Orthopedic Research and Reviews最新文献

{"title":"Trial Tibial Inserts May Result in Different Knee Kinematics from Final Poly Inserts in Total Knee Arthroplasty.","authors":"Sahil Prabhnoor Sidhu,&nbsp;Brent Lanting,&nbsp;Paul Kelly,&nbsp;Edward Vasarhelyi,&nbsp;Ryan Willing","doi":"10.2147/ORR.S309995","DOIUrl":"10.2147/ORR.S309995","url":null,"abstract":"<p><strong>Introduction: </strong>Trialling is a key step in total knee arthroplasty (TKA) and helps the surgeon assess for adequate balancing, range of motion, and stability. Despite this, there are no studies investigating knee kinematics when using trial versus final polyethylene tibial inserts.</p><p><strong>Materials and methods: </strong>Fourteen fresh frozen cadaveric specimens were cycled in a VIVO joint motion simulator. Using both simple compression and simulated muscle loads, joints were tested after TKA with a trial insert or a final tibial poly insert. Anterior/posterior (AP), internal/external (IE), and varus/valgus (VV) kinematics and laxities were analyzed.</p><p><strong>Results: </strong>Knees with trial poly inserts had significantly greater AP hysteresis (difference between flexion and extension motion) than those with final poly inserts (p=0.001). There was no significant difference in IE (p=0.563) or VV (p=0.580) hysteresis. There was no difference in AP, IE, or VV motion or laxities when considering the flexion path alone. Prosthetic joints followed different paths in flexion versus extension.</p><p><strong>Conclusion: </strong>While trial tibial inserts impart valuable information, they may not accurately reproduce the same joint kinematics as final inserts. Balancing of the knee at specific degrees of flexion may depend on the path taken to get there.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"81-88"},"PeriodicalIF":2.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/5f/orr-13-81.PMC8253892.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39162283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic Fractures and Associated Injuries in Patients Admitted to and Treated at Emergency Department of Tibebe Ghion Specialized Hospital, Bahir Dar University, Ethiopia.","authors":"Biruk Ferede,&nbsp;Asteray Ayenew,&nbsp;Worku Belay","doi":"10.2147/ORR.S311441","DOIUrl":"https://doi.org/10.2147/ORR.S311441","url":null,"abstract":"<p><strong>Background: </strong>Pelvic fractures are high-risk injuries that require careful evaluation due to significant patient morbidity and mortality associated with damage to major blood vessels, nerves, and organs. Thus, the aim of this study was to assess pelvic fractures and associated injuries among patients presented at the emergency department of Tibebe Ghion Specialized Hospital, Bahir Dar, Ethiopia.</p><p><strong>Methods: </strong>This is a cross-sectional study with a retrospective facility-based data collection technique. All patients who were managed for pelvic fracture from September 2018 to February 2021 were included. The patient's chart number was collected from the orthopedics surgery morning register sheet and their case folders were retrieved from the medical record department. We used a structured and pretested checklist, and chart review for data collection. The collected data were cleaned, coded, and entered into Epi Info version 7 and exported to SPSS version 24 for analysis. Binary logistic regression analysis was used to identify factors associated with a pelvic fracture.</p><p><strong>Results: </strong>We studied 64 cases of pelvic fracture during the study period. Pelvic was common among males with a ratio of 7:1 and young population (15-35 years). The most common associated injuries were lower extremity 23 (35.9%), abdominal injuries 16 (25.0%), and urethral injury in 13 (20.3%). Moreover, most patients with pelvic fracture have Tile A fracture 56.3%, Tile C in 20 (31.3%), and Tile B in 8 (12.5%) patients. The road traffic accident was the most common cause of pelvic fracture in 56.3%, followed by fall down accident (28.1%), and bullet injury (12.5%).</p><p><strong>Conclusion: </strong>The incidence of pelvic fracture was high in the study area. It reflects the need for strong and multi-sectoral collaboration to prevent pelvic fracture. Additionally, it needs a careful, systematic management approach for survival, healing, and to address the associated complexities and the polytrauma nature.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"73-80"},"PeriodicalIF":2.