The mobile bearing Oxford unicompartmental knee arthroplasty (OUKA) is recommended to be performed with the leg in the hanging leg (HL) position, and the thigh placed in a stirrup. This comparative cadaveric study assesses implant positioning and intraoperative kinematics of OUKA implanted either in the HL position or in the supine leg (SL) position. A total of 16 fresh-frozen knees in eight human cadavers, without macroscopic anatomical defects, were selected. The knees from each cadaver were randomized to have the OUKA implanted in the HL or SL position.Aims
Methods
Injuries of the both menisci and complete ACL tear is quite common. In the literature, functional outcome in these patients is often variable and less than satisfactory. We studied the functional outcome of this group of patients (retrospective study of prospectively followed case series). All patients who were diagnosed with ACL injury by arthroscopy at an tertiary hospital in southern India between January2013 and june2017 were enrolled in the study. From the total of 189 consecutive patients who had ACL tears with either one meniscus or both meniscus tear, 41 patients had injuries of both menisci of the same knee with ACL tear. 6 patients were lost to follow up. All patients underwent repair/balancing of one/both meniscus and reconstruction of ACL. There were 29 males and 6 females with age ranging from 18 – 60yrs (mean 25.2) years available for final analysis.BACKGROUND
MATERIAL AND METHODS
The subvastus approach to the knee has been described as early as 1929. This approach for primary total knee arthroplasty (TKA) maintains the integrity of the quadriceps mechanism and maintains the vascularity of the patella. We have conducted a prospective, double blind, randomised trial to evaluate the quadriceps function in TKA after the paramedian and the subvatus approaches in 40 patients with osteoarthitis. Patients were randomised to the two groups and were evaluated by an independent observer blinded to the approach used. The two groups were compared as regards function (range of motion, quadriceps lag, quadriceps power); functional outcomes (Hospital for Special Surgery scores); patellofemoral alignment (Patellar tilt); and operative time, blood loss and hospital stay. There was a statistically significance difference between the two groups as regards quadriceps power and lag in the first post-operative week. The subvastus group performed better than the paramedian group. The range of motion was also better in the subvastus group, though this difference was not statistically significant. The subvastus approach avoids the painful inhibitory arc of the quadriceps and allows for better and rapid rehabilitation in the early post-opertaive phase. There were fewer lateral retinacular releases in the subvastus group. The presence of an intact extensor mechanism allows for more accurate assesment of the patellofemoral alignment intraoperatively. The patello-femoral alignment readings were better in the subvastus group. The subvastus approach does not interfere with the vascular supply of the patella. The patients operated by the subvatus group were discarged from hospitals early.
