RESUMEN

BACKGROUND: Rotating-platform posterior-stabilized total knee arthroplasty (PS-TKA) has become a commonly used procedure. It has the potential risk of causing mobile-bearing spinout. In our study, we investigated the factors affecting the bearing thickness when performing rotating-platform PS-TKA. METHODS: This single-arm, prospective, single-hospital cohort study included 100 consecutive patients who underwent rotating-platform PS-TKA between September 2020 and August 2022. We examined the relationship between bearing thickness and several patient characteristics. RESULTS: The results of the univariate analysis showed that the bearing thickness was significantly associated with weight (risk ratio = 3.4; 95% confidence interval (CI) = 1.1-11.0; P = 0.016) and implant size of the tibia (risk ratio = 3.4; 95% CI = 1.0-11.5; P = 0.030). We performed multivariate analysis regarding the weight and implant size of the tibia. Neither the weight nor the implant size of the tibia was significantly different from the bearing thickness in the multivariate analysis. CONCLUSIONS: In rotating-platform PS-TKA, body weight and tibia size may affect the bearing thickness. Weight >60 kg and tibial implant size >67 cm may be risk factors for bearing thickening. Therefore, the surgery can be performed better if these risk factors are considered.

Asunto(s)

Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla , Osteoartritis de la Rodilla , Humanos , Artroplastia de Reemplazo de Rodilla/métodos , Prótesis de la Rodilla/efectos adversos , Estudios de Cohortes , Estudios Prospectivos , Rango del Movimiento Articular , Diseño de Prótesis , Articulación de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/cirugía , Osteoartritis de la Rodilla/cirugía

RESUMEN

Introduction: Remote cerebellar hemorrhage (RCH) has been reported as a serious complication of spine surgery and is considered to be caused by dural injury. However, we have experienced a case in which intracranial hemorrhage occurred immediately after lumbar spine surgery without dural tear. There were no reports of RCH in spinal surgery without dural injury as far as we could find. Case Report: We described a rare presentation of an 80-year-old male who suffered a loss of consciousness after lumbar surgery. He was diagnosed with impaired consciousness due to chronic and acute intracranial hemorrhage. He went through two hematoma removal surgeries and his consciousness improved. Conclusion: RCH can occur in spinal surgery in patients with predicted cerebrovascular fragility, even in the absence of dural injury. Pre-operative imaging evaluation could be useful in assessing cerebrovascular fragility.