Abstract：
BACKGROUND:Although some clinical reports suggest patient-specific instrumentation in TKA may improve alignment, reduce surgical time, and lower hospital costs, it is unknown whether it improves pain- and function-related outcomes and gait. QUESTIONS/PURPOSES:We hypothesized that TKA performed with patient-specific instrumentation would improve patient-reported outcomes measured by validated scoring tools and level gait as ascertained with three-dimensional (3-D) analysis compared with conventional instrumentation 3 months after surgery. METHODS:We randomized 40 patients into two groups using either patient-specific instrumentation or conventional instrumentation. Patients were evaluated preoperatively and 3 months after surgery. Assessment tools included subjective functional outcome and quality-of-life (QOL) scores using validated questionnaires (New Knee Society Score(©) [KSS], Knee Injury and Osteoarthritis Outcome Score [KOOS], and SF-12). In addition, gait analysis was evaluated with a 3-D system during level walking. The study was powered a priori at 90% to detect a difference in walking speed of 0.1 m/second, which was considered a clinically important difference, and in a post hoc analysis at 80% to detect a difference of 10 points in KSS. RESULTS:There were improvements from preoperatively to 3 months postoperatively in functional scores, QOL, and knee kinematic and kinetic gait parameters during level walking. However, there was no difference between the patient-specific instrumentation and conventional instrumentation groups in KSS, KOOS, SF-12, or 3-D gait parameters. CONCLUSIONS:Our observations suggest that patient-specific instrumentation does not confer a substantial advantage in early functional or gait outcomes after TKA. It is possible that differences may emerge, and this study does not allow one to predict any additional variances in the intermediate followup period from 6 months to 1 year postoperatively. However, the goals of the study were to investigate the recovery period as early pain and functional outcomes are becoming increasingly important to patients and surgeons. LEVEL OF EVIDENCE:Level I, therapeutic study. See the Instructions to Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Abdel MP,Parratte S,Blanc G,Ollivier M,Pomero V,Viehweger E,Argenson JNdoi
10.1007/s11999-014-3544-7subject
Has Abstractpub_date
2014-08-01 00:00:00pages
2468-76issue
8eissn
0009-921Xissn
1528-1132journal_volume
472pub_type
杂志文章,随机对照试验abstract：:The results of 65 consecutive revision total knee arthroplasties performed for mechanical failure were reviewed. Fifty-nine of the knees were followed for an average of five years (range, 2-10 years). The types of implants used included: total condylar, posterior stabilized, total condylar III, and the kinematic rotat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：:Fourteen knees were studied by a method called spatial location, to determine the contact and load-bearing areas between the femur and the upper tibia in non-loaded and loaded conditions, at various angles of flexion. Under no load, contact occurred primarily on the menisci; the lateral aspects contacted at 0 degrees...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197506000-00027
更新日期：1975-01-01 00:00:00
abstract：BACKGROUND:Improved patient care is related to validated outcome measures requiring the collection of three distinct data types: (1) demographics; (2) patient outcome measures; and (3) physician treatment. Previous impediments to widespread data collection have been: cost, office disruption, personnel requirements, phy...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1397-2
更新日期：2010-10-01 00:00:00
abstract：:The benefit of reduced polyethylene wear with ceramic in hip replacements does not seem to have been universally appreciated. In this current study, wear predictions from laboratory and clinical studies were compared for ceramic-on-polyethylene and cobalt chrome-on-polyethylene combinations. Many laboratory studies in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200010000-00006
更新日期：2000-10-01 00:00:00
abstract：BACKGROUND:Strict criteria have been used before removing cervical collars in patients with injuries who have midline pain or are unable to be reliably examined. This sometimes leads to prolonged immobilization in cervical collars or use of MRI to rule out injury. Several studies suggest a collar may be removed in the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2286-7
更新日期：2012-06-01 00:00:00
abstract：:Osteoblastic and chondroblastic (i.e., osteogenic) cells belong to the stromal cell system, which is associated with bone marrow, and bone and is separate from the hematopoietic stem-cell system. Stromal stem cells are capable of producing reticular, fibroblastic, osteogenic, and adipose stromal lines. Marrow-derived ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-03-01 00:00:00