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5b/8f/orr-13-73.PMC8203598.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39243752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unicompartmental Knee Arthroplasty for Severe Osteoarthritis and Pseudarthrosis in a Patient with Neurofibromatosis.","authors":"Ayush Balaji, Akira Toga, Jun Kano, Atsuki Fujimaru, Taisuke Matsumoto, Shojiro Katoh","doi":"10.2147/ORR.S304651","DOIUrl":"10.2147/ORR.S304651","url":null,"abstract":"<p><p>We describe the case of a 76-year-old Asian female patient who presented with severe pain and a valgus deformity of the right knee. Her past medical history included neurofibromatosis, which resulted in a severe anterior slope of the right knee, limb shortening, and congenital pseudarthrosis. She was diagnosed with severe anterolateral osteoarthritis and eburnation of the right knee that was treated surgically with a lateral unicompartmental knee arthroplasty (UKA). Bone and cartilage fragments were removed from the joint space and a UKA implant (Zimmer^®) with dimensions of 29 mm × 50 mm was inserted. Perioperative imaging revealed that the procedure resulted in the correction of the valgus deformity. Pain was reduced and the patient was able to walk for 10 meters with support during the immediate postoperative period. One week post-surgery, the patient sustained an oblique tibial fracture that extended from the medial edge of the implant to the medial slope of the proximal tibia. This complication may have been attributed to large implant size or sagittal overcutting. The fracture was treated surgically with a rotated anterolateral locking plate (A.L.P.S^®) inserted into the distal tibia. The patient was capable of ambulation at full weight load at two months after the second procedure. It is critical to recognize that there are no standard protocols that can be used to guide the treatment of neurofibromatosis-induced osteoarthritis. The specific preoperative condition of the individual patient plays a large role in determining the appropriate treatment option. In this case, the availability of custom-fitted UKA implants might have improved outlook, we understand that these devices are costly and may not be available at all hospitals. However, we strongly believe that the \"gold standard\" in these cases is patient-specific treatment that addresses the issues of the highest concern using the resources that are available at that time.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"63-71"},"PeriodicalIF":2.0,"publicationDate":"2021-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8b/3b/orr-13-63.PMC8131347.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39004432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Insall-Salvati Ratio Among the Vietnamese Population: Application for Diagnosis of Patellar Malalignment.","authors":"Thu Le Hoang Di,&nbsp;Thanh Hoang Ngoc,&nbsp;Dac Hong An Ngo,&nbsp;Nghi Thanh Nhan Le,&nbsp;Binh Le Trong,&nbsp;Khoan Le Trong,&nbsp;Thao Nguyen Thanh","doi":"10.2147/ORR.S306316","DOIUrl":"https://doi.org/10.2147/ORR.S306316","url":null,"abstract":"<p><strong>Introduction and purpose: </strong>An abnormal patellar position has been proven to be associated with anterior knee pain and several other conditions that affect the patellofemoral joint. The purpose of this study was to determine the incidence of patella alta and patella baja and the applicability of the normal range of the Insall-Salvati ratio in the Vietnamese population.</p><p><strong>Methodology: </strong>Magnetic resonance imaging (MRI) was used to examine 455 Vietnamese subjects' knees. The Insall-Salvati ratio-the ratio of patellar ligament length (LL) and patellar length (PL)-was measured using sagittal T1-weighted images.</p><p><strong>Results: </strong>The overall mean LL/PL ratio was 1.02 (standard deviation 0.15). No significant differences in the LL/PL ratio were observed between sexes. The frequencies of patella alta (Insall-Salvati ratio >1.32) and patella baja (Insall-Salvati ratio <0.72) were 0.9% and 2.4%, respectively.</p><p><strong>Conclusion: </strong>The Insall-Salvati ratio is applicable to Vietnamese populations in which high flexion activities such as kneeling and sitting cross-legged are customary. According to our measurement, the normal range of the ratio among Vietnamese subjects was 0.72 to 1.32.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"57-61"},"PeriodicalIF":2.