Patient Satisfaction after Arthroplasty is being considered as a priority outcome and an important addition to traditional outcome measures. The reported satisfaction rate in the literature is disappointing (75%–89%). Traditional techniques for TKA have made neutral (0° ±3°) coronal alignment a primary technical goal. We present the results of “Ideal Arthroplasty Kinematics” ie a perfectly balanced knee irrespective of mechanical alignment. The primary technical goal was to achieved tensiometer controlled balance, within 2 degrees, of medial and lateral soft tissues throughout range of motion, and equal gap sizes within 2 mm. 864 (92.9%) of 914 patients, operated by one surgeon, between January 2007 and December 2012 were prospectively followed for an average of 40.4 months. They were asked if they were satisfied, unsatisfied or unsure by an independent research-nursing sister. Unsure patients were categorized as unsatisfied. 817 (94.5%) of this group had satisfactory postoperative long leg x-rays as per Paley's technique. The patient satisfaction was correlated to post-operative mechanical axis (M.A.)Introduction:
Materials and Methods:
Meniscal tears in middle-aged patients are common. There is a lack of consensus regarding the optimum management of these injuries. Although arthroscopic partial meniscectomy (APM) is a frequently performed surgical option, literature has failed to prove its effectiveness over conservative approaches. We retrospectively reviewed 102 middle-aged (age > 40 years) patients who had been treated for meniscal tears between January 2010 and December 2012. We followed these patients up telephonically to assess knee outcome satisfaction rates, any early (6 weeks) improvements in pain and knee function and their pre-morbid and post-treatment activity levels (Tegner Activity Scale).Introduction
Materials and Methods
Valgus knees are generally more difficult to get acceptable alignment and balance than the varus knee. Most of these are due to anatomical variations in both the diaphysis of the femur, with low valgus angles (angle between the anatomic and mechanical axis of the femur) and the tibial diaphysis. In addition there are those with dysplastic lateral distal femoral condyle s and low external femoral angles (below 84 degrees) To assess the clinical results, patient satisfaction and alignment and balance achieved in those with a pre-operative mechanical valgus above 10 degrees.Introduction
Aim
South Africa has a very sports orientated population and a high blunt trauma prevalence. In August 2008, we re-established the soft tissue knee service at our academic hospital. Our clinic is staffed by a sessional Consultant, a Registrar, and is overseen by a senior honorary Consultant. Here we present a review of our first 2 years experience. The clinic operates on a referral basis. All patients have all their clinical and demographic data and referral data entered into a Soft Tissue Database. The Data for 2009 and 2010 data were collated and analysed.Introduction:
Methods:
To assess whether anterior cruciate ligament (ACL) reconstruction performed at an Academic Hospital improves knee function and allows patients to return to their pre-injury level of normal and sporting activity. We included patients with an isolated ACL injury who had an ACL reconstruction performed by the arthroscopy unit at an academic hospital. A single follow-up visit at a minimum of 1 year after surgery was performed, testing the following: Range of movement, test of the stability of the reconstruction using a KT1000 arthrometer, a single hop test and presence of wound infection or sepsis was also noted. An x-ray of the knee was also done to check for complications. A Lysholm knee questionnaire was completed and compared to the pre-operative score. A Tegner Activity Scale to determine pre and post-operative level of normal and sporting activity was also recorded.Purpose
Methods
Recurrent patellar dislocation is a relatively common disorder in young patients. Historically, treatment options have been based on the underlying disorder predisposing the patient to the dislocation. This has resulted in various soft tissue reefing procedures, patella tendon realignment procedures and boney realignment procedures. Further research has shown that the medial patellofemoral ligament (MPFL) is the primary restraint to lateral patella subluxation and dislocation. Many authors have published their successful treatment of recurrent patella dislocation by reconstruction of the medial patellofemoral ligament. The most widely used is autologous semitendinosis tendon grafts, as well as synthetic materials, and MPFL reconstructions may be combined with boney procedures. Varieties of fixation techniques have been described involving both the patella and femoral sides. We present a technique of MPFL reconstruction using the autologous ipsilateral quadriceps tendon. Our technique avoids the morbidity associated with semitendinosis graft harvesting and the drill holes in, and potential resulting fracture of, the patella. The technique is also simple and is associated with decreased procedure costs. We present the technique and a series of 6 patients (7 knees) with follow up ranging from 8 months to 9 years. The average age of patients at the time of surgery 16–28 years (mean = 20years). There have been no redis-locations. The median Kujala patellofemoral knee score at follow up was 97 out of 100 (Range 69–100). The results compare very favourably to published results using other techniques. Our technique of reconstructing the MPFL is reliable, produces good results using an objective knee score, and is cost effective.
