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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/29332662/a-survivorship-study-of-838-total-elbow-replacements-a-report-from-the-norwegian-arthroplasty-register-1994-2016
#1
Yngvar Krukhaug, Geir Hallan, Eva Dybvik, Stein A Lie, Ove N Furnes
BACKGROUND: The aim of this study was to present the long-term survivorship (20 years) of total elbow arthroplasty (TEA) for a relatively large population and to compare different prosthesis brands and patient subgroups. METHODS: Between 1994 and 2017, a total of 838 primary TEAs were reported to the Norwegian Arthroplasty Register. Implant survival was calculated using the Kaplan-Meier method. Risk differences were examined using Cox regression analyses and exact Cox regression for rare events...
February 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29329883/oxidation-damage-mechanisms-and-reasons-for-revision-of-sequentially-annealed-highly-crosslinked-polyethylene-in-total-knee-arthroplasty
#2
Daniel W MacDonald, Genymphas B Higgs, Antonia F Chen, Arthur L Malkani, Michael A Mont, Steven M Kurtz
BACKGROUND: Sequentially annealed, highly crosslinked polyethylene (HXLPE) has been used clinically in total knee arthroplasty (TKA) for over a decade. However, little is known about the revision reasons; its surface damage mechanisms; or its in vivo oxidative stability relative to conventional polyethylene. We asked whether retrieved HLXPE tibial inserts exhibited: (1) similar revision reasons; (2) improved resistance to surface damage; and (3) improved oxidative stability, when compared with conventional gamma inert sterilized polyethylene inserts...
September 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29326531/medial-pivot-in-total-knee-arthroplasty-literature-review-and-our-first-experience
#3
REVIEW
Luigi Sabatini, Salvatore Risitano, Gennaro Parisi, Ferdinando Tosto, Pier Francesco Indelli, Francesco Atzori, Alessandro Massè
Background: Traditional total knee implants designs, usually, are not able to reproduce the physiological kinematics of the knee, leaving almost 20% of the patients, those who underwent a total knee arthroplasty (TKA), not fully satisfied. Modern inserts are nowadays designed with a fully congruent medial compartment to reproduce the normal medial pivoting biomechanics of the knee. The aim of this article was to evaluate preliminary clinical improvement using the Medial Congruent (MC) insert as specific level of constraint...
2018: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29325840/early-comparative-outcomes-of-unicompartmental-and-total-knee-arthroplasty-in-severely-obese-patients
#4
Zachary C Lum, David A Crawford, Adolph V Lombardi, Jason M Hurst, Michael J Morris, Joanne B Adams, Keith R Berend
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) may have advantages over total knee arthroplasty (TKA) in the setting of obesity. There has been no direct comparison between the two cohorts. This study compares outcomes and complications of severely obese patients undergoing medial UKA versus TKA. METHODS: Six hundred and fifty medial UKA and 1300 TKA were performed in patients with BMI >35kg/m2 (mean 41kg/m2) between 2007 and 2012. Pre- and postoperative ROM, Knee Society scores, perioperative factors, complications and reoperations were compared...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29325835/synthetic-mesh-vs-allograft-extensor-mechanism-reconstruction-in-total-knee-arthroplasty-a-systematic-review-of-the-literature-and-meta-analysis
#5
REVIEW
David Shau, Ryan Patton, Suhag Patel, Laura Ward, George Guild
BACKGROUND: Extensor mechanism disruption after total knee arthroplasty (TKA) is a devastating complication. Reconstruction with allograft and synthetic mesh has been described. However, these reports have typically been small case series, and controversy exists with regard to which reconstruction technique is optimal. METHODS: The authors performed a systematic review using PUBMED, MEDLINE, EMBASE, BIOSIS, Clinicaltrials.gov, and Cochrane Database of Systematic Reviews identifying 14 articles meeting inclusion criteria and producing 204 knees for comparison...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29312854/antibiotic-bone-cement-s-effect-on-infection-rates-in-primary-and-revision-total-knee-arthroplasties
#6
Donald Kleppel, Jacob Stirton, Jiayong Liu, Nabil A Ebraheim
