Secondary resurfacing of the patella in total knee arthroplasty

Anterior knee pain following primary total knee arthroplasty is common and can be difficult to treat satisfactorily. We reviewed 28 consecutive patients (29 knees) who underwent secondary resurfacing of the patella for persistent anterior knee pain and report on the results. Mean follow-up was 28 months (range12-61) with no cases lost to follow-up. Oxford knee scores, range of motion, the patient's assessment of outcome and overall satisfaction were recorded. Seventeen out of 19 (59%) felt their knee was better following patellar resurfacing, 10 out of 29 (34%) felt it was the same and two out of 29 (7%) felt it was worse. There was a significant improvement in Oxford knee scores (p < 0.001) and significant increase in patient satisfaction (p < 0.001) following secondary resurfacing. While secondary resurfacing of the patella does not provide the solution for every case of anterior knee pain following total knee joint replacement, in greater than 50% of cases it can be effective at relieving symptoms and in this series carries a low risk of worsening symptoms or complications

Electromagnetic navigation in total knee arthroplasty—a single center, randomized, single-blind study comparing the results with conventional techniques

We report on the results of a randomized study (n = 200) to compare total knee arthroplasty performed using conventional instrumentation or electromagnetic computer assisted surgical technique. 92% of navigated and 85% of conventional knees were implanted within ± 3° from neutral mechanical alignment; there was no statistically significant difference between these proportions. There was also no difference in femoral or tibial rotation assessed by CT scan. At 1 year follow up there was no statistical difference between the two groups in American Knee Society Score, Oxford Knee Scores, patient satisfaction, quality of life, hospital length of stay, complication rates or other adverse events. Tourniquet time in the navigated group was longer. Proving value for navigation in total knee arthroplasty surgery remains a challenge

Electromagnetic navigated versus conventional total knee arthroplasty—a five-year follow-up of a single-blind randomized control trial

Background: The objective of this study is to provide the 5-year follow-up results of a randomized study comparing conventional versus electromagnetic computer navigated total knee arthroplasty. Methods: Analysis of 127 patients (66 navigated and 61 conventional surgeries) was performed from a prospective, single-blinded, randomized controlled trial. Patient-reported outcome measures were collected at 5 years after surgery and compared with previously published 1-year clinical outcomes. Five-year surgical revision rates were collated and compared between intervention groups. Results: Overall, there have been continued improvements in the clinical scores of patients in both groups when compared with clinical data at 1 year; however, at 5 years, there is no statistical difference in any of the patient-reported outcome measures between conventional and navigated surgery. Interestingly, improved implant survivorship was observed in the navigated (0% revision rate) compared with the conventional group (4.9% all-cause revision rate). Conclusion: Electromagnetic computer navigated technology produces similar clinical outcomes compared with traditional surgery. Further work is required to monitor implant survivorship, and clinical outcomes with long-term follow-up, to determine the cost effectiveness of this technology