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https://www.readbyqxmd.com/read/28197660/radiographic-and-surgical-considerations-in-arthritis-surgery-of-the-hand
#1
REVIEW
Violeta Nikac, Philip Blazar, Brandon Earp, Barbara N Weissman
Indications for hand surgeries include unremitting joint pain, deformity and stiffness, often secondary to arthritis. Several surgical options are available, including arthrodesis (fusion) and joint arthroplasty. Classically arthrodesis is performed in situations with poor bone stock and supporting soft tissues. Arthroplasty is reserved for patients and joints in which preservation of function is important and bone stock and soft tissue support are adequate. In this article we will review various techniques for arthrodesis and arthroplasty, their post-surgical imaging appearance, including key findings important to surgeons, and the findings that indicate post-surgical complications...
February 14, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28176355/strain-shielding-inspired-re-design-of-proximal-femoral-stems-for-total-hip-arthroplasty
#2
Myriam Cilla, Sara Checa, Georg N Duda
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement...
February 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28167867/hip-resurfacing-international-perspectives-review-article
#3
REVIEW
Julien Girard
BACKGROUND: The hip resurfacing concept was developed for young and active patients, especially for femoral bone stock preservation. However, concerns about metal-on-metal bearings with adverse reactions to metal debris have led to a drop off in hip-resurfacing procedures. QUESTIONS/PURPOSES: The goal of this review is to evaluate our current knowledge of survivorship of second-generation hip resurfacing devices and elaborate international perspectives for product improvement...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28149733/arthroscopic-interpositional-arthroplasty-of-the-second-metatarsophalangeal-joint
#4
Tun Hing Lui
Painful degenerative diseases of the second metatarsophalangeal joint are frequently progressive and difficult to treat. Surgical options for the degenerated second metatarsophalangeal joint include joint debridement and synovectomy, drilling and microfracture, core decompression, dorsal closing-wedge metatarsal osteotomies, joint arthroplasty (implant or interpositional), elevation of the depressed articular fragment and bone graft, distraction arthroplasty, osteochondral plug transplantation, osteochondral distal metatarsal allograft reconstruction, and resection arthroplasty (phalangeal base or metatarsal head)...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28148669/hemiarthroplasty-or-total-hip-arthroplasty-for-the-treatment-of-a-displaced-intracapsular-fracture-in-active-elderly-patients-12-year-follow-up-of-randomised-trial
#5
RANDOMIZED CONTROLLED TRIAL
M C J M Tol, M P J van den Bekerom, I N Sierevelt, E F Hilverdink, E L F B Raaymakers, J C Goslings
AIMS: Our aim was to analyse the long-term functional outcome of two forms of surgical treatment for active patients aged > 70 years with a displaced intracapsular fracture of the femoral neck. Patients were randomised to be treated with either a hemiarthroplasty or a total hip arthroplasty (THA). The outcome five years post-operatively for this cohort has previously been reported. We present the outcome at 12 years post-operatively. PATIENTS AND METHODS: Initially 252 patients with a mean age of 81...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148666/custom-made-total-ankle-arthroplasty-for-the-salvage-of-major-talar-bone-loss
#6
J Wagener, C E Gross, C Schweizer, T Horn Lang, B Hintermann
AIMS: A failed total ankle arthroplasty (TAA) is often associated with much bone loss. As an alternative to arthrodesis, the surgeon may consider a custom-made talar component to compensate for the bone loss. Our aim in this study was to assess the functional and radiological outcome after the use of such a component at mid- to long-term follow-up. PATIENTS AND METHODS: A total of 12 patients (five women and seven men, mean age 53 years; 36 to77) with a failed TAA and a large talar defect underwent a revision procedure using a custom-made talar component...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148664/validation-of-the-english-language-forgotten-joint-score-12-as-an-outcome-measure-for-total-hip-and-knee-arthroplasty-in-a-british-population
#7
D F Hamilton, F L Loth, J M Giesinger, K Giesinger, D J MacDonald, J T Patton, A H R W Simpson, C R Howie
AIMS: To validate the English language Forgotten Joint Score-12 (FJS-12) as a tool to evaluate the outcome of hip and knee arthroplasty in a United Kingdom population. PATIENTS AND METHODS: All patients undergoing surgery between January and August 2014 were eligible for inclusion. Prospective data were collected from 205 patients undergoing total hip arthroplasty (THA) and 231 patients undergoing total knee arthroplasty (TKA). Outcomes were assessed with the FJS-12 and the Oxford Hip and Knee Scores (OHS, OKS) pre-operatively, then at six and 12 months post-operatively...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148663/pre-operative-functional-mobility-as-an-independent-determinant-of-inpatient-functional-recovery-after-total-knee-arthroplasty-during-three-periods-that-coincided-with-changes-in-clinical-pathways
#8
G van der Sluis, R A Goldbohm, J E Elings, M W Nijhuis-van der Sanden, R P Akkermans, R Bimmel, T J Hoogeboom, N L van Meeteren
AIMS: To investigate whether pre-operative functional mobility is a determinant of delayed inpatient recovery of activities (IRoA) after total knee arthroplasty (TKA) in three periods that coincided with changes in the clinical pathway. PATIENTS AND METHODS: All patients (n = 682, 73% women, mean age 70 years, standard deviation 9) scheduled for TKA between 2009 and 2015 were pre-operatively screened for functional mobility by the Timed-up-and-Go test (TUG) and De Morton mobility index (DEMMI)...
