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Mary E Brindle, Derek J Roberts, Oluwatomilayo Daodu, Alex Bernard Haynes, Christy Cauley, Elijah Dixon, Claude La Flamme, Paul Bain, William Berry
INTRODUCTION: To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs)...
May 9, 2017: BMJ Open
Jan Nadorf, Stefan Kinkel, Simone Gantz, Eike Jakubowitz, J Philippe Kretzer
INTRODUCTION: Revision total knee arthoplasty often requires modular implants to treat bone defects of varying severity. In some cases, it may not be clear which module size and implant combination (e.g. sleeve and stem) should be chosen for a specific defect. When balancing implant stability and osseointegration against stress-shielding, it is important to choose an appropriate implant combination in order to match the given level of bone loss. Therefore, the necessity of stems in less extensive tibial defects and the advantage of different stems (lengths and stiffnesses) in combination with large metaphyseal sleeves on implant fixation and bone flexibility using a modular tibial revision knee system, were analyzed...
2017: PloS One
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...
May 2017: Archives of Orthopaedic and Trauma Surgery
David J Kim, Shiqian Shen, George M Hanna
BACKGROUND: Total hip arthroplasty (THA) is a common surgical treatment for several conditions of the hip. While the majority of patients obtain satisfactory results, many develop chronic post-arthroplasty hip pain that can be difficult to treat. OBJECTIVE: We evaluate the effectiveness of cooled (60°C) radiofrequency lesioning of the articular branches of the femoral nerve (ABFN) as a minimally invasive treatment for patients suffering from chronic post-arthroplasty hip pain...
February 2017: Pain Physician
Kenichi Oe, Hirokazu Iida, Kohei Tsuda, Tomohisa Nakamura, Naofumi Okamoto, Yusuke Ueda
BACKGROUND: The purpose of this study was to identify the long-term durability of the Kerboull-type reinforcement device (KT plate) in acetabular reconstruction for massive bone defects, assessing the remodeling of structural bone grafts. METHODS: This study retrospectively evaluated 106 hips that underwent acetabular reconstruction using a KT plate between November 2000 and December 2010. Thirty-eight primary total hip arthoplasties (THAs) and 68 revised THAs were performed, and the mean duration of clinical follow-up was 8 years (5-14 years)...
August 24, 2016: Journal of Arthroplasty
Alexandra Roren, Marie-Martine Lefevre-Colau, Agnès Roby-Brami, Christelle Nguyen, Serge Poiraudeau
OBJECTIVE: Scapular motion is essential for full, functional mobility of the arm. Many shoulder pathologies are associated with alterations of scapular kinematics which have been only little studied in total shoulder arthroplasties. The aim of this study was to compare the 3D scapula kinematics in two groups of patients with total shoulder anatomic (aTSA) or reverse (rTSA) arthoplasties to asymptomatic controls of comparable age during two arm elevation tasks (abduction and flexion) and two simulations of activity of daily living ("hair combing" and "back washing")...
September 2016: Annals of Physical and Rehabilitation Medicine
Gerrit Steffen Maier, Uwe Maus, Djordje Lazovic, Konstantin Horas, Klaus Edgar Roth, Andreas Alois Kurth
BACKGROUND: The purpose of this observational study was to evaluate serum levels of 25-OH-D in patients scheduled to undergo elective hip or knee arthroplasty. We hypothesised that 25-OH-D level is an independent risk factor for length of stay in orthopaedic patients after elective hip or knee arthoplasty. MATERIALS AND METHODS: 25-OH-D levels were measured in 1083 patients admitted to an orthopaedic surgery department to undergo elective hip or knee arthroplasty...
December 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Aleksandra Truszczyńska, Zbigniew Trzaskoma, Jerzy Białecki, Justyna Drzał-Grabiec, Emilia Dadura, Kazimierz Rąpała, Adam Tarnowski
BACKGROUND: Postural stability is of great importance because imbalances and muscle weakness are significant risk factors for falls experienced by the elderly. Hip arthrosis, which causes pain and gait disorders that affect balance control, is common in the ageing population. AIM: The aim of this study was to assess postural stability in patients with unilateral hip arthrosis before total hip arthroplasty. METHODS: The study population consisted of 52 patients with hip arthrosis (study group) and 47 subjects with no history of clinical symptoms of hip pain...
