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RISS 인기검색어
- 검색키워드
- 저자 : ( Chloe E. H. Scott ) (검색결과 2 건)
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( Oisin J. F. Keenan ),( Lauren A. Ross ),( Matthew Magill ),( Matthew Moran ),( Chloe E. H. Scott ) 대한슬관절학회 2021 대한슬관절학회지 Vol.33 No.-
Purpose: This study aimed to determine whether unrestricted weight-bearing as tolerated (WBAT) following lateral locking plate (LLP) fixation of periprosthetic distal femoral fractures (PDFFs) is associated with increased failure and reoperation, compared with restricted weight-bearing (RWB). Materials and methods: In a retrospective cohort study of consecutive patients with unilateral PDFFs undergoing LLP fixation, patients prescribed WBAT were compared with those prescribed 6 weeks of RWB. The primary outcome measure was reoperation. Kaplan-Meier and Cox multivariable analyses were performed. Results: There were 43 patients (mean age 80.9 ± 11.7 years, body mass index 26.8 ± 5.7 kg/m<sup>2</sup> and 86.0% female): 28 WBAT and 15 RWB. There were more interprosthetic fractures in the RWB group (p = 0.040). Mean follow-up was 3.8 years (range 1.0-10.4). Eight patients (18.6%) underwent reoperation. Kaplan-Meier analysis demonstrated no difference in 2-year survival between WBAT (80.6%, 95% CI 65.3-95.9) and RWB (83.3%, 95% CI 62.1-100.0; p = 0.54). Cox analysis showed increased reoperation risk with medial comminution (hazard ratio 10.7, 95% CI 1.5-80; p = 0.020) and decreased risk with anatomic reduction (hazard ratio 0.11, 95% CI 0.01-1.0; p = 0.046). Immediate weightbearing did not significantly affect the risk of reoperation compared with RWB (relative risk 1.03, 95% CI 0.61-1.74; p = 0.91). Conclusions: LLP fixation failure was associated with medial comminution and non-anatomic reductions, not with postoperative weight-bearing. Medial comminution should be managed with additional fixation. Weight-bearing restrictions additional to this appear unnecessary and should be avoided.
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( Katherine L. Elcock ),( Deborah J. Macdonald ),( Nick D. Clement ),( Chloe E. H. Scott ) 대한슬관절학회 2023 대한슬관절학회지 Vol.35 No.-
Background Patients with severe obesity [body mass index (BMI) ≥ 40 kg/m<sup>2</sup>] potentially overload the tibial component after total knee arthroplasty (TKA), risking tibial subsidence. Using a cemented single-radius cruciate-retaining TKA design, this study compared the outcomes of two tibial baseplate geometries in patients with BMI ≥ 40 kg/m<sup>2</sup>: standard keeled (SK) or universal base plate (UBP), which incorporates a stem. Methods This was a retrospective, single-centre cohort study with minimum 2 years follow-up of 111 TKA patients with BMI ≥ 40 kg/m<sup>2</sup>: mean age 62.2 ± 8.0 (44-87) years, mean BMI 44.3 ± 4.6 (40-65.7) kg/m<sup>2</sup> and 82 (73.9%) females. Perioperative complications, reoperations, alignment and patient-reported outcomes (PROMS): EQ-5D, Oxford Knee Score (OKS), Visual Analogue Scale (VAS) pain score and satisfaction were collected preoperatively, and at 1 year and final follow-up postoperatively. Results Mean follow-up was 4.9 years. SK tibial baseplates were performed in 57 and UBP in 54. There were no significant differences in baseline patient characteristics, post-operative alignment, post-operative PROMs, reoperations or revisions between the groups. Three early failures requiring revision occurred: two septic failures in the UBP group and one early tibial loosening in the SK group. Five-year Kaplan-Meier survival for the endpoint mechanical tibial failure was SK 98.1 [94.4-100 95% confidence interval (CI)] and UBP 100% (p = 0.391). Overall varus alignment of the limb (p = 0.005) or the tibial component (p = 0.031) was significantly associated with revision and return to theatre. Conclusions At early to mid-term follow-up, no significant differences in outcomes were found between standard and UBP tibial components in patients with BMI ≥ 40 kg/m<sup>2</sup>. Varus alignment of either tibial component or the limb was associated with revision and return to theatre.
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