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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/28439486/bilateral-simultaneous-revision-total-knee-arthroplasty-as-a-single-staged-procedure-a-case-report-and-review-of-literature
#1
Raju Vaishya, Amit Kumar Agarwal, Chirag Jaiswal, Vipul Vijay, Abhishek Vaish
Bilateral revision total knee arthroplasty (TKA) is a surgical procedure, which is rarely done simultaneously as it is a difficult surgery and the safety of simultaneous bilateral single stage surgery remains unknown. We report a case of a 67-year-old woman who presented to us with bilateral painful and unstable TKA (right > left) of six months duration. The primary bilateral TKA were done 14 years ago. Bilateral simultaneous revision TKA was performed, using cemented, constrained, long-stem prostheses. The intraoperative and postoperative periods remained uneventful...
March 23, 2017: Curēus
https://www.readbyqxmd.com/read/28436397/reduced-culture-time-and-improved-isolation-rate-through-culture-of-sonicate-fluid-in-blood-culture-bottles
#2
Viktor Janz, Andrej Trampuz, Carsten F Perka, Georgi I Wassilew
BACKGROUND AND OBJECTIVE: The aim of this study was to investigate if the cultivation of sonicate fluid (SFC) in blood culture bottles (BCB) leads to a higher rate of bacterial isolations than agar plate culture (APC) and to investigate whether the utilization of BCB leads to a reduction in culture time. METHODS: We performed a retrospective analysis of 206 revision total knee and total hip arthroplasty patients comparing the results of both synovial fluid culture and SFC in both BCB and conventional APC...
April 7, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28436379/economic-analysis-of-4221-revisions-due-to-periprosthetic-joint-infection-in-poland
#3
Ireneusz Babiak, Piotr Pędzisz, Jakub Janowicz, Mateusz Kulig, Paweł Małdyk
BACKGROUND: Periprosthetic joint infection (PJI) is one of the most severe complications of total hip (THA) and total knee (TKA) arthroplasty. The aim of the study is to determine the number and type of hip and knee prosthesis revisions in Poland performed due to infection and reimbursement of the cost of septic revisions and to compare the costs of septic and aseptic revisions in Poland and other countries. MATERIAL AND METHODS: The data published for the period 2009-2013 by the National Health Fund (NHF) were analysed and the average cost of septic and aseptic revisions was calculated...
January 26, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28434695/the-influence-of-a-failed-irrigation-and-debridement-on-the-outcomes-of-a-subsequent-2-stage-revision-knee-arthroplasty
#4
Scott R Nodzo, Keely K Boyle, Allina A Nocon, Michael W Henry, David J Mayman, Geoffrey H Westrich
BACKGROUND: Previous work has suggested a failed irrigation and debridement (I&D) before a 2-stage exchange negatively impacts the outcome of the subsequent 2-stage revision. METHODS: This was a retrospective review of 132 patients who underwent a 2-stage exchange without prior I&D (2-Stage), and 45 patients had a failed I&D before their 2-stage exchange (I&D+2Stage) between April 2009 and April 2015. Charts were reviewed for patient demographics, presenting inflammatory laboratory values, type of antibiotic spacer used, surgical details, microbiology data, length of postoperative antibiotic treatment, and reoperation...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28418574/inadequacy-of-joint-aspiration-for-detection-of-persistent-periprosthetic-infection-during-two-stage-septic-revision-knee-surgery
#5
Bernd Preininger, Viktor Janz, Philipp von Roth, Andrej Trampuz, Carsten F Perka, Tilman Pfitzner
Despite the lack of validation, synovial aspiration remains a common practice during 2-stage septic revision total knee arthroplasty (TKA). The goal of this study was to investigate the diagnostic validity of synovial polymethylmethacrylate (PMMA) spacer aspiration of temporary knee arthrodesis to detect persistent periprosthetic joint infection before TKA reimplantation. This retrospective cohort study included 73 consecutive patients who underwent 2-stage septic revision TKA according to a standard protocol...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28413139/evaluation-of-extensor-mechanism-in-revision-knee-arthroplasty
#6
Vadym Zhamilov, Vasfi Karatosun, Serpil Kalkan, Bayram Unver, Izge Gunal
