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Revision knee arthroplasty

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https://www.readbyqxmd.com/read/28716659/articulating-antibiotic-impregnated-spacers-in-prosthetic-joint-infections-where-do-we-stand
#1
Owen J Diamond, Bassam A Masri
Peri-prosthetic joint infection remains one of the most difficult and challenging complications following hip and knee arthroplasty for both patients and surgeons. Two-stage revision arthroplasty for infection remains the most popular option for the majority of patients and arguably the only option for some. The use antibiotic spacers and in particular articulating spacers has improved the quality of life for patients between stages. The spacers provides local delivery of high concentration antibiotics and provides many benefits to the soft tissues including maintaining soft tissue tension and range of movement...
July 14, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28714050/superiority-of-the-sonication-method-against-conventional-periprosthetic-tissue-cultures-for-diagnosis-of-prosthetic-joint-infections
#2
Sofia Tani, Panagiotis Lepetsos, Antonios Stylianakis, John Vlamis, Konstantinos Birbas, Ioannis Kaklamanos
INTRODUCTION: Diagnosis of periprosthetic infections is challenging. The aim of this study was to compare the diagnostic accuracy of conventional periprosthetic tissue culture and culture of sonication fluid of the explanted prostheses. METHODS: We prospectively enrolled 114 patients undergoing revision hip or knee arthroplasty because of loosening of the prostheses, at our institution, between July 2012 and July 2016. Patients' medical history and demographic characteristics were recorded...
July 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28711951/optimizing-patellar-positioning-during-total-knee-arthroplasty-an-anatomical-and-clinical-study
#3
Chahine Assi, Nadim Kheir, Camille Samaha, Mary Deeb, Kaissar Yammine
INTRODUCTION: Optimal positioning of the patellar component is crucial for the success of a total knee arthroplasty (TKA). Usually, the patellar component is placed empirically over the presumed centre of the patellar cut. Medialization of the prosthetic patella has been recommended; however, no evidence-based guidelines have been reported. MATERIAL AND METHOD: This anatomical study aims to quantify a pre-defined optimal location for positioning of the patellar component with regard to the centre of the patellar cut...
July 15, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28709613/a-regional-registry-study-of-216-patients-investigating-if-patient-satisfaction-after-total-knee-arthroplasty-changes-over-a-time-period-of-five-to-20years
#4
Odei Shannak, Jeya Palan, Colin Esler
AIMS: To determine the temporal changes in patient dissatisfaction following primary knee arthroplasty surgery (TKA). PATIENTS AND METHODS: Three hundred and ninety patients that had previously indicated they were either dissatisfied or unsure with their TKA at one-year post-surgery in our region were mailed a simple questionnaire in addition to the Oxford Knee Score and EQ-5D. RESULTS: A 55% response rate was achieved. The mean follow-up time period was 9...
August 2017: Knee
https://www.readbyqxmd.com/read/28708301/quantification-of-interfacial-motions-following-primary-and-revision-total-knee-arthroplasty-a-verification-study-versus-experimental-data
#5
Noel Conlisk, Colin R Howie, Pankaj Pankaj
Motion at the bone-implant interface, following primary or revision knee arthroplasty, can be detrimental to the long term survival of the implant. This study employs experimentally verified computational models of the distal femur to characterise the relative motion at the bone-implant interface for three different implant types; a posterior stabilising implant (PS), a total stabilising implant (TS) with short stem (12mm x 50mm), and a total stabilising implant (TS) with long offset stem (19mm x 150mm with a 4mm lateral offset)...
July 14, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28704747/two-cases-of-late-medial-instability-of-the-knee-due-to-hip-disease-after-total-knee-arthroplasty
#6
Masanori Tsubosaka, Tomoyuki Matsumoto, Koji Takayama, Naoki Nakano, Ryosuke Kuroda
INTRODUCTION: There are few specific reports of late medial instability after total knee arthroplasty (TKA). We described two cases of late medial instability of the knee due to hip disease with osteoarthritis or rheumatoid arthritis after TKA, which required revision TKA. PRESENTATION OF CASES: An 82-year-old woman experienced right femoral neck fracture due to a fall that required conservative treatment at age 77 years and underwent left TKA at age 80 years. A 68-year-old woman underwent left TKA at age 54 years, right TKA at age 64 years, and left THA at age 67 years...
June 29, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28697864/porous-coated-metaphyseal-sleeves-for-severe-femoral-and-tibial-bone-loss-in-revision-tka
#7
Tyler S Watters, John R Martin, Daniel L Levy, Charlie C Yang, Raymond H Kim, Douglas A Dennis
BACKGROUND: Metaphyseal bone loss is commonly encountered in revision total knee arthroplasty (TKA). Anderson Orthopaedic Research Institute types 2 and 3 defects generally require some form of metaphyseal fixation or augmentation. This study evaluates the midterm results of stepped, porous-coated metaphyseal sleeves in revision TKA in the setting of severe bone loss. METHODS: Patients who underwent revision TKA using metaphyseal sleeves from March 2006 to May 2014 at our institution were identified from a prospective research database...
