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Periprosthetic Fracture

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https://www.readbyqxmd.com/read/27926677/transfemoral-amputation-after-failure-of-knee-arthroplasty-a-nationwide-register-based-study
#1
Tinne B Gottfriedsen, Henrik M Schrøder, Anders Odgaard
BACKGROUND: Transfemoral amputation is considered the last treatment option for failed knee arthroplasty. The extent to which this procedure is performed is not well known. The purpose of this study was to identify the incidence and causes of amputation following failure of knee arthroplasty in a nationwide population. METHODS: Data were extracted from the Danish Civil Registration System, the Danish National Patient Register, and the Danish Knee Arthroplasty Register...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27917354/results-of-a-hydroxyapatite-coated-femoral-stem-corail-in-chinese-a-minimum-10-year-follow-up
#2
Jianda Xu, Zikang Xie, Jianning Zhao, Yi Gao, Hong Zhao, Libo Peng, Yuxing Qu
BACKGROUND: Due to the adverse effects of cemented hip arthroplasty, uncemented stems with hydroxyapatite (HA) coating reduces these risks and enhanced integration. The concept of an extensive HA coating for the fixation of a tapered femoral stem (Corail(®)) was introduced, which can achieve durable biological fixation and preserve normal periprosthetic bone activity. Here we describe the clinical and radiological outcome in patients with the Corail(®) stem. METHODS: 92 total hip replacements in 81 patients using the Corail(®) stem were followed-up...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27909122/femoral-impaction-bone-grafting-in-revision-hip-arthroplasty-705-cases-from-the-originating-centre
#3
M J Wilson, S Hook, S L Whitehouse, A J Timperley, G A Gie
AIMS: Femoral impaction bone grafting was first developed in 1987 using morselised cancellous bone graft impacted into the femoral canal in combination with a cemented, tapered, polished stem. We describe the evolution of this technique and instrumentation since that time. PATIENTS AND METHODS: Between 1987 and 2005, 705 revision total hip arthroplasties (56 bilateral) were performed with femoral impaction grafting using a cemented femoral stem. All surviving patients were prospectively followed for a mean of 14...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27898357/catastrophic-metallosis-after-tumoral-knee-prosthesis-failure-a-case-report
#4
Luca La Verde, Domenico Fenga, Maria Silvia Spinelli, Francesco Rosario Campo, Michela Florio, Michele Attilio Rosa
INTRODUCTION: Metallosis is a condition characterized by an infiltration of periprosthetic soft tissues and bone by metallic debris resulting from wear or failure of joint arthroplasties. PRESENTATION OF CASE: Authors describe a case of a 45-year-old man treated for an osteosarcoma of the distal femur with a modular prosthesis when he was 18 years old, he developed massive metallosis with skin dyspigmentation after 17 years. His medical\surgical history was remarkable for a left tumoral knee prosthesis implanted 21 years ago...
November 18, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27895366/intra-operative-implantation-errors-during-austin-moore-hemiarthroplasty
#5
Zohaib Gulzar Naqvi, Javed Ali Markhand, Syed Kamran Ahmed, Amin Chinoy, Mansoor Ali Khan
Austin Moore hemiarthroplasty is an established treatment in elderly patients with neck of femur fractures. Being commonly performed, it is also associated with several technical errors of implantation which results in complications and failure requiring revision surgery. This retrospective pre- and post-operative radiographic study to determine the frequency of technical errors was conducted at the Indus Hospital, Karachi, and comprised data of 50 patients who underwent Austin Moore hemiarthroplasty between January and November 2016...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27890690/successful-outcome-with-minimally-invasive-plate-osteosynthesis-for-periprosthetic-tibial-fracture-after-total-knee-arthroplasty
#6
Hee-June Kim, Ki-Chul Park, Joon-Woo Kim, Chang-Wug Oh, Hee-Soo Kyung, Jong-Keon Oh, Kyeong-Hyeon Park, Seong-Dae Yoon
INTRODUCTION: The incidence of periprosthetic fracture after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fracture, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The purpose of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) technique with locking plates for periprosthetic tibial fractures after TKA...
November 24, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27889849/principles-of-managing-vancouver-type-b-periprosthetic-fractures-around-cemented-polished-tapered-femoral-stems
#7
REVIEW
Conal Quah, Matthew Porteous, Arthur Stephen
The management of periprosthetic fractures around total hip replacements is a complex and challenging problem. Getting it right first time is an important factor in reducing the morbidity, mortality and financial burden associated with these injuries. Understanding and applying the basic principles of fracture management helps increase the chance of successful treatment. Based on these principles, we suggest a treatment algorithm for managing periprosthetic fractures around polished tapered femoral stems.