abstract：BACKGROUND:Several recently published population-based studies have highlighted the association between insurance status and survival in patients with various cancers such as breast, head and neck, testicular, and lymphoma [22, 24, 38, 41]. Generally, these studies demonstrate that uninsured patients or those with Medi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000000889
更新日期：2020-03-01 00:00:00
abstract：:A technique of computed tomography with intravenous contrast has proven useful in the differentiation between osteoid osteoma and other similar appearing lucent lesions of bone in 6 cases. The clinical evaluation of benign appearing radiolucent lesions of long bones has been greatly improved by the use of modern imagi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199606000-00030
更新日期：1996-06-01 00:00:00
abstract：:Aneurysmal bone cysts are benign primary or secondary lesions that commonly arise in long bones and often before skeletal maturity. Little has been written about aneurysmal bone cysts that abut the physeal plate. The records of 15 patients with juxtaphyseal aneurysmal bone cysts were reviewed. Fourteen of the patients...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199907000-00026
更新日期：1999-07-01 00:00:00
abstract：UNLABELLED:The outcome of isolated patellar component revisions after metal-backed patellar failure is variable with satisfactory results reported from 78% to 100%. To supplement information in the literature we determined the failure rate and the functional outcome based on the Knee Society clinical and roentgenograph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0414-1
更新日期：2008-11-01 00:00:00
abstract：BACKGROUND:Acetabular cartilage damage has been described in patients with femoroacetabular impingement (FAI). However, most reports of articular cartilage damage in hip FAI have been focused on the acetabular cartilage and derived from single-center, retrospective studies of relatively small patient cohorts. Identifyi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1097/CORR.0000000000000649
更新日期：2019-05-01 00:00:00
abstract：:Our research group developed an implant retrieval program to study in vivo degradation of polyethylene. We now have evidence to support our hypothesis that degradation of radiation-sterilized polyethylene occurs in the body for not only historical gamma air sterilized liners, but also for conventional gamma inert ster...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000246547.18187.0b
更新日期：2006-12-01 00:00:00
abstract：:A human osteosarcoma cell line, HuO9, was established from a tumor that was heterotransplanted into athymic nude mice. Antiserum against nude mouse spleen cells was added to the early passage cultures to eliminate the host fibroblastic cells. The cell line retained a high activity of liver/bone/kidney-type alkaline ph...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:The ideal local antibiotic delivery system has not been created. Antibiotic-laden bone cement has become the gold standard in the treatment of infected orthopaedic implants and there are confirmatory laboratory and clinical data that support the use of these materials. Heat-stable antibiotics elute from antibiotic-lad...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000143741.92384.18
更新日期：2004-10-01 00:00:00
abstract：:Mature female rhesus monkeys were used to evaluate the effects of a one-year course of tetracycline (50 mg/kg/day, intramuscularly) on the formation, maturation, and mineralization of mandibular bone. The bones from the treated group contained normal concentrations of calcium (Ca), inorganic phosphorus (Pi), and hydro...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-11-01 00:00:00
abstract：:External malrotation is a frequent complication following Ender nailing. Biomechanical studies demonstrate that the standard Ender nail tends to produce external malrotation when the fracture is unstable. This type of malrotation does not develop to the same degree if the nails are bent into a 25 degree angle of antev...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：:The first 100 cases of the 135 THARIES surface replacement procedures with 4--32 months follow-up, are evaluated in terms of clinical results, radiographic information and complications. The short but detailed follow-up suggests that this procedure was an excellent alternative for the younger and more active populatio...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：UNLABELLED:As the number of unicompartmental knee arthroplasties performed continues to rise, so too will the number of failures. In order to justify its continued use, conversion to total knee arthroplasty must be evaluated. From 1993-2004, 22 consecutive knees from 18 patients with a failed unicondylar knee arthropla...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000214431.19033.fa
