RESUMO
The authors assessed the effect of proximal tibial osteotomy on the results of a subsequent total knee arthroplasty. A retrospective, clinical and radiographic analysis was carried out between a study group of 39 patients with 42 total knee arthroplasties following osteotomy and a control group of 39 patients with 41 primary arthroplasties. Outcome was assessed using the Hospital for Special Surgery (HSS) knee score, pain, function, range of motion, and radiographic evaluation. The follow-up period averaged 37 months (range, 24-50 months). The study group had 88% good or excellent results using the HSS score, compared to 90% in the control group. Function and pain improved equally in both groups. The control group had, on average, 14 degrees greater range of motion (115 degrees v. 101 degrees) after arthroplasty. The control group had, on average, posterior inclination of the tibial plateau of 7 degrees before operation and 3 degrees after operation; the corresponding values in the study group were 2 degrees and 1 degree. Using the HSS score and pain and function as parameters, previous osteotomy does not seem to affect the outcome of total knee arthroplasty. Conversely, range of motion following arthroplasty appears to be less in those with prior osteotomy. In addition, a high tibial osteotomy may alter the inclination of the tibial plateau.
Assuntos
Articulação do Joelho/cirurgia , Prótese do Joelho , Osteoartrite/cirurgia , Tíbia/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Movimento , Osteotomia , Dor/epidemiologia , Prognóstico , Radiografia , Reoperação , Estudos Retrospectivos , Tíbia/diagnóstico por imagemAssuntos
Acetábulo/lesões , Fraturas do Colo Femoral/complicações , Fraturas Ósseas/complicações , Traumatismo Múltiplo/diagnóstico por imagem , Acetábulo/diagnóstico por imagem , Adulto , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Compartmental pressure measurement through an electromechanical process can be readily, accurately and inexpensively accomplished with standard hospital equipment. Best results will be obtained when personnel familiar with the set up and continued use of pressure monitoring equipment are assigned for the care and recording of data. The most frequently encountered problems associated with this technique are improper settings or inadequate calibration of pressure monitors and stopcocks or thrombosis of the wick catheter itself.
Assuntos
Síndromes Compartimentais/fisiopatologia , Eletrônica Médica/métodos , Cateterismo , Eletrônica Médica/instrumentação , Humanos , Monitorização Fisiológica/métodos , Pressão , TransdutoresRESUMO
A series of 71 patients was identified and studied over a period of 30 months. Twenty-five patients underwent fasciotomy, all but one patient had a compartment pressure finding of more than 30 millimeters of mercury. Sixteen patients underwent fasciotomy on the basis of pressure measurement alone. Patients with a pressure measurement of less than or equal to 30 millimeters of mercury and those with an absence of clinical findings were spared fasciotomy. Continued accumulation of data in various patient groups should yield specific comments and observations using this important adjunctive technique.
