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bone joint arthroplasty

Hidetoshi Hamada, Masaki Takao, Takashi Sakai, Nobuhiko Sugano
PURPOSE: For successful joint preservation in osteonecrosis of the femoral head (ONFH), it is important to understand the mechanism of collapse. The purpose of this study was to investigate the initiation of subchondral fracture in ONFH by using micro-CT imaging of the whole femoral head, focusing on the three-dimensional relationship between the subchondral fracture and the bone resorption area. METHODS: A total of 40 femoral heads from 37 patients retrieved during total hip arthroplasty for stage 3A or 3B ONFH by Japanese Investigation Committee criteria were scanned using micro-CT with a 0...
March 14, 2018: International Orthopaedics
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Maria Teresa Trentinaglia, Catherine Van Der Straeten, Ilaria Morelli, Nicola Logoluso, Lorenzo Drago, Carlo L Romanò
BACKGROUND: Antibacterial coatings (ABCs) of implants have proven safe and effective to reduce postsurgical infection, but little is known about their possible economic impact on large-scale use. This study evaluated the point of economic balance, during the first year after surgery, and the potential overall annual healthcare cost savings of 3 different antibacterial technologies applied to joint arthroplasty: a dual-antibiotic-loaded bone cement (COPAL G + C), an antibacterial hydrogel coating (DAC), and a silver coating (Agluna)...
February 10, 2018: Journal of Arthroplasty
Gulraj S Matharu, Andrew Judge, David W Murray, Hemant G Pandit
BACKGROUND: Metal-on-metal hip replacement (MoMHR) revision surgery for adverse reactions to metal debris (ARMD) has been associated with an increased risk of early complications and reoperation and inferior patient-reported outcome scores compared with non-ARMD revisions. As a result, early revision specifically for ARMD with adoption of a lower surgical threshold has been widely recommended with the goal of improving the subsequent prognosis after ARMD revisions. However, no large cohorts have compared the risk of complications and reoperation after MoMHR revision surgery for ARMD (an unanticipated revision indication) with those after non-ARMD revisions (which represent conventional modes of arthroplasty revision)...
February 2018: Clinical Orthopaedics and related Research
Kenneth W Donohue, Eric T Ricchetti, Jason C Ho, Joseph P Iannotti
BACKGROUND: Glenoid morphology and rotator cuff muscle quality are important anatomic factors that can impact longevity of the glenoid component following total shoulder arthroplasty (TSA). We hypothesized that rotator cuff muscle fatty infiltration is associated with increased pathologic glenoid bone loss in glenohumeral osteoarthritis (OA). METHODS: We retrospectively reviewed 190 preoperative computed tomography (CT) scans of 175 patients (mean age, 66 years; range, 44 to 90 years) who underwent TSA for the treatment of primary glenohumeral OA...
March 7, 2018: Journal of Bone and Joint Surgery. American Volume
Danielle Thomas, David Thordarson
BACKGROUND: Hallux rigidus is a common osteoarthritic disease of the first metatarsophalangeal joint (MTPJ). Few salvage treatment options exist that preserve motion for patients who have failed an initial procedure and who are not amenable to fusion, typically patients who are active or who would like to wear high heels. Allograft tendon interpositional arthroplasty is an unconventional salvage treatment option that may preserve motion and prevent bone loss. METHODS: A retrospective chart review is reported of 19 patients who failed previous procedures and refused fusion who underwent allograft tendon interpositional arthroplasty of the hallux MTPJ by a single surgeon between 2012 and 2015...
March 1, 2018: Foot & Ankle International
Peter L Lewis, David C Davidson, Stephen E Graves, Richard N de Steiger, William Donnelly, Alana Cuthbert
BACKGROUND: Some surgeons contend that unicompartmental knee arthroplasty (UKA) can easily be revised to a TKA when revision is called for, whereas others believe that this can be complex and technically demanding. There has been little research regarding the efficacy or rationale of using metal augmentation and tibial stem extensions when revising a UKA to a TKA. QUESTION/PURPOSES: (1) Is the use of stem extensions for the tibial component associated with increased survival when revising a UKA to a TKA? (2) Is the addition of modular augments associated with increased survival compared with stem extensions alone? (3) Is TKA design (minimally stabilized versus posterior-stabilized) or (4) tibial fixation (cemented versus cementless) associated with differences in survivorship? METHODS: Data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) were used to analyze implant survival after revision of a UKA to a TKA, comparing results in which tibial components were used with and without modular components...
