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Periprosthetic Fracture

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https://www.readbyqxmd.com/read/28622117/periprosthetic-femoral-fractures-in-the-emergency-department-what-the-orthopedic-surgeon-wants-to-know
#1
Richard A Marshall, Michael J Weaver, Aaron Sodickson, Bharti Khurana
Femoral fracture in the setting of a hip arthroplasty is an increasingly common complication encountered in the emergency department (ED). Diagnosis and management of periprosthetic fractures are complicated, and orthopedic surgeons rely on imaging findings to guide the appropriate management approach to the injury. Delay in identification and appropriate definitive management of periprosthetic fractures is associated with high morbidity and mortality. At present, the Vancouver classification system for periprosthetic hip fractures is the most common classification system used by orthopedic surgeons...
June 16, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28607784/use-of-nonvascularized-autologous-fibular-strut-graft-in-the-treatment-of-major-bone-defect-after-periprosthetic-knee-fracture
#2
Vincenzo Giordano, Bruno Parilha Coutinho, Mateus Kenji Miyahira, Felipe Serrão Mendes de Souza, Ney Pecegueiro do Amaral
We present the case of a patient who suffered a comminuted supracondylar periprosthetic femur fracture. The patient was an 86-year-old lady who suffered a minor fall at home and presented at our hospital with a right comminuted distal femur fracture around a total knee arthroplasty. The patient was submitted to a cruciate-sacrificing total knee replacement 6 years before at the same institution. Despite severe metaphyseal fragmentation and short distal fragment, the prosthesis was stable; thus, open fracture reduction and stabilization with internal fixation were performed...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28602532/what-is-the-difference-between-modular-and-nonmodular-tapered-fluted-titanium-stems-in-revision-total-hip-arthroplasty
#3
Yong Huang, Yixin Zhou, Hongyi Shao, Jianming Gu, Hao Tang, Qiheng Tang
BACKGROUND: Both modular and nonmodular tapered fluted titanium stems are used in revision total hip arthroplasty (THA), with follow-up showing good results for both stems. We aimed to determine whether there were any differences in clinical outcomes, survivorship, or frequency of complications. METHODS: A retrospective review of 160 consecutive THAs (153 patients) revised with a tapered fluted modular titanium stem from 2002 to 2014 and 129 consecutive THAs (128 patients) revised with a tapered fluted nonmodular titanium stem between 2008 and 2014 was conducted...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28599634/the-mayo-conservative-hip-complication-analysis-and-management-of-the-first-41-cases-performed-at-a-university-level-1-department
#4
Jörg Arnholdt, Fabian Gilbert, Marc Blank, Jannis Papazoglou, Maximilian Rudert, Ulrich Nöth, Andre F Steinert
BACKGROUND: To prevent bone loss in hip arthroplasty, several short stem systems have been developed, including the Mayo conservative hip system. While there is a plethora of data confirming inherent advantages of these systems, only little is known about potential complications, especially when surgeons start to use these systems. METHODS: In this study, we present a retrospective analysis of the patients' outcome, complications and the complication management of the first 41 Mayo conservative hips performed in 37 patients...
June 9, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28591963/-extensively-porous-coated-distal-fixation-long-stem-prosthesis-for-unstable-proximal-femur-fracture-with-complex-hip-disease
#5
Song Hong, Jia-Sheng Lin, Yong Zhou, Chang Zou, Wen-Li Zhang, Hong Duan, Chong-Qi Tu
OBJECTIVES: To evaluate the clinical results of femoral proximal fracture with complex hip diseases using an uncemented extensively porous-coated long femoral stems. METHODS: 15 cases of femoral proximal fracture with complex hip diseases treated with the uncemented extensively porous-coated long femoral stem were retrospectively reviewed. All patients were followed up at 1, 3, 6, 12 months in the first year postoperatively and once a year from the second year on...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28590378/increasing-body-mass-index-is-associated-with-worse-outcomes-after-shoulder-arthroplasty
#6
Eric R Wagner, Matthew T Houdek, Cathy Schleck, William S Harmsen, Joaquin Sanchez-Sotelo, Robert Cofield, John W Sperling, Bassem T Elhassan
BACKGROUND: Although obesity is associated with increased complication rates after lower-extremity arthroplasty, there is a relative paucity of studies examining the effect of body mass index (BMI) on shoulder arthroplasty. The purpose of this investigation was to evaluate the effect of BMI on implant survival and the rate of complications after shoulder arthroplasty. METHODS: Using an institutional total joint registry, 4,567 consecutive shoulder arthroplasty cases from 1970 to 2013 were studied...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28588662/management-of-painful-reverse-shoulder-arthroplasty
#7
REVIEW
Anders L Ekelund
Even though reverse shoulder arthroplasty is a very successful procedure, painful complications occur. During the initial postoperative years, the most common reasons for pain are instability, postoperative fracture of the acromion or spine, and periprosthetic infection. Later, aseptic loosening, with humeral loosening being more frequent that glenoid loosening, can be a source of pain and reduction in function. A careful patient history, clinical examination, plain radiographs, computed tomography and blood tests give an explanation for the pain in most cases...
