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Foot and Ankle Clinics Jun 2017Total ankle arthroplasty has advanced rapidly in the last 20 years. Early agility implants enjoyed improved survivability compared with more archaic total ankle... (Review)
Review
Total ankle arthroplasty has advanced rapidly in the last 20 years. Early agility implants enjoyed improved survivability compared with more archaic total ankle implants. When talar subsidence occurs, the revision options include a stemmed component to improve stability by spanning the subtalar joint. Removal and revision of these stemmed components can be difficult because of ingrowth and bone loss.
Topics: Aged; Ankle Joint; Arthrodesis; Arthroplasty, Replacement, Ankle; Device Removal; Humans; Joint Prosthesis; Middle Aged; Osteotomy; Prosthesis Design; Prosthesis Failure; Reoperation; Retrospective Studies
PubMed: 28502352
DOI: 10.1016/j.fcl.2017.01.005 -
The Journal of Bone and Joint Surgery.... Sep 2016
Review
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans
PubMed: 27655987
DOI: 10.2106/JBJS.16.00702 -
Journal of Shoulder and Elbow Surgery Jul 2015The in vivo effects of metal hypersensitivity remain a topic of much debate. At the core of this debate is the possible, although still hotly contested, link between... (Review)
Review
The in vivo effects of metal hypersensitivity remain a topic of much debate. At the core of this debate is the possible, although still hotly contested, link between metal hypersensitivity and poorly functioning or failing implants. There are multiple studies on this topic in the hip and knee arthroplasty literature, but the applicability of this experience to shoulder arthroplasty remains unclear. Although how often metal hypersensitivity affects shoulder arthroplasty patients remains uncertain, a multitude of case reports have implicated metallic implants as a source of local and systemic allergic reactions. We recommend a cautious approach to patients with a history of metal hypersensitivity, including a careful evaluation of suspected metal hypersensitivities in all patients undergoing shoulder arthroplasty. If available, we recommend a metallic implant with low to no nickel content in patients with metal hypersensitivity. Given the large and increasing, number of total shoulder arthroplasty procedures and the high percentage of the population having a known or suspected metal hypersensitivity, this review is intended to guide and educate the shoulder surgeon in the evaluation and treatment of this patient population and to point out the areas where evidence-based recommendations are lacking.
Topics: Arthroplasty, Replacement; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Humans; Hypersensitivity; Joint Prosthesis; Mass Screening; Metals; Shoulder Joint
PubMed: 25799922
DOI: 10.1016/j.jse.2015.01.015 -
Hand Clinics May 2018Salvaging a failed proximal interphalangeal (PIP) joint implant arthroplasty remains a considerable technical and rehabilitation challenge. Experienced arthroplasty... (Review)
Review
Salvaging a failed proximal interphalangeal (PIP) joint implant arthroplasty remains a considerable technical and rehabilitation challenge. Experienced arthroplasty surgeons have reported 70% survival of revision PIP implants at 10 years with 25% of patients requiring subsequent revision surgery. At this time, there is no consensus surgical approach or implant proven superior for revision implant arthroplasty of the PIP joint. Secondary arthrodesis or amputation may be required to salvage the failed PIP implant arthroplasty with compromised bone stock or soft tissue envelopes that are inadequate for implant arthroplasty.
Topics: Arthrodesis; Arthroplasty, Replacement, Finger; Finger Joint; Hand Deformities, Acquired; Humans; Joint Prosthesis; Patient Positioning; Postoperative Care; Preoperative Care; Reoperation; Salvage Therapy
PubMed: 29625641
DOI: 10.1016/j.hcl.2017.12.011 -
Journal of Biomedical Materials... Oct 2017Joint replacement is a commonly performed, highly successful orthopaedic procedure, for which surgeons have a large choice of different materials and implant designs.... (Review)
Review
Joint replacement is a commonly performed, highly successful orthopaedic procedure, for which surgeons have a large choice of different materials and implant designs. The materials used for joint replacement must be both biologically acceptable to minimize adverse local tissue reactions, and robust enough to support weight bearing during common activities of daily living. Modern joint replacements are made from metals and their alloys, polymers, ceramics, and composites. This review focuses on the biological response to the different biomaterials used for joint replacement. In general, modern materials for joint replacement are well tolerated by the body as long as they are in bulk (rather than in particulate or ionic) form, are mechanically stable and noninfected. If the latter conditions are not met, the prosthesis will be associated with an acute/chronic inflammatory reaction, peri-prosthetic osteolysis, loosening and failure. This article (Part 1 of 2) is dedicated to the use of metallic devices in orthopaedic surgery including the associated biological response to metallic byproducts is a review of the basic science literature regarding this topic. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2162-2173, 2017.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Metals
PubMed: 27328111
DOI: 10.1002/jbm.b.33734 -
Foot and Ankle Surgery : Official... Jul 2022The National Institute for Health and Care Excellence criterion for hip replacements is a (projected) revision rate of less than 5% after 10 years. No such criterion is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The National Institute for Health and Care Excellence criterion for hip replacements is a (projected) revision rate of less than 5% after 10 years. No such criterion is available for ankle prostheses. The objective of the current study is to compare survival rates of contemporary primary ankle prostheses to the hip-benchmark.
METHODS
The PRISMA methodology was used. Eligible for inclusion were clinical studies reporting revision rates of currently available primary total ankle prostheses. Data was extracted using preconstructed forms. The total and prosthesis-specific annual revision rate was calculated.
RESULTS
Fifty-seven articles of eight different ankle prostheses were included (n = 5371), totaling 513 revisions at an average 4.6 years of follow-up. An annual revision rate of 2.2 was found (i.e. an expected revision rate of 22% at 10 years).
