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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/29160123/fast-tracking-for-total-knee-replacement-reduces-use-of-institutional-care-without-compromising-quality
#1
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29151013/decreasing-the-incidence-of-surgical-site-infections-following-joint-replacement-surgery
#2
Lorraine Hutzler, Jarrett Williams
OBJECTIVE: Despite the generalized use of prophylactic antibiotics in orthopaedic surgery, Surgical Site Infections (SSIs) are still a major source of morbidity, mortality, and hospital cost. This is due in part to the increasing prevalence of antibiotic resistant organisms. METHODS: A review of local epidemiology, the importance of an antibiotic stewardship program, patient optimization, and risk stratification options to reduce SSIs. RESULTS: The proportion of revisions due to infection is projected to rise rapidly over the next 25 years...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29147744/consistency-in-patient-reported-outcome-measures-after-total-knee-arthroplasty-using-patient-specific-instrumentation-a-5-year-follow-up-of-200-consecutive-cases
#3
Daphne A L Schoenmakers, Martijn G M Schotanus, Bert Boonen, Nanne P Kort
PURPOSE: The purpose of this study was to evaluate the 5-year follow-up results of the first 200 total knee arthroplasties (TKA) performed by one high-volume surgeon, using patient-specific information (PSI). To date, there has been no other research into the mid-term follow-up of TKA performed using PSI. MATERIALS AND METHODS: A total of 184 consecutive patients (200 TKA) were evaluated. Outcome measures included implant survival rate, adverse events, and the following patient-reported outcome measures (PROMs); Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Pain Visual Analogue Score (VAS) and EuroQol-5D Score (EQ-5D)...
November 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29147743/low-implant-migration-of-the-sigma-%C3%A2-medial-unicompartmental-knee-arthroplasty
#4
Daan Koppens, Maiken Stilling, Stig Munk, Jesper Dalsgaard, Søren Rytter, Ole Gade Sørensen, Torben Bæk Hansen
PURPOSE: The purpose of this study was to evaluate implant migration of the fixed-bearing Sigma(®) medial unicompartmental knee arthroplasty (UKA). UKA is a regularly used treatment for patients with medial osteoarthritis (OA) of the knee. UKA has a higher revision rate than total knee arthroplasty. Implant migration can be used as a predictor of implant loosening. METHODS: A prospective radiostereometric cohort study was performed. Forty-five patients with medial OA of the knee were included and received a cemented Sigma(®) UKA...
November 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29141925/unusual-salmonella-typhi-periprosthetic-joint-infection-involving-bilateral-knees-management-options-and-literature-review
#5
Ashok Rajgopal, Inayat Panda, Anu Gupta
A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29140738/do-outcomes-of-osteochondral-allograft-transplantation-differ-based-on-age-and-sex-a-comparative-matched-group-analysis
#6
Rachel M Frank, Eric J Cotter, Simon Lee, Sarah Poland, Brian J Cole
BACKGROUND: The effect of patient age or sex on outcomes after osteochondral allograft transplantation (OCA) has not been assessed. PURPOSE: To determine clinical outcomes for male and female patients aged ≥40 years undergoing OCA compared with a group of patients aged <40 years. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A review of prospectively collected data of consecutive patients who underwent OCA by a single surgeon with a minimum follow-up of 2 years was conducted...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29132552/intravenous-drug-abuse-is-a-risk-factor-in-the-failure-of-two-stage-treatment-for-infected-total-hip-arthroplasty
#7
Yu-Jie Su, Sung-Yen Lin, Hsuan-Ti Huang, Je-Ken Chang, Chung-Hwan Chen
Reinfection after two-stage revision hip arthroplasty (RHA) is still a complex issue. Only few studies revealed the factors affecting the success rate in the treatment of periprosthetic hip infection (PHI), especially risk factors. A retrospective study was conducted using records of 30 patients underwent two-stage RHA for infected total hip arthroplasty (THA). Treatment was defined as successful if a patient did not need any reoperation or invasive procedure such as image-guided drainage during the two years after reimplantation...
