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Revision arthroplasty

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https://www.readbyqxmd.com/read/28097416/-use-of-dual-mobility-cups-for-revision-hip-arthroplasty
#1
E Röhner, G Matziolis
The dual mobility cup (DMC) is an increasingly important tool not only in primary but also in revision total hip arthroplasty to prevent dislocation and eventually reduce postoperative complication rates. Various studies have shown survival rates with DMCs of up to 100% with an average dislocation rate of less than 1.5% after primary hip arthroplasty and a follow-up of 10 years. In revision surgery, survival rates of up to 99% were reported with dislocation rates between 0 and 10% after an average of 5 years after implantation...
January 17, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28097117/cobalt-intoxication-heart-failure-after-revision-total-hip-replacement-for-ceramic-head-fracture-a-case-report
#2
Chul-Ho Kim, Young Hyun Choi, Mi Yeon Jeong, Jae Suk Chang, Pil Whan Yoon
In 1960s, toxic heart failure due to cobalt poisoning was firstly reported from Canadian industrial worker. Following development of bearing materials in hip arthroplasties, using cobalt-chrome alloy in bearing surface, there were rarely reported of systemic affect toxic cobaltism include toxic heart failure due to articulation wear in Western countries. It could be happened more easily by third body wear from ceramic particle especially revision total hip replacement (THR) surgery using cobalt-chrome alloy following ceramic articulation breakage which index surgery performed by ceramic on ceramic bearing...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28097115/granulomatous-lung-disease-a-novel-complication-following-metallosis-from-hip-arthroplasty
#3
Theodoros Balbouzis, Thomas Georgiadis, Peter Grigoris
A case of a female patient with local and systemic complications of metallosis, following catastrophic wear of a revised hip arthroplasty, is presented. The patient had a history of a fractured ceramic-on-ceramic implant, exchanged with a metal-on-polyethylene prosthesis. Systemic complications included sarcoidosis-like reactions, presenting as granulomatous lung disease, along with chorioretinitis, erythema nodosum, and cardiomyopathy. High local and circulating cobalt and chromium levels established the diagnosis...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28095724/reverse-hybrid-total-hip-arthroplasty
#4
Helge Wangen, Leif I Havelin, Anne M Fenstad, Geir Hallan, Ove Furnes, Alma B Pedersen, Søren Overgaard, Johan Kärrholm, Göran Garellick, Keijo Mäkelä, Antti Eskelinen, Lars Nordsletten
Background and purpose - 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. The Nordic Arthroplasty Register Association (NARA) has already published 2 papers describing results of reverse hybrid THAs in different age groups. Based on data collected over 2 additional years, we wanted to perform in depth analyses of not only the reverse hybrid concept but also of the different cup/stem combinations used...
January 18, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28091802/increased-risk-of-revision-reoperation-and-implant-constraint-in-tka-after-multiligament-knee-surgery
#5
Steven I Pancio, Paul L Sousa, Aaron J Krych, Matthew P Abdel, Bruce A Levy, Diane L Dahm, Michael J Stuart
BACKGROUND: The risk of major complications and revision arthroplasty after TKA in patients who previously underwent multiligament knee surgery have been poorly characterized. QUESTIONS/PURPOSES: Is multiligament knee surgery before TKA associated with (1) worse implant survival, (2) increased use of TKA design constraint, (3) a greater risk for major complications, and (4) poorer scores for pain and function compared with similar patients receiving TKA for primary osteoarthritis? METHODS: Fifty-nine TKAs were performed at our institution between 1985 and 2014 in 59 patients (36 men, 23 women; mean age, 53 years) with a history of previous multiligament knee surgery (≥ two ligaments)...
January 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28089827/plication-of-the-posterior-capsule-for-intraoperative-posterior-instability-during-anatomic-total-shoulder-arthroplasty
#6
Eduard Alentorn-Geli, Andrew T Assenmacher, John W Sperling, Robert H Cofield, Joaquín Sánchez-Sotelo
BACKGROUND: Restoration of soft tissue balance for intraoperative posterior instability during anatomic total shoulder arthroplasty (TSA) is particularly difficult. The effectiveness of posterior capsular plication (PCP) in restoring soft tissue balance is largely unknown. The purpose of this study was to report the outcomes, complications, and reoperations of primary TSA in which a PCP was performed to correct excessive intraoperative posterior subluxation. METHODS: Thirty-eight shoulders (37 patients) underwent PCP for intraoperative posterior instability during anatomic TSA...
