53-458: Anthony Molloy may refer to: Anthony Molloy (Gaelic footballer) (born 1962), former Donegal captain Anthony Molloy (lawyer) (born 1944), New Zealand author and lawyer Anthony James Pye Molloy ( c. 1754–1814), Royal Navy officer [REDACTED] Topics referred to by the same term This disambiguation page lists articles about people with
106-410: A CR knee and unnatural physiologic loads may increase wear of the polyethylene. Multiple studies have demonstrated minimal to no difference between the two designs. MC knee replacements attempt to mimic a more natural knee motion by decreasing motion on the medial aspect of the knee and allowing for increased motion on the lateral aspect of the joint. This mimics the external rotation and abduction of
159-404: A higher risk of surgical complications (deep wound infection, superficial wound infection, and wound dehiscence) compared with nonsmokers. They also have a higher risk of pneumonia after surgery. Fracturing or chipping of the polyethylene platform between the femoral and tibial components may be of concern. These fragments may become lodged in the knee and create pain or may move to other parts of
212-443: A knee replacement does not appear to change outcomes. The surgery involves exposure of the front of the knee, with detachment of part of the quadriceps muscle ( vastus medialis ) from the patella . The patella is displaced to one side of the joint, allowing exposure of the distal end of the femur and the proximal end of the tibia . The ends of these bones then are cut accurately to shape, using cutting guides oriented to
265-604: A niece of his was killed while working as a nurse in the Royal Melbourne Hospital . She was also his goddaughter . Molloy won the Under-14 Championship with his club in 1976. He played during the 1982 All-Ireland Under-21 Football Championship , which Donegal won. Molloy went on to play for his county at senior level for twelve years, amassing 123 appearances. He played senior football for Donegal from 1982 until 1994. Molloy played against Cavan in
318-420: A total knee replacement are fixed to the bone by using either cement or cementless total knee replacement implants. Cemented fixation is performed on the vast majority of total knee replacements. However, short-term trials suggest that there may be relief of pain. There are concerns regarding tibial loosening after implantation, prohibiting widespread adoption of cementless knee replacements at this time. There
371-677: A total knee replacement is based on the Musculoskeletal Infection Society (MSIS) criteria. They are: 1. There is a sinus tract communicating with the prosthesis; or 2. A pathogen is isolated by culture from at least two separate tissue or fluid samples obtained from the affected prosthetic joint; or Four of the following six criteria exist: 1.Elevated serum erythrocyte sedimentation rate (ESR>30mm/hr) and serum C-reactive protein (CRP>10 mg/L) concentration, 2.Elevated synovial leukocyte count, 3.Elevated synovial neutrophil percentage (PMN%), 4.Presence of purulence in
424-631: Is an Irish former Gaelic footballer who played for Ard an Rátha and the Donegal county team . He captained Donegal to the Sam Maguire Cup in 1992 . Molloy is from Leamagowra. This is a small townland on the way over Glengesh Pass on the way towards Glencolmcille . He was born on 28 May 1962. In 1992, he was living at 61 Conlin Road in Killybegs . He is the uncle of C. J. Molloy . In December 2019,
477-403: Is an option for some people. The knee is generally divided into three "compartments": medial , lateral , and patellofemoral . Most people with arthritis severe enough to consider knee replacement have significant wear in two or more of the above compartments, and are treated with total knee replacement (TKA). A minority of people with osteoarthritis have wear primarily in one compartment, usually
530-524: Is currently an important part of patient care. There is some evidence that it may slightly reduce anxiety before knee-replacement surgery, with low risk of detrimental effects. Knee replacement referrals are often blocked if a person is overweight because it is believed they may benefit less from surgery. However, knee replacements have been found to reduce pain and improve function, regardless of people's weight. After 10 years, most people did not need repeat surgery. In addition, weight loss surgery before
583-509: Is debate regarding denervating the patella. Anterior knee pain is thought to be related to the association of the patella and femoral component. Some surgeons believe that by using electrocautery to denervate the patella, it reduces the chance of anterior knee pain postoperatively. Many surgeons in the US perform patella resurfacing routinely, while many surgeons in Asia and Europe do not. Patella resurfacing
