objective of this study was to present the methodology of the linguistic validation of the PKIP. The Japanese version of the PKIP was developed using a standard linguistic validation (LV) process. The LV involved the following steps: (1) conceptual analysis of the original version; (2) translation into Japanese using a dual forward/backward translation process; (3) review by an orthopaedics surgeon; (4) test on five respondents; and (5) proofreading. The translation itself did not reveal major translatability issues, either cultural, semantic, or syntactic. Most of the activities listed (e.g., going up stairs, getting in/out of a car, and walking up a hill/ramp/incline) were easily translated. Only one activity was culturally sensitive and raised some discussion, i.e., "sitting down on a toilet," since the style of Japanese toilets is different from the western style. Overall, the respondents well understood the questionnaire. However, the expression "how your knee is working with your body" used in the opening sentence was an issue for both the clinician and the respondents. A compromise was found by using a Japanese equivalent of "how your knee functions with your legs." The rigorous translation process, which involved the collaboration of a minimum of thirteen people (sponsor, four translators, two coordinators (one in Japan and one in Europe), one clinician, and five respondents) enabled the production of a Japanese version of the PKIP conceptually equivalent to the USA English original.

Computational-Design Enabled Wearable and Tunable Metamaterials via Freeform Auxetics for Magnetic Resonance Imaging.

Metamaterials hold significant promise for enhancing the imaging capabilities of magnetic resonance imaging (MRI) machines as an additive technology, due to their unique ability to enhance local magnetic fields. However, despite their potential, the metamaterials reported in the context of MRI applications have often been impractical. This impracticality arises from their predominantly flat configurations and their susceptibility to shifts in resonance frequencies, preventing them from realizing their optimal performance. Here, a computational method for designing wearable and tunable metamaterials via freeform auxetics is introduced. The proposed computational-design tools yield an approach to solving the complex circle packing problems in an interactive and efficient manner, thus facilitating the development of deployable metamaterials configured in freeform shapes. With such tools, the developed metamaterials may readily conform to a patient's knee, ankle, head, or any part of the body in need of imaging, and while ensuring an optimal resonance frequency, thereby paving the way for the widespread adoption of metamaterials in clinical MRI applications.

Early Weight-bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament (ACL) injury is one of the common sports injuries. Anterior cruciate ligament reconstruction (ACLR) is the mainstream treatment for ACL injury, aiming to regain normal anatomical structure and stability of the knee joint and promote the patient's return to sports. Under the guidance of the concept of enhanced recovery after surgery, early weight-bearing rehabilitation (EWB) is an important factor affecting patient function and quality of life. However, there is no consensus on whether EWB rehabilitation can be performed after ACL surgery. This study aims to explore the safety and feasibility of EWB after ACL surgery. The study implemented a gradual EWB rehabilitation program in the experimental group, including weight-shifting training, balance training, and gait training on the affected lower limb, and assessed wound healing and stability of the knee joint. The study found that EWB after ACLR is safe and feasible. EWB rehabilitation not only does not pose a negative effect on the patient's knee pain, swelling, wound healing, and stability, but also helps to improve knee active flexion and quality of life faster and better. The EWB program in this study is simple, safe, and effective, and it provides strong theoretical guidance and practical demonstration for accelerated rehabilitation after ACLR.

FUNCTIONAL OUTCOME OF FIXATION OF TIBIA SCHATZKER TYPE II AND TYPE III FRACTURES UNDER ARTHROSCOPIC GUIDANCE

The tibial plateau fracture is a common type of orthopaedic fracture. An alternative to open reduction and internal fixation (ORIF) is arthroscopic-assisted reduction and internal fixation, which provides direct visualisation of the articular surface of the plateau, evaluation of the reduction of the articular surface, and management of any intra-articular pathology that may be associated with the reduction of the articular surface. This study aimed to determine the functional outcome of patients who received tibial fixation under arthroscopic supervision for Schatzker's Type II and III tibial fractures. The research was conducted over six months in the Orthopaedic Surgical Department at Jinnah Hospital in Lahore from November 17, 2022, to May 17, 2023. Sixty patients met the inclusion criteria were recruited after obtaining written informed permission. A clinical and historical examination of each patient's knees was conducted, followed by arthroscopy-guided internal reduction and repair of the tibial fracture under general anaesthesia. All patients received a post-operative rehabilitation regimen. At the three-month follow-up, standing AP radiographs were taken to examine the general alignment of the limbs, and Rasmussen score results were recorded. The average age of the patients was 46 years, and 63.3% were men and 36.7% were women. Schatzker grades II and III tibial plateau fractures were present in 53.3% and 46.7% of the patients, respectively. The mean Rasmussen clinical score was 27.33, indicating that 50 out of 60 patients had excellent recovery, nine out of 60 patients had good recovery, and one out of 60 patients had fair recovery. The mean Rasmussen radiological score was 7.36, indicating that 48 out of 60 patients had outstanding recovery, 11 out of 60 patients had good recovery, and one out of 60 patients had fair recovery. In conclusion, arthroscopic-assisted reduction and internal fixation is a good technique for treating young patients with Schatzker grades II-III tibial plateau fractures, and it enables control of co-existing injuries of intra-articular soft tissues, leading to faster recovery and greater patient satisfaction. However, having expertise in trauma and arthroscopic methods is important to carry out the procedure correctly.

