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Revision knee replacement

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https://www.readbyqxmd.com/read/28724376/sonication-contribution-to-identifying-prosthetic-joint-infection-with-ralstonia-pickettii-a-case-report-and-review-of-the-literature
#1
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/28698316/description-of-the-rates-trends-and-surgical-burden-associated-with-revision-for-prosthetic-joint-infection-following-primary-and-revision-knee-replacements-in-england-and-wales-an-analysis-of-the-national-joint-registry-for-england-wales-northern-ireland-and
#2
Erik Lenguerrand, Michael R Whitehouse, Andrew D Beswick, Andrew D Toms, Martyn L Porter, Ashley W Blom
OBJECTIVES: To describe the prevalence rates of revision surgery for the treatment of prosthetic joint infection (PJI) for patients undergoing knee replacement, their time trends, the cumulative incidence function of revision for PJI and estimate the burden of PJI at health service level. DESIGN: We analysed revision knee replacements performed due to a diagnosis of PJI and the linked index procedures recorded in the National Joint Registry from 2003 to 2014 for England and Wales...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28695187/infection-burden-in-total-hip-and-knee-arthroplasties-an-international-registry-based-perspective
#3
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
#4
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/28688643/topical-anesthesia-for-staple-removal-from-surgical-wounds-on-the-knee-a-prospective-double-blind-randomized-trial
#5
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/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
#6
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/28669018/revision-knee-arthroplasty-using-a-distal-femoral-replacement-prosthesis-for-periprosthetic-fractures-in-elderly-patients
#7
Ehab Girgis, Christoph McAllen, Jonathan Keenan
PURPOSE: Distal femoral periprosthetic fractures above a total knee replacement in elderly patients are technically challenging to treat. Bone quality is often poor, the fractures comminuted, and post-operative mobilisation is difficult. This study assesses the clinical, radiological and functional outcome of revision knee distal femoral replacement (DFR) in these fractures. METHODS: We identified 14 patients over 70 years of age (70-94) who underwent DFR for periprosthetic fractures above a knee replacement...
July 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28667383/comparison-of-fixed-bearing-and-mobile-bearing-total-knee-arthroplasty-after-high-tibial-osteotomy
#8
Philippe Hernigou, Maxime Huys, Jacques Pariat, François Roubineau, Charles Henri Flouzat Lachaniette, Arnaud Dubory
PURPOSE: There is no information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in the same patients previously treated by high tibial osteotomy. The purpose was therefore to compare fixed-bearing and mobile-bearing total knee replacements in patients treated with previous high tibial osteotomy. METHODS: We compared the results of 57 patients with osteoarthritis who had received a fixed-bearing prosthesis after high tibial osteotomy with the results of 41 matched patients who had received a rotating platform after high tibial osteotomy...
June 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28657570/two-stage-revision-after-total-knee-arthroplasty
#9
Paolo Di Benedetto, Enrico Daniele Di Benedetto, Michele Mario Buttironi, D De Franceschi, Alessandro Beltrame, Renato Gissoni, Vanni Cainero, Araldo Causero
Periprosthetic knee infection is a complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5,6% in revisions; incidence is increasing over the years. Two-stage revision is the technique used in chronic infection. Aim of the work is to check success rate in our data. Methods. We analyzed retrospectively data of patients who undergone two stage revision surgery between 01/01/2010 to 31/12/2015. We made a clinical and radiological control after 1, 3, 6, 12, 24 months and we evaluate the outcome in December 2016...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657569/acute-periprosthetic-knee-infection-is-there-still-a-role-for-dair
#10
Paolo Di Benedetto, Enrico Daniele Di Benedetto, Daniele Salviato, Alessandro Beltrame, Renato Gissoni, Vanni Cainero, Araldo Causero
BACKGROUND AND AIM OF THE WORK: Periprosthetic knee infection is a rare complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5.6% in revisions. Indications for debridment, antibiotics and implant retention (DAIR) are early acute infections or acute delayed infection. Aim of the work is to check if this technique is still a successful in early infections. METHODS: We have analyzed recent literature data on DAIR and all DAIR procedures in our clinic in the last 10 years, the mean time between onset of symptoms and surgery, the mean antibiotic therapy duration and results we have obtained...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657568/metal-hypersensitivity-after-knee-arthroplasty-fact-or-fiction
#11
Massimo Innocenti, Berti Vieri, Tommaso Melani, Tommaso Paoli, Christian Carulli
BACKGROUND AND AIM OF THE WORK: Hypersensitivity to metals in the general population has an incidence of about 15%, and in rising also for the higher number of joint replacements in the last decades. Total Knee Arthroplasty (TKA) represents the most performed orthopaedic procedure during last years, and it seems to be particularly associated with sensitization after surgery. On the other hand, there is a rising amount of patients with painful but well implanted and functioning TKAs: in certain cases, after the exclusion of the most frequent causes of failure, a condition of hypersensitivity may be found, and a revision with anallergic implants is mandatory...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28655567/total-knee-replacement-in-young-patients-survival-and-causes-of-revision-in-a-registry-population
#12
Francesco Castagnini, Alessandra Sudanese, Barbara Bordini, Enrico Tassinari, Susanna Stea, Aldo Toni
BACKGROUND: The incidence of total knee replacements (TKRs) in young patients is increasing. Few reports described encouraging results and acceptable survival rates. However, many concerns still persist, in particular about the high rates of infection and aseptic loosening. Aim of this article was to investigate the survival of TKRs in patients aged 45 years or younger in a registry population. METHODS: The Emilia-Romagna registry RIPO was enquired about TKRs in patients ≤45 years; 238 TKRs were evaluated at a mean follow-up of 5...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28653546/cruciate-retaining-compared-with-posterior-stabilised-nexgen-total-knee-arthroplasty-results-at-10-years-in-a-matched-cohort
#13
Aiw Mayne, H P Harshavardhan, L R Johnston, W Wang, A Jariwala
INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken...
