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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/28215968/unicompartmental-knee-arthroplasty-vs-total-knee-arthroplasty-for-medial-compartment-arthritis-in-patients-older-than-75-years-comparable-reoperation-revision-and-complication-rates
#1
Homayoun Siman, Atul F Kamath, Nazly Carrillo, William S Harmsen, Mark W Pagnano, Rafael J Sierra
BACKGROUND: Prior studies comparing unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) in the elderly are limited by heterogeneity in arthritic disease patterns and patient selection. We report the results of UKA and TKA in patients 75 years and older with isolated medial compartmental arthritis, with special emphasis on immediate postoperative recovery, complications, reoperation rates, and implant survivorship at midterm follow-up. METHODS: A retrospective review was performed of all patients 75 years and older who underwent UKA or TKA at our institution between 2002 and 2012...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28211301/early-results-of-patellofemoral-inlay-resurfacing-arthroplasty-using-the-hemicap-wave-prosthesis
#2
Akash Patel, Zakir Haider, Amarjit Anand, Dominic Spicer
BACKGROUND: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28209277/revision-arthroplasty-for-the-management-of-stiffness-after-primary-tka
#3
Joaquin Moya-Angeler, Marcel A Bas, H John Cooper, Matthew S Hepinstall, Jose A Rodriguez, Giles R Scuderi
BACKGROUND: The aim of this study was to evaluate the results of revision surgery for the treatment of stiffness after total knee arthroplasty (TKA). METHODS: An IRB-approved retrospective review was performed to identify patients who were revised due to stiffness after a primary TKA. Patients were included when at least one major component had to be revised due to stiffness after primary TKA with a minimum follow-up of 2 years. Patients with history of previous infection and those treated with isolated polyethylene exchange were excluded...
January 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209274/long-term-durability-of-ceramic-tri-condylar-knee-implants-a-minimum-15-year-follow-up
#4
Shinichiro Nakamura, Hiromu Ito, Kenji Nakamura, Shinichi Kuriyama, Moritoshi Furu, Shuichi Matsuda
BACKGROUND: Ceramic bearings are not commonly used in total knee arthroplasty (TKA). So far, little information is available about whether long-term survivorship and good clinical outcomes can be ensured with ceramic knee implants. The purposes of the present study were to evaluate the clinical and radiological outcomes, and to assess the long-term durability of a ceramic tri-condylar implant. METHODS: A total of 507 consecutive TKAs were carried out using a ceramic tri-condylar femoral implant...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209273/venous-thromboembolic-disease-in-revision-vs-primary-total-knee-arthroplasty
#5
Matthew R Boylan, Dean C Perfetti, Bhaveen H Kapadia, Ronald E Delanois, Carl B Paulino, Michael A Mont
BACKGROUND: Venous thromboembolic disease (VTED) is a serious complication of primary and revision total knee arthroplasty (TKA). However, the incidence and risk of VTED for revision compared with primary TKA cases have not been well-described. METHODS: We identified 225,584 TKAs (208,954 primaries, 16,630 revisions) in the 2003-2012 Statewide Planning and Research Cooperative System database. Odds ratios (ORs) expressed the risk of VTED for revision vs primary TKA, and models were adjusted for age, gender, race, and Charlson comorbidity scores...
January 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28209272/midterm-clinical-and-radiographic-results-of-mobile-bearing-revision-total-knee-arthroplasty
#6
Raymond H Kim, J Ryan Martin, Douglas A Dennis, Charlie C Yang, Jason M Jennings, Gwo-Chin Lee
BACKGROUND: Constrained implants are frequently required in revision total knee arthroplasty (TKA) and are associated with an increase in aseptic component loosening and damage or wear to the constraining mechanisms, compared with primary TKA. The purpose of the following study was to evaluate the midterm clinical and radiographic results including the incidence of bearing complications in a group of patients undergoing revision TKA using mobile-bearing revision TKA implants. METHODS: We retrospectively reviewed 316 consecutive mobile-bearing revision TKAs performed at 2 centers between 2006 and 2010...
