Osteoarthritis of the knee - a condemnation of a prosthesis for a young person? ATLAS Knee System as an effective method of relieving the medial compartment of the knee

Introduction: Osteoarthritis of the knee is one of the more common causes of disability in the elderly. In the United States, one in four adults suffers from the condition, half of whom are under the age of 65. The most commonly affected joint is the knee. A significant proportion of people in the 35-65 age range have degeneration in one compartment of the knee joint. Among the younger population, when non-operative methods are already failing and it is too early for surgery, there is a place for the ATLAS Knee System. Aim of the study:  The purpose of our work is to present a new and innovative form of treatment for single-compartment osteoarthritis of the knee. Based on the available literature, to show the advantages, disadvantages and results of treatment with the ATLAS Knee System. Methods and materials: A literature review was conducted in the PubMed database, using the keywords: "Atlas Knee System"; "osteoarthritis"; "knee osteoarthritis". Results: The ATLAS system is built with an absorber that, as the knee is stretched, absorbs the forces acting on the medial compartment, while not putting stress on the rest of the knee joint. After patients use the implant, a significant reduction in pain and improvement in knee function is observed. Conclusion: Osteoarthritis is a significant health problem increasingly prevalent even among the younger population. The ATLAS system provides an alternative for younger people in whom conservative treatment has failed, while more invasive methods such as osteotomies and total or single-unit prosthetics are impossible or rejected by the patient. More studies are needed, on a larger number of people to accurately evaluate this system

Isokinetic Identification of Knee Joint Torques before and after Anterior Cruciate Ligament Reconstruction.

The aim of this study was to evaluate the serial change of isokinetic muscle strength of the knees before and after anterior cruciate ligament reconstruction (ACLR) in physically active males and to estimate the time of return to full physical fitness. Extension and flexion torques were measured for the injured and healthy limbs at two angular velocities approximately 1.5 months before the surgery and 3, 6, and 12 months after ACLR. Significant differences (p ≤ 0.05) in peak knee extension and flexion torques, hamstring/quadriceps (H/Q) strength ratios, uninvolved/involved limb peak torque ratios, and the normalized work of these muscles between the four stages of rehabilitation were identified. Significant differences between extension peak torques for the injured and healthy limbs were also detected at all stages. The obtained results showed that 12 months of rehabilitation were insufficient for the involved knee joint to recover its strength to the level of strength of the uninvolved knee joint. The results helped to evaluate the progress of the rehabilitation and to implement necessary modifications optimizing the rehabilitation training program. The results of the study may also be used as referential data for physically active males of similar age

Boletín de Segovia: Número 153 - 1844 diciembre 17

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 200

Boletín de Segovia: Número 68 - 1841 junio 8

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 200

Normalized work (Nm) of the involved leg in consecutive stages of rehabilitation.

<p>Normalized work (Nm) of the involved leg in consecutive stages of rehabilitation.</p

Gravitationally corrected knee flexion torque and angular acceleration of the knee attachment.

<p>Gravitationally corrected knee flexion torque and angular acceleration of the knee attachment.</p

Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial)

In young patients with medial knee osteoarthritis (OA), surgical intervention may not be desirable due to preferences to avoid bone cutting procedures, return to high activity levels, and prolong implant survival. The Atlas Knee System was designed to fill the gap between ineffective conservative treatments and invasive surgery. This single-arm study included 26 patients, aged 25 to 65 years, who completed 12 months of follow-up. All dimensions of the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score significantly improved from baseline to 12 months. About 96.2% and 92.3% of patients experienced a ⩾20% improvement in their KOOS pain and WOMAC pain scores, respectively, at 12 months. This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months

H/Q ratio in consecutive stages of rehabilitation.

<p>H/Q ratio in consecutive stages of rehabilitation.</p

Rehabilitation after one-stage anterior cruciate reconstruction and osteochondral grafting

At least 10–20% of all ACL reconstructions require additional cartilage repair. The aim of this study was to compare the activity recovered by patients after one-stage open ACL reconstruction and osteochondral autologous grafting of articular cartilage lesions and after isolated open ACL reconstruction. The study group included 21 patients with chronic ACL deficiency and grade III or IV cartilage lesion according to the ICRS scale who were treated with combined ACL reconstruction and osteochondral grafting in one step. The control group included 32 patients with chronic ACL insufficiency and no chondral deficit higher than grade I on the ICRS scale who underwent isolated reconstruction of the ligament. For the assessment, the Lysholm and Gillquist (L&G) score and the functional Marshall score were used. Both groups displayed a statistically significant improvement in the L&G score and the Marshall score between the preoperative and 12-month assessments. The mean gain in L&G score over this period was 30.66±7.79 in the study group and 31.65±6.96 in the control group. The difference between the control group and the study group was not significant. The difference between 12 months and initial assessment was counted. The mean gain in Marshall score was 9.05±3.81 in the study group and 10.71±3.43 in the control group. The difference between the initial and the 12-month evaluation was statistically significant (p=0.49). Return to normal activity was slower and patient satisfaction was lower during the first year after operation in the study group than in the control group, however the overall advantage of the one-step operation outweighs the slightly inferior functional results at 12 months

Comparison of bioabsorbable interference screws and posts for distal fixation in anterior cruciate ligament reconstruction

Comparison of the results of bioabsorbable interference screws and posts for hamstring graft distal fixation in ACL reconstructions are presented. The results of 20 patients with bioabsorbable screws were compared to 22 patients with posts. The assessement was based on Lysholm-Gillquist and Marshall scores and the KT-1000 device. In the study group the points gained were 38.9 in the Lysholm-Gillquist and 12.89 in the Marshall scale. The average KT-1000 difference was 2.46 mm. In the control group the points gained were 32.93 in the Lysholm-Gillquist and 11.47 in the Marshall scale. The average KT-1000 difference was 2.5 mm. There were 14 patients in the study group with interference screw problems; in 2 the implants were removed. (1) There are no differences in outcome using bioabsorbable interference screws and posts for distal fixation of hamstring ACL grafts. (2) The lack of bioabsorbtion with poly L-lactide interference screws is frequent and causes problems