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#1732904813470636-734: Is deemed too hazardous. Similarly, total knee replacement can be performed to correct mild valgus or varus deformity . Serious valgus or varus deformity should be corrected by osteotomy . Physical therapy has been shown to improve function, and may delay or prevent the need for knee replacement. Pain often is noted when performing physical activities requiring a wide range of motion in the knee joint. To indicate knee replacement in case of osteoarthritis , its radiographic classification and severity of symptoms both should be substantial. Such radiography should consist of weightbearing X-rays of both knees: AP, lateral, and 30 degrees of flexion. AP and lateral views may not show joint space narrowing, but
689-486: Is intended to preserve the quadriceps tendon and vastus medialis. To reduce blood loss, a pressurized pneumatic tourniquet may be used during this operation. The current body of evidence suggests if a tourniquet is used in knee replacement surgery, it probably increases the risk of severe side effects and postoperative pain. The evidence did not show any clear benefit on patient function, treatment success or quality of life. The femoral, tibial and patellar components of
742-400: Is most commonly performed in people with advanced osteoarthritis and should be considered when conservative treatments have been exhausted. Total knee replacement is also an option to correct significant knee joint or bone trauma in young patients, treat complex fractures in elderly, either due to previous symptomatic osteoarthritis or situations where internal fixation with plates and screws
795-734: Is performed by removing the cartilage from the surface of the knee and replacing it with polyethylene. Surgeons who do not routinely resurface the patella do not believe that it is a significant contribution to pain, when there is no evidence of arthritis to the patellofemoral joint . Some surgeons believe it is not cost-effective routinely to resurface the kneecap and that routine patella resurfacing may lead to increased complications such as patella fracture. Other surgeons are concerned that patients with an unresurfaced patella may have increased pain postoperatively. A meta-analysis evaluating outcomes following patella resurfacing found that routine resurfacing more reliably relieves patient's pain. Polyethylene
848-413: Is significant variation in revision rates, depending on implant design and implantation technique. Standardized zones around the components are used for specifying, for example, signs of loosening on radiographic follow-up. There are various classification systems for specifying such zones, including by KS (Knee Society) zones published in 2015. Specific KS zones are as follows, with * meaning that
901-455: Is symptomatic in 2–3%. Nerve injuries occur in 1–2% of patients. Persistent pain or stiffness occurs in 8–23% of patients. Prosthesis failure occurs in approximately 2% of patients at 5 years. There is increased risk of complications for obese people going through total knee replacement. The morbidly obese should be advised to lose weight before surgery and, if medically eligible, would probably benefit from bariatric surgery . Smokers have
954-425: Is the plastic component that is inserted between the femoral and tibial components. There are several different polyethylene component designs that have been published, including posterior stabilized (PS), cruciate retaining (CR), bicruciate retaining (BCR), medial congruent (MC) and mobile bearing. The posterior cruciate ligament (PCL) is important to the stability of the knee by preventing posterior subluxation of
1007-560: The 2012 All-Ireland Senior Football Championship Final , Molloy raised the hand of Murphy at the local homecoming event, where Paddy McGrath and Pat Shovelin also featured. Towards the end of 2009, Molloy joined the Gaelic Players Association but found it unpalatable. He was regarded as a leading candidate to replace P. J. McGowan as County Chairman when McGowan's five years came to an end in December 2012. In 2013, Molloy
1060-700: The Fianna Fáil political party in the Glenties Electoral Area at the 2019 Donegal County Council election and won a seat. He was re-elected for the Fianna Fáil political party in the Glenties Electoral Area at the 2024 Donegal County Council election . His autobiography, titled Life, Glory and Demons , was published by Hero Books in 2022. The Man in Dublin: S. Ferriter The Man in
1113-666: The Mater Private in October 2008. He funded the earlier operations with his own insurance . However, the €22,000 owed for the replacement was nearly double the maximum allowed by his insurance and this led to Molloy receiving solicitors' letters from the hospital. He expressed disappointment at the lack of interest from the Donegal County Board in resolving the issue. Molloy contacted his former manager Brian McEniff; McEniff contacted GAA Director General Páraic Duffy and eventually
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#17329048134701166-485: The quadriceps tendon . There are different definitions of minimally invasive knee surgery, which may include a shorter incision length, retraction of the patella without eversion (rotating out), and specialized instruments. There are few randomized trials, with studies finding less postoperative pain, shorter hospital stays, and shorter recovery times. These studies have not shown long-term benefits. Unicompartmental arthroplasty (UKA), also called partial knee replacement ,
