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Revision knee replacement

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https://www.readbyqxmd.com/read/29762447/gastrocnemius-myocutaneous-flaps-for-knee-joint-coverage
#1
Alice Mayoly, Jean-Camille Mattei, Pierre Moullot, Charlotte Jaloux, Alexandre Rochwerger, Dominique Casanova, Baptiste Bertrand, Cécile Philandrianos
INTRODUCTION: The gastrocnemius muscular flap has already proven its efficiency for soft tissue coverage in cases of knee joint exposure. However, it may be too small to cover large defects and has not the same aesthetic and mechanical properties as normal skin. Perforator fasciocutaneous flaps have recently been described in knee joint coverage with good results as they replace skin by skin, but they can be hard to harvest. Gastrocnemius flaps can be easily harvested with a planned skin paddle designed over the chosen muscle...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29731320/the-largest-survivorship-and-clinical-outcomes-study-of-the-fixed-bearing-stryker-triathlon-partial-knee-replacement-a-multi-surgeon-single-centre-cohort-study-with-a-minimum-of-two-years-of-follow-up
#2
S W F Middleton, P J Schranz, V I Mandalia, A D Toms
BACKGROUND: The surgical management of isolated medial compartment degenerative disease of the knee causes debate. Unicompartmental arthroplasty options include fixed and mobile bearing implant designs with fixed bearing becoming increasingly popular. We present the largest cohort of a fixed bearing single radius design, Stryker Triathlon Partial Knee Replacement (PKR). METHODS: We prospectively collected demographic data and patient reported outcome measures (PROMs) on our cohort of PKR implants since its adoption in our unit, 2009 until March 2015...
May 3, 2018: Knee
https://www.readbyqxmd.com/read/29703630/mid-to-long-term-survivorship-of-oxidised-zirconium-total-knee-replacements-performed-in-patients-under-50years-of-age
#3
Alexander W Glover, Alasdair J A Santini, John S Davidson, Jill A Pope
BACKGROUND: Oxidised zirconium has the wear properties of ceramic with the breakage resistance of metal. This results in less wear and is of benefit to younger, higher demand patients. We report the short- to mid-term survival of 103 Profix zirconium total knee replacements performed in patients under 50years of age at time of surgery. METHODS: Data was collected prospectively and survival analysis undertaken with strict end points used. SF (Short Form) 12 and WOMAC (Western Ontario and McMaster University) scores were recorded at pre-operatively and at twelve months, one, three, five, seven and ten years...
April 24, 2018: Knee
https://www.readbyqxmd.com/read/29695317/influence-of-joint-kinematics-on-polyethylene-wear-in-anatomic-shoulder-joint-arthroplasty
#4
Steffen Braun, Stefan Schroeder, Ulrike Mueller, Robert Sonntag, Matthias Buelhoff, Jan Philippe Kretzer
BACKGROUND: Despite the positive results in total shoulder arthroplasties (TSAs), a higher revision rate is documented compared with total hip and knee replacements. Wear is the possible main cause of TSA failure in the long-term. This study investigated the effect of joint kinematics and the influence of the rotator cuff on the polyethylene wear performance in an anatomic TSA. METHODS: Lifting a load of 2 kg with an abduction/adduction of 0° to 90° was simulated for 2 × 106 cycles as a primary motion using a fully kinematic joint simulator...
April 23, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29692188/severe-heterotopic-ossification-following-total-knee-replacement
#5
A Brown, R D Banerjee
We present a case of severe heterotopic ossification following a primary total knee replacement, which was complicated by a severe intraoperative anaphylactic reaction, and the successful treatment by revision to a rotating platform hinged implant, 32 months following the index procedure.
