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https://www.readbyqxmd.com/read/28332156/the-pathology-of-failed-mckee-farrar-implants-correlation-with-modern-metal-on-metal-implant-failure
#1
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/28331300/dementia-and-delirium-the-outcomes-in-elderly-hip-fracture-patients
#2
Christina A Mosk, Marnix Mus, Jos Pam Vroemen, Tjeerd van der Ploeg, Dagmar I Vos, Leon Hgj Elmans, Lijckle van der Laan
BACKGROUND: Delirium in hip fractured patients is a frequent complication. Dementia is an important risk factor for delirium and is common in frail elderly. This study aimed to extend the previous knowledge on risk factors for delirium and the consequences. Special attention was given to patients with dementia and delirium. METHODS: This is a retrospective cohort study performed in the Amphia Hospital, Breda, the Netherlands. A full electronic patient file system (Hyperspace Version IU4: Epic, Inc...
2017: Clinical Interventions in Aging
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
#3
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/28326417/the-management-of-complex-periprosthetic-fractures
#4
EDITORIAL
Christopher M Melnic, Wayne G Paprosky
No abstract text is available yet for this article.
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28321490/c-reactive-protein-may-misdiagnose-prosthetic-joint-infections-particularly-chronic-and-low-grade-infections
#5
Daniel Pérez-Prieto, María E Portillo, Lluís Puig-Verdié, Albert Alier, Santos Martínez, Lluisa Sorlí, Juan P Horcajada, Joan C Monllau
BACKGROUND: Periprosthetic tissue cultures, sonication and synovial fluid cultures remain the gold standard for prosthetic joint infection (PJI) diagnosis. However, some 15-20% culture-negative PJI are still reported. Therefore, there is the need for other diagnostic criteria. One point of concern relative to the different definitions of PJI is as to the inclusion of the c-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR) as diagnostic criteria for PJI despite them being non-specific inflammatory blood tests...
March 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28318868/management-of-periprosthetic-joint-infection-the-more-we-learn-the-less-we-know
#6
Robert A Henderson, Matthew S Austin
BACKGROUND: Despite the tremendous and long-standing success of total hip arthroplasty and total knee arthroplasty as treatments for end-stage arthritis, periprosthetic joint infection (PJI) remains a rare but feared complication of these procedures. METHODS: This review highlights some of the difficulties inherent to studying PJI. These include the difficulty in powering studies to capture this relatively uncommon complication, as well as the heterogeneity in clinical presentation and manifestations associated with the diagnosis and treatment of PJI...
February 23, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318867/efficacy-of-alendronate-for-the-prevention-of-bone-loss-in-calcar-region-following-total-hip-arthroplasty
#7
Yohei Yukizawa, Yutaka Inaba, Naomi Kobayashi, Hyonmin Choe, So Kubota, Tomoyuki Saito
BACKGROUND: Bone mineral density (BMD) loss around femoral implants, particularly in the proximal femur, is a common outcome after total hip arthroplasty. Previous studies reported the prevention of postsurgical decrease in BMD with the use of osteoporosis drug therapy. This randomized study evaluated the efficacy of alendronate and alfacalcidol for preserving BMD over a long-term follow-up. METHODS: Sixty consecutive patients with hip osteoarthritis who had undergone primary cementless total hip arthroplasty were randomly assigned to an alendronate (n = 20), alfacalcidol (n = 18), or control (n = 22) group...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28318862/have-periprosthetic-hip-infection-rates-plateaued
#8
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/28316960/lower-urinary-tract-infection-and-periprosthetic-joint-infection-after-elective-primary-total-hip-arthroplasty
#9
Chan Ho Park, Young-Kyun Lee, Kyung-Hoi Koo
PURPOSE: Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is a grave complication. Urinary tract infection (UTI) as a source for PJI is controversial. Our purposes were, (1) to evaluate the incidence of PJI after elective primary THA and (2) to determine whether UTI was associated with a risk of PJI after elective primary THA. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 527 patients who underwent elective primary THA by using universal aseptic technique from May 2003 to October 2007...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28316959/comparative-study-of-peripheral-rim-fixation-using-jumbo-cup-in-revisional-hip-arthroplasty
#10
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/28303585/the-effect-of-depth-of-centrifuged-synovial-fluid-on-leukocyte-esterase-test-for-periprosthetic-joint-infection
#11
Pakpoom Ruangsomboon, Sriprapa Chinprasertsuk, Varanya Khejonnit, Keerati Chareancholvanich
Centrifugation of aspirated synovial fluid before leukocytes esterase (LE) testing for diagnosing periprosthetic joint infection (PJI) may make blood tinged specimens interpretable. We aimed to establish the proper sampling depth of centrifuged specimens for LE testing as one diagnostic criterion and also AS-D chloroacetate esterase (CAE) staining testing as an adjunctive tool. A definite PJI knee joint group and an aseptic primary total knee arthroplasty control group were studied quasi-experimentally (N = 46)...
