1,721,002 research outputs found
TRATTAMENTO CONSERVATIVO E CHIRURGICO. PATELLO-FEMORAL INSTABILITY: CONSERVATIVE AND SURGICAL TREATMENT
No full textTotal knee arthroplasty in elderly osteoporotic patients
No full textOften in daily practice the choice of a prosthesis does not rise out of considerations about literature evidences, but it seems to be related to the personal experience and "surgical philosophy" of surgeon. The choice of prosthesis in total joint replacement is usually justified by biological and mechanical parameters that the surgeon considers before surgery. Osteoporosis is a disease characterized by a reduced bone mass and a degeneration of the bone tissue; it leads to bone fragility, so to a higher risk of fractures. Bone resistance, as all the changes in the microarchitecture of the bone tissue, is linked to bone density. Because of the bone density variation and/or the changes in the bone micro-architecture, as the bone strength decreases, the risk of fractures increases. It is important to understand all the factors taking part in both normal and abnormal bone remodelling. Osteoporosis does not imply a concrete bone loss, but a change of the bone micro-architecture itself. In these cases the choice of the patient and implant design are very important. In the period between March 1997-July 2002, we implanted 100 consecutive TKA (total knee arthroplasty) Genesis II in 97 subjects (79 female); mean age was 77.1 years old. All TKA were performed because of primary osteoarthritis of the knee. All patients had complete pain relief and excellent knee score. The surgical and medical complications were in accordance with the published literature. We must consider all existing medical conditions, the state of the knee and local needs of the elderly patient. Thus, within these limits, the total knee can improve the ability of patients to manage the activities of daily living and improve their quality of life. ©2011, Editrice Kurtis
Painful knee prosthesis: CT scan to assess patellar angle and implant malrotation
No full textAccording to literature, the incidence of pain in knee prostheses is on the increase. In the last decade Authors have focused attention on rotational alignment of the prosthetic components. The aim of this study is to evaluate the efficiency of a new angle, which we define as patellar angle, in order to achieve early diagnosis of malrotation.
METHODS:
We set up a retrospective observational study recruiting 100 subjects who had undergone total knee prosthesis. 50 subjects suffered from knee anterior pain and 50 without any symptoms. Through CAT scan and VITREA software®, we were able to study the rotation of prosthetic components. We defined a new angle, which links the tibial component and the patella margins. The angles were measured by two different orthopaedic surgeons blinded to the study.
RESULTS:
The patella angle ranged from 10 to 28°, with an average value of 23.2° in the control group; in the study group the angle ranged from 26 to 34°, with an average value of 29.9°.
CONCLUSION:
Our data supported the reproducibility and efficacy of new angular value. It would represent a new method to detect tibial rotational malalignment
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