February 23, 2018: Clinical Orthopaedics and related Research
Chloe E H Scott, Frazer A Wade, Deborah MacDonald, Richard W Nutton
INTRODUCTION: Biomechanical studies have suggested that proximal tibial strain is elevated in UKAs incorporating all-polyethylene tibial components with concern that this leads to premature failure. This study reports minimum 10-year outcomes for a UKA incorporating an all-polyethylene tibial component to determine whether these concerns were realised. MATERIALS AND METHODS: 109 fixed bearing UKAs (97 patients, mean age 68 (range 48-87), 54/97 (56%) female) with all-polyethylene tibial components were followed up for ≥ 10 years with Oxford Knee Scores, Forgotten Joint Scores and Kaplan-Meier analysis...
February 23, 2018: Archives of Orthopaedic and Trauma Surgery
J Mehl, A B Imhoff, K Beitzel
PATHOGENESIS: Osteoarthritis of the shoulder is characterized by a progressive degenerative process, which is based on chronic inflammation with intra-articular release of different cytokines and proteolytic enzymes. The main predisposing factors are a history of trauma or surgery, as well as chronic overuse or instability of the glenohumeral joint. Affected patients especially suffer from impaired joint function and pain, which are often associated with cognitive and psychosocial restrictions...
February 20, 2018: Der Orthopäde
Daniel L Riddle, Hassan Ghomrawi, William A Jiranek, Levent Dumenci, Robert A Perera, Antonio Escobar
Appropriateness classification for total knee arthroplasty (TKA) has received substantial attention recently, and Katz and colleagues published an Orthopaedic Forum on the topic in The Journal of Bone & Joint Surgery in February 2017. Classifications of appropriateness are particularly important given the rapid rise in use of TKA and a variety of third-party payer approaches designed to control health-care costs. We respond to some of the concerns addressed by Katz and colleagues, and elaborate on what we believe are some important issues related to both older and newer appropriateness criteria for TKA...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
Seiichi Matsumoto
The treatment of soft tissue tumors has maderemarkable progress through advancements in diagnostic imaging and analysis ofsurgical materials. Changes in the treatment of soft tissue tumors are describedfrom my experience since 1977. Prior to the introduction of CT scans, radiography and angiography were the only methods for tumor localization. Wholebody CT, echography, and soft tissue radiography were introduced around 1980,and significant progress was seen in the localization of soft tissue tumors.Although the localization and diagnostic characteristics of tumors becameeasier with the introduction of MRI, radiography and ultrasound still remainedthe primary diagnostic method for soft tissue tumors...
February 16, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Jie Shi, Wei Wang, Xiao-le He, Xu-Sheng Li
Rheumatoid arthritis (RA) is a most common inflammatory joint disease with direct invasion of joint synovial membrane, cartilage and bone. Currently, although the RA mitigation drugs are being improved continously, but these drugs only can delay the development of joint dysfunction. Total hip arthroplasty or total knee arthroplasty(THA or TKA) has become the only choices for patients with advanced RA, and the joint function and deformity of the patients after surgical treatment can be improved to some extent...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Juehong Li, Yamin Li, Xiaochun Peng, Bin Li, Xiangwei Yuan, Yunsu Chen
Aseptic loosening due to wear particles is a serious challenge for orthopedic surgeons, sabotaging the long-term success of total joint arthroplasty. The existing treatments for aseptic loosening are still far from satisfactory, necessitating more aggressive drug exploration. Here, we examined the effect of emodin on titanium particle-induced osteolysis and further investigated its underlying mechanism in vivo and in vitro. Thirty-two C57BL/6 mice were randomly assigned into four groups: the Sham group (sham operation with vehicle injection), Vehicle group (titanium particle treatment with vehicle injections), Low group (titanium particle treatment with injections of 10 mg/kg/day emodin) and High group (titanium particle treatment with injections of 50 mg/kg/day emodin)...
February 15, 2018: Molecular Immunology
Anita Vijapura, Harlan B Levine, Michele Donato, Mark A Hartzband, Melissa Baker, Gregg R Klein
The immunosuppressive regimens required for hematopoietic stem cell transplantation predispose recipients to complications, including avascular necrosis. Cancer-related comorbidities, immunosuppression, and poor bone quality theoretically increase the risk for perioperative medical complications, infection, and implant-related complications in total joint arthroplasty. This study reviewed 20 primary total hip arthroplasties for avascular necrosis in 14 patients. Outcomes were assessed at routine clinical visits and Harris hip scores were calculated...
