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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/29776853/outcomes-of-a-fixed-bearing-medial-cemented-unicondylar-knee-arthroplasty-design-survival-analysis-and-functional-score-of-460-cases
#1
Philip Winnock de Grave, Justine Barbier, Thomas Luyckx, Alexander Ryckaert, Paul Gunst, Luc Van den Daelen
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant. METHODS: Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system...
April 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29776814/metallosis-in-cemented-titanium-alloy-total-knee-arthroplasty-without-apparent-metal-on-metal-articulation
#2
James Ho, John Mahajan, Martin Taylor, Ashlyn Byers, Paul Arauz, Young-Min Kwon
BACKGROUND: Metallosis is an uncommon phenomenon observed in late failures of cemented total knee arthroplasty (TKA), and it is rarely seen in the absence of metal-on-metal articulation. METHODS: We report the case of a TKA patient with cemented titanium-alloy components and a polyethylene patella that was revised for early loosening with intra-operative severe metallosis. RESULTS: We found that loosening and severe metallosis were associated with methacrylate particle abrasion on titanium alloy surfaces...
May 16, 2018: Knee
https://www.readbyqxmd.com/read/29773404/large-tibial-geode-which-developed-several-years-after-a-left-medial-oxford-unicondylar-knee-arthroplasty-treated-with-curettage-and-bone-grafting
#3
Matthew K Curran, James R Murray
BACKGROUND: Tibial geodes are rare, and usually reported in association with rheumatoid arthritis. This case study reported the rare occurrence of a tibial geode in association with a left unicondylar knee arthroplasty (UKA). The patient, a 55-year-old male, was initially pleased with his UKA, which was performed at another institution. However, just over one year after the operation he began experiencing pain and discomfort. He did not present to the current institution until he was six years after UKA...
May 14, 2018: Knee
https://www.readbyqxmd.com/read/29773277/-thicker-polyethylene-bearings-are-not-associated-with-higher-failure-rates-in-primary-total-knee-arthroplasty
#4
Nicholas J Greco, David A Crawford, Keith R Berend, Joanne B Adams, Adolph V Lombardi
BACKGROUND: Despite improvements in polyethylene bearing surface properties, only 1 previous study has examined the results of larger thickness bearings. The purpose of this study was to determine whether polyethylene thickness influenced patient outcomes and implant survival following modular total knee arthroplasty. METHODS: A retrospective review was performed of patients undergoing primary total knee arthroplasty from 2003 to 2014 in a single practice database...
April 23, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29770589/short-term-follow-up-of-antibiotic-loaded-articulating-cement-spacers-in-two-stage-revision-of-infected-total-knee-arthroplasty-a-case-series
#5
Meng-Qiang Tian, Xian-Teng Yang, Xiao-Bin Tian, Yun-Bo Sun, Yuan-Hui Duan, Li Sun
OBJECTIVE: Infection of total knee arthroplasty (TKA) is a rare but devastating complication. Two-stage revision is an effective treatment for late infected TKA. This study aimed to assess the short-term results of two-stage revision using articulating antibiotic-loaded spacers. METHODS: Twenty-five patients (10 men and 15 women) were diagnosed with late infections after TKA and treated with two-stage revision from April 2006 to August 2010; 19 of these patients had TKA for osteoarthritis and 6 for rheumatoid arthritis...
