-
Lancet (London, England) Jan 2016Periprosthetic joint infections are a devastating complication after arthroplasty and are associated with substantial patient morbidity. More than 25% of revisions are... (Review)
Review
Periprosthetic joint infections are a devastating complication after arthroplasty and are associated with substantial patient morbidity. More than 25% of revisions are attributed to these infections, which are expected to increase. The increased prevalence of obesity, diabetes, and other comorbidities are some of the reasons for this increase. Recognition of the challenge of surgical site infections in general, and periprosthetic joint infections particularly, has prompted implementation of enhanced prevention measures preoperatively (glycaemic control, skin decontamination, decolonisation, etc), intraoperatively (ultraclean operative environment, blood conservation, etc), and postoperatively (refined anticoagulation, improved wound dressings, etc). Additionally, indications for surgical management have been refined. In this Review, we assess risk factors, preventive measures, diagnoses, clinical features, and treatment options for prosthetic joint infection. An international consensus meeting about such infections identified the best practices and further research needs. Orthopaedics could benefit from enhanced preventive, diagnostic, and treatment methods.
Topics: Anti-Bacterial Agents; Arthroplasty, Replacement; Debridement; Humans; Infection Control; Joint Prosthesis; Perioperative Care; Prosthesis-Related Infections; Reoperation; Risk Factors; Therapeutic Irrigation
PubMed: 26135702
DOI: 10.1016/S0140-6736(14)61798-0 -
Journal of ISAKOS : Joint Disorders &... Oct 2023The reverse shoulder arthroplasty conceived by Paul Grammont in 1985 has gradually gained popularity as a treatment for multiple shoulder diseases. Unlike previous... (Review)
Review
The reverse shoulder arthroplasty conceived by Paul Grammont in 1985 has gradually gained popularity as a treatment for multiple shoulder diseases. Unlike previous reverse shoulder prosthesis characterized by unsatisfactory results and a high glenoid implant failure rate, the Grammont design has immediately shown good clinical outcomes. This semi constrained prosthesis solved the issues of the very first designs by medializing and distalizing the center of rotation with an increased stability of the replacement of the component. The indication was initially limited to cuff tear arthropathy (CTA). It has then been expanded to irreparable massive cuff tears and displaced humeral head fractures. The most frequent problems of this design are a limited postoperative external rotation and scapular notching. Different modifications to the original Grammont design have been proposed with the aim of decreasing the risk of failure and complications and improving the clinical outcomes. Both the position and version/inclination of the glenosphere and the humeral configuration (e.g. neck shaft angle) influence the RSA outcomes. A lateralized glenoid (whether with bone or metal) and a 135° Inlay system configuration leads to a moment arm which is the closest to the native shoulder. Clinical research will focus on implant designs reducing bone adaptations and revision rate, strategies to prevent more effectively infections. Furthermore, there is still room for improvement in terms of better postoperative internal and external rotations and clinical outcomes after RSA implanted for humeral fracture and revision shoulder arthroplasty.
Topics: Humans; Arthroplasty, Replacement, Shoulder; Shoulder Joint; Shoulder Prosthesis; Joint Prosthesis; Rotator Cuff Tear Arthropathy
PubMed: 37301479
DOI: 10.1016/j.jisako.2023.05.007 -
Hand Surgery & Rehabilitation Sep 2021In 1970, Jean-Yves de la Caffinière developed the first trapeziometacarpal (TMC) joint prosthesis, a ball-and-socket design based on hip replacement implants. From 1970...
In 1970, Jean-Yves de la Caffinière developed the first trapeziometacarpal (TMC) joint prosthesis, a ball-and-socket design based on hip replacement implants. From 1970 to 1990, the first generation of cemented prostheses was developed. At that time, trapeziectomy, with tendon interposition or suspension arthroplasty, and Swanson silastic spacers remained the most widely used surgical procedures for thumb basal joint arthritis. From 1990 to 2010, a second generation of cementless prostheses was developed. The third generation was introduced after 2010 and consisted of dual mobility prostheses. In 2020, TMC arthroplasty (simple or dual mobility) is a reliable option in thumb basal joint arthritis with an implant survival rate of 90% at 10 years of follow-up, while providing pain relief and restoring strength and mobility. Restoration of the thumb's length corrects most thumb Z-deformities, so the TMC joint prosthesis may be a viable alternative surgical solution to trapeziectomy, which remains the gold standard in English-speaking countries. Moreover, trapeziectomy after failed TMC arthroplasty provides outcomes equivalent to those of primary trapeziectomy.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Osteoarthritis; Tendons; Thumb
PubMed: 33540123
DOI: 10.1016/j.hansur.2020.09.013 -
Hand Clinics May 2022Thumb carpometacarpal implant arthroplasty aims to preserve thumb length and motion and to provide pain relief and functional recovery after a short postoperative time.... (Review)
Review
Thumb carpometacarpal implant arthroplasty aims to preserve thumb length and motion and to provide pain relief and functional recovery after a short postoperative time. For several decades, implant arthroplasty has been performed with total trapeziometacarpal joint prosthesis using the concept of "ball-and-socket" joint. More recently, pyrocarbon implants used as hemiarthroplasty or interposition arthroplasty have been proposed. Whatever the type of arthroplasty used, the surgical technique must be precise and may require a learning curve. Implant arthroplasty has proven that in the medium and long-term, it may be considered as a valid and reliable alternative to trapeziectomy.