November 10, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jack Porrino, Blake Carlson, Kimia K Kani, Hyojeong Mulcahy, Alvin Wyatt, Felix S Chew
Most of the destructive joint disease necessitating arthoplasty is the result of an insidious and protracted process that occurs over the course of many years. However, there are a variety of diseases that may result in a rapid progressive deterioration of a joint. We describe both the common and less common etiologies of rapidly destructive arthropathy that one should consider, with imaging examples, and present discriminative factors when present.
January 2017: Current Problems in Diagnostic Radiology
Fabio Jansen Angelini, Camilo Partezani Helito, Bruno Azevedo Veronesi, Tales Mollica Guimarães, José Ricardo Pécora, Marco Kawamura Demange
OBJECTIVE: To evaluate the results of total knee arthoplasty revisions performed in high complexity cases, with large bone defects or serious ligament deficiencies using a constrained implant hinge associated to a rotating tibial basis. METHODS: We evaluated 11 patients in which we used the constrained implant hinge associated to rotating tibial basis, with minimum follow-up of two years. The indications for the procedure included instability, septic loosening, late postoperative infection without loosening and periprosthetic fracture...
January 2016: Acta Ortopedica Brasileira
Ahmed Mushtaq Khan, Syed Faraz Anwar, Sohail Hafeez
OBJECTIVE: To explore a less pain-inciting implant in terms of anterior thigh pain after hip hemi-arthroplasty in displaced intra-capsular fractures of the neck of femur. METHODS: The cross-sectional comparative study was conducted at the Combined Military Hospital, Rawalpindi, from November 2013 to June 2014, and comprised patients of either genders with age above 55 years and having displaced intra-capsular fractures of the neck of femur. The patients were divided into two equal groups, with Group A patients undergoing Austin Moore hemi-arthoplasty and Group B having cemented bipolar hemi-arthoplasty...
November 2015: JPMA. the Journal of the Pakistan Medical Association
M Siddiqui, A Bidaye, E Baird, R Abu-Rajab, A Stark, B Jones, R Ingram, I Anthony
OBJECTIVE: This study compared three methods of surgical wound dressing in patients undergoing primary total hip arthroplasty to determine their effect on wound leakage. METHOD: Total hip arthroplasties were randomised to 3 groups: 2-octyl cyanoacrylate (Dermabond-Ethicon Inc, G) with Opsite (Smith & Nephew; O) [G+O], 2-octyl cyanoacrylate with Tegaderm (3M; T) [G+T], and Opsite without 2-octyl cyanoacrylate [O]. Postoperative wound leakage was assessed and graded daily until discharge, the frequency of the dressing changes was also recorded...
January 2016: Journal of Wound Care
Gunnar T R Hischebeth, Thomas M Randau, Johanna K Buhr, Matthias D Wimmer, Achim Hoerauf, Ernst Molitor, Isabelle Bekeredjian-Ding, Sascha Gravius
Periprosthetic joint infection (PJI) is one of the most challenging complications in orthopedic surgery. In cases of suspected periprosthetic joint infection several diagnostic methods are available. In this study we investigated the performance of the newly available Unyvero i60 implant and tissue infection (ITI) multiplex PCR System. 62 specimens from 31 patients with suspected PJI or aseptic loosening of a painful joint arthoplasty were included in this study. Besides the established diagnostic procedures we included a commercial multiplex PCR detection system for diagnosis of PJI...
February 2016: Journal of Microbiological Methods
Marc-Olivier Fischer, Georges Daccache, Sandrine Lemoine, Benoît Tavernier, Vincent Compère, Christophe Hulet, Chems Eddine Bouchakour, Christophe Canevet, Jean-Louis Gérard, Lydia Guittet, Emmanuel Lorne, Jean-Luc Hanouz, Jean-Jacques Parienti
BACKGROUND: Hemodynamic optimization during surgery is of major importance to decrease postoperative morbidity and length of hospital stay. However, conventional cardiac output monitoring is rarely used at the bedside. Recently, the plethysmographic variability index (PVI) was described as a simplified alternative, using plug-and-play noninvasive technology, but its clinical utility remains to be established. METHODS/DESIGN: The hemodynamic optimization using the PVI (OPVI) trial is a multicenter randomized controlled two-arm trial, randomizing 440 patients at intermediate risk of postoperative complications after orthopedic surgery...
