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The Journal of Bone and Joint Surgery.... Sep 2022
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans
PubMed: 35980042
DOI: 10.2106/JBJS.22.00535 -
Instructional Course Lectures 2015The management of periprosthetic fractures is an issue of increasing importance for orthopaedic surgeons. Because of the expanding indications for total joint... (Review)
Review
The management of periprosthetic fractures is an issue of increasing importance for orthopaedic surgeons. Because of the expanding indications for total joint arthroplasty (TJA) and an aging population with increasingly active lifestyles, the incidence of primary and revision TJA is increasing, and there is a corresponding increase in the prevalence of periprosthetic fractures about a TJA. The management of these fractures is often complex because of issues with obtaining fixation around implants, dealing with osteopenic bone or compromised bone stock, and the potential need for revising loose TJA components. In addition, these injuries frequently occur in frail, elderly patients, and the literature has demonstrated that both morbidity and mortality in these patients is similar to that of the geriatric hip fracture population. As such, the early restoration of function and ambulation is critical in patients with these injuries, and effective surgical strategies to achieve these goals are essential.
Topics: Arthroplasty, Replacement; Fracture Fixation; Humans; Joint Prosthesis; Periprosthetic Fractures; Prosthesis Failure; Reoperation
PubMed: 25745902
DOI: No ID Found -
Der Orthopade Jan 2017Geriatric traumatology is increasing in importance due to the demographic transition. In cases of fractures close to large joints it is questionable whether primary... (Review)
Review
BACKGROUND
Geriatric traumatology is increasing in importance due to the demographic transition. In cases of fractures close to large joints it is questionable whether primary joint replacement is advantageous compared to joint-preserving internal fixation.
OBJECTIVE
The aim of this study was to describe the importance of prosthetic joint replacement in the treatment of geriatric patients suffering from frequent periarticular fractures in comparison to osteosynthetic joint reconstruction and conservative methods.
MATERIAL AND METHODS
A selective search of the literature was carried out to identify studies and recommendations concerned with primary arthroplasty of fractures in the region of the various joints (hip, shoulder, elbow and knee).
RESULTS
The importance of primary arthroplasty in geriatric traumatology differs greatly between the various joints. Implantation of a prosthesis has now become the gold standard for displaced fractures of the femoral neck. In addition, reverse shoulder arthroplasty has become an established alternative option to osteosynthesis in the treatment of complex proximal humeral fractures. Due to a lack of large studies definitive recommendations cannot yet be given for fractures around the elbow and the knee. Nowadays, joint replacement for these fractures is recommended only if reconstruction of the joint surface is not possible.
CONCLUSION
The importance of primary joint replacement for geriatric fractures will probably increase in the future. Further studies with larger patient numbers must be conducted to achieve more confidence in decision making between joint replacement and internal fixation especially for shoulder, elbow and knee joints.
Topics: Arthroplasty, Replacement; Evidence-Based Medicine; Fractures, Bone; Geriatrics; Humans; Joint Prosthesis; Practice Guidelines as Topic; Traumatology; Treatment Outcome
PubMed: 27966179
DOI: 10.1007/s00132-016-3369-z -
The Journal of Hand Surgery Mar 2017Total wrist arthroplasty using current design implants has evolved into a fairly predictable procedure for rheumatoid, osteoarthritic, and posttraumatic patients.... (Review)
Review
Total wrist arthroplasty using current design implants has evolved into a fairly predictable procedure for rheumatoid, osteoarthritic, and posttraumatic patients. Although complications can occur, the incidence of these has dropped over the past decade with implant design modifications. The article summarizes the current use of total wrist arthroplasty and touches on issues of revision surgery, secondary fusion, complications, wrist fusion takedown, and radiolucency around implants. Technical tips are also provided for both primary and revision surgery.
