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Periprosthetic Fracture

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https://www.readbyqxmd.com/read/28926381/total-elbow-arthroplasty-for-distal-humeral-fractures-a-ten-year-minimum-follow-up-study
#1
Raul Barco, Philipp N Streubel, Bernard F Morrey, Joaquin Sanchez-Sotelo
BACKGROUND: Total elbow arthroplasty is commonly considered for elderly patients with comminuted distal humeral fractures. Satisfactory short-term outcomes have been reported, but long-term outcomes are unknown. Our purpose was to assess the long-term outcomes of total elbow arthroplasty after distal humeral fracture and to determine differences between elbows with or without inflammatory arthritis at the time of fracture. METHODS: Forty-four total elbow arthroplasties were performed after distal humeral fracture; those patients were followed for a minimum of 10 years and were evaluated with regard to pain, motion, Mayo Elbow Performance Scores, complications, and reoperations...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28924020/microindentation-a-tool-for-measuring-cortical-bone-stiffness-a-systematic-review
#2
M Arnold, S Zhao, S Ma, F Giuliani, U Hansen, J P Cobb, R L Abel, O Boughton
OBJECTIVES: Microindentation has the potential to measure the stiffness of an individual patient's bone. Bone stiffness plays a crucial role in the press-fit stability of orthopaedic implants. Arming surgeons with accurate bone stiffness information may reduce surgical complications including periprosthetic fractures. The question addressed with this systematic review is whether microindentation can accurately measure cortical bone stiffness. METHODS: A systematic review of all English language articles using a keyword search was undertaken using Medline, Embase, PubMed, Scopus and Cochrane databases...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28918227/bone-remodeling-of-the-distal-femur-after-uncemented-total-knee-arthroplasty-a-2-year-prospective-dxa-study
#3
Mikkel Rathsach Andersen, Nikolaj S Winther, Thomas Lind, Henrik M Schrøder, Michael Mørk Petersen
Loss of bone stock as a response to the bone trauma, immobilization, and stress shielding related to joint replacement surgery increases the risk of fracture of the distal femur after total knee arthroplasty. Previous studies of uncemented femoral components have reported very high levels of bone loss in the distal femur. This study investigates the adaptive bone remodeling of the distal femur after uncemented total knee arthroplasty. We performed a 2-year follow-up of 53 patients (mean age 61.5 [38-70] years, F/M = 27/26, body mass index 29...
September 13, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28914349/reverse-total-shoulder-arthroplasty-for-type-i-fracture-sequelae-after-internal-fixation-of-proximal-humerus-fractures
#4
Benedikt Schliemann, Christina Theisen, Clemens Kösters, Michael J Raschke, Andre Weimann
INTRODUCTION: Complications after internal fixation of proximal humerus fracture are common and may require surgical revision. Reverse total shoulder arthroplasty (RTSA) is frequently performed in such cases. The aim of the present study was to evaluate the functional results and complications after RTSA for the treatment of type I fracture sequelae after internal fixation of proximal humerus fractures. MATERIALS AND METHODS: 26 patients (18 female, 8 male) underwent surgical revision of type I fracture sequelae of the proximal humerus after locking plate (n = 22) or intramedullary nail (n = 4) fixation...
September 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28913406/long-term-results-of-a-porous-tantalum-monoblock-tibia-component-clinical-and-radiographic-results-at-follow-up-of-10-years
#5
Daniel Gerscovich, Catherine Schwing, Anthony Unger
BACKGROUND: The purpose of this study is to assess the long-term follow-up of cementless total knee arthroplasty with the trabecular metal (TM) monoblock tibial component at an average 10-year follow-up. This report is an extension of our previously reported series of 108 TM tibias reported in 2011 (Unger and Duggan, 2011). METHODS: Fifty-eight of the original 108 knees were available for review. Each follow-up patient was evaluated by radiologic and clinical Knee Society Scores...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28913396/severe-heterotopic-ossification-and-stiffness-after-revision-knee-surgery-for-a-periprosthetic-fracture
#6
Maher Baroudi, Pascale Derome, Michel Malo
Although heterotopic ossification (HO) after total hip arthroplasty has been very well described as a cause of disability, much less was written on clinical dysfunction of HO after total knee arthroplasty (TKA). To the extent of our knowledge, there has been no published case of complete bony ankylosis, secondary to severe generalized HO, after a TKA. We present the case of a 67-year-old female treated successfully, with surgical excision of ossification and TKA revision surgery, using a rotating hinge system...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28900737/the-benefit-of-the-systematic-revision-of-the-acetabular-implant-in-favor-of-a-dual-mobility-articulation-during-the-treatment-of-periprosthetic-fractures-of-the-femur-a-49-cases-prospective-comparative-study
#7
A Perrin, M Saab, S Putman, K Benad, E Drumez, C Chantelot
INTRODUCTION: The SOFCOT symposium (2005) on periprosthetic fractures of the femur (PFFs) highlighted a high rate of dislocation (15.6% at 6 months) after change of prosthesis. So far, no study has ever proved the benefit of dual-mobility articulation during PFFs revisions. We conducted a comparative study on two prospective cohorts in order to (1) assess the influence of systematic acetabular revision in favor of a double mobility on dislocation rate (2) and in order to evaluate the rate of morbidity associated with this extra surgical procedure...
