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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 -
Acta Orthopaedica Jun 2020
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis
PubMed: 32406288
DOI: 10.1080/17453674.2020.1763566 -
The Journal of Hand Surgery, European... Jan 2024Total wrist arthroplasty (TWA) is gaining interest as a management option for wrist arthritis. This review article summarizes the current evidence base for TWA, focusing... (Review)
Review
Total wrist arthroplasty (TWA) is gaining interest as a management option for wrist arthritis. This review article summarizes the current evidence base for TWA, focusing on the performance and survivorship of fourth-generation implants. These appear to offer satisfactory patient-reported outcomes and survivorship over the medium term, but heterogeneity between implants and patient populations complicates data interpretation. We discuss issues facing TWA practice, including surgical competency, volume, implant development and stewardship. We acknowledge the need for further research on this topic and highlight a number of questions that need answering.
Topics: Humans; Joint Prosthesis; Wrist; Wrist Joint; Arthroplasty, Replacement; Arthritis
PubMed: 37882664
DOI: 10.1177/17531934231209638 -
The Journal of Bone and Joint Surgery.... Sep 2020
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans; Postoperative Complications; Treatment Outcome
PubMed: 32773488
DOI: 10.2106/JBJS.20.00927 -
Current Osteoporosis Reports Feb 2022Joint replacement has revolutionized the treatment of end-stage arthritis. We highlight the key role of macrophages in the innate immune system in helping to ensure that... (Review)
Review
PURPOSE OF REVIEW
Joint replacement has revolutionized the treatment of end-stage arthritis. We highlight the key role of macrophages in the innate immune system in helping to ensure that the prosthesis-host interface remains biologically robust.
RECENT FINDINGS
Osteoimmunology is of great interest to researchers investigating the fundamental biological and material aspects of joint replacement. Constant communication between cells of the monocyte/macrophage/osteoclast lineage and the mesenchymal stem cell-osteoblast lineage determines whether a durable prosthesis-implant interface is obtained, or whether implant loosening occurs. Tissue and circulating monocytes/macrophages provide local surveillance of stimuli such as the presence of byproducts of wear and can quickly polarize to pro- and anti-inflammatory phenotypes to re-establish tissue homeostasis. When these mechanisms fail, periprosthetic osteolysis results in progressive bone loss and painful failure of mechanical fixation. Immune modulation of the periprosthetic microenvironment is a potential intervention to facilitate long-term durability of prosthetic interfaces.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Macrophages; Osteolysis; Prosthesis Failure
PubMed: 35133558
DOI: 10.1007/s11914-022-00720-3 -
BMJ (Clinical Research Ed.) Apr 2024
Topics: Humans; Arthroplasty, Replacement, Shoulder; Shoulder Joint; Shoulder Prosthesis; Prosthesis Design
PubMed: 38688527
DOI: 10.1136/bmj.q952 -
Skeletal Radiology Jun 2020Despite improved strategies to prevent prosthetic joint infection, as the total number of joint replacements increases, so does the absolute number of infections.... (Review)
Review
Despite improved strategies to prevent prosthetic joint infection, as the total number of joint replacements increases, so does the absolute number of infections. Radiography serves as the first-line imaging modality for the assessment of a suspected prosthetic joint infection. Additionally, serial radiographs acquired after a surgery to eradicate a prosthetic joint infection are an important clinical tool. Prosthetic joint infections are often treated with a 2-stage replacement arthroplasty utilizing a prosthesis with antibiotic-loaded acrylic cement. While complications are uncommon with this procedure, imaging may demonstrate periprosthetic fractures, as well as spacer migration, joint dislocation, and spacer fracture. We describe the classification of prosthetic joint infections, the clinical and imaging diagnosis, and treatment strategies. Familiarity with the hardware utilized in the management of the prosthetic joint infection, and its potential complications is fundamental to accurate imaging interpretation.
