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Total joint arthroplasty

Zhenyang Mao, Bing Yue, You Wang, Mengning Yan, Kerong Dai
BACKGROUND: Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular administration of TXA. This study aimed to evaluate the effects of peri-articular injection of TXA in reducing blood loss after TKA and compare them to those of intra-articular TXA injection...
October 19, 2016: BMC Musculoskeletal Disorders
Olivier Borens, Pablo S Corona, Lars Frommelt, Stergios Lazarinis, Michael Richard Reed, Carlo Luca Romano
Total Joint Arthroplasty (TJA) continues to gain acceptance as the standard of care for the treatment of severe degenerative joint disease, and is considered one of the most successful surgical interventions in the history of medicine. A devastating complication after TJA is infection. Periprosthetic joint infection (PJI), represents one of the major causes of failure and remains a significant challenge facing orthopaedics today. PJI usually requires additional surgery including revision of the implants, fusion or amputations causing tremendous patient suffering but also a heavy health economics burden...
October 19, 2016: Advances in Experimental Medicine and Biology
Erik V de Kelft
STUDY DESIGN: This is a feasibility study to confirm the design, patient population, and the surgical technique for FENIX implants. OBJECTIVE: This study evaluated the safety and the clinical and radiologic performance of bilaterally implanted FENIX facet resurfacing device. INTRODUCTION: Facet joint osteoarthritis is responsible for up to 30% of chronic low back pain. Arthroplasty is a surgical treatment option that aims to relieve pain while maintaining or restoring motion...
November 2016: Clinical Spine Surgery
Atsushi Minatani, Kentaro Uchida, Gen Inoue, Shotaro Takano, Jun Aikawa, Masayuki Miyagi, Hisako Fujimaki, Dai Iwase, Kenji Onuma, Toshihide Matsumoto, Masashi Takaso
BACKGROUND: Calcitonin gene-related peptide (CGRP) is a 37-amino-acid vasodilatory neuropeptide that binds to receptor activity-modifying protein 1 (RAMP1) and the calcitonin receptor-like receptor (CLR). Clinical and preclinical evidence suggests that CGRP is associated with hip and knee joint pain; however, the regulation mechanisms of CGRP/CGRP receptor signaling in synovial tissue are not fully understood. METHODS: Synovial tissues were harvested from 43 participants with radiographic knee osteoarthritis (OA; unilateral Kellgren/Lawrence (K/L) grades 3-4) during total knee arthroplasty...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Panna Sanga, Nathaniel Katz, Elena Polverejan, Steven Wang, Kathleen M Kelly, Juergen Haeussler, John Thipphawong
OBJECTIVE: To evaluate long-term safety and efficacy of fulranumab in patients with moderate-to-severe chronic osteoarthritis (OA) knee or hip pain. METHODS: In this placebo-controlled, phase-2 double-blind (DB) extension study, patients who were equally randomized to 1mgQ4wk, 3mgQ8wk, 3mgQ4wk, 6mgQ8wk, or10mgQ8wk fulranumab (s.c.) or placebo in the 12-week DB efficacy phase, and completed this DB efficacy phase, were eligible to continue the dose throughout a 92-week extension phase followed by a 24-week posttreatment follow-up (PFTU)...
October 16, 2016: Arthritis & Rheumatology
Tressa D Amirthanayagam, Andrew A Amis, Peter Reilly, Roger J H Emery
BACKGROUND: The deltopectoral approach for total shoulder arthroplasty can result in subscapularis dysfunction. In addition, glenoid wear is more prevalent posteriorly, a region difficult to access with this approach. We propose a posterior approach for access in total shoulder arthroplasty that uses the internervous interval between the infraspinatus and teres minor. This study compares this internervous posterior approach with other rotator cuff-sparing techniques, namely, the subscapularis-splitting and rotator interval approaches...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Carlo Gamba, Pau Guirro, Santos Martínez-Díaz, Juan P Horcajada, Andrej Trampuz, Joan C Monllau
BACKGROUND: Culture negative prosthetic joint infections (PJI) still remain an issue even with the advantages of the new diagnostic tools for PJI. This is why some orthopedic surgeons have reservations relative to the use of preoperative antibiotic prophylaxis when a PJI is suspected. The purpose of the present study was to evaluate the influence of preoperative antibiotic prophylaxis on intraoperative cultures. MATERIAL AND METHODS: An enhanced diagnostic protocol for PJI (Zimmerli criteria) was used for the inclusion criteria in order to collect all PJI that were seen in a university hospital...
