Knee replacements

 
Most knee replacements are considered successful, but some doctors think the procedure is overused and its benefits oversold.  Published in nbcnews.
 
 
The knee is the biggest joint in your body -- and it helps you do a lot. How your knees work
 
 
Article published in the Journal of Biomechanics
 
 
Sector to grow 3.7 percent during the forecast period, according to new report.  Article published in Orthopedics Design and Technology.
 
 
Manufactured by Smith & Nephew – The device has a higher than expected risk of revision due to early component loosening.
 
 
Nylon sutures and skin staples are used commonly in total knee arthroplasty surgical wound closure; study suggests the benefit of skin staples over nylon stitches was a decrease in operative time, but they were more painful upon removal.  Published in Bone and Joint Research.
 
 
Review Summary from Health News Review.
 
 
Paper published in The Bone and Joint Journal.  Total knee arthroplasty is now a more common procedure than total hip arthroplasty but satisfaction following the surgery remains inferior; study finds that there is no difference between kinematically and mechanically aligned knee arthroplasties
 
Outpatient Total Knee Arthroplasty (TKA)

A Clinical Summary in JBJS details that more than 700,000 total knee arthroplasties (TKAs) are performed in the US annually, and the rate is increasing.

 
A paper published in Clinical Orthopaedics and Related Research.
 
 
Paper published in The Knee.
 
 
Total knee arthroplasty is a cost effective and extremely successful operation but the 10-year failure rate stands at around 5%; BJJ present a current concepts review on the epidemiology of failure using data from worldwide registries.
 
 
Up to 50,000 patients undergoing full knee replacements each year could benefit more from simpler surgery, according to a new study.  Article pulished in The Telegraph.
 
 
Many more people facing surgery for knee problems would be better off with a partial rather than total knee replacement, which should allow them to recover faster, say experts.
 
 
Between 6% and 12% of total knee arthroplasties fail as a result of malposition and malalignment of the components; do patient-specific instrument guides help?  Published in the Bone and Joint Journal.
 
 
This is a Systemic Review paper published in the Brazilian Journal of Phusical Therapy.
 
 
Paper published in JBJS.
 
 
More than 700,000 total knee arthroplasties (TKAs) are performed in the US annually, and the rate is increasing.  Published in JBJS.
 
 
BMJ Open article.  Length of stay for joint replacement fell substantially from 1997 to 2014. 
 
 
Avoiding your next revision.  Article published in the Bone and Joint Journal.
 
 
Even after using a conservative projection approach, the number of TKAs in the US, which already has the highest IR of knee arthroplasty in the world, is expected to increase 143% by 2050.
 
 
This research does not support the routine use of patient-specific instrumentation when undertaking total knee arthroplasty.  Publiched in the Bone and Joint Journal.
 
 
Article published in Clincal Orthopaedics and Related Research on spindle failures.
 
 
Paper published in Clinical Orthopaedics and Related Research.  The results suggest that after a mean time in vivo of 18 months the crosslink density decreases.
 
 
Article published in Acta Orthopaedica about uni-compartmental knees.
 
 
In this study a unique collection of autopsy-retrieved TKR and THR components that were well-functioning at the time of retrieval was used to compare volumetric wear differences between hip and knee polyethylene components made from identical material.  Article published in CORR.
 
 
Article published in Journal of Clinical Nursing on both hips and knees. 

Allergy in total knee arthroplasty - a review of the facts

Paper punlished in The Bone and Joint Journal (BJJ) investigating whether allergy and hypersensitivity  have a clinical basis for implant selection in total knee arthroplasty.

Unusually High Rate of Early Failure of Tibial Component in ATTUNE Total Knee Arthroplasty System at Implant–Cement Interface

Paper publiched in J. Knee Surg.

How is revision surgery different from knee replacement?

Read more about the procedure in this BoneSmart article.