November 26, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27889839/what-is-the-fate-of-the-neck-after-a-collum-femoris-preserving-prosthesis-a-nineteen-years-single-center-experience
#8
Matteo Formica, Luca Cavagnaro, Marco Basso, Andrea Zanirato, Augusto Palermo, Lamberto Felli
PURPOSE: The aim of our study is to evaluate long-term outcomes from a cohort of patients treated with collum femoris preserving (CFP) stem correlating neck resorption with comorbidities, clinical outcomes, and complications. METHODS: One hundred seventy-six patients (194 hips) were retrospectively reviewed with a minimum follow-up (f.u.) of ten years. Demographic and surgical data were collected. Clinical and radiological evaluation was performed at the last follow up...
November 26, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27886355/acetabular-spacers-in-2-stage-hip-revision-is-it-worth-it-a-single-centre-retrospective-study
#9
Giorgio Burastero, Marco Basso, Giuliana Carrega, Luca Cavagnaro, Francesco Chiarlone, Carlo Salomone, Gabriele Papa, Lamberto Felli
PURPOSE: The aim of this work is to evaluate an acetabular antibiotic loaded bone cement spacer in 2-stage revision surgery as a potential approach able to reduce complications during the inter-stage period (i.e. dislocation, acetabular wear), as well as simplify 2-stage hip revision surgery and improve hip biomechanics. METHODS: We performed a retrospective comparative study and evaluated clinical, radiological and surgical data of 71 patients affected by periprosthetic hip infection who were treated with 2-stage exchange...
November 25, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27874910/short-versus-long-cephalomedullary-nails-for-pertrochanteric-hip-fracture
#10
Nicholas B Frisch, Nickolas J Nahm, Jad G Khalil, Clifford M Les, Stuart T Guthrie, Michael A Charters
This study compared patients who underwent treatment with short or long cephalomedullary nails with integrated cephalocervical screws and linear compression. Patients with AO/OTA 31-A2 or A3 pertrochanteric fractures treated with either short (n=72) or long (n=97) InterTAN (Smith & Nephew, Memphis, Tennessee) cephalomedullary nails were reviewed. Information on perioperative measures (estimated blood loss, surgical time, and fluoroscopy time) and postoperative orthopedic complications (infection, implant failure, screw cutout, and periprosthetic femur fracture) was included...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27866949/perioperative-periprosthetic-fractures-associated-with-primary-total-hip-arthroplasty
#11
Kwan J Park, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Periprosthetic fracture (PPF) is a rare but devastating complication of primary total hip arthroplasty (THA). While PPF is associated with increased morbidity and mortality, early revision rate, and poor patient outcome, there is a paucity of data on patient and hospital-dependent risk factors. Using a large administrative database, we investigated epidemiology and the risk factors associated with perioperative PPF after primary THA. METHODS: We performed a retrospective review of the National Inpatient Sample records from 2006 to 2011 and identified 1062 PPFs of 1,187,969 patients using International Classification of Diseases, Ninth Revision code for PPF (996...
August 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27822001/osteomyelitis-recent-advances-in-pathophysiology-and-therapeutic-strategies
#12
REVIEW
Mitchell C Birt, David W Anderson, E Bruce Toby, Jinxi Wang
This review article summarizes the recent advances in pathogenic mechanisms and novel therapeutic strategies for osteomyelitis, covering both periprosthetic joint infections and fracture-associated bone infections. A better understanding of the pathophysiology including the mechanisms for biofilm formation has led to new therapeutic strategies for this devastating disease. Research on novel local delivery materials with appropriate mechanical properties, lower exothermicity, controlled release of antibiotics, and absorbable scaffolding for bone regeneration is progressing rapidly...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27821999/early-results-of-the-lps%C3%A2-limb-preservation-system-in-the-management-of-periprosthetic-femoral-fractures
#13
M Curtin, C Bryan, E Murphy, C G Murphy, W Curtin
INTRODUCTION: Achieving skeletal fixation in the presence of progressive bone loss is a surgical challenge, especially in cases of periprosthetic fracture (PPF). Unpredictable fracture patterns and preexisting bone loss frequently combine in this patient group. Megaprosthetic arthroplasty allows for immediate mobilisation and shorter periods of rehabilitation. We describe the clinical outcomes of a cohort of LPS™ megaprostheses performed for PPF by a single surgeon at our institution...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27818985/bilateral-distal-femoral-fracture-after-total-knee-arthroplasty
#14
Fabrício Bolpato Loures, Jorge Rafael Wenck Motta, Rodrigo Sattamini Pires E Albuquerque, João Maurício Barretto, Naason Trindade Cavanellas
The number of total knee arthroplasties has increased exponentially and their indications have been expanded. This procedure presents challenging complications for orthopedic surgeons that are potentially catastrophic for patients. Here, a rare case of simultaneous bilateral periprosthetic fracture of the knee is reported, with discussion of the causal factors, possible management and prophylaxis.