September 23, 2016: Diagnostic Microbiology and Infectious Disease
Bradley Schoch, Jean-David Werthel, John W Sperling, Robert H Cofield, Joaquin Sanchez-Sotelo
INTRODUCTION: Charcot arthropathy is a rare cause of debilitating joint destruction. Shoulder arthroplasty for Charcot arthropathy is challenging secondary to local bone and soft tissue loss, lack of protective sensation, and altered muscle control. The purpose of this study is to review the outcomes, complications, and survivorship of shoulder arthroplasty for Charcot arthropathy. METHODS: Between January 2000 and December 2011, ten shoulders with Charcot arthropathy were treated with shoulder arthroplasty at our Institution (six hemiarthroplasty, one total shoulder arthroplasty, three reverse shoulder arthroplasty)...
October 14, 2016: International Orthopaedics
Yongcai Chen, Zhuo Chen, Shuo Cui, Zhiyang Li, Zhengjiang Yuan
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss during joint replacements, including total knee arthroplasty (TKA) and total hip arthroplasty (THA). However, there is no final consensus regarding the composition of an optimal administration of TXA regime between topical and systemic (intravenous). The purpose of our study was to compare the efficacy of topical and intravenous (IV) regimen of TXA during TKA and THA. METHODS: Five relevant electronic online databases, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Chinese Biomedical Database were systematically searched in November 2015...
October 2016: Medicine (Baltimore)
C Belvedere, A Ensini, M d'Amato, P Barbadoro, A Leardini
PURPOSE: Physiological elongation and orientation of patellar tendon fibres are among the scopes of total knee arthroplasty, but little is known in the three dimensions. The study aims to assess in vitro these variations at the intact and replaced knee, with and without patellar resurfacing. It was hypothesised that fibre patterns differ before and after prosthesis implantation, and between specific prosthesis designs. It was also expected that patellar resurfacing would affect relevant results...
October 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
E Fiaux, M Titecat, O Robineau, J Lora-Tamayo, Y El Samad, M Etienne, N Frebourg, N Blondiaux, B Brunschweiler, F Dujardin, E Beltrand, C Loiez, V Cattoir, J P Canarelli, C Hulet, M Valette, S Nguyen, F Caron, H Migaud, E Senneville
BACKGROUND: Outcome of patients with streptococcal prosthetic joint infections (PJIs) is not well known. METHODS: We performed a retrospective multicenter cohort study that involved patients with total hip/knee prosthetic joint (THP/TKP) infections due to Streptococcus spp. from 2001 through 2009. RESULTS: Ninety-five streptococcal PJI episodes (50 THP and 45 TKP) in 87 patients of mean age 69.1 ± 13.7 years met the inclusion criteria...
October 13, 2016: BMC Infectious Diseases
Shin Xu, Dustin K Baker, Justin C Woods, Eugene W Brabston, Brent A Ponce
Hospital readmissions are costly for patients and institutions. We conducted a study to evaluate rates of readmission within 30 days after anatomical total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) and to determine independent risk factors for readmission. We queried the National Surgical Quality Improvement Program database for ATSAs and RTSAs performed between 2011 and 2013 and found a combined total of 3501 cases and an overall readmission rate of 2.7%. Of the readmissions, 67% were for medical complications, and 33% were for surgical complications...
