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Revision arthroplasty

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https://www.readbyqxmd.com/read/28822068/polyethylene-damage-increases-with-varus-implant-alignment-in-posterior-stabilized-and-constrained-condylar-knee-arthroplasty
#1
Zhichang Li, Christina I Esposito, Chelsea N Koch, Yuo-Yu Lee, Douglas E Padgett, Timothy M Wright
BACKGROUND: Implant malalignment in primary TKA has been reported to increase stresses placed on the bearing surfaces of implant components. We used a longitudinally maintained registry coupled with an implant retrieval program to consider whether preoperative, postoperative, or prerevision malalignment was associated with increased risk of revision surgery after TKA. QUESTIONS/PURPOSES: (1) What is the relative polyethylene damage on medial and lateral compartments of the tibial plateaus from revised TKAs? (2) Does coronal TKA alignment affect implant performance, such that TKAs aligned in varus are predisposed to experience increased polyethylene damage? (3) Does TKA alignment differ between postoperative and prerevision radiographs, and if so, what does this difference suggest about the mechanical contact load placed on a knee with a TKA? METHODS: Between 2007 and 2012, we performed 18,065 primary TKAs at our institution...
August 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28821464/multi-elemental-nanoparticle-exposure-after-tantalum-component-failure-in-hip-arthroplasty-in-depth-analysis-of-a-single-case
#2
Janosch Schoon, Sven Geißler, Juliane Traeger, Andreas Luch, Jutta Tentschert, Giorgio Perino, Frank Schulze, Georg N Duda, Carsten Perka, Anastasia Rakow
Porous tantalum components are widely used for complex acetabular reconstructions in revision hip arthroplasty. Multiple other metal alloys such as titanium-aluminum-vanadium or cobalt-chromium-molybdenum are principally used in artificial joint setups. We report a case of tantalum component failure being both cause and effect of a multiple metal exposure. Our aims were to assess and to characterize associated particle exposure and biological consequences. Metal level quantification revealed substantial in vivo exposure to particulate and dissociated tantalum, zirconium, chromium, cobalt, molybdenum, titanium, aluminum and vanadium in periprosthetic compartments...
August 16, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28819613/aseptic-loosening-after-total-hip-arthroplasty-in-an-acromegalic-patient-a-case-report
#3
Simon Koulischer, Bilal Kapanci, Nicolas Bloemers, Tatiana Charles, Marc Jayankura
INTRODUCTION: Acromegaly is a rare disorder characterized by excess secretion of growth hormone and its principle mediator, insulin-like growth factor-1. Although acromegaly is frequently associated with osteoarthritis, the outcome of arthroplasty in this population is not documented. CASE REPORT: We report here a case of aseptic loosening of an uncemented total hip arthroplasty acetabulum in an acromegalic patient that was revised with a cemented cup. It has been suggested that the incidence of this complication is increased in other pathology with a similarly high bone-turnover (e...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819611/acute-stress-fracture-of-the-pelvis-after-total-hip-arthroplasty-a-case-report
#4
Oluwaseun Akinbo, Vineet Tyagi
INTRODUCTION: Acute hip pain following total hip arthroplasty (THA) could have numerous causes to include stress fracture of the pelvis. Stress fractures of the pelvis are rare and have been reported to involve the medial wall and the pubic ramus. A unique case is presented demonstrating the clinical presentation and management of an acute stress fracture of ilium and anterior column following a THA. CASE REPORT: A 72-year-old man underwent an uncomplicated right THA...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819595/early-intraprosthetic-dislocation-of-a-dual-mobility-acetabular-construct-after-total-hip-arthroplasty
#5
Vineet Tyagi, Oluwaseun Akinbo
INTRODUCTION: The concept of a dual mobility (DM) cup has been in existence for more than 40 years and was initially popularized in Europe. Only recently has it started to garner attention in the United States. Its design, consisting of a small femoral head articulating within a larger polyethylene (PE) insert, which articulates with an outer shell, has found increasing use in patients that are at risk for post-operative dislocations. This case report describes a case of recurrent total hip arthroplasty (THA) dislocation managed with the implantation of a DM cup with an acute intraprosthetic dislocation of the DM construct...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28807468/are-revision-hip-arthroplasty-patients-at-higher-risk-for-venous-thromboembolic-events-than-primary-hip-arthroplasty-patients
#6
P Maxwell Courtney, Anthony J Boniello, Brett R Levine, Neil P Sheth, Wayne G Paprosky
