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https://www.readbyqxmd.com/read/29789904/revision-knee-arthroplasty-with-rotating-hinge-systems-in-patients-with-gross-ligament-instability
#1
Sebastian P Boelch, Joerg Arnholdt, Boris M Holzapfel, Axel Jakuscheit, Maximilian Rudert, Maik Hoberg
PURPOSE: The clinical and radiographic outcomes after revision total knee arthroplasty (TKA) for instability with two rotating hinge knee prostheses were compared. METHODS: Fifty-one patients revised for TKA instability were prospectively randomized to either the Link Endo-Model (N = 26) or the EnduRo (N = 25). Clinical and radiographic outcome scores were compared pre-operatively and at 12 months' follow-up. Failure mechanisms were recorded. RESULTS: Age, BMI, operation, and tourniquet-time did not differ significantly between groups...
May 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29785589/a-novel-technology-for-3d-knee-prosthesis-planning-and-treatment-evaluation-using-2d-x-ray-radiographs-a-clinical-evaluation
#2
Guoyan Zheng, Hagen Hommel, Alper Akcoltekin, Benedikt Thelen, Jan Stifter, Geert Peersman
PURPOSE:  To present a clinical validation of a novel technology called "3X" which allows for 3D prosthesis planning and treatment evaluation in total knee arthroplasty (TKA) using only 2D X-ray radiographs. MATERIALS AND METHODS:  After local institution review board approvals, 3X was evaluated on 43 cases (23 for preoperative planning and 20 for postoperative treatment evaluation). All the patients underwent CT scans according to a standard protocol...
May 21, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29785313/management-of-an-infected-nonunion-of-an-opening-wedge-high-tibial-osteotomy-with-2-stage-implantation-of-rotating-hinge-knee-prosthesis
#3
Sandrine Mariaux, Olivier Borens
Introduction: High tibial osteotomy (HTO) is a frequent and effective treatment for unicompartmental gonarthritis. Only a few articles are focused on the treatment of infected nonunion. Patient and Method: A 50-year-old obese patient was operated on by medial opening-wedge HTO. She developed a painful nonunion treated by hardware removal, allograft, and plate fixation. However, the nonunion persisted. 2 years later, cellulitis appeared with an abscess adjacent to the HTO plate...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29771899/excess-cost-and-inpatient-stay-of-treating-deep-spinal-surgical-site-infections
#4
James Barnacle, Dianne Wilson, Christopher Little, Christopher Hoffman, Nigel Raymond
AIM: To determine the excess cost and hospitalisation associated with surgical site infections (SSI) following spinal operations in a New Zealand setting. METHODS: We identified inpatients treated for deep SSI following primary or revision spinal surgery at a regional tertiary spinal centre between 2009 and 2016. Excess cost and excess length of stay (LOS) were calculated via a clinical costing system using procedure-matched controls. RESULTS: Twenty-eight patients were identified...
May 18, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29770589/short-term-follow-up-of-antibiotic-loaded-articulating-cement-spacers-in-two-stage-revision-of-infected-total-knee-arthroplasty-a-case-series
#5
Meng-Qiang Tian, Xian-Teng Yang, Xiao-Bin Tian, Yun-Bo Sun, Yuan-Hui Duan, Li Sun
OBJECTIVE: Infection of total knee arthroplasty (TKA) is a rare but devastating complication. Two-stage revision is an effective treatment for late infected TKA. This study aimed to assess the short-term results of two-stage revision using articulating antibiotic-loaded spacers. METHODS: Twenty-five patients (10 men and 15 women) were diagnosed with late infections after TKA and treated with two-stage revision from April 2006 to August 2010; 19 of these patients had TKA for osteoarthritis and 6 for rheumatoid arthritis...
May 17, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29770556/reliability-of-the-animated-activity-questionnaire-for-assessing-activity-limitations-of-patients-with-hip-and-knee-osteoarthritis
#6
W F Peter, H C W de Vet, C B Terwee
OBJECTIVE: The aim of the study was to determine the internal consistency, test-retest reliability and measurement error of the Animated Activity Questionnaire (AAQ) for assessing activity limitations in hip and knee osteoarthritis (HKOA) patients. METHODS: A total of 1,177 patients, from six countries (the Netherlands, UK, France, Denmark, Italy and Spain), completed the AAQ, a questionnaire consisting of videos displaying 17 activities with 3-5 levels of performance, from which patients choose the video that best matches their own performance...
