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Revision arthroplasty

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https://www.readbyqxmd.com/read/28342695/in%C3%A2-vivo-serum-concentration-of-vancomycin-in-antibiotic-loaded-acrylic-cement-for-the-treatment-and-prevention-of-periprosthetic-hip-infection
#1
Kenichi Oe, Hirokazu Iida, Narumi Ueda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: Although antibiotic-loaded acrylic cement (ALAC) is used to prevent and treat periprosthetic hip infection, it is unknown how much antibiotic is deposited in the body in vivo, how high the serum concentration rises, or how long its effects last. The aim of this study was firstly to determine the amount of vancomycin (VCM) deposited as ALAC in the body, and secondly to assess the safety and drug elution profile of VCM in ALAC. METHODS: We administered VCM to prevent infection after total hip arthroplasty (THA) or to treat patients with methicillin-resistant Staphylococcus aureus...
March 22, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28339315/identification-of-asymptomatic-prosthetic-joint-infection-microbiologic-and-operative-treatment-outcomes
#2
Przemysław L Bereza, Alicja Ekiel, Aleksandra Auguściak-Duma, Małgorzata Aptekorz, Iwona Wilk, Piotr Wojciechowski, Damian J Kusz, Gayane Martirosian
BACKGROUND: This prospective study investigated the role of mechanical and biological factors in aseptic implant loosening or presumed silent prosthetic joint infection (PJI). METHODS: Thirty-seven patients were investigated. Microbiologic and molecular methods were used to detect bacteria on the surface of the failed implants removed during revision arthroplasty. Histopathologic analysis was performed. The influence of body mass index (BMI) and various co-morbidities on implant failure also was determined...
March 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28337731/arthroplasty-registries-around-the-world-valuable-sources-of-hip-implant-revision-risk-data
#3
REVIEW
Richard E Hughes, Aditi Batra, Brian R Hallstrom
PURPOSE OF REVIEW: National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337536/functional-and-patient-reported-outcomes-of-the-swanson-metacarpo-phalangeal-arthroplasty-in-the-rheumatoid-hand
#4
Firas K Elherik, Sean Dolan, John Antrum, Frank Unglaub, Colin R Howie, Steffen J Breusch
INTRODUCTION: Replacement of the metacarpo-phalangeal joints (MCPJ) with silastic Swanson's implants can help decrease pain, stiffness and allow for improved function in rheumatoid arthritis (RA). There is a lack of patient reported outcome measure (PROM) studies assessing the efficacy of this procedure in RA. The aim of this study was to report any change in function, pain, stiffness and satisfaction following the Swanson MCPJ replacement using patient reported outcomes in a rheumatoid population...
March 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28336251/distal-extension-of-the-anterior-approach-to-the-hip-using-the-femoral-interbundle-technique-surgical-technique-and-case-series
#5
Stijn G M Ghijselings, Ronald Driesen, Jean-Pierre Simon, Kristoff Corten
BACKGROUND: The direct anterior approach (DAA) is becoming more popular as the standard surgical approach for primary total hip arthroplasty. However, it has been associated with an increased incidence of intraoperative femoral fractures in particular during the learning curve. Distal extension of the approach may be needed in case of intraoperative complications. The aim of the present study is to describe the distal extension of the DAA using the femoral interbundle technique. METHODS: A stepwise approach based on a cadaveric study to extend the DAA distally is presented...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28336249/current-epidemiology-of-revision-total-hip-arthroplasty-in-the-united-states-national-inpatient-sample-2009-to-2013
#6
Chukwuweike U Gwam, Jaydev B Mistry, Nequesha S Mohamed, Melbin Thomas, Kevin C Bigart, Michael A Mont, Ronald E Delanois
BACKGROUND: Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28331989/does-the-tibia-component-design-affect-the-need-for-offset-stems-in-revision-total-knee-arthroplasty
#7
X Foruria, T Schmidt-Braekling, D Arana Nabarte, M Faschingbauer, M Kasparek, F Boettner
INTRODUCTION: The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty. MATERIALS AND METHODS: Hip to ankle standing radiographs and lateral radiographs of 75 patients were analyzed using digital templating software. The offset in the anterior-posterior as well as medial-lateral plane between the center of the tibial diaphysis and the stem of the tibial baseplate were determined for an anatomic and symmetric tibial baseplate, respectively...