January 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202207/catastrophic-varus-collapse-of-the-tibia-in-obese-total-knee-arthroplasty
#7
Thomas K Fehring, Keith A Fehring, Lucas A Anderson, Jesse E Otero, Bryan D Springer
BACKGROUND: Mechanical complications have been underemphasized in reports on total knee arthroplasty (TKA) in obese patients. Noticing an increased prevalence of varus collapse of the tibia in obese total knee patients, we sought to determine if variability in proximal tibial cancellous bone strength played a role in failure. We attempted to define a cancellous threshold above which alternative methods of fixation should be used. METHODS: One thousand one hundred six revision TKAs from 2004-2014 identified 35 patients with varus collapse of the tibia, defined as a change in component position of >10°...
January 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196619/development-and-verification-of-novel-porous-titanium-metaphyseal-cones-for-revision-total-knee-arthroplasty
#8
Ahmad Faizan, Manoshi Bhowmik-Stoker, Amanda E Kirk, Viktor E Krebs, Steven F Harwin, R Michael Meneghini
BACKGROUND: Porous metaphyseal cones are widely used in revision knee arthroplasty. A new system of porous titanium metaphyseal cones has been designed based on the femoral and tibial morphology derived from a computed tomography-based anatomical database. The purpose of this study is to evaluate the initial mechanical stability of the new porous titanium revision cone system by measuring the micromotion under physiologic loading compared with a widely-used existing porous tantalum metaphyseal cone system...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28196393/does-manipulation-under-anesthesia-increase-the-risk-of-revision-total-knee-arthroplasty-a-matched-case-control-study
#9
Todd P Pierce, Kimona Issa, Anthony Festa, Anthony J Scillia, Vincent K McInerney, Michael A Mont
Manipulation under anesthesia (MUA) can help patients regain an adequate range of motion (ROM) following total knee arthroplasty (TKA). Although there are studies reporting that MUA can assist in improving ROM, there is a paucity of studies regarding whether requiring an MUA is associated with an increased risk of revision. The purpose of this study was to assess the: (1) incidence of revision TKA and (2) outcomes of those undergoing MUA and compare it with a matched cohort who did not require MUA. A prospectively collected database of two high-volume institutions was assessed for patients who required a single MUA following TKA between 2005 and 2011...
February 14, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28196034/long-term-results-after-total-knee-arthroplasty-with-contemporary-rotating-hinge-prostheses
#10
Umberto Cottino, Matthew P Abdel, Kevin I Perry, Kristin C Mara, David G Lewallen, Arlen D Hanssen
BACKGROUND: Total knee arthroplasty (TKA) with a rotating-hinge prosthesis is considered a salvage procedure. While excellent immediate stability is achieved, the historically high failure rate has tempered its use. The goal of this study was to determine clinical outcomes, radiographic results, and survivorship after TKA with contemporary rotating-hinge components. METHODS: We identified 408 consecutive TKAs performed with rotating-hinge components for nononcologic indications from 2002 to 2012 at a single academic institution...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28196029/twelve-year-outcomes-of-an-oxinium-total-knee-replacement-compared-with-the-same-cobalt-chromium-design-an-analysis-of-17-577-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#11
Christopher J Vertullo, Peter L Lewis, Stephen Graves, Lan Kelly, Michelle Lorimer, Peter Myers
BACKGROUND: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#12
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28185777/survivorship-and-patient-satisfaction-of-robotic-assisted-medial-unicompartmental-knee-arthroplasty-at-a-minimum-two-year-follow-up
#13
Andrew D Pearle, Jelle P van der List, Lily Lee, Thomas M Coon, Todd A Borus, Martin W Roche
BACKGROUND: Successful clinical outcomes following unicompartmental knee arthroplasty (UKA) depend on lower limb alignment, soft tissue balance and component positioning, which can be difficult to control using manual instrumentation. Although robotic-assisted surgery more reliably controls these surgical factors, studies assessing outcomes of robotic-assisted UKA are lacking. Therefore, a prospective multicenter study was performed to assess outcomes of robotic-assisted UKA. METHODS: A total of 1007 consecutive patients (1135 knees) underwent robotic-assisted medial UKA surgery from six surgeons at separate institutions between March 2009 and December 2011...
