Recent Advancements in Total Knee Arthroplasty, Revision Knee Arthroplasty and Salvage Procedures

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (20 November 2023) | Viewed by 2327

Special Issue Editors


E-Mail Website
Guest Editor
Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany
Interests: orthopaedic trauma; trauma surgery; orthopaedic surgery

E-Mail Website
Guest Editor
Department for Trauma and Orthopaedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt, Germany
Interests: clinical trials; traumatology orthopedic surgery; molecular biology

Special Issue Information

Dear Colleagues,

Total knee arthroplasty has been shown to be an effective treatment strategy for severe osteoarthritis. Based on recent projection studies, the number of implantations will rapidly rise in the upcoming years, putting an immense burden on future orthopedic surgeons. However, despite the overall good survival rates, some patients remain dissatisfied. Therefore, there has been a constant development of promising new technologies such as patient-specific implants, fast-track knee arthroplasty, as well as peri-operative anesthesia and postoperative rehabilitation programs to further improve the outcomes.

On the other side, there will inevitably be a rise in patients needing surgical revision for various reasons, such as septic or aseptic loosening, instability or stiffness. In particular, periprosthetic infections represent a diagnostic, surgical and economic challenge due to the complex interdisciplinary treatment strategies and treatment-resistant pathogens. In addition, the reconstruction of bony defects is one of the major challenges of revision total knee arthroplasty (TKA), frequently reaching the limits of reconstructability. However, chronic persistent infection or a destroyed extensor mechanism preclude successful reconstruction with the currently available revision TKA systems in some cases. In these situations, salvage procedures such as knee arthrodesis usually remain the only viable option if a limb-preserving treatment is considered.

With this Special Issue, we want to provide an update about recent advancements in knee arthroplasty and revision arthroplasty as well as provide an insight on possible salvage procedures in order to facilitate a comprehensive overview in this emerging surgical field.

Topics of interest to this Special Issue include (but are not limited to):

  • current concepts, advantages and limitations in total and unicompartmental knee arthroplasty;
  • personalized approaches in knee arthroplasty;
  • fast-track knee arthroplasty;
  • patient-specific and customized implants;
  • patient-specific alignment (PSA);
  • implant positioning and limb alignment;
  • robotic-assisted systems, smart tools and/or navigation technology for knee arthroplasty;
  • implant geometries and materials for knee arthroplasty;
  • concepts in revision arthroplasty;
  • treatment concepts for chronic painful TKA;
  • treatment of bony defects;
  • diagnosis and treatment concepts for periprosthetic infection;
  • salvage procedures;
  • and knee arthrodesis.

I am looking forward to your contributions.

Dr. Alexander Klug
Dr. Yves Gramlich
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (2 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

12 pages, 1308 KiB  
Article
Acute Treatment of Osteochondral Detachment Following Patellar Dislocation: Clinical and Short-Term MRI Follow-Up
by Leonardo Puddu, Giovanni Lugani, Francesco Perusi, Damiano Brunialti, Fabrizio Cont, Corrado Ciatti, Eleonora Poleggi, Leonardo Locatelli, Francesco Pisanu, Carlo Doria, Fabrizio Cortese and Gianfilippo Caggiari
Life 2024, 14(1), 85; https://doi.org/10.3390/life14010085 - 4 Jan 2024
Viewed by 974
Abstract
Background: The aim of our study is to emphasizes the significance of prompt diagnosis and intervention in younger patients affected by osteochondral detachment after patellar dislocation, where the first objective is to minimize in the shortest possible time complications and ingravescence. The method [...] Read more.
Background: The aim of our study is to emphasizes the significance of prompt diagnosis and intervention in younger patients affected by osteochondral detachment after patellar dislocation, where the first objective is to minimize in the shortest possible time complications and ingravescence. The method involves a clinical patient assessment and MRI follow-up in subjects who underwent to an immediate surgical intervention for osteochondral damage. Methods: From January 2020 to December 2022, 22 patellar dislocation cases were assessed; osteochondral lesions were identified in 12 (54%) patients; nine of these patients were treated immediately with knee arthroscopy, while in seven instances the osteochondral fragment was reattached using bioabsorbable pins. Post-operative clinical evaluations were conducted at one-, three-, and six-month intervals; finally, a six-month post-operative MRI was performed for all surgically treated patients. Results: The MRI evaluations, conducted six months post-operation for all seven patients, indicated successful integration of the reattached osteochondral fragment. Every patient returned to their pre-injury activities after surgery. However, two of them reported mild pain in the anterior region of the knee post-surgery. Conclusions: in young patients, swift diagnosis and immediate surgical intervention for osteochondral detachment resulting from patellar dislocation are crucial. This approach has been identified as the best practice, since it substantially minimizes immediate functional restrictions and significantly lowers the long-term risk of femoral-patellar osteoarthritis. Full article
Show Figures

Figure 1

18 pages, 4877 KiB  
Article
The Effect of Congruent Tibial Inserts in Total Knee Arthroplasty: A Network Meta-Analysis of Randomized Controlled Trials
by Yen-Lin Tsai, Sung Huang Laurent Tsai, Chia-Han Lin, Chun-Ru Lin and Chih-Chien Hu
Life 2023, 13(9), 1942; https://doi.org/10.3390/life13091942 - 21 Sep 2023
Viewed by 1045
Abstract
Objective: The aim of this study was to determine whether modern congruent tibial inserts are associated with superior outcomes in total knee arthroplasty (TKA). Background: Ultracongruent fixed-bearing (UCFB) and medial congruent fixed-bearing (MCFB) inserts have been known to be effective in [...] Read more.
Objective: The aim of this study was to determine whether modern congruent tibial inserts are associated with superior outcomes in total knee arthroplasty (TKA). Background: Ultracongruent fixed-bearing (UCFB) and medial congruent fixed-bearing (MCFB) inserts have been known to be effective in total knee arthroplasty with patient satisfaction. Nonetheless, no supporting evidence to date exists to rank the clinical outcomes of these various congruent inserts in TKA compared with other important considerations in TKA including cruciate-retaining fixed-bearing (CRFB) and posterior-stabilized fixed-bearing (PSFB) inserts. Methods: We searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus up to 15 May 2022. We selected studies involving an active comparison of UCFB or MCFB in TKAs. We performed a network meta-analysis (NMA) of randomized controlled trials (RCTs) and compared different congruent inserts. We ranked the clinical outcomes by SUCRA score with the estimate of the best treatment probability. Our primary outcomes were revision rates and radiolucent lines. Secondary outcomes were functional scores, including the range of motion (ROM), the Knee Society Score (KSS), the Oxford Knee Score (OKS), and WOMAC. Results: Eighteen RCTs with 1793 participants were analyzed. Our NMA ranked MCFB, CRFB, and UCFB with the lowest revision rates. CRFB and UCFB had the fewest radiolucent lines. UCFB had overall the best ROM. UCFB and MCFB had the best OKS score overall. Conclusions: The ranking probability for better clinical outcomes in congruent inserts demonstrated the superiority of congruent tibial inserts, including UCFB and MCFB. UCFB may be associated with better ROM and postoperative functional outcomes. However, integrating future RCTs for high-level evidence is necessary to confirm these findings. Full article
Show Figures

Figure 1

Back to TopTop