March 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28326442/long-term-follow-up-of-a-non-randomised-prospective-cohort-of-one-hundred-and-ninety-two-total-knee-arthroplasties-using-the-nexgen-implant
#8
Alfredo Schiavone Panni, Franceso Falez, Rocco D'Apolito, Katia Corona, Carlo Perisano, Michele Vasso
PURPOSE: The purpose of this study was to retrospectively analyse the clinical, functional and radiological outcomes, and the long-term survivorship of the NexGen Legacy Posterior Stabilised (LPS) knee prosthesis (Zimmer Biomet, Warsaw, IN, USA). METHODS: Between 1996 and 2001, 197 primary NexGen LPS total knee arthroplasties (TKAs) were implanted by a single surgeon; 132 prostheses in 124 patients with a minimum follow-up of 15 years were included in the study...
March 22, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28326430/still-no-single-gold-standard-for-using-cementless-femoral-stems-routinely-in-total-hip-arthroplasty
#9
Joseph T Moskal, Susan G Capps, John A Scanelli
BACKGROUND: There is now a clear trend with increased usage of cementless femoral stems for all ages and most patients. As the number of total hip arthroplasties (THAs) performed annually continues to increase with expanding indications for THA and demands for improved quality of life, so will the prevalence of THA in the elderly and aging populations. This is worrisome as the risk of complications with cementless femoral stems increases in elderly patients and those with poor bone quality...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326429/ceramic-on-ceramic-bearings-total-hip-arthroplasty-in-young-patients
#10
Tao Wang, Jun-Ying Sun, Xi-Jiang Zhao, Yong Liu, Hai-Bo Yin
BACKGROUND: The results of ceramic-on-ceramic (CoC) total hip arthroplasty (THA) in younger patients were not univocal. This study aims to evaluate the results of CoC bearing THA in patients younger than 50 years. METHODS: A total of 90 younger patients performed CoC THAs during March 2003 and May 2008 were included in this study. Hip function and activity were evaluated with Harris hip score and University of California Los Angeles activity score. We had discussed survival rates, radiological findings of component loosening or osteolysis, and ceramic-related complications in these patients...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326427/posterior-stabilized-total-knee-arthroplasty-a-matched-pair-analysis-of-a-classic-and-its-evolutional-design
#11
Pier Francesco Indelli, Gennaro Pipino, Paul Johnson, Angelo Graceffa, Massimiliano Marcucci
BACKGROUND: Total knee arthroplasty (TKA) designs continue to be modified to optimize patient's outcome. This study was designed to compare clinical and radiological results of classic worldwide used TKA posterior-stabilized (PS) design to those of its recent evolution. METHODS: A consecutive group of 100 patients undergoing TKA using a classic cemented fixed-bearing PS TKA system was matched by age, gender, body max index to 100 patients having the newer cemented fixed-bearing PS design, both by the same manufacturer...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326426/use-of-locking-plates-for-fixation-of-the-greater-trochanter-in-patients-with-hip-replacement
#12
Allison K Tetreault, Brian J McGrory
BACKGROUND: Fixation of the greater trochanter with total hip replacement is challenging and associated with short- and long-term complications. Locking plate technology has been used for fixation of other bones and may be applied successfully in trochanteric fixation. The purpose of this retrospective study was to analyze the utility of the use of trochanteric locking plates in total hip arthroplasty (THA) patients. METHODS: From 2004 to 2014, 32 procedures were performed to fix the greater trochanter in patients with trochanteric fracture, osteotomy, or nonunion in the setting of THA...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326423/removing-a-well-fixed-femoral-sleeve-during-revision-total-knee-arthroplasty
#13
J Ryan Martin, Tyler S Watters, Daniel L Levy, Jason M Jennings, Douglas A Dennis
The following surgical technique describes a case of a 51-year-old man with severe juvenile rheumatoid arthritis that required a 2-stage revision of an infected revision total knee implant. The patient had previously been implanted with a revision rotating platform, constrained condylar device which gained excellent fixation through the use of diaphyseal-engaging stems, and a well-ingrown, fully porous-coated femoral metaphyseal sleeve. To avoid intraoperative complications while removing the femoral sleeve, a novel technique for femoral sleeve extraction was used...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326418/combining-a-hip-arthroplasty-stem-with-trochanteric-reattachment-bolt-and-a-polyaxial-locking-plate-in-the-treatment-of-a-periprosthetic-fracture-below-a-well-integrated-implant
#14
Urban Hedlundh, Lars Karlsson
