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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/28924355/revision-total-knee-arthroplasty-using-the-modern-constrained-condylar-knee-prosthesis
#1
Naoki Nakano, Tomoyuki Matsumoto, Hirotsugu Muratsu, Kazunari Ishida, Ryosuke Kuroda, Masahiro Kurosaka
OBJECTIVE: To determine whether the second-generation constrained condylar prosthesis provided satisfactory results in revision total knee arthroplasty. METHODS: A series of 41 cases of revision total knee arthroplasty using the second-generation constrained condylar knee prosthesis was reviewed. The series comprised 7 men and 34 women with a mean age of 73.2 years. The original diagnosis was predominantly osteoarthritis. The most common reason for revision surgery was aseptic loosening...
November 2016: Acta Ortopedica Brasileira
https://www.readbyqxmd.com/read/28915156/a-risk-calculator-using-preoperative-opioids-for-prediction-of-total-knee-revision-arthroplasty
#2
Jordan Starr, Irene Rozet, Alon Ben-Ari
OBJECTIVES: Total knee arthroplasty (TKA) is a procedure to improve quality of life. However, some patients require early total knee revision (TKR). Chronic opioid use before TKA is associated with TKR. No risk calculator including opioid use or other risk factors is currently available for predicting TKR. MATERIALS AND METHODS: We retrospectively analyzed medical records of Veterans Affairs patients who underwent TKA from January 1, 2006 to January 1, 2012. Patients were followed until January 1, 2013...
September 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28913406/long-term-results-of-a-porous-tantalum-monoblock-tibia-component-clinical-and-radiographic-results-at-follow-up-of-10-years
#3
Daniel Gerscovich, Catherine Schwing, Anthony Unger
BACKGROUND: The purpose of this study is to assess the long-term follow-up of cementless total knee arthroplasty with the trabecular metal (TM) monoblock tibial component at an average 10-year follow-up. This report is an extension of our previously reported series of 108 TM tibias reported in 2011 (Unger and Duggan, 2011). METHODS: Fifty-eight of the original 108 knees were available for review. Each follow-up patient was evaluated by radiologic and clinical Knee Society Scores...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28913396/severe-heterotopic-ossification-and-stiffness-after-revision-knee-surgery-for-a-periprosthetic-fracture
#4
Maher Baroudi, Pascale Derome, Michel Malo
Although heterotopic ossification (HO) after total hip arthroplasty has been very well described as a cause of disability, much less was written on clinical dysfunction of HO after total knee arthroplasty (TKA). To the extent of our knowledge, there has been no published case of complete bony ankylosis, secondary to severe generalized HO, after a TKA. We present the case of a 67-year-old female treated successfully, with surgical excision of ossification and TKA revision surgery, using a rotating hinge system...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28910828/comparative-analysis-between-cone-and-sleeve-in-managing-severe-bone-defect-during-revision-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#5
Hyun Jung Kim, O-Sung Lee, Seung Hoon Lee, Yong Seuk Lee
No abstract text is available yet for this article.
September 14, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28902602/reestablishment-of-the-posterior-stability-after-the-posterior-cruciate-ligament-released-cruciate-retaining-total-knee-arthroplasty
#6
Yasushi Oshima, Joseph Fetto
PURPOSE: The cruciate retaining (CR) design was developed to obtain knee stability with the natural posterior cruciate ligament (PCL) in total knee arthroplasty (TKA). However, the preservation of the PCL can limit knee exposure and increase the technical challenge during the procedure. Knee exposure is easily achieved under the released PCL, and we hypothesized that the PCL naturally repairs after release, thus re-establishing the posterior stability. Accordingly, the objective of this study was to evaluate the varying of the posterior stability after the PCL-released CR TKA over time...
May 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28899593/radiographic-findings-in-patients-with-catastrophic-varus-collapse-after-total-knee-arthroplasty
#7
J Ryan Martin, Keith A Fehring, Chad D Watts, Bryan D Springer, Thomas K Fehring
BACKGROUND: Catastrophic varus collapse is an uncommon mechanism of failure in primary total knee arthroplasty (TKA). Varus collapse has been associated with obesity and smaller implant sizes. However, to our knowledge, preoperative radiographic characterization of this cohort has not been performed. Therefore, the following study evaluated preoperative alignment and how this correlates with the degree of eventual varus collapse identified in this patient population prior to revision...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28887020/narcotic-use-and-total-knee-arthroplasty
#8
Jourdan M Cancienne, Kishan J Patel, James A Browne, Brian C Werner
BACKGROUND: Although the United States is in the midst of a narcotic epidemic, risk factors for use and the impact of perioperative narcotic use on total knee arthroplasty (TKA) outcomes is ill-defined. METHODS: A national database was queried for patients who underwent primary TKA from 2007 to 2015. Patients taking narcotics in the preoperative, and for a prolonged period of time postoperatively, were identified. The risk factors for prolonged narcotic use were analyzed with a regression analysis, in addition to evaluating preoperative and prolonged postoperative use as independent risk factors for short-term and long-term complications...