Topics: Anti-Bacterial Agents; Arthroplasty, Replacement; Bone Cements; Humans; Joint Prosthesis; Prosthesis-Related Infections; Reoperation
PubMed: 32040604
DOI: 10.1007/s00256-020-03389-w -
Journal of Stomatology, Oral and... Sep 2023Alloplastic total temporomandibular joint replacement (TMJR) is the treatment of choice for end-stage temporomandibular joint diseases. Extended TMJR (eTMJR) is a... (Review)
Review
Alloplastic total temporomandibular joint replacement (TMJR) is the treatment of choice for end-stage temporomandibular joint diseases. Extended TMJR (eTMJR) is a modification of the standard alloplastic fossa-condyle joint that includes components extending further to the skull base or the mandible. The aim of this study is to review the use of the eTMJR prosthesis for the treatment of large craniomaxillofacial defects. Data mining was performed according to the PRISMA statement using online search in databases such as PubMed (Medline), Google Scholar, Dimensions, Semantic Scholar and Web of Science. A total of 19 case reports, 08 case series and 03 retrospective studies were identified. A total of 49 patients were presented in the case reports and case series, who were implanted with 56 eTMJR prostheses (07 bilateral and 42 unilateral procedures). The mean age of the patients was 36.02±16.54 years, the male to female patient ratio was 1:1.72 and the mean follow-up time was 23.74 ± 19.83 months. The eTMJR prosthesis was most frequently used to treat ameloblastoma and hemifacial microsomia. Analysis of the retrospective studies was performed in three domains: the baseline characteristic of patients, treatment outcomes in terms of functional variables and complications after eTMJR prostheses implantation. This study concluded that the implantion of the eTMJR prosthesis was uncommon, that appropriate class of eTMJR prosthesis was not reported, and that the width of the mandibular component (like the length) of eTMJR prosthesis has substantial variations.
Topics: Adult; Female; Humans; Male; Middle Aged; Young Adult; Arthroplasty, Replacement; Joint Prosthesis; Retrospective Studies; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 36720364
DOI: 10.1016/j.jormas.2023.101404 -
La Revue Du Praticien Dec 2020Temporomandibular joint prosthesis. The temporomandibular joint can be affected by end-stage pathology such as arthritic disease, trauma, ankylosis. The main...
Temporomandibular joint prosthesis. The temporomandibular joint can be affected by end-stage pathology such as arthritic disease, trauma, ankylosis. The main debilitating symptoms results in limited mouth opening and pain. TMJ prosthesis is recommended for disease resulting in an anatomical modification and aims at restoring joint function with pain relief. Despite its initial history of health scandals, prosthetic replacement for end-stage TMJ disease is gradually becoming a common procedure because of good functional results and low morbidity. Significant advances have been made in the design of the temporomandibular joint prostheses during the last decades, specially thanks to the use of 3D printing. The indications should be further clarified and extended.
Topics: Ankylosis; Arthroplasty, Replacement; Humans; Joint Prosthesis; Prosthesis Design; Temporomandibular Joint; Temporomandibular Joint Disorders
PubMed: 33739661
DOI: No ID Found -
Hand Surgery & Rehabilitation Feb 2022Proximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate... (Review)
Review
Proximal interphalangeal (PIP) joint arthroplasty is an unsolved biomechanical challenge despite advances in materials and new implant designs. This leads to a high rate of complications. Moreover, there is heterogeneity in postoperative management according to the literature. The present structured review examined the therapeutic strategies utilized by physiotherapists to restore a functional finger chain and prevent postoperative complications following PIP joint replacement. Patients undergoing primary total PIP joint arthroplasty of the index, ring, middle or little finger were included. Articles published from 2008 onwards, in French or English, and reporting on PIP joint replacement and postoperative management, were included. Therapeutic strategies were organized according to the surgical approach. Details of splint strategies, mobilization and muscle strengthening and management of postoperative complications were collected. Forty-eight studies, 3 of which provided a description of surgical techniques, were included. In relation to hand function, most authors advocated joint mobilization (n = 45) and some recommended muscle strengthening (n = 4). Static (n = 43) and dynamic splints (n = 14) and buddy taping (n = 12) were frequently recommended to prevent and manage postoperative complications. Few studies (n = 13) reported wound assessment or control of postoperative edema. Precise recommendations concerning therapeutic strategies following PIP joint arthroplasty cannot be made based on available evidence. Specific protocols for rehabilitation following PIP joint replacement need to be clarified in future research.
Topics: Arthroplasty, Replacement, Finger; Finger Joint; Fingers; Humans; Joint Prosthesis; Range of Motion, Articular
PubMed: 34619399
DOI: 10.1016/j.hansur.2021.09.007