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https://www.readbyqxmd.com/read/28332761/a-uk-national-survey-of-care-pathways-and-support-offered-to-patients-receiving-revision-surgery-for-prosthetic-joint-infection-in-the-highest-volume-nhs-orthopaedic-centres
#1
Andrew J Moore, Michael R Whitehouse, Rachael Gooberman-Hill, Jason Heddington, Andrew D Beswick, Ashley W Blom, Tim J Peters
BACKGROUND: Deep prosthetic joint infection (PJI) is a devastating complication of joint replacement surgery. It is difficult to treat, and patients often require multiple major revision surgeries to eradicate the infection. Treatment can have negative and long-term impact on patients' quality of life. Understanding current service provision provides valuable information needed to design and evaluate support interventions for patients. AIM: This survey aimed to identify usual care pathways and support in UK National Health Service (NHS) orthopaedic centres for patients receiving revision surgery for PJI after hip or knee replacement...
March 23, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28331989/does-the-tibia-component-design-affect-the-need-for-offset-stems-in-revision-total-knee-arthroplasty
#2
X Foruria, T Schmidt-Braekling, D Arana Nabarte, M Faschingbauer, M Kasparek, F Boettner
INTRODUCTION: The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty. MATERIALS AND METHODS: Hip to ankle standing radiographs and lateral radiographs of 75 patients were analyzed using digital templating software. The offset in the anterior-posterior as well as medial-lateral plane between the center of the tibial diaphysis and the stem of the tibial baseplate were determined for an anatomic and symmetric tibial baseplate, respectively...
March 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28326430/still-no-single-gold-standard-for-using-cementless-femoral-stems-routinely-in-total-hip-arthroplasty
#3
Joseph T Moskal, Susan G Capps, John A Scanelli
BACKGROUND: There is now a clear trend with increased usage of cementless femoral stems for all ages and most patients. As the number of total hip arthroplasties (THAs) performed annually continues to increase with expanding indications for THA and demands for improved quality of life, so will the prevalence of THA in the elderly and aging populations. This is worrisome as the risk of complications with cementless femoral stems increases in elderly patients and those with poor bone quality...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326429/ceramic-on-ceramic-bearings-total-hip-arthroplasty-in-young-patients
#4
Tao Wang, Jun-Ying Sun, Xi-Jiang Zhao, Yong Liu, Hai-Bo Yin
BACKGROUND: The results of ceramic-on-ceramic (CoC) total hip arthroplasty (THA) in younger patients were not univocal. This study aims to evaluate the results of CoC bearing THA in patients younger than 50 years. METHODS: A total of 90 younger patients performed CoC THAs during March 2003 and May 2008 were included in this study. Hip function and activity were evaluated with Harris hip score and University of California Los Angeles activity score. We had discussed survival rates, radiological findings of component loosening or osteolysis, and ceramic-related complications in these patients...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326426/use-of-locking-plates-for-fixation-of-the-greater-trochanter-in-patients-with-hip-replacement
#5
Allison K Tetreault, Brian J McGrory
BACKGROUND: Fixation of the greater trochanter with total hip replacement is challenging and associated with short- and long-term complications. Locking plate technology has been used for fixation of other bones and may be applied successfully in trochanteric fixation. The purpose of this retrospective study was to analyze the utility of the use of trochanteric locking plates in total hip arthroplasty (THA) patients. METHODS: From 2004 to 2014, 32 procedures were performed to fix the greater trochanter in patients with trochanteric fracture, osteotomy, or nonunion in the setting of THA...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326425/bilateral-pelvic-discontinuity-a-unique-condition-characterized-by%C3%A2-high-failure-rates-of-current-treatment
#6
John R Martin, Ian Barrett, Rafael J Sierra, David G Lewallen, Daniel J Berry
