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Revision knee replacement

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https://www.readbyqxmd.com/read/28223094/a-decade-of-the-catalonian-arthroplasty-register-racat-variability-exhaustivity-and-survival-of-prostheses-between-2005-and-2014
#1
J Arias-de la Torre, A Capdevila, O Martínez, L Domingo, M Marinelli, N Robles, J Nardi, L Puig-Verdié, F Pallisó, M Espallargues
BACKGROUND AND AIM: The Catalonian Arthroplasty Register (RACat) is a public health-based population register used to analyse and evaluate hip and knee replacements in Catalonia. The aim of this study is to present the outcomes after 10 years in operation (January 2005-December 2014). METHODOLOGY: Using the information from the RACat and the minimum basic data set at hospital discharge, an analysis was made of the quality and exhaustivity of the data, as well as a descriptive analysis of the patients, prostheses, and care process...
February 17, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28211301/early-results-of-patellofemoral-inlay-resurfacing-arthroplasty-using-the-hemicap-wave-prosthesis
#2
Akash Patel, Zakir Haider, Amarjit Anand, Dominic Spicer
BACKGROUND: Common surgical treatment options for isolated patellofemoral osteoarthritis include arthroscopic procedures, total knee replacement and patellofemoral replacement. The HemiCap Wave patellofemoral resurfacing prosthesis is a novel inlay design introduced in 2009 with scarce published data on its functional outcomes. We aim to prospectively evaluate early functional outcomes and complications, for patients undergoing a novel inlay resurfacing arthroplasty for isolated patellofemoral arthrosis in an independent centre...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28209371/the-effect-of-patient-age-at-intervention-on-risk-of-implant-revision-after-total-replacement-of-the-hip-or-knee-a-population-based-cohort-study
#3
Lee E Bayliss, David Culliford, A Paul Monk, Sion Glyn-Jones, Daniel Prieto-Alhambra, Andrew Judge, Cyrus Cooper, Andrew J Carr, Nigel K Arden, David J Beard, Andrew J Price
BACKGROUND: Total joint replacements for end-stage osteoarthritis of the hip and knee are cost-effective and demonstrate significant clinical improvement. However, robust population based lifetime-risk data for implant revision are not available to aid patient decision making, which is a particular problem in young patient groups deciding on best-timing for surgery. METHODS: We did implant survival analysis on all patients within the Clinical Practice Research Datalink who had undergone total hip replacement or total knee replacement...
February 13, 2017: Lancet
https://www.readbyqxmd.com/read/28196029/twelve-year-outcomes-of-an-oxinium-total-knee-replacement-compared-with-the-same-cobalt-chromium-design-an-analysis-of-17-577-prostheses-from-the-australian-orthopaedic-association-national-joint-replacement-registry
#4
Christopher J Vertullo, Peter L Lewis, Stephen Graves, Lan Kelly, Michelle Lorimer, Peter Myers
BACKGROUND: Oxidized zirconium (Oxinium) was introduced as an alternative bearing surface to cobalt-chromium (CoCr) in an attempt to reduce polyethylene wear and decrease aseptic mechanical failure of total knee replacements. While noncomparative reports have been described as promising, we were aware of no short or long-term clinical studies showing the superiority of Oxinium on polyethylene as a bearing surface. Using data from a comprehensive national joint replacement registry, we compared the long-term outcomes after cruciate-retaining total knee arthroplasty (TKA) with an Oxinium femoral component and those with the same prosthetic design but with a CoCr femoral component...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28185755/the-james-a-rand-young-investigator-s-award-administrative-claims-vs-surgical-registry-capturing-outcomes-in-total-joint-arthroplasty
#5
Joseph T Patterson, David Sing, Erik N Hansen, Bobby Tay, Alan Zhang
BACKGROUND: Administrative claims in total joint arthroplasty are used for observational studies and payment adjustments under the Comprehensive Care for Joint Replacement (CJR) legislation. Claims data have not been validated against prospective surgical outcome registries for primary total hip (THA) or knee arthroplasty (TKA). We hypothesized that significant differences in reported comorbidity and adverse event measures exist between administrative claims and prospective registry data relevant to payment adjudication under the CJR reimbursement model...
