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https://www.readbyqxmd.com/read/29156169/next-generation-minimal-resection-fixed-bearing-total-ankle-replacement-indications-and-outcomes
#1
REVIEW
Justin Tsai, David I Pedowitz
Total ankle arthroplasty is an increasingly popular procedure to address tibiotalar joint arthritis. Implant design and the rationale behind it have changed throughout the years. Newer generation implants allow for minimal resection of bone and use fixed-bearing technology. Long-term follow-up multicenter studies will determine the lifetime of these devices and their effectiveness in addressing pain and improving function for patients with endstage tibiotalar arthritis.
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29145010/the-use-of-hardened-bone-cement-as-an-impaction-grafting-extender-for-revision-hip-arthroplasty
#2
Mark Ruddy, David P FitzPatrick, Kenneth T Stanton
Impaction bone grafting is a method of restoring bone stock to patients who have suffered significant bone loss due to revision total hip surgery. The procedure requires morsellised cancellous bone (MCB) to be impacted into the site of bone loss in order to stabilise the prosthesis with the aim of long term resorption and reintegration of the impacted bone graft. Due to financial cost and the potential to transmit disease, the use of supplementary material, known as an extender, is frequently used to increase the graft material volume...
November 13, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29137563/stem-anteversion-mismatch-to-the-anatomical-anteversion-causes-loss-of-periprosthetic-bone-density-after-tha
#3
Shinya Hayashi, Shingo Hashimoto, Tomoyuki Matsumoto, Koji Takayama, Kotaro Nishida, Kazunari Ishida, Ryosuke Kuroda
The short tapered-wedge stem is popular worldwide because it potentially preserves more bone stock during total hip arthroplasty (THA). However, stem version mismatch may affect physiological stress distribution. In this study, we analyzed the correlations between periprosthetic bone mineral density (BMD) changes and anteversion mismatch in patients who underwent THA using a short tapered-wedge stem. The study included 44 patients (44 joints) who underwent THA with a Tri-Lock stem. At baseline and at 6 and 24 months postoperatively, the BMDs in the seven Gruen zones were evaluated using dual-energy X-ray absorptiometry...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29132902/histopathological-assessment-of-primary-osteoarthritic-knees-in-large-patient-cohort-reveal-the-possibility-of-several-potential-patterns-of-osteoarthritis-initiation
#4
V P Mantripragada, N S Piuzzi, T Zachos, N A Obuchowski, G F Muschler, R J Midura
OBJECTIVE: The two main objectives of the study include (1) Test the hypothesis that the lateral femoral condyle (LFC) in patients with primary OA and varus knees undergoing total knee arthroplasty (TKA) can be used as a model to better characterize varying histological features of human OA, (2) Correlate characteristic OA features using the established histopathological scoring systems (HHGS and OARSI) to understand potential histopathological patterns of OA initiation. DESIGN: Two osteochondral specimens (4×4×8mm) were collected from fifty patient's LFC at the time of TKA (total 100 specimens), who presented preserved lateral knee compartment with joint space width>2mm...
November 10, 2017: Current Research in Translational Medicine
https://www.readbyqxmd.com/read/29132347/knee-arthrodesis-versus-above-the-knee-amputation-after-septic-failure-of-revision-total-knee-arthroplasty-comparison-of-functional-outcome-and-complication-rates
#5
Sven Hungerer, Martin Kiechle, Christian von Rüden, Matthias Militz, Knut Beitzel, Mario Morgenstern
BACKGROUND: After septic failure of total knee arthroplasty (TKA) and multiple revision operations resulting in impaired function, bone and/or soft-tissue damage a reconstruction with a revision arthroplasty might be impossible. Salvage procedures to regain mobility and quality of life are an above-the-knee amputation or knee arthrodesis. The decision process for the patient and surgeon is difficult and data comparing arthrodesis versus amputation in terms of function and quality of life are scarce...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29126455/micrognathia-with-temporomandibular-joint-ankylosis-and-obstructive-sleep-apnea-treated-with-mandibular-distraction-osteogenesis-using-skeletal-anchorage-a-case-report
#6
Hiroshi Tomonari, Hiroko Takada, Tomofumi Hamada, Sangho Kwon, Tsuyoshi Sugiura, Shouichi Miyawaki
BACKGROUND: We describe the case of a 16-year-old female patient with micrognathia, temporomandibular joint (TMJ) ankylosis, and obstructive sleep apnea, who was treated with mandibular distraction osteogenesis (DO) combined with sliding genioplasty, using skeletal anchorage. CASE PRESENTATION: We first performed interpositional arthroplasty, in which an interposition of fascia temporalis and surrounding fat tissue was inserted into the defect after bilateral condylectomy, increasing the maximum mouth opening from 5...