Knee osteoarthritis has doubled in prevalence since the mid-20th century

The results from this study published in the Proceedings of the National Academy of Sciences of the United States of America contradict the view that the recent surge in knee osteoarthritis occurred simply because people live longer and are more commonly obese. Instead, this results highlight the need to study additional, likely preventable risk factors that have become ubiquitous within the last half-century

Improvements in physical function and pain sustained for up to 10 years after knee or hip arthroplasty irrespective of mental health status before surgery

Acta Orthopaedica article on 9,737 middle-aged and 9,292 older women from the Australian Longitudinal Study on Women’s Health and National Joint Replacement Registry

Activity levels and return to work following total knee arthroplasty in patients under 65 years of age

This study aims to identify factors which predict return to work following TKA in patients of working age in the United Kingdom.  BJJ article.

Financial analysis of revision knee surgery based on NHS tariffs and hospital costs - does it pay to provide a revision service?

Revision total knee arthroplasty (TKA) is a complex procedure which carries both a greater risk for patients and greater cost for the treating hospital than does a primary TKA. As well as the increased cost of peri-operative investigations, blood transfusions, surgical instrumentation, implants and operating time, there is a well-documented increased length of stay which accounts for most of the actual costs associated with surgery.

Novel Methods for Sensing Acoustical Emissions from the Knee for Wearable Joint Health Assessment

These proposed methods have the potential for enabling knee joint acoustics measurement outside the clinic/lab and permitting long-term monitoring of knee health for patients rehabilitating an acute knee joint injury.

Navigation and Robotics in Knee Arthroplasty

JBJS Reviews article.

Financial analysis of revision knee surgery based on NHS tariffs and hospital costs

An article published in The Bone and Joint Journal discusses whether it pays to provide a revision service.

Meta-Review of the Quantity and Quality of Evidence for Knee Arthroplasty Devices

Research article published in PLOS ONE.

Zimmer Biomet Launches Vanguard Individualized Design Knee Replacement

Orthopedic Design and Technology report on a unique design that individually treats the compartments of the knee, enabling a personalized implant. 

Exercise therapy versus arthroscopic partial meniscectomy for degenerative meniscal tear in middle aged patients: randomised controlled trial with two year follow-up

Research article in the BMJ.

Zimmer Biomet Celebrates 40th Anniversary of the Oxford Partial Knee System

Since its launch in 1976, the Oxford Partial Knee System has been used in more than 600,000 surgeries across 50 countries.  This article was published in Orthopedic Design and Technology.

Disparities in TKA Outcomes: Census Tract Data Show Interactions Between Race and Poverty

A paper discussing the the racial disparities in TKA outcomes published in Clinical Orthopaedics and Related Research.

Do Stemmed Tibial Components in Total Knee Arthroplasty Improve Outcomes in Patients With Obesity?

Article published in Clinical Orthopaedics and Related Research.

What Can Be Learned From Minimum 20-year Followup Studies of Knee Arthroplasty?

Article published in Clinical Orthopaedics and Related Research.

A Randomized, Controlled Trial of Total Knee Replacement

New England Journal of Medicine article.

Stryker prepares for launch of total knee replacements on its Mako robot

FierceMedicalDevices: Stryker detailed its robotic surgery plans during its Q3 earnings calls as it prepares for the commencement of total knee replacements on the Mako robot. The launch of the new Mako application will commence later this year, ramping up slowly and reaching full speed toward the end of 2016.

On a recall, 3-D printed knee implant maker ConforMIS falls 25% to IPO price

ConforMIS had one of the most staggeringly successful med tech IPOs this summer. The custom 3-D printed orthopedic implant company saw its share price climb as high as almost $27--but all that ground has been lost on this week's news of a voluntary recall by the company

Meniscal Transplantation in Symptomatic Patients Under Fifty Years of Age

New JBJS study: Medium- and long-term survival of meniscal transplants in the knees of young patients.

