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https://www.readbyqxmd.com/read/28102158/use-of-trabecular-titanium-implants-for-primary-hip-arthroplasty
#1
Paweł Kamiński, Jakub Szmyd, Jarosław Ambroży, Wojciech Jurek, Jerzy Mirosław Jaworski
BACKGROUND: Total hip arthroplasty is an increasingly common procedure. The large number of cases inevitably includes patients who require filling of their acetabular defect even in their primary surgery. The use of a utogenous grafts and allografts as well as resistance rings requires patients to avoid loading the limb for a long time to enable implant integration. This disadvantage may be partially eliminated by using trabecular titanium implants. The aim of this paper is to present the outcomes of the use of trabecular titanium implants in primary hip arthroplasty...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28099305/characterizing-the-propionibacterium-load-in-revision-shoulder-arthroplasty-a-study-of-137-culture-positive-cases
#2
Zahab S Ahsan, Jeremy S Somerson, Frederick A Matsen
BACKGROUND: Propionibacterium is commonly recovered from explants or surrounding tissues in revision shoulder arthroplasty. Rather than attempting to differentiate a true infection from a false-positive result on the basis of the number of positive cultures, we characterized the amount of these bacteria in each specimen and shoulder. METHODS: The study included 137 revision shoulder arthroplasties from which a minimum of 4 specimens had been submitted for culture and at least 1 was positive for Propionibacterium...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28099298/low-dose-aspirin-is-effective-chemoprophylaxis-against-clinically-important-venous-thromboembolism-following-total-joint-arthroplasty-a-preliminary-analysis
#3
Javad Parvizi, Ronald Huang, Camilo Restrepo, Antonia F Chen, Matthew S Austin, William J Hozack, Jess H Lonner
BACKGROUND: Aspirin is a safe and effective prophylaxis for the prevention of venous thromboembolism following total joint arthroplasty. The optimal dose of aspirin prophylaxis is unknown. Our hypothesis was that lower-dose aspirin is as effective as higher-dose aspirin for the prevention of venous thromboembolism and is associated with fewer gastrointestinal side effects. METHODS: In a prospective, crossover study, we analyzed 4,651 primary total joint arthroplasty cases performed from July 2013 to June 2015...
January 18, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28094191/functional-results-of-bilateral-reverse-total-shoulder-arthroplasty
#4
Chris R Mellano, Robert Thorsness, Peter N Chalmers, Terrence F Feldheim, Patrick O'Donnell, Brian J Cole, Nikhil N Verma, Anthony A Romeo, Gregory P Nicholson
BACKGROUND: The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. METHODS: At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#5
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28093896/intravenous-combined-with-topical-administration-of-tranexamic-acid-in-primary-total-hip-arthroplasty-a-randomized-controlled-trial
#6
Yi Zeng, Hai-Bo Si, Bin Shen, Jing Yang, Zong-Ke Zhou, Peng-de Kang, Fu-Xing Pei
OBJECTIVE: Although there are still some controversies, large previous studies have confirmed that intravenous (i.v.) tranexamic acid (TXA) can effectively reduce blood loss and transfusions in total hip arthroplasty (THA) without increasing the risk of deep venous thrombosis. However, few studies have investigated the combination of i.v. and topical application of TXA in primary THA. The purpose of our current study is to examine whether i.v. combined with topical administration of TXA decreases postoperative blood loss and transfusion rates after THA...
January 17, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#7
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28091766/pre-operative-intra-articular-deep-tissue-sampling-with-novel-retrograde-forceps-improves-the-diagnostics-in-periprosthetic-joint-infection
#8
Matthias D Wimmer, Milena M Ploeger, Max J Friedrich, Thomas Hügle, Sascha Gravius, Thomas M Randau
BACKGROUND: Histopathological tissue analysis is a key parameter within the diagnostic algorithm for suspected periprosthetic joint infections (PJIs), conventionally acquired in open surgery. In 2014, Hügle and co-workers introduced novel retrograde forceps for retrograde synovial biopsy with simultaneous fluid aspiration of the knee joint. We hypothesised that tissue samples acquired by retrograde synovial biopsy are equal to intra-operatively acquired deep representative tissue samples regarding bacterial detection and differentiation of periprosthetic infectious membranes...
