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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/28532493/distal-femoral-replacement-with-the-mml-system-a-single-center-experience-with-an-average-follow-up-of-86%C3%A2-months
#1
Andreas Toepfer, Norbert Harrasser, Paul-Ruben Schwarz, Florian Pohlig, Ulrich Lenze, Heinrich M L Mühlhofer, Ludger Gerdesmeyer, Ruediger von Eisenhart-Rothe, Christian Suren
BACKGROUND: The aim of this study was to compare the functional outcomes and complication rates after distal femoral replacement (DFR) performed with the modular Munich-Luebeck (MML) modular prosthesis (ESKA/Orthodynamics, Luebeck, Germany) in patients being treated for malignant disease or failed total knee arthroplasty. METHODS: A retrospective review of patient charts and a functional investigation (involving Musculoskeletal Tumor Society Score [MSTS], American Knee Society Score [AKSS], Oxford Knee Score [OKS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], Toronto Extremity Salvage Score [TESS], the 12-Item Short-Form [SF-12] Health Survey, and a failure classification system developed by Henderson et al...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28532409/variation-in-prosthetic-joint-infection-and-treatment-strategies-during-4-5%C3%A2-years-of-follow-up-after-primary-joint-arthroplasty-using-administrative-data-of-41397-patients-across-australian-european-and-united-states-hospitals
#2
Perla J Marang-van de Mheen, Ellie Bragan Turner, Susan Liew, Nora Mutalima, Ton Tran, Sten Rasmussen, Rob G H H Nelissen, Andrew Gordon
BACKGROUND: To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. METHODS: Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28530850/fresh-osteochondral-allograft-transplantation-is-graft-storage-time-associated-with-clinical-outcomes-and-graft-survivorship
#3
Kenneth J Schmidt, Luís E Tírico, Julie C McCauley, William D Bugbee
BACKGROUND: Regulatory concerns and the popularity of fresh osteochondral allograft (OCA) transplantation have led to a need for prolonged viable storage of osteochondral grafts. Tissue culture media allow a longer storage time but lead to chondrocyte death within the tissue. The long-term clinical consequence of prolonged storage is unknown. HYPOTHESIS: Patients transplanted with OCAs with a shorter storage time would have lower failure rates and better clinical outcomes than those transplanted with OCAs with prolonged storage...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28526202/capnocytophaga-canimorsus-an-underestimated-cause-of-periprosthetic-joint-infection
#4
Marcel Orth, Patrick Orth, Konstantinos Anagnostakos
BACKGROUND: Periprosthetic joint infection (PJI) is a major clinical problem in orthopedic surgery. Capnocytophaga canimorsus (C. canimorsus) is an unusual and hardly detectable bacterium. A review of the literature indicates that C. canimorsus affects mainly immunocompromised patients. It has not been reported to cause periprosthetic joint infections in immunocompetent patients so far. This case report aims to raise awareness of C. canimorsus in orthopedic surgery with special regard to joint arthroplasty...
May 16, 2017: Knee
https://www.readbyqxmd.com/read/28502536/results-of-a-modular-revision-system-in-total-knee-arthroplasty
#5
David A Crawford, Keith R Berend, Michael J Morris, Joanne B Adams, Adolph V Lombardi
BACKGROUND: Revision total knee arthroplasty (TKA) poses unique challenges compared with primary TKA such as bone loss, deformity, and ligament instability. Modular component options allow flexibility to deal with these complexities. The purpose of this study was to evaluate midterm outcomes for revision TKA using a modular revision knee system with complete interchangeability and multiple options for augmentation, offset, constraint, and stem extensions. METHODS: A query of our practice registry revealed 257 consented patients (274 knees and 278 TKA) with minimum 2-year follow-up who underwent aseptic revision TKA with a modular system (Vanguard Super Stabilized Knee; Zimmer Biomet, Warsaw, IN) between 2005 and 2013...
April 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28502535/even-cementless-surgeons-use-cement
#6
A Gulati, A R J Manktelow
BACKGROUND: Patients presenting with hip arthritis have huge variability in anatomy, bone quality, and functional expectation. These can contribute to a varying degree of complexity on both the femoral and acetabular sides. Surgeons should be aware of all the various options in fixation, bearing surface, and surgical technique. METHODS: In this article, based on a presentation given at the recent American Association of Hip and Knee Surgeons meeting in Dallas, we will discuss why and how cemented fixation can, and indeed should, be considered when making decisions regarding how a primary, complex primary, or revision hip arthroplasty should be performed...
March 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28493211/what-mechanisms-are-associated-with-tibial-component-failure-after-kinematically-aligned-total-knee-arthroplasty
#7
Alexander J Nedopil, Stephen M Howell, Maury L Hull
PURPOSE: Eight patients treated with kinematically-aligned (KA) total knee arthroplasty (TKA) presented with tibial component failure. We determined whether radiographic measurements and clinical characteristics are different between patients with and without tibial component failure to identify mechanisms of failure and strategies to reduce the risk. METHODS: Out of 3,212 primary TKAs (2,725 TKAs with a two-year minimum follow up), of which all were performed with KA, eight patients presented with tibial component failure...
