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Revision knee

Kevin D Stockwell, Sarfraz Malleck, Trevor C Gascoyne, Thomas R Turgeon
BACKGROUND: Despite the extensive study of primary arthroplasty, revision surgery is rarely discussed due to the reduced frequency and variability between patients. A new revision knee system was introduced to build off the geometry of a successful knee replacement system. This study seeks to assess the survival, clinical outcomes and radiographic assessment of this revision system at the early to mid-term. METHODS: A consecutive cohort of 234 rTKAs was identified from an institutional database...
December 12, 2018: Knee
Samuel E McMahon, Emer Doran, Seamus O'Brien, Roslyn S Cassidy, Jens G Boldt, David E Beverland
BACKGROUND: Total knee arthroplasty designs can be categorized by bearing design and fixation method. The mobile-bearing concept was developed with the aim of increasing longevity and improving function by reduced polyethylene wear and closer replication of physiological knee motion. Cementless fixation has the goal of achieving a long-lasting "biological" fixation between prosthesis and bone. METHODS: Prospective analysis of the survivorship and patient-reported functional outcomes of a series of 500 low contact stress rotating-platform mobile-bearing total knee arthroplasties with a cementless tibial component with a minimum 17-year follow-up...
November 23, 2018: Journal of Arthroplasty
Xiang-Dong Wu, Meng-Meng Liu, Ya-Ying Sun, Zhi-Hu Zhao, Quan Zhou, Joey S W Kwong, Wei Xu, Mian Tian, Yao He, Wei Huang
INTRODUCTION: Joint arthroplasty is a particularly complex orthopaedic surgical procedure performed on joints, including the hip, knee, shoulder, ankle, elbow, wrist and even digit joints. Increasing evidence from volume-outcomes research supports the finding that patients undergoing joint arthroplasty in high-volume hospitals or by high-volume surgeons achieve better outcomes, and minimum case load requirements have been established in some areas. However, the relationships between hospital/surgeon volume and outcomes in patients undergoing arthroplasty are not fully understood...
December 14, 2018: BMJ Open
Du Hyun Ro, Heejin Jin, Jae-Young Park, Myung Chul Lee, Sungho Won, Hyuk-Soo Han
PURPOSE: This study hypothesized that the use of bisphosphonates (BPs) after total joint arthroplasty (TJA) is associated with a lower implant revision rate. This study aimed (1) to investigate the association between BP use and the revision rate of TJA and (2) to determine the relationship between the medication period and the revision rate of TJA. METHODS: National Health Insurance Service data on surgeries, medications, diagnoses, and screenings of 50 million Koreans were reviewed...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jared M Newman, Marcelo B P Siqueira, Alison K Klika, Robert M Molloy, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Continuous wound drainage after arthroplasty can lead to the development of a periprosthetic joint infection. Closed incisional negative pressure wound therapy (ciNPWT) has been reported to help alleviate drainage and other wound complications. The purpose of this prospective randomized controlled trial is to compare the use of ciNPWT with our standard of care dressing in revision arthroplasty patients who were at high risk to develop wound complications. METHODS: A total of 160 patients undergoing elective revision arthroplasty were prospectively randomized to receive either ciNPWT or a silver-impregnated occlusive dressing after surgery in a single institution...
November 17, 2018: Journal of Arthroplasty
Nima Eftekhary, James E Feng, Afshin A Anoushiravani, Ran Schwarzkopf, Jonathan M Vigdorchik, William J Long
BACKGROUND: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score is a nationally standardized measure of a patient's inpatient experience. This study aims to assess whether HCAHPS scores differ between patients undergoing primary total joint arthroplasty (TJA) and patients undergoing revision TJA. METHODS: Patients who underwent primary or revision total hip or total knee arthroplasty (THA or TKA) and returned a completed HCAHPS survey were included in this study...