AIM: To compare infection rates in primary and revision total knee arthroplasty (TKA) procedures using antibiotic impregnated bone cement (AIBC) to those rates in procedures not using AIBC. METHODS: A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies (RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29312851/evaluation-of-1031-primary-titanium-nitride-coated-mobile-bearing-total-knee-arthroplasties-in-an-orthopedic-clinic
#7
Stefan J M Breugem, Jeroen Linnartz, Inger Sierevelt, Jon D Bruijn, Marcel J M Driessen
AIM: To evaluate the influence of the titanium nitride (TiN) coating on the results of a total knee arthroplasty (TKA). METHODS: A total of 910 patients (338 men; 572 woman), with a mean age of 65 (range 36-94) undergoing 1031 primary TKAs were assessed. Clinical evaluation and patient-reported outcomes were gathered one year after surgery. The questionnaires included the Knee injury and Osteoarthritis Outcome Score (KOOS)-Dutch version, Visual Analogue Scale (VAS) pain scores in rest and during active knee movement, VAS-satisfaction scores, and EQ-5D-3L health scores...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29310652/what-makes-patients-aware-of-their-artificial-knee-joint
#8
F L Loth, M C Liebensteiner, J M Giesinger, K Giesinger, H R Bliem, B Holzner
BACKGROUND: Joint awareness was recently introduced as a new concept for outcome assessment after total knee arthroplasty (TKA). Findings from qualitative and psychometric studies suggest that joint awareness is a distinct concept especially relevant to patients with good surgical outcome and patients at late follow-up time points. The aim of this study was to improve the understanding of the concept of joint awareness by identifying situations in which patients are aware of their artificial knee joint and to investigate what bodily sensations and psychological factors raise a patient's awareness of her/his knee...
January 8, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29306499/an-alternative-treatment-for-osteoporotic-su-type-iii-periprosthetic-supracondylar-femur-fractures-double-locking-plate-fixation
#9
Hakan Çiçek, Ümit Tuhanioğlu, Hasan Ulaş Oğur, Fırat Seyfettinoğlu, Murat Bozkurt
INTRODUCTION: Patients with Su Type III fractures based on total knee arthroplasty (TKA) constitute a patient group with problematic treatment and management. Although it has difficulties, open reduction and internal fixation is one of the treatment options. METHOD: A retrospective evaluation was made of 22 patients surgically treated in our clinic with double locking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. The patients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS), WOMAC and radiological evaluations...
January 3, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29305449/mid-term-results-of-lateral-unicondylar-mobile-bearing-knee-arthroplasty-a-multicentre-study-of-363-cases
#10
T Walker, N Zahn, T Bruckner, M R Streit, G Mohr, P R Aldinger, M Clarius, T Gotterbarm
AIMS: The aim of this independent multicentre study was to assess the mid-term results of mobile bearing unicondylar knee arthroplasty (UKA) for isolated lateral osteoarthritis of the knee joint. PATIENTS AND METHODS: We retrospectively evaluated 363 consecutive, lateral UKAs (346 patients) performed using the Oxford domed lateral prosthesis undertaken in three high-volume knee arthroplasty centres between 2006 and 2014. Mean age of the patients at surgery was 65 years (36 to 88) with a mean final follow-up of 37 months (12 to 93) RESULTS: A total of 36 (10...
January 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29305286/clinical-outcomes-of-osteochondral-allograft-transplantation-for-secondary-treatment-of-osteochondritis-dissecans-of-the-knee-in-skeletally-mature-patients
#11
Eric J Cotter, Rachel M Frank, Kevin C Wang, Trifon Totlis, Sarah Poland, Maximillian A Meyer, Brian J Cole
PURPOSE: To report clinical outcomes of osteochondral allograft transplantation (OCA) for skeletally mature patients with osteochondritis dissecans (OCD) lesions of the knee in whom prior surgical intervention has failed, and to describe return-to-sport (RTS) rates and any predictive demographic or preoperative variables associated with a higher likelihood to RTS. METHODS: Patients who underwent OCA by a single surgeon (B.J.C.) between October 1, 2002, and November 30, 2014, for a diagnosis of OCD with a minimum of 2 years' follow-up were included...