2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148661/cement-in-cement-femoral-component-revision-in-the-multiply-revised-total-hip-arthroplasty-results-with-a-minimum-follow-up-of-five-years
#9
N A Sandiford, S S Jameson, M J Wilson, M J W Hubble, A J Timperley, J R Howell
AIMS: We present the clinical and radiological results at a minimum follow-up of five years for patients who have undergone multiple cement-in-cement revisions of their femoral component at revision total hip arthroplasty (THA). PATIENTS AND METHODS: We reviewed the outcome on a consecutive series of 24 patients (10 men, 14 women) (51 procedures) who underwent more than one cement-in-cement revision of the same femoral component. The mean age of the patients was 67...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148659/variation-in-functional-pelvic-tilt-in-patients-undergoing-total-hip-arthroplasty
#10
J Pierrepont, G Hawdon, B P Miles, B O' Connor, J Baré, L R Walter, E Marel, M Solomon, S McMahon, A J Shimmin
AIMS: The pelvis rotates in the sagittal plane during daily activities. These rotations have a direct effect on the functional orientation of the acetabulum. The aim of this study was to quantify changes in pelvic tilt between different functional positions. PATIENTS AND METHODS: Pre-operatively, pelvic tilt was measured in 1517 patients undergoing total hip arthroplasty (THA) in three functional positions - supine, standing and flexed seated (the moment when patients initiate rising from a seated position)...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148658/long-term-outcomes-of-transtrochanteric-rotational-osteotomy-for-non-traumatic-osteonecrosis-of-the-femoral-head
#11
D Morita, Y Hasegawa, T Okura, Y Osawa, N Ishiguro
AIMS: Transtrochanteric rotational osteotomy (TRO) is performed for young patients with non-traumatic osteonecrosis of the femoral head (ONFH) to preserve the hip. We aimed to investigate the long-term outcomes and the risk factors for failure 15 years after this procedure. PATIENTS AND METHODS: This study included 95 patients (111 hips) with a mean age of 40 years (21 to 64) who underwent TRO for ONFH. The mean follow-up was 18.2 years (3 to 26). Kaplan-Meier survivorship analyses were performed with conversion to total hip arthroplasty (THA) and radiological failure due to secondary collapse of the femoral head or osteoarthritic changes as the endpoint...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28148655/meta-analysis-of-gap-balancing-versus-measured-resection-techniques-in-total-knee-arthroplasty
#12
REVIEW
T Huang, Y Long, D George, W Wang
AIMS: There are two techniques widely used to determine the rotational alignment of the components in total knee arthroplasty (TKA); gap balancing (GB) and measured resection (MR). Which technique is the best remains controversial. We aimed to investigate this in a systematic review and meta-analysis. MATERIALS AND METHODS: In accordance with the methods of Cochrane, databases were searched for all randomised controlled trials in the literature between January 1986 and June 2015 comparing radiographic and clinical outcomes between the use of these two tecniques...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28145954/intra-articular-vancomycin-powder-eliminates-methicillin-resistant-s-aureus-in-a-rat-model-of-a-contaminated-intra-articular-implant
#13
Adam I Edelstein, Joseph A Weiner, Ralph W Cook, Danielle S Chun, Emily Monroe, Sean M Mitchell, Abhishek Kannan, Wellington K Hsu, S David Stulberg, Erin L Hsu
BACKGROUND: Periprosthetic joint infection following hip and knee arthroplasty leads to poor outcomes and exorbitant costs. Topical vancomycin powder has been shown to decrease infection in many procedures such as spine surgery. The role of vancomycin powder in the setting of total joint arthroplasty remains undefined. Our aim was to evaluate the efficacy of intra-articular vancomycin powder in preventing infection in a rat model of a contaminated intra-articular implant. METHODS: Thirty-two female Sprague-Dawley rats underwent knee arthrotomy and implantation of a femoral intramedullary wire with 1 mm of intra-articular communication...
February 1, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28138955/recent-advances-in-hydrogels-for-cartilage-tissue-engineering
#14
S L Vega, M Y Kwon, J A Burdick
Articular cartilage is a load-bearing tissue that lines the surface of bones in diarthrodial joints. Unfortunately, this avascular tissue has a limited capacity for intrinsic repair. Treatment options for articular cartilage defects include microfracture and arthroplasty; however, these strategies fail to generate tissue that adequately restores damaged cartilage. Limitations of current treatments for cartilage defects have prompted the field of cartilage tissue engineering, which seeks to integrate engineering and biological principles to promote the growth of new cartilage to replace damaged tissue...