February 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28167881/poor-prognosis-of-patients-treated-for-periprosthetic-joint-infection
#6
REVIEW
Cynthia A Kahlenberg, Alexia Hernandez-Soria, Michael B Cross
The study by Gomez et al., "The Fate of Spacers in the Treatment of Periprosthetic Joint Infection," evaluates the clinical course and success rate of treatment of periprosthetic joint infection with two-stage revision with spacer placement in the interim period. The current review critically analyzes the findings of this study and examines how these findings may influence patient care in the field of hip and knee replacement. Gomez et al. report sobering results of two-stage revision with spacer placement for periprosthetic joint infection...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167876/comparison-of-revision-rates-of-non-modular-constrained-versus-posterior-stabilized-total-knee-arthroplasty-a-propensity-score-matched-cohort-study
#7
Mohamed E Moussa, Yuo-Yu Lee, Geoffrey H Westrich, Nabil Mehta, Stephen Lyman, Robert G Marx
BACKGROUND: Attaining stability during total knee arthroplasty (TKA) is essential for a successful outcome. Although traditional constrained total knee prostheses have generally been used in conjunction with intramedullary stems, some devices have been widely used without the use of stems, referred to as non-modular constrained condylar total knee arthroplasty (NMCCK). QUESTIONS/PURPOSES: The aim of this study was to compare revisions rates after total knee replacement with a non-modular constrained condylar total knee (NMCCK) compared to a posterior-stabilized (PS) design...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167870/the-survival-of-total-knee-arthroplasty-current-data-from-registries-on-tribology-review-article
#8
REVIEW
Roberto Civinini, Christian Carulli, Fabrizio Matassi, Andrea Cozzi Lepri, Luigi Sirleo, Massimo Innocenti
BACKGROUND: Polyethylene (PE) wear is a major contributor to implant loosening following total knee arthroplasty (TKA), and advanced bearings in TKA are being investigated with hopes of reducing or eliminate wear-related loosening. Currently, information on knee tribology is available from national joint registries and may be the best tools to evaluate the efficacy and safety of design innovations in joint arthroplasty. QUESTIONS/PURPOSES: We performed a review of national joint registries trying to answer the following questions: "Which is the main factor directly related to revisions rate in TKA?" and "Are there new bearing options better than conventional ones?" METHODS: A review was performed of all published annual reports of National Joint Registers, as well as of the literature...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28144717/-individualized-unicondylar-knee-replacement-use-of-patient-specific-implants-and-instruments
#9
J Arnholdt, B M Holzapfel, L Sefrin, M Rudert, J Beckmann, A F Steinert
OBJECTIVE: Unicompartmental knee replacement in patients with osteoarthritis (OA) of the medial compartment. Individualized instruments and implants with a planning protocol for optimal fit. The individualized instruments and implants (ConforMIS Inc.; Burlington, MA, USA) are manufactured based on a computed tomography scan of the affected lower extremity and are provided together with a planning protocol (iView®) of the surgery. INDICATIONS: Unicompartmental OA of the knee (Kellgren & Lawrence stage IV) or Morbus Ahlbäck after unsuccessful conservative or joint preserving surgery...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28144716/bicompartmental-individualized-knee-replacement-use-of-patient-specific-implants-and-instruments-iduo%C3%A2
#10
A F Steinert, J Beckmann, B M Holzapfel, M Rudert, J Arnholdt
OBJECTIVE: Bicompartmental knee replacement in patients with combined osteoarthritis (OA) of the medial or lateral and patellofemoral compartment. Patient-specific instruments and implants (ConforMIS iDuo™) with a planning protocol for optimal implant fit. INDICATIONS: Bicompartmental OA of the knee (Kellgren & Lawrence stage IV) affecting both the medial or lateral and patellofemoral compartment after unsuccessful conservative or joint-preserving surgery. CONTRAINDICATIONS: Tricompartmental OA, knee ligament instabilities, knee deformities >15° (varus, valgus, extension deficit)...
February 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28144580/-meniscal-scar-as-a-landmark-for-the-joint-line-in-revision-total-knee-replacement
#11
Wasim Sardar Khan, Jagmeet Bhamra, Rhodri Williams, Rhidian Morgan-Jones
AIM: To determine whether tissue identified at the joint line was actually remnant "meniscal" scar tissue or not. METHODS: Nine patients undergoing revision knee surgery following informed consent had meniscal scar tissue sent to the histology department for analyses. All revisions were performed where joint line had been raised or lowered at earlier surgery. Although preoperative radiographic evaluations suggested that the joint line had been altered, intraoperatively there was scar tissue at the level of the recreated joint line...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28122467/high-blood-metal-ion-levels-in-19-of-22-patients-with-metal-on-metal-hinge-knee-replacements
#12
Minna Laitinen, Jyrki Nieminen, Aleksi Reito, Toni-Karri Pakarinen, Piia Suomalainen, Konsta Pamilo, Jyrki Parkkinen, Tonis Lont, Antti Eskelinen
Background and purpose - There has been increasing alarm regarding metal-on-metal (MoM) joint replacements leading to elevated levels of metal ions and adverse reactions to metal debris (ARMDs). There is little information available concerning the prevalence of and risk factors for these adverse reactions, except with MoM hip joint replacements. We determined the levels of metal ions in blood and the rate of revision due to ARMDs in patients treated with MoM hinge total knee arthroplasty (TKA). Patients and methods - 22 patients with TKAs and MoM hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and/or ≥2 years after surgery...
