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https://www.readbyqxmd.com/read/28337656/what-factors-are-associated-with-femoral-component-internal-rotation-in-tka-using-the-gap-balancing-technique
#1
Seung-Yup Lee, Hong-Chul Lim, Ki-Mo Jang, Ji-Hoon Bae
BACKGROUND: When using the gap-balancing technique for TKA, excessive medial release and varus proximal tibial resection can be associated with internal rotation of the femoral component. Previous studies have evaluated the causes of femoral component rotational alignment with a separate factor analysis using unadjusted statistical methods, which might result in treatment effects being attributed to confounding variables. QUESTIONS/PURPOSES: (1) What pre- and intraoperative factors are associated with internal rotation of the femoral component in TKA using the gap balancing technique? (2) To what degree does femoral component rotation as defined by the navigation system differ from rotation as measured by postoperative CT? METHODS: Three hundred seventy-seven knees that underwent computer-assisted primary TKA attributable to degenerative osteoarthritis with varus or mild valgus alignment in which medial soft tissue release was performed, and those with preoperative radiographs including preoperative CT between October 2007 and June 2014 were included in the study...
March 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28336947/an-ideal-dielectric-coat-to-avoid-prosthesis-rf-artefacts-in-magnetic-resonance-imaging
#2
U Zanovello, L Matekovits, L Zilberti
The number of people submitted to total hip or knee arthroplasty increased in the last years and it is likely to grow further. Hence, the importance of a proper investigation tool that allows to determine and recognize the potential presence of perioperative and/or postoperative diseases becomes clear. Although the Magnetic Resonance Imaging (MRI) technique demonstrated several advantages over the other common tomography tools, it suffers from the arise of image artefacts if it is performed in presence of metallic prostheses...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28332156/the-pathology-of-failed-mckee-farrar-implants-correlation-with-modern-metal-on-metal-implant-failure
#3
Mitsuru Munemoto, George Grammatopoulos, Yasuhito Tanaka, Max Gibbons, Nicholas A Athanasou
The McKee-Farrar (MF) prosthesis was the first widely used total hip replacement (THR) to employ a metal-on-metal (MoM) articulation. These implants had a high rate of early aseptic loosening but a number achieved good long-term implant survival, stimulating the reintroduction of second and third generation implants of this type. In this study we analysed archival histopathology of periprosthetic tissues in twenty cases of MF aseptic implant failure to determine if there was evidence of an innate and adaptive immune response similar to that seen in modern MoM implants...
May 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28323248/accuracy-and-reproducibility-of-preoperative-three-dimensional-planning-for-total-hip-arthroplasty-using-biplanar-low-dose-radiographs-a-pilot-study
#4
Didier Mainard, Olivier Barbier, Yohann Knafo, Rémi Belleville, Laurence Mainard-Simard, Jean-Baptiste Gross
BACKGROUND: In total hip arthroplasty (THA), the acetabular cup and femoral stem must be correctly sized and positioned to avoid intraoperative and postoperative complications, achieve good functional outcomes and ensure long-term survival. Current two-dimensional (2D) techniques do not provide sufficient accuracy, while low-dose biplanar X-rays (EOS) had not been assessed in this indication. Therefore we performed a case-control study to: 1) evaluate the prediction of stem and cup size for a new 3D planning technique (stereoradiographic imaging plus 3D modeling) in comparison to 2D templating on film radiographs and 2) evaluate the accuracy and reproducibility of this 3D technique for preoperative THA planning...
March 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28322115/lower-extremity-kinematics-of-curve-sprinting-displayed-by-runners-using-a-transtibial-prosthesis
#5
Yumeng Li, Kathy J Simpson, Lee Nolan, Marilyn Miller, Benjamin Johnson
The purpose of the study was to determine if the kinematics exhibited by skilled runners wearing a unilateral, transtibial prosthesis during the curve section of a 200-m sprint race were influenced by interaction of limb-type (prosthetic limb (PROS-L) vs. nonprosthetic limb (NONPROS-L)) and curve-side (inside and outside limb relative to the centre of the curve). Step kinematics, toe clearance and knee and hip flexion/extension, hip ab/adduction for one stride of each limb were generated from video of 13 males running the curve during an international 200 m transtibial-classified competition...