November 20, 2018: Journal of Arthroplasty
Eric Kim, Carl T Talmo, Marie C Anderson, Olivia J Bono, James V Bono
During cruciate retaining (CR) total knee arthroplasty (TKA), the posterior cruciate ligament (PCL) may avulse at its insertion. The incidence of PCL avulsion fracture has not been previously studied. The aim of this study is to report on the incidence and clinical significance of intraoperative PCL avulsion during primary CR TKA and to identify potential risk factors. Our institutional joint registry was retrospectively reviewed for PCL avulsion occurring during CR TKA implanted between April 2008 and April 2016...
December 13, 2018: Journal of Knee Surgery
Ming-Chou Ku, Yiing-Feng Hwang, Cheng-Kung Cheng, Jr-Kai Chen, Atul Kumar
Instability of the knee joint after total knee replacement (TKR) is one of the most important reasons for revision TKR. Inadequate release or tightening of the collateral ligaments in the knee joint may cause instability and early failure. This study presents a case series study of a new technique for ligament balancing wherein the collateral ligament is detached from its origin and rotated (twisted) around its longitudinal axis to tighten the ligament before the origin is reattached to its original position...
December 2018: Techniques in Orthopaedics: TIO
Michael T Busch, Crystal A Perkins, Brian T Nickel, Daniel J Blizzard, Samuel Clifton Willimon
INTRODUCTION: The insertion of 2 elastic stable intramedullary nails (ESINs) is a common treatment for pediatric femur fractures. However, the use of this technique in length-unstable or metadiaphyseal fractures has historically been associated with higher complication rates. To improve stability, the addition of a third ESIN has been assessed biomechanically and clinically, but the addition of a fourth nail has only been evaluated biomechanically. The purpose of this study is to report our surgical technique and radiographic outcomes using a quartet of ESINs in pediatric femur fractures...
January 2019: Journal of Pediatric Orthopedics
Antonio Mazzotti, Fabrizio Perna, Davide Golinelli, Irene Quattrini, Susanna Stea, Barbara Bordini, Cesare Faldini
PURPOSE: The aim of this study was to assess whether preoperative valgus or varus deformity affected survivorship after total knee arthroplasty (TKA) and to quantify the risk factors for implant failure in a registry-based population. METHODS: The Emilia-Romagna Registry of Prosthetic Orthopedic Implants was examined regarding TKAs performed on patients with a preoperative diagnosis of valgus or varus deformity. Demographics, implant characteristic and survivorships were investigated and compared...
December 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Fuzhen Yuan, Zewen Sun, Haijun Wang, Yourong Chen, Jiakuo Yu
PURPOSE: A cutting guide technique for patella resurfacing in total knee arthroplasty was expected to result in less patellofemoral syndromes. The aim of this study was to identify differences in the patellofemoral function, clinical outcomes, and radiographic parameters between the freehand and cutting guide patellar resection techniques in patients undergoing total knee arthroplasty. METHODS: A prospective randomized controlled trial was conducted. The study was registered in a public trials registry (International Standard Randomized Trial No...
December 11, 2018: International Orthopaedics
Frank S Fröschen, Nadine Gravius, Jan-Frederic Lau, Thomas Martin Randau, Eva Kaup, Max J Friedrich, Sascha Gravius
PURPOSE: The contact allergens nickel, cobalt, and chromium are often discussed as possible triggers of allergic reactions to orthopedic implants. Additionally, acrylates and polymerization additives in bone cement (e.g., benzoyl peroxide (BPO)) have been implicated as triggers of eczema, wound healing disorders, and aseptic implant loosening. We report about six patients with aseptic loosening after total knee arthroplasty (TKA), who underwent revision surgery after testing positive for BPO hypersensitivity...
December 11, 2018: International Orthopaedics
Shaw Bronner, Igor Reis Urbano
The Dance Functional Outcome Survey (DFOS) was developed as a self-report questionnaire for healthy and injured ballet and modern dancers, focusing on the low back and lower extremities. Our aim was to determine factor analysis and internal consistency of the 16 items and to investigate test-retest and equivalence reliability and validity of the DFOS compared to three orthopedic outcomes instruments. Data were collected from 80 healthy and injured adult ballet and modern pre-professional and professional dancers...