Topics: Arthritis; Arthroplasty, Replacement; Humans; Joint Prosthesis; Prosthesis Design; Reoperation; Wrist Joint
PubMed: 28111060
DOI: 10.1016/j.jhsa.2016.12.004 -
The Bone & Joint Journal Jul 2022
Topics: Arthroplasty, Replacement, Hip; Congresses as Topic; Hip Prosthesis; Humans; Reoperation
PubMed: 35775185
DOI: 10.1302/0301-620X.104B7.BJJ-2022-0490 -
The Journal of Hand Surgery, European... Feb 2024We reviewed the incidence and management of complications after total wrist arthroplasty, as reported in the literature, with so-called fourth-generation implants and... (Review)
Review
We reviewed the incidence and management of complications after total wrist arthroplasty, as reported in the literature, with so-called fourth-generation implants and other recent designs. While early intraoperative and postoperative complications, including fractures, tendon lacerations, infection, nerve compression, tendonitis, stiffness and chronic regional pain syndrome, had an acceptable incidence, late complications, such as periprosthetic osteolysis and implant loosening, occurred more frequently. Implant survival at 10 years was in the range of 70%-80% in most publications. Several of the implants have been modified or withdrawn. Instability and dislocation were frequent after a pyrocarbon spacer. Failed arthroplasties can be salvaged by revision arthroplasty or total wrist arthrodesis. Revision arthroplasty has a lower survival rate than primary arthroplasty and does not clearly offer important significant advantages over total wrist arthrodesis in terms of patient-reported outcome measures. Further development of prosthetic design, new materials and more knowledge on patient-related risk factors are needed.
Topics: Humans; Wrist; Arthroplasty, Replacement; Joint Prosthesis; Postoperative Complications; Risk Factors; Reoperation
PubMed: 38315136
DOI: 10.1177/17531934231203297 -
Bulletin of the Hospital For Joint... Jan 2017Total wrist arthroplasty (TWA), first performed in the late 19th Century, is still an infrequently used operation. It is most commonly indicated in patients with... (Review)
Review
Total wrist arthroplasty (TWA), first performed in the late 19th Century, is still an infrequently used operation. It is most commonly indicated in patients with rheumatoid arthritis who have pan-carpal wrist involvement. It is an alternative to total wrist arthrodesis in patients who wish to preserve joint motion. Patients must lead a low-demand lifestyle and have failed non-operative measures. Complications are not insignificant and have been reported to be as high as 43%. Modern generation implants most often fail due to dislocation or loosening. Because wrist arthrodesis remains the gold standard treatment, particularly in patients with higher physical demands, it remains to be seen whether TWA will gain greater acceptance as prosthetic designs evolve.
Topics: Arthrodesis; Arthroplasty, Replacement; Biomechanical Phenomena; Hemiarthroplasty; Humans; Joint Prosthesis; Prosthesis Design; Prosthesis Failure; Range of Motion, Articular; Recovery of Function; Risk Factors; Treatment Outcome; Wrist Joint
PubMed: 28214456
DOI: No ID Found -
Orthopaedic Surgery Nov 2016Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy.... (Review)
Review
Patient-specific orthopaedic implants are emerging as a clinically promising treatment option for a growing number of conditions to better match an individual's anatomy. Patient-specific implant (PSI) technology aims to reduce overall procedural costs, minimize surgical time, and maximize patient outcomes by achieving better biomechanical implant fit. With this commercially-available technology, computed tomography or magnetic resonance images can be used in conjunction with specialized computer programs to create preoperative patient-specific surgical plans and to develop custom cutting guides from 3-D reconstructed images of patient anatomy. Surgeons can then place these temporary guides or "jigs" during the procedure, allowing them to better recreate the exact resections of the computer-generated surgical plan. Over the past decade, patient-specific implants have seen increased use in orthopaedics and they have been widely indicated in total knee arthroplasty, total hip arthroplasty, and corrective osteotomies. Patient-specific implants have also been explored for use in total shoulder arthroplasty and spinal surgery. Despite their increasing popularity, significant support for PSI use in orthopaedics has been lacking in the literature and it is currently uncertain whether the theoretical biomechanical advantages of patient-specific orthopaedic implants carry true advantages in surgical outcomes when compared to standard procedures. The purpose of this review was to assess the current status of patient-specific orthopaedic implants, to explore their future direction, and to summarize any comparative published studies that measure definitive surgical characteristics of patient-specific orthopaedic implant use such as patient outcomes, biomechanical implant alignment, surgical cost, patient blood loss, or patient recovery.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Bone Plates; Computer-Aided Design; Humans; Joint Prosthesis; Magnetic Resonance Imaging; Patient-Specific Modeling; Prosthesis Design; Tomography, X-Ray Computed