February 16, 2018: Orthopedics
Frank W Roemer, C Kent Kwoh, Tomoko Fujii, Michael J Hannon, Robert M Boudreau, David J Hunter, Felix Eckstein, Markus R John, Ali Guermazi
OBJECTIVE: Aims were to assess (1) structural progression in knees with no/mild radiographic osteoarthritis (ROA) (i.e. Kellgren-Lawrence (K-L) grades 0 to 2) that will undergo knee replacement (KR) during a 5-year period; (2) differences in structural damage on MRI between knees with no/mild ROA vs. those with severe ROA (i.e. K-L 3 and 4) at baseline; and (3) differences in pain levels between those groups. METHODS: All participants who underwent KR from baseline (BL) to 60 months were drawn from the Osteoarthritis Initiative...
February 13, 2018: Arthritis Care & Research
Zhe Du, Zhonglin Zhu, Bing Yue, Zhanchun Li, You Wang
Polyether-ether-ketone (PEEK) is a potential alternative to metal alloys for use in the orthopedic implants; however, an in vivo study in an appropriate animal model is essential and has not yet been initiated. The aim of the present study was to gather some preliminary evidence regarding the performance and safety of a cemented PEEK-based knee replacement device in a goat model. Fifteen adult goats were randomly divided into two groups; the control group (n = 5), which received a sham operation, and the experimental group (n = 10), which received a total knee arthroplasty with a PEEK-based knee replacement device...
February 13, 2018: Artificial Organs
Konstantinos I Alexiou, Andreas Roushias, Sokratis E Varitimidis, Konstantinos N Malizos
Fractures due to fragility of the bone around the hip joint have become a major public health issue, presenting with an increasing incidence due to the growth of the elderly population. The purpose of this review was to evaluate the impact of hip fractures on the quality of life (QoL), health status (HS), functioning, and psychological parameters, and factors influencing the outcome and the appropriate interventions for improvement of elderly patients. A systematic electronic search of the relevant literature was carried out using the CINAHL, Cochrane, EMBASE, Medline (OvidSP), and PubMed databases spanning the time period from their establishment up to January 2017...
2018: Clinical Interventions in Aging
Jigang Lou, Beiyu Wang, Tingkui Wu, Wenjie Wu, Huibo Li, Ziyang Liu, Hao Liu
BACKGROUND: A study was designed to quantify the extent of porous osseointegration at the prosthesis-bone interface in the Prestige LP prosthesis containing a plasma-sprayed titanium coating. METHODS: Using an anterior surgical approach, cervical disc arthroplasty was performed in 8 mature male goats at the C3-C4 segment, followed by implantation of the Prestige LP prosthesis. The vertebral specimens were examined using microcomputed tomograph for histomorphometric quantification, and proceeded by routine paraffin processing for histological observation...
February 7, 2018: BMC Musculoskeletal Disorders
Marco A Martínez Bocanegra, Javier Bayod Lopez, A Vidal-Lesso, Ricardo Becerro de Bengoa Vallejo, Raúl Lesso-Arroyo
BACKGROUND: Currently, the metatarsophalangeal joint replacement through a restorative arthroplasty, where implants are used, is a viable invasive surgical medical procedure in the treatment of severe cases of osteoarthritis in this joint, better known as hallux rigidus. However, few things are known about the postoperative complications that implants can cause on the joint, like Swanson and Tornier implants.Research in this field can provide a valuable information that would help the specialist surgeon in the decision-making during the selection of the more suitable joint implant in each patient, as well as the redesign of the devices, to make them more efficient, durable and biocompatible with the human body...
October 20, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Francesc Malagelada, Matthew J Welck, Callum Clark
BACKGROUND: The operative management of failed first metatarso-phalangeal joint (MTPJ) surgery is often complicated by bone loss and shortening of the hallux. Restoration of first ray length and alignment often cannot be achieved with in situ fusion and reconstruction techniques with bone graft are therefore required. We present a novel technique of longitudinal (proximo-distal) bone dowel arthrodesis for first MTPJ arthrodesis with bone loss. METHODS: Between August 2007 and February 2015, eight patients have been treated by the senior author with this technique...
February 27, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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