November 10, 2017: Head & Face Medicine
https://www.readbyqxmd.com/read/29125919/autologous-chondrocyte-implantation-sandwich-technique-compared-with-autologous-bone-grafting-for-deep-osteochondral-lesions-in-the-knee
#7
Tom Minas, Takahiro Ogura, Jeff Headrick, Tim Bryant
BACKGROUND: Treating symptomatic osteochondral defects is challenging, especially in young adults with deep (>8-10 mm) empty defects after osteochondritis dissecans (OCD) or collapsed condyles secondary to avascular necrosis (AVN). For this population, osteoarthritis (OA) is inevitable if articular congruence is not restored. PURPOSE: To describe the autologous chondrocyte implantation (ACI) "sandwich" technique with autologous bone grafting (ABG) and compare it with ABG alone for restoration of the osteochondral unit...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29123932/hyperphosphatemic-tumoral-calcinosis-after-total-knee-arthroplasty
#8
Takeshi Mochizuki, Katsunori Ikari
We report a case of hyperphosphatemic tumoral calcinosis (TC) that occurred after total knee arthroplasty. A 64-year-old Japanese man presented with painful swellings in both shoulders, the left elbow, and the right hip that developed after he underwent total knee arthroplasty (TKA). The pathology of the patient's bone at the time of TKA included a thick osteoid seam with calcareous deposition at the margin of the trabecular bone, which is not generally seen in osteoarthritis. Computed tomography scans of the swollen joints demonstrated leaflet and amorphous calcification masses around the joints...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29110910/treatment-of-giant-cell-tumor-of-distal-radius-with-limited-soft-tissue-invasion-curettage-and-cementing-versus-wide-excision
#9
Kamran Mozaffarian, Mehra Modjallal, Amir Reza Vosoughi
BACKGROUND: Intralesional curettage and adjuvant versus wide en bloc excision (WEE) as the best treatment method of giant cell tumor (GCT) of distal radius with limited soft tissue extension is a controversial topic. METHODS: Prospectively, 13 patients who had GCT of distal radius with perforation of either volar or dorsal cortex of the bone and soft tissue extension which was confined to one plane were enrolled in the study. Six patients treated with ICC and seven cases cured by WEE technique and proximal fibular arthroplasty...
October 27, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29109029/transcriptional-profile-of-human-macrophages-stimulated-by-ultra-high-molecular-weight-polyethylene-particulate-debris-of-orthopedic-implants-uncovers-a-common-gene-expression-signature-of-rheumatoid-arthritis
#10
Mohamad Alaa Terkawi, Masanari Hamasaki, Daisuke Takahashi, Masahiro Ota, Ken Kadoya, Tomoyo Yutani, Keita Uetsuki, Tsuyoshi Asano, Tohru Irie, Ryuta Arai, Tomohiro Onodera, Masahiko Takahata, Norimasa Iwasaki
Osteolysis is a serious postoperative complication of total joint arthroplasty that leads to aseptic loosening and surgical revision. Osteolysis is a chronic destructive process that occurs when host macrophages recognize implant particles and release inflammatory mediators that increase bone-resorbing osteoclastic activity and attenuate bone-formation osteoblastic activity. Although much progress has been made in understanding the molecular responses of macrophages to implant particles, the pathways/signals that initiate osteolysis remain poorly characterized...
November 3, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/29107499/clinical-outcome-of-massive-endoprostheses-used-for-managing-periprosthetic-joint-infections-of-the-hip-and-knee
#11
Abtin Alvand, George Grammatopoulos, Floris de Vos, Matthew Scarborough, Ben Kendrick, Andrew Price, Roger Gundle, Duncan Whitwell, William Jackson, Adrian Taylor, Christopher L M H Gibbons
BACKGROUND: Endoprosthetic replacement (EPR) is an option for management of massive bone loss resulting from infection around failed lower limb implants. The aim of this study is to determine the mid-term outcome of EPRs performed in the treatment of periprosthetic joint infection (PJI) and infected failed osteosyntheses around the hip and knee joint and identify factors that influence it. METHODS: We retrospectively reviewed all hip and knee EPRs performed between 2007 and 2014 for the management of chronic infection following complex arthroplasty or fracture fixation...
October 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29098919/current-methods-of-preventing-aseptic-loosening-and-improving-osseointegration-of-titanium-implants-in-cementless-total-hip-arthroplasty-a-review
#12
Dragos Apostu, Ondine Lucaciu, Cristian Berce, Dan Lucaciu, Dan Cosma
Hip osteoarthritis is the most common joint disorder, and is represented by a degenerative process, resulting in pain and functional impairment. If conservative treatment for hip osteoarthritis fails, the only remaining option is hip arthroplasty. Despite good survival of implants, loosening of components is the most common complication. This leads to revision surgeries, which are technically demanding, expensive, and result in a low satisfaction rate. Uncemented hip replacements require proper osseointegration for increased survival...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29098354/-total-elbow-arthroplasty-in-traumatic-and-post-traumatic-bone-defects
#13
REVIEW
M Hackl, L P Müller, T Leschinger, K Wegmann
Total elbow arthroplasty is currently most commonly carried out due to acute trauma or post-traumatic conditions. Bone defects are often present and must be considered in the (pre-)operative workup. The use of semi-constrained prostheses with a systematic cementing technique through a triceps-on approach leads to satisfying clinical results, however, the outcome is worse when compared with rheumatic patients.Primary total elbow arthroplasty for complex distal humerus fractures in the elderly patient or secondary implantation following failed conservative treatment or osteosynthesis represent possible indications for (post‑)traumatic joint replacement...