January 30, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28131544/evidence-based-indications-for-mobile-bearing-unicompartmental-knee-arthroplasty-in-a-consecutive-cohort-of-thousand-knees
#15
Thomas W Hamilton, Hemant G Pandit, Cathy Jenkins, Stephen J Mellon, Christopher A F Dodd, David W Murray
BACKGROUND: The indications for unicompartmental knee arthroplasty remain controversial. Previously recommended contraindications include the following: age under 60 years, weight 180 lb (82 kg) or over, patients undertaking heavy labor, chondrocalcinosis, and exposed bone in the patellofemoral joint. This study explores whether these contraindications are valid in mobile-bearing unicompartmental knee arthroplasty. METHODS: Using a prospective series of 1000 consecutive medial unicompartmental knee arthroplasties in which the reported contraindications were not applied, the functional outcome and survival in patients with or without contraindications were compared...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28112787/posterior-cortical-axis-a-new-landmark-to-control-femoral-component-rotation-in-total-knee-arthroplasty
#16
Doerte Matziolis, Marius Meiser, Norbert Sieber, Ulf Teichgräber, Georg Matziolis
Rotation errors of the femoral component are held responsible for occurrences such as instability in flexion and midflexion, patellar maltracking, and arthrofibrosis following total knee arthroplasty. However, in many cases, the epicondylar axis cannot be reliably identified due to bone defects or metal artifacts on computed tomography, so alternative landmarks are necessary to evaluate the femoral component rotation. The current study sought to determine the relationship of the posterior cortical bone and the anterior cortical bone in relation to the epicondylar axis...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28111125/superficial-vancomycin-coating-of-bone-cement-in-orthopedic-revision-surgery-a-safe-technique-to-enhance-local-antibiotic-concentrations
#17
Florian Amerstorfer, Stefan Fischerauer, Patrick Sadoghi, Gerold Schwantzer, Klaus Dieter Kuehn, Andreas Leithner, Mathias Glehr
BACKGROUND: The use of antibiotic-loaded cement has become a well-accepted method to develop high local antibiotic concentrations in revision surgery of infected arthroplasty. A new surgical technique has been established to further increase the local antibiotic concentration and thereby minimizes the risk of reinfection. Our study aim was to investigate the safety of additional superficial vancomycin coating (SVC) by analyzing postoperative joint and serum vancomycin concentrations, as well as the creatinine levels of patients with orthopedic revision surgery...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28110363/bone-morphotypes-of-the-varus-and-valgus-knee
#18
E Thienpont, P E Schwab, O Cornu, J Bellemans, J Victor
BACKGROUND: Coronal deformity correction with total knee arthroplasty (TKA) is an important feature in the treatment of osteoarthritis (OA). The hypothesis of this study was that bone morphology would be different in varus and valgus deformity, both before osteoarthritis development as well as during and after the disease process of OA. MATERIALS AND METHODS: Retrospective study with measurements on preoperative and postoperative full leg standing radiographs of 96 patients who underwent TKA...
January 21, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28108481/clinically-insignificant-trunnionosis-in-large-diameter-metal-on-polyethylene-total-hip-arthroplasty
#19
H S Hothi, D Kendoff, C Lausmann, J Henckel, T Gehrke, J Skinner, A Hart
OBJECTIVES: Mechanical wear and corrosion at the head-stem junction of total hip arthroplasties (THAs) (trunnionosis) have been implicated in their early revision, most commonly in metal-on-metal (MOM) hips. We can isolate the role of the head-stem junction as the predominant source of metal release by investigating non-MOM hips; this can help to identify clinically significant volumes of material loss and corrosion from these surfaces. METHODS: In this study we examined a series of 94 retrieved metal-on-polyethylene (MOP) hips for evidence of corrosion and material loss at the taper junction using a well published visual grading method and an established roundness-measuring machine protocol...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28100411/comparison-of-mid-term-results-between-conversion-total-knee-arthroplasties-following-closed-wedge-high-tibial-osteotomy-and-primary-total-knee-arthroplasties-a-matched-pair-study-including-patellar-symptom-and-position
#20
Dae Kyung Bae, Sang Jun Song, Cheol Hee Park, Hu Liang, Jung Kwon Bae
BACKGROUND: The purpose of this study was to compare mid-term clinical and radiographic results of conversion total knee arthroplasties (TKA) following a closed-wedge high tibial osteotomy (HTO) and primary TKAs. METHODS: A total of 32 conversion TKAs (29 patients) were compared with a matched control group of patients who had undergone primary TKA. The clinical results were evaluated using the Knee Society Knee and Function score, the Western Ontario and McMaster Universities score, patella score, and range of motion (ROM)...
January 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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