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Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal

BACKGROUND: The options to perform total knee arthroplasty (TKA) with retained hardware in femur are mainly – removal of hardware, use of extramedullary guide, or computer-assisted surgery. Patient-specific blocks (PSBs) have been introduced with many potential advantages, but their use in retained...

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Autores principales: Vaishya, Raju, Vijay, Vipul, Agarwal, Amit K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858209/
https://www.ncbi.nlm.nih.gov/pubmed/29576643
http://dx.doi.org/10.4103/ortho.IJOrtho_166_16
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author Vaishya, Raju
Vijay, Vipul
Agarwal, Amit K
author_facet Vaishya, Raju
Vijay, Vipul
Agarwal, Amit K
author_sort Vaishya, Raju
collection PubMed
description BACKGROUND: The options to perform total knee arthroplasty (TKA) with retained hardware in femur are mainly – removal of hardware, use of extramedullary guide, or computer-assisted surgery. Patient-specific blocks (PSBs) have been introduced with many potential advantages, but their use in retained hardware has not been adequately explored. The purpose of the present study was to outline and assess the usefulness of the PSBs in performing TKA in patients with retained femoral hardware. Materials and MATERIALS AND METHODS: Nine patients with retained femoral hardware underwent TKA using PSBs. All the surgeries were performed by the same surgeon using same implants. Nine cases (7 males and 2 females) out of total of 120 primary TKA had retained hardware. The average age of the patients was 60.55 years. The retained hardware were 6 patients with nails, 2 with plates and one patient had screws. Out of the nine cases, only one patient needed removal of a screw which was hindering placement of pin for the PSB. RESULTS: All the patients had significant improvement in their Knee Society Score (KSS) which improved from 47.0 to postoperative KSS of 86.77 (P < 0.00). The mechanical axis was significantly improved (P < 0.03) after surgery. No patient required blood transfusion and the average tourniquet time was 41 min. CONCLUSION: TKA using PSBs is useful and can be used in patients with retained hardware with good functional and radiological outcome.
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spelling pubmed-58582092018-03-23 Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal Vaishya, Raju Vijay, Vipul Agarwal, Amit K Indian J Orthop Original Article BACKGROUND: The options to perform total knee arthroplasty (TKA) with retained hardware in femur are mainly – removal of hardware, use of extramedullary guide, or computer-assisted surgery. Patient-specific blocks (PSBs) have been introduced with many potential advantages, but their use in retained hardware has not been adequately explored. The purpose of the present study was to outline and assess the usefulness of the PSBs in performing TKA in patients with retained femoral hardware. Materials and MATERIALS AND METHODS: Nine patients with retained femoral hardware underwent TKA using PSBs. All the surgeries were performed by the same surgeon using same implants. Nine cases (7 males and 2 females) out of total of 120 primary TKA had retained hardware. The average age of the patients was 60.55 years. The retained hardware were 6 patients with nails, 2 with plates and one patient had screws. Out of the nine cases, only one patient needed removal of a screw which was hindering placement of pin for the PSB. RESULTS: All the patients had significant improvement in their Knee Society Score (KSS) which improved from 47.0 to postoperative KSS of 86.77 (P < 0.00). The mechanical axis was significantly improved (P < 0.03) after surgery. No patient required blood transfusion and the average tourniquet time was 41 min. CONCLUSION: TKA using PSBs is useful and can be used in patients with retained hardware with good functional and radiological outcome. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC5858209/ /pubmed/29576643 http://dx.doi.org/10.4103/ortho.IJOrtho_166_16 Text en Copyright: © 2018 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Vaishya, Raju
Vijay, Vipul
Agarwal, Amit K
Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title_full Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title_fullStr Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title_full_unstemmed Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title_short Total Knee Arthroplasty Using Patient-specific Blocks after Prior Femoral Fracture without Hardware Removal
title_sort total knee arthroplasty using patient-specific blocks after prior femoral fracture without hardware removal
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858209/
https://www.ncbi.nlm.nih.gov/pubmed/29576643
http://dx.doi.org/10.4103/ortho.IJOrtho_166_16
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