November 2018: Sports medicine international open
Filippo Migliorini, Markus Tingart, Marc Niewiera, Björn Rath, Jörg Eschweiler
PURPOSE: In the last couple of years, a significant amount of studies comparing the UKA and TKA for unicompartmental knee osteoarthritis have been published. However, there is a lack of recent meta-analysis comparing the two implants. Since the number of performed UKAs is currently increasing and the indications are obsolete, it becomes important to update current evidences and outcomes. With these premises, a meta-analysis of clinical trials comparing UKA versus TKA was conducted. METHODS: In October 2018, the following databases were accessed: Cochrane Systematic Reviews, Scopus, PubMed and Google Scholar...
December 7, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Joseph S Tramer, Mohsin S Fidai, Omar Kadri, Toufic R Jildeh, Zamaan Hooda, Eric C Makhni, Terrence Lock
Background: A proposed mechanism for recurrent instability following anterior cruciate ligament (ACL) reconstruction is failure of the anterolateral ligament (ALL). Presently, there are a number of approaches to treating ALL pathology. Purpose: To determine practice patterns among orthopaedic surgeons regarding ALL during ACL reconstruction. Study Design: Cross-sectional study. Methods: An online 7-question survey was sent to all physicians registered with the American Orthopaedic Society for Sports Medicine between June and July 2017...
December 2018: Orthopaedic Journal of Sports Medicine
Joseph F Konopka, Yuo-Yu Lee, Edwin P Su, Alexander S McLawhorn
Background: The quality-adjusted life year (QALY) is the preferred outcome measurement for cost-effectiveness analysis in health care. QALYs measure patient health-related quality of life with use of a value between 0 and 1. Few studies have provided original data delineating QALYs after hip and knee arthroplasty. In the present study, we evaluated patient utility preoperatively and 2 years after total hip arthroplasty, hip resurfacing, revision hip arthroplasty, total knee arthroplasty, unicompartmental knee arthroplasty, and revision knee arthroplasty...
September 25, 2018: JB & JS open access
Goris Nazari
No abstract text is available yet for this article.
December 6, 2018: Journal of Physiotherapy
Gareth G Jones, Susannah Clarke, Martin Jaere, Justin P Cobb
High tibial osteotomy is an attractive treatment option for young active patients wishing to return to high-level activities. However, it is not considered a long-term solution, with 30% revised at ten years. Currently, the only revision option is a total knee arthroplasty, a procedure that might not deliver the functional level expected by these highly active patients. This paper describes a novel joint preserving approach to HTO revision, using assistive technology, in the form of 3D printed guides, to reverse the osteotomy and simultaneously perform a unicompartmental knee replacement...
December 5, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Shuxiang Li, Xiaomin Luo, Han Sun, Kun Wang, Kaifeng Zhang, Xiaoliang Sun
BACKGROUND: There remains a controversy regarding the risks in subsequent total joint arthroplasty (TJA) with and without previous bariatric surgery (BS). We performed a meta-analysis based on the current evidence-based study to determine the influences of prior BS on the short-term and long-term outcomes following TJA. METHODS: From the inception to July 2018, the EMBASE, PubMed, Web of Science, and Cochrane Library electronic databases were searched for all relevant English language trials...
November 20, 2018: Journal of Arthroplasty
S Fornell, E Prada, P Barrena, A García-Mendoza, E Borrego, G Domecq
BACKGROUND: This research was undertaken to evaluate Oxford Domed Lateral unicompartmental knee replacement (UKR) survival and clinical and radiological outcomes. The study also considered the influence of body mass index (BMI) on results and proposed contralateral healthy knee anatomic femorotibial angle (AFTA) as a predictor of postoperative knee alignment. METHODS: A retrospective evaluation of 41 primary Oxford Domed Lateral UKR performed in 41 patients in the same institution was undertaken on a patient group comprising of 10 men and 31 women with a mean age of 63 years (range: 38-81 years)...
December 2018: Knee
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