1219-506: The 1983 Ulster final, won by Donegal. He played against Armagh in the 1990 Ulster final, won by Donegal. He was the captain that year. Molloy captained Donegal to the 1992 All-Ireland title. He famously exclaimed " Sam 's for the hills " as he did so. His speech is still held in high regard within the sport nationally. He would win an All Star in 1992 as well. Molloy also won two New York Senior Football Championships in 1986 and 1992, while playing for Donegal New York . By
1272-475: The 30-degree flexion view is most sensitive for narrowing. Full-length projections also are used in order to adjust the prosthesis to provide a neutral angle for the distal lower extremity. Two angles used for this purpose are: The patient is to perform range-of-motion exercises, and hip, knee and ankle strengthening as directed daily. Exercises that include strengthening of hip flexors, hip abductors and knee flexors helps to recover faster post operatively. Before
1325-517: The GAA paid "the outstanding amount". Molloy managed the county minor team to an Ulster Minor Football Championship title in 1996. Molloy, assisted by Naomh Columba's Michael Oliver McIntyre and Paddy McBride of Downings, also led the team to the 1996 Ulster Minor Football League title. Molloy was mentioned as a possible successor to P. J. McGowan as manager in 1997 in a dual role with Tom Conaghan . He withdrew and Declan Bonner became manager. He
1378-610: The Stand: P. McShea Team doctor: A. O'Kennedy (p) = player-manager Knee replacement Knee replacement , also known as knee arthroplasty , is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability, most commonly offered when joint pain is not diminished by conservative sources. It may also be performed for other knee diseases, such as rheumatoid arthritis . In patients with severe deformity from advanced rheumatoid arthritis , trauma, or long-standing osteoarthritis,
1431-570: The affected joint, 5.Isolation of a microorganism in one culture of periprosthetic tissue or fluid, or 6. Greater than five neutrophils per high-power field in five high-power fields observed from histologic analysis of periprosthetic tissue at ×400 magnification. None of the above laboratory tests has 100% sensitivity or specificity for diagnosing infection. Specificity improves when the tests are performed in patients in whom clinical suspicion exists. ESR and CRP remain good 1st line tests for screening (high sensitivity, low specificity). Aspiration of
1484-492: The aging patient population and can occur intraoperatively or postoperatively. Depending on the location of the fracture and the stability of the prosthesis, these can be treated surgically with open reduction and internal fixation or revision of the prosthesis. The knee at times may not recover its normal range of motion (0–135 degrees usually) after total knee replacement. Much of this is dependent on pre-operative function. Most patients can achieve 0–110 degrees, but stiffness of
1537-573: The blood to prevent thrombotic events include direct oral anticoagulants (i.e. rivaroxaban, dabigatran, and apixaban), low-molecular weight heparins (i.e. dalteparin, enoxaparin), and the antiplatelet agent aspirin. Although it is suggested that aspirin is non-inferior to rivaroxaban, it is unclear if aspirin is appropriate for all patients. This is specifically the case for those people who have additional risk factors for venous thromboembolisms, and those people who are at risk of aspirin resistance. Periprosthetic fractures are becoming more frequent with
1590-591: The body. Advancements in implant design have greatly reduced these issues but the potential for such an event is still present over the life span of the knee replacement. According to the American Academy of Orthopedic Surgeons (AAOS), deep vein thrombosis in the leg is "the most common complication of knee replacement surgery... prevention... may include periodic elevation of patient's legs, lower leg exercises to increase circulation, support stockings and medication to thin your blood." Some medications used to thin
1643-416: The bone or fixed using polymethylmethacrylate (PMMA) cement. Alternative techniques exist that affix the implant without cement. These cement-less techniques may involve osseointegration , including porous metal prostheses. Finally, stability and range of motion are checked, followed by irrigation , hemostasis , placement of hemovacs, and closure. A round-ended implant is used for the femur, mimicking
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1696-514: The end of his playing days, Molloy had been left with a troublesome left knee. It had no joint left, simply bone on bone. Molloy described it, in the Sean Potts-edited book Voices from Croke Park: The Stories of 12 GAA heroes , as being "riddled with arthritis ". County team doctor Austin O'Kennedy regarded it as being one of the worst knees he had ever seen. Molloy had surgery on "seven or eight" occasions, before having his knee replaced at
