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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#1
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28077394/metal-backed-versus-all-polyethylene-unicompartmental-knee-arthroplasty-proximal-tibial-strain-in-an-experimentally-validated-finite-element-model
#2
C E H Scott, M J Eaton, R W Nutton, F A Wade, S L Evans, P Pankaj
OBJECTIVES: Up to 40% of unicompartmental knee arthroplasty (UKA) revisions are performed for unexplained pain which may be caused by elevated proximal tibial bone strain. This study investigates the effect of tibial component metal backing and polyethylene thickness on bone strain in a cemented fixed-bearing medial UKA using a finite element model (FEM) validated experimentally by digital image correlation (DIC) and acoustic emission (AE). MATERIALS AND METHODS: A total of ten composite tibias implanted with all-polyethylene (AP) and metal-backed (MB) tibial components were loaded to 2500 N...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#3
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#4
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28068306/revision-knee-arthroplasty-in-patients-with-inherited-bleeding-disorders-a-single-center-experience
#5
Andrzej Kotela, Magdalena Wilk-Frańczuk, Piotr Żbikowski, Paweł Łęgosz, Paweł Ambroziak, Ireneusz Kotela
BACKGROUND The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD. MATERIAL AND METHODS A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed...
January 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28065944/evaluating-the-effect-of-obesity-on-total-knee-arthroplasty-a-longitudinal-study
#6
You-Bo Ji, Chen-Yu Wang, Xiao-Nan Wang, Hui Jin
OBJECTIVE: To evaluate the effect of obesity on total knee arthroplasty, and on patient-reported outcomes. METHODS: The longitudinal study was conducted from September 2013 to August 2015 at The Second Hospital of Jinlin University, Changchun, Jinlin, China, a tertiary hospital. Using universal sampling method, all patients who underwent elective total knee arthroplasty were included in the study. Data was collected using a semi-structured questionnaire, Oxford Knee Score, and Short Form 12 Questionnaire...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28065627/revision-total-hip-and-knee-arthroplasties-after-solid-organ-transplant
#7
Cameron K Ledford, Joseph M Statz, Brian P Chalmers, Kevin I Perry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: As solid organ transplant (SOT) patients' survival improves, the number undergoing total hip (THA) and total knee arthroplasty (TKA) is increasing. Accordingly, the number of revision procedures in this higher-risk group is also increasing. The goals of this study were to identify the most common failure mechanisms, associated complications, clinical outcomes, and patient survivorship of SOT patients after revision THA or TKA. METHODS: A retrospective review identified 39 revision procedures (30 revision THAs and 9 revision TKAs) completed in 37 SOT patients between 2000 and 2013...
December 11, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28060239/a-risk-factor-out-of-control-commentary-on-an-article-by-alon-ben-ari-md-et-al-preoperative-opioid-use-is-associated-with-early-revision-after-total-knee-arthroplasty-a-study-of-male-patients-treated-in-the-veterans-affairs-system
#8
https://www.readbyqxmd.com/read/28060227/preoperative-opioid-use-is-associated-with-early-revision-after-total-knee-arthroplasty-a-study-of-male-patients-treated-in-the-veterans-affairs-system
#9
Alon Ben-Ari, Howard Chansky, Irene Rozet
BACKGROUND: Opioid use is endemic in the U.S. and is associated with morbidity and mortality. The impact of long-term opioid use on joint-replacement outcomes remains unknown. We tested the hypothesis that use of opioids is associated with adverse outcomes after total knee arthroplasty (TKA). METHODS: We performed a retrospective analysis of patients who had had TKA within the U.S. Veterans Affairs (VA) system over a 6-year period and had been followed for 1 year postoperatively...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28056570/different-incidences-of-knee-arthroplasty-in-the-nordic-countries
#10
Mika J NiemeläInen, Keijo T MäKelä, Otto Robertsson, Annette W-Dahl, Ove Furnes, Anne M Fenstad, Alma B Pedersen, Henrik M Schrøder, Heini Huhtala, Antti Eskelinen
Background and purpose - The annual number of total knee arthroplasties (TKAs) has increased worldwide in recent years. To make projections regarding future needs for primaries and revisions, additional knowledge is important. We analyzed and compared the incidences among 4 Nordic countries Patients and methods - Using Nordic Arthroplasty Register Association (NARA) data from 4 countries, we analyzed differences between age and sex groups. We included patients over 30 years of age who were operated with TKA or unicompartmental knee arthroplasty (UKA) during the period 1997-2012...
January 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28056527/osteochondral-allograft-transplantation-of-the-knee
#11
Rachel M Frank, Simon Lee, David Levy, Sarah Poland, Maggie Smith, Nina Scalise, Gregory L Cvetanovich, Brian J Cole
BACKGROUND: Osteochondral allograft transplantation (OAT) is being performed with increasing frequency, and the need for reoperations is not uncommon. PURPOSE: To quantify survival for OAT and report findings at reoperations. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A review of prospectively collected data of 224 consecutive patients who underwent OAT by a single surgeon with a minimum follow-up of 2 years was conducted...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28053250/the-painful-total-ankle-arthroplasty-a-diagnostic-and-treatment-algorithm
#12
REVIEW
E Vulcano, M S Myerson
The last decade has seen a considerable increase in the use of in total ankle arthroplasty (TAA) to treat patients with end-stage arthritis of the knee. However, the longevity of the implants is still far from that of total knee and hip arthroplasties. The aim of this review is to outline a diagnostic and treatment algorithm for the painful TAA to be used when considering revision surgery. Cite this article: Bone Joint J 2017;99-B:5-11.