Distally anchored uncemented modular tapered porous stems are often the preferred treatment in total hip arthroplasty revisions and failed subtrochanteric fractures. These conditions mainly affect elderly osteoporotic patients, with an increased risk of later fractures below the well-fixated implant. Treatment in secondary fractures with long looking plates is the recommended treatment, where stability is a key to fracture healing. We report a complicated case in which this was achieved by an innovative technique combing the trochanteric attachment bolt of the stem system and a locking plate with polyaxial screws...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326411/medial-tibial-spackling-to-lessen-chronic-medial-tibial-soft-tissue-irritation
#15
J Ryan Martin, Tyler Steven Watters, Daniel L Levy, Jason M Jennings, James P Boyle, Douglas A Dennis
We describe a unique, utilitarian reconstructive treatment option known as tibial "spackling" for chronic, localized medial joint line pain corresponding with progressive radiographic peripheral medial tibial bone loss beneath a well-fixed revision total knee arthroplasty tibial baseplate. It is believed that this localized pain is due to chronic irritation of the medial capsule and collateral ligament from the prominent medial edge of the tibial component. In the setting of failed nonoperative treatment, our experience with utilizing bone cement to reconstruct the medial tibial bone defect and create a smooth medial tibial surface has been successful in eliminating chronic medial soft tissue irritation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326410/growth-of-an-intrapelvic-pseudotumor-associated-with-a-metal-on-metal-total-hip-arthroplasty-after-revision-arthroplasty-causing-a-femoral-nerve-neuropathy
#16
Patrick Leung, James C Kudrna
The development of pseudotumors is not uncommon with metal-on-metal total hip arthroplasty. Pseudotumors that dissect into the retroperitoneal space can cause symptoms of nerve compression. We describe a case of a 53-year-old male with a metal-on-metal total hip arthroplasty who developed mild symptoms of a femoral nerve neuropathy 6 years postoperatively. Revision arthroplasty to a ceramic-on-polyethylene articulation and debridement of the pseudotumor was performed. Postoperatively, the patient's femoral neuropathy progressed and a repeat magnetic resonance imaging showed an increase in size of the pseudotumor despite the removal of the offending metal-on-metal articulation...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326406/histologic-evaluation-of-the-bone-ceramic-interface-of-an-alumina-ceramic-cup-arthroplasty-retrieved-after-25-years-in%C3%A2-vivo
#17
Fuminori Higuchi, Shigeo Fukunishi, Shoji Nishio, Tomokazu Fukui, Yuki Fujihara, Shohei Okahisa, Yu Takeda, Shinichi Yoshiya
A 47-year-old man underwent ceramic cup arthroplasty when he was 22 years old. Revision total hip arthroplasty was performed 25 years later because of limited range of motion without implant loosening. Histologic examination revealed that the femoral head and ceramic implant were well fixed through a thin fibrous membrane. The energy-dispersive X-ray analysis indicated that calcium and phosphorus were detected in the same peak pattern as cancellous bone in the bone-ceramic interface.
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326404/comparing-contemporary-revision-burden-among-hip-and-knee-joint-replacement-registries
#18
Brian J McGrory, Caryn D Etkin, David G Lewallen
BACKGROUND: Hip and knee arthroplasties are common and successful procedures, however, success and durability are not guaranteed. The revision burden, defined as the ratio of implant revisions to the total number of arthroplasties in a specific period, is a measure of the steady state of arthroplasty success in a given registry. This study examines the hypothesis that revision burden would be similar among contemporary joint replacement registries and improving over time compared with historic controls...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326401/an-unusual-presentation-of-catastrophic-failure-of-hip-arthroplasty-with-a-thigh-mass
#19
Florian Dibra, Hari Parvataneni
In the advent of increasing demand for total hip arthroplasty, surveillance of these patients is imperative to identify potential complications requiring revision surgery. This is especially important in the young population, as revision is usually necessary during their lifetime. We present a case of a young female patient with a history of total hip arthroplasty 17 years prior, who presented with left hip pain and anterior thigh mass. The prosthetic hip had progressed to catastrophic failure with the cobalt-chrome femoral head having eroded through the polyethylene and acetabular socket...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326397/fracture-of-an-uncemented-tantalum-patellar-component
#20
Nathan L Grimm, Robert A Henderson, Joseph J Kavolus, Patrick D Millikan, Paul F Lachiewicz
A 62-year-old man presented with the acute, atraumatic onset of pain 3 years after uncemented right total knee arthroplasty. He complained of new mechanical locking with the knee held in extension on examination and unable to flex the knee. On the plain radiographs, the patellar component peg was fractured and the plate was dislocated. The knee was immobilized, and revision to a cemented 3-peg component was performed. Fracture of a single-peg, tantalum-backed uncemented patellar component has not been described...
June 2016: Arthroplasty Today
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