November 4, 2015: Trials
Y J Mahale, N Aga
In this retrospective observational cohort study, we describe 17 patients out of 1775 treated for various fractures who developed mycobacterium tuberculosis (MTB) infection after surgery. The cohort comprised 15 men and two women with a mean age of 40 years (24 to 70). A total of ten fractures were open and seven were closed. Of these, seven patients underwent intramedullary nailing of a fracture of the long bone, seven had fractures fixed with plates, two with Kirschner-wires and screws, and one had a hemiarthroplasty of the hip with an Austin Moore prosthesis...
September 2015: Bone & Joint Journal
Rafael Luque, Belen Rizo, Antonio Urda, Rodrigo Garcia-Crespo, Enrique Moro, Luis López-Durán
PURPOSE: Severe cases of osteoarthritis with ligamentous instability require the use of a modular knee arthoplasty. To assess the survival, the complications, the clinical, radiological and functional outcomes, and the quality of life of those patients in whom a Optetrak Condylar Constrained Knee (CCK) had been implanted as a primary implant. To study how the pre-operative conditions (deformity, age, sex …) and the characteristics of the arthroplasty (stems, supplements, constrained component …) could change the survival or the clinical outcomes of the implants...
November 2015: International Orthopaedics
T Hofstaedter, C Fink, U Dorn, B Pötzelsberger, C Hepperger, K Gordon, E Müller
The aim of the study was to assess the effect of a recreational alpine skiing intervention on implant-related factors, such as loosening and wear, in patients with total knee arthoplasty (TKA). A group of 16 TKA patients were examined 2.3 ± 0.1 years after skiing about 80 days over three seasons inclusive of a ski intervention of 2-3 times per week (25.5 days) over a 12-week period. Mean follow-up period was 5.1 ± 1 years after surgery. All patients had excellent clinical and radiological outcomes...
August 2015: Scandinavian Journal of Medicine & Science in Sports
Badaruddin Sahito, Dileep Kumar, Hassan Dost Afridi, Farooq Mamji
Metallosis is serious condition that comes about when metallic debris builds up in the soft tissues of the body. This condition is seen in individuals undergoing joint replacement surgery, like those of the hip, knee and elbow. Incidence of metallosis is not common. Here we present a case of 61 year-old male, who had undergone right-sided total hip replacement 20 years earlier due to avascular necrosis. He presented to us with one-year history of massive swelling of right thigh and mild pain and discomfort in September 2013...
December 2014: JPMA. the Journal of the Pakistan Medical Association
Brad Miles, Elizabeth Kolos, William L Walter, Richard Appleyard, Angela Shi, Qing Li, Andrew J Ruys
Subject-specific finite element (FE) modeling methodology could predict peri-prosthetic femoral fracture (PFF) for cementless hip arthoplasty in the early postoperative period. This study develops methodology for subject-specific finite element modeling by using the element deactivation technique to simulate bone failure and validate with experimental testing, thereby predicting peri-prosthetic femoral fracture in the early postoperative period. Material assignments for biphasic and triphasic models were undertaken...
June 2015: Medical Engineering & Physics
Christiaan P van Lingen, Harmen B Ettema, Bart H Bosker, Cees C P M Verheyen
Large-head metal-on-metal (MoM) total hip arthroplasties were introduced because of their purported advantages. Inflammatory pseudotumours occasionally occur after MoM hip arthroplasty and often lead to revision. The purpose of this study was to assess the outcome of revision of large-head MoM total hip arthroplasties after an extensive screening protocol for all MoM articulations with a minimum 2 year follow-up. We identified 50 hips that had undergone large-head MoM total hip arthoplasty and required revision at a mean of 44 months after index operation...
May 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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