Midterm Comparison of Tibial Fixation between Posterior Cruciate-Retaining and Substituting Porous Tantalum Total Knee Arthroplasty: Three-Dimensional Computed Tomography Analysis

Early postoperative gait characteristics after unicompartmental knee arthroplasty: results and clinical implications

BACKGROUND AND OBJECTIVE

Despite the established efficacy of unicompartmental knee arthroplasty (UKA), quantitative assessments of early postoperative changes in gait and stability remain limited. This study investigated preoperative and postoperative alterations in gait and stability following UKA.

METHODS

A cohort of 30 patients undergoing unilateral UKA at the Joint Surgery Department of the Affiliated Hospital of Xuzhou Medical University between May 2021 and 2022 was compared with a control group of 15 healthy elderly individuals without a history of hip or knee pathology. Evaluated parameters included Hospital for Special Surgery (HSS) scores, center of pressure path length, 95% confidence ellipse area, pace, stride length, stride frequency, gait cycle, and single support time percentage. Measurements were obtained preoperatively and at 1 and 3 months postoperatively for both groups.

RESULTS

Step frequency remained unchanged between preoperative and 1-month postoperative assessments (p > 0.05). Stability declined at 1 month postoperatively relative to baseline, whereas other gait parameters showed significant improvement (p < 0.05). By 3 months, HSS scores and all gait and stability metrics exhibited substantial enhancement compared to baseline (p < 0.05).

CONCLUSIONS

Early gait recovery following UKA demonstrated a positive trajectory; however, step frequency showed minimal improvement, and stability remained compromised at 1 month postoperatively. Quantitative gait analysis provides a robust framework for monitoring rehabilitation progress after UKA.

Diagnostic Value Comparison between Multislice Spiral Computerized Tomography and Magnetic Resonance Imaging under Artificial Intelligence Algorithm in Diagnosing Occult Fractures of the Knee Joint

The aim of this study was to explore the application value of multislice spiral computerized tomography (MSCT) and magnetic resonance imaging (MRI) under intelligent algorithm in the diagnosis of occult fractures of the knee joint (OFKJ). 47 patients with negative X-ray examination and suspected fracture were included for this research. According to the examination methods, the patients were divided into the MSCT group and MRI group. The diagnostic results of the two methods were compared, and then compared with the traditional algorithm to explore their superiorities. The results demonstrated that the algorithm applied in this study had a clearer segmentation than traditional algorithms, and it run significantly faster than other algorithms. The results of MSCT, MRI, and pathological examination were all different, but which was of no statistical significance, P > 0.05. The specificity, accuracy, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) of MSCT were 83%, 96%, 94%, and 98%, respectively; and its coincidence rate, missed diagnosis rate, and misdiagnosis rate were 98.20%, 1.60%, and 0.20%, respectively. Compared with MRI, the differences were significant statistically, P < 0.05. The segmentation effect of MSCT was closer to the standard segmentation, with the higher efficiency. MSCT under the intelligent algorithm produced the better diagnostic performance and the higher detection rate than MRI in diagnosing OFKJ. It could be used for clinical auxiliary diagnosis and evaluation of OFKJ, deserving an application value.

Intraoperative joint balancing procedure using an imageless robotic assisted technique does not necessarily result in kinematically aligned bicruciate stabilized total knee arthroplasty

The primary aim of this study was to retrospectively evaluate the hip- knee- ankle. (HKA) angle and prosthetic alignment with three-dimensional computed tomography (3DCT) measurements in patients who underwent robotic-assisted (RA) TKA, with consideration of the soft tissue envelope via an intraoperative joint-balancing procedure. We hypothesized that intraoperative consideration of soft tissue laxity in individual patients using imageless RA technology will not necessarily result in kinematically aligned bicruciate stabilized total knee arthroplasty (KA TKA). This retrospective study included consecutive patients who underwent RA TKA between 2019 and 2020. The indication for TKA was varus osteoarthritis of the knee. During this period, 60 RA bi-cruciate stabilized TKAs were performed. Prosthetic alignments were measured using computer software with 3DCT. We determined prosthetic positioning and bone resection volume with consideration of the soft tissue envelope using an intraoperative full range of motion joint-balancing procedure during RA TKA. 3DCT scans of the entire lower extremity were taken before and after surgery. Postoperative varus HKA alignment occurred in 58% of patients who underwent RA TKA, 31% of knees were in femoral valgus alignment and tibial varus alignment, and 42% had femoral components in internal rotation among knees with femoral valgus alignment and tibial varus alignment. The mean thickness of the osteotomized medial and lateral posterior condyles of the femur were 11.2 and 9.1 mm, respectively, based on 3DCT measurements. Intraoperative consideration of soft tissue laxity in individual patientsusing an imageless RA technique does not necessarily result in KA bicruciate TKA.