January 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29299476/have-the-annual-trends-of-total-knee-arthroplasty-in-ankylosing-spondylitis-patients-decreased
#12
Roby Abraham, John J Kelly, Jared M Newman, Qais Naziri, Nipun Sodhi, Anton Khlopas, Jaiben George, Neil V Shah, Assem A Sultan, Morad Chughtai, John W Barrington, Carl B Paulino, Michael A Mont
Background: Ankylosing spondylitis (AS) is characterized by osteoproliferation-induced structural damage and spinal inflammation, which lead to spinal deformity and functional disability. Though AS commonly affects the axial skeleton and sacroiliac joints, up to 70% of patients have involvement of the knees and other joints. Despite pharmacological efforts, advancing joint involvement may ultimately require surgical intervention. Total knee arthroplasty (TKA) is effective in managing patients with AS, yet it remains unclear whether or not the annual rates of TKA have been affected...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29299473/economic-evaluation-of-different-suture-closure-methods-barbed-versus-traditional-interrupted-sutures
#13
REVIEW
Randa K Elmallah, Anton Khlopas, Mhamad Faour, Morad Chughtai, Arthur L Malkani, Peter M Bonutti, Martin Roche, Steven F Harwin, Michael A Mont
Healthcare systems are receiving increasing pressures from payers, such as the Centers for Medicare and Medicaid (CMS), to reduce the costs associated with procedures, and with the implementation of the Affordable Care Act, high costs are addressed through pay-for-performance programs. Thus, multiple areas of total knee arthroplasty (TKA) surgery are under scrutiny, including surgical times, material costs, and the costs of associated complications and readmissions. Suture type has been determined to be a factor that may influence closure times, as well as direct material costs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29299471/outcomes-of-a-newer-generation-cementless-total-knee-arthroplasty-design-in-patients-less-than-50-years-of-age
#14
Michael A Mont, Chukwuweike Gwam, Jared M Newman, Morad Chughtai, Anton Khlopas, Prem N Ramkumar, Steven F Harwin
Background: Younger patients undergoing cemented total knee arthroplasty (TKA) may be at risk for lower implant survivorship and higher revision rates due to the historical increased prevalence of aseptic loosening and instability in this cohort. The recent advances of cementless TKAs may mitigate some of these complications. However, there is a paucity of studies reporting on patients who are under 50 years who have undergone a cementless TKA. Therefore, this study evaluated: (I) implant survivorship; (II) functional outcomes and complications; and (III) radiographic outcomes in patients who were less than 50 years of age and underwent cementless TKA...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298463/long-term-clinical-results-of-unicompartmental-knee-arthroplasty-in-patients-younger-than-60-years-of-age-minimum-10-year-follow-up
#15
Kyung Tae Kim, Song Lee, Jung Soo Lee, Min Su Kang, Ki Hyuk Koo
Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in patients younger than 60 years of age. Materials and Methods: One hundred and six cases of medial UKA with a minimum follow-up of 10 years were selected for this study. There were 80 patients and the preoperative diagnosis was osteoarthritis in all cases. The mean age of the patients was 54.2 years and the mean duration of follow-up was 12.1 years...