BACKGROUND: The success of revision total knee arthroplasty depends on adequate exposure that does not produce complications. The purpose of this study was to compare the results of revision total knee arthroplasty between V-Y quadricepsplasty (QP) and quadriceps snip (QS) approaches. METHODS: In the study, 92 knees with follow-up of 12-108 months which were operated by using QP (55) and QS (37) were evaluated retrospectively. Measurements were taken by using universal transparent goniometer, also varus valgus deformities, knee flexion angles, instability, Hospital for Special Surgery and Lower Extremity Functional Scale scores, functional condition of the knee and activity levels of the patients were evaluated cross-sectionally...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28406878/bone-loss-in-revision-total-knee-arthroplasty-evaluation-and-management
#7
Neil P Sheth, Marcelo Batista Bonadio, Marco Kawamura Demange
With the increasing number of total knee arthroplasty (TKA) procedures being performed annually, the burden of revision surgery is also expected to increase. Addressing bone loss during revision TKA is a considerable challenge that requires proper preoperative evaluation and surgical planning. In addition to an assessment of femoral and tibial bone loss, a systematic approach to the management of bone loss associated with TKA includes careful implant selection, adherence to the general principles of revision TKA, and an understanding of the available reconstruction options...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28401796/unicompartmental-knee-arthroplasties-are-performed-on-the-patients-with-radiologically-too-mild-osteoarthritis
#8
J Knifsund, J Hatakka, H Keemu, K Mäkelä, M Koivisto, T Niinimäki
BACKGROUND: Patient selection for either total knee arthroplasty or unicompartmental knee arthroplasty remains controversial. The latter has several reported advantages over total knee arthroplasty, but it also appears to have significant drawbacks in terms of revision rates. AIMS: This study aimed to determine the influence of the preoperative degree of osteoarthritis on the risk of reoperation following unicompartmental knee arthroplasty. METHODS: Surgery was carried out on 294 knees in 241 patients between 2001 and 2012 at a single institute, using cemented Oxford phase III unicompartmental knee arthroplasty...
April 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28399605/cementless-total-knee-arthroplasty-in-patients-older-than-75-years
#9
Jared M Newman, Anton Khlopas, Morad Chughtai, Chukwuweike U Gwam, Jaydev B Mistry, George A Yakubek, Steven F Harwin, Michael A Mont
Some surgeons have been hesitant to use cementless fixation for total knee arthroplasty (TKA) in elderly patients due to concerns regarding successful bone biological fixation. Therefore, this study evaluated: (1) implant survivorship, (2) functional outcomes, (3) radiographic outcomes, and (4) complications in patients over 75 years of age who underwent cementless total knee arthroplasty. A total of 134 patients (142 TKAs) older than 75 years at a single institution between June 2008 and June 2014 were retrospectively reviewed...
April 11, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28392132/acute-kidney-disease-after-total-hip-and-knee-arthroplasty-incidence-and-associated-factors
#10
Eric X Jiang, Hrishikesh C Gogineni, Joel L Mayerson, Andrew H Glassman, Robert A Magnussen, Thomas J Scharschmidt
BACKGROUND: The development of acute kidney disease (AKD) following total joint arthroplasty has not been well characterized in the literature. We sought to calculate the incidence and identify risk factors associated with postoperative AKD for patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: A total of 1000 consecutive cases (860 unique patients, including revisions) of TKA or THA performed between January 2010 and May 2016 were identified...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28389879/superior-long-term-survival-for-fixed-bearing-compared-with-mobile-bearing-in-ligament-balanced-total-knee-arthroplasty
#11
P J C Heesterbeek, A H van Houten, J S Klenk, H Eijer, B Christen, A B Wymenga, A J Schuster
PURPOSE: Only few long-term data on ligament-balanced cruciate-retaining total knee arthroplasty (CR TKA) are currently available. Either a mobile- or fixed-bearing insert can be chosen, which showed good mid-term outcome and few complications and revisions. This multi-centre retrospective cross-sectional cohort study investigated the 12-year results of primary TKA using a balancing gap technique and compared survival and clinical outcome between fixed and mobile inserts. METHODS: In this retrospective cross-sectional cohort study, 557 cases of three clinics (2 Swiss, 1 Dutch) operated between 1998 and 2003 with the first series of a TKA implanted with a balanced gap technique (433 (77...
