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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/28331989/does-the-tibia-component-design-affect-the-need-for-offset-stems-in-revision-total-knee-arthroplasty
#1
X Foruria, T Schmidt-Braekling, D Arana Nabarte, M Faschingbauer, M Kasparek, F Boettner
INTRODUCTION: The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty. MATERIALS AND METHODS: Hip to ankle standing radiographs and lateral radiographs of 75 patients were analyzed using digital templating software. The offset in the anterior-posterior as well as medial-lateral plane between the center of the tibial diaphysis and the stem of the tibial baseplate were determined for an anatomic and symmetric tibial baseplate, respectively...
March 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28326442/long-term-follow-up-of-a-non-randomised-prospective-cohort-of-one-hundred-and-ninety-two-total-knee-arthroplasties-using-the-nexgen-implant
#2
Alfredo Schiavone Panni, Franceso Falez, Rocco D'Apolito, Katia Corona, Carlo Perisano, Michele Vasso
PURPOSE: The purpose of this study was to retrospectively analyse the clinical, functional and radiological outcomes, and the long-term survivorship of the NexGen Legacy Posterior Stabilised (LPS) knee prosthesis (Zimmer Biomet, Warsaw, IN, USA). METHODS: Between 1996 and 2001, 197 primary NexGen LPS total knee arthroplasties (TKAs) were implanted by a single surgeon; 132 prostheses in 124 patients with a minimum follow-up of 15 years were included in the study...
March 22, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28326427/posterior-stabilized-total-knee-arthroplasty-a-matched-pair-analysis-of-a-classic-and-its-evolutional-design
#3
Pier Francesco Indelli, Gennaro Pipino, Paul Johnson, Angelo Graceffa, Massimiliano Marcucci
BACKGROUND: Total knee arthroplasty (TKA) designs continue to be modified to optimize patient's outcome. This study was designed to compare clinical and radiological results of classic worldwide used TKA posterior-stabilized (PS) design to those of its recent evolution. METHODS: A consecutive group of 100 patients undergoing TKA using a classic cemented fixed-bearing PS TKA system was matched by age, gender, body max index to 100 patients having the newer cemented fixed-bearing PS design, both by the same manufacturer...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326423/removing-a-well-fixed-femoral-sleeve-during-revision-total-knee-arthroplasty
#4
J Ryan Martin, Tyler S Watters, Daniel L Levy, Jason M Jennings, Douglas A Dennis
The following surgical technique describes a case of a 51-year-old man with severe juvenile rheumatoid arthritis that required a 2-stage revision of an infected revision total knee implant. The patient had previously been implanted with a revision rotating platform, constrained condylar device which gained excellent fixation through the use of diaphyseal-engaging stems, and a well-ingrown, fully porous-coated femoral metaphyseal sleeve. To avoid intraoperative complications while removing the femoral sleeve, a novel technique for femoral sleeve extraction was used...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326411/medial-tibial-spackling-to-lessen-chronic-medial-tibial-soft-tissue-irritation
#5
J Ryan Martin, Tyler Steven Watters, Daniel L Levy, Jason M Jennings, James P Boyle, Douglas A Dennis
We describe a unique, utilitarian reconstructive treatment option known as tibial "spackling" for chronic, localized medial joint line pain corresponding with progressive radiographic peripheral medial tibial bone loss beneath a well-fixed revision total knee arthroplasty tibial baseplate. It is believed that this localized pain is due to chronic irritation of the medial capsule and collateral ligament from the prominent medial edge of the tibial component. In the setting of failed nonoperative treatment, our experience with utilizing bone cement to reconstruct the medial tibial bone defect and create a smooth medial tibial surface has been successful in eliminating chronic medial soft tissue irritation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#6
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326397/fracture-of-an-uncemented-tantalum-patellar-component
#7
Nathan L Grimm, Robert A Henderson, Joseph J Kavolus, Patrick D Millikan, Paul F Lachiewicz
A 62-year-old man presented with the acute, atraumatic onset of pain 3 years after uncemented right total knee arthroplasty. He complained of new mechanical locking with the knee held in extension on examination and unable to flex the knee. On the plain radiographs, the patellar component peg was fractured and the plate was dislocated. The knee was immobilized, and revision to a cemented 3-peg component was performed. Fracture of a single-peg, tantalum-backed uncemented patellar component has not been described...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28318864/weight-gain-after-primary-total-knee-arthroplasty-is-associated-with-accelerated-time-to-revision-for-aseptic-loosening
#8
Chin Tat Lim, Stuart B Goodman, James I Huddleston, Alex H S Harris, Subhrojyoti Bhowmick, William J Maloney, Derek F Amanatullah
BACKGROUND: Obesity is a major health problem worldwide and is associated with complications after total knee arthroplasty (TKA). It remains unknown whether a change in body mass index (BMI) after primary TKA affects the reasons for revision TKA or the time to revision TKA. METHODS: A total of 160 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to change in BMI from the time of their primary TKA to revision TKA...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28314891/revision-total-knee-arthroplasty-with-porous-coated-metaphyseal-sleeves-provides-radiographic-ingrowth-and-stable-fixation
#9
Catherine J Fedorka, Antonia F Chen, Michael R Pagnotto, Lawrence S Crossett, Brian A Klatt
PURPOSE: Porous-coated metaphyseal sleeves are designed to fill bone defects and facilitate osseointegration when bone loss in encountered during revision total knee arthroplasty (TKA). The purpose of this study is to evaluate short-term results of porous-coated metaphyseal sleeves with regards to implant fixation and clinical outcomes. METHODS: A retrospective review was conducted on 50 patients (79 sleeves-49 tibial and 30 femoral) who had a press-fit metaphyseal sleeve with revision TKA...