February 6, 2017: Knee
https://www.readbyqxmd.com/read/28185755/the-james-a-rand-young-investigator-s-award-administrative-claims-vs-surgical-registry-capturing-outcomes-in-total-joint-arthroplasty
#14
Joseph T Patterson, David Sing, Erik N Hansen, Bobby Tay, Alan Zhang
BACKGROUND: Administrative claims in total joint arthroplasty are used for observational studies and payment adjustments under the Comprehensive Care for Joint Replacement (CJR) legislation. Claims data have not been validated against prospective surgical outcome registries for primary total hip (THA) or knee arthroplasty (TKA). We hypothesized that significant differences in reported comorbidity and adverse event measures exist between administrative claims and prospective registry data relevant to payment adjudication under the CJR reimbursement model...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28185754/does-residual-varus-alignment-cause-increasing-varus-laxity-at-a-minimum-of-five-years-after-total-knee-arthroplasty
#15
Kazuhisa Hatayama, Masanori Terauchi, Kenichi Saito, Hiroshi Higuchi
BACKGROUND: The purpose of this study is to investigate whether varus-valgus laxity of cruciate-retaining (CR) total knee arthroplasty (TKA) changes between 1 year and >5 years after surgery based on postoperative limb alignment. METHODS: One hundred twenty-one varus osteoarthritic knees that underwent CR TKA were included. The minimum follow-up was 5 years. Weight-bearing full-leg radiographs were obtained postoperatively and the hip-knee-ankle (HKA) angle was measured...
January 17, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167881/poor-prognosis-of-patients-treated-for-periprosthetic-joint-infection
#16
REVIEW
Cynthia A Kahlenberg, Alexia Hernandez-Soria, Michael B Cross
The study by Gomez et al., "The Fate of Spacers in the Treatment of Periprosthetic Joint Infection," evaluates the clinical course and success rate of treatment of periprosthetic joint infection with two-stage revision with spacer placement in the interim period. The current review critically analyzes the findings of this study and examines how these findings may influence patient care in the field of hip and knee replacement. Gomez et al. report sobering results of two-stage revision with spacer placement for periprosthetic joint infection...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#17
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167876/comparison-of-revision-rates-of-non-modular-constrained-versus-posterior-stabilized-total-knee-arthroplasty-a-propensity-score-matched-cohort-study
#18
Mohamed E Moussa, Yuo-Yu Lee, Geoffrey H Westrich, Nabil Mehta, Stephen Lyman, Robert G Marx
BACKGROUND: Attaining stability during total knee arthroplasty (TKA) is essential for a successful outcome. Although traditional constrained total knee prostheses have generally been used in conjunction with intramedullary stems, some devices have been widely used without the use of stems, referred to as non-modular constrained condylar total knee arthroplasty (NMCCK). QUESTIONS/PURPOSES: The aim of this study was to compare revisions rates after total knee replacement with a non-modular constrained condylar total knee (NMCCK) compared to a posterior-stabilized (PS) design...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167871/clinical-results-of-oxidized-zirconium-femoral-component-in-tka-a-review-of-long-term-survival-review-article
#19
REVIEW
Roberto Civinini, Fabrizio Matassi, Christian Carulli, Luigi Sirleo, Andrea Cozzi Lepri, Massimo Innocenti
BACKGROUND: Oxidized zirconium (OxZr) femoral component for total knee arthroplasty (TKA) have been introduced in an attempt to reduce polyethylene wear and secondary osteolysis and improve longevity of implants. QUESTIONS/PURPOSES: We reviewed clinical studies in literature evaluating OxZr femoral component for TKA. The aim of this review was to evaluate the clinical outcome and survival rate of TKA with an OxZr femoral component. METHODS: A review of the existing literature was undertaken to collect data on the OxZr femoral component in order to provide a better understanding of its performance...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167870/the-survival-of-total-knee-arthroplasty-current-data-from-registries-on-tribology-review-article
#20
REVIEW
Roberto Civinini, Christian Carulli, Fabrizio Matassi, Andrea Cozzi Lepri, Luigi Sirleo, Massimo Innocenti
BACKGROUND: Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty. QUESTIONS/PURPOSES: We performed a review of national joint registries trying to answer the following questions: "Which is the main factor directly related to revisions rate in TKA?" and "Are there new bearing options better than conventional ones?" METHODS: A review was performed of all published annual reports of National Joint Registers, as well as of the literature...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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