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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/29789904/revision-knee-arthroplasty-with-rotating-hinge-systems-in-patients-with-gross-ligament-instability
#1
Sebastian P Boelch, Joerg Arnholdt, Boris M Holzapfel, Axel Jakuscheit, Maximilian Rudert, Maik Hoberg
PURPOSE: The clinical and radiographic outcomes after revision total knee arthroplasty (TKA) for instability with two rotating hinge knee prostheses were compared. METHODS: Fifty-one patients revised for TKA instability were prospectively randomized to either the Link Endo-Model (N = 26) or the EnduRo (N = 25). Clinical and radiographic outcome scores were compared pre-operatively and at 12 months' follow-up. Failure mechanisms were recorded. RESULTS: Age, BMI, operation, and tourniquet-time did not differ significantly between groups...
May 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29788680/two-sequential-free-flaps-for-coverage-of-a-total-knee-implant
#2
Siew Weng Ng, Hui Chai Fong, Bien-Keem Tan
Knee revision arthroplasty following peri-prosthetic joint infections is a formidable challenge. Patients are at a high risk of recurrent infection, and the soft tissue over the revised implant is often of questionable quality. Flap reconstruction has improved the salvage rates of infected arthroplasties, and should be considered in all cases of revision arthroplasty. We present a challenging case requiring staged reconstruction with two free latissimus dorsi flaps after the initial use of a medial gastrocnemius flap...
May 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29785448/patella-alta-and-patellar-subluxation-might-lead-to-early-failure-with-inlay-patello-femoral-joint-arthroplasty
#3
J Beckmann, C Merz, J Huth, B Rath, C Schnurr, E Thienpont
PURPOSE: With the growing interest in resurfacing procedures, several new implants have been recently introduced for isolated patello-femoral joint arthroplasty (PFA). However, not much data are available for these new techniques or about the right indications for each type of implant. METHODS: Out of a retrospective cohort of 20 inlay PFA, 11 PFA with an elevated Insall-Salvati index and an increased patello-femoral congruence angle showed an initial satisfactory result, but presented thereafter with recurrent pain and "clunk" phenomena...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29783271/mid-term-clinical-outcome-and-reconstruction-of-posterior-tibial-slope-after-uka
#4
Alois Franz, Christoph Kolja Boese, Andrej Matthies, Jörg Leffler, Christian Ries
Unicompartmental knee arthroplasty (UKA) has gained growing popularity over the last decades. The posterior tibial slope (PTS) has been shown to play a significant role for knee biomechanics and is thought to be crucial for clinical function of the UKA. We evaluated the clinical outcome at mid-term follow-up after UKA. Furthermore, the reconstruction of the individual PTS was analyzed. A total of 91 consecutive patients undergoing medial UKA for osteoarthritis were included. Patients were contacted by telephone for a survival analysis at a minimum of 30 months after surgery...
May 21, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29776853/outcomes-of-a-fixed-bearing-medial-cemented-unicondylar-knee-arthroplasty-design-survival-analysis-and-functional-score-of-460-cases
#5
Philip Winnock de Grave, Justine Barbier, Thomas Luyckx, Alexander Ryckaert, Paul Gunst, Luc Van den Daelen
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant. METHODS: Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system...
April 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29776814/metallosis-in-cemented-titanium-alloy-total-knee-arthroplasty-without-apparent-metal-on-metal-articulation
#6
James Ho, John Mahajan, Martin Taylor, Ashlyn Byers, Paul Arauz, Young-Min Kwon
BACKGROUND: Metallosis is an uncommon phenomenon observed in late failures of cemented total knee arthroplasty (TKA), and it is rarely seen in the absence of metal-on-metal articulation. METHODS: We report the case of a TKA patient with cemented titanium-alloy components and a polyethylene patella that was revised for early loosening with intra-operative severe metallosis. RESULTS: We found that loosening and severe metallosis were associated with methacrylate particle abrasion on titanium alloy surfaces...
May 16, 2018: Knee
https://www.readbyqxmd.com/read/29776813/unicompartmental-knee-arthroplasty-for-spontaneous-osteonecrosis-of-the-medial-tibial-plateau
#7
Tomoyuki Kamenaga, Takafumi Hiranaka, Yuichi Hida, Takaaki Fujishiro, Koji Okamoto
BACKGROUND: There have been very few reports on isolated medial tibial plateau osteonecrosis, and the condition has not been clearly described. Unicompartmental knee arthroplasty (UKA) may be an appropriate treatment method for this condition. The aims of this study were to report our experience of using mobile-bearing knee implants for osteonecrosis of the medial tibial plateau and to discuss the etiology and treatment of this type of osteonecrosis. METHODS: This study included six consecutive patients with isolated medial tibial plateau osteonecrosis treated with an Oxford mobile-bearing knee implant...