Topics: Arthroplasty; Arthroplasty, Replacement; Carpometacarpal Joints; Humans; Joint Prosthesis; Osteoarthritis; Range of Motion, Articular; Thumb; Trapezium Bone
PubMed: 35465939
DOI: 10.1016/j.hcl.2021.12.006 -
Der Orthopade May 2019Arthroplasty of metacarpophalangeal (MCP) joints is crucial for patients with rheumatoid arthritis. Motion preserving therapies are mandatory for this joint, since loss... (Review)
Review
BACKGROUND
Arthroplasty of metacarpophalangeal (MCP) joints is crucial for patients with rheumatoid arthritis. Motion preserving therapies are mandatory for this joint, since loss of function of the MCP joint is detrimental. Many protheses or spacers have been introduced over the last 80 years, but most of them have been dismissed due to major complications.
CURRENT PROCEDURES
Since the 1960s the Swanson spacer has been established as the reference standard for motion preserving procedures of the finger MCP joints. High fracture rates of the spacer do not seem to limit function and patient satisfaction after all. Current long-term studies show at least promising results for pyrolytic carbon protheses with respect to range of motion, survival, and revision rates in comparison to the Swanson spacer.
Topics: Arthritis, Rheumatoid; Arthroplasty, Replacement; Finger Joint; Follow-Up Studies; Humans; Joint Prosthesis; Metacarpophalangeal Joint; Range of Motion, Articular
PubMed: 30915483
DOI: 10.1007/s00132-019-03715-8 -
Der Unfallchirurg Apr 2016
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Periprosthetic Fractures; Reoperation
PubMed: 27003193
DOI: 10.1007/s00113-016-0157-5 -
Zeitschrift Fur Rheumatologie Dec 2023Arthrosis and autoimmune arthritis frequently lead to major impairment of hand function. Primary therapy consists of well- tried conservative treatments and joint... (Review)
Review
Arthrosis and autoimmune arthritis frequently lead to major impairment of hand function. Primary therapy consists of well- tried conservative treatments and joint preserving surgical options for special indications. In advanced stages silicon spacers remain the gold standard surgical option for replacement of proximal interphalangeal and metacarpophalgeal joints of the fingers. Alternatively, surface replacement prostheses can restore the biomechanical properties of these joints more porperly. In case of the carpometacarpal (CMC) joint of the thumb, arthroplasty is gaining popularity as modern implants show excellent mid-term outcome. Although current forth generation implants for wrist replacement are promising, total wrist arthroplasty is currently reserved for exceptional indications.
Topics: Humans; Wrist; Joint Prosthesis; Arthroplasty; Hand; Arthroplasty, Replacement; Joint Diseases; Wrist Joint
PubMed: 37828110
DOI: 10.1007/s00393-023-01420-8 -
Clinics in Podiatric Medicine and... Oct 2019Total ankle arthroplasty has been in development for more than 40 years. Although early designs were experimental with high failure rates, current implants are... (Review)
Review
Total ankle arthroplasty has been in development for more than 40 years. Although early designs were experimental with high failure rates, current implants are significantly improved, showing promising functional results and clinical outcomes. Total ankle replacement designs are split into mobile-bearing and fixed-bearing designs. When deciding whether to perform ankle arthroplasty, many factors need to be considered to determine if the patient is suitable and which implant is the best fit for patient and surgeon. Many prostheses are available in the United States today and the purpose of this article is to outline options for foot and ankle surgeons.
Topics: Arthroplasty, Replacement, Ankle; Humans; Joint Prosthesis; Prosthesis Design; United States
PubMed: 31466570
DOI: 10.1016/j.cpm.2019.06.005 -
Dermatologie (Heidelberg, Germany) Jan 2024
Topics: Humans; Antibiosis; Arthroplasty, Replacement; Joint Prosthesis; Endocarditis, Bacterial
PubMed: 37991532
DOI: 10.1007/s00105-023-05264-w -
The Journal of Bone and Joint Surgery.... Sep 2022
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans
PubMed: 35980042
DOI: 10.2106/JBJS.22.00535