May 17, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#7
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29744425/preliminary-focus-on-the-mechanical-and-antibacterial-activity-of-a-pmma-based-bone-cement-loaded-with-gold-nanoparticles
#8
T Russo, A Gloria, R De Santis, U D'Amora, G Balato, A Vollaro, O Oliviero, G Improta, M Triassi, L Ambrosio
In total knee arthroplasty (TKA) and total hip replacement (THR) the restoration of the normal joint function represents a fundamental feature. A prosthetic joint must be able to provide motions and to transmit functional loads. As reported in the literature, the stress distribution may be altered in bones after the implantation of a total joint prosthesis. Some scientific works have also correlated uncemented TKA to a progressive decrease of bone density below the tibial component. Antibiotic-loaded bone cements are commonly employed in conjunction with systemic antibiotics to treat infections...
September 2017: Bioactive Materials
https://www.readbyqxmd.com/read/29727776/knee-adduction-moment-peak-and-impulse-do-not-change-during-the-first-six-months-of-walking-with-a-prosthesis
#9
Rebecca L Krupenevich, Ross H Miller, Brad D Hendershot, Barri L Schnall, Alison L Pruziner
BACKGROUND: Individuals with unilateral lower limb loss are at increased risk for developing knee osteoarthritis in their contralateral limb. The mechanisms underlying this phenomenon are unknown, but large or unusual loads on the limb are thought to contribute to osteoarthritis development. Yet, to our knowledge, there have been no longitudinal assessments of knee joint kinetics to assist with identifying the origin or progression of such loads. RESEARCH QUESTION: This study aimed to examine knee joint kinetics of individuals with lower limb loss as a function of time from independent ambulation...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29723652/kinetic-differences-between-level-walking-and-ramp-descent-in-individuals-with-unilateral-transfemoral-amputation-using-a-prosthetic-knee-without-a-stance-control-mechanism
#10
Yusuke Okita, Nobuya Yamasaki, Takashi Nakamura, Tsutomu Kubo, Atsuko Mitsumoto, Toru Akune
BACKGROUND: Individuals with transfemoral amputation (TFA) have difficulty in descending ramps. Although individuals with TFA who descend ramps are speculated to have greater biomechanical demands, this has not been quantified. RESEARCH QUESTION: How do individuals with TFA wearing a prosthetic knee without a stance control mechanism adapt their gait biomechanics to a slightly declined surface? METHODS: We retrospectively analyzed data of level walking and ramp descent (5° decline) from six subjects with TFA who used a prosthesis without a stance control mechanism...
April 26, 2018: Gait & Posture
https://www.readbyqxmd.com/read/29715222/alpha-defensin-lateral-flow-test-for-diagnosis-of-periprosthetic-joint-infection-not-a-screening-but-a-confirmatory-test
#11
Nora Renz, Katsiaryna Yermak, Carsten Perka, Andrej Trampuz
BACKGROUND: Determination of alpha defensin in synovial fluid has shown promising results for diagnosing periprosthetic joint infection (PJI). The purposes of our study were to assess the performance of alpha defensin lateral flow (ADLF) test for the diagnosis of acute and chronic PJI using 3 classification systems and to compare its performance with the synovial fluid leukocyte count. METHODS: Patients in whom aspiration of a prosthetic hip or knee joint was performed before revision arthroplasty were prospectively included...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#12
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29701041/-acupuncture-combined-with-femoral-nerve-block-for-postoperative-analgesia-after-total-knee-arthroplasty-and-functional-rehabilitation-a-randomized-controlled-trial
#13
Yonghui Zhang, Lin Zhang, Min Lu
OBJECTIVE: To observe the therapeutic effects on the postoperative analgesia after total knee arthroplasty (TKA) and functional rehabilitation with acupuncture at the distal points along the affected meridians and femoral nerve block. METHODS: A total of 60 patients with knee prosthesis were collected and randomized into an observation group and a control group, 30 cases in each one. All of the patients received the femoral nerve block before operation. The analgesia pump was used for analgesia after operation and TKA postoperative rehabilitation was adopted...
March 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29685499/how-does-the-inclination-of-the-tibial-component-matter-a-three-dimensional-finite-element-analysis-of-medial-mobile-bearing-unicompartmental-arthroplasty
#14
Xuesong Dai, Jinghua Fang, Lifeng Jiang, Yan Xiong, Miaofeng Zhang, Sunan Zhu
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) using Oxford mobile-bearing prosthesis is performed in the treatment of medial compartmental arthritis of the knee. However, little is known about the stress distributions for mobile-bearing UKA on the medial tibial plateau. METHODS: In this study, the stresses on the coronal plane were calculated in a three-dimensional model of the proximal tibia. The features of the stress distribution were investigated when the tibial tray was placed in 15°, 10°, six degrees, and three degrees varus, neutral (0°), and in three degrees, six degrees, 10°, and 15° valgus on the coronal plane of the medial plateau...
