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Biomedical subjects

John A L Hart

Publications and source records attributed to John A L Hart.

4 recordsLinked to original sources

A comparison of 2 continuous passive motion protocols after total knee arthroplasty: a controlled and randomized study.

Effect of continuous passive motion (CPM) protocols on outcomes after total knee arthroplasty. In this prospective randomized controlled study, 147 patients were assigned to 1 of 3 treatment groups: CPM from 0 degrees to 40 degrees and increased by 10 degrees per day, CPM from 90 degrees to 50 degrees (early flexion) and gradually progressed into full extension over a 3-day period, and a no-CPM group. The CPM was administered twice a day for 3 hours over a 5-day period. All patients participated in the same postoperative physiotherapy program. Patients were assessed preoperatively, day 5, 3 months, and 1 year postoperatively. The early flexion group had significantly more range of flexion than both the standard and control groups at day 5. There was no significant difference between the groups for any other variable tested at any time frame. Key words: total knee arthroplasty, CPM, rehabilitation, outcomes.

Aged↗

Joint replacement surgery.

Joint replacement is the most effective healthcare measure in improving patient quality-of-life outcomes. More than 46000 hip and knee replacements were performed in Australia between July 2000 and July 2001. The need for joint replacements will increase as the population ages. More than 90% of hip and/or knee replacements survive for 10-15 years. Prosthesis selection needs to be tailored to each patient, although rationalisation of types of prosthesis used is required.

Adult↗

Osteotomy of the knee: is there a seat at the table?

Osteotomy is an alternative treatment for unicompartmental osteoarthritis of the knee. In genu varum, a high valgus closing wedge osteotomy is preferred, with overcorrection by 5 degrees. Complications and poor outcomes can be overcome by incomplete osteotomy with careful preoperative planning, precise use of cutting jigs, compression fixation, and early mobilization and weight bearing. Patella baja is related to postoperative immobilization, and unicompartmental arthroplasties are more difficult to revise because of bone loss. Supracondylar femoral osteotomy is preferred for genu valgum using a lateral opening wedge with a toothed plate, allowing easy access to the lateral compartment of the knee. Osteotomy, far from being obsolete, has an increasing role in joint resurfacing procedures.

Humans↗