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Revision arthroplasty

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https://www.readbyqxmd.com/read/29653241/navigation-for-lower-limb-alignment-during-internal-fixation-of-complex-tibial-plateau-fractures
#1
B Vibert, R Pailhé, V Morin, B Rubens-Duval, D Saragaglia
In complex fractures of the proximal tibial metaphysis and epiphysis, possible adverse outcomes after internal fixation include not only joint surface incongruity, but also lower limb malalignment requiring revision surgery. Navigation has been proven effective for the intra-operative control of lower limb alignment during osteotomy and knee arthroplasty. In complex traumatic fractures, temporary fixation by a locking screw plate allows sensor positioning followed by navigation manoeuvres to adjust lower limb alignment...
April 10, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29652237/failure-of-facet-replacement-system-with-metal-on-metal-bearing-surface-and-subsequent-discovery-of-cobalt-allergy-report-of-2-cases
#2
Matthew L Goodwin, William Ryan Spiker, Darrel S Brodke, Brandon D Lawrence
The aim of this study was to report on 2 patients in whom metal-on-metal (MOM) facet replacements failed, with subsequent positive findings on allergy testing. Motion-preserving devices have been used with limited success when instrumentation is indicated in the mobile spine. MOM-bearing surfaces in orthopedics were developed to increase implant longevity, yet have been associated with numerous adverse outcomes, including local tissue reactions, pseudotumors, metallosis, and the need for revision surgery. Five patients with spinal stenosis and low-grade spondylolisthesis were randomized to undergo facet replacement surgery with the ACADIA facet replacement system at the authors' institution...
April 13, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29651610/periprosthetic-femoral-fracture-as-cause-of-early-revision-after-short-stem-hip-arthroplasty-a-multicentric-analysis
#3
Sang-Min Kim, Seung-Beom Han, Kee Hyung Rhyu, Jeong Joon Yoo, Kwang-Jun Oh, Je Hyun Yoo, Kyung-Jae Lee, Seung-Jae Lim
BACKGROUND: The objective of this study was to analyze the prevalence and causes of early re-operation after hip replacement surgery using short bone-preserving stems in a large multicentre series. Specifically, we evaluated the clinical features of periprosthetic fractures occurring around short stems. METHODS: A total of 897 patients (1089 hips) who underwent primary total hip arthroplasty or bipolar hemiarthroplasty from January 2011 to February 2015 using short bone-preserving femoral stems were recruited...
April 12, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29643694/bone-preserving-techniques-for-explanting-the-well-fixed-cemented-acetabular-component
#4
Jarrad Stevens, Gavin Macpherson, Colin Howie
Background: Removal of a well-fixed, cemented acetabular component at the time of revision hip surgery can be complex. It is essential to remove the implant and cement mantle in a timely fashion while preserving bone stock and osseous integrity. The biomechanical properties of polymethylmethacrylate cement and polyethylene can be utilised to aid with the removal of well cemented implants which are often harder than the surrounding bone. While removal of loose components may be relatively straightforward, the challenge for the revision arthroplasty surgeon often involves the removal of well-fixed implants...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29643692/correlation-of-tibial-bone-defect-shape-with-patient-demographics-following-total-knee-revision
#5
Madhav Bole, Matthew Teeter, Brent A Lanting, James L Howard
Background: Bone defects of the proximal tibia following revision total knee arthroplasty (TKA) are challenging to manage, but must be addressed to provide lasting stability. This paper will categorize tibial bone defects into shape groups and correlate resulting groups to patient demographic data. Methods: Retrospective analysis of four hundred and four patients post revision TKA between January 2005 and February 2014 was conducted. One hundred and eighteen met the inclusion criteria and were subcategorized by defect shape on their post-operative lateral and anterior-posterior (AP) radiographs...
June 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29643202/comparison-of-the-diagnostic-accuracy-of-periprosthetic-tissue-culture-in-blood-culture-bottles-to-prosthesis-sonication-fluid-culture-for-diagnosis-of-prosthetic-joint-infection-using-bayesian-latent-class-modeling-and-idsa-pji-criteria-for-classification
#6
Qun Yan, Melissa J Karau, Kerryl E Greenwood-Quaintance, Jayawant N Mandrekar, Douglas Osmon, Matthew P Abdel, Robin Patel
We have previously demonstrated that culturing periprosthetic tissue in blood culture bottles (BCBs) improves sensitivity compared to conventional agar and broth culture methods for diagnosis of prosthetic joint infection (PJI). We have also shown that prosthesis sonication culture improves sensitivity compared to periprosthetic tissue culture using conventional agar and broth methods. The purpose of this study was to compare the diagnostic accuracy of tissue culture in BCBs (subsequently referred to as tissue culture) to prostheses sonication culture (subsequently referred to as sonicate fluid culture)...
