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Revision hip replacement

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https://www.readbyqxmd.com/read/28790473/longitudinal-followup-of-incidentally-detected-pseudotumors-in-patients-with-metal-on-metal-implants-a-retrospective-study
#1
Khushboo Pilania, Bhavin Jankharia
BACKGROUND: This study describes the significance and temporal evolution of incidentally detected, presumed, metal-induced reactive periprosthetic masses in patients with metal on metal (MoM) hip arthroplasty and its management. The literature concerning the temporal evolution of these lesions is meagre and so it is still unclear, whether asymptomatic patients with periprosthetic collections should undergo revision. MATERIALS AND METHODS: Patients with MoM hip replacements fitted with a recalled implant (ASR, DuPuy) often undergo magnetic resonance imaging with metal artifact reduction sequences to look for complications...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790470/management-guidelines-for-metal-on-metal-hip-resurfacing-arthroplasty-a-strategy-on-followup
#2
Naoki Nakano, Andrea Volpin, Jonathan Bartlett, Vikas Khanduja
Despite the initial promise of metal-on-metal (MoM) implants as the ideal bearing surface for hip replacements and resurfacings, high short term failure rates due to an adverse reaction to metal debris (ARMD) have led to a dramatic reduction in the number of MoM implants used in the modern era. With over one million patients worldwide having undergone hip operations utilizing a MoM bearing surface, the long term outcomes for such patients remains unknown, and there is much debate as to the most effective management of these patients...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28777383/3rd-generation-ceramic-on-ceramic-cementless-total-hip-arthroplasty-a-minimum-10-year-follow-up-study
#3
Yeong J Lau, Shashank Sarmah, Johan D Witt
INTRODUCTION: 3rd generation ceramic bearings were introduced in total hip arthroplasty (THA) with the potential to have better mechanical strength and wear properties than their predecessors. At present, there are few studies looking at the long-term results of this latest generation of ceramic bearings.The purpose of our study was to investigate the long-term clinical and radiographic results of 3rd generation ceramic-on-ceramic THA and the incidence of ceramic specific complications such as squeaking and bearing surface fracture...
July 29, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28776632/interprosthetic-fractures-of-the-femur
#4
Nicholas M Romeo, Reza Firoozabadi
As the rate of hip and knee arthroplasty procedures increases, so will the rate of interprosthetic fractures. Several factors, including bone quality, bone quantity, and stability of the prosthetic components, play a role in determining the appropriate operative treatment. Patients with stable components should undergo reduction and internal fixation, while patients with loose components should undergo either revision arthroplasty, with or without additional fixation, or conversion to total femur replacement...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28773989/bacterial-infection-and-implant-loosening-in-hip-and-knee-arthroplasty-evaluation-of-209-cases
#5
Ulrike Dapunt, Stephanie Radzuweit-Mihaljevic, Burkhard Lehner, Gertrud Maria Haensch, Volker Ewerbeck
The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients (n = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28770293/case-series-of-patients-with-pathological-dyaphiseal-fractures-from-metastatic-bone-disease
#6
Dinu Vermesan, Radu Prejbeanu, Horia Haragus, Alis Dema, Manuel D Oprea, Diana Andrei, Dan V Poenaru, Marius Niculescu
INTRODUCTION: Fractures on pathologic bone have major impact on life quality. The appropriate treatment is not standardized, but the current literature delineates that surgery must provide adequate stabilization for the life expectancy. We aimed to review the epidemiology, treatment outcomes and survival in our department. MATERIAL AND METHODS: The electronic database from a major referral centre was searched for patients treated for tumours and fractures by the corresponding ICM-10 codes over five years...