May 16, 2018: Knee
https://www.readbyqxmd.com/read/29773404/large-tibial-geode-which-developed-several-years-after-a-left-medial-oxford-unicondylar-knee-arthroplasty-treated-with-curettage-and-bone-grafting
#8
Matthew K Curran, James R Murray
BACKGROUND: Tibial geodes are rare, and usually reported in association with rheumatoid arthritis. This case study reported the rare occurrence of a tibial geode in association with a left unicondylar knee arthroplasty (UKA). The patient, a 55-year-old male, was initially pleased with his UKA, which was performed at another institution. However, just over one year after the operation he began experiencing pain and discomfort. He did not present to the current institution until he was six years after UKA...
May 14, 2018: Knee
https://www.readbyqxmd.com/read/29773277/-thicker-polyethylene-bearings-are-not-associated-with-higher-failure-rates-in-primary-total-knee-arthroplasty
#9
Nicholas J Greco, David A Crawford, Keith R Berend, Joanne B Adams, Adolph V Lombardi
BACKGROUND: Despite improvements in polyethylene bearing surface properties, only 1 previous study has examined the results of larger thickness bearings. The purpose of this study was to determine whether polyethylene thickness influenced patient outcomes and implant survival following modular total knee arthroplasty. METHODS: A retrospective review was performed of patients undergoing primary total knee arthroplasty from 2003 to 2014 in a single practice database...
April 23, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29770589/short-term-follow-up-of-antibiotic-loaded-articulating-cement-spacers-in-two-stage-revision-of-infected-total-knee-arthroplasty-a-case-series
#10
Meng-Qiang Tian, Xian-Teng Yang, Xiao-Bin Tian, Yun-Bo Sun, Yuan-Hui Duan, Li Sun
OBJECTIVE: Infection of total knee arthroplasty (TKA) is a rare but devastating complication. Two-stage revision is an effective treatment for late infected TKA. This study aimed to assess the short-term results of two-stage revision using articulating antibiotic-loaded spacers. METHODS: Twenty-five patients (10 men and 15 women) were diagnosed with late infections after TKA and treated with two-stage revision from April 2006 to August 2010; 19 of these patients had TKA for osteoarthritis and 6 for rheumatoid arthritis...
May 17, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29768019/does-anterior-cruciate-ligament-reconstruction-affect-the-outcome-of-osteochondral-allograft-transplantation-a-matched-cohort-study-with-a-mean-follow-up-of-6-years
#11
Luís E P Tírico, Julie C McCauley, Pamela A Pulido, William D Bugbee
BACKGROUND: Few studies have evaluated the influence of anterior cruciate ligament (ACL) reconstruction on the outcome of cartilage repair. Hypothesis/Purpose: The purpose was to investigate the association between ACL reconstruction and functional outcomes after osteochondral allograft (OCA) transplantation. The hypothesis was that patients treated with OCA transplantation who had a history of ACL reconstruction would have inferior clinical outcomes and lower osteochondral graft survivorship when compared with a matched group of patients undergoing OCA transplantation without a history of ACL reconstruction...
May 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29763476/drug-induced-linear-iga-bullous-dermatosis-in-a-patient-with-a-vancomycin-impregnated-cement-spacer
#12
Kelsie Riemenschneider, Daren A Diiorio, John A Zic, Matthew R Livingood, Jo-David Fine, Jennifer G Powers, Jeffrey P Zwerner, Eric Tkaczyk
Linear IgA bullous dermatosis (LABD) is an autoimmune blistering rash caused by IgA autoantibodies against the epidermal basement membrane zone. It commonly is drug induced, often in association with systemic vancomycin. We report a case of a previously healthy 77-year-old man who developed a diffuse macular rash and hemorrhagic bullae on the left leg 10 days after placement of a vancomycin-impregnated cement spacer (VICS) during a revision knee arthroplasty and initiation of postoperative treatment with intravenous (IV) vancomycin...