Unlocked Knee Syndrome: An Unnoticed form of Knee Pain

Introduction: A ligament tear or torn cartilage are two examples of injuries that can cause knee pain. Medical conditions like gout, arthritis, and infections can also cause knee pain. The existence of knee pain is a better predictor for any stuctural alterations in the knee joint. Case Report: Having undergone a right knee arthroscopy 15 years prior for knee pain related to an ACL injury, a 46-year-old man presented our department with intermittent right knee discomfort that had been persistent for four months. The patient's primary regions of pain include the area over the right shin, the medial and lateral portions of the right tibia, as well as the medial patellar region. The patient's knee pain made it challenging for him to carry out daily tasks like walking, squatting, and climbing stairs. Conclusion: This is a unique case presentation of chronic knee-unlocking syndrome followed by an ACL injury. Other symptoms and indicators that the patient complains about are secondary biomechanical changes and adaptations brought on by his unlocked knee posture.

An Automatic Method Framework for Personalized Knee Prosthetic Modeling Based on Kinematic Geometry.

The shape of a knee prosthesis has an important impact on the effect of total knee arthroplasty. Comparing to a standard common prosthesis, the personalized prosthesis has inherent advantages. However, how to construct a personalized knee prosthesis has not been studied deeply. In this paper, we present an automatic method framework of modeling personalized knee prostheses based on shape statistics and kinematic geometry. Firstly, the average healthy knee model is established through an unsupervised process. Secondly, the sTEA (Surgical Transecpicondylar Axis) is calculated, and the average healthy knee model is resized according to it. Thirdly, the resized model is used to simulate the knee's motion in a healthy state. Fourthly, according to the target patient's condition, an excising operation is simulated on both patient's knee model and the resized model to generate an initial knee prosthesis model. Finally, the initial prosthesis model is adjusted according to the simulated motion results. The average maximum error between the resized healthy knee model and the patient's own knee model is less than 2 mm, and the average maximum error between the motion simulation results and actual motion results is less than 3 mm. This framework can generate personalized knee prosthesis models according to the patient's different conditions, which makes up for the deficiencies of standard common prostheses.

Preoperative foot and ankle radiographic evaluation for total knee arthroplasty

PurposeTo radiographically evaluate the ankle and foot complications in preoperative patients for total knee arthroplasty (TKA) in Japan. MethodsThis study included 500 legs of 500 patients who planned to undergo primary TKA in affiliated hospitals of our university from August 2020 to November 2021. Hip to calcaneus view, anterior view of the ankle joint, and anterior and lateral views of the foot were taken within 1 month preoperatively. We measured hip-knee-ankle angle (HKA), mechanical ankle joint axis point (MAJAP), lateral distal tibial angle (LDTA), tibio-plafound inclination (TPI), talar inclination (TI), ankle joint line convergence angle (A-JLCA), talo-first metatarsal angle (TMA), calcaneal pitch angle (CPA), hallux valgus angle (HVA), first-second intermetatarsal angle (M1M2A), first fifth intermetatarsal angle (M1M5A), talonavicular coverage angle (TNCA), and percentage of Takakura Tanaka classification. ResultsMean measured values were as follows: HKA: 11.0°; MAJAP, 39.6%; LDTA: 92.2°; TPI: 6.9°; TI: 7.2°; A-JLCA: 0.3°; TMA:−4.3° (<−4° in 247 feet, 49.4%); CPA: 15.9°(<20° in 366 feet, 73.2%); HVA: 16.8° (mild in 70 feet, 14.0%; moderate in 42 feet, 8.4%; severe in 23 feet, 4.6%); M1M2A: 11.1°(>9° in 373 feet, 74.6%); M1M5A: 31.1°(≥30° in 321 feet, 64.2%); TNCA: 10.6° (≥7° in 375 feet, 75.0%); Takakura Tanaka classification Stage ​≥ ​IIIa in 108 feet, 21.6%. ConclusionsMild-to-severe hallux valgus was noted in 26.5% of patients and Stage IIIa or higher ankle osteoarthritis in 21.6%, and abnormal alignment—including flat feet—was indicated in some patients. Patient's knee, foot, and ankle symptoms should be considered before TKA.

Effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament tibial insertion fracture in adults

To explore the effectiveness of arthroscopic binding fixation using suture through single bone tunnel for posterior cruciate ligament (PCL) tibial insertion fractures in adults. Between October 2019 and October 2021, 16 patients with PCL tibial insertion fractures were treated with arthroscopic binding fixation using suture through single bone tunnel. There were 11 males and 5 females with an average age of 41.1 years (range, 26-58 years). The fractures were caused by traffic accident in 12 cases and sports in 4 cases. The time from injury to operation ranged from 2 to 10 days with an average of 6.0 days. The fractures were classified as Meyers-McKeever type Ⅱ in 4 cases and type Ⅲ in 9 cases, and Zaricznyi type Ⅳ in 3 cases. There were 2 cases of grade Ⅰ, 7 cases of grade Ⅱ, and 7 cases of grade Ⅲ in the posterior drawer test. There were 3 cases combined with lateral collateral ligament injury and 2 cases with meniscus injury. The visual analogue scale (VAS) score, Lysholm score, International Knee Documentation Committee (IKDC) score, and knee range of motion were used to evaluate knee joint function. The posterior drawer test and knee stability tester (Kneelax 3) were used to evaluate knee joint stability. The X-ray films were used to evaluate fracture reduction and healing. All incisions healed by first intention after operation. There was no incision infection, popliteal neurovascular injury, or deep venous thrombosis of lower limbs. All patients were followed up 6-12 months, with an average of 10 months. X-ray films at 6 months after operation showed the fractures obtained bone union. There were 11 cases of grade 0, 4 cases of gradeⅠ, and 1 case of grade Ⅱin posterior drawer test, showing significant difference when compared with preoperative results ( Z=23.167, P<0.001). The VAS score, Lysholm score, IKDC score, knee range of motion, and the results of Kneelax3 examination all significantly improved when compared with preoperative results ( P<0.05). For adult patients with PCL tibial insertion fractures, the arthroscopic binding fixation using suture through single bone tunnel has the advantages of minimal trauma, good fracture reduction, reliable fixation, and fewer complications. The patient's knee joint function recovers well.

Management and Outcome of Elderly Patients With Patellar Fracture Treated With Novel Modified Cerclage Wiring.

The purpose of this study is to assess the efficacy and security of a fixation method for fixing patellar fractures in elderly patients utilizing modified cerclage wire. From January 2015 to December 2020, 31 cases (age≥65years old) of closed patellar fracture were treated by modified cerclage wiring. Patients in these instances ranged in age from 65 to 87 (73.7 ± 7.2years), with 15 men and 16 women. 4 instances were type 34-C1 (transverse fracture) according to the AO/OTA classification, 27 cases (87%) were comminuted fractures, including 11 cases that were type 34-C2 (3 fragments), and 16 cases that were type 34-C3 (more than 3 fragments). Postoperative problems such as fragment re-displacement, nonunion, internal fixation loosening, infection, and internal fixation rupture were evaluated. The clinical grading systems of Böstman were used to assess the postoperative clinical outcomes. Thirty one patients in all were monitored for 14 to 31months (22.2 ± 4.5months). After the procedure, the fracture took 2.5-3.5months (2.92 ± .25months) to heal. There were no postoperative issues like infection, dislocation, implant breakage, uncomfortable hardware, or post-traumatic osteoarthritis. According to the clinical grading scales of Böstman, the average score of the final follow-up was 28.6 ± 1.1 (range 26-30). 29 (94%) of the patients had excellent results, whereas just 2 (6%) had good results. The patient's knee flexion activity ranged from 110 to 140°, making for a favorable prognosis. Most patella fractures in the elderly are comminuted. Elderly patients with patellar fractures may be successfully treated with modified cerclage wire, with good results and no noticeable side effects.

Anterior cruciate ligament tear detection based on deep belief networks and improved honey badger algorithm

The Anterior Cruciate Ligament (ACL) tear is a common injury among athletes who participate in extreme sports such as basketball, football, American football, and skiing. When an ACL tear is suspected, doctors usually take X-Rays of the patient's knee to identify the injury. MRI can often be used to help with diagnosis. This study proposes a novel hierarchical approach for more accurate ACL injury detection. The method starts by applying preprocessing techniques to improve image quality, then using Co-occurrence Matrix (GLCM) and Discrete Cosine Transform (DCT) in combination, and features from the images are retrieved. The features are then sent into a Deep Belief Network (DBN) which has been trained for classification and is further optimized using a new metaheuristic method known as the “Improved Honey Badger Algorithm”. Results are compared with methods like Euclidean Distance and Neural Networks (ED/NN), Random Forest (RF), Fuzzy and Convolutional Neural Networks (CNN) and it is seen that the proposed method achieves 96% accuracy, 98% sensitivity, and 80% specificity, proving highest efficiency than all other methods.