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/3b/orr-13-57.PMC8064714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38915291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent Pain After Operative Treatment for Chronic Lateral Ankle Instability.","authors":"Byung-Hyun Ahn,&nbsp;Byung-Ki Cho","doi":"10.2147/ORR.S299409","DOIUrl":"https://doi.org/10.2147/ORR.S299409","url":null,"abstract":"<p><p>A high frequency of associated injuries is seen in patients with chronic lateral ankle instability. Comorbidities include intraarticular pathologies (osteochondral lesion, soft tissue or bony impingement syndrome, loose body, synovitis, etc.), peroneal tendon pathologies, neural injuries, and other extraarticular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate with clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, postoperative residual pain, which can negatively affect clinical outcomes and patient satisfaction, is highly prevalent (13-35%). The aim of this review was to discuss the causes of persistent pain after operative treatment for chronic lateral ankle instability.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"47-56"},"PeriodicalIF":2.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/f0/orr-13-47.PMC8064723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38915290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Functional Limitation and Associated Factors in Adults with Following Lower Limb Fractures, Gondar, Ethiopia in 2020: Prospective Cross-Sectional Study.","authors":"Yihalem Belete,&nbsp;Gashaw Jember Belay,&nbsp;Tamiru Dugo,&nbsp;Moges Gashaw","doi":"10.2147/ORR.S300459","DOIUrl":"https://doi.org/10.2147/ORR.S300459","url":null,"abstract":"<p><strong>Background: </strong>Lower limb fractures account for approximately one-third of all fractures. Lower limb fracture complications are one of the major reasons for hospital stays and have high impact on rehabilitation services. Functional limitations with lower extremities fractures are related to decreased functional mobility, the need for long term use of assistive devices, lack of independence, and the long term need for assistive care. This study aimed to assess the functional limitation and identify the possible predictors among lower limb fracture patients by using the Lower Extremity Functional Scale (LEFS).</p><p><strong>Methods: </strong>A prospective institutional-based cross-sectional study was conducted from July to October 30/2020, at University of Gondar, comprehensive specialized hospital. The data of 226 participants were collected through face-to-face interviews, patient record review and by physical examination with simple random sampling techniques. Binary logistic regression was used to identify predictors of functional limitation among lower limb fracture with SPSS 25. The strength of the association was present by adjusted odds ratios (OR).</p><p><strong>Results: </strong>One hundred and eighty-two (n = 182 (80.5%): 95% CI (74.8 to 85.8) patients with following lower limb fracture have functional limitation. Level of education (AOR =5.50; 95% CI: 1.707-17.742), presence of hospitalized complication AOR=3.26; 95% CI (1.147-9.294), severity of pain AOR=3.19; 95% CI (1.399-7.259), duration of onset AOR=9.512; 95% CI (3.585-25.237), knee flexion limitation AOR=7.13; 95% CI (1.926-26.368) were the independent risk factors for functional limitation.</p><p><strong>Conclusion: </strong>The magnitude of functional limitation in following lower limb fracture individual was considerably high in study setup. Level of education, presence of hospitalized complication, severity of pain, duration of onset, knee flexion limitation were the independent risk factors for functional limitation.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"35-45"},"PeriodicalIF":2.0,"publicationDate":"2021-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/f3/orr-13-35.PMC7955725.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25485166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Low Back Pain Among Bank Workers in Gondar City, Northwest Ethiopia.","authors":"Belayneh Shetie Workneh,&nbsp;Enyew Getaneh Mekonen","doi":"10.2147/ORR.S300823","DOIUrl":"https://doi.org/10.2147/ORR.S300823","url":null,"abstract":"<p><strong>Introduction: </strong>Low back pain is a very common health problem that most people experience at some point in their working life. It results in sick leave, disability, producing significant restrictions on usual activity and participation among many office workers. The working style of bank workers is sedentary mostly and the alignment of their chairs, table, and computers is not designed based on their health aspects which exposes them to low back pain.