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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/28634096/reconstruction-of-disrupted-extensor-mechanism-after-total-knee-arthroplasty
#1
C T Lim, Derek F Amanatullah, James I Huddleston, Alex H S Harris, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a debilitating complication that results in extension lag, limited range of motion, difficulty in walking, frequent falls, and chronic pain. This study presents the clinical and radiographic results of reconstruction after extensor mechanism disruption in TKA patients. METHODS: Consecutive patients with allograft reconstruction of extensor mechanism after TKA were identified retrospectively from an academic tertiary center for revision TKA...
May 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28632587/the-clinical-outcome-of-computer-navigated-compared-with-conventional-knee-arthroplasty-in-the-same-patients-a-prospective-randomized-double-blind-long-term-study
#2
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
BACKGROUND: The available comparative studies of computer navigation-assisted and conventional knee arthroplasties have short-term follow-up periods. Therefore, the clinical benefits after long-term follow-up are not clear. The purposes of the current long-term study were to compare clinical outcomes, alignment of the knee components, prevalence of aseptic loosening of the components, implant survival, and complications of total knee arthroplasties performed with and without computer navigation...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28622842/two-stage-knee-arthrodesis-with-a-modular-intramedullary-nail-due-to-septic-failure-of-revision-total-knee-arthroplasty-with-extensor-mechanism-deficiency
#3
Max J Friedrich, Jan Schmolders, Matthias D Wimmer, Andreas C Strauss, Milena M Ploeger, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
BACKGROUND: Periprosthetic joint infection is a serious complication and reconstruction after failed revision total knee arthroplasty with significant bone loss and compromised soft-tissues can be challenging. Objective of this study was to assess clinical and functional results, implant survival and infection recurrence rates in patients treated with two-stage arthrodesis after failed revision TKA with extensor mechanism deficiencies due to PJI, and to identify the factors that affect outcomes after surgery...
June 13, 2017: Knee
https://www.readbyqxmd.com/read/28618871/five-year-follow-up-of-knee-joint-distraction-clinical-benefit-and-cartilaginous-tissue-repair-in-an-open-uncontrolled-prospective-study
#4
Jan-Ton A D van der Woude, Karen Wiegant, Peter M van Roermund, Femke Intema, Roel J H Custers, Felix Eckstein, Jaap M van Laar, Simon C Mastbergen, Floris P J G Lafeber
Objective In end-stage knee osteoarthritis, total knee arthroplasty (TKA) may finally become inevitable. At a relatively young age, this comes with the risk of future revision surgery. Therefore, in these cases, joint preserving surgery such as knee joint distraction (KJD) is preferred. Here we present 5-year follow-up data of KJD. Design Patients ( n = 20; age <60 years) with conservative therapy resistant tibiofemoral osteoarthritis considered for TKA were treated. Clinical evaluation was performed by questionnaires...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28617518/tibiofemoral-instability-after-primary-total-knee-arthroplasty-posterior-stabilized-implants-for-obese-patients
#5
Ata Can, Fahri Erdogan, Ayse Ovul Erdogan
Tibiofemoral instability is a common complication after total knee arthroplasty (TKA), accounting for up to 22% of all revision procedures. Instability is the second most common cause of revision in the first 5 years after primary TKA. In this study, 13 knees with tibiofemoral instability after TKA were identified among 693 consecutive primary TKA procedures. Patient demographics, body mass index, clinical symptoms, previous deformity, previous knee surgery, complications, interval between index TKA and first tibiofemoral instability, causes of instability, and interval between index TKA and revision TKA were retrospectively reviewed...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28615121/implications-of-the-getting-it-right-first-time-initiative-for-regional-knee-arthroplasty-services
#6
Richard Barksfield, James Murray, James Robinson, Andrew Porteous
STUDY AIM: The aim of this case study of regional orthopaedic practice was to estimate the potential impact of the GIRFT recommendations (iGIRFT) of minimum unit and surgeon specific volumes to orthopaedic units within the Severn Region, UK. METHOD: Practice profiles for surgeons and units were generated using the UK National Joint Registry Surgeon and Hospital Profile Database. Minimum volume thresholds were set at 13 procedures/year for surgeons and 30 procedures/year for units...
June 11, 2017: Knee
https://www.readbyqxmd.com/read/28602536/national-incidence-of-reportable-quality-metrics-in-the-knee-arthroplasty-population
#7
Joseph E Tanenbaum, Derrick M Knapik, Steven J Fitzgerald, Randall E Marcus
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) characterizes adverse quality events in the inpatient setting as patient safety indicators (PSI). The incidence of PSI has not been quantified in the total knee arthroplasty (TKA) population. METHODS: All patients in the Nationwide Inpatient Sample who underwent primary TKA during an inpatient episode in 2013 were identified using International Classification of Disease, Ninth Revision, Clinical Modification codes...
