Paul A. Lotke

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BACKGROUND Stiffness is an uncommon but disabling problem after total knee arthroplasty. The prevalence of stiffness after knee replacement has not been well defined in the literature. In addition, the outcomes of revision surgery for a stiff knee following arthroplasty have not been evaluated in a large series of patients, to our knowledge. The purposes of(More)
The early clinical results of geometric total knee arthroplasty were compared with the position of the prosthetic device by a roentgenographic score system. It was noted that there is a statistically significant positive correlation between a good clinical result and a well positioned prosthesis. In addition, it was appreciated that perfect positioning of(More)
Bone density was measured using dual photon absorptiometry and dual xray absorptiometry below the tibial component under the medial and lateral plateaus, under the central peg, and distal to the central peg. Measurements of bone density were taken at 1 week, 6 weeks, 6 months, and 1 year after surgery in 31 patients. Seven of these patients also had(More)
We reviewed the clinical outcomes of fifty primary total knee arthroplasties that had been performed with cement in forty patients who were considered morbidly obese (a Quetelet index of more than forty). These results were compared with those of 1768 similar procedures, performed during the same time-period by the same surgeon, in 1539 patients who were(More)
We prospectively studied the cases of 121 patients who were being operated on for insertion of a unilateral total knee prosthesis with cement, and we placed them randomly in four groups. In Group I, the tourniquet was inflated throughout the operative procedure, and we released it postoperatively after a compressive dressing had been applied; a splint was(More)
Osteonecrosis of the medial femoral condyle presents as a sudden onset of pain on the medial side of the knee. This is associated with a positive bone scan and, frequently, a radiolucent lesion in the subchondral zone. In a review of 79 patients with this disease, performed to establish guidelines for treatment, the patients are divided into three groups(More)
We have described two entities of osteonecrosis-like syndromes about the knee. One involves the medial femoral condyle and may or may not be associated with radiolucent lesions and collapse of the femoral condyle. Treatment depends on identification of the size and location of the lesion. The other entity is an osteonecrosis-like lesion of the tibial(More)
The purpose of this study was to review our experience in treating acute gram-positive infections after total knee arthroplasty with debridement, component retention, and intravenous antibiotics. Thirty-one total knee arthroplasties with acute gram-positive infections, seen at our institution over a 10-year period, were treated with open debridement and(More)
BACKGROUND In the presence of large extra-articular deformity, complex imbalance of the collateral ligaments may result if standard techniques of soft-tissue releases and intra-articular bone resection are used during total knee arthroplasty. The purpose of this paper is to review our experience with simultaneous corrective osteotomy and total knee(More)
Ten cases of isolated, complete paralysis of the serratus anterior muscle were diagnosed in young athletes during a three-year period. One patient had recurrent partial paralysis of the serratus anterior muscle, the first such case reported. From studies on cadavera and clinical observations, we concluded that paralysis of the serratus anterior muscle(More)