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Revision total knee arthroplasty

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https://www.readbyqxmd.com/read/28318864/weight-gain-after-primary-total-knee-arthroplasty-is-associated-with-accelerated-time-to-revision-for-aseptic-loosening
#1
Chin Tat Lim, Stuart B Goodman, James I Huddleston, Alex H S Harris, Subhrojyoti Bhowmick, William J Maloney, Derek F Amanatullah
BACKGROUND: Obesity is a major health problem worldwide and is associated with complications after total knee arthroplasty (TKA). It remains unknown whether a change in body mass index (BMI) after primary TKA affects the reasons for revision TKA or the time to revision TKA. METHODS: A total of 160 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to change in BMI from the time of their primary TKA to revision TKA...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28314891/revision-total-knee-arthroplasty-with-porous-coated-metaphyseal-sleeves-provides-radiographic-ingrowth-and-stable-fixation
#2
Catherine J Fedorka, Antonia F Chen, Michael R Pagnotto, Lawrence S Crossett, Brian A Klatt
PURPOSE: Porous-coated metaphyseal sleeves are designed to fill bone defects and facilitate osseointegration when bone loss in encountered during revision total knee arthroplasty (TKA). The purpose of this study is to evaluate short-term results of porous-coated metaphyseal sleeves with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on 50 patients (79 sleeves-49 tibial and 30 femoral) who had a press-fit metaphyseal sleeve with revision TKA...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#3
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28302132/long-term-results-and-comparison-of-the-three-different-high-tibial-osteotomy-and-fixation-techniques-in-medial-compartment-arthrosis
#4
Gökhan Polat, Halil İbrahim Balcı, Mehmet Fevzi Çakmak, Mehmet Demirel, Cengiz Şen, Mehmet Aşık
BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study...
March 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#5
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28298194/patient-endorsement-of-the-outcome-measures-in-rheumatology-omeract-total-joint-replacement-tjr-clinical-trial-draft-core-domain-set
#6
Jasvinder A Singh, Michelle Dowsey, Peter F Choong
BACKGROUND: A patient- and surgeon-Delphi-derived Outcome Measures in Rheumatology (OMERACT) draft core domain set for total joint arthroplasty (TJR) trials was recently developed. Our objective was to obtain further patient stakeholder endorsement of draft core domain set for TJR clinical trials. METHODS: We surveyed two patient groups: (1) OMERACT patient partners; and (2) patients who had undergone hip or knee TJR. Patients received an introductory email with explanations about the core domain set and instructions to rate the core domains, i...
March 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#7
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#8
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28285901/a-novel-percentage-based-system-for-determining-aseptic-loosening-of-total-knee-arthroplasty-tibial-components
#9
Brian P Chalmers, Peter K Sculco, Keith A Fehring, Robert T Trousdale, Michael J Taunton
BACKGROUND: There are limited data on evaluating the significance of radiolucent lines and aseptic loosening in total knee arthroplasty (TKA). We sought to compare the sensitivity, specificity, and reliability of the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System (KSRES) in detecting tibial component loosening compared to a novel percentage-based system (PBS). METHODS: We retrospectively reviewed radiographs obtained from 48 patients within 6 months prior to revision TKA...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285899/clinical-results-and-survivorship-of-the-genesis-ii-total-knee-arthroplasty-at-a-minimum-of-15-years
#10
Richard W McCalden, Gavin P Hart, Steven J MacDonald, Douglas D Naudie, James H Howard, Robert B Bourne
BACKGROUND: The purpose of this study was to examine the 15-year survivorship and long-term clinical outcomes of the GENESIS II total knee arthroplasty (TKA). METHODS: Patients who underwent TKA with the GENESIS II system between 1995 and 1999 were retrieved from our institutional database. We report a Kaplan-Meier survival analysis as well as Western Ontario and McMaster Universities Arthritis Index, the Short Form Health Survey-12 (SF-12), and the Knee Society Scores at a mean of 16 years...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285897/arthrofibrosis-associated-with-total-knee-arthroplasty
#11
REVIEW
Victor A Cheuy, Jared R H Foran, Roger J Paxton, Michael J Bade, Joseph A Zeni, Jennifer E Stevens-Lapsley
The purpose of this article is to review the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after total knee arthroplasty (TKA). Arthrofibrosis is a debilitating postoperative complication of TKA. This condition is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. Characterized by the excessive proliferation of scar tissue during an impaired wound healing response, the resulting stiffness of arthrofibrosis causes functional deficits in activities of daily living, such as walking, stair climbing, and standing from a chair...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28271092/loosening-of-total-knee-arthroplasty-after-brucellosis-infection-a-case-report
#12
Mohammad Ali Sazegari, Fateme Bahramian, Fateme Mirzaee, Zohreh Zafarani, Hamidreza Aslani
In this report we describe a 78-year-old man whose total knee arthroplasty showed the symptoms of infection with brucella with radiographic signs of loosening 5 years after the index surgery. The patient was treated successfully after a 2-stage revision arthroplasty surgery along with using rifampicin and doxycycline for 8 weeks.
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28266241/tibial-component-rotation-around-the-transverse-axis-measured-by-radiostereometry-predicts-aseptic-loosening-better-than-maximal-total-point-motion
#13
Asgeir Gudnason, Gunnar Adalberth, Kjell-Gunnar Nilsson, Nils P Hailer
Background and purpose - Maximal total point motion (MTPM) measured by radiostereometry (RSA) is widely used as a predictor of total knee arthroplasty (TKA) loosening. We compared the ability of different RSA measurements at different time points to predict loosening of tibial TKA components in the long term. Patients and methods - 116 TKAs in 116 patients were included in our analysis. 16 (14.8-17.4) years after surgery, 5 tibial components had been revised due to aseptic loosening. Receiver operating characteristic curves were calculated in order to investigate the specificity and sensitivity of different RSA parameters at different thresholds...