December 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29132347/knee-arthrodesis-versus-above-the-knee-amputation-after-septic-failure-of-revision-total-knee-arthroplasty-comparison-of-functional-outcome-and-complication-rates
#8
Sven Hungerer, Martin Kiechle, Christian von Rüden, Matthias Militz, Knut Beitzel, Mario Morgenstern
BACKGROUND: After septic failure of total knee arthroplasty (TKA) and multiple revision operations resulting in impaired function, bone and/or soft-tissue damage a reconstruction with a revision arthroplasty might be impossible. Salvage procedures to regain mobility and quality of life are an above-the-knee amputation or knee arthrodesis. The decision process for the patient and surgeon is difficult and data comparing arthrodesis versus amputation in terms of function and quality of life are scarce...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29130878/a-novel-technique-utilizing-a-vastus-lateralis-anchor-in-treatment-of-chronic-patellar-dislocation-after-total-knee-arthroplasty
#9
Allison Mayfield, Vamsi Singaraju, Afshin A Anoushiravani, Zain Sayeed, Jamal K Saleh, Khaled J Saleh
Extensor mechanism complications involving the patella frequently result in total knee arthroplasty (TKA) failure. Postoperative patellar dislocation may be caused by soft tissue imbalance, improper sizing, and position of the prosthesis. This report describes a case of revision TKA requiring several rounds of soft tissue releases in an effort to treat the patient's chronic patellar dislocation. In the process, a novel surgical approach was developed for the surgical management of refractory chronic patellar dislocations...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29129618/rotating-hinge-implants-for-complex-primary-and-revision-total-knee-arthroplasty
#10
Sean M Kearns, Brian M Culp, Daniel D Bohl, Scott M Sporer, Craig J Della Valle, Brett R Levine
BACKGROUND: Contemporary rotating hinge knee (RHK) prosthesis has shown improved survival rates over earlier generations. However, reports of high complication and mechanical failure rates highlight the need for more clinical outcome data in the complex primary and revision setting. The purpose of this study is to report our results of using a contemporary rotating hinge for complex primary and revision total knee arthroplasty. METHODS: Using a prospectively maintained surgical database, 79 knees in 76 patients who underwent an RHK of a single design for either a complex primary (14 knees) or revision total knee arthroplasty (65 knees) were identified...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29126382/analysis-of-medical-service-use-of-knee-osteoarthritis-and-knee-meniscal-and-ligament-injuries-in-korea-a-cross-sectional-study-of-national-patient-sample-data
#11
Chang Yong Suh, Yoon Jae Lee, Joon-Shik Shin, Jinho Lee, Me-Riong Kim, Wonil Koh, Yun-Yeop Cha, Byung-Cheul Shin, Eui-Hyoung Hwang, Kristin Suhr, Mia Kim, In-Hyuk Ha
BACKGROUND: Osteoarthritis (OA) and meniscal and ligament injuries of the knee are the two most common knee disorders in Korea. The aim of this study was to analyze the demographic characteristics, medical service use and related costs for these disorders, and the results are expected to help inform practitioners, researchers, and policy-makers. METHODS: The present study aimed to evaluate incidence and patient characteristics, and to assess current medical service use, usual care, and medical expenses of knee disorders by analyzing 2014 national patient sample data from the Korean Health Insurance Review and Assessment Service...
November 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29114630/unicompartmental-knee-arthroplasty-modes-of-failure-and-conversion-to-total-knee-arthroplasty
#12
REVIEW
Michele Vasso, Katia Corona, Rocco D'Apolito, Giuseppe Mazzitelli, Alfredo Schiavone Panni
Despite the excellent success rates of the modern unicompartmental knee arthroplasty (UKA), results of knee replacement registries still shows a relatively high revision and failure rate for UKA, especially when compared with traditional total knee arthroplasty (TKA). Bearing dislocation continues to be advocated as the predominant mechanism of failure in mobile UKA, whereas polyethylene wear and aseptic loosening remains the main cause of failure of fixed UKA. Degeneration of the unreplaced compartments has been reported in both mobile and fixed designs...
March 2017: Joints
https://www.readbyqxmd.com/read/29113757/eight-hundred-twenty-five-medial-mobile-bearing-unicompartmental-knee-arthroplaties-the-first-10-year-us%C3%A2-multi-center-survival-analysis
#13
Omar K Alnachoukati, John W Barrington, Keith R Berend, Michael C Kolczun, Roger H Emerson, Adolph V Lombardi, David R Mauerhan
BACKGROUND: FDA approval for the Oxford phase III device was approved for use in the United States in 2004. This study seeks to provide the first long-term, large patient sample size, Oxford phase III multi-site survivorship study in the United States, investigating patient reported outcomes of pain and function, while also providing an in-depth analysis of causes for revision, and finally addressing recent advancements that can help aid the unicompartmental knee arthroplasty (UKA) process and further improve partial knee survivorship...