EVALUATION OF THE PATIENT’S KNEE IMPLANT PERFORMANCE (PKIP) SCORE IN REVISION KNEE ARTHROPLASTY

Patient reported outcome measures (PROMs) after total knee arthroplasty (TKA) are typically used to assess longitudinal change in pain and function after total knee arthroplasty (TKA). The Patient's Knee Implant Performance (PKIP) score was developed to evaluate outcomes more broadly including function, stability, confidence, and satisfaction. Although validated in patients having a primary TKA, the PKIP has not been evaluated as an outcome measure for patients having revision TKA. This study examined patient outcomes at one year following primary and revision TKA measured using the PKIP, compared to Oxford Knee Scores.A retrospective analysis of pre-operative and one-year post-operative outcomes was completed for 39 patients (21 female) who had primary (n=27) or revision (n=12) TKA with a single surgeon between 2017 and 2020. The mean age was 69.2±7.4 years, and mean weight 87.4± 5.1kg. The change over time and correlation between the self-reported outcome measures was evaluated.There was a significant improvement in the PKIP overall score at the 12-month follow-up (32± 13 v 69± 15, p= &lt;0.001), with no significant difference between groups (3.3 points, p=0.50). Among the PKIP sub-scores, there was a significant improvement in knee confidence (3.5±2 vs 7.7±2; p&lt;0.001), stability (3.4±2 vs 7.4±3; p&lt;0.001) and satisfaction (2.5±1.7 vs 6.6±3, p&lt;0.001). Between group differences in PKIP sub-scores one year after surgery were small and non-significant. For all patients, the OKS and PKIP scores were moderately correlated before surgery (r=0.64, p=&lt;0.05), and at 1 year after surgery (r=0.61, p= &lt;0.001).Significant improvements in knee confidence, stability, and satisfaction one year after TKA were identified from the PKIP responses, with no significant difference between primary and revision surgery. The moderate correlation with the OKS suggests these questionnaires measure difference constructs and may provide complementary outcome information in this patient cohort.

PELAKSANAAN FISIOTERAPI PADA KASUS POST OPERASI TOTAL KNEE REPLACEMENT

This study aims to determine; (1) Can Infrared (IR) modality improve blood circulation and reduce pain? (2) Knowing whether exercise therapy can increase muscle strength. (3) Whether exercise therapy can increase the strength of the Joint Scope of Motion by using a Goniometer. This research is a qualitative research with a case study design, namely to determine: (1) Whether the Infrared (IR) modality can improve blood circulation and reduce pain. (2) Knowing whether exercise therapy can increase muscle strength. (3) Whether exercise therapy can increase the strength of the Joint Scope of Motion by using a Goniometer. The subjects in this study were patients who complained of pain, muscle weakness, and joint limitations in the patient's knees. The research subject consisted of one person. Data were obtained by conducting interviews, observations and physiotherapy management actions in postoperative cases of total knee replacement. Based on the results of the research that has been done, the results show that after intervention with infrared (IR) modalities, and exercise therapy with a frequency of 6 consecutive treatments. It was found that there was a decrease in pain, an increase in muscle strength in the right knee, and an increase in the range of motion of the knee joint.Keywords: Physiotherapy management, postoperative total knee replacement cases

Effects of total knee arthroplasty on balance and fall risk in elderly patients with severe gonarthrosis: An age- and sex-matched comparative study.

Falls are a severe cause of morbidity and mortality in elderly patients, and gonarthrosis causes a tendency to fall. Total knee arthroplasty (TKA) is a widely used successful surgical procedure for end-stage gonarthrosis. To investigate whether there is a difference in the frequency of falls, balance and fall risk, and clinical and radiological results in patients with end-stage gonarthrosis with and without TKA. This was a single-center, retrospective, case-control study with age- and gender-matched groups. A total of 100 patients over 60 years of age, with end-stage gonarthrosis and who met the inclusion criteria were included in the study. Fall risk was analyzed using the Berg Balance Scale (BBS), TUG tests, and the ITAKI Fall Risk Test. Knee varus angles were measured using standing long-leg radiographs, and radiological gonarthrosis grading was performed. Pain levels and quality of life were assessed using the VAS and WOMAC. Each patient's knee extensor muscle strength and range of motion were measured. WOMAC, ITAKI, TUG test, and VAS scores were significantly higher in the control group than in the TKA group. BBS scores were significantly lower in the control group. Although the number of falls was high in the control group, there was no statistically significant difference between the two groups. The results of this study showed that total knee arthroplasty provided statistically significant improvement in the clinical, radiological, and fall risk results of the patients. Although there was a decrease in the frequency of falls compared to the control group, it was statistically insignificant. In addition, in our study, it was evaluated that the most important risk factor for falling was advanced age.