March 7, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28259490/what-do-patients-expect-from-total-knee-arthroplasty-a-delphi-consensus-study-on-patient-treatment-goals
#14
Toni Lange, Jochen Schmitt, Christian Kopkow, Elisabeth Rataj, Klaus-Peter Günther, Jörg Lützner
BACKGROUND: Although total knee arthroplasty (TKA) is among the most frequent orthopedic procedures for end-stage knee osteoarthritis (OA), systematically developed patient treatment goals for this elective intervention are missing. This constitutes a relevant barrier toward patient-centered healthcare. METHODS: A Delphi consensus study was conducted. Patients who were candidates for TKA were recruited through 11 outpatient orthopedic surgeons, 4 physiotherapists, and a patient organization in Germany...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28252475/management-of-interprosthetic-femur-fractures
#15
John A Scolaro, Ran Schwarzkopf
Femoral fractures between a total hip arthroplasty prosthesis and total knee arthroplasty prosthesis, also called interprosthetic fractures, are challenging clinical problems. The number of patients who have undergone ipsilateral primary or revision joint arthroplasty procedures in both the hip and the knee continues to rise, and the number of interprosthetic fractures is increasing, as well. The growing body of biomechanical and clinical literature on interprosthetic fractures reflects the increased frequency of and interest in these injuries...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28249349/revision-of-total-knee-arthroplasties-performed-in-young-active-patients-with-posttraumatic-and-osteoarthritis
#16
Andrew Brian Old, William John Long, W Norman Scott
Rates of total knee arthroplasty (TKA) in younger patients are rising significantly. A recent study performed at our institute illustrated the excellent survivorship of TKAs in patients younger than 55 years at a mean follow-up period of 25 years. This study reports on the 25 knees in this series that required revision surgery. Twenty-five revisions were performed in 24 patients. Indication for revision, clinical outcomes, and radiographs were reviewed at their most recent follow-up. Revisions were performed in 5 cases of infection, 2 cases of fracture/trauma, 17 cases of wear/loosening, and 1 case of instability...
March 1, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28244917/in-vivo-three-dimensional-patellar-mechanics-normal-knees-compared-with-domed-and-anatomic-patellar-components
#17
Adrija Sharma, Trevor F Grieco, Sumesh M Zingde, Douglas A Dennis, Matthew R Anderle, Richard D Komistek
BACKGROUND: Patellofemoral complications are a major cause of revision surgery following total knee arthroplasty (TKA). High forces occurring at the patellofemoral articulation coupled with a small patellofemoral contact area pose substantial design challenges. In this study, the three-dimensional (3D) in vivo mechanics of domed and anatomically shaped patellar components were compared with those of native patellae. METHODS: Ten normal knees, 10 treated with an LCS-PS (low contact stress-posterior stabilized) TKA (anatomically shaped patellar component), and 10 treated with a PFC Sigma RP-PS (press-fit condylar Sigma rotating platform-posterior stabilized) TKA (domed patellar component) were analyzed under fluoroscopic surveillance while the patient performed a weight-bearing deep knee bend from full knee extension to maximum knee flexion...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28238584/perioperative-and-early-postoperative-comparison-of-a-modern-cemented-and-cementless-total-knee-arthroplasty-of-the-same-design
#18
Denis Nam, Judith E Kopinski, Zachary Meyer, Richard D Rames, Ryan M Nunley, Robert L Barrack
BACKGROUND: Cementless total knee arthroplasty (TKA) designs that incorporate a highly porous, titanium surface have the potential to achieve biologic fixation and improve component survivorship. This study's purpose was to compare perioperative and early postoperative outcomes of a cemented vs cementless TKA of the same design. METHODS: This was a retrospective review of a consecutive series of TKAs performed at a single institution using a cemented or cementless TKA of the same design (Triathlon, Stryker Inc, Mahwah, NJ)...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28237217/outcomes-of-newer-generation-cementless-total-knee-arthroplasty-beaded-periapatite-coated-vs-highly-porous-titanium-coated-implants
#19
Steven F Harwin, Nirav K Patel, Morad Chughtai, Anton Khlopas, Prem N Ramkumar, Martin Roche, Michael A Mont
BACKGROUND: Newer generation cementless total knee arthroplasty (TKA) designs are available and have novel implant coatings. We evaluated and compared beaded periapatite (PA)-coated vs highly porous titanium-coated cementless TKAs. Specifically, we compared: (1) survivorship, (2) Knee Society Scores (KSSs) and range of motion, (3) complications, and (4) radiographic findings. METHODS: There were 805 TKAs with beaded PA-coated tibial and patellar components (PA group; mean age 67 years; range 41-86 years), and 219 TKAs with highly porous titanium-coated tibial and patella components (mean age 66 years; range 34-88 years)...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28236551/soft-tissue-releases-in-total-knee-arthroplasty-for-valgus-deformities
#20
Ke Xie, Steven T Lyons
BACKGROUND: Primary total knee arthroplasty (TKA) for valgus knee deformities can be challenging. Soft tissue releases are often necessary to achieve a well-balanced knee. We reviewed the frequency of soft tissue releases including lateral retinacular release (LRR) as it pertains to preoperative limb alignment. Postoperatively, we evaluated limb alignment, knee range of motion, and complications. METHODS: From 2010 to 2016, 214 primary TKAs with valgus deformity were performed by a single surgeon...
January 25, 2017: Journal of Arthroplasty
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