September 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/27815952/incidence-of-distal-femoral-periprosthetic-fractures-after-total-knee-arthroplasty
#15
Tyler Welch, Richard Iorio, Andrew J Marcantonio, Michael S H Kain, John F Tilzey, Lawrence M Specht, William L Healy
BACKGROUND: The incidence of distal femoral periprosthetic fractures associated with total knee arthroplasty (TKA) has been reported as 0.3% to 2.5%. This study examined the incidence of distal femoral periprosthetic fractures at one hospital over a 16-year period. We hypothesized that the incidence of these fractures would be lowered after the introduction of lugged femoral implants and insertion of a distal femoral intramedullary bone graft during TKA. METHODS: From 1994 to 2010, 4,943 primary TKAs were performed...
November 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27812774/optimum-stem-length-for-mitigation-of-periprosthetic-fracture-risk-following-primary-total-knee-arthroplasty-a-finite-element-study
#16
Noel Conlisk, Colin R Howie, Pankaj Pankaj
PURPOSE: Due to age-related changes to the material properties and thinning of the cortical bone structure, older patients with osteoporosis may be at greater risk of femoral fracture following total knee arthroplasty. This study investigates whether there is a potential role for stemmed prostheses in such scenarios to help mitigate peri-implant fracture risk, and if so what should the optimum stem length be to balance surgical bone loss with reduced fracture risk. METHODS: Finite element models of the distal femur implanted with four different implant types: a posterior stabilising implant, a total stabilising implant with short stem (12 mm × 50 mm), a TS implant with medium stem (12 mm × 75 mm), and a TS implant with long stem (12 mm × 100 mm), were developed and analysed in this study...
November 3, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/27810265/effect-of-smoking-on-complications-following-primary-shoulder-arthroplasty
#17
Taku Hatta, Jean-David Werthel, Eric R Wagner, Eiji Itoi, Scott P Steinmann, Robert H Cofield, John W Sperling
BACKGROUND: The purpose of this study was to examine the effect of smoking on the incidence of complications after primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). METHODS: All patients who underwent primary TSA or RSA at our institution between 2002 and 2011 and had a minimum 2-year follow-up were included. Smoking status was assessed at the time of surgery. Current smokers, former smokers, and nonsmokers were compared for periprosthetic infection, fractures (intraoperative and postoperative), and loosening after surgery...
October 31, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27803224/periprosthetic-fractures-associated-with-total-knee-arthroplasty-an-update
#18
S Konan, N Sandiford, F Unno, B S Masri, D S Garbuz, C P Duncan
Fractures around total knee arthroplasties pose a significant surgical challenge. Most can be managed with osteosynthesis and salvage of the replacement. The techniques of fixation of these fractures and revision surgery have evolved and so has the assessment of outcome. This specialty update summarises the current evidence for the classification, methods of fixation, revision surgery and outcomes of the management of periprosthetic fractures associated with total knee arthroplasty. Cite this article: Bone Joint J 2016;98-B:1489-96...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27803221/five-year-outcome-of-proximal-femoral-endoprosthetic-arthroplasty-for-non-tumour-indications
#19
G Grammatopoulos, A Alvand, H Martin, D Whitwell, A Taylor, C L M H Gibbons
OBJECTIVES: A possible solution for the management of proximal femoral bone loss is a modular femoral endoprosthesis (EPR). Although the outcome of EPRs in tumour surgery has been well described, the outcome of their use in revision hip surgery has received less attention. The aim of this study was to describe the outcome of using EPR for non-neoplastic indications. METHODS: A retrospective review of 79 patients who underwent 80 EPRs for non-neoplastic indications was performed, including the rates of complication and survival and the mean Oxford Hip Scores (OHS), at a mean of five years post-operatively...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27800574/periprosthetic-occult-fractures-of-the-acetabulum-occur-frequently-during-primary-tha
#20
Kazuhiro Hasegawa, Tamon Kabata, Yoshitomo Kajino, Daisuke Inoue, Hiroyuki Tsuchiya
BACKGROUND: Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery. QUESTIONS/PURPOSES: In this study, using routine CT scans that were obtained as part of another primary hip arthroplasty study protocol, we retrospectively assessed (1) the prevalence of occult fractures of the acetabulum occurring during primary THA, (2) the location of occult fractures of the acetabulum during THA, and (3) risk factors contributing to such occult fractures...
October 31, 2016: Clinical Orthopaedics and related Research
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