March 17, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28302460/one-stage-exchange-arthroplasty-a-surgical-technique-update
#12
David A George, Fares S Haddad
BACKGROUND: Standard surgical treatment for a periprosthetic knee infection has been based on a staged surgical technique, in order to assure infection eradication prior to implantation of a new prosthesis. METHODS: In this article, we discuss our surgical technique in undertaking a single-stage exchange of a chronic knee periprosthetic infection. RESULTS: This technique, which is based on the fundamental principles of controlling infection, preventing recurrence, and restoring function, has been shown to deliver high success rates...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#13
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28298285/characterization-of-18-f-fluorodeoxyglucose-uptake-pattern-in-noninfected-prosthetic-heart-valves
#14
Cédric Mathieu, Nidaa Mikaïl, Khadija Benali, Bernard Iung, Xavier Duval, Patrick Nataf, Guillaume Jondeau, Fabien Hyafil, Dominique Le Guludec, François Rouzet
BACKGROUND: (18)F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has been recently acknowledged as a diagnostic tool for prosthetic valve endocarditis, but its specificity is limited by uptake on noninfected valves. The objective of this study was to outline the main features of FDG uptake on PET/CT in patients with noninfected prosthetic heart valve (PHV). METHODS AND RESULTS: Our institution's PET/CT database was reviewed to identify patients with PHV, excluding those suspected of infection or who had received antibiotic treatment...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#15
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28291188/quantification-of-peri-implant-bacterial-load-and-in-vivo-biofilm-formation-in-an-innovative-clinically-representative-mouse-model-of-periprosthetic-joint-infection
#16
Alberto V Carli, Samrath Bhimani, Xu Yang, Matthew B Shirley, Karen L de Mesy Bentley, F Patrick Ross, Mathias P G Bostrom
BACKGROUND: Periprosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty. Current animal models of PJI are limited because of a lack of quantitative methods and failure to effectively recreate the periprosthetic space. We therefore developed a murine PJI model involving a 3-dimensionally printed Ti-6Al-4V implant capable of bearing weight and permitting quantitative analysis of periprosthetic bacterial load and evaluation of biofilm. METHODS: Twenty-five 12-week-old C57BL/6 mice received a unilateral proximal tibial implant and intra-articular injection of either 3 × 10 colony forming units (CFUs) of Staphylococcus aureus Xen 36 or saline solution...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28291177/long-term-outcomes-of-reverse-total-shoulder-arthroplasty-a-follow-up-of-a-previous-study
#17
Guillaume Bacle, Laurent Nové-Josserand, Pascal Garaud, Gilles Walch
BACKGROUND: Despite the increasing numbers of reverse total shoulder arthroplasty (RTSA) procedures, the long-term results have been rarely reported. We previously reported early outcomes of a cohort of patients treated with a Grammont-style RTSA. The purpose of this study was to evaluate the outcomes after a minimum of 10 years, and to document prosthetic survival and complications. METHODS: Clinical outcome assessment was based on the absolute and relative Constant scores and the active range of motion...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#18
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#19
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28287012/low-sensitivity-of-implant-sonication-when-screening-for-infection-in-revision-surgery
#20
Floor M Van Diek, Christiaan G M Albers, Miranda L Van Hooff, Jacques F Meis, Jon H M Goosen
Background and purpose - Prosthetic-joint infection (PJI) is the most serious complication of arthroplasty, and accurate identification of a potentially responsible microorganism is essential for successful antibiotic treatment. We therefore determined the diagnostic accuracy of sonication and compared it with tissue culture as a screening tool in detecting prosthetic joint infection in revision arthroplasty. Patients and methods - 252 consecutive revision arthroplasty cases were enrolled. These cases were determined as being suspected or unsuspected of having infection according to standard criteria...
March 13, 2017: Acta Orthopaedica
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