BACKGROUND: The purpose of this study is to determine whether revision total hip arthroplasty (THA) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) when compared to primary THA. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program database for all primary and revision THA cases from 2011 to 2014. Demographic data, medical comorbidities, and venous thromboembolic rates within 30 days of surgery were compared between the primary and revision THA groups...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#7
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803815/patient-specific-contact-stress-does-not-predict-polyethylene-wear-rate-in-a-specific-pressfit-cup
#8
Georg Matziolis, Linda Krakow, Frank Layher, Klaus Sander, Joerg Bossert, Steffen Brodt
BACKGROUND: The most common reason for revision total hip arthroplasty remains polyethylene wear. Development dysplasia of the hip and revision situations requires a conscious compromise of implant position. The surgeon should know about the consequence on wear via a possible change in hip contact force. The objective of this study is to investigate whether annual wear is dependent on hip contact force. METHODS: Forty-five inserts (DuraLoc, DePuy) that were explanted in our department were included...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28803814/revision-total-hip-arthroplasty-with-a-monoblock-splined-tapered-grit-blasted-titanium-stem
#9
Michael D Hellman, Sean M Kearns, Daniel D Bohl, Bryan D Haughom, Brett R Levine
BACKGROUND: In revision total hip arthroplasty (THA), proximal femoral bone loss creates a challenge of achieving adequate stem fixation. The purpose of this study was to examine the outcomes of a monoblock, splined, tapered femoral stem in revision THA. METHODS: Outcomes of revision THA using a nonmodular, splined, tapered femoral stem from a single surgeon were reviewed. With a minimum of 2-year follow-up, there were 68 cases (67 patients). Paprosky classification was 3A or greater in 85% of the cases...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28802851/does-hydroxyapatite-coating-of-uncemented-cups-improve-long-term-survival-an-analysis-of-28-605-primary-total-hip-arthroplasty-procedures-from-the-nordic-arthroplasty-register-association-nara
#10
Stergios Lazarinis, Keijo T Mäkelä, Antti Eskelinen, Leif Havelin, Geir Hallan, Søren Overgaard, Alma B Pedersen, Johan Kärrholm, Nils P Hailer
OBJECTIVE: It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. METHOD: We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n=28,605)...
August 9, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28801816/are-tkas-performed-in-high-volume-hospitals-less-likely-to-undergo-revision-than-tkas-performed-in-low-volume-hospitals
#11
Elke Jeschke, Mustafa Citak, Christian Günster, Andreas Matthias Halder, Karl-Dieter Heller, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Thorsten Gehrke
BACKGROUND: High-volume hospitals have achieved better outcomes for THAs and unicompartmental knee arthroplasties (UKAs). However, few studies have analyzed implant survival after primary TKA in high-volume centers. QUESTIONS/PURPOSES: Is the risk of revision surgery higher when receiving a TKA in a low-volume hospital than in a high-volume hospital? METHODS: Using nationwide billing data of the largest German healthcare insurer for inpatient hospital treatment, we identified 45,165 TKAs in 44,465 patients insured by Allgemeine Ortskrankenkasse who had undergone knee replacement surgery between January 2012 and December 2012...
August 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28800919/similar-outcomes-after-osteochondral-allograft-transplantation-in-anterior-cruciate-ligament-intact-and-reconstructed-knees-a-comparative-matched-group-analysis-with-minimum-2-year-follow-up
#12
Dean Wang, Claire D Eliasburg, Tim Wang, Ryan R Fader, Francesca R Coxe, Mollyann D Pais, Riley J Williams
PURPOSE: To compare failure rates and clinical outcomes of osteochondral allograft transplantation (OCA) in anterior cruciate ligament (ACL)-intact versus ACL-reconstructed knees at midterm follow-up. METHODS: After a priori power analysis, a prospective registry of patients treated with OCA for focal chondral lesions ≥2 cm(2) in size with minimum 2-year follow-up was used to match ACL-reconstructed knees with ACL-intact knees by age, sex, and primary chondral defect location...
August 8, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28800854/up-to-seven-years-follow-up-of-short-cemented-stems-in-complex-primary-total-knee-arthroplasty-a-prospective-study
#13
Mathieu Angers-Goulet, Martin Bédard
BACKGROUND: Although primary total knee arthroplasty (TKA) shows good clinical, functional and radiological results, it can be complicated by certain conditions or pathologies. The main objective of this study was to evaluate the global performance of short cemented metaphyseal stem components in patients undergoing complex primary TKA. METHODS: This is a single-surgeon prospective case series of 91 patients who underwent complex primary TKA requiring short stem fixation between January 2009 and October 2014...