April 11, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29643154/associations-between-preoperative-oxford-hip-and-knee-scores-and-costs-and-quality-of-life-of-patients-undergoing-primary-total-joint-replacement-in-the-nhs-england-an-observational-study
#7
Peter Eibich, Helen A Dakin, Andrew James Price, David Beard, Nigel K Arden, Alastair M Gray
OBJECTIVES: To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). DESIGN: Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. SETTING: UK secondary care. PARTICIPANTS: Men and women undergoing primary THR or TKR...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29629592/revision-of-failed-total-ankle-arthroplasty-to-a-hindfoot-fusion
#8
A A Ali, R A Forrester, P O'Connor, N J Harris
Aims The aim of this study was to present a series of patients with aseptic failure of a total ankle arthroplasty (TAA) who were treated with fusion of the hindfoot using a nail. Patients and Methods A total of 23 TAAs, in 22 patients, were revised for aseptic loosening and balloon osteolysis to a hindfoot fusion by a single surgeon (NH) between January 2012 and August 2014. The procedure was carried out without bone graft using the Phoenix, Biomet Hindfoot Arthrodesis Nail. Preoperative investigations included full blood count, CRP and ESR, and radiological investigations including plain radiographs and CT scans...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29629588/reliable-outcomes-and-survivorship-of-unicompartmental-knee-arthroplasty-for-isolated-compartment-osteonecrosis
#9
B P Chalmers, K G Mehrotra, R J Sierra, M W Pagnano, M J Taunton, M P Abdel
Aims Primary (or spontaneous) and secondary osteonecrosis of the knee can lead to severe joint degeneration, for which either total or unicompartmental arthroplasty may be considered. However, there are limited studies analyzing outcomes of unicompartmental knee arthroplasties (UKAs) for osteonecrosis involving an isolated compartment of the knee. The aims of this study were to analyze outcomes of UKAs for osteonecrosis with specific focus on 1) survivorship free of any revision or reoperation, 2) risk factors for failure, 3) clinical outcomes, and 4) complications...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29629579/anatomical-total-shoulder-arthroplasty-in-young-patients-with-osteoarthritis
#10
M O Gauci, N Bonnevialle, G Moineau, M Baba, G Walch, P Boileau
Aims Controversy about the use of an anatomical total shoulder arthroplasty (aTSA) in young arthritic patients relates to which is the ideal form of fixation for the glenoid component: cemented or cementless. This study aimed to evaluate implant survival of aTSA when used in patients aged < 60 years with primary glenohumeral osteoarthritis (OA), and to compare the survival of cemented all-polyethylene and cementless metal-backed glenoid components. Materials and Methods A total of 69 consecutive aTSAs were performed in 67 patients aged < 60 years with primary glenohumeral OA...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29629577/usage-of-unicompartmental-knee-arthroplasty
#11
D W Murray, R W Parkinson
Unicompartmental knee arthroplasty (UKA) has numerous advantages over total knee arthroplasty (TKA) and one disadvantage, the higher revision rate. The best way to minimize the revision rate is for surgeons to use UKA for at least 20% of their knee arthroplasties. To achieve this, they need to learn and apply the appropriate indications and techniques. This would decrease the revision rate and increase the number of UKAs which were implanted, which would save money and patients would benefit from improved outcomes over their lifetime...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29628696/do-local-antibiotics-reduce-periprosthetic-joint-infections-a-retrospective-review-of-744-cases
#12
Craig Winkler, Joel Dennison, Adam Wooldridge, Eneko Larumbe, Cyrus Caroom, Mark Jenkins, George Brindley
Periprosthetic joint infections (PJI) are uncommon but not rare and have significant morbidity and financial implications. Local antibiotics have been used successfully in other areas of orthopedics to reduce postoperative infections, but this method has not been proven in total joint arthroplasty (TJA). Beginning January 1, 2014, our primary investigators began using surgical site lavage with providone-iodine solution and administering 2 g of vancomcyin powder in the surgical wound prior to capsule closure for all primary and revision total hip and knee arthroplasties...
