Early Knee Arthroplasty for Knee Fractures in Elderly: A Malaysian Study
Journal name: The Malaysian Journal of Medical Sciences
Original article title: Short-Term Outcome of Early Primary Total Knee Arthroplasty for Fractures Around the Knee in the Elderly Population: The Experience of a Secondary Healthcare Centre in Malaysia
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Ng Bing Wui, Muhammad Afiq Ahmad Anuar, Abdul Muttalib Abdul Wahid
The Malaysian Journal of Medical Sciences:
(A peer-reviewed, open-access journal)
Full text available for: Short-Term Outcome of Early Primary Total Knee Arthroplasty for Fractures Around the Knee in the Elderly Population: The Experience of a Secondary Healthcare Centre in Malaysia
Year: 2020 | Doi: 10.21315/mjms2020.27.4.6
Copyright (license): CC BY 4.0
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Summary of article contents:
Introduction
Fractures around the knee in the elderly population are often challenging to manage due to the complexities arising from both the patients' age and the nature of the fractures. Traditional treatment approaches include open reduction and internal fixation (ORIF) or external fixation, which may not always be effective in older patients with osteoporotic bones. This study investigates the short-term outcomes of elderly patients who underwent primary total knee arthroplasty (TKA) as a treatment method for knee-related fractures. It emphasizes the treatment of patients aged 70 years and older with poor bone quality or those 55 years and older with severe knee osteoarthritis.
Early Primary Total Knee Arthroplasty: Advantages and Outcomes
The study identified ten elderly patients who had TKA performed due to knee fractures, with the aim of evaluating their clinical outcomes. The results showed that patients who did not encounter post-operative complications enjoyed favorable short-term outcomes, closely approximating their pre-fracture conditions. On average, patients exhibited a knee score of 87.7 ± 10.0 and a functional knee score of 56 ± 41.9. However, those who experienced surgical site infections had notably lower functional scores. The findings illustrate that early primary TKA can bypass many of the complications associated with traditional surgical interventions, allowing for early weight-bearing and better recovery.
Conclusion
In conclusion, early total knee replacement demonstrates significant potential as a viable option for treating fractures around the knee in elderly patients, with the advantage of facilitating quicker patient recovery and improved autonomy. While the study reported a notable infection rate of 20%, indicating a significant risk associated with this procedure, the overall results suggest that with careful patient selection and thorough pre-operative planning, early TKA leads to satisfactory outcomes. Future studies are encouraged to investigate long-term outcomes and establish further evidence supporting this approach in the geriatric population.
FAQ section (important questions/answers):
What was the aim of the study on knee fractures in the elderly?
The study aimed to investigate the short-term outcomes of elderly patients treated with primary total knee arthroplasty for knee fractures, specifically focusing on those with poor bone quality and severe concomitant knee osteoarthritis.
What were the inclusion criteria for the study participants?
Participants included patients aged at least 70 with poor bone quality or those aged 55 and older with severe knee osteoarthritis presenting with fractures around the knee.
What were the main findings related to postoperative complications?
The study found that 20% of patients developed surgical site infections, which negatively impacted functional knee scores. However, patients without complications experienced outcomes close to their pre-fracture conditions.
What does the study conclude about early total knee replacement?
The study concludes that early total knee replacement is a viable treatment option for knee fractures in the elderly, yielding good short-term outcomes, albeit with the risk of infection.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Early Knee Arthroplasty for Knee Fractures in Elderly: A Malaysian Study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Study (Studying):
In the context of medical research, a study is a systematic investigation intended to enhance knowledge about a particular health issue or treatment. This particular study focuses on the outcomes of total knee arthroplasty in elderly patients with knee fractures. It provides valuable insights into surgical efficacy and patient recovery.
2) Post:
The term 'post' often refers to the period after a surgical procedure or an event. In this study, post-operative outcomes are critically assessed to understand complications and recovery trajectories of patients who underwent total knee arthroplasty, which is vital for evaluating surgical success and enhancing patient care.
3) Table:
Tables present organized data clearly and efficiently for analysis. In clinical studies, including this one, tables summarize patient demographics, complications, surgical details, and outcomes, facilitating easier comparisons and understanding of the results, thus aiding clinicians in making informed medical decisions based on the findings.
4) Fixation:
Fixation refers to the stabilization of bones or tissues, particularly after fractures, using methods like open reduction and internal fixation (ORIF). This study evaluates the challenges of using fixation techniques in elderly patients with knee fractures and how total knee arthroplasty may serve as an alternative treatment.
5) Pur:
The term 'poor' often describes inadequate outcomes or quality. In the context of this study, it addresses aspects like poor bone quality or poor functional outcomes observed post-operatively. Recognizing 'poor' outcomes is essential for assessing treatment efficacy and identifying areas where improvements in surgical techniques or patient care can be made.
6) Pain:
Pain is a crucial indicator of patient health and function, often assessed through clinical scoring systems. In this study, knee pain factors into the evaluation of surgical outcomes post-total knee arthroplasty. Effective pain management significantly enhances patient satisfaction and recovery, making it a key consideration in any surgical intervention.
