Lateral meniscal injury after a successful medial unicompartmental knee arthroplasty.

A case of an active 52-year-old woman who, after a medial unicompartmental knee arthroplasty, began complaining of lateral joint line pain and a persistent knee effusion. A lateral meniscal tear was diagnosed clinically, and she underwent an arthroscopic partial meniscectomy that resolved her problems. This case demonstrates the importance of considering a meniscal problem as the cause of any unexplained joint line pain in the unoperated compartment after a successful unicompartmental knee arthroplasty and not simply attributing it to progression of degenerative change within the lateral compartment.

Effect of total knee arthroplasty on recreational and sporting activity.

BACKGROUND: Common concerns of patients undergoing total knee arthroplasty (TKA) are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present study was designed to determine preoperative and postoperative activities, the numbers participating and the time to resume these activities. METHODS: Between 1 and 2 years after TKA, patients who had undergone 144 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. The Oxford knee score and estimate of physical activity was also collected. RESULTS: Out of the 144 TKA performed, 122 participated in sport and recreational activity preoperatively and 108 participated postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting and recreational activities although the number of sporting events decreased. By multiplying individuals by the number of activities they participated in, there were 254 occurrences of sport and recreational activities preoperatively giving a mean for the group of 1.76 sports/patient. Postoperatively this had reduced to 204, giving a mean of 1.41. Three activities showed a significant change for individual patients from pre- to postoperation. Those which showed an increase were exercise walking, where 19 patients (13.2%) who did not walk before surgery took up walking afterwards (P < 0.006) and aqua aerobics, where five took up aqua aerobics postoperatively for the first time (P < 0.025). Golf was the only sport which had a significant fall in participation from pre- to postoperation, with 10 out of 19 golfers giving up (P < 0.025). CONCLUSION: The present study has shown that patients are adopting lower impact activities to participate in after TKA. The total number of patients performing a sport decreases postoperatively and the total amount of sport played decreases. These data will help to counsel patients.

Effect of total hip arthroplasty on recreational and sporting activity.

BACKGROUND: Common concerns of patients undergoing total hip arthroplasty are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present paper describes preoperative and postoperative activities, the numbers participating and the time to resume these activities. METHODS: Between 1 and 2 years after total hip arthroplasty, 216 patients, who had undergone a total of 235 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. A general hip score and estimate of physical activity was also collected. RESULTS: The number of patients participating in sport increased from 188 preoperatively to 196 postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting activities although the number of sporting events decreased. By multiplying individuals by the number of sports they participated in, there were 434 occurrences of sport preoperatively giving a mean for the group of 1.9 sports per patient. Postoperatively this had reduced to 382, giving a mean of 1.7. Five sports showed a significant change for individual patients from pre to postoperation. Those which showed an increase were exercise walking, where 38 patients (16.8%) who did not walk before surgery took up walking afterwards (P < 0.0001) and aqua aerobics, where 15 took up this activity postoperatively for the first time (P = 0.002). There were three sports which decreased significantly from pre to postoperation. They were, golf where 13 out of 39 (P = 0.005), tennis 13 out of 14 (P = 0.01) and jogging where six out of seven (P = 0.01) patients stopped participating. CONCLUSION: This study has shown that patients are adopting lower impact activities to participate in after total hip arthroplasty. The total number of patients performing a sport increases postoperatively but the total amount of sport played decreases. These data will help to counsel patients.

Retrieval study of tibial baseplate fracture after total knee arthroplasty.

Twenty-five cases of fractured metal tibial baseplates were reviewed from retrieved knee arthroplasty. A total of 74 cases have been reported, including the 25 in this series. Baseplate fracture is an avoidable problem with careful choice of prosthesis, attention to surgical detail, and satisfactory postoperative follow-up. There is a relatively short duration of symptoms before fracture, (mean, 10.8 months; range, 1-36 months). Patients should also be advised to self-report if there is sudden onset of pain or any symptoms of instability or mechanical failure, such as squeaks, clicks, or swelling. Early revision should be considered if there is concern about potential baseplate fracture as delay may compromise the ultimate result. A classification for these baseplate fractures is proposed, and the multifactorial etiology is discussed.