March 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28302461/data-quality-in-institutional-arthroplasty-registries-description-of-a-model-of-validation-and-report-of-preliminary-results
#10
Maria P Bautista, Guillermo A Bonilla, Klaus W Mieth, Adolfo M Llinás, Fernanda Rodríguez, Laura L Cárdenas
BACKGROUND: Arthroplasty registries are a relevant source of information for research and quality improvement in patient care and its value depends on the quality of the recorded data. The purpose of this study is to describe a model of validation and present the findings of validation of an Institutional Arthroplasty Registry (IAR). METHODS: Information from 209 primary arthroplasties and revision surgeries of the hip, knee, and shoulder recorded in the IAR between March and September 2015 were analyzed in the following domains...
February 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28302132/long-term-results-and-comparison-of-the-three-different-high-tibial-osteotomy-and-fixation-techniques-in-medial-compartment-arthrosis
#11
Gökhan Polat, Halil İbrahim Balcı, Mehmet Fevzi Çakmak, Mehmet Demirel, Cengiz Şen, Mehmet Aşık
BACKGROUND: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. METHODS: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study...
March 16, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28299718/have-the-causes-of-revision-for-total-and-unicompartmental-knee-arthroplasties-changed-during-the-past-two-decades
#12
Gro S Dyrhovden, Stein Håkon L Lygre, Mona Badawy, Øystein Gøthesen, Ove Furnes
BACKGROUND: Revisions after knee arthroplasty are expected to increase, and the epidemiology of failure mechanisms is changing as new implants, technology, and surgical techniques evolve. QUESTIONS/PURPOSES: (1) Was there improvement in survival for TKA and unicompartmental knee arthroplasty (UKA) when comparing two consecutive 11-year periods with similar followups in a national registry? (2) Were there changes in the causes of revision during the two times? (3) Could the changes in revision causes be attributed to patient or implant characteristics? METHODS: A total of 60,623 TKAs (2426 revisions) and 7648 UKAs (725 revisions) were selected from the Norwegian Arthroplasty Register and analyzed based on year of primary surgery: 1994 to 2004 (Period 1) and 2005 to 2015 (Period 2)...
March 15, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28298194/patient-endorsement-of-the-outcome-measures-in-rheumatology-omeract-total-joint-replacement-tjr-clinical-trial-draft-core-domain-set
#13
Jasvinder A Singh, Michelle Dowsey, Peter F Choong
BACKGROUND: A patient- and surgeon-Delphi-derived Outcome Measures in Rheumatology (OMERACT) draft core domain set for total joint arthroplasty (TJR) trials was recently developed. Our objective was to obtain further patient stakeholder endorsement of draft core domain set for TJR clinical trials. METHODS: We surveyed two patient groups: (1) OMERACT patient partners; and (2) patients who had undergone hip or knee TJR. Patients received an introductory email with explanations about the core domain set and instructions to rate the core domains, i...
March 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28290738/increased-risk-of-intraoperative-and-early-postoperative-periprosthetic-femoral-fracture-with-uncemented-stems
#14
Martin Lindberg-Larsen, Christoffer C Jørgensen, Søren Solgaard, Anne G Kjersgaard, Henrik Kehlet
Background and purpose - The use of uncemented fixation in total hip arthroplasty (THA) is increasing. Registry studies have indicated an increased risk of revision of uncemented implants due to early periprosthetic femoral fracture. In this paper, we describe the incidence and predisposing factors for intraoperative and early postoperative (≤ 90 days) periprosthetic femoral fractures after cemented and uncemented THA. Patients and methods - This was a prospective observational study in 8 Danish high-volume centers from February 2010 to November 2013...