August 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28886100/biomechanical-evaluation-of-tibial-bone-adaptation-after-revision-total-knee-arthroplasty-a-comparison-of-different-implant-systems
#9
María Paz Quilez, Belen Seral, María Angeles Pérez
The best methods to manage tibial bone defects following total knee arthroplasty remain under debate. Different fixation systems exist to help surgeons reconstruct knee osseous bone loss (such as tantalum cones, cement, modular metal augments, autografts, allografts and porous metaphyseal sleeves) However, the effects of the various solutions on the long-term outcome remain unknown. In the present work, a bone remodeling mathematical model was used to predict bone remodeling after total knee arthroplasty (TKA) revision...
2017: PloS One
https://www.readbyqxmd.com/read/28882962/prospective-analysis-of-a-sterile-semi-automated-tissue-biopsy-homogenization-method-in-the-diagnosis-of-prosthetic-joint-infections
#10
Christian Suren, Norbert Harrasser, Florian Pohlig, Ingo J Banke, Ulrich Lenze, Florian Lenze, Carolin Knebel, Rüdiger VON Eisenhart-Rothe, Johannes Schauwecker, Heinrich M L Mühlhofer
BACKGROUND/AIM: Prosthetic joint infection (PJI) remains a serious complication of total joint arthroplasty. To effectively treat PJI, it is essential to identify the microorganism causing it and be able to combine correct surgical and anti-infective treatments. This cannot always be achieved with the currently employed diagnostic methods. The aim of this study was to evaluate a semi-automated tissue biopsy bead milling method (Ultra-TurrAX, Axonlab AG; Reichenbach, Germany) based on the hypothesis that the results are more sensitive for microbe detection and less prone to contamination...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28869114/multidrug-resistant-organisms-in-the-setting-of-periprosthetic-joint-infection-diagnosis-prevention-and-treatment
#11
REVIEW
Matthew P Siljander, Ali H Sobh, Kevin C Baker, Erin A Baker, Lige M Kaplan
BACKGROUND: Periprosthetic joint infection (PJI) is a rare yet challenging problem in total hip and knee arthroplasties. The management of PJI remains difficult primarily due to the evolution of resistance by the infecting organisms. METHODS: This review profiles acquired mechanisms of bacterial resistance and summarizes established and emerging techniques in PJI diagnosis, prevention, and treatment. RESULTS: New techniques in PJI diagnosis and prevention continue to be explored...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28860397/diagnosis-of-prosthetic-joint-infection-with-alpha-defensin-using-a-lateral-flow-device-a-multicentre-study
#12
MULTICENTER STUDY
P Berger, M Van Cauter, R Driesen, J Neyt, O Cornu, J Bellemans
AIMS: The purpose of this current multicentre study is to analyse the presence of alpha-defensin proteins in synovial fluid using the Synovasure lateral flow device and to determine its diagnostic reliability and accuracy compared with the prosthetic joint infection (PJI) criteria produced by the Musculoskeletal Infection Society (MSIS). PATIENTS AND METHODS: A cohort of 121 patients comprising 85 total knee arthroplasties and 36 total hip arthroplasties was prospectively evaluated between May 2015 and June 2016 in three different orthopaedic centres...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28855192/the-effect-of-implant-position-on-bone-strain-following-lateral-unicompartmental-knee-arthroplasty-a-biomechanical-model-using-digital-image-correlation
#13
A M Ali, S D S Newman, P A Hooper, C M Davies, J P Cobb
OBJECTIVES: Unicompartmental knee arthroplasty (UKA) is a demanding procedure, with tibial component subsidence or pain from high tibial strain being potential causes of revision. The optimal position in terms of load transfer has not been documented for lateral UKA. Our aim was to determine the effect of tibial component position on proximal tibial strain. METHODS: A total of 16 composite tibias were implanted with an Oxford Domed Lateral Partial Knee implant using cutting guides to define tibial slope and resection depth...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28844630/do-porous-tantalum-metaphyseal-cones-improve-outcomes-in-revision-total-knee-arthroplasty
#14
Daniel D Bohl, Nicholas M Brown, Mitchell A McDowell, Brett R Levine, Scott M Sporer, Wayne G Paprosky, Craig J Della Valle
BACKGROUND: Some authors have advocated for use of porous tantalum metaphyseal cones to manage bone defects during revision total knee arthroplasty (TKA). The purpose of this study is to compare results with porous metaphyseal cones to results with traditional hybrid stem fixation in revision TKA. METHODS: Forty-nine patients undergoing revision TKA with femoral and/or tibial metaphyseal cones (39 tibial only, 3 femoral only, 7 both) were matched by surgical indication to 49 patients undergoing revision TKA with a traditional hybrid stem (non-cone) technique...