PubMed: 28032697
DOI: 10.1111/os.12282 -
Journal of ISAKOS : Joint Disorders &... Oct 2023Anatomical total shoulder arthroplasty in its modern form where it reproduces the normal shoulder has been utilized clinically for more than half a century. As the... (Review)
Review
Anatomical total shoulder arthroplasty in its modern form where it reproduces the normal shoulder has been utilized clinically for more than half a century. As the technology and the designs have changed to recreate the humeral and glenoid sides of the joint, the sophistication of design has resulted in the growing number of cases annually worldwide. This increase is due in part to the increasing number of indications that the prosthesis can treat with successful results. On the humeral side, there have been design changes to better reflect the proximal humeral anatomy, and humeral stems are increasingly placed safely without cement. Platform systems which allow conversion of a failed arthroplasty to a reverse configuration without stem extraction is another design change. Similarly, there has been increasing utilization of short stem and stemless humeral components. Extensive experience with shorter stem and stemless devices, however, has yet to demonstrate the purported advantages of these devices, as recent studies have demonstrated equivalent blood loss, fracture rates, operative times, and outcome scores. Easier revision with these shorter stems remains to be definitively established, with only one study comparing the ease of revision between stem types. On the glenoid side, hybrid cementless glenoids, inlay glenoids, cementless all-polyethylene glenoids, and augmented glenoids have all been investigated; however, the indications for these devices remain unclear. Lastly, innovative surgical approaches to implanting shoulder arthroplasty and the use of patient specific guides and computerized planning, while interesting concepts, still await validation before they are utilized on a widespread basis. While reverse shoulder arthroplasty has been increasingly used to reconstruct the arthritic shoulder, anatomic glenohumeral replacement maintains a significant role in the armamentarium of the shoulder surgeon.
Topics: Humans; Prosthesis Design; Arthroplasty, Replacement, Shoulder; Joint Prosthesis; Shoulder Prosthesis; Polyethylene
PubMed: 37207983
DOI: 10.1016/j.jisako.2023.05.001 -
Current Osteoporosis Reports Jun 2018Recently, significant progress has been made in the research related to regenerative medicine. At the same time, biomedical implants in orthopedics and dentistry are... (Review)
Review
PURPOSE OF REVIEW
Recently, significant progress has been made in the research related to regenerative medicine. At the same time, biomedical implants in orthopedics and dentistry are facing many challenges and posing clinical concerns. The purpose of this chapter is to provide an overview of the clinical applications of current regenerative strategies to the fields of dentistry and orthopedic surgery. The main research question in this review is: What are the major advancement strategies in regenerative medicine that can be used for implant research?
RECENT FINDINGS
The implant surfaces can be modified through patient-specific stem cells and plasma coatings, which may provide methods to improve osseointegration and sustainability of the implant. Overall understanding from the review suggesting that the outcome from the studies could lead to identify optimum solutions for many concerns in biomedical implants and even in drug developments as a long-term solution to orthopedic and dental patients.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Bone-Implant Interface; Dental Implants; Hip Prosthesis; Humans; Joint Prosthesis; Knee Prosthesis; Orthopedics; Osseointegration; Osteoarthritis; Prostheses and Implants; Regenerative Medicine; Spondylosis; Stem Cells; Total Disc Replacement
PubMed: 29679306
DOI: 10.1007/s11914-018-0441-0