April 2018: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/29762282/uncemented-tantalum-monoblock-tibial-fixation-for-total-knee-arthroplasty-in-patients-less-than-60-years-of-age-mean-10-year-follow-up
#13
Christopher J DeFrancesco, José A Canseco, Charles L Nelson, Craig L Israelite, Atul F Kamath
BACKGROUND: Although tibial component loosening has been considered a concern after total knee arthroplasty without cement, such implants have been used in younger patients because of the potential for ingrowth and preservation of bone stock. However, mid-term and long-term studies of modern uncemented implants are lacking. We previously reported promising prospective 5-year outcomes after using an uncemented porous tantalum tibial component in patients who underwent surgery before the age of 60 years...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29762280/long-term-outcomes-of-pedicled-gastrocnemius-flaps-in-total-knee-arthroplasty
#14
Matthew T Houdek, Eric R Wagner, Cody C Wyles, William S Harmsen, Arlen D Hanssen, Michael J Taunton, Steven L Moran
BACKGROUND: Deficient soft tissue following total knee arthroplasty (TKA) can jeopardize outcome. The gastrocnemius flap is an important means of providing coverage of a knee with deficient soft tissue. There is a paucity of long-term studies on the use of the gastrocnemius flap in the setting of TKA. The purpose of this study was to review the outcomes after the use of pedicled gastrocnemius flaps for coverage of a soft-tissue defect at the time of TKA. METHODS: Eighty-three patients in whom a gastrocnemius flap had been used to cover the site of a primary (n = 18) or revision (n = 65) TKA over a 25-year period were identified...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29754982/computed-tomography-techniques-help-understand-wear-patterns-in-retrieved-total-knee-arthroplasty
#15
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Lorenzo Dall'Ava, Paul Shearing, Michael T Hirschmann, Alister J Hart
BACKGROUND: Suboptimal total knee arthroplasty (TKA) position of both femoral and tibial components is thought to be linked with poor clinical outcomes, polyethylene wear and the "unexplained" painful knee arthroplasty. The aim of this study was to better understand the effect of implant orientation on knee implant performance. METHODS: We analyzed 30 retrieved contemporary TKA implants. Implant positioning measurements in the coronal plane were made prior to revision using a diagnostic algorithm, based on 3D computed tomography (CT) images...
April 16, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#16
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#17
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29725747/no-difference-in-mid-term-survival-and-clinical-outcome-between-patient-specific-and-conventional-instrumented-total-knee-arthroplasty-a-randomized-controlled-trial
#18
M G M Schotanus, B Boonen, W van Weegen, H Hoekstra, R van Drumpt, R Borghans, R Vos, L van Rhijn, N P Kort
PURPOSE: The purpose of this multicentre prospective randomized controlled trial was to compare the survival rate and clinical outcome in total knee arthroplasty (TKA) after MRI-based patient-specific instruments (PSI) and conventional instruments 5 years after initial surgery. METHODS: At a mean follow-up of 5.1 years (0.4), 163 patients (90.6%) with a mean age of 71.8 years (8.7) were analysed. A survival analysis with revision of the TKA as endpoint was performed...
May 3, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29715553/development-and-validation-of-baseline-perioperative-and-at-discharge-predictive-models-for-postsurgical-prosthetic-joint-infection
#19
María Dolores Del Toro, Cecilia Peñas, Ana Conde Albarracín, Julián Palomino, Francisco Brun, Santiago Sánchez, Jesús Rodríguez-Baño
OBJECTIVES: To develop and validate baseline, perioperative and at-discharge risk-scoring systems for postsurgical prosthetic joint infection (PJI) in patients undergoing arthroplasty. PATIENTS AND METHODS: A multicentre, prospective cohort study of patients undergoing hip and knee arthroplasty was performed. Patients were randomly assigned (2:1) to a derivation cohort (DC) or a validation cohort (VC). Multivariable predictive models of PJI were constructed at baseline (preoperative period), perioperative (adding perioperative variables), and at-discharge (adding wound state at-discharge)...
April 28, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29715226/development-and-evaluation-of-a-preoperative-risk-calculator-for-periprosthetic-joint-infection-following-total-joint-arthroplasty
#20
Timothy L Tan, Mitchell G Maltenfort, Antonia F Chen, AliSina Shahi, Carlos A Higuera, Marcelo Siqueira, Javad Parvizi
BACKGROUND: Preoperative identification of patients at risk for periprosthetic joint infection (PJI) following total hip arthroplasty (THA) or total knee arthroplasty (TKA) is important for patient optimization and targeted prevention. The purpose of this study was to create a preoperative PJI risk calculator for assessing a patient's individual risk of developing (1) any PJI, (2) PJI caused by Staphylococcus aureus, and (3) PJI caused by antibiotic-resistant organisms. METHODS: A retrospective review was performed of 27,717 patients (12,086 TKAs and 31,167 THAs), including 1,035 with confirmed PJI, who were treated at a single institution from 2000 to 2014...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
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