January 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089825/clinical-and-radiographic-outcome-of-revision-surgery-of-total-elbow-prosthesis-midterm-results-in-19-cases
#7
Jetske Viveen, Ante Prkic, Koen L M Koenraadt, Izaäk F Kodde, Bertram The, Denise Eygendaal
BACKGROUND: The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty. METHODS: All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#8
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28087166/future-surgery-after-revision-shoulder-arthroplasty-the-impact-of-unexpected-positive-cultures
#9
Eric M Padegimas, Cassandra Lawrence, Alexa C Narzikul, Benjamin M Zmistowski, Joseph A Abboud, Gerald R Williams, Surena Namdari
BACKGROUND: The clinical implications and treatment of unexpected positive cultures (UPCs) in revision shoulder arthroplasty are not well defined. The purpose of this study was to describe results of patients with and without UPCs after revision shoulder arthroplasty. METHODS: A single institutional database was used to retrospectively identify all revision shoulder arthroplasties performed between January 1, 2011, and December 31, 2013. Patients with preoperative suspicion of infection were excluded...
January 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087160/mri-retrieval-analysis-and-histologic-evaluation-of-adverse-local-tissue-reaction-in-metal-on-polyethylene-total-hip-arthroplasty
#10
Scott R Nodzo, Christina I Esposito, Hollis G Potter, Chitranjan S Ranawat, Timothy M Wright, Douglas E Padgett
BACKGROUND: The severity and location of adverse local tissue reaction (ALTR) seen in metal-on-polyethylene total hip arthroplasty (THA) is not well described. METHODS: We retrospectively reviewed the records of patients who underwent a revision THA using our biomechanics database. We included all patients who underwent revision surgery for the diagnosis of ALTR with THA implants that had modularity solely at the head-neck junction and excluded patients with implant modularity at sites other than the head-neck junction...
December 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28079735/incidence-of-local-anesthetic-systemic-toxicity-in-orthopedic-patients-receiving-peripheral-nerve-blocks
#11
Eva E Mörwald, Nicole Zubizarreta, Crispiana Cozowicz, Jashvant Poeran, Stavros G Memtsoudis
BACKGROUND AND OBJECTIVES: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28078363/short-term-outcome-after-total-hip-arthroplasty-using-dual-mobility-cup-report-from-lithuanian-arthroplasty-register
#12
Sarunas Tarasevicius, Alfredas Smailys, Kazimieras Grigaitis, Otto Robertsson, Justinas Stucinskas
PURPOSE: The purpose of the study was to investigate how the use of dual-mobility cups (DMCs) affected the risk of revision due to dislocation as well as overall risk of revision compared with a conventional total hip arthroplasty (THA) system in the short term. METHODS: A total of 12,657 primary THAs were registered from the start of 2011 to the end of 2014. 620 THAs were with DMCs. For comparison, we included all registered THAs with Exeter cup and a cemented Exeter stem combined with 28-mm femoral head...
January 12, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28078362/use-of-dual-mobility-cup-in-revision-hip-arthroplasty-reduces-the-risk-for-further-dislocation-analysis-of-seven-hundred-and-ninety-one-first-time-revisions-performed-due-to-dislocation-reported-to-the-swedish-hip-arthroplasty-register
#13
Maziar Mohaddes, Peter Cnudde, Ola Rolfson, Alexander Wall, Johan Kärrholm
PURPOSE: Dislocation after total hip arthroplasty (THA) is a common reason for revision. The last decade fostered a significant increase in the use of dual-mobility cups (DMCs). Here we report our study on the short-term survival rate of a cemented DMC reported to the Swedish Hip Arthroplasty Register (SHAR) compared with other cemented designs used in first-time revision due to dislocation. METHODS: During 2005-2015, 984 first-time revisions for dislocation were reported to SHAR...
