The patellar clunk syndrome describes painful catching, grinding or jumping of the patella when the knee moves from a flexed to an extended position after total knee replacement (TKR). The posterior stabilised TKR had been noted to have a higher incidence of this problem. Mobile-bearing posteriorly stabilised TKRs have been introduced to improve patellar tracking and related problems by a mecha...

Importance Black patients with advanced osteoarthritis (OA) of the knee are significantly less likely than white patients to undergo surgery. No strategies have been proved to improve access to surgery for black patients with end-stage OA of the knee. Objective To assess whether a decision aid improves access to total knee replacement (TKR) surgery for black patients with OA of the knee. De...

OBJECTIVE To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding total knee replacement. PARTICIPANTS A non-DHHS, non-advocate 11-member panel representing the fields of orthopaedics, rheumatology, internal medicine, nursing, physical therapy, rehabilitation, biostatistics, epidemiology, and health services resear...

IN THIS ISSUE OF JAMA, CRAM AND COLLEAGUES 1 report detailed analysis of primary and revision total knee replacement (TKR) performed on more than 3.2 million Medicare beneficiaries from 1991 to 2010. This analysis confirms and quantifies several important findings. First, the use of primary and revision TKRs in Medicare beneficiaries has increased both in absolute volume from 93 230 procedures ...

IntroductIon In 2005, approximately 285,000 individuals underwent total hip replacement (THR) procedures, and approximately 523,000 individuals had total knee replacement (TKR) procedures in the U.S.1 As the population ages, it is estimated that by 2030 the demand for these surgeries will increase, and the numbers are expected to grow to 572,000 THR procedures and 3,480,000 TKR procedures annua...

BACKGROUND Intra-articular injection of hyaluronic acid (HA) for knee osteoarthritis (OA) effectively reduces pain and delays total knee replacement (TKR) surgery; however, little is known about relative differences in clinical and cost outcomes among different HA products. OBJECTIVE To compare disease-specific costs and risk of TKR among patients receiving different HA treatments in a commer...

The economic costs of knee osteoarthritis (OA) and its treatment are important considerations for patients, physicians, and healthcare systems when making decisions about the management of knee OA, especially given the direct costs associated with total knee replacement (TKR) [1, 2], and the estimated increase in demand by 2030 projected for TKR in the United States (673% increase from 2005 for...

Knee osteoarthritis is a disease that causes pain, functional limitation and disability and its incidence rate is gradually rising with an increase in the elderly population (Felson & Anderson, 1987; McKay, Prapavessis & Doherty, 2012). A total knee replacement is an effective surgical intervention for the patients with knee osteoarthritis by reducing pain in the knee joints and enhancing the q...

BACKGROUND Unilateral total knee replacement (TKR) results in a substantial blood loss and 30 to 50 percent of patients receive allogeneic blood transfusion (ABT). Therefore, the effectiveness of a restrictive transfusion trigger (hemoglobin [Hb] level < 8 g/dL) plus stimulation of erythropoiesis was evaluated, with or without blood salvage, for reducing ABT in TKR patients. STUDY DESIGN AND ...

Free radicals, such as reactive oxygen species (ROS) which are released abruptly after deflation of an ischaemic tourniquet, cause reperfusion injuries. Ischaemic precondition (IPC), however, can reduce the injury. In clinical practice, the sequential application and release of tourniquets is often used in bilateral total knee replacement (TKR) to obtain a clearer operative field, but the effec...