1749-412: The joint can occur. In some situations, manipulation of the knee under anesthetic is used to reduce post operative stiffness. There are also many implants from manufacturers that are designed to be "high-flex" knees, offering a greater range of motion. In some patients, the kneecap dislocates to the outer side of the knee after surgery. This is painful and usually needs to be treated by surgery to realign
1802-1116: The knee has a good range of movement, and is stable and aligned. In some cases the articular surface of the patella also is removed and replaced by a polyethylene button cemented to the posterior surface of the patella. In other cases, the patella is replaced unaltered. In recent years, there has been an increase in technology assistance with implantation of total knee replacements. Traditionally, knee replacements were performed using mechanical jigs, not unlike those used in carpentry. These mechanical jigs rely on vision and human judgment. Using computer assistance to provide navigation, navigated knee replacements provide assistance in more accurate placement of implanted knee replacements based on mechanical axis. While these implants are placed more accurately, there has not been much improvement in long-term outcomes. Similarly, sensor-based guidance provides accurate feedback to demonstrate soft-tissue tension to assist in guidance of insertion of knee replacements. Robotic-assisted knee replacements take into account both mechanical axis and soft-tissue balancing in order to assist
1855-420: The knee. The operation typically involves substantial postoperative pain and includes vigorous physical rehabilitation. The recovery period may be 12 weeks or longer and may involve the use of mobility aids (e.g. walking frames, canes, crutches) to enable the patient's return to preoperative mobility. It is estimated that approximately 82% of total knee replacements will last 25 years. Knee replacement surgery
1908-465: The kneecap. However, this is quite rare. Loosening of the prosthesis can be indicated on X-ray by thin radiolucent spaces around the implant, or more obviously by implant displacement. The current classification of AAOS divides prosthetic infections into four types. While it is relatively rare, periprosthetic infection remains one of the most challenging complications of joint arthroplasty. A detailed clinical history and physical examination remain
1961-469: The long axis of the bones. The cartilages and the anterior cruciate ligament are removed; the posterior cruciate ligament also may be removed but the tibial and fibular collateral ligaments are preserved. Whether the posterior cruciate ligament is removed or preserved depends on the type of implant used, although there appears to be no clear difference in knee function or range of motion favoring either approach. Metal components are then impacted onto
2014-588: The medial, and may be candidates for unicompartmental knee replacement. Advantages of UKA compared to TKA include smaller incision, easier post-op rehabilitation, better postoperative range of motion, shorter hospital stay, less blood loss, lower risk of infection, stiffness, and blood clots , but a harder revision if necessary. Persons with infectious or inflammatory arthritis ( rheumatoid arthritis , lupus , psoriasis ), or marked deformity are not candidates for this procedure. Many studies demonstrate higher revision rates associated with partial knee replacements. There
2067-457: The message he gave us. We're still trying to live by those words now; in every game we play we're living in the present, trying to grab the chance. Molloy didn't beat around the bush when he came in. He warned us that there was no point in us living with the false hope that it would all be quiet, but that we needed to be ourselves. His big message was about seizing the opportunity and how they thought after '92 that they'd win more". When Donegal won
2120-550: The most reliable tool to recognize a potential periprosthetic infection. In some cases the classic signs of fever, chills, painful joint, and a draining sinus may be present, and diagnostic studies are simply done to confirm the diagnosis. In reality though, most patients do not present with those clinical signs, and in fact the clinical presentation may overlap with other complications such as aseptic loosening and pain. In those cases diagnostic tests can be useful in confirming or excluding infection. Modern diagnosis of infection around
2173-417: The natural shape of the joint. On the tibia the component is flat, although it sometimes has a stem that goes down inside the bone for further stability. A flattened or slightly dished high-density polyethylene surface is then inserted onto the tibial component so the weight is transferred metal to plastic, not metal to metal. During the operation any deformities must be corrected, and the ligaments balanced so