Former OtisMed CEO sentenced to two years in prison for shipping device after FDA rejected it

The former CEO of orthopedics company OtisMed, Charlie Chi, was sentenced to two years in prison. He will also face a year of supervised release and a $75,000 fine, all for distributing the OtisKnee cutting guide after the FDA denied its 510(k) application.

Daily walking 'does not have a negative impact on knee osteoarthritis'

New study discussed by Arthritis Research UK.

Survival rates and causes of revision in cemented primary total knee replacement

A report from the Norwegian Arthroplasty Register 1994 - 2009.  Published in the Bone and Joint Journal.

Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms

Article published in the BMJ discussing the benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease.

Scientists harness new technology for artificial knee implants

FierceMedicalDevices: As the med tech industry targets innovative technologies to treat orthopedic injuries, scientists are developing artificial knee implants that could help ward off arthritis and surgery further down the road.

From TGA Australia "LCS Complete RPS Knee System (used in knee replacements)" hazard alert

Hazard alert - higher than expected revision rate when used without patella resurfacing. Consumers and health professionals are advised that Johnson & Johnson Medical, in consultation with the TGA, has issued a hazard alert regarding its LCS Complete RPS Knee System due to a higher than expected revision rate when the patella is not resurfaced.  Knee implants can be used in a variety of configurations. One option is to use a 'button' to 'resurface' the back of the patient's patella and keep it from potentially rubbing against the implant as the knee bends.  An additional analysis of data derived from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2014 Report shows that the revision rate for the LCS Complete RPS Knee System when used without a patella button is higher than the revision rate of other unresurfaced posterior-stabilised (PS) knee implants being used in Australia.

Zimmer recalls part of Persona--a total knee replacement that helped drive 2014 growth

Zimmer is in the midst of a recall of a component of its latest total knee replacement system, Persona. The orthopedic company notified customers in mid-February and the FDA has now classified the action as a Class 2 recall.

OrthoSensor raises $17M for electronic implant that assists in knee replacement surgery

Florida's OrthoSensor, the maker of an electronic implant to assist orthopedic surgeons during knee replacement surgery, disclosed that it has raised nearly $17 million in funding, bringing its total haul to almost $70 million of equity since 2010.  The insert contains sensors to help orthopedic surgeons optimize the artificial knee's placement and make other clinical decisions during surgery. The information is displayed on a computer monitor.

Open access article just published: "The Swedish Knee Arthroplasty Register: a review"

This review is written by physicians and scientists who have worked with the Swedish Knee Arthroplasty Register (SKAR) periodically since it began. It reviews the history of the register and describes the methods used and lessons learned.

Open access article: "Higher revision risk for unicompartmental knee arthroplasty in low-volume hospitals"

Data from 5,791 cases in the Norwegian Arthroplasty Register (published in Acta Orthopaedica).

Approximately a third of TKA surgeries were judged to be inappropriate

Article in Arthritis & Rheumatology journal: Using a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: A multi-center longitudinal cohort study.

Decline in mortality rates associated with knee replacements between 2003 and 2011

Lancet article assesing trends in death within 45 days of knee replacement for osteoarthritis in England and Wales.

From TGA Australia: "Journey Bi-Cruciate Stabilised (BCS) knee replacement system - femoral implant" hazard alert

Consumers and health professionals are advised that Smith & Nephew, in consultation with the TGA, has issued a hazard alert regarding the femoral implant component of the Journey Bi-Cruciate Stabilised (BCS) knee replacement system.

About the knee joint

To fully understand knee degeneration, learn about the knee joint and how it functions first.

In contrast to a previous view, some hyaluronic acid injections into the knee can have a benefical effect

Researchers have concluded that intra-articular injections of hyaluronic acid for the treatment of knee osteoarthritis significantly improve pain and function compared to placebo.

Industry-funded studies on HA present more favorable conclusions

An article discussing a paper in press presenting results on the use of hyaluronic acid injections in patients with osteoarthritis of the knee.