August 8, 2017: Knee
https://www.readbyqxmd.com/read/28797880/smoking-is-associated-with-earlier-time-to-revision-of-total-knee-arthroplasty
#14
Chin Tat Lim, Stuart B Goodman, James I Huddleston, Alex H S Harris, Subhrojyoti Bhowmick, William J Maloney, Derek F Amanatullah
BACKGROUND: Smoking is associated with early postoperative complications, increased length of hospital stay, and an increased risk of revision after total knee arthroplasty (TKA). However, the effect of smoking on time to revision TKA is unknown. METHODS: A total of 619 primary TKAs referred to an academic tertiary center for revision TKA were retrospectively stratified according to the patient smoking status. Smoking status was then analyzed for associations with time to revision TKA using a Chi square test...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28795909/reduced-revision-rate-and-maintained-function-after-hip-arthroplasty-for-femoral-neck-fractures-after-transition-from-posterolateral-to-direct-lateral-approach
#15
Sebastian Mukka, Björn Knutsson, Ammar Majeed, Arkan S Sayed-Noor
Background and purpose - The direct lateral (DL) approach to the hip for femoral neck fractures (FNF) has been shown to reduce the rate of dislocation and reoperations. We evaluate the effect of transition from the posterolateral (PL) to DL approach on reoperation and dislocation rates and patients' reported outcome. Patients and methods - In a prospective cohort study between 2012 and 2015, we enrolled 362 patients (median age 83 years, 70% women, mean follow-up 25 months) with a displaced FNF. The first group of 146 patients were operated using the PL and the second group of 216 patients with a DL approach, after change of our routines...
August 10, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28793979/outcome-of-prosthesis-matched-and-unmatched-patella-components-in-primary-and-revision-total-knee-replacement
#16
Peter L Lewis, Ai E Gamboa, David G Campbell, Michelle Lorimer
BACKGROUND: Although knee replacements have specifically designed patella prostheses that correspond to the geometry of their femoral components, a patella prosthesis that is unmatched to the femoral component may occasionally be inserted. In revision total knee arthroplasty (TKA), an originally resurfaced patella may be left, but the femoral component revised to one that does not match the patella. Few studies have compared the outcome of matched and unmatched patella components in TKA...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28793978/patellofemoral-arthroplasty-conversion-to-total-knee-arthroplasty-retrieval-analysis-and-clinical-correlation
#17
Alexander B Christ, Elexis Baral, Chelsea Koch, Beth E Shubin Stein, Alejandro Gonzalez Della Valle, Sabrina M Strickland
BACKGROUND: Patellofemoral arthroplasty (PFA) can be a successful, bone-sparing treatment for isolated patellofemoral arthritis. However, progression of tibio-femoral arthritis or incorrect indications may predispose patients to early conversion to total knee arthroplasty (TKA). The purpose of this study was to review the clinical cases and perform retrieval analysis of PFA conversions to TKA at our institution. METHODS: Twenty one patellofemoral arthroplasties in 18 patients that were converted to TKA were identified through our implant retrieval registry...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28790473/longitudinal-followup-of-incidentally-detected-pseudotumors-in-patients-with-metal-on-metal-implants-a-retrospective-study
#18
Khushboo Pilania, Bhavin Jankharia
BACKGROUND: This study describes the significance and temporal evolution of incidentally detected, presumed, metal-induced reactive periprosthetic masses in patients with metal on metal (MoM) hip arthroplasty and its management. The literature concerning the temporal evolution of these lesions is meagre and so it is still unclear, whether asymptomatic patients with periprosthetic collections should undergo revision. MATERIALS AND METHODS: Patients with MoM hip replacements fitted with a recalled implant (ASR, DuPuy) often undergo magnetic resonance imaging with metal artifact reduction sequences to look for complications...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790472/total-hip-arthroplasty-in-patients-of-post-polio-residual-paralysis-a-retrospective-case-series
#19
Francisco Borja Sobrón, Álvaro Martínez-Ayora, Manuel Cuervas-Mons, Tania Quevedo, Rafael Laguna, Javier Vaquero
BACKGROUND: Poliomyelitis is a viral, nervous system disease that affects both the upper and the lower extremities. The treatment of severe coxarthrosis in these patients with total hip arthroplasty (THA) has been widely questioned because of the high risk of subsequent complications. The aim of the present study was to describe both radiological and medium term clinical results in a series of patients with post polio residual paralysis that underwent THA. MATERIALS AND METHODS: We report a retrospective review of a series of 5 five patients diagnosed with severe coxarthrosis secondary to post polio residual paralysis who were operated between 2008 and 2012...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28790470/management-guidelines-for-metal-on-metal-hip-resurfacing-arthroplasty-a-strategy-on-followup
#20
Naoki Nakano, Andrea Volpin, Jonathan Bartlett, Vikas Khanduja
Despite the initial promise of metal-on-metal (MoM) implants as the ideal bearing surface for hip replacements and resurfacings, high short term failure rates due to an adverse reaction to metal debris (ARMD) have led to a dramatic reduction in the number of MoM implants used in the modern era. With over one million patients worldwide having undergone hip operations utilizing a MoM bearing surface, the long term outcomes for such patients remains unknown, and there is much debate as to the most effective management of these patients...
July 2017: Indian Journal of Orthopaedics
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