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2226-567: The polyethylene within the tibial component. Other component designs have the polyethylene member fixed to the tibial component, and only articulate at the femur/polyethylene junction. There is no strong evidence that this approach improves knee function, mortality, adverse events, or amount of pain, compared with a fixed bearing approach for total knee replacement. Mobile bearing designs are important to ensuring decreased wear rates in hinged knee arthroplasty. Minimally invasive procedures have been developed in total knee replacement that do not cut
2279-410: The risk for instability or nerve injury. Some benefits in femoral nerve blocks are a reduction in morphine consumption and a decrease in pain intensity. A combined approach of local infiltration analgesia and femoral nerve block to achieve multimodal analgesia is common. Introduced in 2018, a modified intervastus approach to the anterior knee may be used for total knee arthroplasty. The procedure
2332-516: The same name. If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Anthony_Molloy&oldid=1139321777 " Category : Human name disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Anthony Molloy (Gaelic footballer) Anthony Molloy (born 28 May 1962)
2385-641: The size of components which will be needed. Medications such as warfarin and aspirin will be stopped some days before surgery to reduce the amount of bleeding. Patients may be admitted on the day of surgery if the pre-op work-up is done in the pre- anesthetic clinic or may come into hospital one or more days before surgery. As of 2017, there was insufficient quality evidence to support the use of pre-operative physiotherapy in older adults undergoing total knee arthroplasty. However, as of 2022, there has been renewed interest in improving patient outcomes and "prehab" has become standard practice. Preoperative education
2438-419: The surgeon in placement of a knee replacement. Short-term outcomes of robotic-assisted knee replacements are promising. The regional analgesia techniques (neuraxial anesthesia or continuous femoral nerve block or adductor canal block) are used most commonly. Local anesthesia infiltration in the pericapsular area using liposomal bupivacaine provides good analgesia in the post-operative period without increasing
2491-416: The surgery is performed, pre-operative tests are done: usually a complete blood count , electrolytes , APTT and PT to measure blood clotting , chest X-rays , ECG , and blood cross-matching for possible transfusion . About a month before the surgery, the patient may be prescribed supplemental iron to boost the hemoglobin in their blood system. Accurate X-rays of the affected knee are needed to measure
2544-440: The surgery may be more complicated and carry higher risk. Osteoporosis does not typically cause knee pain, deformity, or inflammation, and is not a reason to perform knee replacement. Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of
2597-558: The tibia that is seen during normal ambulation. While several studies have shown improved gait profiles, long-term studies are needed to demonstrate improved results. Conversely, the BCR knee retains the Anterior and posterior cruciate ligaments to try to mimic the normal tension of the knee's ligaments. Concerns over increased revision frequency have led to some designs being pulled from the market. A mobile bearing design allows for free motion of
2650-449: The tibia, reducing shear stress , increasing flexion and lever arm of the extensor mechanism by inducing femoral rollback upon flexion, and thus minimizing polyethylene abrasion through reducing stress applied to the articular surface. The PS implant uses a post that is built into the implant to accommodate for the loss of PCL. Proponents of retaining the PCL advise that it is difficult to balance
2703-434: The zone can be specified as "A" (anterior), "P" (posterior), "M" (medial) or "L" (lateral): Risks and complications in knee replacement are similar to those associated with all joint replacements . The most serious complication is infection of the joint, which occurs in <1% of patients. Risk factors for infection are related to both patient and surgical factors. Deep vein thrombosis occurs in up to 15% of patients, and
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#17329048134702756-627: Was managing his local club in 2007. He has also been assistant manager. Molloy has also managed the Naomh Columba club. Immediately following Donegal's All-Ireland semi-final victory over Cork in 2012 , manager Jim McGuinness had Molloy deliver a message to the players beneath the Hogan Stand in Croke Park. Captain Michael Murphy later described it: "'Seize the opportunity' was pretty much
2809-444: Was one of six nominees for the position of vice-chairman of the Donegal County Board executive. He was critical of the selection process used to decide the new Donegal senior manager in 2017. Molloy has spoken publicly of his struggles with alcoholism. He presented the documentary Deoch an Dorais ( Name Your Poison ), aired on TG4 on 28 December 2015. He has been involved in insurance, property, sales and with pubs. He stood for
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