May 17, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29762282/uncemented-tantalum-monoblock-tibial-fixation-for-total-knee-arthroplasty-in-patients-less-than-60-years-of-age-mean-10-year-follow-up
#6
Christopher J DeFrancesco, José A Canseco, Charles L Nelson, Craig L Israelite, Atul F Kamath
BACKGROUND: Although tibial component loosening has been considered a concern after total knee arthroplasty without cement, such implants have been used in younger patients because of the potential for ingrowth and preservation of bone stock. However, mid-term and long-term studies of modern uncemented implants are lacking. We previously reported promising prospective 5-year outcomes after using an uncemented porous tantalum tibial component in patients who underwent surgery before the age of 60 years...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29762280/long-term-outcomes-of-pedicled-gastrocnemius-flaps-in-total-knee-arthroplasty
#7
Matthew T Houdek, Eric R Wagner, Cody C Wyles, William S Harmsen, Arlen D Hanssen, Michael J Taunton, Steven L Moran
BACKGROUND: Deficient soft tissue following total knee arthroplasty (TKA) can jeopardize outcome. The gastrocnemius flap is an important means of providing coverage of a knee with deficient soft tissue. There is a paucity of long-term studies on the use of the gastrocnemius flap in the setting of TKA. The purpose of this study was to review the outcomes after the use of pedicled gastrocnemius flaps for coverage of a soft-tissue defect at the time of TKA. METHODS: Eighty-three patients in whom a gastrocnemius flap had been used to cover the site of a primary (n = 18) or revision (n = 65) TKA over a 25-year period were identified...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29754982/computed-tomography-techniques-help-understand-wear-patterns-in-retrieved-total-knee-arthroplasty
#8
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Lorenzo Dall'Ava, Paul Shearing, Michael T Hirschmann, Alister J Hart
BACKGROUND: Suboptimal total knee arthroplasty (TKA) position of both femoral and tibial components is thought to be linked with poor clinical outcomes, polyethylene wear and the "unexplained" painful knee arthroplasty. The aim of this study was to better understand the effect of implant orientation on knee implant performance. METHODS: We analyzed 30 retrieved contemporary TKA implants. Implant positioning measurements in the coronal plane were made prior to revision using a diagnostic algorithm, based on 3D computed tomography (CT) images...
April 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#9
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#10
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29725747/no-difference-in-mid-term-survival-and-clinical-outcome-between-patient-specific-and-conventional-instrumented-total-knee-arthroplasty-a-randomized-controlled-trial
#11
M G M Schotanus, B Boonen, W van Weegen, H Hoekstra, R van Drumpt, R Borghans, R Vos, L van Rhijn, N P Kort
PURPOSE: The purpose of this multicentre prospective randomized controlled trial was to compare the survival rate and clinical outcome in total knee arthroplasty (TKA) after MRI-based patient-specific instruments (PSI) and conventional instruments 5 years after initial surgery. METHODS: At a mean follow-up of 5.1 years (0.4), 163 patients (90.6%) with a mean age of 71.8 years (8.7) were analysed. A survival analysis with revision of the TKA as endpoint was performed...
May 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29715553/development-and-validation-of-baseline-perioperative-and-at-discharge-predictive-models-for-postsurgical-prosthetic-joint-infection
#12
María Dolores Del Toro, Cecilia Peñas, Ana Conde Albarracín, Julián Palomino, Francisco Brun, Santiago Sánchez, Jesús Rodríguez-Baño
OBJECTIVES: To develop and validate baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing arthroplasty. PATIENTS AND METHODS: A multicentre, prospective cohort study of patients undergoing hip and knee arthroplasty was performed. Patients were randomly assigned (2:1) to a derivation cohort (DC) or a validation cohort (VC). Multivariable predictive models of PJI were constructed at baseline (preoperative period), perioperative (adding perioperative variables), and at-discharge (adding wound state at-discharge)...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29715226/development-and-evaluation-of-a-preoperative-risk-calculator-for-periprosthetic-joint-infection-following-total-joint-arthroplasty
#13
Timothy L Tan, Mitchell G Maltenfort, Antonia F Chen, AliSina Shahi, Carlos A Higuera, Marcelo Siqueira, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk for periprosthetic joint infection (PJI) following total hip arthroplasty (THA) or total knee arthroplasty (TKA) is important for patient optimization and targeted prevention. The purpose of this study was to create a preoperative PJI risk calculator for assessing a patient's individual risk of developing (1) any PJI, (2) PJI caused by Staphylococcus aureus, and (3) PJI caused by antibiotic-resistant organisms. METHODS: A retrospective review was performed of 27,717 patients (12,086 TKAs and 31,167 THAs), including 1,035 with confirmed PJI, who were treated at a single institution from 2000 to 2014...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#14
