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Digital arthroplasty

Robert A Sershon, Alejandro Diaz, Daniel D Bohl, Brett R Levine
BACKGROUND: Digital templating is becoming more prevalent in orthopedics. Recent investigations report high accuracy using digital templating in total hip arthroplasty (THA); however, the effect of body mass index (BMI) on templating accuracy is not well described. METHODS: Digital radiographs of 603 consecutive patients (645 hips) undergoing primary THA by a single surgeon were digitally templated using OrthoView (Jacksonville, FL). A 25-mm metallic sphere was used as a calibration marker...
September 28, 2016: Journal of Arthroplasty
Tressa D Amirthanayagam, Andrew A Amis, Peter Reilly, Roger J H Emery
BACKGROUND: The deltopectoral approach for total shoulder arthroplasty can result in subscapularis dysfunction. In addition, glenoid wear is more prevalent posteriorly, a region difficult to access with this approach. We propose a posterior approach for access in total shoulder arthroplasty that uses the internervous interval between the infraspinatus and teres minor. This study compares this internervous posterior approach with other rotator cuff-sparing techniques, namely, the subscapularis-splitting and rotator interval approaches...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Thomas Suter, Christopher W Kolz, Robert Z Tashjian, Heath B Henninger, Ariane Gerber Popp
BACKGROUND: The best chance that a shoulder arthroplasty will restore motion and muscle balance across the glenohumeral joint is by closely replicating natural articular morphology. Defining the humeral osteotomy plane along clear landmarks at the anatomic neck is critical. We hypothesized that a new osteotomy, based on alternative landmarks on the anatomic neck, would restore 3-dimensional humeral head morphology more reliably than the traditional osteotomy. METHODS: The anatomic neck was digitized in 30 human cadaver shoulders and compared with its 3-dimensional computed tomography reconstruction...
October 6, 2016: Journal of Shoulder and Elbow Surgery
Yaxia Zhang, Michael Joyce, Jean Schils, Thomas W Bauer
Sarcoidosis is a systemic inflammatory disorder characterized by non-caseating granulomas, predominantly involving lung, mediastinal lymph nodes and other organs. Synovium involvement is infrequent, and as far as we know, involvement of a periprosthetic membrane has not been reported in the English literature. Intra-articular diffuse tenosynovial giant cell tumor ("conventional diffuse pigmented villonodular synovitis") is an uncommon, locally aggressive neoplasm with few previous case reports in which it arose in periprosthetic tissues after knee arthroplasty...
October 7, 2016: Skeletal Radiology
Peter Cnudde, Ola Rolfson, Szilard Nemes, Johan Kärrholm, Clas Rehnberg, Cecilia Rogmark, John Timperley, Göran Garellick
BACKGROUND: Sweden offers a unique opportunity to researchers to construct comprehensive databases that encompass a wide variety of healthcare related data. Statistics Sweden and the National Board of Health and Welfare collect individual level data for all Swedish residents that ranges from medical diagnoses to socioeconomic information. In addition to the information collected by governmental agencies the medical profession has initiated nationwide Quality Registers that collect data on specific diagnoses and interventions...
October 4, 2016: BMC Musculoskeletal Disorders
Hang Feng, Xiangyi Fang, Dageng Huang, Chengcheng Yu, Songchuan Zhao, Dingjun Hao
BACKGROUND CONTEXT: Cervical disc arthroplasty has been gradually adopted as an alternative for the treatment of cervical degenerative disease. However, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical end plates. PURPOSE: This study aimed to accurately and comprehensively quantify the three-dimensional (3D) anatomic morphology of the cervical vertebral end plate and provide a theoretical basis for designing appropriate disc prostheses...