May 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28492106/higher-risk-of-revision-for-infection-using-systemic-clindamycin-prophylaxis-than-with-cloxacillin
#8
Otto Robertsson, Olof Thompson, Annette W-Dahl, Martin Sundberg, Lars Lidgren, Anna Stefánsdóttir
Background and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative. We examined whether there were differences in the rate of revision due to infection depending on which antibiotic was used as systemic prophylaxis...
May 11, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28488164/up-to-twelve-year-follow-up-of-the-oxford-phase-three-unicompartmental-knee-replacement-in-china-seven-hundred-and-eight-knees-from-an-independent-centre
#9
Huaming Xue, Yihui Tu, Tong Ma, Tao Wen, Tao Yang, Minwei Cai
PURPOSE: There have been few large sample studies reporting the midterm outcome of Oxford phase 3 unicompartmental knee arthroplasty (UKA) in Asian patients. METHODS: The study included 708 consecutive medial Oxford UKAs between February 2005 and May 2014 in Chinese patients. All cases were performed for the recommended indications with a minimally-invasive surgical technique. The functional and radiological outcomes were subsequently examined. In particular, we divided patients into the spontaneous osteonecrosis of the knee (SONK) group and the osteoarthritis (OA) group...
May 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28488017/c-reactive-protein-course-during-the-first-5-days-after-total-knee-arthroplasty-cannot-predict-early-prosthetic-joint-infection
#10
Christoph Windisch, Steffen Brodt, Eric Roehner, Georg Matziolis
INTRODUCTION: Periprosthetic joint infection (PJI) is one of the most devastating major complications after total knee arthroplasty (TKA). The laboratory value C-reactive protein (CRP) is the inflammatory biomarker most suitable for detecting a potential postoperative (p.o.) early infection in orthopaedic surgery. However, on the basis of multiple receiver operating characteristic (ROC) analyses, CRP only has limited sensitivity and specificity. The objective of the present study was to test the hypothesis that, besides the absolute preoperative CRP value, also the absolute postoperative CRP value and its course over the first 5 days after TKA are valid indicators of periprosthetic early infection...
May 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28484205/clinical-outcome-evaluation-of-primary-total-knee-arthroplasty-in-patients-with-diabetes-mellitus
#11
Pengcheng Liu, Junfeng Liu, Kuo Xia, Liyang Chen, Xing Wu
BACKGROUND The aim of this study was to evaluate the safety and clinical outcome of primary total knee arthroplasty in patients with diabetes mellitus. MATERIAL AND METHODS Among the patients who were treated with total knee arthroplasty, there were 98 patients (116 knees) associated with diabetes. Osteoarthritis was diagnosed in 90 patients and rheumatoid arthritis was diagnosed in 8 patients. Various degrees of preoperative knee deformities were found in 82 knees. The average fasting blood glucose was 9.8±3...
May 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28481956/tibial-revision-knee-arthroplasty-with-metaphyseal-sleeves-the-effect-of-stems-on-implant-fixation-and-bone-flexibility
#12
Jan Nadorf, Stefan Kinkel, Simone Gantz, Eike Jakubowitz, J Philippe Kretzer
INTRODUCTION: Revision total knee arthoplasty often requires modular implants to treat bone defects of varying severity. In some cases, it may not be clear which module size and implant combination (e.g. sleeve and stem) should be chosen for a specific defect. When balancing implant stability and osseointegration against stress-shielding, it is important to choose an appropriate implant combination in order to match the given level of bone loss. Therefore, the necessity of stems in less extensive tibial defects and the advantage of different stems (lengths and stiffnesses) in combination with large metaphyseal sleeves on implant fixation and bone flexibility using a modular tibial revision knee system, were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28478964/the-risk-factor-of-preoperative-deep-vein-thrombosis-in-patients-undergoing-total-knee-arthroplasty
#13
Hiroki Wakabayashi, Masahiro Hasegawa, Rui Niimi, Toshio Yamaguchi, Yohei Naito, Akihiro Sudo
OBJECTIVES: The objective of this retrospective study was to investigate the prevalence of asymptomatic deep vein thrombosis (DVT) and the risk of DVT in patients admitted to hospital for total knee arthroplasty (TKA). METHODS: From September of 2003 to December of 2013, 322 patients admitted for TKA were eligible for this retrospective study. A diagnosis of DVT was confirmed by Doppler ultrasonography. The prevalence of silent DVT in the lower limbs in patients before TKA was assessed...