April 7, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28379915/total-knee-arthroplasty-in-patients-with-cerebral-palsy-a-matched-cohort-study-to-patients-with-osteoarthritis
#12
Matthew T Houdek, Chad D Watts, Cody C Wyles, Robert T Trousdale, Todd J Milbrandt, Michael J Taunton
INTRODUCTION: Currently, few data examine the use of total knee arthroplasty (TKA) in patients with cerebral palsy (CP). This study reviewed the outcomes of TKA in patients with CP compared with a matched cohort undergoing TKA for primary osteoarthritis. METHODS: Over a 28-year period, 15 TKAs in patients with a diagnosis of CP were identified. The cohort was 53% men, with a mean age of 58 years. Patients with CP were matched 1:2 based on age, sex, body mass index, and year of surgery with a group of patients undergoing TKA for osteoarthritis...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28378008/surgical-site-infection-and-transfusion-rates-are-higher-in-underweight-total-knee-arthroplasty-patients
#13
Jorge Manrique, Antonia F Chen, Miguel M Gomez, Mitchell G Maltenfort, William J Hozack
BACKGROUND: Underweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion. METHODS: A case-control study was conducted using a prospectively collected institutional database...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28378000/revision-total-knee-arthroplasty-using-a-custom-tantalum-implant-in-a-patient-following-multiple-failed-revisions
#14
Colin A McNamara, Raúl G Gösthe, Preetesh D Patel, Kristopher C Sanders, Gustavo Huaman, Juan C Suarez
The number of revision total knee arthroplasty procedures performed annually is increasing and, subsequently, so is the number of patients presenting following a failed revision. Rerevising a total knee arthroplasty after one or more failed revision procedures presents many challenges, including diminished bone stock for prosthetic fixation. "Off the shelf" implants may not offer the best alternative for reconstruction. We present the case of a 55-year-old patient who required a rerevision total knee arthroplasty following multiple failed revisions with severe femoral and tibia bone loss...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28372918/all-polyethylene-tibial-component-use-for-elderly-low-demand-total-knee-arthroplasty-patients
#15
Kenneth A Gustke, Martin K Gelbke
BACKGROUND: Potential advantages combined with lower cost have prompted a renewed interest in modern all-polyethylene tibial designs. METHODS: A total of 317 Natural Knee total knee arthroplasties with an all-polyethylene tibial component that was performed since 1993 were retrospectively reviewed to confirm that cost savings were not associated with inferior clinical results. They were primarily used in elderly, low-demand patients. The average age at the time of surgery was 80...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28372917/fewer-complications-following-revision-hip-and-knee-arthroplasty-in-patients-with-normal-vitamin-d-levels
#16
Sophia A Traven, Alexander M Chiaramonti, William R Barfield, Patricia A Kirkland, Harry A Demos, Harold D Schutte, Jacob M Drew
BACKGROUND: Surgeons and hospitals increasingly face penalty for complications and readmission following total joint arthroplasty; therefore, optimization of modifiable risk factors is paramount. Literature associates low vitamin D with risk of periprosthetic joint infection, and we hypothesized low vitamin D to be predictive of increased rate of complications and readmissions. METHODS: A retrospective review of 126 revision total joint arthroplasty patients between 2010 and 2014 was performed...
March 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28366313/short-to-midterm-outcomes-of-revision-total-knee-arthroplasty-patients-with-a-total-stabilizer-knee-system
#17
Chukwuweike U Gwam, Morad Chughtai, Anton Khlopas, Nequesha Mohamed, Randa K Elmallah, Arthur L Malkani, Michael A Mont
BACKGROUND: Revision total knee arthroplasty (TKA) can often be challenging. The use of a new revision system may aid in providing better stability, improved function, fit, and implant longevity. Therefore, we assessed: (1) survivorship, (2) clinical outcomes, (3) postoperative complications, and (4) radiographic outcomes of patients who underwent revision TKA using this system. METHODS: Patients from 2 hospitals who underwent revision TKA using a newer generation revision knee system between June 2008 and December 2013 for component instability or aseptic loosening were included...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28364965/high-rate-of-local-recurrence-and-complications-following-total-knee-arthroplasty-in-the-setting-of-synovial-chondromatosis
#18
Matthew T Houdek, Cody C Wyles, Peter S Rose, Michael J Stuart, Franklin H Sim, Michael J Taunton
BACKGROUND: Synovial chondromatosis is a rare, monoarticular arthropathy due to synovial metaplasia. There is a paucity of data examining the outcome of total knee arthroplasty (TKA) in the setting of synovial chondromatosis. The purpose of this study is to investigate the outcome and function in patients undergoing TKA for management of synovial chondromatosis. METHODS: Twenty patients who received TKA for synovial chondromatosis over a 25-year period were identified for analysis and followed for a mean of 7 years...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28364321/satisfactory-outcomes-following-combined-unicompartmental-knee-replacement-and-anterior-cruciate-ligament-reconstruction
#19
REVIEW
Andrea Volpin, S G Kini, D E Meuffels
PURPOSE: There exist limited options for treatment of patients with combined medial compartment arthritis and anterior cruciate ligament (ACL) deficiency. Ideal treatment is one that offers lasting relief of symptoms not compromising any future surgery. Unicompartmental knee replacement has shown consistently good results in the relatively young and active population, but there is a high reported incidence of failure up to 20%, if performed in ACL-deficient knees. One of the recognized treatment modality is combined ACL reconstruction and unicompartmental arthroplasty...
March 31, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28361283/corr-insights-%C3%A2-have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#20
Andrew J Schoenfeld
No abstract text is available yet for this article.
March 30, 2017: Clinical Orthopaedics and related Research
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