September 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28899823/a-predictive-radiological-analysis-of-short-stems-versus-both-shortened-and-long-stems-in-primary-hip-replacement-a-case-control-study-of-100-cases-of-metha-versus-abg-ii-and-omnifit-ha-at-2-8-years-follow-up
#8
Jean-Alain Epinette, Michel Brax, Yves Chammaï
INTRODUCTION: Short hip stems, intended to conserve bone stock and ensure a more physiological distribution of stress in the femur under loading, are meeting with renewed interest. Radiologic semiology is not known exactly, particularly in relation to conventional implants; we therefore conducted a case-control study of 3 types of implant differing only in stem length: short, shortened or long. The aim was 1) to compare radiographic aspects, 2) to attempt to systematize medium-term radiologic status for the 3 types, and 3) to assess the impact of radiographic aspect on loosening and revision rates...
September 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28870190/monobloc-implants-in-cementless-total-hip-arthroplasty-in-patients-with-legg-calve-perthes-disease-a-long-term-follow-up
#9
Ze-Yu Luo, Hao-Yang Wang, Duan Wang, Hui Pan, Fu-Xing Pei, Zong-Ke Zhou
BACKGROUND: The purpose of this study was to evaluate 10-year outcomes in cementless monobloc total hip arthroplasty (THA) in a group of hips with Legg-Calve-Perthes disease (LCPD). METHODS: We reviewed 71 patients (88 hips) who underwent cementless THA with a diagnosis of LCPD from 2003 to 2009. From the total of 71 patients, 34 men and 37 women with an average age of 49.94 years were included. The mean follow-up period was 10 years. RESULTS: The mean Harris Hip Score improved significantly from 46...
September 5, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28869116/teriparatide-administration-increases-periprosthetic-bone-mineral-density-after-total-knee-arthroplasty-a-prospective-study
#10
Tatsuya Suzuki, Fumio Sukezaki, Takashi Shibuki, Yoichi Toyoshima, Takashi Nagai, Katsunori Inagaki
BACKGROUND: Teriparatide is a currently available therapeutic agent for osteoporosis. Previous studies have reported that teriparatide affects periprosthetic bone mineral density (BMD) after total knee arthroplasty (TKA). However, little agreement has been reached concerning the treatment of periprosthetic BMD after TKA with teriparatide. Moreover, BMD in the femoral and tibial sides of the joints together has never been examined. We investigated the efficacy of teriparatide to inhibit BMD loss in the femoral and tibial side and considered complications such as migration and periprosthetic fractures after TKA...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28852333/perioperative-considerations-when-treating-isolated-periprosthetic-distal-femur-fractures
#11
Michael S Reich, Mindy Duong, Mary A Breslin, Mai P Nguyen, Heather A Vallier
BACKGROUND: Periprosthetic distal femur (PPDF) fractures occur most frequently via low energy mechanisms in elderly patients. This population is often frail and ill-suited to the physiologic burden of trauma and surgery. Here, we describe the perioperative and early hospital course for patients with PPDF fractures, and identify risk factors for poor outcomes. METHODS: Consecutive patients with isolated PPDF fractures from 2005 - 2015 were treated operatively at a Level I trauma center...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852332/radiographic-risk-factors-for-interprosthetic-femur-fractures
#12
Jason S Lipof, Ari D Amitai, Kyle T Judd, John T Gorczyca
PURPOSE: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are among the most common orthopaedic procedures performed in the United States annually. As the number of patients undergoing these procedures increases so too does the incidence of periprosthetic femur fractures. A number of these periprosthetic fractures occur between two ipsilateral implants, so-called interprosthetic fractures. Recent biomechanical data has challenged the importance of these interprosthetic distances, relating that cortical width and osteoporotic bone are more closely correlated with fracture than interprosthetic distance...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28852328/optimizing-hybrid-plate-fixation-with-a-locked-oblique-end-screw-in-osteoporotic-fractures
#13
Aaron Wynkoop, Osy Ndubaku, Paul M Carpentier, Jeffrey B Peck, Norman E Walter, Patrick Atkinson
