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Periprosthetic Fracture

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https://www.readbyqxmd.com/read/28222211/the-learning-curve-for-the-direct-anterior-approach-for-total-hip-arthroplasty-a-single-surgeon-s-first-500-cases
#1
James M Hartford, Michael J Bellino
BACKGROUND: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty. PURPOSE: The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach. METHODS: The 1st 500 primary total hip arthroplasties are reviewed. The patients were evaluated out to 3 months. Rates of major complications, reoperations, periprosthetic fractures, heterotopic ossification, leg length discrepancies and lateral femoral cutaneous nerve deficits were identified for each of 100 patients...
February 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28218379/the-corail-stem-as-a-reverse-hybrid-survivorship-and-x-ray-analysis-at-10-years
#2
Helge Wangen, Lars Nordsletten, Jens G Boldt, Anne M Fenstad, David E Beverland
BACKGROUND: The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA have been sparsely described.We report our experience of reverse hybrid THA, using the Elite plus polyethylene cemented cup together with the Corail fully hydroxyapatite-coated uncemented stem and a 28-mm alumina ceramic head. PATIENTS AND METHODS: 132 consecutive reverse hybrid hip arthroplasties were performed from January 2000 to December 2003 in 126 patients with a mean age of 54...
February 8, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28215222/nf-%C3%AE%C2%BAb-as-a-therapeutic-target-in-inflammatory-associated-bone-diseases
#3
T-H Lin, J Pajarinen, L Lu, A Nabeshima, L A Cordova, Z Yao, S B Goodman
Inflammation is a defensive mechanism for pathogen clearance and maintaining tissue homeostasis. In the skeletal system, inflammation is closely associated with many bone disorders including fractures, nonunions, periprosthetic osteolysis (bone loss around orthopedic implants), and osteoporosis. Acute inflammation is a critical step for proper bone-healing and bone-remodeling processes. On the other hand, chronic inflammation with excessive proinflammatory cytokines disrupts the balance of skeletal homeostasis involving osteoblastic (bone formation) and osteoclastic (bone resorption) activities...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28209401/the-effect-of-prophylactic-cerclage-wires-in-primary-total-hip-arthroplasty-a-biomechanical-study
#4
Andrew C Waligora, John R Owen, Jennifer S Wayne, Shane R Hess, Gregory J Golladay, William A Jiranek
BACKGROUND: Despite literature to support the use of various cerclage techniques to address intraoperative femoral fractures in total hip arthroplasty, there are limited data to support prophylactic cerclage wiring of the femur during cementless implant placement. This study aims to evaluate the effect of prophylactic calcar cerclage wires on the biomechanical parameters required to produce periprosthetic femoral fractures and on the morphology of these fracture patterns in stable cementless femoral implants...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28202208/survivorship-analysis-of-eighty-revised-hip-arthroplasties-with-the-impaction-grafting-technique-using-whole-femoral-head-allografts-with-the-articular-cartilage
#5
Ahmed Fadulelmola, Efstathios Drampalos, John Hodgkinson, Mukesh Hemmady
BACKGROUND: Acetabular impaction bone grafting aims to restore anatomy in hip revision surgery. This is an effective but expensive and time-consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. We aimed to reproduce the same results retaining the cartilage of the allograft. METHODS: Eighty acetabular revisions using impacted morselized bone graft retaining the articular cartilage and a cemented cup were studied retrospectively...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#6
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28194713/use-of-compressive-osseointegration-endoprostheses-for-massive-bone-loss-from-tumor-and-failed-arthroplasty-a-viable-option-in-the-upper-extremity
#7
Krista A Goulding, Adam Schwartz, Steven J Hattrup, R Lor Randall, Donald Lee, Damian M Rispoli, Daniel M Lerman, Christopher Beauchamp
BACKGROUND: Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. QUESTIONS/PURPOSES: (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? METHODS: A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant(®) Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28194710/exchangeable-femoral-neck-dual-modular-tha-prostheses-have-poorer-survivorship-than-other-designs-a-nationwide-cohort-of-324-108-patients
#8
Sandrine Colas, Assia Allalou, Antoine Poichotte, Philippe Piriou, Rosemary Dray-Spira, Mahmoud Zureik
BACKGROUND: Exchangeable neck stems, defined as those with a dual taper (that is, a modular junction between the femoral head and the femoral neck and an additional junction between the neck and the stem body), were introduced in THA to improve restoration of joint biomechanics (restoring anteversion, offset, and limb length) and reduce the risk of dislocation. However exchangeable necks have been reported to result in adverse effects such as stem fractures and acute local tissue reaction...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28185753/predicting-the-incremental-hospital-cost-of-adverse-events-among-medicare-beneficiaries-in-the-comprehensive-joint-replacement-program-during-fiscal-year-2014
#9
Steven D Culler, David S Jevsevar, Kevin J McGuire, Kevin G Shea, Kenneth M Little, Michael J Schlosser
BACKGROUND: The Medicare program's Comprehensive Care for Joint Replacement (CJR) payment model places hospitals at financial risk for the treatment cost of Medicare beneficiaries (MBs) undergoing lower extremity joint replacement (LEJR). METHODS: This study uses Medicare Provider Analysis and Review File and identified 674,777 MBs with LEJR procedure during fiscal year 2014. Adverse events (death, acute myocardial infarction, pneumonia, sepsis or shock, surgical site bleeding, pulmonary embolism, mechanical complications, and periprosthetic joint infection) were studied...
