Diagnostic efficacy of standard knee magnetic resonance imaging and radiography in evaluating integrity of anterior cruciate ligament before unicompartmental knee arthroplasty.

OBJECTIVE: The purpose of this study was to investigate the diagnostic efficacy of standard magnetic resonance imaging (MRI) and plain radiographs in determining the status of anterior cruciate ligament (ACL) for surgical decision-making processes in cases of medial unicompartmental knee arthroplasty (UKA). METHODS: A total of 59 knees of 36 consecutive patients who underwent knee replacement surgery were analyzed retrospectively. MRI scans were assessed independently by 3 observers (radiologists), while the plain radiographs were evaluated by an independent radiologist. Results were compared with the intraoperative ACL status. Cross tabulation was used for descriptive statistics to analyze sensitivity, specificity, and accuracy of MRI and plain radiographs. RESULTS: When the same observer assessed and classified the MRI twice, the reproducibility of the classification system varied from moderate to excellent. However, the interobserver concordance was moderate. The sensitivity of MRI was 73% and the specificity was 81%, while the sensitivity and specificity of plain radiographs was 36% and 79%, respectively. The accuracy of MRI was 80%, while that of the radiographs was 71%. CONCLUSION: Detection of intact ACL may be possible on available plain radiographs without necessity for additional means such as MRI, which may cause increase costs and loss of time. In cases where there is uncertainty regarding ACL integrity in degenerative knees, although standard MRI provides additional information on ACL status, it is not of sufficient diagnostic value.

An assessment of sleep quality in patients undergoing total knee arthroplasty before and after surgery.

OBJECTIVE: The aim of this study was to compare the sleep quality of patients who underwent total knee arthroplasty before and after the surgery and analyze the effect of total knee arthroplasty on sleep quality. METHODS: The study included 42 patients (32 females, 10 males) who underwent total knee arthroplasty for primary knee osteoarthritis. For each patient the preoperative 1 day and postoperative 3 months results of Pittsburgh Sleep Quality Index (PSQI) and 100-mm visual analogue scale (VAS) were compared. RESULTS: The preoperative mean PSQI was 9. VAS score decreased in 97.6% of the patients, while sleep quality increased in 78.6%. 85.7% of the patients reported to have less episodes of pain related sleep disturbances. While both the PSQI and VAS improved after the surgery, there was no correlation between the parameters (p>0.05). CONCLUSION: Our results suggested that total knee arthroplasty surgery relieves pain and improves sleep quality. The improvement in sleep quality does not appear to be related to pain relief.