Thermal damage done to bone by burring and sawing with and without irrigation in knee arthroplasty

Heat from bone resecting tools used in knee surgery can induce thermal osteonecrosis, potentially causing aseptic implant loosening. This study compared oscillating saws to burrs in terms of temperature generation and histologic damage. Use of irrigation to reduce bone temperature was also investigated. Temperatures were recorded during sawing and burring with or without irrigation (uncooled or cooled). Histologic analyses were then carried out. Differences between groups were tested statistically (α = 0.05). On average, burring produced higher temperatures than sawing (P < .001). When uncooled irrigation was used, bone temperatures were significantly lower in sawed bone than in burred bone (P < .001). Irrigation lowered temperatures and thermal damage depths and increased osteocyte viability (P < .001). These results suggest that irrigating bone during resection could prevent osteonecrosis onset

Body Mass Index and Sex and Their Effect on Patient-Reported Outcomes Following Cartilage Repair: An Insight from the ICRS Patient Registry

BackgroundChondral injuries in the knee, whether isolated or accompanying other injuries are found in as many as 60% of arthroscopic examinations. Although current research has identified negative outcomes for patients with a BMI &gt;30kg/m2 undergoing chondral repair, our understanding of the relationship between pre-surgery BMI and post-operative patient reported outcomes across all BMI categories remains lacking. Through the International Cartilage Regeneration and Joint Preservation Society (ICRS) Patient Registry, this study aimed to explore this relationship, taking into account sex variations.MethodsThe ICRS Patient Registry was used to extract the data for this study. The outcomes in focus were the Knee Osteoarthritis Outcome Score (KOOS) and EQ-5D scores. Pearson and Spearman correlation methods were applied and the level of significance was set as = 0.05.ResultsOf 3,194 Registry patients at the time of data extraction, 1,757 had undergone a surgical procedure, and 336 of these had complete KOOS or EQ-5D scores available for 6-weeks, 6-months, and 1-year post-operation. Analyses revealed that neither male (average BMI – 28.2kg/m2) nor female (average BMI – 25.3 kg/m2) datasets indicated a correlation between BMI and the patient-reported outcomes.ConclusionBMI, irrespective of sex, is not correlated with patient-reported outcomes in patients enrolled in the ICRS Registry with a BMI &lt;30kg/m2. Although BMIs in the overweight classification were not associated with poorer outcomes than BMIs in the normal classification, the current literature continues to support the notion that a BMI &gt;30kg/m2 is linked to poor cartilage repair and failure.<br/

Gait Characteristics of Patients with Symptomatic Cartilage Lesions of the Knee

Introduction: Little is known about the impact of articular cartilage lesions on knee joint biomechanics. Objectives: This investigation aimed to determine the gait characteristics of patients with symptomatic articular cartilage defects of the knee. Methods: Gait analyses were performed at a regional joint preservation centre. Assessments were completed on a treadmill with a 15-camera 3D motion-capture system. Participants walked for two minutes at a self-selected speed at 0° inclination. The resulting kinematic and spatiotemporal parameters were averaged across 20 consecutive gait cycles. Paired t-tests or Wilcoxon ranked tests were performed on the data to compare biomechanical parameters between knees (α=0.05). Results: Patients (n=30) walked at an average speed of 3.0±0.7km/h with a cadence of 60.4±16.2 steps/minute. Step lengths were comparable between limbs (p=0.595). Maximum flexion during swing did not differ between knees (p=0.507), but were lower than previously reported healthy adults. In the frontal plane, both knees remained in adduction throughout the gait cycle (p=0.385). The maximal adduction reported in both knees were greater than previously reported for healthy adults. Maximal internal-external rotation patterns were comparable in stance (p=0.475) and swing (p=0.762) and to previous literature. Conclusion: Gait characteristics were generally comparable between injured and contralateral knees of patients with symptomatic cartilage lesions of the knee. However, some parameters of gait in the sagittal and frontal plane were pathological when compared to previously published data from healthy adults.<br/