October 3, 2016: Spine Journal: Official Journal of the North American Spine Society
Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Koji Murakami, Hidehiko Higaki, Hiroyuki Nakahara, Takeshi Shimoto, Hideki Mizu-Uchi, Yukio Akasaki, Yukihide Iwamoto
The purpose of this study was to investigate in vivo kinematics in healthy and osteoarthritic (OA) knees during stepping using image-matching techniques. Six healthy volunteers and fourteen patients with medial OA knee before undergoing total knee arthroplasty performed stepping under periodic anteroposterior X-ray images. We analyzed the three-dimensional kinematic parameters of knee joints using X-ray images and CT-derived digitally reconstructed radiographs. The average extension/flexion angle ranged 6°/53° and 16°/44° in healthy and OA knees with significant difference in extension (p = ...
October 5, 2016: Journal of Applied Biomechanics
Simona Gurzu, Sabin Gligore Turdean, Sorin Tudor Pop, Ancuta Zazgyva, Ciprian Oliviu Roman, Mihaela Opris, Ioan Jung
PURPOSE: To present a hypothesis regarding the pathways of angiogenesis in primary versus secondary hip osteoarthritis (OA). METHODS: In synovial tissue samples provided by 57 consecutive patients who underwent hip arthroplasty, immunohistochemical examinations were performed using the following angiogenesis-related antibodies: VEGF-A, COX-2, maspin and the endothelial cells markers CD31 and CD105. The cases were divided into three categories: classic primary hip OA (group A; n = 16), rapidly destructive hip OA (group B; n = 24) and hip OA secondary to avascular osteonecrosis of the femoral head (group C; n = 17)...
October 4, 2016: International Orthopaedics
Michael E Steinhaus, Alexander S McLawhorn, Shawn S Richardson, Patrick Maher, David J Mayman
BACKGROUND: Proper alignment of total knee arthroplasty (TKA) is essential for TKA function and may reduce the risk of aseptic failure. Technologies that prevent malalignment may reduce the risk of revision surgery. QUESTIONS/PURPOSES: The purpose of this study was to compare two competing TKA systems that purport improved alignment: patient-specific instrumentation (PSI), and a handheld portable navigation device (NAV). METHODS: After IRB approval, 49 consecutive PSI TKAs (40 patients) were matched based on preoperative characteristics to 49 NAV TKAs (40 patients) performed by a single surgeon...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Hao Tang, Dejin Yang, Shengjie Guo, Jing Tang, Jian Liu, Dacheng Wang, Yixin Zhou
OBJECTIVES: For postoperative imaging assessment of cementless hip arthroplasty, radiography and computed tomography (CT) were restricted by overlapping structures and metal artifacts, respectively. A new tomosynthesis with metal artifact reduction (TMAR) is introduced by using metal extraction and ordered subset-expectation maximization (OS-EM) reconstruction. This study investigated the effectiveness of TMAR in assessing fixation stability of cementless hip arthroplasty components. MATERIALS AND METHODS: We prospectively included 48 consecutive patients scheduled for revision hip arthroplasty in our hospital, with 41 femoral and 35 acetabular cementless components available for evaluation...
November 2016: Skeletal Radiology
Nam L Dinh, Alexander Cm O'Chong, Justin K Walden, Scott C Adrian, Robert P Cusick
BACKGROUND: With the advent of new bone cements with different viscosities, it is important to understand how they respond to different cementing techniques. The purpose of this study was to evaluate the high viscosity (HV) bone cement intrusion characteristics comparing negative pressure intrusion technique (NPI) and finger-packing technique in a cadaveric proximal tibial bone. METHODS: Soft tissues were removed from twenty- four fresh frozen cadaver proximal tibiae, and standard arthroplasty tibial cuts were performed...
2016: Iowa Orthopaedic Journal
Justin K Walden, Alexander C M Chong, Nam L Dinh, Scott Adrian, Robert Cusick, Paul H Wooley
The purpose of this study was to evaluate and compare the intrusion characteristics of Simplex-HV to Simplex-P and Palacos-R in cadaveric proximal tibial bone. Eighteen fresh-frozen cadaver proximal tibiae were examined with standard arthroplasty tibial cuts. Each tibia was randomly assigned to receive one of the three bone cements for use with finger packing technique. Sagittal sections were prepared and analyzed using digital photography and stereoscopic micrographs to evaluate cement intrusion characteristics...