July 2017: Shoulder & Elbow
https://www.readbyqxmd.com/read/28574126/radiographic-outcomes-of-cable-plate-versus-cable-grip-fixation-in-periprosthetic-fractures-of-the-proximal-femur
#8
Benjamin F Ricciardi, Scott R Nodzo, Kathryn Oi, Yuo-Yu Lee, Geoffrey H Westrich
BACKGROUND: Newer generation cable-plate designs are commonly used for periprosthetic proximal femur fractures; however, comparisons relative to cable-grips remain limited. The aim of this study was to compare radiographic healing rates of cable-plate versus cable-grip fixation for periprosthetic proximal femur fractures. PATIENTS AND METHODS: Consecutive patients with an acute or chronic Vancouver A, B1, or B2 periprosthetic proximal femur fracture undergoing trochanteric fixation with a cable-plate (n = 46 cases) or cable-grip (n = 24 cases) system were identified retrospectively from a single-centre hospital database (mean follow-up 28 months [range 6-89 months])...
May 23, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28574123/orthogonal-plating-of-vancouver-b1-and-c-type-periprosthetic-femur-fracture-nonunions
#9
Christopher E Birch, Michael Blankstein, Jesse D Chlebeck, Craig S Bartlett Rd
BACKGROUND: Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). METHODS: A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015...
May 27, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28567225/clinical-outcomes-and-complications-during-the-learning-curve-for-reverse-total-shoulder-arthroplasty-an-analysis-of-the-first-40-cases
#10
Chul-Hyun Cho, Kwang-Soon Song, Tae-Won Koo
BACKGROUND: The purpose of this study was to investigate the results and complications during the learning curve of reverse total shoulder arthroplasty (RTSA) for rotator cuff deficiency. METHODS: We retrospectively reviewed the first 40 cases of RTSA performed by a single surgeon. The mean age of patients was 72.7 years (range, 63 to 81 years) and mean follow-up period was 26.7 months (range, 9 to 57 months). Clinical outcomes were evaluated using a visual analog scale (VAS) for pain, the University of California at Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeon (ASES) score, subjective shoulder value (SSV), and active range of motion (ROM)...
June 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28567150/cortical-fenestration-for-megaprosthesis-stem-revision
#11
Vincent Y Ng, Philip Louie, Stephanie Punt, Ernest U Conrad Iii
BACKGROUND: The most common modes of failure for megaprostheses are aseptic loosening followed by periprosthetic infection and stem fracture. Surgical technique for bone and implant exposure is controversial and may influence the success of revision and the need for additional future revisions. The purpose of this study was to evaluate the effectiveness of cortical fenestration for megaprosthesis revision, particularly for stem fracture. METHODS: From 1985-2014, 196 adult and pediatric patients underwent limb salvage with a distal femoral or proximal tibial megaprosthesis (109 cemented, 87 pressfit)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28566786/short-and-mid-term-results-of-revision-total-knee-arthroplasty-with-global-modular-replacement-system
#12
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/28566392/mid-term-results-of-the-biolox-delta-ceramic-on-ceramic-total-hip-arthroplasty
#13
Y K Lee, Y C Ha, J-I Yoo, W L Jo, K-C Kim, K H Koo
AIMS: We conducted a prospective study of a delta ceramic total hip arthroplasty (THA) to determine the rate of ceramic fracture, to characterise post-operative noise, and to evaluate the mid-term results and survivorship. PATIENTS AND METHODS: Between March 2009 and March 2011, 274 patients (310 hips) underwent cementless THA using a delta ceramic femoral head and liner. At each follow-up, clinical and radiological outcomes were recorded. A Kaplan-Meier analysis was undertaken to estimate survival...
