Artroplastia

BACKGROUND: Cementless fixation for hip arthroplasties has increased in the last decades, particularly in younger patients. The purpose of this study was to compare the long-term results three different types of fixations in patients under 50 years old. METHODS: Cemented, hybrid and cementless fixations were assessed in patients under 50 years old with a minimum follow-up of 8 years. Loosening, demarcation, complications, and prosthesis survival were assessed. Functional analysis was performed with the modified Harris Hip Score and Visual analogue scale was collected...

INTRODUCTION: Achieving stability in total knee arthroplasty (TKA) is crucial for long-term implant survival. In cases of severe deformity or ligament laxity, constrained implants may be required. Traditionally, increasing constraint involved intramedullary stems. However, there are intermediary alternatives, including employing a constrained polyethylene insert without stems, thereby avoiding complications related to them. The study aims to evaluate our experience with a non-modular constrained (NMC) implant in primary TKA...

UNLABELLED: Osteoarthritis is a disabling pathology characterized by joint pain and stiffness. A prevalence of coxarthrosis of 7.4% is reported in our country. Total hip joint replacement is indicated in advanced stages, a procedure that is not free of complications, the most frequent being prosthetic dislocation, which can be prevented with dual mobility systems. The following study aims to determine the rate of complications and clinical outcomes in dual mobility systems in primary coxarthrosis...

INTRODUCTION AND OBJECTIVES: periprosthetic hip fractures show increasing incidence and complexity, representing a challenge for the surgeon. We aimed to evaluate the survival of uncemented modular tapered stems in the treatment of periprosthetic Vancouver B2 and B3 type fractures and review the main complications and factors associated with decreased survival. MATERIALS AND METHODS: we performed a retrospective study of patients submitted to revision arthroplasty for treatment of periprosthetic femoral stem Vancouver B2 and B3 type fractures with an uncemented modular fluted tapered stem (MRP-Titan)...

BACKGROUND AND OBJECTIVE: Vancomycin powder (VP) has been positively used in spinal surgery to reduce the rate of infections. Hardly any data have been published on hip and knee joint replacement surgery, and its usefulness is questioned. Our objective was to investigate the effectiveness of VP in reducing prosthetic infection and its possible complications. METHODS: Primary hip (THA) and knee (TKA) arthroplasties were reviewed, performed by five surgeons in one hospital centre, between 2017 and 2018...

RESULTS: A total of 68 patients were evaluated, with 31 patients in the AVIP group and 33 in the Control group completing the follow-up. Both groups demonstrated improvement in clinical outcomes based on the WOMAC and mHHS hip tests, a reduction in perceived pain, and an enhancement in quality of life according to the SF-12 test. Patients in the AVIP study group exhibited non-inferiority in clinical outcomes and satisfaction compared to the control group, as well as lower anxiety levels and improved walking capabilities after the first month of follow-up...

Background and aim Currently, we do not have a gold standard for pain management after total knee arthroplasty. We may use one of more drug delivery systems, none of which are ideal. An ideal depot delivery system would provide therapeutic, nontoxic, doses of drug at the surgical side, especially during 72 h postoperatively. The bone cement used in arthroplasties has been used as a drug delivery system, especially antibiotics, since 1970. Based on this principle, we developed this study with the aim to characterize the elution profile of two local anaesthetics (lidocaine hydrochloride and bupivacaine hydrochloride) from PMMA (polymethilmethacrylate) bone cement...

INTRODUCTION: The aim of this study was to evaluate the efficacy of aspirin versus low molecular weight heparins (LMWH) for the prophylaxis of venous thromboembolism (VTE), deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing total knee arthroplasty (TKA) and/or total hip arthroplasty (THA). MATERIALS AND METHODS: Systematic review and meta-analysis. Sixteen studies were selected. The risk of VTE, DVT and PE were analysed. Mortality, risk of bleeding and surgical wound complications was also analysed...

Introduction The total knee arthroplasty (TKA) has been shown to be a successful and cost-benefit procedure in terms of pain improvement in patient with symptomatic knee osteoarthritis. However, almost a 20% of the patients are not satisfied with the result of the surgery. Material and method We have carried out a transversal unicentric cases controls study with clinical cases of the own hospital, obtained by a clinical records revision. A total of 160 patients with a TKA with at least 1 year of follow-up were selected...

Developmental dysplasia of the hip is the cause of approximately one third of secondary coxarthrosis. Anatomy alterations make it difficult to place a total hip prosthesis in its anatomical position and for it to be stable in the long term; there are several techniques to achieve this goal. In the present work, we used autograft of the femoral head (shelf graft or reinforced roof), to improve the coverage of the acetabular component with favourable results. Materials ad methods Sixteen cases were included in 14 patients with a diagnosis of developmental dysplasia of the hip (13 women and one man), the mean age was 44...