March 21, 2017: Journal of Sports Sciences
https://www.readbyqxmd.com/read/28318394/effect-of-foot-and-ankle-immobilization-on-able-bodied-gait-as-a-model-to-increase-understanding-about-bilateral-transtibial-amputee-gait
#6
Antonia Nepomuceno, Matthew J Major, Rebecca Stine, Steven Gard
BACKGROUND: The anatomical foot-ankle complex facilitates advancement of the stance limb through foot rockers and late-stance power generation during walking, but this mechanism is altered for persons with bilateral transtibial amputation when using passive prostheses. OBJECTIVES: To study the effects of bilateral foot and ankle immobilization on able-bodied gait to serve as a model for understanding gait of persons with bilateral transtibial amputation and associated compensatory mechanisms...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28318387/a-qualitative-study-of-the-challenges-of-providing-pre-prosthetic-rehabilitation-in-rural-south-africa
#7
Liezel Ennion, Anton Johannesson Johannesson
BACKGROUND: There is a known shortage of rehabilitation staff in rural settings and a sharp increase in the number of lower limb amputations being performed. A lack of adequate pre-prosthetic rehabilitation will result in worse physical and psychological outcomes for a person with a lower limb amputation, and they will not be eligible to be fitted with a prosthesis. OBJECTIVE: To explore therapists' experiences with providing pre-prosthetic rehabilitation in a rural setting...
March 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28317312/evaluation-of-dose-calculation-accuracy-of-treatment-planning-systems-at-hip-prosthesis-interfaces
#8
David Paulu, Parham Alaei
There are an increasing number of radiation therapy patients with hip prosthesis. The common method of minimizing treatment planning inaccuracies is to avoid radiation beams to transit through the prosthesis. However, the beams often exit through them, especially when the patient has a double-prosthesis. Modern treatment planning systems employ algorithms with improved dose calculation accuracies but even these algorithms may not predict the dose accurately at high atomic number interfaces. The current study evaluates the dose calculation accuracy of three common dose calculation algorithms employed in two commercial treatment planning systems...
March 20, 2017: Journal of Applied Clinical Medical Physics
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
#9
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/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#10
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
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
#11
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
https://www.readbyqxmd.com/read/28300363/activation-of-hip-prostheses-in-high-energy-radiotherapy-and-resultant-dose-to-nearby-tissue
#12
Stephanie Keehan, Ryan L Smith, Jeremy Millar, Max Esser, Michael L Taylor, Peta Lonski, Tomas Kron, Rick D Franich
High energy radiotherapy can produce contaminant neutrons through the photonuclear effect. Patients receiving external beam radiation therapy to the pelvis may have high-density hip prostheses. Metallic materials such as those in hip prostheses, often have high cross-sections for neutron interaction. In this study, Thackray (UK) prosthetic hips have been irradiated by 18 MV radiotherapy beams to evaluate the additional dose to patients from the activation products. Hips were irradiated in- and out-of field at various distances from the beam isocenter to assess activation caused in-field by photo-activation, and neutron activation which occurs both in and out-of-field...
March 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28293984/hip-prosthesis-in-sitting-posture-for-bilateral-transfemoral-amputee-after-burn-injury-a-case-report
#13
Yukiyo Shimizu, Hirotaka Mutsuzaki, Takayuki Maezawa, Yuji Idei, Kazuya Takao, Ryoko Takeuchi, Shinzo Onishi, Yasushi Hada, Masashi Yamazaki, Yasuyoshi Wadano
BACKGROUND: To overcome the challenges of rehabilitation of bilateral transfemoral amputees, we developed a novel "hip prosthesis in the sitting posture." Case Description and Methods: A 64-year-old male bilateral transfemoral amputee was transferred for rehabilitation 4 months following a burn injury. His wounds remained unhealed for 20 months; thus, he was unable to participate in standing training with the standard prosthetic sockets. Hip prosthesis in the sitting posture has very little friction between the sockets and residual limbs, which facilitated our patient to begin standing and walking exercises...
December 1, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28286463/range-of-movement-for-impingement-and-dislocation-avoidance-in-total-hip-replacement-predicted-by-finite-element-model
#14
Laura Ezquerra, María Paz Quilez, María Ángeles Pérez, Jorge Albareda, Belén Seral
Dislocation is a serious complication in total hip replacement (THR). An inadequate range of movement (ROM) can lead to impingement of the prosthesis neck on the acetabular cup; furthermore, the initiation of subluxation and dislocation may occur. The objective of this study was to generate a parametric three-dimensional finite element (FE) model capable of predicting the dislocation stability for various positions of the prosthetic head, neck, and cup under various activities. Three femoral head sizes (28, 32, and 36 mm) were simulated...