April 20, 2018: Knee
https://www.readbyqxmd.com/read/29684539/fewer-complications-after-uka-than-tka-in-patients-over-85-years-of-age-a-case-control-study
#15
Quentin Ode, Romain Gaillard, Cécile Batailler, Yannick Herry, Philippe Neyret, Elvire Servien, Sébastien Lustig
INTRODUCTION: Implanting a knee prosthesis in patients aged over 85 years is not without risk. Unicompartmental knee arthroplasty (UKA) is reputed to show lower morbidity and mortality than total knee arthroplasty (TKA). Elderly patients with isolated unicompartmental osteoarthritis without specific contraindications are thus good candidates for this procedure. The present retrospective case-control study compared complications rates in elderly patients receiving UKA versus TKA. The study hypothesis was that UKA incurs fewer complications, with equivalent functional results...
April 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29678418/a-new-method-to-quantify-liner-deformation-within-a-prosthetic-socket-for-below-knee-amputees
#16
Amy L Lenz, Katie A Johnson, Tamara Reid Bush
Many amputees who wear a leg prosthesis develop significant skin wounds on their residual limb. The exact cause of these wounds is unclear as little work has studied the interface between the prosthetic device and user. Our research objective was to develop a quantitative method for assessing displacement patterns of the gel liner during walking for patients with transtibial amputation. Using a reflective marker system and a custom clear socket, evaluations were conducted with a clear transparent test socket mounted over a plaster limb model and a deformable limb model...
April 13, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29676961/development-and-preliminary-evaluation-of-a-new-anatomically-based-prosthetic-alignment-method-for-below-knee-prosthesis
#17
Nahid Tafti, Masoud Karimlou, Mohammad Ali Mardani, Amir Salar Jafarpisheh, Gholam Reza Aminian, Reza Safari
The objectives of current study were to a) assess similarities and relationships between anatomical landmark-based angles and distances of lower limbs in unilateral transtibial amputees and b) develop and evaluate a new anatomically based static prosthetic alignment method. First sub-study assessed the anthropometrical differences and relationships between the lower limbs in the photographs taken from amputees. Data were analysed via paired t-test and regression analysis. Results show no significant differences in frontal and transverse planes...
April 20, 2018: Assistive Technology: the Official Journal of RESNA
https://www.readbyqxmd.com/read/29668473/the-history-of-bone-tumour-treatment-and-the-state-of-the-art-in-vienna
#18
Rainer Kotz
PURPOSES: Bone tumours have been a tragedy for the patient in any time period. In the majority of the cases it occurs in children or young adults. In the past the affected limbs could not be spared and the overall prognosis was poor. METHODS: Chemotherapy successfully introduced for the purpose of overcoming the poor overall prognosis (Rosen and Jaffe) and tumour prostheses were invented for the purpose of salvaging the affected limbs (Marcove, Scales, Campanacci, Sivas, Salzer)...
December 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/29666082/knee-joint-instability-after-total-knee-replacement-in-a-patient-with-ehlers-danlos-syndrome-the-role-of-insert-changes-as-practical-solution
#19
Ajmal Farid, Stefan Beekhuizen, Joris van der Lugt, Marijn Rutgers
Treatment of knee joint instability in patients with hypermobile Ehlers-Danlos syndrome (EDS) can be challenging. A 53-year-old woman with hypermobile EDS underwent bilateral total knee replacement (TKR) due to valgus osteoarthritis. During follow-up, she developed hypermobility of both knee replacements. Revision of the insert resolved the issue in her left knee; however, the right TKR required two insert exchanges and unfortunately instability persisted. Therefore, a revision to a constrained prosthesis was performed...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29656978/high-rate-of-early-revision-after-iuni-custom-made-unicondylar-knee-arthroplasty
#20
Carl T Talmo, Marie C Anderson, Eliot S Jia, Claire E Robbins, Jason D Rand, Brian P McKeon
BACKGROUND: There has been a recent interest in custom-made partial knee arthroplasties to provide patient-specific instrumentation and better fit of the prosthesis. While unicondylar knee arthroplasties (UKAs) have demonstrated good outcomes and durable results in many studies, there is little evidence on outcomes of these custom-made implants. METHODS: We performed a retrospective review of all custom-made UKAs performed at our institution by one surgeon from 2008 to 2015...
March 15, 2018: Journal of Arthroplasty
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