Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Total Knee Arthroplasty After Ipsilateral Below-knee Amputation: A Review of the Literature and Surgical Techniques.

ABSTRACT: Patients with knee osteoarthritis in the setting of ipsilateral below-knee amputation present a challenge in terms of patient positioning, intraoperative assistance, implant alignment, postoperative rehabilitation, and prosthesis adjustment. This is a report of a patient with a history of below-knee amputation with ipsilateral knee pain due to osteoarthritis, treated with elective total knee arthroplasty. This was done using custom cutting blocks made via preoperative computed tomography scans, and a single assistant as well as a large hip bump and lateral support were used for positioning. The patient was weight-bearing as tolerated in his regular below-knee prosthesis starting from postoperative day 1, with 1 prosthetic adjustment made during the first week of rehabilitation. The patient was pain-free with full range of motion at 1-year follow-up.

SUBMITTER: Dong K

PROVIDER: S-EPMC9234005 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Total Knee Arthroplasty After Ipsilateral Below-knee Amputation: A Review of the Literature and Surgical Techniques.

Dong Katherine K Cohen-Rosenblum Anna A Hartzler Molly M

Arthroplasty today 20220617

Patients with knee osteoarthritis in the setting of ipsilateral below-knee amputation present a challenge in terms of patient positioning, intraoperative assistance, implant alignment, postoperative rehabilitation, and prosthesis adjustment. This is a report of a patient with a history of below-knee amputation with ipsilateral knee pain due to osteoarthritis, treated with elective total knee arthroplasty. This was done using custom cutting blocks made via preoperative computed tomography scans, ...[more]

PMID: 35769769

Similar Datasets

Total Knee Arthroplasty in Patients With Prior Ipsilateral Hip Fusion: A Surgical Technique.

Project description:BackgroundIn patients with severe osteoarthritis of the knee with prior ipsilateral hip fusion who require total knee arthroplasty (TKA), a controversial issue is whether to first convert the hip fusion to a total hip arthroplasty (THA) or to perform TKA without reconstruction of the hip. Also, immobility of the ipsilateral, fused hip adds significant technical challenge because the usual positioning of the leg requires modification in order to gain access needed for the TKA.TechniqueIn such cases, we position the patient with the knee suspended, similar to how we perform knee arthroscopy. In our experience, the ipsilateral knee has significant deformity and is best addressed with a constrained, hinged TKA.ResultsIn 3 patients with severe knee osteoarthritis with prior ipsilateral hip fusion-a 72-year-old man and a 79-year-old woman with hip arthrodesis due to posttraumatic arthritis and an 81-year-old woman with hip arthrodesis due to congenital dislocation of the hip-rotating-hinge knee prostheses were implanted due to severe knee instability. All 3 patients had satisfactory results, without complications, after follow-up of 1 to 5 years.ConclusionsWe obtained satisfactory results in the short and medium term without previously converting the hip arthrodesis to THA by positioning patients with the knee suspended, in a way similar to when knee arthroscopy is performed, and implanting rotating hinge TKAs due to severe preoperative knee instability.

| S-EPMC8753539 | biostudies-literature

Total Knee Arthroplasty with Prior Ipsilateral Hip Arthrodesis.

Project description:Total knee arthroplasty (TKA) in the setting of previous hip fusion is rare with a paucity of evidence in the orthopaedic literature. Traditionally, TKA is performed supine, with the aid of knee-positioning devices allowing for hip flexion and range of motion of the knee to facilitate ease of surgical intervention. However, TKA using traditional positioning would not be possible in the presence of ipsilateral hip arthrodesis preventing hip motion. This case report describes a TKA performed for a 72-year-old woman with end-stage osteoarthritis of the right knee, ipsilateral hip arthrodesis, and leg-length discrepancy as the sequelae of slipped capital femoral epiphysis. We describe novel surgical positioning to be used to facilitate TKA in the absence of ipsilateral hip motion with bed modifications and the use of an extremity positioning device.

| S-EPMC7527288 | biostudies-literature

Functional Outcome of Above-Knee Amputation After Infected Total Knee Arthroplasty

