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Revision knee replacement

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https://www.readbyqxmd.com/read/27912929/survival-failure-modes-and-function-of-combined-distal-femur-and-proximal-tibia-reconstruction-following-tumor-resection
#1
F Sevelda, W Waldstein, J Panotopoulos, C Stihsen, A Kaider, P T Funovics, R Windhager
BACKGROUND: Tumor spread to the knee joint or skip metastasis to the adjacent bones of the knee require reconstruction with combined distal femur and proximal tibia replacements. The literature on implant survival and failure modes with this type of reconstruction is sparse. The goals of this study were to determine the implant survival, the different failure modes and the functional outcome of this megaendoprosthetic reconstruction. PATIENTS AND METHODS: Thirty-nine patients with combined distal femur and proximal tibia reconstruction were retrospectively reviewed...
November 23, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27898194/inflammatory-cell-induced-corrosion-in-total-knee-arthroplasty-a-retrieval-study
#2
Arianna Cerquiglini, Johann Henckel, Harry S Hothi, Anna Di Laura, John A Skinner, Alister J Hart
Metal release in patients with joint replacements is associated with local tissue reactions, pain, and ultimately revision of implants. One of the causes of this metal loss is speculated to be due to a mechanism of inflammatory cell-induced corrosion (ICIC). In this knee retrieval study, we aimed to: (1) identify the extent and location of ICI corrosion patterns on our femoral and tibial components and (2) correlate our findings with implant and clinical information. We investigated 28 femoral and 9 tibial components made of polished CoCr for presence of ICIC, using macroscopic and microscopic screening and statistical analyses to identify any significant correlations between our results and clinical information...
November 29, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27891054/patellofemoral-joint-arthroplasty-our-experience-in-isolated-patellofemoral-and-bicompartmental-arthritic-knees
#3
L Sabatini, M Schirò, F Atzori, G Ferrero, A Massè
INTRODUCTION: Isolated patellofemoral (PF) arthritis is rare, and there is no complete agreement about the best surgical treatment. The operative treatments are total knee arthroplasty and patellofemoral replacement (PFR). The incidence of many early complications of PF arthroplasty has decreased with the introduction of newer designs. Nowadays, the main cause of revision surgery is the progression of tibiofemoral osteoarthritis. In the past, PF arthroplasty was contraindicated in patients with evidence of osteoarthritis or pain in medial or lateral tibiofemoral compartments...
2016: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27869619/five-year-survival-of-20-946-unicondylar-knee-replacements-and-patient-risk-factors-for-failure-an-analysis-of-german-insurance-data
#4
Elke Jeschke, Thorsten Gehrke, Christian Günster, Joachim Hassenpflug, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Halder
BACKGROUND: Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. METHODS: Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27846360/-non-traumatic-posterior-instability-in-primary-total-knee-replacement-and-its-revision
#5
E Carbó, R Laguna, F Del Moral, J Barrientos, J Vaquero
BACKGROUND: Dislocation after total knee arthroplasty is a rare complication and a difficult problem to address. When the flexion gap is larger than the extension gap and the collateral ligaments are injured, instability and knee arthroplasty dislocation can occur. MATERIAL AND METHODS: We report the case of a patient presenting with a posterior dislocation of a posterior-stabilized prosthesis without trauma. Frank instability in varus stress test and a positive anterior drawer test with tibial internal rotation dismissed the conservative treatment...
March 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/27826627/-complications-and-costs-in-primary-knee-replacement-surgery-in-an-endoprosthetics-centre-influence-of-state-of-training
#6
C Windisch, S Brodt, E Röhner, G Matziolis
BACKGROUND: This work examines the hypothesis that in endoprosthesis implantation there are differences between experienced primary and senior caregivers (S-Op) and less experienced follow-up assistants (T-Op) with respect to process-relevant parameters. The main hypothesis is that compared to S‑Op, T‑Op cause significantly longer surgery times and thus additional operating theatre costs. As sub-hypotheses, differences in various perioperative (p-o) parameters between T‑Op and S‑Op were examined...
November 8, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27812775/long-term-results-of-total-knee-arthroplasty-in-haemophilic-patients-an-18-year-follow-up
#7
Lukas Ernstbrunner, Andreas Hingsammer, Sabrina Catanzaro, Reto Sutter, Brigit Brand, Karl Wieser, Sandro F Fucentese
PURPOSE: Total knee arthroplasty (TKA) for patients with end-stage haemophilic arthropathy is considered to be a successful procedure with satisfying mid- to long-term results. It was the purpose of this study to provide clinical and radiological long-term results of TKAs implanted in a consecutive cohort of haemophilic patients. METHODS: Primary TKA was performed in 43 consecutive knees in 30 haemophilic patients. After a mean of 18 (SD ± 4) years, 15 patients (21 knees) with a mean age of 58 (SD ± 8) years were available for follow-up...