January 26, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28103308/results-after-cementless-medial-oxford-unicompartmental-knee-replacement-incidence-of-radiolucent-lines
#13
Benjamin Panzram, Ines Bertlich, Tobias Reiner, Tilman Walker, Sébastien Hagmann, Marc-André Weber, Tobias Gotterbarm
PURPOSE: Tibial radiolucent lines (RL) are commonly seen in cemented unicompartmental knee replacement (UKR). In the postoperative course, they can be misinterpreted as signs of loosening, thus leading to unnecessary revision. Since 2004, a cementless OUKR is available. First studies and registry data have shown equally good clinical results of cementless OUKR compared to the cemented version and a significantly reduced incidence of RL in cementless implants. METHODS: This single-centre retrospective cohort study includes the first 30 UKR (27 patients) implanted between 2007 and 2009 with a mean follow-up of 5 years...
2017: PloS One
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#14
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#15
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#16
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
February 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28060227/preoperative-opioid-use-is-associated-with-early-revision-after-total-knee-arthroplasty-a-study-of-male-patients-treated-in-the-veterans-affairs-system
#17
Alon Ben-Ari, Howard Chansky, Irene Rozet
BACKGROUND: Opioid use is endemic in the U.S. and is associated with morbidity and mortality. The impact of long-term opioid use on joint-replacement outcomes remains unknown. We tested the hypothesis that use of opioids is associated with adverse outcomes after total knee arthroplasty (TKA). METHODS: We performed a retrospective analysis of patients who had had TKA within the U.S. Veterans Affairs (VA) system over a 6-year period and had been followed for 1 year postoperatively...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28027386/paresis-of-the-peroneal-nerve-a-rare-but-severe-long-term-complication-of-polyethylene-wear-in-knee-arthroplasty
#18
Matthias Aurich, Mark Lenz, Norman Best
One of the most important limiting factors in the long-term success of total knee arthroplasty is polyethylene wear. Particles of the polyethylene inserts have been shown to elicit a foreign body response, which produces bone resorption and osteolysis, ultimately leading to loosening and component failure. The authors report on a case of an elderly patient who underwent a total knee arthroplasty almost 2 decades ago. Clinical and radiological checkups of the knee had not been performed recently. He now presented with a painful and swollen knee, recurrent joint effusion and swelling of the lower leg, and paresis of the peroneal nerve...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28008373/clinical-factors-disease-parameters-and-molecular-therapies-affecting-osseointegration-of-orthopedic-implants
#19
Hilal Maradit Kremers, Eric A Lewallen, Andre J van Wijnen, David G Lewallen
Total hip and knee arthroplasty are effective interventions for management of end-stage arthritis. Indeed, about 7 million Americans are currently living with artificial hip and knee joints. The majority of these individuals, however, will outlive their implants and require revision surgeries, mostly due to poor implant osseointegration and aseptic loosening. Revisions are potentially avoidable with better management of patient-related risk factors that affect the osseointegration of orthopedic implants. In this review, we summarize the published clinical literature on the role of demographics, biologic factors, comorbidities, medications and aseptic loosening risk...
September 2016: Current Molecular Biology Reports
https://www.readbyqxmd.com/read/28005112/can-a-total-knee-arthroplasty-perioperative-surgical-home-close-the-gap-between-primary-and-revision-tka-outcomes
#20
Chijioke Iwuchukwu, David Wright, Anna Sofine, Ran Schwarzkopf
Given the steady increase in the number of primary and revision total knee arthroplasties (TKAs) performed in the United States, we wanted to determine if an evidence-based TKA perioperative surgical home could close the perioperative morbidity gap between primary and revision TKAs. We conducted a prospective cross-sectional cohort study comparing outcomes of patients who had primary TKA (n = 235) with outcomes of patients who had revision TKA (n = 50). We measured several perioperative outcomes: length of stay, discharge disposition, 30-day readmission rate, and 30-day reoperation rate...
November 2016: American Journal of Orthopedics
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