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Bio-Implants Derived from Biocompatible and Biodegradable Biopolymeric Materials
Published in P. Mereena Luke, K. R. Dhanya, Didier Rouxel, Nandakumar Kalarikkal, Sabu Thomas, Advanced Studies in Experimental and Clinical Medicine, 2021
Among the knee replacement procedures, about 90% is the total knee replacement. During TKR procedure, the repair of the knee joint is by covering the thighbone with metal and encasing the shinbone with a plastic frame. The procedure makes replacement of the rough and irregular surface of the worn bone with a smooth surface. The undersurface of the kneecap will be replaced with a plastic surface to decrease the pain and provide a smooth functional joint. The process is to remove some of the parts of bones and cartilage. In case of a partial knee replacement, only the part of the knee that’s damaged or arthritic will be replaced. It requires only smaller operation procedure and involves less bone and blood loss and also produces less pain. These are the advantages to this approach. Partial knee replacement patients will get a faster recovery time compared to TKR procedures. The disadvantage of the process is that there can be arthritis developed which needs another surgery in the parts of the knee that are not replaced [70, 71].
Surgery of the Knee
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Alexander D Liddle, Lee A David, Timothy WR Briggs
The ultimate goals of revision knee replacement are pain relief, functional stability and eradication of infection, if present. In order to achieve these goals, the important factors are preservation of bone stock, reconstruction of defects, adequate fixation of implants, ligamentous balancing and restoration of the joint line.
Answers
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Specific complications of a total knee replacement include: Intraoperative: Tibial fractureImmediate: Vascular injuryEarly: DVT/PE, peroneal nerve palsy, infectionLate: Infection, instability
Postoperative pain: a review of emerging therapeutic options
Published in Expert Review of Neurotherapeutics, 2021
Abhishek K Gupta, Shayla Mena, Zhaosheng Jin, Tong J Gan, Sergio Bergese
In a cross-sectional study conducted by Komann et al, patients who used use non-pharmacologic therapy had significantly better pain relief than patients that did not. The largest benefit was seen in patients after total knee replacement. However, there were no significant differences in analgesic requirement [133]. In gynecologic surgery, six hours of cryotherapy revealed lower visual analog scale scores at 6 and 12 hours post-operatively, but there was no difference in morphine requirements and hospital length of stay [134]. For women undergoing Cesarean section, intraoperative meditation and music therapy led to less postoperative pain, anxiety, while contributing to greater psychological wellbeing [135] and better postoeprative recovery [136]. A systematic review on relaxation therapy (e.g. jaw relaxation, Benson’s relaxation, progressive muscle relaxation, and systematic relaxation) showed that patients undergoing abdominal surgery had greater pain relief compared to controls [137]. The authors cited a lack of quality to the included studies as a limitation and drive for further research.
Hip, knee and revision hip replacement – are they as clinically and cost effective as we think?
Published in Acta Orthopaedica, 2020
This paper is a landmark as it elegantly demonstrates the effectiveness and cost effectiveness of both hip and knee replacements, whilst showing what many surgeons suspected that knee replacement results in slightly lower gains, compared to hip replacements, at higher costs. Probably the most interesting finding is that revision hip replacement results in little or no improvement in overall quality of life despite being very expensive. This finding should cause surgeons to reflect on their practice. Certainly, many revisions are performed to prevent symptoms worsening (such as after fracture or infection) and this analysis compares before and after rather than the sequelae of treatment versus no treatment. However, many revisions, particularly after knee replacement, are performed to treat stable conditions such as persistent pain. Even though the work presented here was published in 2007, we as a community have not yet established the utility, efficacy and wisdom of performing revision arthroplasty for stable conditions affecting pain and function. The findings of Rasanen and colleagues are as pertinent today as they were in 2007.
The effectiveness of a 595 nm pulsed-dye-laser in the treatment of surgical scars following a knee arthroplasty
Published in Journal of Cosmetic and Laser Therapy, 2019
Padcha Pongcharoen, Boonchana Pongcharoen, Wareeporn Disphanurat
A knee replacement is an excellent procedure for the treatment of advanced knee arthritis (1,2). Unfortunately, this surgery produces a long vertical wound that does not follow the skin tension line and can be as long as 8–12 cm over the patellar knee joint line and results in excessive tension from knee joint flexion and extension. As a result of the excessive wound tension, scar tissue is more abundant and has been shown to favor the development of keloid and hypertrophic scars. This is more predominant than is seen in other surgical wounds (3). Moreover, dark-skinned individuals have been found to be more susceptible to keloid formation. Patients who develop keloid and hypertrophic scars after knee replacement may have pain or pruritus with their scars. Excessive scar tissue may result in stiffness of the knee joint and patients may experience an inability to fully straighten the leg, bend the knee backwards, or both.