Project description:Background Periprosthetic joint infection is a serious complication of total knee arthroplasty (TKA). Management usually involves irrigation and debridement, polyethylene liner exchange, one-stage revision, two-stage revision, knee arthrodesis, or ultimately above-knee amputation (AKA). We present our experience with 21 patients who underwent AKA as a sequela of unresolved infected TKA, highlighting their etiology and functional outcomes. Methods A retrospective chart review was performed for all cases of infected TKA treated with AKA at 1 institute from January 2007 to December 2020, with a minimum follow-up of 1 year. Patient demographics, Charlson comorbidity index, culture results, ambulation status, prosthesis fitting, and functional outcomes were collected. Short Form-36 and activities of daily living questionnaires were used for functional outcome assessment. Results Twenty-one patients were identified, 7 of whom were male (33.3%). Mean ± standard deviation follow-up was 5.7 ± 3.1 years (range, 1-11 years). Mean ± standard deviation age was 57.9 ± 10.7 years (range, 38-87 years), and the mean body mass index was 33.5 ± 6.4 kg/m2 (range, 25.4-46 kg/m2). Gram-positive organisms were identified in 15 cases (66.7%). Prosthesis fitting was successful in 17 patients (81%). Post-AKA ambulation was achieved in 12 patients (57.1%). The ambulating group showed higher Short Form-36 and activities of daily living scores when compared with patients who did not ambulate (60.2 vs 43.3, P = .041, and 67.2 vs 52.7, P = .029, respectively). Conclusions AKA should be considered solely as the final recourse for infected TKA. Despite the low-to-moderate patient-reported postoperative outcomes, prosthesis fitting and maintaining ambulation can improve postoperative functional outcomes.

| S-EPMC10472144 | biostudies-literature

Total knee arthroplasty in a patient with ipsilateral calcific myonecrosis.

Project description:Calcific myonecrosis (CM) is a rare soft tissue condition associated with previous trauma that presents with a large lower extremity mass and can be misdiagnosed as a malignancy. Biopsy, accidental entry, or disturbance to the lesion can be accompanied by a high risk of complications. We present the case of a 72-year-old man with severe post-traumatic knee arthritis, as well as a large pretibial mass consistent with CM, who successfully underwent total knee arthroplasty. To our knowledge, this is the first report focusing on total knee arthroplasty in a patient with CM and we discuss considerations for evaluation, tourniquet usage, component positioning and placement, postoperative care, and range-of-motion expectations.

| S-EPMC6287287 | biostudies-literature

Expression data from total knee arthroplasty patients

Project description:Ischaemic preconditioning is a method of protecting tissue against ischaemia-reperfusion injury. It is an innate protective mechanism that increases a tissue's tolerance to prolonged ischaemia when it is first subjected to short burst of ischaemia and reperfusion. It is thought to provide this protection by increasing the tissue's tolerance to ischaemia, therby reducing oxidative stress, inflammation and apoptosis in the preconditioned tissue. We used microarrays to investigate the genomic response induced by ischaemic preconditioning in muscle biopsies taken from the operative leg of total knee arthroplasty patients in order to gain insight into the ischaemic preconditioning mechanism. Patients undergoing primary knee arthroplasty were randomised to control and treatment (ischaemic preconditioning) groups. Patients in the treatment group received a preconditioning stimulus immediately prior to surgery. The ischaemic preconditioning stimulus consisted of three five-minute periods of tourniquet insufflation on the lower operative limb, interrupted by five minute periods of reperfusion. All patients had a tourniquet applied to the lower limb after the administration of spinal anaesthesia, as per normal protocol for knee arthroplasty surgery. Muscle biopsies were taken from the quadriceps muscle of the operative knee at the immediate onset of surgery (T0) and at 1 hour into surgery (T1). Total RNA was extracted from biospies of four control and four treatment patients and hybridised to the Affymetrix Human U133 2.0 chip.

2010-04-12 | E-GEOD-21164 | biostudies-arrayexpress

Total Knee Arthroplasty as the Primary Surgical Treatment After Knee Dislocation.

