RESUMO
Total knee arthroplasty is a consistently successful, cost-efficient, and highly effective surgical procedure for treating severe knee osteoarthritis. The success and longevity of total knee arthroplasty depend significantly on the fixation method used to secure the prosthetic components. This comprehensive review examines the primary fixation methods (cemented, cementless, and hybrid fixation), analysing their biomechanics, clinical outcomes, advantages, and disadvantages, focusing on recent advances and trends in total knee arthroplasty fixation.
Assuntos
Artroplastia do Joelho , Humanos , Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia , Prótese do Joelho , Fenômenos BiomecânicosRESUMO
OBJECTIVE: To demonstrate if there is a difference in the time that the surgery is prolonged to implant a knee prosthesis according to the instrumentation system used. MATERIAL AND METHODS: Retrospective analysis of the duration of 243 interventions (skin-to-skin time and ischemia time) performed by the same surgeon. Seventy-two cases operated with conventional instruments (IC), 68 by means of computer assisted surgery (CAS) and 103 with personalized instrumentation system (PSI). RESULTS: IC skin-to-skin time 87,85 min (SD 11,86). IC ischemia time 94,44 min (SD 11,49). Computer assisted surgery skin-to-skin time 123,46 min (SD 11,27). Computer assisted surgery ischemia time 129,63 min (SD 11,37). PSI skin-to-skin time 78,69 min (SD 13,06). PSI ischemia time 84,63 min (SD 12,06). There is a significant difference between PSI and the other instrumentation systems (p 0,000). CONCLUSIONS: In our study, the time consumption for the implantation of a knee prosthesis has been significantly lower when cutting blocks have been used, than when we have used other systems.
Assuntos
Artroplastia do Joelho/instrumentação , Prótese do Joelho , Duração da Cirurgia , Osteoartrite do Joelho/cirurgia , Cirurgia Assistida por Computador/instrumentação , Idoso , Artroplastia do Joelho/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Cirurgia Assistida por Computador/métodos , Resultado do TratamentoRESUMO
OBJECTIVES: To non-invasively assess tissue lesion secondary to ischaemia applied during knee replacement surgery. Secondary objectives: to assess whether this lesion correlates with the duration of ischaemia and whether instrumental and gender variables influence it. MATERIAL AND METHODS: Prospective cohort study. Pre and postoperative serum lactate levels have been determined as an indicator of glycolytic activity secondary to ischaemia in 88 patients. Serum lactate determination was performed by reactive strips of enzymatic-amperometric detection on capillary blood. RESULTS: Preoperative serum lactate levels (mean and SD): 2.467±1.036 mmol/L. Postoperative serum lactate levels: 3.938±2.018 mmol/L. Ischaemia time 102.98±18.25minutes. Postoperative serum lactate levels were significantly higher than preoperative lactate levels. There are no statistical differences according to the time that the ischaemia was prolonged, gender or type of instrumentation used. CONCLUSIONS: In our study, postoperative serum lactate values were significantly higher than preoperative lactate values, with no correlation to the duration of ischaemia during knee replacement surgery.