BACKGROUND: Bilateral pelvic discontinuity is characterized by complete dissociation of the superior and inferior pelvis secondary to bone loss or fracture. The end result is a freely mobile inferior pelvis at the level of each discontinuity which presents a significant reconstruction challenge. This clinical entity has not been described previously, and the results of surgical treatment are not known. METHODS: We retrospectively reviewed all identified cases of pelvic discontinuity (PD) treated with revision THA at one institution...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326418/combining-a-hip-arthroplasty-stem-with-trochanteric-reattachment-bolt-and-a-polyaxial-locking-plate-in-the-treatment-of-a-periprosthetic-fracture-below-a-well-integrated-implant
#7
Urban Hedlundh, Lars Karlsson
Distally anchored uncemented modular tapered porous stems are often the preferred treatment in total hip arthroplasty revisions and failed subtrochanteric fractures. These conditions mainly affect elderly osteoporotic patients, with an increased risk of later fractures below the well-fixated implant. Treatment in secondary fractures with long looking plates is the recommended treatment, where stability is a key to fracture healing. We report a complicated case in which this was achieved by an innovative technique combing the trochanteric attachment bolt of the stem system and a locking plate with polyaxial screws...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326410/growth-of-an-intrapelvic-pseudotumor-associated-with-a-metal-on-metal-total-hip-arthroplasty-after-revision-arthroplasty-causing-a-femoral-nerve-neuropathy
#8
Patrick Leung, James C Kudrna
The development of pseudotumors is not uncommon with metal-on-metal total hip arthroplasty. Pseudotumors that dissect into the retroperitoneal space can cause symptoms of nerve compression. We describe a case of a 53-year-old male with a metal-on-metal total hip arthroplasty who developed mild symptoms of a femoral nerve neuropathy 6 years postoperatively. Revision arthroplasty to a ceramic-on-polyethylene articulation and debridement of the pseudotumor was performed. Postoperatively, the patient's femoral neuropathy progressed and a repeat magnetic resonance imaging showed an increase in size of the pseudotumor despite the removal of the offending metal-on-metal articulation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326406/histologic-evaluation-of-the-bone-ceramic-interface-of-an-alumina-ceramic-cup-arthroplasty-retrieved-after-25-years-in%C3%A2-vivo
#9
Fuminori Higuchi, Shigeo Fukunishi, Shoji Nishio, Tomokazu Fukui, Yuki Fujihara, Shohei Okahisa, Yu Takeda, Shinichi Yoshiya
A 47-year-old man underwent ceramic cup arthroplasty when he was 22 years old. Revision total hip arthroplasty was performed 25 years later because of limited range of motion without implant loosening. Histologic examination revealed that the femoral head and ceramic implant were well fixed through a thin fibrous membrane. The energy-dispersive X-ray analysis indicated that calcium and phosphorus were detected in the same peak pattern as cancellous bone in the bone-ceramic interface.
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#10
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326401/an-unusual-presentation-of-catastrophic-failure-of-hip-arthroplasty-with-a-thigh-mass
#11
Florian Dibra, Hari Parvataneni
In the advent of increasing demand for total hip arthroplasty, surveillance of these patients is imperative to identify potential complications requiring revision surgery. This is especially important in the young population, as revision is usually necessary during their lifetime. We present a case of a young female patient with a history of total hip arthroplasty 17 years prior, who presented with left hip pain and anterior thigh mass. The prosthetic hip had progressed to catastrophic failure with the cobalt-chrome femoral head having eroded through the polyethylene and acetabular socket...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28322718/pseudoaneurysm-of-a-branch-of-the-femoral-circumflex-artery-as-a-complication-of-revision-arthroscopic-release-of-the-iliopsoas-tendon
#12
Naoki Nakano, Laughter Lisenda, Vikas Khanduja
Treatment of painful internal snapping hip via arthroscopic release of the iliopsoas tendon is becoming the preferred option over open techniques because of the benefits of minimal dissection and fewer complications. However, complications do occur with arthroscopic techniques as well. We present the case of a 33-year-old woman who presented with painful internal snapping of her right hip and underwent arthroscopic release of the iliopsoas tendon. Following the procedure she continued to complain of pain in her groin and was therefore investigated further with a magnetic resonance imaging (MRI) which revealed a swelling near the femoral circumflex vessels...
