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Knee prosthesis

Majd Tarabichi, Abtin Alvand, Noam Shohat, Karan Goswami, Javad Parvizi
A 62-year-old man who had undergone a primary knee arthroplasty 3 years earlier, presented to the emergency department with an infected prosthesis. He underwent prosthesis resection. All cultures failed to identify the infecting organism. Analysis of the intraoperative samples by next-generation sequencing revealed Streptococcus canis (an organism that resides in the oral cavity of dogs). It was later discovered that the patient had sustained a dog scratch injury several days earlier. The patient reports that his dog had licked the scratch...
March 2018: Arthroplasty Today
Richard D Swenson, James A Butterfield, Timothy J Irwin, John J Zurlo, Charles M Davis
BACKGROUND: Acute and acute hematogenous prosthetic joint infections (PJIs) are often treated with open debridement and polyethylene exchange (ODPE) in an effort to save the prosthesis, decrease morbidity, and reduce costs. However, failure of ODPE may compromise a subsequent 2-stage treatment. The purpose of this study is to identify patient factors that impact the success of ODPE for acute and acute hematogenous PJIs. METHODS: A retrospective review examined comorbidities, preoperative laboratory values, and patient history for patients with successful and failed ODPE treatment for acute perioperative or acute hematogenous periprosthetic hip or knee joint infections...
February 1, 2018: Journal of Arthroplasty
Ramin Mandegaran, Kanhaiyalal Agrawal, Sanjay Vijayanathan, Gopinath Gnanasegaran
OBJECTIVE: The purpose of this study was to assess the incremental value of technetium-99m-methyl diphosphonate (Tc-MDP) single-photon emission computed tomography/computed tomography (SPECT/CT) over Tc-MDP two-phase bone scan (TPBS) in the assessment of the patients with pain following knee arthroplasty. PATIENTS AND METHODS: Tc-MDP TPBS and Tc-MDP SPECT/CT were performed in 49 patients with knee pain after knee arthroplasty. The scans were reviewed by two readers (nuclear medicine physician and musculoskeletal radiologist)...
March 16, 2018: Nuclear Medicine Communications
Hans-Peter W van Jonbergen, Robin E Westerbeek
BACKGROUND: Clinical outcomes in patellofemoral joint replacement may be related to femoral component rotation. Assessment of rotational alignment is however difficult as patients with isolated patellofemoral osteoarthritis often have trochlear dysplasia. The use of the medial malleolus as a landmark to guide rotation has been suggested. The purpose of our study was to evaluate this technique with regard to femoral component rotation, and to correlate rotation with clinical outcomes at one-year follow-up...
March 15, 2018: Knee
A M Vilardell, N Cinca, N Garcia-Giralt, S Dosta, I G Cano, X Nogués, J M Guilemany
Three different surface treatments on a Ti6Al4V alloy have been in vitro tested for possible application in cementless joint prosthesis. All of them involve the novelty of using the Cold Spray technology for their deposition: (i) an as-sprayed highly rough titanium and, followed by the deposition of a thin hydroxyapatite layer with (ii) microcrystalline or (iii) nanocrystalline structure. Primary human osteoblasts were extracted from knee and seeded onto the three different surfaces. Cell viability was tested by MTS and LIVE/DEAD assays, cell differentiation by alkaline phosphatase (ALP) quantification and cell morphology by Phalloidin staining...
June 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
Lukas Leitner, Silvia Türk, Martin Heidinger, Bernd Stöckl, Florian Posch, Werner Maurer-Ertl, Andreas Leithner, Patrick Sadoghi
Arthroplasty registers were originally established in Scandinavia to receive clinically relevant information from pooled data, to improve quality and reduce revision surgeries, with socioeconomic benefit. In Austria, where the highest rate of total knee arthroplasties (TKA) per inhabitant of all OECD countries was reached in 2014, arthroplasties are centrally reported since 2009. Study purpose was to perform the first analysis of the Austrian database, aiming to obtain data on trends in arthroplasty in Austria over time in relation to demographic development...
