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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#1
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28801816/are-tkas-performed-in-high-volume-hospitals-less-likely-to-undergo-revision-than-tkas-performed-in-low-volume-hospitals
#2
Elke Jeschke, Mustafa Citak, Christian Günster, Andreas Matthias Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers. QUESTIONS/PURPOSES: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital? METHODS: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28800919/similar-outcomes-after-osteochondral-allograft-transplantation-in-anterior-cruciate-ligament-intact-and-reconstructed-knees-a-comparative-matched-group-analysis-with-minimum-2-year-follow-up
#3
Dean Wang, Claire D Eliasburg, Tim Wang, Ryan R Fader, Francesca R Coxe, Mollyann D Pais, Riley J Williams
PURPOSE: To compare failure rates and clinical outcomes of osteochondral allograft transplantation (OCA) in anterior cruciate ligament (ACL)-intact versus ACL-reconstructed knees at midterm follow-up. METHODS: After a priori power analysis, a prospective registry of patients treated with OCA for focal chondral lesions ≥2 cm(2) in size with minimum 2-year follow-up was used to match ACL-reconstructed knees with ACL-intact knees by age, sex, and primary chondral defect location...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28800854/up-to-seven-years-follow-up-of-short-cemented-stems-in-complex-primary-total-knee-arthroplasty-a-prospective-study
#4
Mathieu Angers-Goulet, Martin Bédard
BACKGROUND: Although primary total knee arthroplasty (TKA) shows good clinical, functional and radiological results, it can be complicated by certain conditions or pathologies. The main objective of this study was to evaluate the global performance of short cemented metaphyseal stem components in patients undergoing complex primary TKA. METHODS: This is a single-surgeon prospective case series of 91 patients who underwent complex primary TKA requiring short stem fixation between January 2009 and October 2014...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28797880/smoking-is-associated-with-earlier-time-to-revision-of-total-knee-arthroplasty
#5
Chin Tat Lim, Stuart B Goodman, James I Huddleston, Alex H S Harris, Subhrojyoti Bhowmick, William J Maloney, Derek F Amanatullah
BACKGROUND: Smoking is associated with early postoperative complications, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). However, the effect of smoking on time to revision TKA is unknown. METHODS: A total of 619 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to the patient smoking status. Smoking status was then analyzed for associations with time to revision TKA using a Chi square test...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28793979/outcome-of-prosthesis-matched-and-unmatched-patella-components-in-primary-and-revision-total-knee-replacement
#6
Peter L Lewis, Ai E Gamboa, David G Campbell, Michelle Lorimer
BACKGROUND: Although knee replacements have specifically designed patella prostheses that correspond to the geometry of their femoral components, a patella prosthesis that is unmatched to the femoral component may occasionally be inserted. In revision total knee arthroplasty (TKA), an originally resurfaced patella may be left, but the femoral component revised to one that does not match the patella. Few studies have compared the outcome of matched and unmatched patella components in TKA...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28793978/patellofemoral-arthroplasty-conversion-to-total-knee-arthroplasty-retrieval-analysis-and-clinical-correlation
#7
Alexander B Christ, Elexis Baral, Chelsea Koch, Beth E Shubin Stein, Alejandro Gonzalez Della Valle, Sabrina M Strickland
BACKGROUND: Patellofemoral arthroplasty (PFA) can be a successful, bone-sparing treatment for isolated patellofemoral arthritis. However, progression of tibio-femoral arthritis or incorrect indications may predispose patients to early conversion to total knee arthroplasty (TKA). The purpose of this study was to review the clinical cases and perform retrieval analysis of PFA conversions to TKA at our institution. METHODS: Twenty one patellofemoral arthroplasties in 18 patients that were converted to TKA were identified through our implant retrieval registry...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28780223/modifiable-risk-factors-are-common-in-early-revision-hip-and-knee%C3%A2-arthroplasty
#8
James R Kee, Simon C Mears, Paul K Edwards, C Lowry Barnes
BACKGROUND: Obesity, smoking, uncontrolled diabetes, and poor dental health are modifiable risk factors for revision total joint arthroplasty. To protect patients from revision surgery while also reducing cost, some joint arthroplasty practices use these conditions as contraindications until they are improved. However, this practice is variable among joint arthroplasty surgeons. We hypothesize that a relatively high rate of revision arthroplasty patients had modifiable risk factors at the time of primary surgery...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28777663/frondlike-synovitis-on-mri-and-correlation-with-polyethylene-surface-damage-of-total-knee-arthroplasty
#9
Angela E Li, Christine C Johnson, Darryl B Sneag, Chelsea N Koch, Kara Fields, Theodore T Miller, Timothy M Wright, Douglas E Padgett, Hollis G Potter
OBJECTIVE: The purpose of this study is to determine the association between polyethylene surface damage and the severity of frondlike hypertrophied synovitis, joint distention, capsular thickness, and osteolysis on MRI compared with other patient factors. Another goal of this study is to ascertain the interobserver reliability in MRI evaluation of synovitis. MATERIALS AND METHODS: MR images of 61 patients who had undergone revision total knee arthroplasty (TKA) were retrospectively reviewed...