2017: SICOT-J
https://www.readbyqxmd.com/read/28320566/the-utility-of-metal-ion-trends-in-predicting-revision-in-metal-on-metal-total-hip-arthroplasty
#13
Bayard C Carlson, Andrew J Bryan, Nazly T Carrillo-Villamizar, Rafael J Sierra
BACKGROUND: There is a paucity of data examining metal ion levels over time. METHODS: We retrospectively reviewed 59 patients (69 hips) with an articular surface replacement total hip arthroplasty. We reviewed prerevision cobalt and chromium concentrations over time. RESULTS: Seventy-one percent of patients who were revised and had multiple ion measurements (12/17) demonstrated increasing cobalt ion levels or elevated ion levels over time...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318862/have-periprosthetic-hip-infection-rates-plateaued
#14
Dean C Perfetti, Matthew R Boylan, Qais Naziri, Carl B Paulino, Steven M Kurtz, Michael A Mont
BACKGROUND: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Although the number of revision cases is increasing, the prevalence of PJI as an indication for revision surgery, and the variability of this indication among surgeons and hospitals, is unclear. METHODS: The New York Statewide Planning and Research Cooperative System was used to identify 33,582 patients undergoing revision THA between 2000 and 2013. PJI was identified using International Classification of Diseases, Ninth Revision diagnosis codes...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28317236/rehabilitation-of-revision-total-hip-replacement-a-multi-centre-survey-of-current-practice
#15
Meredith Newman, Karen Barker
BACKGROUND: Demand for revision total hip replacement (RTHR) is increasing. Outcomes after RTHR are varied, with reasonable pain relief but smaller gains in function and mobility. Whether sub-optimal rehabilitation contributes to poorer functional outcomes is unclear. Current rehabilitation is not well defined and there is little research into RTHR rehabilitation. AIMS AND OBJECTIVES: To gather information about the current rehabilitation of patients undergoing planned, single-stage revision or re-revision THR surgery...
March 20, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28316961/acute-delayed-or-late-infection-of-revision-total-hip-arthroplasty-treated-with-debridement-antibiotic-loaded-cement-beads-and-retention-of-the-prosthesis
#16
Jun-Dong Chang, In-Sung Kim, Sang-Soo Lee, Je-Hyun Yoo
PURPOSE: The treatment of infected revision total hip arthroplasty (THA) is very challenging due to retained revision prosthesis, poor bone stock and soft tissue condition derived from previous revision surgeries, and comorbidities. The purpose of this study was to investigate the effectiveness and short-term outcomes of aggressive debridement and use of antibiotic-loaded cement beads with retention of the prosthesis for acute delayed or late infection of revision THAs. MATERIALS AND METHODS: Ten consecutive patients with symptoms or signs of less than one-week evolution and well-fixed prostheses, were treated with this procedure and a postoperative course of organism-specific antibiotics for a minimum of 6 weeks...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316959/comparative-study-of-peripheral-rim-fixation-using-jumbo-cup-in-revisional-hip-arthroplasty
#17
Woo-Lam Jo, Young-Wook Lim, Jin-Hyung Im, Seung-Chan Kim, Soon-Yong Kwon, Yong-Sik Kim
PURPOSE: It is challenging procedure to revise acetabular component in acetabulum with severe bone defect or deformity. The jumbo cup is good option for revisional arthroplasty in large bone defect. The purpose of this study is to compare the prognosis of revisional total hip arthroplasty using jumbo cup with peripheral rim fixation and no rim fixation. MATERIALS AND METHODS: We included the patients who had performed acetabular revisional total hip arthroplasty from January 2002 to March 2015 in our institute...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#18
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/28302429/does-bony-regrowth-occur-after-arthroscopic-femoroplasty-in-a-group-of-young-adolescents-femoroplasty-regrowth-in-adolescents
#19
Itay Perets, Asheesh Gupta, Edwin O Chaharbakhshi, Lyall Ashberg, David E Hartigan, Mary R Close, Benjamin G Domb
PURPOSE: To evaluate femoral head-neck bone regrowth and PROs in skeletally immature patients that underwent arthroscopic femoroplasties over a minimum 2-year period. METHODS: Eleven skeletally immature hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum 2-year follow-up with patient-reported outcomes (PROs) and radiographs preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively...
March 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28300706/tapered-stems-one-third-proximally-coated-have-higher-complication-rates-than-cylindrical-two-third-coated-stems-in-patients-with-high-hip-dislocation-undergoing-total-hip-arthroplasty-with-step-cut-shortening-osteotomy
#20
Vahit Emre Ozden, Goksel Dikmen, Burak Beksac, Ismail Remzi Tozun
BACKGROUND: The results of cementless stems in total hip arthroplasty (THA) done because of congenital dislocation with step-cut osteotomy is not well known, particularly the influence of the design and the role of extent of porous coating. Therefore we performed a retrospective study to evaluate the mid to long-term results THA performed with a single type acetabular component and different geometry and fixation type stems with ceramic bearings in the setting of step-cut subtrochanteric osteotomy in high hip dislocated (HHD) patients...
March 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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