7) Antibiotic (Antibacterial):
Antibiotics are critical in preventing and treating infections, particularly following surgical procedures. In this study, antibiotic prophylaxis was administered pre-operatively to reduce postoperative infectious complications, which are a significant concern in elderly patients undergoing surgeries like total knee arthroplasty and can affect overall outcomes considerably.
8) Medium:
The term 'medium' in this context relates to the length of follow-up duration in the study, which is essential for evaluating the effectiveness and sustainability of surgical outcomes over time. Medium-term results provide insights into potential late complications or failures of the intervention, informing future practices and expectations.
9) Quality:
Quality pertains to the standard of bone or health of patients involved in the study. Poor bone quality poses challenges during surgical fixation, potentially leading to complications. This study emphasizes assessing bone quality to guide the decision-making process for surgical interventions like total knee arthroplasty in elderly patients.
10) Appar:
In the context of this study, 'Appar' likely refers to 'apparatus,' implying the surgical tools or methods employed during the procedure. Understanding the apparatus used during surgery is essential to assessing its impact on outcomes and complications, as effective tools can significantly enhance surgical precision and recovery.
11) Takai:
Takai likely refers to a researcher or a significant contributor to the topic of total knee arthroplasty and its associated outcomes. Citing past research and collaborators enhances the credibility of the current study and provides a broader context for its findings, supporting the continued exploration of techniques in orthopedic surgery.
12) Bell:
Bell may also reference an author or researcher who has contributed to the literature surrounding knee arthroplasty or related orthopedic procedures. Recognizing influential names in the field is vital for situating the study within existing research and understanding the evolution of treatment techniques and outcomes overall.
13) Chan:
Chan might indicate a researcher who has provided valuable insights or findings relevant to total knee arthroplasty or orthopedic procedures within the context of the study. Inclusion of such references highlights prior work, establishing a foundation upon which new studies can build, further advancing clinical understanding and practices.
14) Inflammation:
Inflammation is a natural body response to injury or infection, affecting healing processes post-surgery. This study considers inflammation in evaluating surgical outcomes and complications. Understanding its role is vital, as managing inflammation can significantly improve recovery times and overall success in orthopedic surgeries like total knee arthroplasty.
15) Discussion:
The discussion section in a medical study critically interprets the findings, linking them back to objectives and relevant literature. It highlights implications for clinical practice, discusses limitations, and suggests areas for future research. In this study, the discussion elucidates the relevance and impact of total knee arthroplasty in elderly patients.
16) Depression:
In this context, 'depression' may refer to a type of injury, specifically a fracture or complication that presents challenges in treatment or recovery. Understanding the nature and treatment of depression fractures is crucial in managing patient outcomes post-surgery, as they may require specialized care or techniques.
17) Inference:
Inference is the process of drawing conclusions based on data analysis, crucial for understanding study outcomes. In clinical research, accurate inferences enhance the interpretation of data, allowing stakeholders to make informed decisions regarding surgical approaches, patient care, and future research directions based on observed trends and results.
18) Swelling:
Swelling, a common clinical symptom following surgical procedures, indicates inflammation or complications in recovery. This study monitors patient swelling post-operatively to assess surgical success. Evaluating swelling is essential for identifying potential issues, guiding interventions, and improving overall patient outcomes in knee arthroplasty and related surgeries.
19) Incision:
An incision is the cut made during surgery, essential for access to the surgical site. The technique and care taken during incision influence postoperative recovery, infection rates, and overall surgical success. This study details the incision technique in total knee arthroplasty, underscoring its importance in patient outcomes.
20) Reason:
Reason relates to the rationale behind choosing total knee arthroplasty over other treatment methods for knee fractures, particularly in elderly patients. Understanding the reasons guiding surgical decisions is critical for evaluating treatment efficacy, guiding future clinical practices, and tailoring patient care to their unique healthcare needs.
21) Filling (Filled):
Filled often pertains to the use of materials (like bone cement) to stabilize and support structures during surgery. In total knee arthroplasty, it refers to addressing bone loss and ensuring appropriate loading. Understanding filling techniques is vital for successful outcomes and reducing the risk of complications post-surgery.
22) Rules:
Rules within a medical study refer to the protocols and guidelines followed during research processes, including inclusion and exclusion criteria for participants. Adherence to established rules ensures the validity of study findings and is crucial in drawing reliable conclusions about the efficacy of treatment approaches like total knee arthroplasty.
23) Visit:
Visit signifies patient appointments for follow-up evaluations post-surgery. Regular visits are important for monitoring recovery, assessing outcomes, and identifying complications. In this study, follow-up visits provide essential data on patient progress and functional recovery after total knee arthroplasty, contributing to the study's overall findings.
24) Sign:
Sign may refer to clinical indicators or symptoms evaluated during the study, essential for determining patient status and outcomes. Monitoring signs post-surgery aids in assessing the success of total knee arthroplasty and provides critical information for clinicians to make informed decisions regarding patient care and management.
25) Male:
Male indicates the gender of patients involved in the study, highlighting demographic distributions. Understanding gender differences in surgical outcomes can inform treatment personalization and rehabilitation strategies. The study findings on male patients contribute to a broader understanding of total knee arthroplasty effectiveness across diverse populations.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Early Knee Arthroplasty for Knee Fractures in Elderly: A Malaysian Study’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
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