April 25, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29666082/knee-joint-instability-after-total-knee-replacement-in-a-patient-with-ehlers-danlos-syndrome-the-role-of-insert-changes-as-practical-solution
#6
Ajmal Farid, Stefan Beekhuizen, Joris van der Lugt, Marijn Rutgers
Treatment of knee joint instability in patients with hypermobile Ehlers-Danlos syndrome (EDS) can be challenging. A 53-year-old woman with hypermobile EDS underwent bilateral total knee replacement (TKR) due to valgus osteoarthritis. During follow-up, she developed hypermobility of both knee replacements. Revision of the insert resolved the issue in her left knee; however, the right TKR required two insert exchanges and unfortunately instability persisted. Therefore, a revision to a constrained prosthesis was performed...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29643169/safety-and-feasibility-evaluation-of-tourniquets-for-total-knee-replacement-safe-tkr-study-protocol
#7
Peter Dh Wall, Imran Ahmed, Andrew Metcalfe, Andrew J Price, Kate Seers, Charles E Hutchinson, Helen Parsons, Jane Warwick, Bushra Rahman, Jaclyn Brown, Martin Underwood
INTRODUCTION: This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible. METHOD AND ANALYSIS: Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29643154/associations-between-preoperative-oxford-hip-and-knee-scores-and-costs-and-quality-of-life-of-patients-undergoing-primary-total-joint-replacement-in-the-nhs-england-an-observational-study
#8
Peter Eibich, Helen A Dakin, Andrew James Price, David Beard, Nigel K Arden, Alastair M Gray
OBJECTIVES: To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). DESIGN: Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. SETTING: UK secondary care. PARTICIPANTS: Men and women undergoing primary THR or TKR...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#9
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29598886/mapping-existing-hip-and-knee-replacement-registries-in-europe
#10
REVIEW
A Lübbeke, A J Silman, C Barea, D Prieto-Alhambra, A J Carr
The general shortage of evidence regarding benefits and harms of medical devices has been highlighted following the serious safety concerns with metal-on-metal hip replacements and silicone breast implants and was again pointed out in a recent survey of European Health Technology Assessment institutions. In this context the new European medical device regulation will enforce post-marketing surveillance of existing and new implants. The usefulness of registry data as a source of information for medical device real-world clinical performance and safety has been demonstrated...
March 17, 2018: Health Policy
https://www.readbyqxmd.com/read/29569138/tumour-endoprosthesis-replacement-in-the-proximal-tibia-after-intra-articular-knee-resection-in-patients-with-sarcoma-and-recurrent-giant-cell-tumour
#11
Jendrik Hardes, Marcel-Philipp Henrichs, Georg Gosheger, Wiebke Guder, Markus Nottrott, Dimosthenis Andreou, Eike Bormann, Maria Eveslage, Gregor Hauschild, Arne Streitbürger
PURPOSE: Proximal tibia replacements are commonly associated with post-operative complications and poor functional results due to an insufficiency of the extensor mechanism. METHODS: This study evaluated the clinical results with a special emphasis of the extensor mechanism reconstruction with a reattachment tube and complications after intra-articular resection of the proximal tibia and reconstruction with a tumour endoprosthesis (MUTARS®) in 98 patients (median age 18 years) with malignant bone tumours or giant cell tumours...
March 22, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29560397/biarticular-total-femur-spacer-for-massive-femoral-bone-loss-the-mobile-solution-for-a-big-problem
#12
Pablo Sanz-Ruiz, Jose Antonio Calvo-Haro, Manuel Villanueva-Martinez, Jose Antonio Matas-Diez, Javier Vaquero-Martín
Bone cement spacers loaded with antibiotic are the gold standard in septic revision. However, the management of massive bone defects constitutes a surgical challenge, requiring the use of different nails, expensive long stems, or cement-coated tumor prostheses for preparing the spacer. In most cases, the knee joint must be sacrificed. We describe a novel technique for preparing a biarticular total femur spacer with the help of a trochanteric nail coated with antibiotic loaded cement, allowing mobility of the hip and knee joints and assisted partial loading until second step surgery...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29556929/extra-articular-deformity-correction-using-taylor-spatial-frame-prior-to-total-knee-arthroplasty
#13
Gautam J K Tawari, Rajan Maheshwari, Sanjeev S Madan
A good long-term outcome following a total knee arthroplasty relies on restoration of the mechanical axis and effective soft tissue balancing of the prosthetic knee. Arthroplasty surgery in patients with secondary osteoarthritis of the knee with an extra-articular tibial deformity is a complex and challenging procedure. The correction of mal-alignment of the mechanical axis is associated with unpredictable result and with higher revision rates. Single-staged deformity correction and replacement surgery often result in the use of constraint implants...
March 20, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29548618/outpatient-focused-joint-arthroplasty-is-the-future-the-midwest-center-for-joint-replacement-experience
#14
Michael E Berend, Wesley G Lackey, Joshua L Carter
BACKGROUND: Perhaps, the most significant developments in joint arthroplasty in the past decade have been in the area of multimodal perioperative management reducing pain, nausea, and length of stay leading to outpatient arthroplasty. METHODS: Over a 2-year period, we performed 1230 arthroplasty cases including partial knee, total hip, total knee, and selected revision cases. RESULTS: Patient satisfaction ranged from 98% to 100% great/good...
