Arteriovenous fistula of the lateral superior and inferior geniculate arteries. A unique cause of a "recurrent prepatellar bursa.

We report a previously undocumented case of an arteriovenous fistula of the superior and inferior lateral geniculate arteries presenting with what was thought to be a recurrent prepatellar bursa requiring repeated drainage and excision. The diagnosis was made by arteriography. Surgical exploration and ligation of the feeding and draining vessels, via a posterior approach, alleviated the symptoms. Vascular injury should be suspected in patients presenting with recurrent postoperative hematomas or hemarthroses following surgery on the knee.

Pre-operative health screening for total knee replacement.

One hundred patients on the waiting list for total knee replacement at the Wirral Hospitals underwent a domiciliary pre-operative assessment with the rheumatology clinical nurse specialist. As a result of this assessment the operations of 31 of the 100 patients were postponed and seven were cancelled because of a variety of medical and surgical problems. All patients, when eventually admitted, underwent their surgery on the appointed date with no further postponements.

Alignment of total knee arthroplasty: the relationship to radiolucency around the tibial component.

Between January 1982 and July 1985, 122 cemented 'Accord' total knee replacements were performed. Out of this number, 21 were lost to follow-up because of death (in 16), revision (2) due to infection, and failure to attend (3). The post-operative alignment of 101 prostheses were compared to the incidence of radiolucencies around the tibial component at 5 years follow-up. The mechanical axis was used as a reference. The mean alignment was 0.99 degrees valgus with a standard deviation of 2.48 degrees. Some 72% of knees were within 3 degrees and 94% within 5 degrees of true alignment. Using two methods of assessing radiolucencies there was a non-significant relationship between the alignment and radiolucencies. The alignment tolerance with this prosthesis is, therefore, at least 5 degrees.

A technique for cementing of the patellar component in total knee arthroplasty.

A technique is described for cementing of the patellar component in total knee arthroplasty that involves pressurization of cement into the patellar-component lug holes, which are drilled in the bone prior to cementing the component. A radiographic comparison of cement penetration with this method versus that obtained by using conventional techniques is illustrated.

A tribological study of a series of retrieved accord knee explants.

A tribological study of a series of 27 retrieved Accord meniscal bearing knee joints has been carried out. The roughness of the articulating surfaces of the meniscal and the femoral components was investigated, and the penetration into the polyethylene meniscal component was determined. There was generally little damage to the highly polished metallic femoral components. A general polishing and smoothing of the ultra high molecular weight polyethylene meniscal components was observed, although there was some subsequent deterioration of the polyethylene surfaces in certain cases. The penetration rate of the femoral components into the menisci was low, and was found to be similar to that reported for other meniscal knee joints.