January 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28089469/does-barbed-suture-lower-cost-and-improve-outcome-in-total-knee-arthroplasty-a-randomized-controlled-trial
#9
Vincent W K Chan, Ping-Keung Chan, Kwong-Yuen Chiu, Chun-Hoi Yan, Fu-Yuen Ng
BACKGROUND: Wound closure is key to prevent infection, facilitate immediate rehabilitation, and improve efficiency of total knee arthroplasty (TKA). Continuous knotless suturing with barbed suture can potentially save time and distribute tension more evenly. However, its role in TKA in terms of cost-effectiveness and wound complications is not clear. This study aims at comparing barbed and traditional sutures' wound closure time and cost in primary TKA. METHODS: One hundred nine knees were randomized into either barbed or traditional group...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28089261/is-previous-nonarthroplasty-surgery-a-risk-factor-for-periprosthetic-infection-in-primary-shoulder-arthroplasty
#10
Jean-David Werthel, Taku Hatta, Bradley Schoch, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: The purpose of this study was to determine the risk of periprosthetic infection after primary shoulder arthroplasty (SA) in patients undergoing previous nonarthroplasty shoulder surgery compared with those without previous surgery. MATERIALS AND METHODS: All patients undergoing primary SA at our institution between 1970 and 2012 were included in this study. The cohort consisted of 4577 patients treated with 2890 total SAs, 1233 hemiarthroplasties, and 454 reverse SAs; 813 (18%) patients had undergone prior nonarthroplasty shoulder surgery on the operative side...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#11
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28087166/future-surgery-after-revision-shoulder-arthroplasty-the-impact-of-unexpected-positive-cultures
#12
Eric M Padegimas, Cassandra Lawrence, Alexa C Narzikul, Benjamin M Zmistowski, Joseph A Abboud, Gerald R Williams, Surena Namdari
BACKGROUND: The clinical implications and treatment of unexpected positive cultures (UPCs) in revision shoulder arthroplasty are not well defined. The purpose of this study was to describe results of patients with and without UPCs after revision shoulder arthroplasty. METHODS: A single institutional database was used to retrospectively identify all revision shoulder arthroplasties performed between January 1, 2011, and December 31, 2013. Patients with preoperative suspicion of infection were excluded...
January 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087159/the-direct-anterior-approach-for-complex-primary-total-hip-arthroplasty-the-extensile-acetabular-approach-on-a-regular-operating-room-table
#13
Ben Molenaers, Ronald Driesen, Guy Molenaers, Kristoff Corten
BACKGROUND: The direct anterior approach on a regular operating room table has been reported with low dislocation rates. This might be beneficial for complex primary total hip arthroplasty (THA) such as in patients with cerebral palsy or following femoral or pelvic osteotomies. Extending the approach is often required to overcome problems such as acetabular deformities or severe contractures. METHODS: We retrospectively evaluated the results and complications of 29 patients with 37 complex primary THA in which an extensile approach was used...
December 22, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#14
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28074257/outcomes-of-dual-mobility-cups-in-a-young-middle-eastern-population-and-its-influence-on-life-style
#15
Chahine Assi, Elie El-Najjar, Camille Samaha, Kaissar Yammine
Dual mobility cups (DMC) in total hip arthroplasty (THA) are becoming popular among orthopaedic surgeons. Substantial benefit of their use has been reported among high risk patients, particularly in reducing post-operative hip instability (dislocation). Many reports stated some concern when implanted in young and active people where complications such as polyethylene wear and mechanical loosening could potentially be higher. This Middle Eastern study analyses a retrospective series of THA for any aetiology other than infection, using DMC for the acetabular component in 75 patients (85 implants) less than 70 years old...
January 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#16
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28070149/outcome-analysis-of-hip-or-knee-arthroplasty-in-patients-with-cirrhotic-liver-disease
#17
Young-Jun Seol, Taek-Rim Yoon, Dong-Hyun Lee, Sun-Ho Lee, Kyung-Soon Park
OBJECTIVE: Present helpful measures to prevent expected complications that occur in patients with liver cirrhosis undergoing arthroplasty. METHODS: 218 patients who underwent hip or knee arthroplasty were included in this study. Prognoses of patients with underlying disease of liver cirrhosis and those without are compared with measures. RESULTS: Patients with liver cirrhosis show an increase in amount of bleeding, hospital stay and infection rate compared to those who do not...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#18
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28068843/outcomes-after-interpositional-arthroplasty-of-the-first-metatarsophalangeal-joint
#19
Michael C Aynardi, Lara Atwater, Eric J Dein, Talal Zahoor, Lew C Schon, Stuart D Miller
BACKGROUND: For patients with hallux rigidus seeking a motion-sparing procedure, interposition arthroplasty is an alternative to fusion. The purpose of this study was to report patient outcomes after interpositional arthroplasty for hallux rigidus. METHODS: All patients undergoing interpositional arthroplasty at our institution from 2001 to 2014 were identified and a retrospective chart review was performed. Follow-up was conducted through a telephone survey to obtain survivorship, satisfaction, and functional scores...
January 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28068306/revision-knee-arthroplasty-in-patients-with-inherited-bleeding-disorders-a-single-center-experience
#20
Andrzej Kotela, Magdalena Wilk-Frańczuk, Piotr Żbikowski, Paweł Łęgosz, Paweł Ambroziak, Ireneusz Kotela
BACKGROUND The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD. MATERIAL AND METHODS A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed...
January 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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