March 16, 2018: Scientific Reports
Ayman Ebied, Ahmed Zayda, Sameh Marei, Hany Elsayed
INTRODUCTION: Successful treatment of knee comminuted periarticular fractures associated with osteoporosis and pre-existing arthritis is a challenging task. METHODS: This is a prospective study on 27 patients who had comminuted intra and periarticular knee fractures and pre-existing arthritis. Fractures were classified according to Muller's AO classification. Primary knee arthroplasty was performed ± internal fixation following 4 weeks of splinting. A stem was added to the tibial tray and Legacy Constrained Condylar Knee (LCCK) or Rotating Hinge (RH) prosthesis were used depending on the level of ligament damage and bone defects...
2018: SICOT-J
Brian W Carey, James Harty
BACKGROUND: The ATTUNE Knee by DePuy Synthes was introduced in 2013. It is designed to provide better range of motion and address patient-reported instability. The PFC Sigma Knee, an earlier prosthesis by DePuy Synthes, is a common knee replacement with a strong clinical track record. Our aim is to compare the outcomes after primary total knee replacement for end-stage knee osteoarthritis of the PFC and ATTUNE knee systems in 21 patients who each have prosthesis in opposite knees using WOMAC, Oxford Knee and SF-12 scores and evaluation of range of motion...
March 15, 2018: Journal of Orthopaedic Surgery and Research
J Gómez-Vallejo, J Albareda-Albareda, B Seral-García, N Blanco-Rubio, M Ranera-García, L Ezquerra-Herrando
INTRODUCTION: The reproduction of the anatomical joint line could be a good index to obtain good results in knee prosthesis surgery, although in revision surgery has not been enough studied. A search for a simple and reproducible method is needed to review these results. MATERIAL AND METHODS: A retrospective study was conducted between January 2000 and December 2013. A total of 97 total revision knee arthroplasties were implanted. Finally, the study group consisted of 67 patients...
September 2017: Acta Ortopédica Mexicana
Sim Johal, Naoki Nakano, Mark Baxter, Ihab Hujazi, Hemant Pandit, Vikas Khanduja
Unicompartmental knee arthroplasty (UKA) is a bone conserving and ligament-sparing procedure that reliably restores normal knee kinematics and function for arthritis limited either to the medial or the lateral compartment of the knee. Although there is enough evidence to demonstrate that the UKA offers good medium to long-term success given the correct patient selection, prosthesis design, and implantation technique, there are several reports to suggest inferior survival rates in comparison with the total knee arthroplasty (TKA)...
March 7, 2018: Journal of Knee Surgery
Hiroshi Inui, Shuji Taketomi, Ryota Yamagami, Nobuyuki Shirakawa, Kouhei Kawaguchi, Sakae Tanaka
A new design of the so-called "guided-motion" total knee arthroplasty (TKA) is expected to produce normal-like kinematics. The implant behaves strictly as a mechanically constraint-guided motion system. However, no previous reports have demonstrated the most appropriate surgical technique or soft-tissue balance that would reproduce ideal kinematics. The purpose of this study was to clarify the relationship between soft-tissue balance and the intraoperative kinematics of guided-motion TKA. In this study, intraoperative kinematics of 95 patients whose TKA was performed with a guided-motion prosthesis (Journey II BCS Smith and Nephew) were measured using the computed tomography (CT)-free navigation system...
March 7, 2018: Journal of Knee Surgery
Minxun Lu, Yongjiang Li, Yi Luo, Wenli Zhang, Yong Zhou, Chongqi Tu
BACKGROUND: Currently, it is challenging to treat massive bone defects of proximal tibia. Although numerous methods are available for reconstruction with epiphysis preservation, limitations in knee function and complications are noted with these methods. Our paper describes our attempt to reconstruct a marked defect in the proximal tibia with an uncemented three-dimensional (3D)-printed prosthesis and to evaluate the prosthesis design and short-term outcomes. CASE PRESENTATION: A 15-year-old boy with metaphyseal osteosarcoma of the tibia underwent intercalary allograft reconstruction following wide tumour resection with epiphysis preservation...
March 6, 2018: World Journal of Surgical Oncology
Ruben Scholten, Jetze Visser, Job L C Van Susante, Corné J M Van Loon
Background and purpose - The Synovasure lateral flow test was developed as a rapid test for the detection or exclusion of periprosthetic joint infection (PJI). 3 studies have reported promising results on its diagnostic value in total joint revision surgery. We aimed to assess the sensitivity and specificity of the Synovasure test to exclude infection in patients undergoing revision surgery for suspected early aseptic loosening of a total hip or knee arthroplasty. Patients and methods - In a prospective study design, 37 patients who underwent revision surgery for suspected early aseptic loosening (< 3 years after primary arthroplasty) were included...