January 11, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28077394/metal-backed-versus-all-polyethylene-unicompartmental-knee-arthroplasty-proximal-tibial-strain-in-an-experimentally-validated-finite-element-model
#14
C E H Scott, M J Eaton, R W Nutton, F A Wade, S L Evans, P Pankaj
OBJECTIVES: Up to 40% of unicompartmental knee arthroplasty (UKA) revisions are performed for unexplained pain which may be caused by elevated proximal tibial bone strain. This study investigates the effect of tibial component metal backing and polyethylene thickness on bone strain in a cemented fixed-bearing medial UKA using a finite element model (FEM) validated experimentally by digital image correlation (DIC) and acoustic emission (AE). MATERIALS AND METHODS: A total of ten composite tibias implanted with all-polyethylene (AP) and metal-backed (MB) tibial components were loaded to 2500 N...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28074774/the-dair-debridement-antibiotics-and-implant-retention-procedure-for-infected-total-knee-replacement-a-literature-review
#15
Sultan Naseer Qasim, Andrew Swann, Robert Ashford
Prosthetic joint infection (PJI) is a devastating complication in total knee arthroplasty (TKA) and third most common cause of revision of TKA with significant morbidity and surgical challenges. Treatment options include non-operative measures with long term antibiotic suppression, debridement and implant retention (DAIR), one- or two-stage revision arthroplasty, arthrodesis and amputation. Implant retention without infection is ideal and DAIR has been reported to have variable success rates depending on patient factors, duration of infection, infecting micro-organisms, choice of procedure, single or multiple debridement procedures, arthroscopic or open, antibiotic choice and duration of antibiotic use...
2017: SICOT-J
https://www.readbyqxmd.com/read/28074234/-biological-downsizing-acetabular-defect-reconstruction-in-revision-total-hip-arthroplasty
#16
S Koob, S Scheidt, T M Randau, M Gathen, M D Wimmer, D C Wirtz, S Gravius
BACKGROUND: Periacetabular bony defects remain a great challenge in revision total hip arthroplasty. After assessment and classification of the defect and selection of a suitable implant the primary stable fixation and sufficient biological reconstitution of a sustainable bone stock are essential for long term success in acetabular revision surgery. Biological defect reconstruction aims for the down-sizing of periacetabular defects for later revision surgeries. TECHNIQUE: In the field of biological augmentation several methods are currently available...
January 10, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28073139/-influence-of-comorbidities-on-revision-rate-within-the-first-year-after-primary-total-hip-arthroplasty
#17
Roman Nesslage, Kerstin Radtke, Lisa Hohloch, Thilo Flörkemeier, Henning Windhagen, Gabriela von Lewinski
: Background Total hip arthroplasty (THA) is very frequently performed. Despite low complication rates, revisions play an important clinical and economical role. The aim of this study was to identify comorbid diseases of patients undergoing primary THA and their potential influence on the survival of hip replacements. Patients/Material and Methods A total of 867 patients were included in this retrospective study. All revisions were reviewed that took place at our hospital within one year of primary implantation of THA...
January 10, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28072898/three-year-results-with-a-ringless-third-generation-porous-plasma-sprayed-acetabular-component-in-primary-total-hip-arthroplasty
#18
Keith R Berend, Joanne B Adams, Michael J Morris, Adolph V Lombardi
INTRODUCTION: We previously reported promising early results in patients undergoing primary total hip arthroplasty (THA) with a third-generation cementless acetabular system that has a porous plasma-sprayed coating on a titanium alloy substrate shell, a ringless barb and groove locking mechanism, and a vitamin E-infused highly crosslinked polyethylene insert. The purpose of this study was to examine the outcomes and need for revision in a subset of patients previously reviewed who now have potential for three-year follow-up...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28070650/revision-total-knee-arthroplasty-due-to-bone-cement-and-metal-hypersensitivity
#19
Ioannis P Stathopoulos, Nicolaos Andrianopoulos, Dimitrios Paschaloglou, Ioannis Tsarouchas
INTRODUCTION: Hypersensitivity to implants is a rare complication of total knee arthroplasty (TKA). Metal and, less frequently, bone cement can produce allergic symptomatology that if unresponsive to conservative treatment could lead to revision. MATERIALS AND METHODS: We present the case of a patient with generalized pruritus and metal taste starting during the first postoperative month after TKA. Dermal allergy exams revealed that the patient had hypersensitivity to nickel sulphate and cobalt chloride and bone cement...
January 9, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#20
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
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