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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/27909124/predicting-dissatisfaction-following-total-knee-arthroplasty-in-patients-under-55-years-of-age
#1
C E H Scott, W M Oliver, D MacDonald, F A Wade, M Moran, S J Breusch
AIMS: Risk of revision following total knee arthroplasty (TKA) is higher in patients under 55 years, but little data are reported regarding non-revision outcomes. This study aims to identify predictors of dissatisfaction in these patients. PATIENTS AND METHODS: We prospectively assessed 177 TKAs (157 consecutive patients, 99 women, mean age 50 years; 17 to 54) from 2008 to 2013. Age, gender, implant, indication, body mass index (BMI), social deprivation, range of movement, Kellgren-Lawrence (KL) grade of osteoarthritis (OA) and prior knee surgery were recorded...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909123/comparative-study-of-computer-assisted-total-knee-arthroplasty-after-opening-wedge-osteotomy-versus-after-unicompartmental-arthroplasty
#2
R Pailhé, J Cognault, J Massfelder, A Sharma, R-C Rouchy, B Rubens-Duval, D Saragaglia
AIMS: The role of high tibial osteotomy (HTO) is being questioned by the use of unicompartmental knee arthroplasty (UKA) in the treatment of medial compartment femorotibial osteoarthritis. Our aim was to compare the outcomes of revision HTO or UKA to a total knee arthroplasty (TKA) using computer-assisted surgery in matched groups of patients. PATIENTS AND METHODS: We conducted a retrospective study to compare the clinical and radiological outcome of patients who underwent revision of a HTO to a TKA (group 1) with those who underwent revision of a medial UKA to a TKA (group 2)...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27904720/clinical-results-of-lateral-unicompartmental-knee-arthroplasty-minimum-2-year-follow-up
#3
Kyung Tae Kim, Song Lee, Jeehyoung Kim, Jin Woo Kim, Min Su Kang
BACKGROUND: We investigated the clinical results and early complications after lateral unicompartmental knee arthroplasty (UKA) using the Zimmer unicompartmental high-flex knee (ZUK) prosthesis with a minimum follow-up of 2 years. METHODS: Twenty-seven patients (30 cases) who underwent lateral UKA with the ZUK prosthesis between January 2011 and February 2014 were selected for this study. The mean age of the patients was 63.3 years at the time of surgery, and the mean followup was 3 years and 2 months (range, 24 to 48 months)...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904221/what-have-we-learned-from-100-success-of-press-fit-condylar-rotating-platform-posterior-stabilized-knees-a-5-10-years-followup-by-a-nondesigner
#4
Shrinand V Vaidya, Siddharth Virani, Rajendra Phunde, Abhishek Mahajan
BACKGROUND: Total joint arthroplasties of the hip and knee represent a remarkable feat of modern medicine in terms of reducing pain and restoring function to millions of patients afflicted with severe arthritis. Oftentimes, the performance and longevity of new implants and devices are based on limited data. This is the first study by a non-designer on the press fit condylar rotating platform posterior stabilized (PFC-RP-PS) design with 100' success. This has a relevance, vis-á -vis bias that one may have in terms of reproducibility of technique and funding from the manufacturer...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27901242/prevalence-of-knee-arthroplasty-in-the-state-of-s%C3%A3-o-paulo-between-2003-and-2010
#5
Rogério Teixeira de Carvalho, Jonny Chaves Lima Canté, Juliana Hoss Silva Lima, Luiz Alberto Barbosa Tavares, Marcelo Itiro Takano, Fernando Gomes Tavares
CONTEXT AND OBJECTIVE: The volume of knee arthroplasty procedures has increased over the last decade. The aim of this study was to estimate the frequency of these procedures performed within the public healthcare system of the state of São Paulo between 2003 and 2010. DESIGN AND SETTING: Cross-sectional study conducted in the state of São Paulo by researchers at Hospital do Servidor Público do Estado de São Paulo. METHODS: A sample of 10,952 patients (7,891 females and 3,061 males) who underwent primary total knee arthroplasty (TKA) and revision of total knee arthroplasty (RTKA) in the state of São Paulo between 2003 and 2010 was evaluated...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27898194/inflammatory-cell-induced-corrosion-in-total-knee-arthroplasty-a-retrieval-study
#6
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Anna Di Laura, John A Skinner, Alister J Hart
Metal release in patients with joint replacements is associated with local tissue reactions, pain, and ultimately revision of implants. One of the causes of this metal loss is speculated to be due to a mechanism of inflammatory cell-induced corrosion (ICIC). In this knee retrieval study, we aimed to: (1) identify the extent and location of ICI corrosion patterns on our femoral and tibial components and (2) correlate our findings with implant and clinical information. We investigated 28 femoral and 9 tibial components made of polished CoCr for presence of ICIC, using macroscopic and microscopic screening and statistical analyses to identify any significant correlations between our results and clinical information...