October 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29113670/primary-arthroplasty-in-healed-osteoarticular-allograft-in-patients-with-history-of-primary-femoral-bone-tumors
#14
Bianca M Verbeek, Courtney L Kaiser, Nuno Rui Paulino Pereira, Francis J Hornicek, Kevin A Raskin, Joseph H Schwab, Santiago A LozanoCalderón
BACKGROUND: Roughly 25-35% of patients who are treated with osteoarticular allograft for primary bone sarcomas or aggressive benign bone tumors require surgery in the long-term due to degenerative changes of the articular surface of the allograft. There are three established methods of reconstruction for this complication; a total hip arthroplasty (THA) or total knee arthroplasty (TKA) in the retained osteoarticular allograft, a proximal or distal endoprosthesis after removal of the allograft, and an allograft-prosthesis composite (APC)...
December 2017: Surgical Oncology
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#15
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29107492/is-rapid-recovery-hip-and-knee-replacements-possible-and-safe-in-the-octogenarian-patient
#16
Paul K Edwards, James R Kee, Simon C Mears, C Lowry Barnes
BACKGROUND: Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasties by discharging patients directly home, shortening hospital length of stay (LOS), and reducing readmission rates. Although patients aged 80 years and older are included in the Medicare bundle, little work has been performed to determine if older patients can safely participate in rapid recovery programs. METHODS: We retrospectively reviewed 2482 patients undergoing primary and revision total hip and knee arthroplasties (THA and TKA) who all participated in a multifaceted rapid recovery program...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29105554/good-clinical-and-radiographic-outcome-of-cementless-metal-metaphyseal-sleeves-in-total-knee-arthroplasty
#17
Martin Thorsell, Margareta Hedström, Marius C Wick, Rüdiger J Weiss
Background and purpose - The number of revision total knee arthroplasties (TKA) is continuously increasing, leading to a growing need for reliable management of metaphyseal bone loss. We evaluated patients operated with a TKA using metal metaphyseal sleeves for bone defects with a minimum 5-year follow-up. Patients and methods - 37 patients had been operated on. 3 patients died and 3 patients were lost during follow-up. Of the 31 remainders (20 women), 9 had been operated on with a primary TKA and 22 with a revision TKA at the index surgery...
November 6, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29104837/is-single-stage-revision-safe-following-infected-total-knee-arthroplasty-a-critical-review
#18
REVIEW
Raju Vaishya, Amit Kumar Agarwal, Sudheer K Rawat, Harsh Singh, Vipul Vijay
With the improvement in outcomes and modern prosthesis design, total knee arthroplasty (TKA) has now become a commonly performed surgery. It is postulated that a total of 2-5% of the primary and revision TKA becomes infected every year, requiring a revision procedure which to date is the conventional two-stage revision. The diagnosis and treatment of these periprosthetic infections is a major and challenging task, as it requires precise identification of the pathogen, meticulous debridement, and postoperative rehabilitation...
August 30, 2017: Curēus
https://www.readbyqxmd.com/read/29103840/the-influence-of-full-thickness-chondral-defects-on-outcomes-following-meniscal-allograft-transplantation-a-comparative-study
#19
Bryan M Saltzman, Maximilian A Meyer, Timothy S Leroux, Matthew E Gilelis, Margot Debot, Adam B Yanke, Brian J Cole
PURPOSE: To compare a series of patients who underwent meniscus allograft transplantation (MAT) with full-thickness chondral defects (FTD) with those with no chondral defect (ND) with regard to the following: change in patient-reported outcomes (PROs) from baseline to 2-year follow-up and baseline to the final follow-up (including comparisons to minimal clinically important differences), complications and complication rates, reoperations and reoperation rates/timing, and failures and time to failure (revision MAT or conversion to total knee arthroplasty)...
November 2, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29103074/diagnostic-accuracy-of-synovial-fluid-blood-markers-and-microbiological-testing-in-chronic-knee-prosthetic-infections
#20
Giovanni Balato, Vincenzo Franceschini, Tiziana Ascione, Alfredo Lamberti, Fiamma Balboni, Andrea Baldini
INTRODUCTION: This retrospective study was undertaken to define cut-off values for synovial fluid (SF) leukocyte count and neutrophil percentage for differentiating aseptic failure and periprosthetic joint infection (PJI) and to evaluate the diagnostic accuracy of blood inflammatory markers, and microbiological testing according to the criteria proposed by the International Consensus Meeting (ICM) of Philadelphia. METHODS: All patients who underwent revision total knee arthroplasty from January 2010 to July 2015 were included: we identified and classified 31 PJIs and 136 aseptic joints...
November 4, 2017: Archives of Orthopaedic and Trauma Surgery
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