November 3, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27803938/biological-knee-reconstruction-with-concomitant-autologous-chondrocyte-implantation-and-meniscal-allograft-transplantation-mid-to-long-term-outcomes
#8
Takahiro Ogura, Tim Bryant, Tom Minas
BACKGROUND: Treating articular cartilage defects and meniscal deficiency is challenging. Although some short- to mid-term follow-up studies report good clinical outcomes after concurrent autologous chondrocyte implantation (ACI) and meniscal allograft transplantation (MAT), longer follow-up is needed. PURPOSE: To evaluate mid- to long-term outcomes after combined ACI with MAT. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We performed a retrospective review of prospectively gathered data from patients who had undergone ACI with MAT between 1999 and 2013...
October 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27803224/periprosthetic-fractures-associated-with-total-knee-arthroplasty-an-update
#9
S Konan, N Sandiford, F Unno, B S Masri, D S Garbuz, C P Duncan
Fractures around total knee arthroplasties pose a significant surgical challenge. Most can be managed with osteosynthesis and salvage of the replacement. The techniques of fixation of these fractures and revision surgery have evolved and so has the assessment of outcome. This specialty update summarises the current evidence for the classification, methods of fixation, revision surgery and outcomes of the management of periprosthetic fractures associated with total knee arthroplasty. Cite this article: Bone Joint J 2016;98-B:1489-96...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27795948/effect-of-body-mass-index-on-functional-outcome-in-primary-total-knee-arthroplasty-a-single-institution-analysis-of-2180-primary-total-knee-replacements
#10
Shane C O'Neill, Joseph S Butler, Adam Daly, Darren F Lui, Patrick Kenny
AIM: To evaluate the effect of body mass index (BMI) on short-term functional outcome and complications in primary total knee arthroplasty. METHODS: All patients undergoing primary total knee arthroplasty at a single institution between 2007 and 2013 were identified from a prospective arthroplasty database. 2180 patients were included in the study. Age, gender, BMI, pre- and post-operative functional scores [Western Ontario and McMaster University Arthritis Index (WOMAC) and SF-36], complications and revision rate were recorded...
October 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27787574/outcome-of-knee-revisions-for-osteoarthritis-and-inflammatory-arthritis-with-postero-stabilized-arthroplasties-a-mean-ten-year-follow-up-with-90-knee-revisions
#11
Philippe Hernigou, Arnaud Dubory, Damien Potage, François Roubineau, Charles Henri Flouzat-Lachaniette
PURPOSE: Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) may require revision total knee replacement. Few studies have compared post-operative complications, results and risk of re-revision in RA and OA patients. MATERIAL AND METHODS: Forty-five RA patients who had undergone revision TKA from 1998 to 2010 were selected and matched with 45 OA patients who had revision during the same period. Results of the use of a revision postero-stabilized implant in osteoarthritis were compared to results of its use in inflammatory arthritis...
October 27, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27775460/survivorship-and-relative-risk-of-revision-in-computer-navigated-versus-conventional-total-knee-replacement-at-8-year-follow-up
#12
Gro S Dyrhovden, Anne M Fenstad, Ove Furnes, Øystein Gøthesen
Background and purpose - The long-term effects of computer-assisted surgery in total knee replacement (CAS) compared to conventionally operated knee replacement (CON) are still not clear. We compared survivorship and relative risk of revision in CAS and CON based on data from the Norwegian Arthroplasty Register. Patients and methods - We assessed primary total knee replacements without patellar resurfacing reported to the Norwegian Arthroplasty Register from 2005 through 2014. The 5 most used implants and the 3 most common navigation systems were included...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27770285/anterior-tibial-tubercle-osteotomy-using-cerclage-wire-fixation-in-total-knee-replacement-a-modification-of-the-usual-technique
#13
Joan Manuel Burdeus González-Solís, Iván Díez-Santacoloma, Albert Isidro Llorens
Anterior tibial tubercle (ATT) osteotomy facilitates exposure in knee arthroplasty. However, it is not without complications. We have introduced some technical modifications that reduce the surgical aggression by designing a short osteotomy that does not invade the intramedullary canal, and synthesizing it with three cerclage wires with a particular layout that increases the solidity of the system. A retrospective review was performed on the surgical revision of total knee replacement cases intervened in our center that required an ATT osteotomy from February 2014 to February 2015, and who had a minimum clinical follow-up of 12 months...