</p><p><strong>Objective: </strong>This study aimed to assess the prevalence and associated factors of low back pain among bank workers in Gondar city.</p><p><strong>Methods: </strong>Institution-based cross-sectional study was conducted from 20th October to 10th November 2020 at banks in Gondar city. A simple random sampling technique was employed to select 296 bank workers. A structured pretested self-administered questionnaire was used to collect data. Data were entered in epi-info version 7, analyzed using SPSS version 21, and presented by frequencies, percentages, and tables. Bivariable and multivariable analyses were employed using a binary logistic regression model. Variables with a p-value < 0.05 were considered as factors significantly associated and the odds ratio with a 95% CI was used to determine the strength of association.</p><p><strong>Results: </strong>The prevalence of low back pain among bank workers in the last 12 months was 55.4%. Being female, work-related stress, lack of physical activity, using a fixed chair and a chair without an armrest, and lifting heavy objects increases the risk of developing low back pain.</p><p><strong>Conclusion: </strong>The prevalence of low back pain among bank workers in Gondar city was high. It is better to establish a health screening team, avail a movable chair and a chair with an armrest, and give special attention to female workers and bank workers with stress, and do physical activity to reduce the risk of developing low back pain.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"25-33"},"PeriodicalIF":2.0,"publicationDate":"2021-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/86/orr-13-25.PMC7881777.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25387246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Study on Implantation of Autologous-Cultured Osteoblasts for the Treatment of Patients with Avascular Necrosis of the Femoral Head.","authors":"Gauresh Palekar,&nbsp;H P Bhalodiya,&nbsp;Shreedhar Archik,&nbsp;Kalpesh Trivedi","doi":"10.2147/ORR.S281030","DOIUrl":"https://doi.org/10.2147/ORR.S281030","url":null,"abstract":"<p><strong>Purpose: </strong>Osteonecrosis of the femoral head is a progressive and debilitating disease that causes pain, osteoarthritis and hip joint collapse, eventually necessitating hip replacement. This study evaluated the long-term outcomes of autologous adult live-cultured osteoblasts (AALCO) implantation in patients with osteonecrosis of femoral head.</p><p><strong>Patients and methods: </strong>In this retrospective multicenter study, we collated and analyzed data of patients ≥12 years of age who underwent AALCO (OSSGROW^®) between 2010 and 2015 for the treatment of osteonecrosis of the femoral head.</p><p><strong>Results: </strong>Data from 64 patients (101 hip joints) were assessed in this study. The mean ±SD duration of disease since diagnosis of osteonecrosis was 7.4±1.6 years. The mean follow-up duration was 6.3±1.4 years. The mean VAS score (n=98 hips) reduced significantly from 58.8 ± 13.8 to 32.2 ± 32.1 post-operatively (mean difference: -26.5±35.2, p=0.001) and Harris hip score (n=97 hips) also significantly improved from 47.1±12.3 to 63.7±27.7 post-operatively (mean difference:16.7±28.7, p=0.0001). Following the AALCO treatment, 29 hips in 13 patients (28.7%) underwent total hip replacement (THA), indicating that AALCO treatment could delay THA for 71.3% of hips. A total of 39.1% of hips diagnosed in early stage versus 60.8% in the late stage of osteonecrosis required THA. Overall, 60.4% of hips improved, 2% remained stable, and 37.6% progressed following the AALCO implantation. The condition of disease was found to have improved in 71.1% of patients in early stage (Grades I and II) versus 58% in the late stage (Grades III and IV) of osteonecrosis.</p><p><strong>Conclusion: </strong>Patients with osteonecrosis who received implantation of autologous-cultured osteoblasts using AALCO showed improvement in joint function and decrease in pain. Treatment with AALCO halted progression of osteonecrosis, preserved the natural hip, and eliminated the need for hip replacement surgeries in 7 out of 10 patients.