更新日期：2006-05-01 00:00:00
abstract：:Bipartite patellae, though not unusual as an incidental roentgenographic finding, are rarely painful. This is a report of bilateral medial bipartite patella in a 20-year-old woman, which seems not to have been previously described in the literature. The symptoms were significantly relieved by an excision of the access...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-07-01 00:00:00
abstract：BACKGROUND:Although postoperative spinal epidural hematoma (SEH) is not uncommon, hematomas that require surgery are rare. Cauda equina syndrome (CES) may be associated with postoperative SEH. In these cases, early recognition and emergency decompression can prevent further damage and better neurologic recovery. CASE ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-2031-7
更新日期：2012-06-01 00:00:00
abstract：:The acute flare of joint inflammation in the child with known juvenile rheumatoid arthritis causes concern primarily regarding the need for additional or modified medical treatment. Acute joint inflammation in an otherwise healthy child creates concern regarding the existence of joint infection. In the early phase of ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200401000-00037
更新日期：2004-01-01 00:00:00
abstract：:Twenty-nine patients with tibial non-union or delayed union were treated by onlay grafting, using long struts from the ipsilateral fibula and without disturbing the non-union site. Internal fixation and excessive dissection can be avoided. Follow-up in 28 patients showed solid healing in all; 20/28 patients united the...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：BACKGROUND:Vitamin D plays an essential role in bone health and muscle function. Some studies have shown a widespread rate of vitamin D deficiency in the general population, but few have reported on the vitamin D status of orthopaedic patients. QUESTIONS/PURPOSES:We investigated (1) the extent of hypovitaminosis D in ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2996-5
更新日期：2013-09-01 00:00:00
abstract：:The treatment of hip disorders in adolescents and young adults has evolved rapidly during the past decade because of enhanced understanding of prearthritic and early arthritic hip disease combined with improved diagnostic skills, better patient selection criteria, and refinements in alternative surgical procedures. De...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/01.blo.0000193511.91643.2a
更新日期：2005-12-01 00:00:00
abstract：BACKGROUND:Large-head metal-on-metal (MoM) hip arthroplasties have demonstrated poor survival. Damage at the taper-trunnion junction is a contributing factor; however, the influence of junction design is not well understood. QUESTIONS/PURPOSES:(1) Does taper type affect fretting, corrosion, and volumetric wear at the ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-3115-3
更新日期：2014-02-01 00:00:00
abstract：:The commonly used classification systems of hip dislocation are based on the direction of the dislocation and the presence of associated lesions. However, no rating system can reliably predict the patient's outcome and prognosis based on the initial presentation and classification. In general, patients with anterior d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200008000-00004
更新日期：2000-08-01 00:00:00
abstract：:Femoral head vitality was evaluated by tetracycline labeling and 99mTc-MDP scintimetry in 317 femoral neck fractures before and after internal fixation with two hook-pins. The preoperative vitality was about the same as that observed by others using comparable methods. The postoperative vitality was reduced in five of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
abstract：:The collagens are products of a superfamily of closely related genes. Currently, there are 13 described collagens encompassing at least 25 separate genes. The collagen molecules can be categorized into four classes. Class I consists of molecules that form the banded collagen fibers that are readily seen by routine ele...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1992-09-01 00:00:00
abstract：:The practice of medicine in rural Arizona has changed remarkably in 25 years. Although the delivery of care to the people of the San Carlos Apache Tribe has many challenges including geographic isolation and cultural differences, there are many rewards, such as knowing that some people would not receive care if the or...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200203000-00016
更新日期：2002-03-01 00:00:00
abstract：:The aseptically loosened prosthesis provided a means for investigating the in vivo and in vitro activity of the cells associated with the loosening process in seven dogs. The cells were isolated and maintained in culture for sufficient periods of time so that their biologic activity could be studied as well as the eff...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-12-01 00:00:00