June 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28696495/robotic-arm-assisted-total-knee-arthroplasty-demonstrated-soft-tissue-protection
#8
Anton Khlopas, Morad Chughtai, Emily L Hampp, Laura Y Scholl, Michael Prieto, Ta-Cheng Chang, Abdullah Abbasi, Manoshi Bhowmik-Stoker, Jason Otto, David J Jacofsky, Michael A Mont
INTRODUCTION: While total knee arthroplasty (TKA) procedures have demonstrated clinical success, occasionally intraoperative complications can occur. Collateral or posterior cruciate ligament injury, instability, extensor mechanism disruption, and tibiofemoral or patellofemoral dislocation are among a few of the intraoperatively driven adverse events prevalently ranked by The Knee Society. Robotic-arm assisted TKA (RATKA) provides a surgeon the ability to three-dimensionally plan a TKA and use intraoperative visual, auditory, and tactile feedback to ensure that only the desired bone cuts are made...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28695971/transfusion-requirements-following-total-knee-arthroplasty-in-patients-with-preexisting-blood-dyscrasia
#9
Martin Roche, Tsun Yee Law, Samuel Rosas, Augustus J Rush, Anton Khlopas, Morad Chughtai, Michael A Mont
INTRODUCTION: There is a paucity of studies investigating the incidence of transfusions in various blood dyscrasias after total knee arthroplasty (TKA). The purpose of this study was: 1) to compare the incidence of transfusion post-TKA in patients with and without blood dyscrasia; 2) to compare the post-TKA transfusion incidence of patients with the various individual blood dyscrasias; and 3) to stratify the findings based on gender and age. MATERIALS AND METHODS: A retrospective review of a Medicare database for patients with preexisting blood dyscrasia was conducted...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28695187/infection-burden-in-total-hip-and-knee-arthroplasties-an-international-registry-based-perspective
#10
Bryan D Springer, September Cahue, Caryn D Etkin, David G Lewallen, Brian J McGrory
BACKGROUND: Infection remains a leading cause of failure of hip and knee replacements. Infection burden is the ratio of implants revised for infection to the total number of arthroplasties in a specific period, measuring the steady state of infection in a registry. We hypothesized infection burden would be similar among arthroplasty registries. METHODS: We evaluated publicly reported data from 6 arthroplasty registries (Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR], New Zealand Joint Registry, Swedish Hip Arthroplasty Register, Swedish Knee Arthroplasty Register, National Joint Registry of England, Wales, Northern Ireland, and the Isle of Man, and the American Joint Replacement Registry) for revisions performed with an infection diagnosis over the last 6 years...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28695185/prospective-quality-of-life-assessment-after-hip-and-knee-arthroplasty-short-and-mid-term-follow-up-results
#11
Juan Pablo Martinez-Cano, Juan Pablo Herrera-Escobar, Ana Sofía Arango Gutierrez, Alfredo Sanchez Vergel, Alfredo Martinez-Rondanelli
BACKGROUND: Hip and knee arthroplasty aims to restore the joint function and to improve health-related quality of life (HRQoL) in patients with articular damage. It is important to quantify the HRQoL improvement and when this is achieved. The Oxford knee score and the Oxford hip score were developed to evaluate patients after knee and hip arthroplasty. We sought to evaluate HRQoL changes in the short and mid term following either primary or revision hip and knee arthroplasty. METHODS: Prospective cohort study during a 20-month period (August 2013 to March 2015) in a tertiary referral hospital...
June 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28692365/robotic-surgery-in-hip-and-knee-arthroplasty
#12
Sujith Konan, Carla Maden, Alex Robbins
This article provides an overview of current use of robotics in hip and knee arthroplasty. Several studies have reported radiographic improvements in joint alignment using robotic-assisted arthroplasty surgery. The economic case made for introducing robotics in joint arthroplasty largely focuses on the hypothesis of reduced hospital stay and reduction in the rate of revisions. This awaits robust data from long-term studies along with the documentation of clinical benefits that will follow the larger implementation of robotic-assisted surgery...
July 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28691647/microbiological-diagnosis-in-revision-of-infected-knee-arthroplasties-in-denmark
#13
Martin Lindberg-Larsen, Frederik T Pitter, Marianne Voldstedlund, Henrik M Schrøder, Jens Bagger
BACKGROUND: Revision of infected knee arthroplasties is associated with high failure rates (30-40%). An understanding of the microbiology is important to optimize treatment and outcome. We describe microbiological diagnostic practice and diagnosis in revision of infected knee arthroplasties. METHODS: One hundred and two partial revisions (open debridement and exchange of tibial insert) and 213 two-stage procedures performed due to infection in 275 patients from 1 July 2011 to 30 June 2013 were included and analysed by linkage to data from a nationwide registry on microbiological test results...