May 19, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28602534/bilateral-total-hip-and-knee-arthroplasties-average-10-year-follow-up
#8
John B Meding, Philip M Faris, Ken E Davis
BACKGROUND: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced. METHODS: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.6 years. Preoperative diagnoses included osteoarthritis in 80% and rheumatoid arthritis in 20%. The average age at the time of the first arthroplasty was 63...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28594503/two-stage-revision-total-knee-arthroplasty-in-the-setting-of-periprosthetic-knee-infection
#9
Zain Sayeed, Afshin A Anoushiravani, Mouhanad M El-Othmani, Monique C Chambers, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Two-stage revision total knee arthroplasty (TKA) is the standard of care for patients who require a revision procedure for the mangement of a late or chronic periprosthetic knee infection. A careful examination of two-stage revision TKA is warranted as the number of patients who require revision TKA in the United States continues to rise. Surgeons should understand the intricacies involved in two-stage revision TKA, including the indications, procedural variations, and current deliberations on two-stage revision TKA in the literature...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594502/single-stage-revision-total-knee-arthroplasty-in-the-setting-of-periprosthetic-knee-infection-indications-contraindications-and-postoperative-outcomes
#10
Afshin A Anoushiravani, Zain Sayeed, Mouhanad M El-Othmani, Monique C Chambers, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Single-stage revision total knee arthroplasty has become an increasingly common treatment option for patients with failed knee prostheses. Periprosthetic knee infection is the leading and most devastating cause of revision total knee arthroplasty. Although periprosthetic knee infection has been extensively studied in the orthopaedic literature, the role of single-stage revision total knee arthroplasty for the treatment of periprosthetic knee infection warrants further research. As healthcare reform shifts from a volume-based to a value-based system, it is imperative that orthopaedic surgeons understand the procedural indications, risks, and benefits of single-stage revision total knee arthroplasty...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594501/prevention-and-diagnosis-of-periprosthetic-knee-infection
#11
Bilal Mahmood, Mouhanad M El-Othmani, William M Mihalko, William A Jiranek, Wayne G Paprosky, Khaled J Saleh
Total knee arthroplasty (TKA) has become an increasingly common treatment option for patients who have debilitating knee arthritis. TKA is a relatively safe and efficient procedure that results in promising outcomes and has a positive effect on a patient's quality of life. More TKAs are being performed annually because the procedure substantially reduces pain and improves functionality; however, as the number of TKAs continues to rise, there is concern for potential complications that may result in prosthetic joint failure...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594500/patellofemoral-arthroplasty-an-evolving-science
#12
Jess H Lonner
Patellofemoral arthroplasty (PFA) has long been a clinical option for patients with isolated patellofemoral arthritis. However, a high rate of failure as a result of patellar instability related to component malposition, soft-tissue imbalance, errant surgical techniques, and poor trochlear implant designs contributed to the underutilization of PFA. The evolution of surgical indications, trochlear implant design, component positioning, and soft-tissue balance has led to improved patellar tracking, fewer failures related to patellar instability, and improved functional outcomes...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28593060/fracture-of-the-tibial-baseplate-16-years-after-miller-galante-ii-total-knee-arthroplasty
#13
Kazuaki Mineta, Masahiko Okada, Soshi Matsumoto, Daisuke Hamada, Tomohiro Goto, Koichi Sairyo
We report a rare case of tibial baseplate fracture of Miller-Galante II (MG II) prosthesis. We examine the factors that may cause such late fracture and review the literature on radiographic analysis and retrieval studies. A 76-year-old woman, who had undergone bilateral MG II total knee arthroplasty due to rheumatoid arthritis 16 years earlier, presented to our department with a 3-month history of left knee pain. Plain radiographs revealed severe distortion of the medial tibial component. During revision knee arthroplasty, we observed severe metallosis in the knee joint, polyethylene insert deformation, and posteromedial coronal baseplate fracture...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28592075/-influence-of-tibial-component-slope-on-short-term-clinical-outcome-for-oxford-unicompartmental-knee-arthroplasty
#14
L Y Ma, W S Guo, Q D Zhang
Objective: To investigate the effects of tibial component slope change after microplasty (MP) Oxford unicompartmental knee arthroplasty (UKA) on short-term clinical outcome. Methods: A total of 116 patients(128 UKAs)underwent UKA in Department of Orthopaedic Surgery of China-Japan Friendship Hospital between January 2014 and December 2015 were retrospectively reviewed. Totally 100 patients (108 UKAs) were finally included in the study. There were 31 males and 69 females, aging from 47 to 90 years (mean 67.2 years)...