PURPOSE: The aim of this study is to assess the time to return to work (TRW) in patients undergoing trapezial resection using the Mini Tightrope system at our Center and to investigate factors that might delay return to work following this surgery. METHODS: A retrospective study was conducted on patients who underwent Trapezial resection and suspensionplasty using the Mini Tightrope system between 2015 and 2016, with a minimum one-year follow-up. Telephone interviews were conducted along with a review of medical records and radiology reports, as well as Temporary Work Disability documents, collecting epidemiological and occupational data...

INTRODUCTION: Aseptic total knee arthroplasty (TKA) failure has been associated with radiolucent lines. This study aimed to determine the impact of the early appearance of radiolucent lines (linear images of 1, 2, or >2 mm at the cement-bone interface) around the TKA on prosthetic survival and functional outcomes in rheumatoid arthritis (RA) patients during a 2-20 years follow-up. METHODS: We retrospectively analysed a consecutive series of RA patients treated with TKA between 2000 and 2011...

BACKGROUND AND OBJECTIVES: The purpose of this study is to analyze the indications, complications, survivorship and clinical/functional outcome of metaphyseal sleeves as a treatment option in revision total knee arthroplasty. MATERIAL AND METHOD: A systematic review was made following the PRISMA recommendations on the use of metaphyseal sleeves for revision total knee arthroplasty. We included prospective and retrospective studies published in the last 10 years looking at implant survivorship, clinical and functional outcome with a minimum follow-up of 2 years...

Managing chronic periprosthetic infections in patients who have undergone limb-salvage surgery following a malignant bone tumor with megaprosthesis often involves a two-stage revision surgery with the use of a cement-spacer. This paper show details the preparation of a self-made intramedullary metal-stabilized mega-cement spacer for patients needing a two-stage revision surgery due to infection after oncologic bone tumor resection and limb-salvage surgery with megaprosthesis and present two clinical cases treated with this technique...

INTRODUCTION: There is an increase in degenerative arthropathies because of the increase in the longevity of world´s population, making primary knee arthroplasties a procedure to recover quality of life without pain. There are factors associated with the length of hospital stay after this procedure. OBJECTIVE: To determine the risk factors influencing the hospital stay during the postoperative period of patients undergoing primary total knee arthroplasty with an enhanced recovery after surgery protocol (ERAS)...

BACKGROUND AND OBJECTIVE: Vancomycin powder (VP) has been positively used in spinal surgery to reduce the rate of infections. Hardly any data have been published on hip and knee joint replacement surgery, and its usefulness is questioned. Our objective was to investigate the effectiveness of VP in reducing prosthetic infection and its possible complications. METHODS: Primary hip (THA) and knee (TKA) arthroplasties were reviewed, performed by five surgeons in one hospital center, between 2017 and 2018...

Progressive population aging and improved healthcare have led to a significant increase in patients with hip arthroplasty (HA). In this patient group, the proportion of those who require a new arthroplasty (prosthetic replacement or secondary revision of the hip), has also increased. For this subgroup of patients in whom surgical prosthetic replacement should be considered but is contraindicated, a new technique has been developed since 2010: percutaneous injection of periprosthetic cement under fluoroscopic or CT control ("femoroplasty; FMP") as an alternative and less invasive treatment compared to surgery to stabilize the HA without replacing it, with excellent results on patients' quality of life...

INTRODUCTION: In México, many patients undergoing total knee arthroplasty (TKA) are obese, which has medical and financial consequences. The functional outcomes and the incidence of complications of these patients remain uncertain due to the inconsistency between studies. OBJECTIVE: To determine the association between obesity, complications and functional results of patients undergoing TKA. MATERIAL AND METHODS: Descriptive, cross-sectional, prospective, observational, cohort study in which patients who underwent TKA between September 1, 2021, and August 30, 2022, were studied...

BACKGROUND AND OBJECTIVE: Frailty scores have not been standardized for the preoperative assessment of patients undergoing total knee replacement (TKR). The aim of this study was to compare the efficacy of the American Society of Anaesthesiology (ASA) score, the Charlson comorbidity index (CCI) and the simple frailty score (SSF) in predicting complications, hospital stay, readmissions and mortality after elective TKR. MATERIALS AND METHODS: We retrospectively studied 448 patients who underwent TKR for osteoarthritis at our institution between 2016 and 2019...

OBJECTIVE: To compare medium- and long-term postoperative surgical results, especially the adjacent syndrome rate, adverse event rate, and reoperation rate, of patients operated on with cervical arthroplasty or anterior cervical arthrodesis in published randomized clinical trials (RCTs), at one cervical level. METHODS: Systematic review and meta-analysis. Thirteen RCTs were selected. The clinical, radiological and surgical results were analysed, taking the adjacent syndrome rate and the reoperation rate as the primary objective of the study...