July 8, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28690039/retained-antibiotic-spacers-after-total-hip-and-knee-arthroplasty-resections-high-complication-rates
#14
Stephen M Petis, Kevin I Perry, Mark W Pagnano, Daniel J Berry, Arlen D Hanssen, Matthew P Abdel
BACKGROUND: Prolonged retention of an antibiotic spacer is occasionally chosen during treatment of periprosthetic joint infections after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of our study was to evaluate the outcome of extended spacer retention. METHODS: We reviewed 1106 cases of periprosthetic joint infection after THA (n = 308) and TKA (n = 798) and identified 17 (5.5%) retained hip and 34 (4.3%) retained knee spacers. Most patients (35 of 51, 69%) underwent spacer retention because they were medically unfit for further surgery...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28688643/topical-anesthesia-for-staple-removal-from-surgical-wounds-on-the-knee-a-prospective-double-blind-randomized-trial
#15
Tzu-Hao Tseng, Ching-Chuan Jiang, Shau-Huai Fu, Tsung-Lin Lee, Ya-Hui Chuang, Hongsen Chiang
BACKGROUND: Staple removal from surgical wounds is painful. Only a few articles have provided expert opinions using anesthetic cream for such a problem; however, direct application of the anesthetic cream to a wound may cause infection. A safe alternative can be an anesthetic patch without wound contact. MATERIALS AND METHODS: This was a prospective, double-blind, randomized clinical trial. Sixty patients who underwent primary total knee replacement were assigned to an experimental group or control group...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28688007/how-is-patella-height-modified-after-total-knee-arthroplasty
#16
Jean Louis Prudhon, Jacques H Caton, Thierry Aslanian, Régis Verdier
INTRODUCTION: Since the first measurement method of patella height in 1929 (Janssen), more than 16 methods have been described. Most of these measures are not suitable to measure patella height after total knee arthroplasty (TKA). One of us (JC) modified the original Caton Deschamps (oCD), index with a new relative index called modified Caton Deschamps (mCD) index, by using new landmarks. The purpose of this study was to determine how patella height is modified after TKA. MATERIAL AND METHOD: Sixty primary TKAs were consecutively prospectively enrolled...
July 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28683980/midterm-survivorship-and-complications-of-total-knee-arthroplasty-in-patients-with-dwarfism
#17
Timothy L Tan, Michael M Kheir, Ronuk Modi, Chi-Lung Chen, Hongyi Shao, Antonia F Chen
BACKGROUND: Dwarfism is associated with skeletal dysplasias and joint deformities that frequently result in osteoarthritis requiring treatment with total knee arthroplasty (TKA). These surgeries can be challenging because of alignment deformities, poor bone stock, and smaller components. This study aims to compare TKA implant survivorship and complications between dwarf and nondwarf patients. METHODS: A retrospective case-control study was performed from 1997-2014 evaluating 115 TKAs in patients under the height threshold of 147...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28678126/the-effect-on-long-term-survivorship-of-surgeon-preference-for-posterior-stabilized-or-minimally-stabilized-total-knee-replacement-an-analysis-of-63-416-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#18
Christopher J Vertullo, Peter L Lewis, Michelle Lorimer, Stephen E Graves
BACKGROUND: Controversy still exists as to the optimum management of the posterior cruciate ligament (PCL) in total knee arthroplasty. Surgeons can choose to kinematically substitute the PCL with a posterior-stabilized total knee replacement or alternatively to utilize a cruciate-retaining, also known as minimally stabilized, total knee replacement. Proponents of posterior-stabilized total knee replacement propose that the reported lower survivorship in registries when directly compared with minimally stabilized total knee replacement is due to confounders such as selection bias because of the preferential usage of posterior-stabilized total knee replacement in more complex or severe cases...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28678122/all-cause-versus-complication-specific-readmission-following-total-knee-arthroplasty
#19
Michele D'Apuzzo, Geoffrey Westrich, Chisa Hidaka, Ting Jung Pan, Stephen Lyman
BACKGROUND: Unplanned readmissions have become an important quality indicator, particularly for reimbursement; thus, accurate assessment of readmission frequency and risk factors for readmission is critical. The purpose of this study was to determine (1) the frequency of and (2) risk factors for readmissions for all causes or procedure-specific complications within 30 days after total knee arthroplasty (TKA) as well as (3) the association between hospital volume and readmission rate. METHODS: The Statewide Planning and Research Cooperative System (SPARCS) database from the New York State Department of Health was used to identify 377,705 patients who had undergone primary TKA in the period from 1997 to 2014...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28674736/the-impact-of-hepatitis-c-virus-infection-on-90-day-outcomes-following-major-orthopaedic-surgery-a-propensity-matched-analysis
#20
Ritam Chowdhury, Muhammad Ali Chaudhary, Daniel J Sturgeon, Wei Jiang, Allan L Yau, Tracey P Koehlmoos, Adil H Haider, Andrew J Schoenfeld
INTRODUCTION: The impact of hepatitis C virus (HCV) infection on outcomes following major orthopaedic interventions, such as joint arthroplasty or spine surgery, has not been effectively studied in the past. Most prior studies are impaired by small samples, limited surveillance for adverse events, or the potential for selection bias to confound results. In this context, we sought to evaluate the impact of HCV infection on 90-day outcomes following joint arthroplasty or spine surgery using propensity-matched techniques...
July 3, 2017: Archives of Orthopaedic and Trauma Surgery
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