2017: Journal of Medical and Biological Engineering
https://www.readbyqxmd.com/read/28285036/stay-short-or-go-long-can-a-standard-cemented-femoral-prosthesis-be-used-at-second-stage-total-hip-arthroplasty-revision-for-infection-following-an-extended-trochanteric-osteotomy
#15
Michael J Petrie, Tim P Harrison, Simon C Buckley, Andrew Gordon, Robert M Kerry, Andrew J Hamer
BACKGROUND: The aim of this study was to review the results of the use of a cemented, standard length, taper-slip femoral component at second stage following an extended trochanteric osteotomy (ETO). METHODS: We reviewed prospectively collected data from the hospital arthroplasty database, identifying and reviewing all patients who had undergone an ETO at first-stage revision for infection, who had subsequently undergone second-stage reimplantation. RESULTS: Over 17 years, 99 patients underwent 102 2-stage procedures with ETO at first stage, with a mean follow-up of 5...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28277592/evaluation-of-the-effects-of-the-metha-short-stem-on-periprosthetic-bone-remodelling-in-total-hip-arthroplasties-results-at-48-months
#16
Paolo D Parchi, Gianluca Ciapini, Iacopo Castellini, Claudia Mannucci, Anna Maria Nucci, Nicola Piolanti, Silvia Maffei, Michele Lisanti
INTRODUCTION: Total hip arthroplasty is one of the most performed procedures in orthopaedic surgery. Implantation of a prosthesis determines changes in the distribution of loads on the host bone, and this phenomenon, known as stress shielding, is related to the biomechanical characteristics of the implant. Usually stress shielding involves the proximal portion of the femur by reducing the mechanical strength and ability to withstand the transmitted loads. The aim of our study is to demonstrate how the use of a short hip stem reduces the stress shielding phenomenon to the proximal femur...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28269629/hip-joint-geometry-effects-on-cartilage-contact-stresses-during-a-gait-cycle
#17
Hui-Hui Wu, Dong Wang, An-Bang Ma, Dong-Yun Gu
The cartilage surface geometry of natural human hip joint is commonly regarded as sphere. It has been widely applied in computational simulation and hip joint prosthesis design. Some new geometry models have been developed and the sphere assumption has been questioned recently. The objective of this study was to analyze joint geometry effects on cartilage contact stress distribution and investigate contact patterns during a whole gait cycle. Hip surface was reconstructed from CT data of a healthy volunteer...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28269573/pose-measurement-of-anterior-pelvic-plane-based-on-inertial-measurement-unit-in-total-hip-replacement-surgeries
#18
Zhe Cao, Shaojie Su, Hong Chen, Hao Tang, Yixin Zhou, Zhihua Wang
In Total Hip Replacement (THR), inaccurate measurement of Anterior Pelvic Plane (APP), which is usually used as a reference plane, will lead to malposition of the acetabular prosthesis. As a result, the risk of impingement, dislocation and wear will increase and the safe range of motion will be limited. In order to acquire the accurate pose of APP, a measurement system is designed in this paper, which includes two parts: one is used to estimate the initial pose of APP and the other is used to trail dynamic motion of APP...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268355/frequency-of-occurrence-of-myoelectric-patterns-to-evaluate-gait-motor-control-strategies-after-hip-replacement-surgery
#19
Valentina Agostini, Francesco Di Nardo, Sandro Fioretti, Laura Burattini, Samanta Rosati, Gabriella Balestra, Marco Knaflitz
Gait alterations are observed even years after hip replacement surgery. Such long-lasting alterations may arise from a global change of the motor control strategies. The aim of this work is to investigate the changes in gait motor control strategies of patients after hip replacement surgery by analyzing the frequency of occurrence (OF) of myoelectric activation patterns. We studied five lower limb muscles during gait, in hip prosthesis patients and controls. We found that patients adopt a motor control strategy that tends to prefer "simplified" myoelectric patterns, showing a smaller number of activations within the gait cycle...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263806/one-stage-computer-assisted-total-knee-arthroplasty-and-tibial-osteotomy
#20
S Denjean, F Chatain, O Tayot
Same-stage tibial osteotomy may deserve consideration in candidates to total knee arthroplasty (TKA) who have severe bone deformities, particularly at extra-articular sites. This strategy obviates the need for either a major and technically difficult ligament release procedure, which may compromise ligament balancing, or the use of a semi-constrained prosthesis. This technical note describes a one-stage, computer-assisted technique consisting in TKA followed by corrective tibial osteotomy to obtain an overall mechanical axis close to 180° without extensive ligament balancing...
March 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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