November 29, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27891054/patellofemoral-joint-arthroplasty-our-experience-in-isolated-patellofemoral-and-bicompartmental-arthritic-knees
#7
L Sabatini, M Schirò, F Atzori, G Ferrero, A Massè
INTRODUCTION: Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27890623/sirt1-protects-osteoblasts-against-particle-induced-inflammatory-responses-and-apoptosis-in-aseptic-prosthesis-loosening
#8
Zhantao Deng, Zhenheng Wang, Jiewen Jin, Yong Wang, Nirong Bao, Qian Gao, Jianning Zhao
: We hypothesized that SIRT1 downregulation in osteoblasts induced by wear particles was one of the reasons for particle-induced osteolysis (PIO) in total joint arthroplasty failure. In the present study, the expression of SIRT1 was examined in osteoblasts treated with TiAl6V4 particles (TiPs) and CoCrMo particles (CoPs) from materials used in prosthetics and specimens from PIO animal models. To address whether SIRT1 downregulation triggers inflammatory responses and apoptosis in osteoblasts, the effect of a SIRT1 activator, resveratrol on the expression of inflammatory cytokines and apoptosis in particle-treated osteoblasts was tested...
November 23, 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27889526/strain-shielding-in-trabecular-bone-at-the-tibial-cement-bone-interface
#9
Priyanka Srinivasan, Mark A Miller, Nico Verdonschot, Kenneth A Mann, Dennis Janssen
Aseptic loosening of the tibial component remains the leading cause for revision surgery in total knee arthroplasty (TKA). Understanding the mechanisms leading to loss of fixation can offer insight into preventative measures to ensure a longer survival rate. In cemented TKA, loosening occurs at the cement-trabecular interface probably due to a stress-shielding effect of the stiffer implant material in comparison with bone. Using finite element models of lab-prepared tibial cement-trabeculae interface specimens (n=4) based on micro-CT images, this study aims to investigate the micromechanics of the interlock between cement and trabecular bone...
November 10, 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27889405/primary-total-knee-arthroplasty-for-elderly-complex-tibial-plateau-fractures
#10
Jie-Feng Huang, Jian-Jian Shen, Jun-Jie Chen, Pei-Jian Tong
OBJECTIVE: The aim of this study is to evaluate the clinical and radiologic results of primary Total Knee Arthroplasty (TKA) for elderly complex tibial plateau fractures. MATERIALS AND METHODS: Between November 2010 and February 2012, six cases of elderly complex tibial plateau fractures were treated with primary TKA using the standard medial parapatellar approach. All six patients were available at follow up with mean duration of 32.3 months (range 25-41 months)...
November 23, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27887875/two-stage-revision-for-infected-shoulder-arthroplasty
#11
Daniel B Buchalter, Siddharth A Mahure, Brent Mollon, Stephen Yu, Young W Kwon, Joseph D Zuckerman
BACKGROUND: Periprosthetic shoulder infections (PSIs) are challenging to treat and often result in significant patient morbidity. Without a standardized treatment protocol, PSIs are often managed similarly to periprosthetic hip and knee infections. Because 2-stage revision is the gold standard for treating periprosthetic hip and knee infections, we performed a case series and literature review to determine its effectiveness in PSIs. METHODS: We identified 19 patients (14 men) from our institution who were treated with a 2-stage revision after presenting with a PSI...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27876582/subperitoneal-approach-in-revision-arthroplasty-for-acetabular-component-protrusion-analysis-of-practiceswithin-the-french-hip-and-knee-society-sfhg
#12
F Gouin, V Crenn, J Tabutin
INTRODUCTION: The complications related to revision for acetabular component protrusion with material migrating into the intrapelvic region remain rare but potentially serious. Today, the literature reports no epidemiological data on the subperitoneal approach (SPA) in revision total hip arthroplasty (RTHA) for protrusion. Therefore we conducted a retrospective study on a large revision arthroplasty database to answer the following questions: 1) What is the frequency of this approach in this population? 2) What are the factors related to this procedure? 3) Is morbidity and mortality of the SPA higher than for an isolated conventional approach? HYPOTHESIS: Major protrusions with material in the superomedial quadrant (SMQ)have a higher probability of being operated using a SPA...
November 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27876465/is-there-still-a-role-for-irrigation-and-debridement-with-liner-exchange-in-acute-periprosthetic-total-knee-infection
#13
Andrés F Duque, Zachary D Post, Rex W Lutz, Fabio R Orozco, Sergio H Pulido, Alvin C Ong
BACKGROUND: Periprosthetic joint infection (PJI) is an important cause of failure in total knee arthroplasty. Irrigation and debridement including liner exchange (I&D/L) success rates have varied for acute PJI. The purpose of this study is to present results of a specific protocol for I&D/L with retention of total knee arthroplasty components. METHODS: Sixty-seven consecutive I&D/L patients were retrospectively evaluated. Inclusion criteria for I&D/L were as follows: fewer than 3 weeks of symptoms, no immunologic compromise, intact soft tissue sleeve, and well-fixed components...
