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Recent Advances in Arthroplasty - Part II

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 10187

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Dr. Viktor Janz

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1. Department of Orthopaedics & Orthopaedic Surgery, University Medicine Greifswald, Greifswald, Germany
2. Sporthopaedicum, Bahnhofpl. 27, 94315 Straubing, Germany
Interests: total hip arthroplasty; total knee arthroplasty; periprosthetic joint infection; hip dysplasia; periacetabular osteotomy
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Dear Colleagues,

Osteoarthritis of the knee is a debilitating disease, resulting in pain, loss of mobility, inability to work and overall reduction in the quality of life. Total knee arthroplasty (TKA) is a safe and effective treatment to alleviate pain and restore the function of the knee joint. For all of its benefits, TKA is not without limitations, and is not able to fully restore the complete function of the knee joint in all cases. However, continuous improvements in implant design, materials and operative technique have led to an evolution of TKA and helped to close the gap between native and replaced knee joints.

After the success of the Special Issue “Recent Advances in Arthroplasty - Part I”, covering a wide array of topics, including advances in implant design and materials as well as the optimization of the surgical process through robotics, a second Special Issue is in production to continue reporting on and providing evidence regarding the ongoing evolution of TKA. I would like to cordially invite you to submit manuscripts regarding our continued strive to advance all aspects of TKA.

Dr. Viktor Janz
Guest Editor

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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.

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Keywords

process digitalisation
innovations arthroplasty

Published Papers (5 papers)

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Research

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9 pages, 2228 KiB

Open AccessArticle

Femoral Component Rotation in Total Knee Arthroplasty Using a Tibia-First, Gap-Balancing, “Functional Alignment” Technique

by Constantin Dlaska, Petros Ismailidis, Kenji Doma, Benjamin Brandon, Matthew Wilkinson and Kaushik Hazratwala

J. Clin. Med. 2022, 11(22), 6680; https://doi.org/10.3390/jcm11226680 - 10 Nov 2022

Cited by 2 | Viewed by 1457

Abstract

Background: The purpose of this study was to describe the femoral component rotation in total knee arthroplasty (TKA) using a tibia-first, gap-balancing, “functional alignment” technique. Methods: Ninety-seven patients with osteoarthritis received a TKA using computer navigation. The tibial resection was performed according to the kinematic alignment (KA) principles, while the femoral rotation was set according to the gap-balancing technique. Preoperative MRIs and intraoperative resection depth data were used to calculate the following rotational axes: the transepicondylar axis (TEA), the posterior condylar axis (PCA) and the prosthetic posterior condylar axis (rPCA). The angles between the PCA and the TEA (PCA/TEA), between the rPCA and the PCA (rPCA/PCA) and between the rPCA and the TEA (rPCA/TEA) were measured. Data regarding patellar maltracking and PROMs were collected for 24 months postoperatively. Results: The mean PCA/TEA, rPCA/TEA and rPCA/PCA angles were −5.1° ± 2.1°, −4.8° ± 2.6° and −0.4° ± 1.7°, respectively (the negative values denote the internal rotation of the PCA to the TEA, rPCA to TEA and rPCA to PCA, respectively). There was no need for lateral release and no cases of patellar maltracking. Conclusions: A tibia-first, gap-balancing, “functional alignment” approach allows incorporating a gap-balancing technique with kinematic principles. Sagittal complexities in the proximal tibia (variable medial and lateral slopes) can be accounted for, as the tibial resection is completed prior to setting the femoral rotation. The prosthetic femoral rotation is internally rotated relative to the TEA, almost parallel to the PCA, similar to the femoral rotation of the KA-TKA technique. This technique did not result in patellar maltracking. Full article

(This article belongs to the Special Issue Recent Advances in Arthroplasty - Part II)

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12 pages, 2694 KiB

Open AccessArticle

Metal Artifact Reduction Sequences MRI: A Useful Reference for Preoperative Diagnosis and Debridement Planning of Periprosthetic Joint Infection

by Changyu Huang, Yang Chen, Haiqi Ding, Zida Huang, Chaofan Zhang, Wenbo Li, Xi Liu, Zhanhai Tu, Wenming Zhang and Xinyu Fang

J. Clin. Med. 2022, 11(15), 4371; https://doi.org/10.3390/jcm11154371 - 27 Jul 2022

Cited by 3 | Viewed by 1782

Abstract

The diagnosis and treatment of periprosthetic joint infection (PJI) is complex and the use of MRI in PJI is gaining attention from orthopedic surgeons as MR technology continues to advance. This study aimed to investigate whether metal artefact reduction sequence (MARS) MRI could be used as an adjunct in the preoperative diagnosis of PJI and to explore its role in PJI debridement planning. From January 2020 to November 2021, participants with metal joint prostheses that needed to be judged for infection were prospectively enrolled. According to Musculoskeletal Infection Society standards, 31 cases were classified as infection, and 20 as non-infection. The sensitivity and specificity of MARS MRI for the diagnosis of PJI were 80.65% and 75%, respectively. In MARS MRI, the incidence of bone destruction, lamellar synovitis, and extracapsular soft tissue oedema were significantly higher in PJI than in non-PJI. Fourteen suspicious occult lesions were found in the preoperative MARS MRI in 9 cases, and the location of 9 infection lesions was confirmed intraoperatively. In conclusion, MARS MRI is an effective diagnostic tool for PJIand can provide a visual reference for preoperative surgical planning. Full article

