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Revision knee replacement

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https://www.readbyqxmd.com/read/28809627/-the-use-of-btb-allograft-in-revision-reconstruction-of-the-anterior-cruciate-ligament-and-its-success-rate-in-terms-of-subjective-patient-satisfaction
#1
J Sklenský, P Vališ, M Repko, M Rouchal, M Maršálek, D Hrůzová
PURPOSE OF THE STUDY A retrospective evaluation of the success rate of revision ACL reconstruction performed using BTB allograft in terms of the life expectancy of the procedure up to and over five years from surgery. MATERIAL AND METHODS Over a ten-year period, from 2003 to 2013, we performed 47 revision ACL reconstruction surgeries. The majority of the primary ACL reconstructions using BTB autografts were not performed at our site. The group observed included 16 women (34%) and 31 men (66%). The women were aged between 25 and 48 years, the median age being 32...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#2
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28801816/are-tkas-performed-in-high-volume-hospitals-less-likely-to-undergo-revision-than-tkas-performed-in-low-volume-hospitals
#3
Elke Jeschke, Mustafa Citak, Christian Günster, Andreas Matthias Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers. QUESTIONS/PURPOSES: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital? METHODS: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28793979/outcome-of-prosthesis-matched-and-unmatched-patella-components-in-primary-and-revision-total-knee-replacement
#4
Peter L Lewis, Ai E Gamboa, David G Campbell, Michelle Lorimer
BACKGROUND: Although knee replacements have specifically designed patella prostheses that correspond to the geometry of their femoral components, a patella prosthesis that is unmatched to the femoral component may occasionally be inserted. In revision total knee arthroplasty (TKA), an originally resurfaced patella may be left, but the femoral component revised to one that does not match the patella. Few studies have compared the outcome of matched and unmatched patella components in TKA...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28793976/influence-of-implant-length-and-bone-defect-situation-on-primary-stability-after-distal-femoral-replacement-in-vitro
#5
Jan Nadorf, Simon B Klein, Simone Gantz, Eike Jakubowitz, Jan Philippe Kretzer, Oliver E Bischel
BACKGROUND: Aseptic loosening is the major reason for failure of distal femoral replacement using current modular megaprostheses. Although the same stems are used for proximal and distal replacement, survival rates in clinical studies with distal reconstruction were lower within the same system compared to proximal reconstruction. We analyzed whether primary stability as presupposition for long-term fixation can be achieved with a current tapered stem design. Additionally, we hypothesized that stem length affects primary stability depending on bone defect situations...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28780594/two-stage-revision-surgery-for-infected-total-knee-replacements-reasonable-function-and-high-success-rate-with-the-use-of-primary-knee-replacement-implants-as-temporary-spacers
#6
Ben Arthur Marson, Samuel T Walters, Benjamin V Bloch, Khosrow Sehat
Two-stage revision surgery for infected total knee replacements remains the gold standard treatment. Articulating spacers are preferred to static spacers for improved functional outcome. Articulating spacers made of cement can be prone to fracture, may not be suitable for full weight bearing, create abrasion debris and necessitate second-stage revision surgery. An alternative is the use of primary knee replacement implants as temporary spacers. With this technique, implants are loosely cemented into place at time of revision, allow the patient reasonable mobility and an ability to fully weight bear and can obviate the need for second-stage surgery...
August 5, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28776632/interprosthetic-fractures-of-the-femur
#7
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
#8
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/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
#9
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/28752819/computer-assisted-navigation-in-total-knee-and-hip-arthroplasty
#10
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
#11
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/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/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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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