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29706257/primary-total-knee-arthroplasty-in-patients-with-neuropathic-charcot-arthropathy-contemporary-results
#15
Meagan E Tibbo, Brian P Chalmers, Daniel J Berry, Mark W Pagnano, David G Lewallen, Matthew P Abdel
BACKGROUND: Total knee arthroplasty (TKA) for neuropathic (Charcot) arthropathy is technically challenging with higher complication rates than primary TKA for osteoarthritis. There is a paucity of data regarding outcomes of TKA in contemporary cohorts with modern implants, techniques, and indications. Our study aimed to determine the (1) survivorship of implants, (2) rates and types of complications, (3) clinical outcomes, and (4) radiographic outcomes in patients treated with primary TKA for Charcot arthropathy...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29705681/midlevel-constraint-without-stem-extensions-in-primary-total-knee-arthroplasty-provides-stability-without-compromising-fixation
#16
David A Crawford, Jesua I Law, Adolph V Lombardi, Keith R Berend
BACKGROUND: Many total knee arthroplasty (TKA) systems allow for so-called midlevel constraint (MLC) articular bearings that can be used with primary implants. The purpose of this study is to report the early outcomes with MLC bearings in primary TKA. MATERIALS/METHODS: From December 2005 to June 2015, minimum 2-year follow-up was available on 96 patients (103 TKA) who underwent primary TKA with an MLC bearing using the Vanguard Total Knee System. Outcomes included pain, Knee Society clinical and functional score, range of motion, and need for revision...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29705680/medial-mobile-bearing-unicompartmental-knee-arthroplasty-in-young-patients-aged-less-than-or-equal-to-50-years
#17
Nicholas J Greco, Adolph V Lombardi, Andrew J Price, Michael E Berend, Keith R Berend
BACKGROUND: Contemporary research has shown medial mobile-bearing unicompartmental knee arthroplasty to be an effective treatment in patients younger than 60 years; however, only one other study has specifically investigated unicompartmental arthroplasty outcomes in patients 50 years or younger. The purpose of this study was to determine the clinical outcomes and survivorship of medial mobile-bearing unicompartmental arthroplasty in this younger patient population. METHODS: A retrospective review of patients undergoing primary unicompartmental knee arthroplasty using the Oxford partial knee from 2003 to 2014 in a single practice database was performed...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29704508/does-psychological-health-influence-hospital-length-of-stay-following-total-knee-arthroplasty-a-systematic-review
#18
REVIEW
Marie K March, Alison R Harmer, Sarah Dennis
OBJECTIVE: To systematically review the literature to determine if pre-operative psychological health affected hospital length of stay among adults following primary unilateral total knee arthroplasty. DATA SOURCES: Systematic review. We searched six online databases for original research published until 31st December 2016 that investigated adults undergoing primary unilateral total knee arthroplasty. STUDY SELECTION: Studies were included that used any measure of pre-operative psychological health and reported length of stay, irrespective of study design...
April 25, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29703336/disease-burden-complication-rates-and-health-care-costs-of-heparin-induced-thrombocytopenia-in-the-usa-a-population-based-study
#19
Binod Dhakal, Lisa Baumann Kreuziger, Lisa Rein, Ariel Kleman, Raphael Fraser, Richard H Aster, Parameswaran Hari, Anand Padmanabhan
BACKGROUND: Heparin-induced thrombocytopenia can be a life-threatening and limb-threatening complication of heparin therapy. Incidence and complication rates of this condition have been extrapolated from studies with modest sample sizes, and despite the availability of therapeutic interventions the outcomes of heparin-induced thrombocytopenia are not well understood. We aimed to estimate disease burden, complication rates, and costs of heparin-induced thrombocytopenia in the USA. METHODS: In this population-based study we analysed data from 2009 to 2013 from the Nationwide (National) Inpatient Sample (NIS), a large, all-payer inpatient health-care database in the USA...
May 2018: Lancet Haematology
https://www.readbyqxmd.com/read/29695317/influence-of-joint-kinematics-on-polyethylene-wear-in-anatomic-shoulder-joint-arthroplasty
#20
Steffen Braun, Stefan Schroeder, Ulrike Mueller, Robert Sonntag, Matthias Buelhoff, Jan Philippe Kretzer
BACKGROUND: Despite the positive results in total shoulder arthroplasties (TSAs), a higher revision rate is documented compared with total hip and knee replacements. Wear is the possible main cause of TSA failure in the long-term. This study investigated the effect of joint kinematics and the influence of the rotator cuff on the polyethylene wear performance in an anatomic TSA. METHODS: Lifting a load of 2 kg with an abduction/adduction of 0° to 90° was simulated for 2 × 106 cycles as a primary motion using a fully kinematic joint simulator...
April 23, 2018: Journal of Shoulder and Elbow Surgery
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