January 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28165600/early-periprosthetic-joint-infection-and-debridement-antibiotics-and-implant-retention-in-arthroplasty-for-femoral-neck-fracture
#10
Carl Mellner, Thomas Eisler, Björn Knutsson, Sebastian Mukka
INTRODUCTION: Periprosthetic joint infection (PJI) is a severe complication of hip arthroplasty for femoral neck fractures (FNF). Debridement, antibiotics and implant retention (DAIR) is recommended in early PJI in association with stable implants. Few studies have evaluated the outcome of DAIR in this fragile population.The purpose of this study was to analyse risk factors for PJI and the short-term outcome of DAIR in FNF patients treated with a hip arthroplasty. METHODS: A consecutive series of 736 patients (median age 81 years, 490 women, 246 men) had been treated with either a total hip arthroplasty or a hemi hip arthroplasty for a displaced FNF at our institution...
January 31, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#11
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28154993/outcome-of-extensive-varus-and-valgus-stem-alignment-in-short-stem-tha-clinical-and-radiological-analysis-using-ebra-fca
#12
Karl Philipp Kutzner, Tobias Freitag, Stefanie Donner, Mark Predrag Kovacevic, Ralf Bieger
INTRODUCTION: The principle of implanting a calcar-guided short stem consists of an individual alignment alongside the medial calcar providing the ability of reconstructing varus and valgus anatomy in a great variety. However, still, there are broad concerns about the safety of extensive varus and valgus positioning in regard to stability, bony alterations, and periprosthetic fractures. MATERIALS AND METHODS: 216 total hip arthroplasties using a calcar-guided short stem (optimys, Mathys Ltd...
February 2, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28150224/isolated-acetabular-revision-with-femoral-stem-retention-after-bipolar-hip-arthroplasty
#13
Nobuhiro Kaku, Tomonori Tabata, Hiroaki Tagomori, Hiroshi Tsumura
INTRODUCTION: In bipolar hemiarthroplasty, migration of the outer cup component into the acetabular cup, with evidence of severe osteolysis in the acetabulum, commonly occurs without loosening of the femoral component. The merits of retaining the stable femoral component in these cases have been debated. Our study aimed to determine whether revision of the acetabular component in isolation could be successfully performed. MATERIALS AND METHODS: The data of 54 patients (61 hips), 44 women, and 10 men, aged 67...