August 2, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28765504/does-early-return-to-theatre-add-value-to-rates-of-revision-at-3-years-in-assessing-surgeon-performance-for-elective-hip-and-knee-arthroplasty-national-observational-study
#7
Alex Bottle, Helen E Chase, Paul P Aylin, Mark Loeffler
BACKGROUND: Joint replacement revision is the most widely used long-term outcome measure in elective hip and knee surgery. Return to theatre (RTT) has been proposed as an additional outcome measure, but how it compares with revision in its statistical performance is unknown. METHODS: National hospital administrative data for England were used to compare RTT at 90 days (RTT90) with revision rates within 3 years by surgeon. Standard power calculations were run for different scenarios...
August 1, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28763420/patients-with-staged-bilateral-total-joint-arthroplasty-in-registries-immortal-time-bias-and-methodological-options
#8
Stéphanie L van der Pas, Rob G H H Nelissen, Marta Fiocco
BACKGROUND: In arthroplasty data, patients with staged bilateral total joint arthroplasty (TJA) pose a problem in statistical analysis. Subgroup analysis, in which patients with unilateral and bilateral TJA are studied separately, is sometimes considered an appropriate solution to the problem; we aim to show that this is not true because of immortal time bias. METHODS: We reviewed patients who underwent staged (at any time) bilateral TJA. The logical fallacy leading to immortal time bias is explained through a simple artificial data example...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28752819/computer-assisted-navigation-in-total-knee-and-hip-arthroplasty
#9
Kamal Deep, Shivakumar Shankar, Ashish Mahendra
INTRODUCTION: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. METHODS: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool...
2017: SICOT-J
https://www.readbyqxmd.com/read/28746022/mortality-after-total-knee-and-total-hip-arthroplasty-in-a-large-integrated-health-care-system
#10
Maria C S Inacio, Mark T Dillon, Alex Miric, Ronald A Navarro, Elizabeth W Paxton
CONTEXT: The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. OBJECTIVE: To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. DESIGN: A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28741029/subtrochanteric-femoral-shortening-osteotomy-combined-with-cementless-total-hip-replacement-for-crowe-type-iv-developmental-dysplasia-a-retrospective-study
#11
Giuseppe Rollo, Giuseppe Solarino, Giovanni Vicenti, Girolamo Picca, Massimiliano Carrozzo, Biagio Moretti
BACKGROUND: Total hip replacement for high dislocation of the hip presents some difficulties, considering patients' young ages, the abnormal hip anatomy and the high rate of complications. In this study, we present our experience in terms of clinical and radiological results in the treatment of Crowe type IV hips with subtrochanteric femoral shortening osteotomy and cementless total hip replacement. MATERIALS AND METHODS: We retrospectively reviewed 15 patients with Crowe type IV hip dysplasia (two bilateral cases for a total of 17 hips) treated with cementless total hip replacement associated with shortening subtrochanteric osteotomies (nine transversal and eight Z-shape osteotomies) between March 2000 to February 2006...
July 24, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#12
Rares Mircea Birlutiu, Mihai Dan Roman, Razvan Silviu Cismasiu, Sorin Radu Fleaca, Crina Maria Popa, Manuela Mihalache, Victoria Birlutiu
BACKGROUND: In the context of an increase number of primary and revision total hip and total knee arthroplasty performed yearly, an increased risk of complication is expected. Prosthetic joint infection (PJI) remains the most common and feared arthroplasty complication. Ralstonia pickettii is a Gram-negative bacterium, that has also been identified in biofilms. It remains an extremely rare cause of PJI. There is no report of an identification of R. pickettii on an extracted spacer loaded with antibiotic...
