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Sports Medicine and Arthroscopy Review Dec 2014Longevity of total anatomic and reversed shoulder arthroplasty largely depends on accurate correction of glenoid deformity and correct positioning and fixation of the... (Review)
Review
Longevity of total anatomic and reversed shoulder arthroplasty largely depends on accurate correction of glenoid deformity and correct positioning and fixation of the glenoid component. However, the morphology of the scapula is inconsistent, varying degrees of osteoarthritis cause numerous anatomic changes, and standard 2-dimensional imaging and standard surgical instrumentation are imprecise for preoperative planning and execution of glenoid reconstruction. Recently, various authors have shown that preoperative 3-dimensional surgical planning and computer navigation technology may increase the accuracy and repeatability of the implantation of the glenoid component, especially for the position and orientation of the glenosphere and screws in reversed arthroplasty. These novel techniques may allow the surgeon to better define the preoperative deformity, select the optimal implant position, and then accurately execute the plan at the time of surgery. Future studies are needed to determine the long-term effect on functional outcome and cost-effectiveness of computer-assisted technology in shoulder arthroplasty.
Topics: Arthroplasty, Replacement; Humans; Imaging, Three-Dimensional; Joint Prosthesis; Prosthesis Design; Shoulder Joint; Surgery, Computer-Assisted
PubMed: 25370882
DOI: 10.1097/JSA.0000000000000045 -
The Orthopedic Clinics of North America Apr 2020Prosthetic joint infection is still a rare but devastating complication following total hip and knee arthroplasty. The incidence of prosthetic joint infection ranges... (Review)
Review
Prosthetic joint infection is still a rare but devastating complication following total hip and knee arthroplasty. The incidence of prosthetic joint infection ranges from 2% to 4% in primary procedures as opposed to nearly 20% in revisions. The challenges that arise here include mainly diagnostic uncertainty, management in immunocompromised patients, recurrent infection, infection around a well-fixed implant, and substantial bone loss, and require careful preoperative assessment and well-defined management plans. This article summarizes recent developments in the diagnosis and management of this increasingly prevalent issue specifically focusing on outcomes following debridement, antibiotics, and implants retention and one-stage revision procedures.
Topics: Anti-Bacterial Agents; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Biomarkers; Debridement; Device Removal; Humans; Joint Prosthesis; Prosthesis-Related Infections; United Kingdom
PubMed: 32138852
DOI: 10.1016/j.ocl.2019.12.003 -
Atlas of the Oral and Maxillofacial... Mar 2016
Review
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Maxillofacial Abnormalities; Orthognathic Surgical Procedures; Plastic Surgery Procedures; Surgery, Computer-Assisted; Temporomandibular Joint Disorders
PubMed: 26847513
DOI: 10.1016/j.cxom.2015.10.006 -
Oral and Maxillofacial Surgery Clinics... Feb 2015Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time... (Review)
Review
Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time requirement in preparation of concomitant orthognathic and temporomandibular joint (TMJ) prostheses cases. The concomitant TMJ and orthognathic surgery-computer-assisted surgical simulation technique increases the accuracy of combined cases. In order to have flexibility in positioning of the total joint prosthesis, recontouring of the lateral aspect of the rami is advantageous.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Orthognathic Surgical Procedures; Surgery, Computer-Assisted; Temporomandibular Joint Disorders
PubMed: 25483443
DOI: 10.1016/j.coms.2014.09.004 -
BMC Musculoskeletal Disorders Apr 2024Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and...
BACKGROUND
Total joint arthroplasty as a surgical treatment option for trapeziometacarpal joint arthritis is recently revived. The aim of this study is to report on mid- and long-term results of the Elektra (single-mobility) and Moovis (dual-mobility) prosthesis for treatment of primary thumb carpometacarpal joint arthritis.
METHODS
In this retrospective, monocentric, descriptive cohort study, 31 prostheses were evaluated that were implanted by a single surgeon in 26 patients between 2009 and 2019. Indication for surgery was trapeziometacarpal joint osteoarthritis (Eaton/Littler Stage II and III). Clinical and radiological follow-up was performed at a minimum of 24 months. The postoperative assessment included range of motion, pain, strength as well as functional scores (DASH, MHQ). Implant survival and complications were the primary endpoints.
RESULTS
10 Elektra and 21 Moovis prostheses were implanted between 2009 and 2019 with a mean follow-up of 74.2 months in the Elektra and 41.4 months in the Moovis group. The average patients' age at surgery was 64 years. Postoperative pain levels (VAS 0-10) were below 2 at rest and under stress in both groups. Grip/pinch strength and range of motion showed results comparable to the contralateral hand. Opposition was excellent with an average Kapandji index of 9.6 in both groups. Elektra achieved slightly better functional scores in the DASH and MHQ score. Satisfaction was high in both groups, and 96% of the patients would recommend the procedure. Metacarpophalangeal hyperextension > 15° was seen in 3 patients per group preoperatively and was corrected to < 5° post-surgery. 3 Elektra prostheses were revised due to cup loosening and dislocation for cup and/or neck replacement or secondary trapeziectomy. 1 Moovis prosthesis was revised with an exchange of the neck to a larger size due to restricted movement. After the mean follow-up of 7.9 years in Elektra and 3.5 years in MOOVIS, cumulative survival was 68.6% vs. 95.2%, respectively.
