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Emmanuel Frimpong, Joanne A. McVeigh and Rebecca M. Meiring

( Ostir et al., 2006 ; Salaffi, Carotti, & Grassi, 2005 ). The most cost-effective treatment for advanced knee OA is total knee arthroplasty (TKA) ( Kim et al., 2011 ; Schache, McClelland, & Webster, 2014 ). TKA is considered as a treatment option after all conservative treatment measures have been

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Roger J. Paxton, Jeri E. Forster, Matthew J. Miller, Kristine L. Gerron, Jennifer E. Stevens-Lapsley and Cory L. Christiansen

Knee osteoarthritis (OA) is the most common cause of chronic disability in the United States ( Dillon, Rasch, Gu, & Hirsch, 2006 ). To alleviate OA-related knee pain, more than 700,000 total knee arthroplasties (TKAs) are performed annually ( Kurtz, Ong, Lau, Mowat, & Halpern, 2007 ), with more

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Tsuyoshi Saida, Masayuki Kawada, Daijiro Kuroki, Yuki Nakai, Takasuke Miyazaki, Ryoji Kiyama and Yasuhiro Tsuneyoshi

function and relates to gait performance; thus, it may be a suitable tool to use for evaluating gait function in patients with knee OA ( Barden, Clermont, Kobsar, & Beauchet, 2016 ). Many patients with knee OA undergo total knee arthroplasty (TKA) to regain lower-extremity function. Improved knee function

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Elaine Trudelle-Jackson, Emerenciana Hines, Ann Medley and Mary Thompson

Osteoarthritis of the knee is a frequent cause of mobility disability commonly treated with total knee arthroplasty (TKA) to alleviate symptoms. 1 The number of TKA surgeries performed in the United States is predicted to rise to 3.48 million per year by 2030. 2 Although TKA is considered as a

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Susanne Fuchs, Guido Schuette, Hartmut Witte, and Carsten Oliver Tibesku

A new design of total knee prosthesis without anterior patellar flange was developed to preserve the anatomical shape of the patellofemoral joint. The aim of the current study was to experimentally compare patellofemoral contact area and pressure in a nonreplaced knee, in a knee after implantation of a conventionally designed total knee arthroplasty, and in a knee after implantation of the newly designed total knee arthroplasty without patellar flange. Six cadaveric legs were examined before and after implantation of either a conventional or a newly developed total knee arthroplasty, both without patellar replacement. The essential change in design is the absence of an anterior patellar flange. Contact area and pressure were measured using pressure sensitive films in 45°, 60°, 90°, and 120° of flexion and the results were compared between the different prosthesis designs and with the nonreplaced knee. The prosthesis without patellar flange showed less average and maximum pressure than the conventional prosthesis. Compared with the nonreplaced knee, the conventional prosthesis led to increased average and maximum pressure and decreased contact area. In an experimental test setup, the newly developed total knee arthroplasty without patellar flange showed reduced patello-femoral contact pressure in comparison with a total knee prosthesis with conventional patellofemoral design. This could possibly lead to a lower incidence of anterior knee complaints in patients.

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Dennis Liem, Katharina Van Fabeck, Wolfgang Poetzl, Winfried Winkelmann and Georg Gosheger

Context:

With the rising number of patients with total hip arthroplasty, there is demand for sporting activities for these patients to stay physically active.

Objectives:

The goal of this study was to evaluate satisfaction and golfing performance for golfers after total hip arthroplasty.

Study Design:

Retrospective cohort study.

Patients:

Data of 46 golfers with an average age of 66.5 years (46–79 years) with an average follow up of 58.8 months (7–253 months) after total hip arthroplasty was analysed.

Results:

37 patients (80.4%) were able to return completely pain free, 9 patients still had pain during golf (19.6%). While satisfaction was high regardless of gender or affected side, only male golfers significantly improved their handicap and driving distance. Time spent on the golf course was the same pre- and postoperatively. Average time for returning to practice was 3.8 months; time until a full round of golf was 5.2 months. Postoperative physiotherapy was a significant factor in achieving an improved performance postoperatively.

Conclusions:

Golfers can return to the golf course with the same frequency and performance level to stay physically active after total hip arthroplasty.

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Cale A. Jacobs, Christian P. Christensen and Michael E. Berend

Over the past 10–15 years, many aspects of total hip arthroplasty (THA) have changed. First and foremost, the patients themselves have changed. Since 1990, the age group that has demonstrated the greatest increase in THA was patients between the ages of 45 and 64. As younger, healthier patients are having surgery, a greater emphasis is being placed on postoperative function, activity, and exercise. The rationale for increased postoperative activity is 2-fold: the obvious cardiovascular benefits of exercise and greater patient desire to return to recreational sporting activities. The purpose of this review is to discuss how recent changes in surgical technique, implant design, and pre- and postoperative rehabilitation have affected postoperative athletic activity for THA patients. Although these topics have been addressed often in the orthopedic literature, to our knowledge no published articles have summarized this information for a targeted audience of rehabilitation specialists.

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Matthew B.A. McCullough, Brian D. Adams and Nicole M. Grosland

Third-generation total wrist arthroplasty devices have provided joint stability, relief from pain and increased wrist motion for patients suffering from severe arthritis. While reports of clinical follow-up appointments describe improved wrist function, the improvement in overall upper extremity function and patient perception remains a question. Therefore, the purpose of this study was to assess the upper extremity function in patients that received the Universal 2 total implant system. Eight patients participated in the complete protocol, which included testing activities of daily living as well as surveys to assess patient perception. The findings of the current study suggest that although patients exhibit motion that exceeds the needed amount, many still have a perceived disability.

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Patrice Rougier, Dalila Belaid, Sylvie Cantalloube, Delphine Lamotte and Jacques Deschamps

To assess the postural strategies developed by patients after total hip arthroplasty (THA), 14 patients were measured 12 days after surgery. The respective role played by both sound and prosthetic legs and the compensatory mechanisms were assessed through a separate measure of the center-of-pressure (CP) trajectories under each foot. The movements of the center-of-gravity (CG) were estimated from those of the resultant CP to determine postural performance. The postural behavior was compared with those of a group of age-matched healthy subjects required to adopt a slightly asymmetrical weight distribution. Patient results indicate greater movements for both plantar and resultant CP displacements, principally along the antero-posterior (AP) axis, a decreased contribution of the hip mechanisms in the production of CP displacements along the medio-lateral (ML) axis, greater resultant CP and CG movements along the AP axis and increased differences between CP and CG along both ML and AP axes. The postural specificity of the THA patients appears to be due to a global sensorimotor impairment that alters the control of the loading-unloading mechanism at the hip level.

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Kerry E. Costello, Janie L. Astephen Wilson, William D. Stanish, Nathan Urquhart and Cheryl L. Hubley-Kozey

arthroplasty may be indicated once nonsurgical interventions become ineffective. 4 Under this model, patients spend years living with pain and disability, and the underlying disease processes are not addressed. A better understanding of factors involved in OA progression is essential to inform interventions