March 6, 2018: Acta Orthopaedica
R Samaniego Alonso, E Gaviria Parada, M Pons Cabrafiga, M Espallargues Carreras, O Martinez Cruz
INTRODUCTION: In our environment, it is increasingly necessary to perform an activity based on scientific evidence and the field of prosthetic surgery should be governed by the same principles. The national arthroplasty registries allow us to obtain a large amount of data in order to evaluate this technique. The aim of our study is to analyse the scientific evidence that supports the primary total knee arthroplasties implanted in Catalonian public hospitals, based on the Arthoplasty Registry of Catalonia (RACat) MATERIAL AND METHODS: A review of the literature was carried out on knee prostheses (cruciate retaining, posterior stabilized, constricted and rotational) recorded in RACat between the period 2005-2013 in the following databases: Orthopedic Data Evaluation Panel, PubMed, TripDatabase and Google Scholar...
February 28, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Sung-Hyun Lee, Sung-Hyun Noh, Keun-Churl Chun, Joung-Kyue Han, Churl-Hong Chun
BACKGROUND: We report the successful use of allograft-prosthesis composite (APC) and structural femoral head allografting in the bilateral reconstruction of large femoral and tibial uncontained defects during revision total knee arthroplasty (RTKA). CASE PRESENTATION: A 67-year-old female with degenerative arthritis underwent bilateral total knee arthroplasty (TKA) using the Press Fit Condylar (PFC) modular knee system at our clinic in March, 1996. At 8 years postoperatively, the patient presented with painful, bilateral varus knees, with swelling, limited passive range of motion (ROM), and severe instability...
March 2, 2018: BMC Musculoskeletal Disorders
Hendrik Kohlhof, Sebastian Köhring, Dieter Christian Wirtz, Hartmut Witte
The number of hip and knee arthroplasty replacement surgeries is increasing steadily. In combination with demographic aging and the number of periprosthetic complications, this development has lead to the phenomenon where the need for revision surgery is rising. The problem is, that, while implantation procedures of hip arthroplasties are more or less standardized, explantation is a non-standardized task for experienced specialists, due to the unpredictability of the adequate loosening method. The surgeon often only gets to decide on which tools and methods may be applied to detach the prosthesis, only after getting access to the operation site...
March 2, 2018: Biomedizinische Technik. Biomedical Engineering
Jaroma Antti, Suomalainen Juha-Sampo, Niemitukia Lea, Soininvaara Tarja, Salo Jari, Kröger Heikki
Background Computed tomography (CT) can be used to assess the rotational alignment of prosthesis components to identify possible underlying causes of symptomatic total knee arthroplasty (TKA). The use of cone beam computed tomography (CBCT) for the imaging of extremities is relatively new, although it has been widely used in dental imaging. Purpose To assess the intra- and inter-observer reproducibility of CBCT, as well as to validate CBCT for TKA component and periprosthetic bone diagnostics. Material and Methods CBCT scans were performed on 18 patients the day before a scheduled revision TKA, from which the intra- and inter-observer reproducibility were assessed...
January 1, 2018: Acta Radiologica
S Miller, A Agarwal, W B Haddon, L Johnston, G Arnold, W Wang, R J Abboud
Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Statistical power was calculated using SPSS. Results No significant difference was found in the spatiotemporal parameters of gait and survival years of the knee prosthesis between the two groups...
February 27, 2018: Annals of the Royal College of Surgeons of England
Todd A Kuiken, Nicholas P Fey, Timothy Reissman, Suzanne B Finucane, Gregory A Dumanian
Background: Excess residual limb fat is a common problem that can impair prosthesis control and negatively impact gait. In the general population, thighplasty and liposuction are commonly performed for cosmetic reasons but not specifically to improve function in amputees. The objective of this study was to determine if these procedures could enhance prosthesis fit and function in an overweight above-knee amputee. Methods: We evaluated the use of these techniques on a 50-year-old transfemoral amputee who was overweight...
January 2018: Plastic and Reconstructive Surgery. Global Open
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Jie Shi, Wei Wang, Xiao-le He, Xu-Sheng Li
Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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