June 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28558347/total-hip-prosthesis-complication-periprosthetic-infection-with-external-fistulizing-due-to-enterobacter-cloacae-complex-multiple-drugs-resistance-a-clinical-case-report
#14
V Amorese, M Corda, M Donadu, D Usai, F Pisanu, F Milia, F Marras, A Sanna, D Delogu, V Mazzarello, G Manzoni, M Conti, G B Meloni, S Zanetti, C Doria
INTRODUCTION: The Enterobacter cloacae is a microorganism found in the intestinal flora of the majority of animals, including humans. Primary infections caused by E. cloacae are rare in immunocompetent patients, but are very common in hospital settings in newborns and immunocompromised patients, and can be aggravated by the insurgence of antibiotic resistance. The incidence of periprosthetic hip infections is just below 2%. CASE PRESENTATION: A 76year old woman with multiple comorbidities underwent surgical implantation of intermediary total hip prosthesis of the left hip, in a different health facility, in February 2014, after the basicervical fracture of the upper femur extremity due to trauma...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28553451/the-use-of-dual-reconstruction-plates-for-failed-fixation-of-patellar-fracture-after-total-knee-replacement-a-case-report
#15
P Sa-Ngasoongsong, K Chulsomlee, S Wongsak, C Suphachatwong, V Kawinwonggowit
Patellar fracture after total knee replacement (TKR) is one of the challenging problems in periprosthetic fracture. Open reduction with internal fixation (ORIF), as tension band wiring (TBW), usually required in cases with extensor mechanism disruption. However, many studies reported a high failure rate after using this technique. In this report, we presented an interesting case of periprosthetic patellar fracture after TKR with TBW failure that was successfully treated with double non-locking reconstruction plates fixation and TBW augmentation...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28552661/30years-of-dxa-technology-innovations
#16
Claus-C Glüer
As the successor of Dual Photon Absorptiometry (DPA), Dual X-ray Absorptiometry (DXA) has seen 30years of continuous technological innovations. Implementation of measures for standardization and quality assurance made DXA a reliable and clinically useful approach. Its use in clinical multicenter drug studies in osteoporosis lead to general acceptance as the standard technique of bone densitometry. The limitations of DXA are well established. As a measure of areal bone mineral density (aBMD) it depends on bone size and is biased by overlaying soft tissue and calcified structures...
May 24, 2017: Bone
https://www.readbyqxmd.com/read/28552443/trochanteric-fixation-with-a-third-generation-cable-plate-system-an%C3%A2-independent-experience
#17
Andrew D Stewart, Hesham Abdelbary, Paul E Beaulé
BACKGROUND: Greater trochanteric fracture/nonunion can be a devastating complication with significant functional impact after total hip arthroplasty, and their fixation remains a challenge because of the significant forces being transmitted as well as the poor bone quality often associated with these fractures. The objective of this study is to investigate the rates of reoperation and trochanteric nonunion using a third-generation cable-plate system at one center. METHODS: Thirty-five patients, mean age 72...
April 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28550971/case-report-a-10-years-follow-up-of-periprosthetic-femoral-fracture-after-total-hip-arthroplasty-in-osteopetrosis
#18
Zhan-Feng Zhang, Dan Wang, Li-Dong Wu, Xue-Song Dai
Osteopetrosis is an inherited disorder characterized by increased bone density and brittle bone quality. Degenerative changes often occur after the age of 40 in patients with osteopetrosis. Operative intervention is the primary treatment option if the clinical manifestation of secondary osteoarthritis is severe. A 44-year-old male suffering autosomal dominant osteopetrosis and progressive unilateral hip osteoarthritis required a total hip arthroplasty. However, there were several technical challenges associated with this procedure including creating a femoral medullary canal and developing a Vancouver type B2 periprosthetic femoral fracture postoperatively...
May 10, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28545174/causes-and-clinical-outcomes-of-revision-total-knee-arthroplasty
#19
Dong-Hyun Lee, Seung-Hun Lee, Eun-Kyoo Song, Jong-Keun Seon, Hong-An Lim, Hong-Yeol Yang
Purpose: The purpose of this study was to evaluate causes and clinical outcomes of revision total knee arthroplasty (TKA) with a minimum 2-year follow-up. Materials and Methods: We performed a retrospective review on the records of 225 revision TKAs performed from 2003 to 2012 at a single institution. Finally, 206 cases were conducted. To evaluate clinical outcomes, we checked the range of motion (ROM), Knee Society (KS) score, Hospital for Special Surgery (HSS) score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score preoperatively, 6 months postoperatively and yearly thereafter and complications after revision TKA...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28537800/advanced-mri-techniques-for-the-hip-joint-focus-on-the-postoperative-hip
#20
Jennifer L Berkowitz, Hollis G Potter
OBJECTIVE: Imaging the hip joint with optimized MRI protocol parameters provides the radiologist with the ability to reliably diagnose complex hip abnormalities. The institution of appropriate metal artifact reduction techniques and dedicated sequences can enhance visualization of the periprosthetic bone and soft tissues and allow improved detection of the more frequently encountered total hip arthroplasty-related conditions, such as mechanical loosening, polyethylene wear, and adverse local tissue reactions...
May 24, 2017: AJR. American Journal of Roentgenology
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