The authors present the case of an 81-year-old man who, despite an anatomically aligned total knee arthroplasty, continued to have knee pain. The patient's ipsilateral rigid flatfoot caused by an earlier partial pedal amputation resulted in a valgus moment during gait, thus creating clinical symptoms in the total knee arthroplasty. Because of the deformity and scarring within the flatfoot, this...

OBJECTIVE Malalignment is associated with knee osteoarthritis (KOA), however, the optimal anatomic axis (AA) knee alignment measurement on a standard limb radiograph (SLR) is unknown. This study compares one-point (1P) and two-point (2P) AA methods using three knee joint centre locations and examines cross-sectional associations with symptomatic radiographic knee osteoarthritis (SRKOA), radiogr...

PURPOSE To evaluate the postoperative knee function and results of unreamed retrograde nailing for distal third femoral shaft fractures. METHODS Between January 2002 and 2003 inclusive, a consecutive series of 27 patients (with 28 fractures) who underwent retrograde nailing were prospectively evaluated. Outcome measures were union time, initiation of weight bearing, deformity and shortening, ...

Abstract Introduction Considerable attention is focused on preoperative templating of radiological images in patients undergoing total knee arthroplasty to obtain optimal alignment and outcome. Several measurements have been described. Purpose In this study, we illustrate a new linear measurement: The coronal offset (LCKO) that can be used analyze the configuration long leg radiographs commonly...

OBJECTIVES Foot orthoses are commonly used in the management of knee OA, although the relationship between foot function and knee OA is still unclear. The purpose of the study was to examine foot function during walking in people with and without medial compartment knee OA. METHODS Motion of the tibia, rearfoot and forefoot in 32 patients with medial compartment knee OA and 28 age-matched con...

OBJECTIVE To evaluate whether an alteration of the lower limb axis is associated with meniscal extrusion. MATERIALS AND METHODS Ninety-four patients who had complained of knee pain with good knee function and had a knee magnetic resonance image (MRI) and a full-length X-ray taken of the lower limb were included in the study. Meniscal extrusion was measured in the coronal MRI. Subluxation of t...

RATIONALE High tibial osteotomy (HTO) has been used widely for medial compartment knee osteoarthritis to correct the deformity and relieve symptoms, especially in young patients who are willing to maintain the high activity level. However, the change of bone morphology, ligament imbalance, limb malalignment, and other complications may influence the short-term outcomes of HTO. Some cases may ev...

Purpose. Patellar resurfacing during prosthetic replacement of the knee is associated with loosening and the need for secondary revision. In many cases the patella is left unreplaced during this procedure in order to decrease the revision risk. Some of these patients remain symptomatic after knee replacement. Secondary isolated resurfacing of the previously unresurfaced patella in total knee ar...

Flexion instability in posterior-stabilized total knee arthroplasty is a relatively uncommon but distinct problem that is often underdiagnosed and may require surgical management. This retrospective study evaluated the authors' management strategy and assessed the results of revision surgery. The authors identified 19 knees that underwent revision for isolated flexion instability after primary ...

After obtaining informed consent, 80 patients were randomised to undergo a navigated or conventional total knee replacement. All received a cemented, unconstrained, cruciate-retaining implant with a rotating platform. Full-length standing and lateral radiographs and CT scans of the hip, knee and ankle joint were carried out five to seven days after operation. No notable differences were found b...