2016: Journal of Surgical Orthopaedic Advances
Christopher Samujh, Samrath Bhimani, Langan Smith, Arthur L Malkani
A major limiting factor in the longevity of total hip replacement is the wear rate of the hip bearing. As manufacturing technology has improved during the past several decades, much attention has been focused on developing newer generations of polyethylene that have lower rates of wear while minimizing free radical formation and subsequent osteolysis. The turning point for the manufacture of polyethylene was moving from gamma irradiation in air to irradiation in a low oxygen environment, which reduced free radical formation while increasing the wear resistance...
August 9, 2016: Orthopedics
Ely L Steinberg, Eitan Segev, Michael Drexler, Tomer Ben-Tov, Snir Nimrod
The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English...
June 2016: Israel Medical Association Journal: IMAJ
Brandon A Haghverdian, David J Wright, Ran Schwarzkopf
OBJECTIVES: Acute pain in the postoperative period after total joint arthroplasty (TJA) has a significant effect on early rehabilitation, hospital length of stay, and the development of chronic pain. Consequently, efforts have been made to predict the occurrence of postoperative pain using preoperative and intraoperative factors. In this study, we tested the usefulness of preoperative pressure pain threshold (PPT) values in the prediction of three outcomes for patients who underwent TJA: visual analog scale pain scores, hospital length of stay, and opioid consumption...
July 29, 2016: Surgical Technology International
Christina M Arnholt, Daniel W MacDonald, Arthur L Malkani, Gregg R Klein, Clare M Rimnac, Steven M Kurtz, Sevi B Kocagoz, Jeremy L Gilbert
BACKGROUND: Metal debris and ion release has raised concerns in joint arthroplasty. The purpose of this study was to characterize the sources of metallic ions and particulate debris released from long-term (in vivo >15 years) total knee arthroplasty femoral components. METHODS: A total of 52 CoCr femoral condyles were identified as having been implanted for more than 15 years. The femoral components were examined for incidence of 5 types of damage (metal-on-metal wear due to historical polyethylene insert failure, mechanically assisted crevice corrosion at taper interfaces, cement interface corrosion, third-body abrasive wear, and inflammatory cell-induced corrosion [ICIC])...
May 12, 2016: Journal of Arthroplasty
Matthew Diamond, Johanna MacKenzie, George Babikian
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
M Worlicek, M Weber, F Zeman, M Wörner, M Schneider, J Grifka, T Renkawitz, B Craiovan
PURPOSE: The purpose of this study was to evaluate the validity of commercially available planning software on plain radiographs after THA compared to CT scans as the gold standard. PATIENTS AND METHODS: In a prospective clinical study, anteroposterior (AP) radiographs and three-dimensional CT scans (3D-CT) were obtained for 121 patients, who underwent minimally invasive, cementless THA with a straight tapered stem, in a lateral decubitus position. For measuring SV, we used digital planning software (TraumaCad 2...
August 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Matthew F Dilisio, Jon J P Warner, Gilles Walch
Inferior glenoid baseplate tilt relative to the coronal axis of the scapular body has been associated with improved results and fewer postoperative complications in reverse shoulder arthroplasty. However, the native glenoid surface is not always a reliable reference for the true scapular axis. Digital preoperative planning software and advanced imaging now allow surgeons to more precisely determine optimal glenoid placement. The purpose of this study was to evaluate the accuracy of the subchondral smile and cannulated surface guide techniques in achieving inferior glenoid baseplate tilt by using 3-dimensional preoperative planning software...
July 1, 2016: Orthopedics
Kandhari V K, Desai M M, Bava S S, Wade R N
INTRODUCTION: Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach...
October 2015: Journal of Orthopaedic Case Reports
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