January 4, 2018: Knee Surgery & related Research
https://www.readbyqxmd.com/read/29298452/have-the-annual-trends-of-total-knee-arthroplasty-in-rheumatoid-arthritis-patients-changed
#16
Matthew A Harb, Max Solow, Jared M Newman, Nipun Sodhi, Robert Pivec, Jaiben George, Assem A Sultan, Anton Khlopas, Neil V Shah, Martin W Roche, Michael A Mont
As the use of disease modifying antirheumatic drugs have increased, it remains unclear whether or not this has affected the rates of total knee arthroplasty (TKA) in rheumatoid arthritis (RA) patients. Therefore, the purpose of this study was to evaluate the annual trends of RA patients who underwent TKA. Specifically, we evaluated: (1) the annual trends of TKAs due to RA in the United States population; and (2) the annual trends in the proportion of TKAs due to RA in the United States. The Nationwide Inpatient Sample was used to identify all patients who underwent TKA between 2002 and 2013 (n = 6,492,873)...
January 3, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29298259/the-accuracy-of-the-alpha-defensin-lateral-flow-device-for-diagnosis-of-periprosthetic-joint-infection-comparison-with-a-gold-standard
#17
Thorsten Gehrke, Christian Lausmann, Mustafa Citak, Tommaso Bonanzinga, Lars Frommelt, Akos Zahar
BACKGROUND: Alpha defensin is a new biomarker that has been shown to have a very high accuracy to rule out periprosthetic joint infection. Recently, a new rapid lateral flow version of the alpha defensin test was developed and introduced to detect high levels of alpha defensin in synovial fluid quickly and with ease. We conducted a single-center prospective clinical study to compare the results of the Synovasure Alpha Defensin Test with those of the Musculoskeletal Infection Society (MSIS) criteria, which are considered to be the gold standard for diagnosing periprosthetic joint infection...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29288184/leak-study-design-of-a-nationwide-randomised-controlled-trial-to-find-the-best-way-to-treat-wound-leakage-after-primary-hip-and-knee-arthroplasty
#18
Claudia A M Löwik, Frank-Christiaan Wagenaar, Walter van der Weegen, Rudolf W Poolman, Rob G H H Nelissen, Sjoerd K Bulstra, Yvette Pronk, Karin M Vermeulen, Marjan Wouthuyzen-Bakker, Inge van den Akker-Scheek, Martin Stevens, Paul C Jutte
INTRODUCTION: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are highly successful treatment modalities for advanced osteoarthritis. However, prolonged wound leakage after arthroplasty is linked to prosthetic joint infection (PJI), which is a potentially devastating complication. On the one hand, wound leakage is reported as a risk factor for PJI with a leaking wound acting as a porte d'entrée for micro-organisms. On the other hand, prolonged wound leakage can be a symptom of PJI...
December 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29286958/chronic-nocardia-cyriacigeorgica-periprosthetic-knee-infection-successfully-treated-with-a-two-stage-revision-a-case-report
#19
Michael M Hadeed, J Ryan MacDonell, Ian J Dempsey, Christopher C Moore, James A Browne
CASE: We report the successful treatment of a Nocardia cyriacigeorgica periprosthetic joint infection (PJI) that occurred at the site of a total knee arthroplasty. To our knowledge, this organism has not previously been reported in the literature as a cause of PJI. Given the need for a prolonged duration of treatment for this organism (a minimum of 6 to 12 months), modifications to the standard 2-stage revision were made in consultation with infectious-disease specialists. CONCLUSION: PJI is a devastating complication that leads to substantial patient morbidity and utilization of health-care resources...
October 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29276122/a-comparison-of-relative-value-units-in-primary-versus-revision-total-knee-arthroplasty
#20
Jennifer Peterson, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Jared M Newman, Assem A Sultan, Kim L Stearns, Michael A Mont
BACKGROUND: In total knee arthroplasty (TKA), revision cases are often technically more challenging, and require more operative time and aftercare than primary cases. These time and effort differences should therefore be appropriately compensated for when using the relative value unit (RVU) system. Therefore, the purpose of this study is to compare the mean (1) RVUs; (2) operative times; and (3) RVU/min; and (4) perform an individualized idealized surgeon annual cost difference analysis for primary vs revision TKA...
December 6, 2017: Journal of Arthroplasty
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