March 14, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28290115/sonication-of-arthroplasty-implants-improves-accuracy-of-periprosthetic-joint-infection-cultures
#15
REVIEW
Adam C Rothenberg, Alan E Wilson, John P Hayes, Michael J O'Malley, Brian A Klatt
BACKGROUND: There is evidence that sonication of explanted prosthetic hip and knee arthroplasty components with culture of the sonication fluid may enhance diagnostic sensitivity. Previous studies on the use of implant sonicate cultures have evaluated diagnostic thresholds but did not elaborate on the clinical importance of positive implant sonicate cultures in the setting of presumed aseptic revisions and did not utilize consensus statements on periprosthetic joint infection (PJI) diagnosis when defining their gold standard for infection...
March 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28285901/a-novel-percentage-based-system-for-determining-aseptic-loosening-of-total-knee-arthroplasty-tibial-components
#16
Brian P Chalmers, Peter K Sculco, Keith A Fehring, Robert T Trousdale, Michael J Taunton
BACKGROUND: There are limited data on evaluating the significance of radiolucent lines and aseptic loosening in total knee arthroplasty (TKA). We sought to compare the sensitivity, specificity, and reliability of the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System (KSRES) in detecting tibial component loosening compared to a novel percentage-based system (PBS). METHODS: We retrospectively reviewed radiographs obtained from 48 patients within 6 months prior to revision TKA...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285899/clinical-results-and-survivorship-of-the-genesis-ii-total-knee-arthroplasty-at-a-minimum-of-15-years
#17
Richard W McCalden, Gavin P Hart, Steven J MacDonald, Douglas D Naudie, James H Howard, Robert B Bourne
BACKGROUND: The purpose of this study was to examine the 15-year survivorship and long-term clinical outcomes of the GENESIS II total knee arthroplasty (TKA). METHODS: Patients who underwent TKA with the GENESIS II system between 1995 and 1999 were retrieved from our institutional database. We report a Kaplan-Meier survival analysis as well as Western Ontario and McMaster Universities Arthritis Index, the Short Form Health Survey-12 (SF-12), and the Knee Society Scores at a mean of 16 years...
February 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28285897/arthrofibrosis-associated-with-total-knee-arthroplasty
#18
REVIEW
Victor A Cheuy, Jared R H Foran, Roger J Paxton, Michael J Bade, Joseph A Zeni, Jennifer E Stevens-Lapsley
The purpose of this article is to review the etiology, economic burden, treatment strategies, and future research directions of arthrofibrosis after total knee arthroplasty (TKA). Arthrofibrosis is a debilitating postoperative complication of TKA. This condition is one of the leading causes of hospital readmission and a predominant reason for TKA failure. The prevalence of arthrofibrosis will increase as the annual incidence of TKA in the United States rises into the millions. Characterized by the excessive proliferation of scar tissue during an impaired wound healing response, the resulting stiffness of arthrofibrosis causes functional deficits in activities of daily living, such as walking, stair climbing, and standing from a chair...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28271092/loosening-of-total-knee-arthroplasty-after-brucellosis-infection-a-case-report
#19
Mohammad Ali Sazegari, Fateme Bahramian, Fateme Mirzaee, Zohreh Zafarani, Hamidreza Aslani
In this report we describe a 78-year-old man whose total knee arthroplasty showed the symptoms of infection with brucella with radiographic signs of loosening 5 years after the index surgery. The patient was treated successfully after a 2-stage revision arthroplasty surgery along with using rifampicin and doxycycline for 8 weeks.
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28266241/tibial-component-rotation-around-the-transverse-axis-measured-by-radiostereometry-predicts-aseptic-loosening-better-than-maximal-total-point-motion
#20
Asgeir Gudnason, Gunnar Adalberth, Kjell-Gunnar Nilsson, Nils P Hailer
Background and purpose - Maximal total point motion (MTPM) measured by radiostereometry (RSA) is widely used as a predictor of total knee arthroplasty (TKA) loosening. We compared the ability of different RSA measurements at different time points to predict loosening of tibial TKA components in the long term. Patients and methods - 116 TKAs in 116 patients were included in our analysis. 16 (14.8-17.4) years after surgery, 5 tibial components had been revised due to aseptic loosening. Receiver operating characteristic curves were calculated in order to investigate the specificity and sensitivity of different RSA parameters at different thresholds...
March 7, 2017: Acta Orthopaedica
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