-
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 -
Journal of Orthopaedics and... May 2023Total knee arthroplasty (TKA) alignment has recently become a hot topic in the orthopedics arthroplasty literature. Coronal plane alignment especially has gained... (Review)
Review
Total knee arthroplasty (TKA) alignment has recently become a hot topic in the orthopedics arthroplasty literature. Coronal plane alignment especially has gained increasing attention since it is considered a cornerstone for improved clinical outcomes. Various alignment techniques have been described, but none proved to be optimal and there is a lack of general consensus on which alignment provides best results. The aim of this narrative review is to describe the different types of coronal alignments in TKA, correctly defining the main principles and terms.
Topics: Humans; Arthroplasty, Replacement, Knee; Knee Joint; Osteoarthritis, Knee; Knee Prosthesis
PubMed: 37217767
DOI: 10.1186/s10195-023-00702-w -
The Bone & Joint Journal May 2023
Topics: Humans; Arthroplasty, Replacement, Hip; Hip Prosthesis; Prosthesis Design; Hip Joint; Treatment Outcome
PubMed: 37121587
DOI: 10.1302/0301-620X.105B5.BJJ-2023-0015.R1 -
Der Orthopade Jul 2020
Topics: Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Humans; Knee Joint; Knee Prosthesis
PubMed: 32613294
DOI: 10.1007/s00132-020-03938-0 -
Der Orthopade Mar 2021Arthroplasty of the shoulder joint leads to excellent clinical results if the indications are valid and the implantation is technically correct. Taking anatomical... (Review)
Review
Arthroplasty of the shoulder joint leads to excellent clinical results if the indications are valid and the implantation is technically correct. Taking anatomical requirements and mechanical functions as well as material properties and developments in surgical techniques into account, articulations and anchoring systems have been developed which, as modular systems enable successful restoration of the biomechanics and consider the importance of the surrounding soft tissues. Scientific data show promising medium-term and long-term results in terms of functionality and pain reduction. Nevertheless, due to the limited bone stock for implant anchoring, especially loosening of the prosthesis or instability of the glenoid joint component, revision arthroplasty remains challenging. This review article summarizes the relevant aspects of shoulder arthroplasty.
Topics: Arthroplasty, Replacement; Arthroplasty, Replacement, Shoulder; Humans; Prosthesis Design; Prosthesis Failure; Reoperation; Shoulder Joint; Shoulder Prosthesis; Treatment Outcome
PubMed: 33543309
DOI: 10.1007/s00132-020-04065-6 -
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 -
Journal of Oral and Maxillofacial... Oct 2020The purpose of the present study was to report the temporomandibular joint (TMJ) alloplastic reconstruction (TMJR) revision and/or replacement rates and associated... (Review)
Review
PURPOSE
The purpose of the present study was to report the temporomandibular joint (TMJ) alloplastic reconstruction (TMJR) revision and/or replacement rates and associated complication outcomes data gathered from experienced TMJ surgeons and to review the recent relevant data.
MATERIALS AND METHODS
A 21-question anonymous on-line survey was sent to all Commission on Dental Accreditation-approved oral and maxillofacial surgery program directors and to members of the European Society of TMJ Surgeons and the American Society of Temporomandibular Joint Surgeons.
RESULTS
Of the surgeons sent the survey, 22% completed the full questionnaire. Most responses were from surgeons who routinely perform TMJR surgery (93.5%). Of the respondents, 28.3% had more than 30 years of experience and 73.9% were full-time academic faculty. A total of 4638 TMJR procedures were recorded and analyzed. The incidence of TMJR revision (keeping the same device) was 3% and that of replacement (placing a new device) was 4.9%. The most common reason for revision was heterotopic ossification (27.5%). The most common reason for replacement was infection (21.1%). Revision was successful in 86.7% and replacement in 94.6% of the patients at the longest follow-up reported.
CONCLUSIONS
The data from the present study have shown that the incidence is low and the success rate is high for TMJR revision and replacement.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Surveys and Questionnaires; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 32610046
DOI: 10.1016/j.joms.2020.05.021 -
Journal of Artificial Organs : the... Sep 2022Artificial joints are exposed to loads on a daily basis. Loads on the bone through the artificial joint and the joint's sliding surface shear force may cause implant... (Review)
Review
Artificial joints are exposed to loads on a daily basis. Loads on the bone through the artificial joint and the joint's sliding surface shear force may cause implant fixation failure, fatigue fractures, wear of the bearing and foreign body reactions. Artificial joints can experience sudden internal damage, which can be fatal if it occurs during activities performed at high altitudes or in water. The standard design hip prosthesis has a metal femoral stem. Most stem fractures are caused at the proximal one third of the stem by fatigue due to repetitive loading. Femoral stem neck fractures can also occur. To eliminate in vivo prosthesis failures, safety performance preclinical studies evaluate stem body and neck breakage. However, the development of new femoral stems via prototyping and fatigue test verification would require excessive time and money. Therefore, evaluation methods based on numerical analyses, such as finite element analysis (FEA), have been introduced to simulate tests on actual machines. Fatigue strength design verification using FEA can efficiently identify a design that can pass International Organization for Standardization fatigue tests. FEA may also aid with composite implant development by enabling efficient preclinical testing to prove safety using minimal actual fatigue testing. Once a biological safety study of a composite material is performed, a clinical trial can prove its clinical efficacy and safety and device regulatory approval can be requested. This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2020 (Vol. 49, No. 3, pp. 195-198), with adding some additional contents and references.
Topics: Arthroplasty, Replacement, Hip; Finite Element Analysis; Hip Prosthesis; Humans; Prosthesis Design; Prosthesis Failure
PubMed: 35842848
DOI: 10.1007/s10047-022-01345-0 -
Orthopaedics & Traumatology, Surgery &... Feb 2023The concept of stemless shoulder arthroplasty was born in 2005. It is now a valid option in the context of either anatomical or reverse shoulder replacement. Several... (Review)
Review
The concept of stemless shoulder arthroplasty was born in 2005. It is now a valid option in the context of either anatomical or reverse shoulder replacement. Several questions have come up over our 15 years of using this system: How was the stemless shoulder arthroplasty concept born? It was motivated by a desire to have epiphyso-metaphyseal fixation using a corolla-shaped impacted anchor design. What are the features of commercially available stemless shoulder arthroplasty implants? The stemless anatomical implants now available have either a cage or central peg that is impacted or a system that is screwed into the epiphysometaphyseal bone. Several companies have introduced stemless reverse implants, some of which have an onlay configuration. How do the results of stemless implants compare to those of traditional stemmed implants? At a mean follow-up of 10 years, the outcomes of stemless TSA can be superimposed with those of traditional stemmed TSA. What are the advantages of stemless shoulder implants? The advantages are their simple implantation, ability to adapt to patient morphology and any malunions, various orientation angles, no stress-shielding, reduced risk of infection and bleeding and less complex revision surgery (if needed). What are the limitations or drawbacks of using stemless implants? The two main limitations are insufficient metaphyseal bone stock and poor bone quality, especially for reverse configurations. What does the future hold for stemless shoulder arthroplasty? Like with traditional stemmed implants, the longevity of stemless shoulder arthroplasty depends on its tribology, which can still be improved. In the future, a stemless implant will need to be convertible like stemmed humeral implants, and if possible, provide an inlay reverse configuration.
Topics: Humans; Adolescent; Arthroplasty, Replacement, Shoulder; Shoulder Joint; Prosthesis Design; Shoulder Prosthesis; Arthroplasty
PubMed: 36942793
DOI: 10.1016/j.otsr.2022.103460