June 27, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28602534/bilateral-total-hip-and-knee-arthroplasties-average-10-year-follow-up
#14
John B Meding, Philip M Faris, Ken E Davis
BACKGROUND: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced. METHODS: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.6 years. Preoperative diagnoses included osteoarthritis in 80% and rheumatoid arthritis in 20%. The average age at the time of the first arthroplasty was 63...
May 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28591928/-does-sports-activity-influence-total-knee-arthroplasty-durability-analysis-with-a-follow-up-of-12-years
#15
Christina Valle, Michael Sperr, Christina Lemhöfer, Karla Elida Bartel, Marcus Schmitt-Sody
Background Total knee replacement is the only surgical option to treat painful degenerative osteoarthritis, restore knee function, improve quality of life, and enable patients to return to sports activity. With an aging population expecting an active life after retirement, patients' expectations of improvement after surgery are increasing as well. In view of the growing demand for higher performance, exercise and athletic activity, clinicians have been increasingly forced to question how much athletic activity a patient may resume after total knee replacement, and what types of athletic activity seem to be acceptable...
June 2017: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/28566786/short-and-mid-term-results-of-revision-total-knee-arthroplasty-with-global-modular-replacement-system
#16
Dariusz Marczak, Jacek Kowalczewski, Jarosław Czubak, Tomasz Okoń, Marek Synder, Marcin Sibiński
BACKGROUND: The original knee megaprostheses with fixed or rotating hinge articulation were custom made and only used for reconstruction of the knee following distal femoral or proximal tibial tumor resections. The aim of the study was to analyze the short- and mid-term results of revision total knee arthroplasty with Global Modular Replacement System (GMRS) used in difficult situations not amenable to reconstruction with standard total knee replacement implants. MATERIALS AND METHODS: Nine patients (9 knees) were treated with this comprehensive modular implant system, with a mean age of 73...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28554493/statistical-shape-modeling-predicts-patellar-bone-geometry-to-enable-stereo-radiographic-kinematic-tracking
#17
Lowell M Smoger, Kevin B Shelburne, Adam J Cyr, Paul J Rullkoetter, Peter J Laz
Complications in the patellofemoral (PF) joint of patients with total knee replacements include patellar subluxation and dislocation, and remain a cause for revision. Kinematic measurements to assess these complications and evaluate implant designs require the accuracy of dynamic stereo-radiographic systems with 3D-2D registration techniques. While tibiofemoral kinematics are typically derived by tracking metallic implants, PF kinematic measurements are difficult as the patellar implant is radiotransparent and a representation of the resected patella bone requires either pre-surgical imaging and precise implant placement or post-surgical imaging...
May 17, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28552448/surgeon-s-preference-in-total-knee-replacement-a-quantitative-examination-of-attributes-reasons-for-alteration-and-barriers-to-change
#18
Christopher J Vertullo, Peter M Grimbeek, Stephen E Graves, Peter L Lewis
BACKGROUND: The reasons why surgeons prefer a particular total knee replacement (TKR) to other viable options with lower cost or lower revision risk remain uncertain. This study examined the concept of surgeon's preference in TKR; including the self-assigned utility of their preferred prosthesis, reasons to alter usual preference and barriers to permanently changing preference. METHODS: Using a multinational electronic survey, 347 TKR performing orthopedic surgeons were studied using anonymous mandatory responses, mutually exclusive closed options, multiple responses blocking, automatic stem randomization, Likert scale weighting, and an absence of neutral options...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#19
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
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
#20
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
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