BACKGROUND: The end screw in a fracture plate creates the greatest resistance to bending. For osteoporotic fractures treated with plates, there is some question as to the optimal screw insertion technique for the screw farthest from the fracture. A locked, oblique end screw was previously shown to increase resistance to periprosthetic fracture. It is unknown, however, how this end screw configuration would resist pullout when subjected to bending. METHODS: Narrow, low contact 3...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844629/total-hip-arthroplasty-after-in-situ-fixation-of-minimally-displaced-femoral-neck-fractures-in-elderly-patients
#14
Nicholas M Hernandez, Brian P Chalmers, Kevin I Perry, Daniel J Berry, Brandon J Yuan, Matthew P Abdel
BACKGROUND: In situ screw fixation remains the most common treatment for minimally displaced femoral neck fractures (FNFs). Total hip arthroplasty (THA) can be used as a salvage procedure, but the results of conversion THA in this population have not been evaluated. The goals of this study were to evaluate (1) unique complications associated with conversion THA, (2) implant survivorship free of revision and reoperation, (3) radiographic results, and (4) clinical outcomes in patients undergoing conversion THA after in situ fixation of nondisplaced FNFs...
July 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28837455/revision-total-knee-arthroplasty-for-the-management-of-periprosthetic-fractures
#15
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/28819592/insufficiency-fractures-of-the-distal-tibia-and-fibula-following-total-hip-arthroplasty-a-case-report
#16
Ryu Kojima, Toshiki Miura, Eisei Fukatani
INTRODUCTION: Although periprosthetic fractures of the femur have been well documented, insufficiency fractures following total hip arthroplasty (THA) have been rarely described. We report a case of an insufficiency fracture in the distal tibia and fibula that occurred after THA. CASE REPORT: A 54-year-old woman presented with severe pain in the bilateral hip joints and was diagnosed with end-stage osteoarthritis. She underwent THA on the right side. Although the postoperative course was uneventful, she suddenly experienced severe pain and swelling in the right leg without any history of trauma 22 weeks after the surgery...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#17
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28768571/a-double-plating-approach-to-distal-femur-fracture-a-clinical-study
#18
Ely L Steinberg, Jacov Elis, Yohai Steinberg, Moshe Salai, Tomer Ben-Tov
BACKGROUND: Locked plating is one of the latest innovative options for treating supracondylar femur fractures with relatively low failure rates. Single lateral plating was often found to have a relative higher failure rate. No clinical studies of double-plating distal femur fixation have thus far been reported. The aim of this study is to present our clinical experience with this surgical approach. PATIENTS AND METHODS: Thirty-two patients (26 females and 6 males, mean age 76 years, range 44-101) were included in the study...
July 25, 2017: Injury
https://www.readbyqxmd.com/read/28739307/conservative-treatment-for-minimally-displaced-type-b-periprosthetic-femoral-fractures
#19
Young-Kyun Lee, Jung Taek Kim, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Surgical treatment has been invariably indicated for Vancouver type B periprosthetic femoral fractures (PFFs), which involve femoral diaphysis around stem. We evaluated the outcomes of nonoperative management in patients with minimally displaced type B PFFs around cementless stem. METHODS: From October 2009 to March 2016, 60 type B PFFs were treated at 1 institution. Among them, 19 minimally (<5 mm) displaced PFFs (31.7%, 19/60), which occurred around cementless stems, were treated nonsurgically with use of teriparatide...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28736126/outcomes-following-osteosynthesis-of-periprosthetic-hip-fractures-around-cemented-tapered-polished-stems
#20
S T Goudie, S Patil, J T Patton, J F Keating
We retrospectively reviewed outcomes of 79 patients with periprosthetic hip fractures around cemented tapered polished stem (CTPS) implants treated with osteosynthesis between January 1997 and July 2011. All patients underwent open reduction and fixation using a broad dynamic compression plate (DCP). Seventy two (91%) of fractures united. There were seven (9%) non-unions with failure of metal work, three (4%) as a result of infection and four (5%) due to mechanical failure. Significant subsidence (>5mm) of the implant was seen in seven (9%) of cases...
July 12, 2017: Injury
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