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Background The incidence and characteristics of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) without pharmacologic prophylaxis have not been fully investigated. This study aimed to determine whether there are any differences in the incidence, location, and characteristics of DVT following TKA with pharmacologic prophylaxis and without pharmacologic prophylaxis. Methods A total of 156 knees were retrospectively evaluated for DVT following TKA by duplex ultrasound on postoperative day 7, after excluding 60 knees from 216 consecutive knees because of antiplatelet or anticoagulant use before surgery, history of venous thromboembolism, or bleeding risk. The 156 knees included in the analysis were divided into two groups: with pharmacologic prophylaxis (n = 79) and without pharmacologic prophylaxis (n = 77). Results The overall incidence of DVT was 34% (54/156 knees). DVT was detected in 31.6% of knees with pharmacologic prophylaxis and in 37.6% of knees without pharmacologic prophylaxis; the difference was not statistically significant. Soleal vein thrombus was observed in 74.6% of the knees with DVT and non-floating thrombus was observed in 98.7%. There were no obvious between-group differences in thrombus characteristics such as compressibility, echogenicity, mean vein diameter, and whether the thrombus was attached to the vein wall or free-floating. Conclusions No differences were found in the incidence, location, or characteristics of DVT following TKA with or without pharmacological prophylaxis.

BackgroundPatellofemoral overstuffing after total knee arthroplasty can cause limited range of motion and anterior knee pain. This study compared anterior prominence of femoral components among different prothesis designs in surgical simulation models utilizing the anterior reference (AR) and posterior reference (PR) techniques.MethodsSurgical simulations were performed using preoperative computed tomography data of 30 patients on a three-dimensional planning system. Four implant models were used: Attune, Persona, Journey II, and Legion. Rotational alignment was set parallel to the transepicondylar axis and size selection was based on absence of notch formation in the femoral anterior cortex and best fit to the shape of the medial posterior femoral condyle. For each combination of surgical technique (AR or PR method) and implant model, measurements were taken of the maximum medial, central, and lateral prominence of the implant from the anterior femoral cortex (mm).ResultsUsing either the AR or PR method, the medial and central prominences were significantly lower with Journey II than with other models. The lateral prominence was the lowest with Attune in the AR method. The AR method was associated with significantly less prominence than the PR method, regardless of implant model.ConclusionsDegree of anterior prominence of the femoral implant is affected by implant design when the AR method is used. The PR method is associated with greater anterior prominence compared with the AR method, with size pitch an additional influencing factor. Journey II is associated with the least anterior prominence when using either method.

BackgroundSome patients complain of noise after total knee arthroplasty (TKA). Controversy still exists how the noise affect the clinical outcomes including joint awareness after TKA. Forgotten Joint Score-12 (FJS-12) measures the clinical outcomes focusing on joint awareness after surgery. The Knee Society Scoring System-2011 (KSS-2011) includes questionnaires for satisfaction, expectation, and functional activities. The aim of this study is to clarify the relationship among FJS-12, KSS-2011 and the noise. Furthermore, the relationship between FJS-12 and KSS-2011 was validated. MethodsUsing the FJS-12 and KSS-2011, 295 knees from 225 patients who underwent TKA was retrospectively evaluated. Noise perception was evaluated by a questionnaire with five grades which is a method that follows the questionnaire form of FJS-12 [“Are you aware of the noise of your artificial joint?” ; never, almost never, seldom, sometimes, mostly]. The correlations among FJS-12, KSS-2011, and noise were analyzed. In addition, patients were divided into four groups based on the mechanism of their implant [cruciate retaining, posterior stabilized, cruciate sacrificed, and bicruciate stabilized (BCS)]. FJS-12, KSS-2011, and noise were compared among the groups. ResultsA strong correlation was observed between FJS-12 and the total score of KSS-2011 (0.70; P < 0.001). FJS-12 also was correlated with KSS-2011 subcategories for “symptoms,” “satisfaction,” and “standard activities” that these correlation coefficients were approximately 0.60. Noise was limited to have weak correlations with FJS-12 (0.28; P < 0.001) and KSS-2011 (0.20 P < 0.001). With comparison among the TKA mechanisms, BCS showed significantly better KSS-2011 and greater range of movement but worse noise scores.ConclusionsNoise perception after TKA had limited effect on joint awareness and clinical outcomes. FJS-12 was correlated strongly with KSS-2011 and associated with satisfaction, residual symptoms, and daily activities as assessed by KSS-2011 subscores.

Background: Forgotten Joint Score-12 (FJS-12) measures the clinical outcomes focusing on joint awareness after surgery, such as total knee arthroplasty (TKA). The Knee Society Scoring System-2011 (KSS-2011) includes questionnaires for satisfaction, expectation, and functional activities. However, the relationship between FJS-12 and KSS-2011 has not been validated to our knowledge. In addition, some patients complain of noise after TKA. However, how the noise affects joint awareness and satisfaction has not been evaluated. The aim of this study is to clarify the relationship among FJS-12, KSS-2011 and the noise. Methods: Using the FJS-12 and KSS-2011, 295 knees from 225 patients who underwent TKA was retrospectively evaluated. Noise perception was evaluated by a questionnaire with five grades which is a method that follows the questionnaire form of FJS-12 [“Are you aware of the noise of your artificial joint?” ; never, almost never, seldom, sometimes, mostly]. The correlations among FJS-12, KSS-2011, and noise were analyzed. In addition, patients were divided into four groups based on the mechanism of their implant [cruciate retaining, posterior stabilized, cruciate sacrificed, and bicruciate stabilized (BCS)]. FJS-12, KSS-2011, and noise were compared among the groups. Results: A strong correlation was observed between FJS-12 and the total score of KSS-2011 (0.70; P < 0.001). FJS-12 also was correlated with KSS-2011 subcategories for “symptoms,” “satisfaction,” and “standard activities” that these correlation coefficients were approximately 0.60. Noise was limited to have weak correlations with FJS-12 (0.28; P < 0.001) and KSS-2011 (0.20 P < 0.001). With comparison among the TKA mechanisms, BCS showed significantly better KSS-2011 and greater range of movement but worse noise scores. Conclusions: Joint awareness assessed by FJS-12 was correlated strongly with KSS-2011 and associated with satisfaction, residual symptoms, and daily activities as assessed by KSS-2011 subscores. Noise perception had limited effect on joint awareness and clinical outcomes.