March 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628687/megaprosthesis-versus-allograft-prosthesis-composite-for-massive-skeletal-defects
#13
REVIEW
Deepak Gautam, Rajesh Malhotra
Massive skeletal defects are encountered in the setting of tumors necessitating excision, failed total hip arthroplasty with periprosthetic bone loss, periprosthetic fracture, complex trauma, multiple failed osteosynthesis and infection. Reconstruction of the segmental defects poses a tremendous challenge to the orthopaedic surgeons. The goal of osseous reconstruction of these defects is to restore the bone length and function. Currently the most commonly employed methods for reconstruction are either a megaprosthesis or an Allograft Prosthesis Composite (APC)...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628686/treatment-options-for-chronic-pelvic-discontinuity
#14
REVIEW
Mark D Hasenauer, Wayne G Paprosky, Neil P Sheth
Chronic pelvic discontinuity is a distinct and unique challenge seen during revision total hip arthroplasty (THA) in which the superior ilium is separated from the inferior ischiopubic segment through the acetabulum, rendering the anterior and posterior columns discontinuous. The operative management of acetabular bone loss in revision THA is one of the most difficult challenges today. Common treatment options include cage reconstruction with bulk acetabular allograft, custom triflange acetabular component, a cup-cage construct, jumbo acetabular cup with porous metal augments, or acetabular distraction with a porous tantalum shell with or without modular porous augments...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628680/rotating-hinge-prosthesis-for-complex-revision-total-knee-arthroplasty-a-review-of-the-literature
#15
REVIEW
Shalen Kouk, Parthiv A Rathod, Aditya V Maheshwari, Ajit J Deshmukh
Introduction: The rotating hinge prosthesis was originally used and designed as a primary total knee arthroplasty implant, but was hampered due to poor outcomes and catastrophic failures. Newer rotating hinge implants can be utilized in complex revision total knee arthroplasties when appropriately indicated, but their outcome data is very difficult to interpret due to the strict and varied indications for use and subsequently small number of procedures performed. The goal of this review is to evaluate the current evidence on large cohort, rotating hinge knee prostheses used in the revision setting, in order to provide a clearer understanding of the indications, outcomes and complications...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29628676/metal-hypersensitivity-in-total-hip-and-knee-arthroplasty-current-concepts
#16
REVIEW
Samuel Akil, Jared M Newman, Neil V Shah, Natasha Ahmed, Ajit J Deshmukh, Aditya V Maheshwari
Metal hypersensitivity (MHS) is a rare complication of total joint arthroplasty that has been linked to prosthetic device failure when other potential causes have been ruled out. The purpose of this review was to conduct an analysis of existing literature in order to get a better understanding of the pathophysiology, presentation, diagnosis, and management of MHS. It has been described as a type IV hypersensitivity reaction to the metals comprising prosthetic implants, often nickel and cobalt-chromium. Patients suffering from this condition have reported periprosthetic joint pain and swelling as well as cutaneous, eczematous dermatitis...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#17
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29627257/robotic-arm-assisted-vs-conventional-unicompartmental-knee-arthroplasty-the-2-year-clinical-outcomes-of-a-randomized-controlled-trial
#18
Alisdair Gilmour, Angus D MacLean, Philip J Rowe, Matthew S Banger, Iona Donnelly, Bryn G Jones, Mark J G Blyth
BACKGROUND: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29625813/sidus-stem-free-shoulder-system-for-primary-osteoarthritis-short-term-results-of-a-multicenter-study
#19
Anna Krukenberg, Julie McBirnie, Stefan Bartsch, Nikolaus Böhler, Ernst Wiedemann, Bernhard Jost, Pierre Mansat, Pierre Bellon-Champel, Renzo Angeloni, Markus Scheibel
BACKGROUND: The aim of this prospective multicenter study was to evaluate clinical and radiologic results of a new metaphyseal anchored system. This system features a different anchor geometry that potentially leads to better bony integration and less loosening. METHODS: From November 2012 until December 2015, 148 patients (151 shoulders) were treated with the Sidus Stem-Free Shoulder System at 9 centers in Europe. The main indication was primary osteoarthritis (80...
April 3, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29625641/salvaging-a-failed-proximal-interphalangeal-joint-implant
#20
REVIEW
Francis J Aversano, Ryan P Calfee
Salvaging a failed proximal interphalangeal (PIP) joint implant arthroplasty remains a considerable technical and rehabilitation challenge. Experienced arthroplasty surgeons have reported 70% survival of revision PIP implants at 10 years with 25% of patients requiring subsequent revision surgery. At this time, there is no consensus surgical approach or implant proven superior for revision implant arthroplasty of the PIP joint. Secondary arthrodesis or amputation may be required to salvage the failed PIP implant arthroplasty with compromised bone stock or soft tissue envelopes that are inadequate for implant arthroplasty...
May 2018: Hand Clinics
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