CONCLUSIONS
The expected 10-year revision rate of contemporary ankle prostheses is lower than the current benchmark for hip prostheses.
Topics: Ankle; Arthroplasty, Replacement, Ankle; Arthroplasty, Replacement, Hip; Humans; Joint Prosthesis; Prosthesis Design; Prosthesis Failure; Reoperation
PubMed: 34116950
DOI: 10.1016/j.fas.2021.05.014 -
The Journal of Hospital Infection Feb 2015Many of the mooted risk factors associated with periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) remain controversial and are not well... (Meta-Analysis)
Meta-Analysis Review
Many of the mooted risk factors associated with periprosthetic joint infection (PJI) after total joint arthroplasty (TJA) remain controversial and are not well characterized. Online and manual searches were performed using Medline, Embase, Chinese National Knowledge Infrastructure and the Cochrane Central Database from January 1980 to March 2014). For inclusion, studies had to meet the quality assessment criteria of the CONSORT statement, and be concerned with evaluation of risk factors for PJI after TJA. Two reviewers extracted the relevant data independently and any disagreements were resolved by consensus. Fourteen studies were included in this meta-analysis. The following significant risk factors for PJI were identified: body mass index (both continuous and dichotomous variables); diabetes mellitus; corticosteroid therapy; hypoalbuminaemia; history of rheumatoid arthritis; blood transfusion; presence of a wound drain; wound dehiscence; superficial surgical site infection; coagulopathy; malignancy, immunodepression; National Nosocomial Infections Surveillance Score ≥2; other nosocomial infection; prolonged operative time; and previous surgery. Factors that were not significantly associated with PJI were: cirrhosis; hypothyroidism; urinary tract infection; illicit drug abuse; alcohol abuse; hypercholesterolaemia; hypertension, ischaemic heart disease; peptic ulcer disease; hemiplegia or paraplegia; dementia; and operation performed by a staff surgeon (vs a trainee). Strategies to prevent PJI after TJA should focus, in particular, on those patients at greatest risk of infection according to their individual risk factors.
Topics: Arthroplasty, Replacement; Humans; Joint Diseases; Joint Prosthesis; Prosthesis-Related Infections; Risk Factors
PubMed: 25575769
DOI: 10.1016/j.jhin.2014.10.008 -
Instructional Course Lectures 2015The number of shoulder arthroplasty procedures performed in the United States is steadily increasing as a result of an expansion in implant options, clinical... (Review)
Review
The number of shoulder arthroplasty procedures performed in the United States is steadily increasing as a result of an expansion in implant options, clinical indications, and surgical experience. Available options include stemmed implants, short-stemmed or stemless prostheses, fracture-specific designs, resurfacing implants, partial surface replacement, metal-backed or polyethylene glenoid components designed for cementation or bone ingrowth, and reverse total shoulder arthroplasty. Efforts to re-create anatomy, improve outcomes, and avoid complications have resulted in many changes in prosthesis design. Despite these changes, failures still occur, and revision surgery is sometimes necessary. A thorough knowledge of current arthroplasty options, indications, and the principles of implantation is necessary to optimize outcomes after shoulder arthroplasty.
Topics: Arthroplasty, Replacement; Humans; Joint Diseases; Joint Prosthesis; Prosthesis Design; Shoulder Joint
PubMed: 25745905
DOI: No ID Found -
International Journal of Oral and... Jan 2017The aim of the present study was to determine which prosthesis has resulted in the best outcomes after total temporomandibular joint replacement (TMJR). A comprehensive... (Meta-Analysis)
Meta-Analysis Review
The aim of the present study was to determine which prosthesis has resulted in the best outcomes after total temporomandibular joint replacement (TMJR). A comprehensive electronic search was undertaken in September 2015. Inclusion criteria encompassed studies that described one of the three current TMJR systems and that had pre- and postoperative data on at least two of the following TMJR indications: pain, diet, function, and maximum inter-incisal opening (MIO). Sixteen papers were included in the systematic review, reporting 10 retrospective studies and six prospective studies (no randomized controlled or case-controlled trials). A total 312 patients with 505 TMJ Concepts prostheses, 728 patients with 1048 Biomet prostheses, and 125 patients with 196 Nexus prostheses were included in the analysis. There was no real difference between the various TMJR systems in terms of pain or diet scores. Function scores improved with the TMJ Concepts, but this was the only prosthesis for which data were available. Biomet prostheses appeared to have a greater increase in MIO mean gain compared to TMJ Concepts and Nexus prostheses; however this was heavily biased by one study. Without this study, there was no real difference in MIO. It is concluded that the prostheses are similar, but most data are available for the TMJ Concepts prosthesis, with results being favourable.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Prosthesis Design; Temporomandibular Joint Disorders
PubMed: 27644588
DOI: 10.1016/j.ijom.2016.08.022 -
Journal of Orthopaedic Surgery (Hong... Dec 201418 English-language studies published between January 2003 and April 2013 were retrieved from the MEDLINE database using the key word 'total wrist arthroplasty'. In most... (Review)
Review
18 English-language studies published between January 2003 and April 2013 were retrieved from the MEDLINE database using the key word 'total wrist arthroplasty'. In most studies, total wrist arthroplasty achieved improvement in pain and function over time. In a meta-analysis, the revision rate was 17% for third-generation implants. The survival rate was 92% for fourth-generation implants at 4 years. Complication rates ranged from 0% to 100% for third-generation implants and from 6% to 47% for fourth-generation implants. Results of total wrist arthroplasty vary greatly; longer-term studies are needed to determine its cost-effectiveness.
Topics: Arthritis; Arthroplasty, Replacement; Humans; Joint Prosthesis; Wrist Joint
PubMed: 25550026
DOI: 10.1177/230949901402200326