October 21, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27763467/hip-and-knee-replacement-in-safety-net-hospitals-recognizing-the-challenges
#14
Nicholas Arlas, Harry Jergesen
Factors endemic in safety-net hospitals may breed poor outcomes in hip and knee arthroplasty. This review highlights these challenges and discusses strategies to reduce operative risk and promote better surgical outcomes. Sub-optimally managed medical co-morbidities, poverty, and substance abuse are examples of challenges common in safety-net hospital populations and are associated with poor surgical outcomes. Patient management strategies that positively affect surgical outcomes may be nonexistent, underfunded, or underused...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27756401/the-use-of-a-policy-dialogue-to-facilitate-evidence-informed-policy-development-for-improved-access-to-care-the-case-of-the-winnipeg-central-intake-service-wcis
#15
Zaheed Damani, Gail MacKean, Eric Bohm, Brie DeMone, Brock Wright, Tom Noseworthy, Jayna Holroyd-Leduc, Deborah A Marshall
BACKGROUND: Policy dialogues are critical for developing responsive, effective, sustainable, evidence-informed policy. Our multidisciplinary team, including researchers, physicians and senior decision-makers, comprehensively evaluated The Winnipeg Central Intake Service, a single-entry model in Winnipeg, Manitoba, to improve patient access to hip/knee replacement surgery. We used the evaluation findings to develop five evidence-informed policy directions to help improve access to scheduled clinical services across Manitoba...
October 18, 2016: Health Research Policy and Systems
https://www.readbyqxmd.com/read/27728925/-diagnostic-algorithm-for-failure-analysis-of-painful-total-hip-arthroplasties
#16
B Fink, R Lass
Background: Total hip arthroplasty (THA) is one of the most common and successful surgical procedures in orthopedic surgery and clinical success can be characterized by the revision rate and improvement of function, as well as the patient's satisfaction and pain. Despite the clinical success of primary THA with 10-year survival rates as high as 96 % (Swedish Hip Arthroplasty Register, 2011), the prevalence of groin pain after conventional total hip replacement ranges from 0.4 to 18.3 % and activity-limiting thigh pain is still an existing problem linked to the femoral component of uncemented hip replacement in up to 1...
October 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27708740/tranexamic-acid-in-a-multimodal-blood-loss-prevention-protocol-to-decrease-blood-loss-in-revision-total-knee-arthroplasty-a-cohort-study
#17
Miguel Ortega-Andreu, Gloria Talavera, Norma G Padilla-Eguiluz, Hanna Perez-Chrzanowska, Reyes Figueredo-Galve, Carlos E Rodriguez-Merchán, Enrique Gómez-Barrena
PURPOSE: To clarify if blood loss and transfusion requirements can be decreased in revision knee surgery through a multimodal blood loss approach with tranexamic acid (TXA). PATIENTS AND METHODS: A retrospective study was designed in 87 knees (79 patients) that received a knee revision between 2007 and 2013. To avoid heterogeneity in the surgical technique, only revisions with one single implant system were included. A treatment series of 44 knees that received TXA and other techniques in a multimodal blood loss protocol was compared to a control series of 43 knees that received neither TXA nor the rest of the multimodal blood loss protocol...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27687918/does-laminar-airflow-make-a-difference-to-the-infection-rates-for-lower-limb-arthroplasty-a-study-using-the-national-joint-registry-and-local-surgical-site-infection-data-for-two-hospitals-with-and-without-laminar-airflow
#18
S Singh, S Reddy, Raj Shrivastva
This study compared the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR) data for total hip replacements (THRs) and total knee replacements (TKRs) from Hospital A [with laminar airflow (LAF)] and Hospital B (without LAF). These hospitals were originally managed by two different trusts that subsequently merged. Consequently, the theatres in Hospital A have always had LAF and those in Hospital B had only conventional ventilation systems. As this merger happened before the establishment of the NJR, it puts us in a unique position, enabling direct comparison of the revision rates for infected hip and knee replacements between the two hospitals that follow similar infection protocols...
September 29, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27661772/ph-and-metal-concentration-of-synovial-fluid-of-osteoarthritic-joints-and-joints-with-metal-replacements
#19
Ingrid Milošev, Vesna Levašič, Janja Vidmar, Simon Kovač, Rihard Trebše
BACKGROUND: Due to degradation and metal dissolution during articulation of metal joint replacements the chemical periprosthetic environment may change. The aim was to establish whether metal replacements cause the local changes in pH and elevated metal concentrations. METHODS: pH was measured on samples from 167 patients: native hip and knee osteoarthritic joints, joints with hip and knee replacements revised for aseptic or septic reasons. pH of synovial fluid and periprosthetic tissue was measured perioperatively using a microelectrode and pH indicator papers for removed metal components...
September 23, 2016: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/27648577/chronic-quadriceps-tendon-rupture-after-total-knee-arthroplasty-augmented-with-synthetic-mesh
#20
Amaia Ormaza, Jesús Moreta, Javier Mosquera, Oskar Sáez de Ugarte, José Luis Martinez-de Los Mozos
Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh...
September 19, 2016: Orthopedics
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