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28042121/conversion-of-a-unicompartmental-knee-arthroplasty-to-a-total-knee-arthroplasty-can-we-achieve-a-primary-result
#13
E Thienpont
OBJECTIVES: Unicompartmental knee arthroplasty (UKA) is a potential treatment for isolated bone on bone osteoarthritis when limited to a single compartment. The risk for revision of UKA is three times higher than for total knee arthroplasty (TKA). The aim of this review was to discuss the different revision options after UKA failure. MATERIALS AND METHODS: A search was performed for English language articles published between 2006 and 2016. After reviewing titles and abstracts, 105 papers were selected for further analysis...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28032700/management-of-acute-hematogenous-infection-following-total-knee-arthroplasty-a-case-series-of-11-patients
#14
Rui He, Liu Yang, Lin Guo, Hao Chen, Ying Zhang, Dian-Ming Jiang
OBJECTIVE: Acute hematogenous infection is a devastating complication that can occur after total knee arthroplasty (TKA). The best strategies for management of this infection remain controversial. Two-stage revision has been well described as the gold standard for the management of chronic late infections. However, there is a paucity of information presently available on the management and outcomes of patients treated for acute hematogenous infections. The purpose of the present study was to report the outcome of acute hematogenous infections following TKA with the treatment of irrigation, debridement, and retention of the prosthetic components...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28032123/ten-year-patient-reported-outcomes-following-total-and-minimally-invasive-unicompartmental-knee-arthroplasty-a-propensity-score-matched-cohort-analysis
#15
Edward Burn, Maria T Sanchez-Santos, Hemant G Pandit, Thomas W Hamilton, Alexander D Liddle, David W Murray, Rafael Pinedo-Villanueva
PURPOSE: For patients with medial compartment arthritis who have failed non-operative treatment, either a total knee arthroplasty (TKA) or a unicompartmental knee arthroplasty (UKA) can be undertaken. This analysis considers how the choice between UKA and TKA affects long-term patient-reported outcome measures (PROMs). METHODS: The Knee Arthroplasty Trial (KAT) and a cohort of patients who received a minimally invasive UKA provided data. Propensity score matching was used to identify comparable patients...
December 29, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28029578/stemmed-tibial-revision-component-alignment-does-an-anatomic-conflict-exist
#16
Kevin M Smith, Andrew Moorman, Sabir K Ismaily, Stephen J Incavo
INTRODUCTION: Obtaining satisfactory coronal plane alignment is important for success in revision total knee arthroplasty (TKA). The study objective was to determine tibial coronal plane alignment after TKA when a tibial stem was used and assess if there was an anatomic conflict in tibial stemmed component alignment. MATERIALS AND METHODS: A radiographic review of 88 revision TKA cases was performed. Full length leg radiographs were examined for varus/valgus alignment, defined as greater than or equal to three degrees from neutral 180 degrees, canal or non-canal filling tibial stems, and any native tibial bow...
October 29, 2016: Knee
https://www.readbyqxmd.com/read/28028570/comparable-outcomes-after-total-knee-arthroplasty-in-patients-under-55%C3%A2-years-than-in-older-patients-a-matched-prospective-study-with-minimum-follow-up-of-10%C3%A2-years
#17
Alejandro Lizaur-Utrilla, Daniel Martinez-Mendez, Francisco A Miralles-Muñoz, Luis Marco-Gómez, Fernando A Lopez-Prats
PURPOSE: To compare outcomes after TKA for osteoarthritis between patients younger than 55 years and older patients. METHODS: A cohort of 61 patients aged 55 years or younger was prospectively matched for gender, body mass index and knee function with patients with median age of 66 (range 60-70) years. Clinical evaluation was performed by the Knee Society scores (KSS), reduced Western Ontario and McMasters Universities (WOMAC) and Short-Form 12 (SF12) questionnaires...
December 27, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28027814/outcome-of-total-hip-and-total-knee-revision-arthroplasty-with-minor-infection-criteria-a-retrospective-matched-pair-analysis
#18
Kevin Staats, Paul Kolbitsch, Irene K Sigmund, Gerhard M Hobusch, Johannes Holinka, Reinhard Windhager
BACKGROUND: Although diagnostic modalities for the detection of periprosthetic joint infection have improved, some infectious revision cases may still be diagnosed as aseptic complications. We raised the question whether patients with positive Musculoskeletal Infection Society minor infection criteria differ in their outcome parameters (revision-free survival, revision rate) when compared to patients with "true" aseptic complications. Additionally, we asked whether the indication for revision surgery (eg, loosening) might have an influence on possible outcome discrepancies...
November 19, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027386/paresis-of-the-peroneal-nerve-a-rare-but-severe-long-term-complication-of-polyethylene-wear-in-knee-arthroplasty
#19
Matthias Aurich, Mark Lenz, Norman Best
One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28026733/long-term-function-following-periprosthetic-fractures
#20
J Zwingmann, M Krieg, F Thielemann, N Südkamp, P Helwig
PURPOSE OF THE STUDY Clinical results of long-term follow-up after traumatic periprosthetic femur fractures and different therapies (ORIF vs. revision arthroplasty) MATERIAL AND METHODS The Visual Analog Scale (VAS), Harris-Hip-Score (HHS), Oxford-Hip-Score (OHS), Oxford-Knee-Score (OKS), Knee-Society-Score (KSS), SF-36 Questionnaire and Funktionsfragebogen Hannover (FFH) were used to evaluate outcome and functionality. Radiological examinations were performed and the Vancouver (THA) and Lewis and Rorabeck (TKA) classifications used...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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