November 2, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/29092997/the-orthopaedic-manifestation-and-outcomes-of-methicillin-sensitive-staphylococcus-aureus-septicaemia
#14
D Makki, T Elgamal, P Evans, D Harvey, G Jackson, S Platt
AIMS: The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive Staphylococcus aureus (MSSA) septicaemia. PATIENTS AND METHODS: A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092992/evaluation-of-fever-in-the-immediate-post-operative-period-following-shoulder-arthroplasty
#15
B M Saltzman, B C Mayo, D D Bohl, R M Frank, B J Cole, N N Verma, G P Nicholson, A A Romeo
AIMS: To determine the incidence and timing of post-operative fevers following shoulder arthroplasty and the resulting investigations performed. PATIENTS AND METHODS: A retrospective review was conducted of all patients undergoing shoulder arthroplasty over a nine-year period. The charts of all patients with a post-operative fever (≥ 38.6°C) were reviewed and the results of all investigations were analysed. RESULTS: A total of 2167 cases (in 1911 patients) were included of whom 92 (4...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092988/a-positive-bacterial-culture-during-re-implantation-is-associated-with-a-poor-outcome-in-two-stage-exchange-arthroplasty-for-deep-infection
#16
D Akgün, M Müller, C Perka, T Winkler
AIMS: The aim of this study was to identify the incidence of positive cultures during the second stage of a two-stage revision arthroplasty and to analyse the association between positive cultures and an infection-free outcome. PATIENTS AND METHODS: This single-centre retrospective review of prospectively collected data included patients with a periprosthetic joint infection (PJI) of either the hip or the knee between 2013 and 2015, who were treated using a standardised diagnostic and therapeutic algorithm with two-stage exchange...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092987/the-unsuspected-prosthetic-joint-infection-incidence-and-consequences-of-positive-intra-operative-cultures-in-presumed-aseptic-knee-and-hip-revisions
#17
A M E Jacobs, M Bénard, J F Meis, G van Hellemondt, J H M Goosen
AIMS: Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. PATIENTS AND METHODS: A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092986/the-analysis-of-synovial-fluid-in-total-knee-arthroplasties-with-flexion-instability
#18
N M Hernandez, M J Taunton, K I Perry, K C Mara, A D Hanssen, M P Abdel
AIMS: Patients with flexion instability after total knee arthroplasty (TKA) often present with a recurrent effusion, which may be a haemarthrosis. While the radiographic factors contributing to flexion instability have been elucidated, the clinical diagnosis remains challenging. Our aim, in this study, was to determine the mean white cell count and differential profile in pre-operative aspirations of synovial fluid in a consecutive series of patients undergoing revision TKA for flexion instability...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092985/fixation-and-clinical-outcome-of-uncemented-peri-apatite-coated-versus-cemented-total-knee-arthroplasty-five-year-follow-up-of-a-randomised-controlled-trial-using-radiostereometric-analysis-rsa
#19
K T van Hamersveld, P J Marang-van de Mheen, R Tsonaka, E R Valstar, S Toksvig-Larsen
AIMS: The optimal method of tibial component fixation remains uncertain in total knee arthroplasty (TKA). Hydroxyapatite coatings have been applied to improve bone ingrowth in uncemented designs, but may only coat the directly accessible surface. As peri-apatite (PA) is solution deposited, this may increase the coverage of the implant surface and thereby fixation. We assessed the tibial component fixation of uncemented PA-coated TKAs versus cemented TKAs. PATIENTS AND METHODS: Patients were randomised to PA-coated or cemented TKAs...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092984/outcomes-following-debridement-antibiotics-and-implant-retention-in-the-management-of-periprosthetic-infections-of-the-hip-a-review-of-cohort-studies
#20
S-T J Tsang, J Ting, A H R W Simpson, P Gaston
AIMS: The aims of the study were to review and analyse the reported series of debridement, antibiotics and implant retention (DAIR) in the management of infected total hip arthroplasties (THAs) to establish the overall success and the influencing factors. PATIENTS AND METHODS: Using a standardised recognised study protocol, meta-analysis of observational studies in epidemiology guidelines, a comprehensive review and analysis of the literature was performed. The primary outcome measure was the success of treatment...
November 2017: Bone & Joint Journal
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