September 2016: American Journal of Orthopedics
J-G Cao, L Wang, H-W Zhao, J Liu
OBJECTIVE: The objective of the study is to evaluate the clinic effectiveness of semitendinosus and gracilis transfer for the treatment of medial collateral ligament (MCL) injury of total knee arthroplasty (TKA). PATIENTS AND METHODS: From March 2009 to May 2014, a series of 11 patients with MCL injuries of primary TKA were treated by semitendinosus and gracilis transfer. Another 18 patients (21 knees) were recruited as control group. The two groups of patients were comparable for gender, age, body mass index, varus knee deformity, KSS score, joint activity degree and type of prosthesis comparison without significant difference (p > 0...
September 2016: European Review for Medical and Pharmacological Sciences
Leif Claassen, Sarah Ettinger, Marc-Frederic Pastor, Stefan Budde, Henning Windhagen, Thilo Floerkemeier
INTRODUCTION: The diagnostic algorithm in cases of assumed low-grade infection after total knee arthroplasty is discussed controversial. The aim of this study was to evaluate the reliability of neosynovium biopsies via knee arthroscopies in predicting a periprosthetic knee joint infection (PJI). METHODS: From 2010 to 2015, 56 consecutive patients received a diagnostic arthroscopy of the knee joint by reason of an assumed PJI. In 34 cases, a revision arthroplasty was performed after the diagnostic arthroscopy...
October 12, 2016: Archives of Orthopaedic and Trauma Surgery
Hamed Ebrahimzadeh Leylabadlo, Elham Zeinalzadeh, Najibeh Asl Rahnemaii Akbari, Hossein Samadi Kafil
Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a Candida species. This is a case report of infection after left knee total arthroplasty caused by Malassezia species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors' knowledge, the present case is the first report of Malassezia species in a patient after total knee arthroplasty...
2016: GMS Hygiene and Infection Control
Ohannes F Plate, Andrew D Wohler, Matthew L Brown, Daniel Sun, Nora F Fino, Jason E Lang
INTRODUCTION: Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications...
October 6, 2016: Surgical Technology International
B Fink, R Lass
Background: Total hip arthroplasty (THA) is one of the most common and successful surgical procedures in orthopedic surgery and clinical success can be characterized by the revision rate and improvement of function, as well as the patient's satisfaction and pain. Despite the clinical success of primary THA with 10-year survival rates as high as 96 % (Swedish Hip Arthroplasty Register, 2011), the prevalence of groin pain after conventional total hip replacement ranges from 0.4 to 18.3 % and activity-limiting thigh pain is still an existing problem linked to the femoral component of uncemented hip replacement in up to 1...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Gözde Özcan Söylev, Hakan Boya
Complex regional pain syndrome (CRPS) is a painful and disabling disorder that usually affects the extremities. This complication may affect the knee joint after total knee arthroplasty (TKA). We report a unique case of CRPS of the foot and ankle, which was an unusual involvement site for CRPS after TKA.
October 7, 2016: Acta Orthopaedica et Traumatologica Turcica
Jacob Matz, James L Howard, David J Morden, Steven J MacDonald, Matthew G Teeter, Brent A Lanting
BACKGROUND: Patellofemoral joint biomechanics contribute to anterior knee pain, instability, and dysfunction following total knee arthroplasty (TKA). Information about specific factors leading to anterior knee pain and dysfunction is currently limited. Changes in patellofemoral joint offset (PFO) refers to a mismatch between the preoperative and postoperative anteroposterior geometry of the patellofemoral joint. It remains unclear whether these changes lead to adverse outcomes in TKA...
September 14, 2016: Journal of Arthroplasty
Cory G Couch, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Epilepsies is a spectrum of brain disorders ranging from severe, life threatening, and disabling to more benign, but little is known about its impact in the perioperative arthroplasty setting. We sought to determine whether epileptic patients undergoing elective total joint arthroplasty (TJA) would be at increased risk for in-hospital complications and death, prolonged stay, and nonroutine discharge. METHODS: Using discharge records from the Nationwide Inpatient Sample (2002-2001), we identified 6,054,344 patients undergoing elective primary TJA, of whom 31,865 (0...
August 20, 2016: Journal of Arthroplasty
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