November 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27876266/knee-arthrodesis-by-the-ilizarov-method-in-the-treatment-of-total-knee-arthroplasty-failure
#14
Andrea Antonio Maria Bruno, Alexander Kirienko, Andrea Peccati, Paolo Dupplicato, Massimo De Donato, Enrico Arnaldi, Nicola Portinaro
BACKGROUND: Currently, the main indication for knee arthrodesis is septic failure of a total knee arthroplasty (TKA). The purpose of this study was to evaluate the results of knee arthrodesis by circular external fixation performed in the treatment of TKA failure in which revision arthroplasty was not indicated. METHODS: The study involved 19 patients who underwent knee arthrodesis by the Ilizarov method. Clinical and functional assessments were performed, including Knee Society Score (KSS)...
November 18, 2016: Knee
https://www.readbyqxmd.com/read/27876254/is-selectively-not-resurfacing-the-patella-an-acceptable-practice-in-primary-total-knee-arthroplasty
#15
Hilal Maradit-Kremers, Omar J Haque, Walter K Kremers, Daniel J Berry, David G Lewallen, Robert T Trousdale, Rafael J Sierra
BACKGROUND: To resurface or not to resurface the patella remains a controversy in total knee arthroplasty (TKA). The purpose of this study was to assess the long-term outcomes associated with selectively not resurfacing the patella. METHODS: This was a historical cohort study of 15,497 patients with 21,371 primary TKA procedures performed at a single institution between 1985 and 2010. The cohort included 402 (2%) knees with unresurfaced patellae and 20,969 knees with all-polyethylene patellae designs...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27872980/preliminary-results-of-managing-large-medial-tibial-defects-in-primary-total-knee-arthroplasty-autogenous-morcellised-bone-graft
#16
Takehiko Sugita, Toshimi Aizawa, Naohisa Miyatake, Akira Sasaki, Masayuki Kamimura, Atsushi Takahashi
PURPOSE: This study reports a case series of 44 primary total knee arthroplasties (TKAs) using autogenous morcellised bone grafting for large (≥10-mm-deep) medial tibial defects, which are generally repaired using metal augmentation. The bone-grafting technique is described in detail and the radiological outcomes are presented. METHODS: A total of 44 TKAs were followed up for a mean period of 58 months (range 24-139 months). Multiple drill holes were made in the sclerotic floor of the defect, followed by the impaction of morcellised cancellous bone grafts to fill the defects...
November 21, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27869619/five-year-survival-of-20-946-unicondylar-knee-replacements-and-patient-risk-factors-for-failure-an-analysis-of-german-insurance-data
#17
Elke Jeschke, Thorsten Gehrke, Christian Günster, Joachim Hassenpflug, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Halder
BACKGROUND: Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. METHODS: Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27869618/meaningful-thresholds-for-the-volume-outcome-relationship-in-total-knee-arthroplasty
#18
Sean Wilson, Robert G Marx, Ting-Jung Pan, Stephen Lyman
BACKGROUND: Increasing evidence supports the finding that patients undergoing a total knee arthroplasty with high-volume physicians and hospitals achieve better outcomes. Unfortunately, the existing definitions for high-volume surgeons and hospitals are highly variable and entirely arbitrary. The aim of this study was to identify a set of meaningful hospital and surgeon total knee arthroplasty volume thresholds. METHODS: Using 289,976 patients undergoing primary total knee arthroplasty from an administrative database, we applied stratum-specific likelihood ratio (SSLR) analysis of a receiver operating characteristic (ROC) curve to generate sets of volume thresholds most predictive of adverse outcomes...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27869063/screening-patients-undergoing-total-hip-or-knee-arthroplasty-with-perioperative-urinalysis-and-the-effect-of-a-practice-change-on-antimicrobial-use
#19
Samuel Bailin, Nicolas Noiseux, Jean M Pottinger, Birgir Johannsson, Ambar Haleem, Sarah Johnson, Loreen A Herwaldt
OBJECTIVE To identify predictors of treatment for urinary tract infections (UTI) among patients undergoing total hip (THA) or knee (TKA) arthroplasties and to assess an intervention based on these predictors. DESIGN We conducted a retrospective cohort study of 200 consecutive patients undergoing THA/TKA between February 21, 2011, and June 30, 2011, to identify predictors of treatment for UTI and a prospective cohort study of 50 patients undergoing these procedures between May 21, 2012, and July 17, 2012, to assess the association of signs or symptoms and UTI treatment...
November 21, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27866951/the-incidence-and-economic-burden-of-in-hospital-venous-thromboembolism-in-the-united-states
#20
Alisina Shahi, Antonia F Chen, Timothy L Tan, Mitchell G Maltenfort, Fatih Kucukdurmaz, Javad Parvizi
BACKGROUND: Venous thromboembolism (VTE) is a potentially preventable and costly complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The in-hospital incidence and economic burden of VTE following total joint arthroplasty (TJA) in the United States is unknown. The aim of this study was to examine this issue. METHODS: The Nationwide Inpatient Sample was used to estimate the total number of THA, TKA, and VTE events using International Classification of Diseases, Ninth Revision procedure codes from years 2002 to 2011...
October 21, 2016: Journal of Arthroplasty
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