May 3, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28473963/rank-ligand-and-osteoprotegerin-as-biomarkers-in-the-differentiation-between-periprosthetic-joint-infection-and-aseptic-prosthesis-loosening
#14
Max J Friedrich, Matthias D Wimmer, Jan Schmolders, Andreas C Strauss, Milena M Ploeger, Hendrik Kohlhof, Dieter C Wirtz, Sascha Gravius, Thomas M Randau
AIM: To assess serum levels of RANK-ligand (RANKL) and osteoprotegerin (OPG) as biomarkers for periprosthetic joint infection (PJI) and compare their accuracy with standard tests. METHODS: One hundred and twenty patients presenting with a painful total knee or hip arthroplasty with indication for surgical revision were included in this prospective clinical trial. Based on standard diagnostics (joint aspirate, microbiological, and histological samples) and Musculoskeletal Infection Society consensus classification, patients were categorized into PJI, aseptic loosening, and control groups...
April 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28465126/cryotherapy-with-dynamic-intermittent-compression-improves-recovery-from-revision-total-knee-arthroplasty
#15
Jérôme Murgier, J Cailliez, M Wargny, P Chiron, E Cavaignac, J M Laffosse
BACKGROUND: The goal of this study was to assess the efficacy of cryotherapy with dynamic intermittent compression (CDIC) in relieving postoperative pain, decreasing blood loss, and improving functional scores after revision total knee arthroplasty (rTKA). METHODS: We conducted a prospective case-control study (level of evidence: I) to evaluate the efficacy of CDIC on postoperative bleeding, pain, and functional outcomes after rTKA. Forty-three cases were included at a single institution and divided in 2 groups: a control group without CDIC (n = 19) and an experimental group with CDIC (n = 24)...
March 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28464756/increased-risk-of-early-and-medium-term-revision-after-post-fracture-total-knee-arthroplasty
#16
Anders El-Galaly, Steffen Haldrup, Alma Becic Pedersen, Andreas Kappel, Michael Ulrich Jensen, Poul Torben Nielsen
Background and purpose - Total knee arthroplasty (TKA) due to posttraumatic fracture osteoarthritis (PTFA) may be associated with inferior prosthesis survival. This study is the first registry-based study solely addressing this issue. Both indications and predictors for revision were identified. Patients and methods - 52,518 primary TKAs performed between 1997 and 2013 were retrieved from the Danish Knee Arthroplasty Register (DKR). 1,421 TKAs were inserted due to PTFA and 51,097 due to primary osteoarthritis (OA)...
June 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28463919/synovial-fluid-cell-count-for-diagnosis-of-chronic-periprosthetic-hip-infection
#17
Carlos A Higuera, Benjamin Zmistowski, Tennison Malcom, Wael K Barsoum, Scott M Sporer, Philipp Mommsen, Daniel Kendoff, Craig J Della Valle, Javad Parvizi
BACKGROUND: There is a paucity of data regarding the threshold of synovial fluid white blood-cell (WBC) count and polymorphonuclear cell (neutrophil) percentage of the WBC count (PMN%) for the diagnosis of chronic periprosthetic joint infection (PJI) after total hip arthroplasty. Despite this, many organizations have provided guidelines for the diagnosis of PJI that include synovial fluid WBC count and PMN%. We attempted to define a threshold for synovial fluid WBC count and PMN% for the diagnosis of chronic PJI of the hip using a uniform definition of PJI and to investigate any variations in the calculated thresholds among institutions...
May 3, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28462215/condylar-constrained-system-in-primary-total-knee-replacement-our-experience-and-literature-review
#18
Luigi Sabatini, Salvatore Risitano, Lorenzo Rissolio, Andrea Bonani, Francesco Atzori, Alessandro Massè
BACKGROUND: Constrained condylar knee (CCK) prosthesis are common used for revision surgery but can also help surgeons to improve implant stability in primary knee arthroplasty, in fact in severe knee arthrosis with serious deformity associated with a significant instability a more constrained articulation is required. With introduction of second generation of semi-constrained prosthesis, rate of complication is real decreased and a good survival rate and functional score results is showed...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28461965/total-knee-arthroplasty-and-infection-how-surgeons-can-reduce-the-risks
#19
REVIEW
Nicola Ratto, Chiara Arrigoni, Federica Rosso, Matteo Bruzzone, Federico Dettoni, Davide Edoardo Bonasia, Roberto Rossi
Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities...
September 2016: EFORT Open Rev
https://www.readbyqxmd.com/read/28456563/total-knee-arthroplasty-for-osteoarthritis-in-patients-less-than-fifty-five-years-of-age-a-systematic-review
#20
REVIEW
Randeep S Aujla, Colin N Esler
BACKGROUND: The proportion of younger patients undergoing total knee arthroplasty (TKA) is increasing and predictions state that the <55 age group will be the fastest growing group by 2030. We aim to collate data across studies to assess functional outcomes following TKA in patients <55 years of age using a systematic review. METHODS: The search identified 980 studies for title and abstract review. Forty-three full texts were then assessed. Thirteen studies underwent quality assessment and data extraction...
March 3, 2017: Journal of Arthroplasty
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