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383 results on '"Kahlenberg, Cynthia A."'

11. Accelerometers

Author

Kahlenberg, Cynthia A., Ast, Michael P., Hansen, Erik, editor, and Kühn, Klaus-Dieter, editor

Published
2022
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19. Anterior-Posterior Laxity in Midflexion After Posterior-Stabilized TKA Is Sensitive to MCLTension in Passive Flexion: An in Vitro Biomechanical Study.

Author

Berube, Erin E., Xiang, William, Manzi, Joseph E., Mayman, David J., Westrich, Geoffrey H., Wright, Timothy M., Chalmers, Brian P., Imhauser, Carl W., Sculco, Peter K., and Kahlenberg, Cynthia A.

Subjects
MEDIAL collateral ligament (Knee), COLLATERAL ligament, TOTAL knee replacement, KNEE, NONLINEAR regression, POSTERIOR cruciate ligament
Abstract

Background: Knee instability in midflexion may contribute to patient dissatisfaction following total knee arthroplasty (TKA). Midflexion instability involves abnormal motions and tissue loading in multiple planes. Therefore, we quantified and compared the tensions carried by the medial and lateral collateral ligaments (MCL and LCL) following posterior-stabilized (PS) TKA through knee flexion, and then compared these tensions with those carried by the native knee. Finally, we examined the relationships between collateral ligament tensions and anterior tibial translation (ATT). Methods: Eight cadaveric knees (from 5 male and 3 female donors with a mean age of 62.6 years and standard deviation of 10.9 years) underwent PS TKA. Each specimen was mounted to a robotic manipulator and flexed to 90°. ATT was quantified by applying 30 N of anterior force to the tibia. Tensions carried by the collateral ligaments were determined via serial sectioning. Robotic testing was also conducted on a cohort of 15 healthy native cadaveric knees (from 9 male and 6 female donors with a mean age of 36 years and standard deviation of 11 years). Relationships between collateral ligament tensions during passive flexion and ATT were assessed via linear and nonlinear regressions. Results: MCL tensions were greater following PS TKA than in the native knee at 15° and 30° of passive flexion, by a median of ≥27 N (p = 0.002), while the LCL tensions did not differ. Median tensions following PS TKA were greater in the MCL than in the LCL at 15°, 30°, and 90° of flexion, by ≥4 N (p ≤ 0.02). Median tensions in the MCL of the native knee were small (≤11 N) and did not exceed those in the LCL (p ≥ 0.25). A logarithmic relationship was identified between MCL tension and ATT following TKA. Conclusions: MCL tensions were greater following PS TKA with this typical nonconforming PS implant than in the native knee. Anterior laxity at 30° of flexion was highly sensitive to MCL tension during passive flexion following PS TKA but not in the native knee. Clinical Relevance: Surgeons face competing objectives when performing PS TKA: they can either impart supraphysiological MCL tension to reduce anterior-posterior laxity or maintain native MCL tensions that lead to heightened anteriorposterior laxity, as shown in this study. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Early Recovery Outcomes in Patients Undergoing Contemporary Posterior Approach Total Hip Arthroplasty: Each Week Shows Progress.

Author

Coxe, Francesca R., Kahlenberg, Cynthia A., Garvey, Matthew, Cororaton, Agnes, Jerabek, Seth A., Mayman, David J., Figgie, Mark P., and Sculco, Peter K.

Abstract

Background: Little is known about patients' postoperative week-by-week progress after undergoing posterior approach total hip arthroplasty (THA) with regard to pain, function, return to work, and driving. Purpose: We sought to evaluate a large cohort of patients undergoing posterior approach THA with modified posterior hip precautions to better understand the trajectory of recovery. Methods: Patients at a single institution undergoing primary posterior approach THA by fellowship-trained arthroplasty surgeons were prospectively enrolled. Patient functional status and early rehabilitation recovery milestones were evaluated preoperatively and each week postoperatively for 6 weeks. Results: Of 312 patients who responded to weekly questionnaires, there were varying response rates per question. At 1 week after surgery, 15% (39/256) of respondents had returned to work, increasing to 57% (129/225) at week 6. At 6 weeks, 77% of patients (174/225) had returned to driving; 25% (56/225) were taking pain medication (including prescription opioids or nonsteroidal anti-inflammatory drugs); and 15% (34/225) were using assistive devices (down from 91%, 78%, 56%, 35%, and 27% at weeks 1, 2, 3, 4, and 5, respectively). Average postoperative Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement and Lower Extremity Functional Scale scores were significantly higher than preoperative scores. Respondents reported significantly less pain at each week postoperatively than the previous week. Conclusion: These findings suggest that there may be an expected pathway for recovery after posterior THA using perioperative pain protocols, modified postoperative precautions, and physical therapy protocols to improve patient outcomes after THA, with most patients returning to normal at 4 weeks. Defining the expected recovery timeline may help surgeons in counseling patients preoperatively and guiding their recovery. [ABSTRACT FROM AUTHOR]

Published
2024
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48. Correction to: At the US Epicenter of the COVID-19 Pandemic, an Orthopedic Residency Program Reorganizes

Author

Morse, Kyle W., Wessel, Lauren E., Premkumar, Ajay, James, Evan W., Anatone, Alex J., Barth, Kathryn, Bovonratwet, Patawut, Jordan, Yusef, Retzky, Julia, Suhardi, Vincentius, Thacher, Ryan, Uppstrom, Tyler, Yang, Brian, Bido, Jennifer, Carey, Edward, Defrancesco, Christopher, Elbuluk, Ameer, Lebrun, Drake, Ondeck, Nathaniel, Pompeu, Yuri, Schimizzi, Gregory, Shafi, Karim, Apostolakos, John M., Barber, Lauren A., Brusalis, Christopher M., Driscoll, Daniel A., Ellsworth, Bridget, Langhans, Mark, Shen, Tony, Wright-Chisem, Joshua, Conti, Matthew, Eliasberg, Claire, Goeb, Yannick, Henry, Jensen, Lin, Kenneth M., Lovecchio, Francis, Samuel, Andre, Dvorzhinskiy, Aleksey, Goodbody, Christine, Gruskay, Jordan, Heaps, Braiden, Hurwit, Daniel, Kahlenberg, Cynthia, Rauck, Ryan, Steinhaus, Michael, Bostrom, Mathias, Cross, Michael, Fabricant, Peter D., Felix, Karla, Green, Daniel, Kim, Han Jo, Leali, Alejandro, Memnon, Carle-Marie, O’Brasky, Martha, Ranawat, Anil, Robbins, Laura, Nwachukwu, Benedict U., and Fufa, Duretti T.

Published
2020
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