CONCLUSIONS
In this mid- to long-term retrospective analysis, total joint arthroplasty in primary trapeziometacarpal joint arthritis results in low pain levels, excellent mobility and clinical function. Patient satisfaction is overall high. While revision due to cup loosening occurred more often in patients with single-mobility implants, no cases of dislocation or loosening of components were observed in the dual-mobility group.
TRIAL REGISTRATION
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Medical Faculty of Heidelberg University, reference number S-150/2020.
Topics: Humans; Male; Retrospective Studies; Female; Middle Aged; Carpometacarpal Joints; Aged; Joint Prosthesis; Osteoarthritis; Range of Motion, Articular; Treatment Outcome; Prosthesis Design; Follow-Up Studies; Trapezium Bone; Arthroplasty, Replacement; Thumb
PubMed: 38664698
DOI: 10.1186/s12891-024-07439-5 -
Foot and Ankle Clinics Mar 2023The present review paper aimed at discussing the current major issues in total ankle replacement, both the technical and biomechanical concepts, and the surgical and... (Review)
Review
The present review paper aimed at discussing the current major issues in total ankle replacement, both the technical and biomechanical concepts, and the surgical and clinical concerns. Designers shall target at the same time restoration of natural ankle kinematics and congruity of the artificial surfaces throughout the range of motion. Surgeons are recommended to expand biomechanical knowledge on ankle joint replacement, and provide appropriate training and key factors to make arthroplasty a good alternative to arthrodesis. Moreover, adequate selection of patients and careful rehabilitation are critical. In the future, custom-made prosthesis components and patient-specific instrumentation are major developments for more complex cases.
Topics: Humans; Arthroplasty, Replacement, Ankle; Biomechanical Phenomena; Treatment Outcome; Ankle Joint; Joint Prosthesis; Prosthesis Design; Arthrodesis
PubMed: 36935170
DOI: 10.1016/j.fcl.2023.01.001 -
Foot & Ankle Specialist Apr 2016Gutter pain and impingement are recognized entities following total ankle arthroplasty (TAA). However, little concrete information is available in the existing... (Review)
Review
UNLABELLED
Gutter pain and impingement are recognized entities following total ankle arthroplasty (TAA). However, little concrete information is available in the existing literature regarding the etiology, potentiating factors, treatment and prevention of gutter disease. This comprehensive monograph discusses this problem in expansive detail and provides insight to surgeons who perform TAA, such that these complications can be minimized in the future.
LEVELS OF EVIDENCE
Level V: Expert opinion.
Topics: Ankle Joint; Arthroplasty, Replacement, Ankle; Humans; Joint Prosthesis; Osteoarthritis; Postoperative Complications
PubMed: 26856983
DOI: 10.1177/1938640016630059 -
Der Orthopade Jan 2017
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement; Female; Geriatric Assessment; Germany; Humans; Joint Prosthesis; Male; Orthopedics; Traumatology
PubMed: 27847978
DOI: 10.1007/s00132-016-3353-7 -
Clinical and radiological results of distal radioulnar joint arthroplasty with the Aptis prosthesis.The Journal of Hand Surgery, European... Apr 2022We report the results of the treatment of disorders of the distal radioulnar joint with the semi-constrained Aptis prosthesis. Nineteen patients were assessed at a mean...
We report the results of the treatment of disorders of the distal radioulnar joint with the semi-constrained Aptis prosthesis. Nineteen patients were assessed at a mean follow-up of 7 years. All patients had been operated on previously at the wrist, forearm or elbow. The Disabilities of Arm, Shoulder and Hand score had a mean value of 40, the Patient-Rated Wrist Evaluation score had a mean of 49 and the visual analogue scale for pain had a mean of 3.9. The mean ranges of pronation, supination, wrist flexion and wrist extension were 78°, 76°, 60° and 51°, respectively. The mean grip strength was 23 kg. Complications were noted in ten patients. Eighteen patients would undergo the operation again. The 10-year cumulative survival rate was 84%. The Aptis prosthesis may be a solution to treat patients in whom previous surgery at the distal radioulnar joint has failed. IV.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Range of Motion, Articular; Supination; Treatment Outcome; Wrist Joint
PubMed: 34861132
DOI: 10.1177/17531934211063608 -
Journal of the Mechanical Behavior of... Jun 2016An integrated cartilage/bone joint prosthesis was designed and fabricated using a two-step molding injection method, in which ethylene-vinyl acetate copolymer (EVA) was...
An integrated cartilage/bone joint prosthesis was designed and fabricated using a two-step molding injection method, in which ethylene-vinyl acetate copolymer (EVA) was used as the upper cartilage layer, and hydroxyapatite/polyamide66 (HA/PA66) composites as the underlying bone layer. Holes punched in the underlying layer improved the interfacial bonding strength between the two layers by means of the mechanical interlocking obviously. Then, the physicochemical properties and in vivo behaviors of the integrated joint prosthesis were investigated. The results showed that the upper layer displayed good bio-tribological properties which were suitable for the articular cartilage replacement, while the underlying layer demonstrated good mechanical performance, excellent biocompatibility and high bioactivity, and could accelerate bone regeneration and the early bio-fixation of the prosthesis. Therefore, the prosthesis prepared here will have a wide prospect to be used in joint replacement.
Topics: Animals; Arthroplasty, Replacement; Bone Regeneration; Cartilage, Articular; Durapatite; Female; Joint Prosthesis; Nylons; Rabbits
PubMed: 26889776
DOI: 10.1016/j.jmbbm.2016.02.001