(This article belongs to the Special Issue Recent Advances in Arthroplasty - Part II)

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12 pages, 1322 KiB

Open AccessArticle

Effectiveness of ERAS (Enhanced Recovery after Surgery) Protocol via Peripheral Nerve Block for Total Knee Arthroplasty

by Hyun Hee Lee, Hyuck Min Kwon, Woo-Suk Lee, Ick Hwan Yang, Yong Seon Choi and Kwan Kyu Park

J. Clin. Med. 2022, 11(12), 3354; https://doi.org/10.3390/jcm11123354 - 10 Jun 2022

Cited by 7 | Viewed by 2036

Abstract

Peripheral nerve block (PNB) for patients with total knee arthroplasty (TKA) is one of the recommended interventions in ERAS protocols. However, most existing studies involved unilateral TKA (UTKA). As such, this study aimed to evaluate the effectiveness of PNB in terms of immediate postoperative analgesia, length of hospital stays (LOS), and early functional outcomes in both UTKA and simultaneous bilateral TKAs (BTKAs). We reviewed 236 patients who underwent primary TKA with PNB, with 138 and 98 being UTKA and BTKAs, respectively; those in the PNB group underwent femoral nerve and adductor canal block. The matched control and PNB groups—who received intravenous/epidural patient-controlled analgesia (IVPCA/PCEA) alone or IVPCA in addition to PNB after surgery, respectively—were compared. The VAS scores at rest until 48 h after surgery were significantly lower in PNB groups compared to those in the IVPCA groups. At 0– 6 h of activity, VAS scores of the UTKA with PNB group were also lower than the IVPCA group. Compared to PCEA groups, VAS scores at 0–6 h of activity were higher in both the UTKA and BTKAs with PNB groups. However, at 24–48 h at rest, the scores of those in the UTKA with PNB group were lower than those in the PCEA group. The control and experimental UTKA and BTKAs groups had similar LOS and functional outcomes at 90 days postoperatively. In primary TKA, PNB has great analgesic effects for immediate postoperative pain control, and represents a similar analgesic effect to epidural PCA. Full article

(This article belongs to the Special Issue Recent Advances in Arthroplasty - Part II)

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9 pages, 1470 KiB

Open AccessArticle

The Design of the Patellar Component Does Not Affect the Patient-Reported Outcome Measures in Primary Posterior-Stabilized Total Knee Arthroplasty: A Randomized Prospective Study

by Oog-Jin Shon and Gi Beom Kim

J. Clin. Med. 2022, 11(5), 1363; https://doi.org/10.3390/jcm11051363 - 02 Mar 2022

Cited by 3 | Viewed by 1516

Abstract

This randomized comparative study was conducted to investigate the outcomes of patellar resurfacing with a medialized dome or an anatomical type in patients receiving primary unilateral posterior-stabilized TKA. Between March 2019 and January 2021, 98 knees were randomly assigned to receive patellar resurfacing by a medialized dome type (group D, 49 knees) or an anatomic type (group A, 49 knees). The primary outcome was the Knee Injury and Osteoarthritis Outcome Score. The secondary outcomes were the Western Ontario and McMaster Universities Osteoarthritis Index, Feller’s patella score, the Kujala anterior knee pain score, knee joint range of motion (ROM), and postoperative complications, including periprosthetic patellar fracture, patellar tilt angle, and lateral patellar shift. Patient-reported outcomes were not significantly different between the two groups. The ROM of the knee joint was significantly better in group A at six months after surgery (p = 0.021). No complications such as patellar fractures were observed. The anatomic type of patellar component showed a significant improvement of the patellar tilt angle after surgery compared with the medialized dome type of component. However, there were no significant differences in patient-reported clinical outcomes between the two groups during the follow-up period of 12 months. Full article

(This article belongs to the Special Issue Recent Advances in Arthroplasty - Part II)

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Review

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25 pages, 3934 KiB

Open AccessReview

Percutaneous-Reinforced Osteoplasty: A Review of Emerging Treatment Strategies for Bone Interventions

by Nischal Koirala, Jyotsna Joshi, Stephen F. Duffy and Gordon McLennan

J. Clin. Med. 2022, 11(19), 5572; https://doi.org/10.3390/jcm11195572 - 22 Sep 2022

Viewed by 2459

Abstract

Percutaneous-reinforced osteoplasty is currently being investigated as a possible therapeutic procedure for fracture stabilization in high-risk patients, primarily in patients with bone metastases or osteoporosis. For these patients, a percutaneous approach, if structurally sound, can provide a viable method for treating bone fractures without the physiologic stress of anesthesia and open surgery. However, the low strength of fixation is a common limitation that requires further refinement in scaffold design and selection of materials, and may potentially benefit from tissue-engineering-based regenerative approaches. Scaffolds that have tissue regenerative properties and low inflammatory response promote rapid healing at the fracture site and are ideal for percutaneous applications. On the other hand, preclinical mechanical tests of fracture-repaired specimens provide key information on restoration strength and long-term stability and enable further design optimization. This review presents an overview of percutaneous-reinforced osteoplasty, emerging treatment strategies for bone repair, and basic concepts of in vitro mechanical characterization. Full article

(This article belongs to the Special Issue Recent Advances in Arthroplasty - Part II)

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