June 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29547115/medium-term-results-of-total-knee-arthroplasty-as-a-primary-treatment-for-knee-fractures
#15
Ayman Ebied, Ahmed Zayda, Sameh Marei, Hany Elsayed
INTRODUCTION: Successful treatment of knee comminuted periarticular fractures associated with osteoporosis and pre-existing arthritis is a challenging task. METHODS: This is a prospective study on 27 patients who had comminuted intra and periarticular knee fractures and pre-existing arthritis. Fractures were classified according to Muller's AO classification. Primary knee arthroplasty was performed ± internal fixation following 4 weeks of splinting. A stem was added to the tibial tray and Legacy Constrained Condylar Knee (LCCK) or Rotating Hinge (RH) prosthesis were used depending on the level of ligament damage and bone defects...
2018: SICOT-J
https://www.readbyqxmd.com/read/29528754/the-effect-of-surgeon-s-preference-for-hybrid-or-cemented-fixation-on-the-long-term-survivorship-of-total-knee-replacement
#16
Christopher J Vertullo, Stephen E Graves, Yi Peng, Peter L Lewis
Background and purpose - Recent direct comparative reports suggest that hybrid fixation may have a similar or superior outcome to cemented fixation in total knee replacement (TKR); however, a paucity of long-term data exists. To minimize the confounders of a direct comparison, we performed an instrumental variable analysis examining the revision rate of 2 cohorts of patients based on their surgeon's preference for cemented or hybrid fixation. Methods - Registry data were obtained from 1999 until 2015 for 2 cohorts of patients who received minimally stabilized TKR, defined as those treated by high-volume hybrid fixation preferring surgeons, designated routinely hybrid (RH), and those treated by high-volume cemented fixation preferring surgeons, designated routinely cemented (RC)...
June 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29520668/3d-patient-imaging-and-retrieval-analysis-help-understand-the-clinical-importance-of-rotation-in-knee-replacements
#17
Arianna Cerquiglini, Johann Henckel, Harry Hothi, Niccoló Rotigliano, Michael T Hirschmann, Alister J Hart
PURPOSE: The purpose of the present study was to correlate highly accurate CT measurements of pre-revision total knee arthroplasty (TKA) implant position with findings of retrieval analysis post-revision, to understand the clinical relevance of TKA orientation. METHODS: This study involved 53 retrieved TKA implants with pre-revision 3D-CT scans used to determine coronal (varus-valgus), sagittal (tibial slope) and rotational (internal rotation-external rotation) TKA orientation as well as tibiofemoral leg axis...
March 8, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29517925/meniscus-root-repair-vs-meniscectomy-or-nonoperative-management-to-prevent-knee-osteoarthritis-after-medial-meniscus-root-tears-clinical-and-economic-effectiveness
#18
Scott C Faucett, Benjamin Peter Geisler, Jorge Chahla, Aaron J Krych, Peter R Kurzweil, Abigail M Garner, Shan Liu, Robert F LaPrade, Jan B Pietzsch
BACKGROUND: Medial meniscus root tears are a common knee injury and can lead to accelerated osteoarthritis, which might ultimately result in a total knee replacement. PURPOSE: To compare meniscus repair, meniscectomy, and nonoperative treatment approaches among middle-aged patients in terms of osteoarthritis development, total knee replacement rates (clinical effectiveness), and cost-effectiveness. STUDY DESIGN: Meta-analysis and cost-effectiveness analysis...
March 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29511786/-anatomical-total-shoulder-replacement-in-glenohumeral-osteoarthritis-indications-current-implants-and-clinical-results
#19
REVIEW
O Lorbach
IMPLANT DESIGNS: Within the last 50 years, implants for shoulder replacement have developed rapidly. Monobloc-stems in few sizes were changed to modular implant systems that allow for an individual adaption of the stem, as well as adaption of the humeral head component according to the specific anatomic situation of the patient. Moreover, stemless und short stem implants are available, which may highly simplify primary implantation, especially in posttraumatic cases as well as in revision cases with a need for removal or change of the implants...
May 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29508661/rsa-migration-of-total-knee-replacements
#20
Bart G Pijls, José W M Plevier, Rob G H H Nelissen
Purpose - We performed a systematic review and meta-analyses to evaluate the early and long-term migration patterns of tibial components of TKR of all known RSA studies. Methods - Migration pattern was defined as at least 2 postoperative RSA follow-up moments. Maximal total point motion (MTPM) at 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years, and 10 years were considered. Results - The literature search yielded 1,167 hits of which 53 studies were included, comprising 111 study groups and 2,470 knees...
June 2018: Acta Orthopaedica
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