June 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28591928/-does-sports-activity-influence-total-knee-arthroplasty-durability-analysis-with-a-follow-up-of-12-years
#15
Christina Valle, Michael Sperr, Christina Lemhöfer, Karla Elida Bartel, Marcus Schmitt-Sody
Background Total knee replacement is the only surgical option to treat painful degenerative osteoarthritis, restore knee function, improve quality of life, and enable patients to return to sports activity. With an aging population expecting an active life after retirement, patients' expectations of improvement after surgery are increasing as well. In view of the growing demand for higher performance, exercise and athletic activity, clinicians have been increasingly forced to question how much athletic activity a patient may resume after total knee replacement, and what types of athletic activity seem to be acceptable...
June 2017: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/28587673/pathohistological-investigation-of-osteochondral-tissue-obtained-during-total-knee-arthroplasty-after-osteochondral-autologous-transfer-a-case-report
#16
Momoko Tanima-Nagai, Hideto Harada, Tomoki Aoyama, Shoki Yamaguchi, Akira Ito, Junichi Tajino, Hirotaka Iijima, Xiankai Zhang, Hiroshi Kuroki, Masahiko Kobayashi
BACKGROUND: Osteochondral autologous transfer is one of the repair techniques for cartilage defects of knee with promising knee function recovery. There are no reports including histopathological images concerning human osteochondral tissue after osteochondral autologous transfer. This is the first report to present pathohistological findings of transplanted plugs and host tissues extracted from the human body 3 years after osteochondral autologous transfer. This study aimed to explore the cause factor of chronic pain using histological techniques...
June 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28585995/outcomes-of-primary-total-knee-arthroplasty-in-patients-with-hematopoietic-stem-cell-transplantation
#17
Brian P Chalmers, Cameron K Ledford, Kevin I Perry, Tad M Mabry, Arlen D Hanssen, Matthew P Abdel
Patients who have undergone hematopoietic stem cell transplantation to treat underlying bone marrow pathology represent a unique and potentially high-risk patient population for total knee arthroplasty (TKA). This study retrospectively reviewed 15 TKA procedures performed on 11 patients with a history of hematopoietic stem cell transplantation. The authors analyzed patient survivorship; clinical outcomes, including complications; and implant survivorship. Mean follow-up was 5 years (range, 2-10 years). Patient survivorship free from mortality was 91% (95% confidence interval, 76%-100%) and 55% (95% confidence interval, 25%-85%) at 2 and 5 years, respectively...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28579447/are-the-outcomes-of-revision-knee-arthroplasty-for-flexion-instability-the-same-as-for-other-major-failure-mechanisms
#18
Ashok Rajgopal, Taufiq R Panjwani, Arun Rao, Vivek Dahiya
BACKGROUND: Aseptic loosening, infection, and flexion instability have emerged as the leading etiologies for revision after total knee arthroplasty (TKA). Although studies have reported improved outcomes after revision TKA, the relative functional and clinical outcomes of patients revised for flexion instability and other failure etiologies have not been extensively reported. The aim of the study was to compare the functional and patient-reported outcomes of revision TKA for the common failure etiologies...
May 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28579262/contact-forces-in-the-tibiofemoral-joint-from-soft-tissue-tensions-implications-to-soft-tissue-balancing-in-total-knee-arthroplasty
#19
Matthias A Verstraete, Patrick A Meere, Gaia Salvadore, Jan Victor, Peter S Walker
Proper tension of the knee's soft tissue envelope is important during total knee arthroplasty; incorrect tensioning potentially leads to joint stiffness or instability. The latter remains an important trigger for revision surgery. The use of sensors quantifying the intra-articular loads, allows surgeons to assess the ligament tension at the time of surgery. However, realistic target values are missing. In the framework of this paper, eight non-arthritic cadaveric specimens were tested and the intra-articular loads transferred by the medial and lateral compartment were measured using custom sensor modules...
May 23, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28578846/the-congruence-and-joint-space-width-of-the-lateral-compartment-can-be-restored-after-medial-unicompartmental-knee-arthroplasty
#20
Fei Cao, Haibo Si, Yi Zeng, Canfeng Li, Yuangang Wu, Bin Shen
BACKGROUND: Progressive degenerative changes in the lateral compartment of the knee after medial unicompartmental arthroplasty (UKA) remain a main cause of revision surgery. The purpose of this study is to evaluate whether tibiofemoral congruence and joint space width (JSW) of the lateral compartment are improved after medial UKA using traditional instruments. METHODS: We retrospectively analyzed the preoperative and postoperative lateral tibiofemoral congruence using validated software that evaluates the geometric relationship between surfaces and calculates a congruence index (CI)...
April 27, 2017: Journal of Arthroplasty
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