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- Syrikas, Ioannis, et al.
(författare)
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Increased complications rates and inferior patient reported outcomes following total knee arthroplasty due to post-traumatic osteoarthritis with previous fracture treatment: a systematic review
- 2023
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Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - 0942-2056. ; 31:10, s. 4124-4141
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Tidskriftsartikel (refereegranskat)abstract
- PurposeThis study aims to present the existing literature relating to patient-reported outcome measures (PROMs) and complications in patients undergoing total knee arthroplasty (TKA) due to posttraumatic osteoarthritis (PTOA) with prior fracture treatment around the knee compared with patients who underwent TKA because of primary osteoarthritis (OA).MethodsA systematic review was undertaken and synthesised in accordance with the PRISMA guidelines by searching existing literature in the following databases: PubMed, Scopus, Cochrane Library and EMBASE. A search string according to the PECO was used. After analysing 2781 studies, 18 studies (5729 PTOA patients/149,843 OA patients) were included for a final review. An analysis revealed that 12 (67%) were retrospective cohort studies, four (22%) were register studies and the remaining two (11%) were prospective cohort studies. The mean Critical Appraisal Skills Programme (CASP) score was 23.6 out of 28, signifying studies of moderate quality.ResultsThe most frequently reported outcome measure were postoperative complications, reported in all eighteen studies. Intraoperative complications were reported in ten (4165 PTOA/124.511 OA) and patient-reported outcome measures (PROMs) in six studies (210 PTOA/2768 OA). A total of nine different PROMs were evaluated. As far as PROMs were concerned, the scores were inferior for PTOA but did not differ statistically from OA, except for one study, which favoured the OA group. Across all studies, postoperative complications were higher in the PTOA group, reporting infections as the most common complication. Furthermore, a higher revision rate was reported in the PTOA group.ConclusionPROM analysis suggests that both patient groups benefit from a TKA in terms of functional outcome and pain relief, however, patient-reported outcomes could be inferior for PTOA patients. There is consistent evidence for increased complication rates following PTOA TKA. Patients undergoing TKA due to PTOA after fracture treatment should be informed about the risk for inferior results and refrain from comparing their knee function to patients with TKA after OA. Surgeons should be aware of the challenges that PTOA TKA poses.
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| 4. |
- Karikis, Ioannis, 1985, et al.
(författare)
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Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 5-Year Follow-Up
- 2017
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Ingår i: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 33, s. 2184-2194
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Arthroscopy Association of North America Purpose To radiographically assess the tibial tunnel up to 5 years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws. Methods Fifty-one patients underwent anatomic single-bundle ACL reconstruction with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5 years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up. Results The mean follow-up period was 65 months (±3.9 months), with a minimum of 59 months. The width of the tibial tunnel on the anteroposterior view was 9.4 mm (±1.4 mm) in the early postoperative period and 9.2 mm (±1.5 mm) at 5 years (P =.64). The corresponding widths on the lateral view were 9.6 mm (±1.5 mm) in the early postoperative pe riod and 9.0 mm (±1.4 mm) at 5 years (P =.014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5 years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment. Conclusions In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5 years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws. Level of Evidence Level II, prospective study.
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| 5. |
- Karikis, Ioannis, 1985, et al.
(författare)
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The Long-Term Outcome After Early and Late Anterior Cruciate Ligament Reconstruction.
- 2018
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Ingår i: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 34:6, s. 1907-1917
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Tidskriftsartikel (refereegranskat)abstract
- To compare long-term clinical and radiographic outcomes in patients undergoing either early (group A) or late (group B) surgery after anterior cruciate ligament (ACL) injury.ACL reconstruction using hamstring tendon autografts was performed in 30 patients in group A (median age, 23years; range, 17-49years) and 31 patients in group B (median age, 27years; range, 17-38years). The patients in group A were operated on within 5months (median, 3months; range, 2-5months) of injury, whereas those in group B were operated on more than 24months (median, 30months; range, 24-48months) after injury. The follow-up period was 10years (median, 117months [range, 77-222months] in group A and 129months [range, 77-206months] in group B; P= .44). Multiple objective clinical evaluation tests and patient-reported outcome measures were obtained preoperatively and at follow-up. At follow-up, radiographic assessments of knee osteoarthritis (OA) bilaterally were performed.The frequency of meniscectomy at the index operation was significantly lower in group A (20%) than in group B (52%) (P= .01). There were no significant differences between the groups in terms of Tegner and Lysholm scores and laxity tests both preoperatively and at follow-up. Both groups improved over time in terms of Tegner and Lysholm scores (P < .05). At follow-up, significantly more medial-compartment OA in the index knee was found in group B than in group A (P= .037) according to the Ahlbäck classification system. The index knee showed significantly more OA than the contralateral knee in both groups (P< .01).Patients who underwent early ACL reconstruction required significantly fewer meniscectomies at the index operation than patients who underwent late reconstruction and showed significantly less OA on the medial side of the knee 10years after reconstruction. However, no significant differences were found between the groups in terms of clinical assessments.Level III, retrospective comparative study.
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