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"15-23"},"PeriodicalIF":2.0,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/64/orr-13-15.PMC7868257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25354883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effect of Gait Aids, Such as Canes, Crutches, and Walkers, on the Accuracy of Step Counters in Healthy Individuals.","authors":"Paul Kooner,&nbsp;Taran Schubert,&nbsp;James L Howard,&nbsp;Brent A Lanting,&nbsp;Matthew G Teeter,&nbsp;Edward M Vasarhelyi","doi":"10.2147/ORR.S292255","DOIUrl":"https://doi.org/10.2147/ORR.S292255","url":null,"abstract":"<p><strong>Background: </strong>Wearable step-counter devices have become inexpensive tools that enable patients, researchers, and clinicians to objectively monitor physical activity. It is unknown how the use of gait aids, such as canes, crutches, and walkers, affects the accuracy of these devices. Such gait aids are commonly used by patients with chronic physical impairment and after joint-replacement surgery. The aim of this study was to determine the effect of gait aids on the accuracy of wearable step counters.</p><p><strong>Methods: </strong>Nine healthy participants wore a Fitbit step counter on their wrist and hip and performed eight walking tests with canes, crutches, and walkers. Bland-Altman analyses were performed for all eight walking tests in order to compare agreement between measurement techniques.</p><p><strong>Results: </strong>Mean overall agreement for subjects walking without gait aids in the hip group was excellent, showing a bias of -2.9, with limits of agreement (LOAs) between -8.72 and 2.95. For use of canes or crutches, the Bland-Altman plots had a range of bias values between the hip and wrist counters from -7.22 to 33.56, with LOAs from -98.55 to 124.2. The wrist counter during the four-wheeled walking test showed very little agreement with the actual step count, with a bias value of 91.33 and LOAs of 64.1-118.6, illustrating exceptionally unreliable step counts.</p><p><strong>Conclusion: </strong>This study suggests that these widely commercially available step counters have poor reliability with gait aids, especially walkers, which should be taken into account in research and clinical settings.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"1-8"},"PeriodicalIF":2.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/67/orr-13-1.PMC7802358.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38820934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Stemmed versus Un-Stemmed Varus-Valgus Constrained Components in Primary Total Knee Arthroplasty.","authors":"Mina W Morcos,&nbsp;James L Howard,&nbsp;Brent Lanting,&nbsp;Steven MacDonald,&nbsp;Douglas Naudie,&nbsp;Richard McCalden,&nbsp;Edward M Vasarhelyi","doi":"10.2147/ORR.S290015","DOIUrl":"https://doi.org/10.2147/ORR.S290015","url":null,"abstract":"<p><strong>Purpose: </strong>The necessity of stemmed components when performing a varus-valgus constrained (VVC) primary total knee arthroplasty (TKA) is unclear. The purpose of this study is to compare the outcomes of primary VVC TKA with and without stems at a minimum of two years.</p><p><strong>Methods: </strong>Patients in our prospectively collected database with primary VVC TKAs were identified. Patient demographics, prosthesis data, time in vivo, characteristics of revision, and radiographs and PROMs were compared between the stemmed and un-stemmed cohorts.</p><p><strong>Results: </strong>Sixty-five patients with 69 primary VVC TKAs were identified; 17 were implanted with stems and 52 without stems. Five of the stemmed TKAs (5/17) required revision at 15.1 years, while only one of the un-stemmed TKA (1/52) required a revision at 21.6 years (p=0.003) for aseptic loosening. Of the 5 stemmed TKAs requiring revision, 3 were for aseptic loosening and 2 were for PPJI. The un-stemmed cohort had a significantly higher final total KSS (p=0.048).</p><p><strong>Conclusion: </strong>There was no increase in aseptic loosening or revision surgery in patients with non-stemmed primary VVC TKA compared to those with stemmed VVC TKA at mid-term follow-up. Utilizing non-stemmed TKA with VVC in appropriate cases is safe and may reduce cost, shorten operative time, and preserve bone-stock.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"13 ","pages":"9-13"},"PeriodicalIF":2.0,"publicationDate":"2021-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d6/5f/orr-13-9.PMC7800685.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38816904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}