August 4, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28776632/interprosthetic-fractures-of-the-femur
#10
Nicholas M Romeo, Reza Firoozabadi
As the rate of hip and knee arthroplasty procedures increases, so will the rate of interprosthetic fractures. Several factors, including bone quality, bone quantity, and stability of the prosthetic components, play a role in determining the appropriate operative treatment. Patients with stable components should undergo reduction and internal fixation, while patients with loose components should undergo either revision arthroplasty, with or without additional fixation, or conversion to total femur replacement...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28773989/bacterial-infection-and-implant-loosening-in-hip-and-knee-arthroplasty-evaluation-of-209-cases
#11
Ulrike Dapunt, Stephanie Radzuweit-Mihaljevic, Burkhard Lehner, Gertrud Maria Haensch, Volker Ewerbeck
The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients (n = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28771059/the-cox-model-is-better-than-the-fine-and-gray-model-when-estimating-relative-revision-risks-from-arthroplasty-register-data
#12
Jonas Ranstam, Otto Robertsson
Background and purpose - Analysis of the revision-free survival of knee and hip prostheses has traditionally been performed using Kaplan-Meier analysis and Cox regression. The competing risk problem that is related to patients who die during follow-up has recently been increasingly discussed, not least with regard to the problem of choosing a suitable statistical method for the analysis. We compared the results from analyses of Cox models and Fine and Gray models. Methods - We used data simulation based on parameter estimates from the Swedish Knee Arthroplasty Register and assessed hypothetical effects of the studied risk factors...
August 3, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28768779/cost-effectiveness-of-patellofemoral-versus-total-knee-arthroplasty-in-younger-patients
#13
H Chawla, B U Nwachukwu, J P van der List, A A Eggman, A D Pearle, H M Ghomrawi
AIMS: Patellofemoral arthroplasty (PFA) has experienced significant improvements in implant survivorship with second generation designs. This has renewed interest in PFA as an alternative to total knee arthroplasty (TKA) for younger active patients with isolated patellofemoral osteoarthritis (PF OA). We analysed the cost-effectiveness of PFA versus TKA for the management of isolated PF OA in the United States-based population. PATIENTS AND METHODS: We used a Markov transition state model to compare cost-effectiveness between PFA and TKA...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28765504/does-early-return-to-theatre-add-value-to-rates-of-revision-at-3-years-in-assessing-surgeon-performance-for-elective-hip-and-knee-arthroplasty-national-observational-study
#14
Alex Bottle, Helen E Chase, Paul P Aylin, Mark Loeffler
BACKGROUND: Joint replacement revision is the most widely used long-term outcome measure in elective hip and knee surgery. Return to theatre (RTT) has been proposed as an additional outcome measure, but how it compares with revision in its statistical performance is unknown. METHODS: National hospital administrative data for England were used to compare RTT at 90 days (RTT90) with revision rates within 3 years by surgeon. Standard power calculations were run for different scenarios...
August 1, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#15
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28752819/computer-assisted-navigation-in-total-knee-and-hip-arthroplasty
#16
Kamal Deep, Shivakumar Shankar, Ashish Mahendra
INTRODUCTION: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. METHODS: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool...
2017: SICOT-J
https://www.readbyqxmd.com/read/28746219/clinical-outcomes-of-medial-collateral-ligament-injury-in-total-knee-arthroplasty
#17
Xiaomeng Wang, Huixin Liu, Pengkai Cao, Chang Liu, Zhenyue Dong, Jianchao Qi, Fei Wang
Intraoperative injury to the medial collateral ligament (MCL) during total knee arthroplasty (TKA) is a rare but severe complication. The main treatment methods are primary repair and revision with a more constrained implant; however, the clinical outcomes of primary reconstruction without a constrained implant have rarely been reported.A retrospective study was performed to evaluate the prevalence of iatrogenic injury to the MCL during primary TKA, and to report the clinical outcomes of MCL reconstruction without the use of a constrained device...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28746022/mortality-after-total-knee-and-total-hip-arthroplasty-in-a-large-integrated-health-care-system
#18
Maria C S Inacio, Mark T Dillon, Alex Miric, Ronald A Navarro, Elizabeth W Paxton
CONTEXT: The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. OBJECTIVE: To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. DESIGN: A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745972/a-20-year-follow-up-after-first-generation-autologous-chondrocyte-implantation
#19
Takahiro Ogura, Brian A Mosier, Tim Bryant, Tom Minas
BACKGROUND: Treating articular cartilage defects is a demanding problem. Although several studies have reported durable and improved clinical outcomes after autologous chondrocyte implantation (ACI) over a long-term period, there is no report with over 20 years' follow-up. PURPOSE: To evaluate clinical outcomes after first-generation ACI for the treatment of knees with disabling, large single and multiple cartilage defects for which patients wished to avoid prosthetic arthroplasty, with a minimum of 20 years' follow-up...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28744756/short-term-outcome-of-unicompartmental-knee-arthroplasty-in-the-octogenarian-population
#20
Baha John Tadros, John Dabis, Roy Twyman
PURPOSE: Unicompartmental knee arthroplasty (UKA) provides significant benefits to patients with anteromedial osteoarthritis, with good long-term results. Morbidity and mortality rates are lower, and recovery is quicker. These benefits would be advantageous to the octogenarian population whom carry significant comorbidities. The primary aim was to compare the short-term functional outcome at 2 years of UKA in the octogenarian population against a stratified younger cohort of patients...
July 25, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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