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Revision knee replacement

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https://www.readbyqxmd.com/read/28929828/increased-risk-of-aseptic-loosening-for-43-525-rotating-platform-vs-fixed-bearing-total-knee-replacements
#1
Oystein Gothesen, Stein Hakon L Lygre, Michelle Lorimer, Stephen Graves, Ove Furnes
Background and purpose - Given similar functional outcomes with mobile and fixed bearings, a difference in survivorship may favor either. This study investigated the risk of aseptic loosening for the most used subtypes of mobile-bearing rotating-platform knees, in Norway and Australia. Patients and methods - Primary TKRs reported to the Norwegian and Australian joint registries, between 2003 and 2014, were analyzed with aseptic loosening as primary end-point and all revisions as secondary end-point. We hypothesized that no difference would be found in the rate of revision between rotating-platform and the most used fixed-bearing TKRs, or between keeled and non-keeled tibia...
September 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28878516/enhanced-recovery-principles-applied-to-revision-hip-and-knee-arthroplasty-reduces-length-of-stay-and-blood-transfusion
#2
Michael Kent, Nick Calvert, Kevin Blades, Alex Swann, Piers Yates
INTRODUCTION: This is the first study reporting the application of Enhanced Recovery Principles (ERP) to revision arthroplasty. METHOD: Retrospective series of 132 revision hip and knee replacements treated with ERP. RESULTS: Infiltration was associated with reduced LOS in knees (6 vs 8.5 days), lower PCA usage and incidence of transfusion in knees (2 vs 3 days) and hips (1 vs 6 days). Revisions for infection had a longer LOS (5.4 vs 11...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28865425/silver-coated-modular-megaendoprostheses-in-salvage-revision-arthroplasty-after-periimplant-infection-with-extensive-bone-loss-a-pilot-study-of-34-patients
#3
Dirk Zajonz, Undine Birke, Mohamed Ghanem, Torsten Prietzel, Christoph Josten, Andreas Roth, Johannes K M Fakler
BACKGROUND: Hip and knee replacements in patients with bone defects after infection correlates with high rates of reinfection. In this vulnerable patient population, the prevention of reinfection is to be considered superordinate to the functionality and defect bridging. The use of silver coating of aseptic implants as an infection prophylaxis is already proven; however, the significance of these coatings in septic reimplantation of large implants is still not sufficiently investigated...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28861196/patellofemoral-joint-arthroplasty-early-results-and-functional-outcome-of-the-zimmer-gender-solutions-patello-femoral-joint-system
#4
Donald Osarumwense, Farhan Syed, Obi Nzeako, Segun Akilapa, Omer Zubair, Jon Waite
BACKGROUND: Improved knee prosthesis designs have led to an increase in the use of patellofemoral arthroplasty as a primary treatment option in recent times. We report the early results and outcomes of the Zimmer Gender Solutions Patello-Femoral Joint (PFJ) system used to treat isolated patellofemoral osteoarthritis (PFA). METHODS: We retrospectively reviewed and analysed data of patients who underwent PFJ replacement (PFJR) at our institution with a minimum follow-up of 2 years...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#5
Paul R T Kuzyk, Evan Watts, David Backstein
Periprosthetic fractures after total knee arthroplasty (TKA) can present reconstructive challenges. Not only is the procedure technically complex, but patients with these fractures may have multiple comorbidities, making them prone to postoperative complications. Early mobilization is particularly beneficial in patients with multiple comorbidities. Certain patient factors and fracture types may make revision TKA the ideal management option. Periprosthetic fractures around the knee implant occur most frequently in the distal femur, followed by the tibia and the patella...
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28834999/-impact-of-case-numbers-on-the-5-year-survival-rate-of-unicondylar-knee-replacements-in-germany
#6
Elke Jeschke, Thorsten Gehrke, Christian Günster, Karl-Dieter Heller, Jürgen Malzahn, Axel Marx, Fritz-Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Matthias Halder
Background Reported survival rates of unicondylar knee arthroplasty (UKA) vary considerably. The influences of patient characteristics and the type of implant have already been examined. This analysis investigated the influence of hospital volume on 5-year-survival rate, using administrative claims data of Germany's largest health insurance provider. Methods We analysed administrative claims data for 20,946 UKAs covered by the German local healthcare funds (Allgemeine Ortskrankenkasse, AOK) between 2006 and 2012...
August 23, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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