February 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28148660/results-of-the-cemented-exeter-femoral-component-in-patients-under-the-age-of-40-an-update-at-ten-to-20-years-follow-up
#14
M W J L Schmitz, E Bronsema, D C J de Kam, J W M Gardeniers, R P H Veth, B W Schreurs
AIMS: We carried out a further study of the long-term results of the cemented Exeter femoral component in patients under the age of 40 with a mean follow-up of 13.6 years (10 to 20). PATIENTS AND METHODS: We reviewed our original cohort of 104 cemented Exeter stems in 78 consecutive patients with a mean age of 31 years (16 to 39). Only one patient was lost to radiological follow-up. RESULTS: A total of six patients (eight hips) had died for reasons unrelated to their surgery...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28137262/direct-anterior-approach-for-total-hip-arthroplasty-with-a-novel-mobile-traction-table-a-prospective-cohort-study
#15
Junichi Nakamura, Shigeo Hagiwara, Sumihisa Orita, Ryuichiro Akagi, Takane Suzuki, Masahiko Suzuki, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: The purpose of this prospective cohort study was to clarify the safety and efficacy of total hip arthroplasty via the direct anterior approach in the supine position with a novel mobile traction table. METHODS: The first experience of consecutive surgeries by a single surgeon using the direct anterior approach with a traction table is described with a two-year follow-up period. Of 121 patients, 100 patients without previous hip surgeries, severe deformity, or cemented implants were divided into two groups comprising the first 50 patients and the second 50 patients...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28131684/rare-implant-specific-complications-of-the-mopyc-radial-head-prosthesis
#16
Michael Hackl, Kilian Wegmann, Thomas C Koslowsky, Felix Zeifang, Oliver Schoierer, Lars P Müller
BACKGROUND: According to currently available data, the clinical short-term results of the MoPyC radial head prosthesis (Bioprofile, Tornier, Montbonnot-Saint-Martin, France) seem favorable. However, we have encountered several implant-specific complications in recent years. Hence, this case series reports rare complications after radial head arthroplasty with the MoPyC prosthesis to make surgeons aware of their existence and to provide information about the underlying cause and possible salvage strategies...
January 25, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28131543/predictors-of-functional-recovery-following-periprosthetic-distal-femur-fractures
#17
John A Ruder, Gavin P Hart, Jeffrey S Kneisl, Bryan D Springer, Madhav A Karunakar
BACKGROUND: Treatment options for periprosthetic distal femur fractures include open reduction internal fixation (ORIF) and distal femoral replacement (DFR). The purpose of this study was to evaluate the complications, and functional recovery (ambulatory status, living situation, mortality) in patients undergoing operative treatment (DFR and ORIF) of periprosthetic distal femur fractures. METHODS: A retrospective review of 58 patients with distal femoral periprosthetic fractures treated with either ORIF or DFR was conducted...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28130016/cortical-strut-allograft-support-of-modular-femoral-junctions-during-revision-total-hip-arthroplasty
#18
Chin Tat Lim, Derek F Amanatullah, James I Huddleston, Katherine L Hwang, William J Maloney, Stuart B Goodman
BACKGROUND: There is risk of junction failure when using modular femoral stems for revision total hip arthroplasty (THA), especially with loss of bone stock in the proximal femur. Using a cortical strut allograft may provide additional support of a modular femoral construct in revision THA. METHODS: We reviewed prospectively gathered clinical and radiographic data for 28 revision THAs performed from 2004 to 2014 using cementless modular femoral components with cortical strut allograft applied to supplement proximal femoral bone loss: 5 (18%) were fluted taper designs and 23 (82%) were porous cylindrical designs All the patients had a Paprosky grade IIIA or greater femoral defect...
December 21, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28122548/conversion-to-total-hip-arthroplasty-after-failed-proximal-femoral-nail-antirotations-or-dynamic-hip-screw-fixations-for-stable-intertrochanteric-femur-fractures-a-retrospective-study-with-a-minimum-follow-up-of-3%C3%A2-years
#19
Xianshang Zeng, Ke Zhan, Lili Zhang, Dan Zeng, Weiguang Yu, Xinchao Zhang, Mingdong Zhao
BACKGROUND: Conversion to total hip arthroplasty (CTHA) is a relatively common procedure after a failed dynamic hip screw (DHS) or proximal femoral nail anti-rotation (PFNA) fixation of intertrochanteric fractures, but there have been far fewer reports specifically describing the long-term results of CTHA after failed treatments of stable intertrochanteric fractures with DHS or PFNA. The aim of the present study was to compare the clinical and radiological outcomes of CTHA after failed PFNA or DHS fixations of stable intertrochanteric fractures after a minimum follow-up of 3 years...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28121928/cementless-total-hip-arthroplasty-in-patients-with-ankylosing-spondylitis-a-retrospective-observational-study
#20
Jun Xu, Min Zeng, Jie Xie, Ting Wen, Yihe Hu
Controversies on the surgical protocols and efficacies of total hip arthroplasty (THA) in ankylosing spondylitis (AS) still exist. The aim of this study was to retrospectively analyze the perioperative managements and their outcomes related to performing THA on patients with AS.Data of 54 AS patients who underwent 81 THAs between 2008 and 2014 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical efficacy.Using posterolateral approach, cementless prostheses were selected in all cases...
January 2017: Medicine (Baltimore)
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