July 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28707830/-patients-with-metal-on-metal-hip-arthroplasty-evaluation-and-management-of-complications
#13
Olivier Guyen, Christophe Tissot
The potentially severe complications related to metal-on-metal (MoM) hip replacements have led to a dramatic decrease of their use. Large diameter heads are more likely to fail than smaller diameters, but complications have been described even with « small » diameters. Therefore, monitoring of MoM arthroplasties is mandatory. This includes physical examination, X-Rays, metal ion levels, and potentially cross-sectional imaging. Despite pathophysiology of adverse reactions to metal debris (ARMD) is better understood, their evolution and the potential systemic complications remain unclear...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28707829/-total-hip-arthroplasty-in-patients-younger-than-50-years
#14
Matthieu Zingg, Morgan Gauthier, Didier Hannouche
Total hip replacement can provide pain relief and restore function in patients suffering from hip arthritis, including in those under the age of 50. However, shortened implant longevity in this age group has been a concern because the clinical results after revision surgery are inferior to those after primary hip arthroplasty. Technical choices (approach, implants, type of fixation and bearing couple) must be made to maximise longevity based on published data and thoroughly discussed with the patient. Finally, long term results (clinical outcome and implant longevity) associated with this surgery are such that it appears unnecessary to postpone the surgery once the indication is established...
December 14, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28695187/infection-burden-in-total-hip-and-knee-arthroplasties-an-international-registry-based-perspective
#15
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
#16
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/28683496/-prosthetic-joint-infection-after-total-hip-arthroplasty-results-of-an-online-questionnaire-about-current-diagnostic-and-therapeutic-procedures-in-107-german-hospitals
#17
Elia Raoul Langenmair, Lukas Konstantinidis, Norbert P Südkamp, Peter Helwig
Background Prosthetic hip joint infection is a common severe complication with a high socio-economic impact. The inconsistency of the available data and the absence of binding guidelines lead to a variety of diagnostic and therapeutic strategies. The aim of this study is to present the current diagnostic and therapeutic approach to treating infections after total hip arthroplasties in German hospitals, link it with current evidence, and evaluate the willingness of these hospitals to participate in prospective multicentre trials...
June 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28668211/survivorship-of-total-hip-joint-replacements-following-isolated-liner-exchange-for-wear
#18
Leone Vadei, David C Kieser, Chris Frampton, Gary Hooper
BACKGROUND: Liner exchange for articular component wear in total hip joint replacements (THJRs) is a common procedure, often thought to be benign with reliable outcomes. Recent studies, however, suggest high failure rates of liner exchange revisions with significant complications. The primary aim of this study was, therefore, to analyze the survivorship of isolated liner exchange for articular component wear, and secondarily to assess the influence of patient demographics (gender, age, and American Society of Anaesthesiologists [ASA] ratings) on rerevisions following isolated liner exchange for wear...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28660436/adventure-sports-and-sexual-freedom-hip-replacement-the-tripolar-hip
#19
James W Pritchett
Certain athletic activities and lifestyles require a completely stable and very mobile hip. Total hip replacement with a natural femoral head size and two mobile-bearing surfaces (i.e., a "tripolar" prosthesis) is the most stable prosthesis. Elegant design and wear-resistant bearing surfaces are the keys to long-term implant survivorship. The hypothesis is that a ceramic-coated tripolar prosthesis using highly cross-linked polyethylene can provide full function and complete stability with low wear. This study sought to determine: (1) patient-reported outcomes, (2) functional outcomes, (3) implant survivorship and complications, and (4) postoperative sexual limitations...
June 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28652437/increased-resistance-of-skin-flora-to-antimicrobial-prophylaxis-in-patients-undergoing-hip-revision-arthroplasty
#20
Heinrich M L Mühlhofer, Lukas Deiss, Philipp Mayer-Kuckuk, Florian Pohlig, Norbert Harrasser, Ulrich Lenze, Hans Gollwitzer, Christian Suren, Peter Prodinger, Rüdiger VON Eisenhart-Rothe, Johannes Schauwecker
BACKGROUND/AIM: Prosthetic joint infection (PJI) remains a major complication after total joint replacement and is the primary indication for revision arthroplasty. Specifically, coagulase-negative Staphylococci (CNS) can cause low-grade infections. Despite the use of cephalosporin-based antimicrobial prophylaxis (AMP) and antiseptic treatment at the surgical site, evidence suggests that a significant number of cases of dermal CNS results in low-grade PJI. Thus, this study examined the bacterial colonization and resistance patterns at the surgical site...
July 2017: In Vivo
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