July 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28844628/revision-total-knee-arthroplasty-in-octogenarians-an-analysis-of-957-cases
#15
Patawut Bovonratwet, Vineet Tyagi, Taylor D Ottesen, Nathaniel T Ondeck, Lee E Rubin, Jonathan N Grauer
BACKGROUND: The number of octogenarians undergoing revision total knee arthroplasty (TKA) is increasing. However, there has been a lack of studies investigating the perioperative course and safety of revision TKA performed in this potentially vulnerable population in a large patient population. The purpose of this study is to compare complications following revision TKA between octogenarians and 2 younger patient populations (<70 and 70-79 year olds). METHODS: Patients who underwent revision TKA were identified in the 2005-2015 National Surgical Quality Improvement Program database and stratified into 3 age groups: <70, 70-79, and ≥80 years...
July 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28837689/type-2-diabetes-and-in-hospital-complications-after-revision-of-total-hip-and-knee-arthroplasty
#16
Ana López-de-Andrés, Valentín Hernández-Barrera, Maria A Martínez-Huedo, Manuel Villanueva-Martinez, Isabel Jiménez-Trujillo, Rodrigo Jiménez-García
PURPOSE: To assess the effect of type 2 diabetes (T2DM) on hospital outcomes such as in hospital postoperative complications (IHPC), length of hospital stay (LOHS) and in-hospital mortality (IHM) after the revision of total hip arthroplasty (RHA) and total knee arthroplasty (RKA) and to identify factors associated with IHPC among T2DM patients undergoing these procedures. METHODS: We performed a retrospective study using the Spanish National Hospital Discharge Database, 2005-2014...
2017: PloS One
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#17
Paul R T Kuzyk, Evan Watts, David Backstein
Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28831821/long-term-outcomes-of-over-8-000-medial-oxford-phase-3-unicompartmental-knees-a-systematic-review
#18
Hasan R Mohammad, Louise Strickland, Thomas W Hamilton, David W Murray
Background and purpose - There is debate as to the relative merits of unicompartmental and total knee arthroplasty (UKA, TKA). Although the designer surgeons have achieved good results with the Oxford UKA there is concern over the reproducibility of these outcomes. Therefore, we evaluated published long-term outcomes of the Oxford Phase 3 UKA. Patients and methods - We searched databases to identify studies reporting ≥10 year outcomes of the medial Oxford Phase 3 UKA. Revision, non-revision, and re-operation rates were calculated per 100 component years (% pa)...
August 23, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28822068/polyethylene-damage-increases-with-varus-implant-alignment-in-posterior-stabilized-and-constrained-condylar-knee-arthroplasty
#19
Zhichang Li, Christina I Esposito, Chelsea N Koch, Yuo-Yu Lee, Douglas E Padgett, Timothy M Wright
BACKGROUND: Implant malalignment in primary TKA has been reported to increase stresses placed on the bearing surfaces of implant components. We used a longitudinally maintained registry coupled with an implant retrieval program to consider whether preoperative, postoperative, or prerevision malalignment was associated with increased risk of revision surgery after TKA. QUESTIONS/PURPOSES: (1) What is the relative polyethylene damage on medial and lateral compartments of the tibial plateaus from revised TKAs? (2) Does coronal TKA alignment affect implant performance, such that TKAs aligned in varus are predisposed to experience increased polyethylene damage? (3) Does TKA alignment differ between postoperative and prerevision radiographs, and if so, what does this difference suggest about the mechanical contact load placed on a knee with a TKA? METHODS: Between 2007 and 2012, we performed 18,065 primary TKAs at our institution...
August 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#20
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
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