Project description:Traumatic knee dislocation (KD) is a rare but serious injury, and a missed diagnosis or incorrect treatment can be limb-threatening due to a significant risk of neurovascular injury. The mechanism of injury is often high-energy trauma, but there is a rising tendency of KD after low-energy trauma in the obese patient. KD often results in multiligament injury which can be a complicated surgical task with long recovery time, especially in older patients. This report presents 4 cases where patients older than 50 years with traumatic KD have been treated with a total knee arthroplasty of revision type as an alternative to multiligament reconstruction.

| S-EPMC9168382 | biostudies-literature

Determinants of demand for total hip and knee arthroplasty: a systematic literature review.

Project description: Not available

| S-EPMC3483199 | biostudies-literature

Challenges of total knee arthroplasty in osteogenesis imperfecta: case report and literature review.

Project description:The majority of adults with mild osteogenesis imperfecta report significant functional impairment due to musculoskeletal concerns. Knee osteoarthritis is common in these patients. Although total knee arthroplasty has become a highly efficient surgical technique for osteoarthritis, this procedure remains uncommon in patients with osteogenesis imperfecta. This current case report describes the important clinical aspects of osteogenesis imperfecta that must be considered during the planning and performance of a total knee replacement. A 62-year-old female patient with a history of osteogenesis imperfecta suffered from severe osteoarthritis of the knee with valgus deformity. Two years after posterior stabilized total knee arthroplasty, her Hospital for Special Surgery knee score had improved from preoperative 53 points to 85 points at the final follow-up. The current case report describes the crucial technical aspects of a successful total knee replacement in this uncommon scenario. Underlying deformities and concomitant pathologies constitute specific surgical challenges. Special care should be taken to protect the patient from potential complications.

| S-EPMC9152202 | biostudies-literature

Outcomes of Total Knee Arthroplasty in Patients With a Prior Contralateral Above-Knee Amputation: A Retrospective Review of a Nationwide Database.

Project description:BackgroundTotal knee arthroplasty (TKA) in patients with a prior contralateral above-knee amputation (AKA) is uncommon, with limited literature describing the outcomes. We used a national database to compare the outcomes of primary TKA in above-knee amputees and nonamputees.MethodsA retrospective review of TKA recipients with prior contralateral AKA was performed using the PearlDiver database from 2010 to Q2 of 2019. Subjects and outcomes were identified using Current Procedural Terminology and International Classification of Diseases, Ninth and Tenth Revisions (ICD-9 and ICD-10). Patients were identified and matched at a 1-to-3 ratio with nonamputee (AKA group = 931; nonamputee group = 2792 patients). Perioperative outcomes and length of stay (LOS) were compared at 90 days, 6 months, 1 year, 3 years, and 5 years after TKA.ResultsThe AKA group had a longer LOS (5.19 vs 3.00, P < .001) and higher overall complications rate (33.8% vs 11.8%). At all studied time intervals, the AKA group had higher periprosthetic infections, revisions, mechanical complications, and respiratory failure (P < .001), as well as surgical site infection, pneumonia, and blood transfusion (P < .05).ConclusionOur study revealed higher overall complications and longer LOS among TKAs in prior contralateral above-knee amputees. Surgeons should evaluate the risks and benefits of performing a TKA on patients with prior contralateral AKA.

| S-EPMC8829440 | biostudies-literature

Minimally invasive total knee arthroplasty: surgical implications for recovery.

Project description:BackgroundDespite growing interest in minimally invasive surgery (MIS) techniques for total knee arthroplasty (TKA), few randomized controlled trials have compared MIS and conventional TKA using a combination of functional performance, knee pain, knee range of motion (ROM), and surgical and radiographic outcomes.MethodsA prospective, randomized investigation comparing early outcomes of TKA using conventional or MIS approaches (n = 44). Patients were assessed preoperatively, 48 hours, 4 and 12 weeks postoperatively by blinded evaluators. Outcome measures included timed-up-and-go, 100-ft walk, knee pain, passive knee ROM, Knee Society Score, blood loss, tourniquet time, hospital length of stay, surgical complications, and radiographic outcomes.ResultsNo significant differences in functional performance, knee pain, knee ROM, surgical, or radiographic outcomes were observed between groups at 48 hours, 4 or 12 weeks postoperatively.ConclusionWhile surgical and radiographic outcomes were not compromised with MIS surgery, there were also no improvements in pain, ROM, or functional performance with MIS TKA.

| S-EPMC4162390 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data