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Clinical Orthopaedics and Related... Jul 2017
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Prognosis; Prosthesis-Related Infections; Risk Factors; Surgical Wound Infection
PubMed: 28444583
DOI: 10.1007/s11999-017-5357-y -
The Bone & Joint Journal Aug 2019There has been a recent resurgence in interest in combined partial knee arthroplasty (PKA) as an alternative to total knee arthroplasty (TKA). The varied terminology...
AIMS
There has been a recent resurgence in interest in combined partial knee arthroplasty (PKA) as an alternative to total knee arthroplasty (TKA). The varied terminology used to describe these procedures leads to confusion and ambiguity in communication between surgeons, allied health professionals, and patients. A standardized classification system is required for patient safety, accurate clinical record-keeping, clear communication, correct coding for appropriate remuneration, and joint registry data collection.
MATERIALS AND METHODS
An advanced PubMed search was conducted, using medical subject headings (MeSH) to identify terms and abbreviations used to describe knee arthroplasty procedures. The search related to TKA, unicompartmental (UKA), patellofemoral (PFA), and combined PKA procedures. Surveys were conducted of orthopaedic surgeons, trainees, and biomechanical engineers, who were asked which of the descriptive terms and abbreviations identified from the literature search they found most intuitive and appropriate to describe each procedure. The results were used to determine a popular consensus.
RESULTS
Survey participants preferred "bi-unicondylar arthroplasty" (Bi-UKA) to describe ipsilateral medial and lateral unicompartmental arthroplasty; "medial bi-compartmental arthroplasty" (BCA-M) to describe ipsilateral medial unicompartmental arthroplasty with patellofemoral arthroplasty; "lateral bi-compartmental arthroplasty" (BCA-L) to describe ipsilateral lateral unicompartmental arthroplasty with patellofemoral arthroplasty; and tri-compartmental arthroplasty (TCA) to describe ipsilateral patellofemoral and medial and lateral unicompartmental arthroplasties. "Combined partial knee arthroplasty" (CPKA) was the favoured umbrella term.
CONCLUSION
We recommend bi-unicondylar arthroplasty (Bi-UKA), medial bicompartmental arthroplasty (BCA-M), lateral bicompartmental arthroplasty (BCA-L), and tricompartmental arthroplasty (TCA) as the preferred terms to classify CPKA procedures. Cite this article: 2019;101-B:922-928.
Topics: Arthroplasty, Replacement, Knee; Bibliometrics; Hemiarthroplasty; Humans; Knee Prosthesis; Osteoarthritis, Knee; Terminology as Topic
PubMed: 31362558
DOI: 10.1302/0301-620X.101B8.BJJ-2019-0125.R1 -
The Bone & Joint Journal Jul 2016As the number of younger and more active patients treated with total knee arthroplasty (TKA) continues to increase, consideration of better fixation as a means of... (Review)
Review
As the number of younger and more active patients treated with total knee arthroplasty (TKA) continues to increase, consideration of better fixation as a means of improving implant longevity is required. Cemented TKA remains the reference standard with the largest body of evidence and the longest follow-up to support its use. However, cementless TKA, may offer the opportunity of a more bone-sparing procedure with long lasting biological fixation to the bone. We undertook a review of the literature examining advances of cementless TKA and the reported results. Cite this article: Bone Joint J 2016;98-B:867-73.
Topics: Arthroplasty, Replacement, Knee; Humans; Knee Prosthesis; Patient Selection; Prosthesis Design; Prosthesis Failure
PubMed: 27365463
DOI: 10.1302/0301-620X.98B7.37367 -
Journal of Orthopaedic Research :... Feb 2016Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute... (Review)
Review
Like any foreign object, orthopaedic implants are susceptible to infection when introduced into the human body. Without additional preventative measures, the absolute number of annual prosthetic joint infections will continue to rise, and may exceed the capacity of health care systems in the near future. Bacteria are difficult to eradicate from synovial joints due to their exceptionally diverse taxonomy, complex mechanistic attachment capabilities, and tendency to evolve antibiotic resistance. When a primary orthopaedic implant fails from prosthetic joint infection, surgeons are generally challenged by limited options for intervention. In this review, we highlight the etiology and taxonomic groupings of bacteria known to cause prosthetic joint infections, and examine their key mechanisms of attachment. We propose that antimicrobial strategies should focus on the most harmful bacteria taxa within the context of occurrence, taxonomic diversity, adhesion mechanisms, and implant design. Patient-specific identification of organisms that cause prosthetic joint infections will permit assessment of their biological vulnerabilities. The latter can be targeted using a range of antimicrobial techniques that exploit different colonization mechanisms including implant surface attachment, biofilm formation, and/or hematogenous recruitment. We anticipate that customized strategies for each patient, joint, and prosthetic component will be most effective at reducing prosthetic joint infections, including those caused by antibiotic-resistant and polymicrobial bacteria.
Topics: Antibiotic Prophylaxis; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Humans; Joint Prosthesis; Prosthesis-Related Infections
PubMed: 26449208
DOI: 10.1002/jor.23068 -
Acta Ortopedica Mexicana 2017Bilateral osteoarthrosis of the knee is very frequent and disabling; the treatment in severe cases is joint replacement. Bilateral condition and severe knee pain are...
UNLABELLED
Bilateral osteoarthrosis of the knee is very frequent and disabling; the treatment in severe cases is joint replacement. Bilateral condition and severe knee pain are common and the definitive treatment can be performed on both.
MATERIAL AND METHODS
We reviewed the records of the first patients undergoing bilateral total knee replacement by our surgical group, between 1993-1998.
RESULTS
The procedure was performed on 56 patients (112 knees) with degenerative joint disease; their age range was 60 to 82 years. The knee replacements were done either simultaneously, consecutively, or via two unique surgeries. The outcomes of each method were analyzed to assess its advantages and disadvantages.
DISCUSSION
Based upon the results of the study, we find that total knee replacements done consecutively provide the best results for patients suffering from articular degeneration.
Topics: Aged; Aged, 80 and over; Arthroplasty, Replacement; Arthroplasty, Replacement, Knee; Humans; Knee Joint; Knee Prosthesis; Middle Aged; Osteoarthritis; Retrospective Studies
PubMed: 29641851
DOI: No ID Found -
BMC Musculoskeletal Disorders Aug 2016The latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral... (Review)
Review
BACKGROUND
The latest generation of shoulder arthroplasty includes canal-sparing respectively stemless designs that have been developed to allow restoration of the glenohumeral center of rotation independently from the shaft, and to avoid stem-related complications. The stemless prosthesis design has also recently been introduced for use in reverse arthroplasty systems.
METHODS
We systematically reviewed the literature for studies of currently available canal-sparing respectively stemless shoulder arthroplasty systems. From the identified series, we recorded the indications, outcome measures, and humeral-sided complications.
RESULTS
We identified 11 studies of canal-sparing respectively stemless anatomic shoulder arthroplasty implants, published between 2010 and 2016. These studies included 929 cases, and had a mean follow-up of 26 months (range, 6 to 72 months). The rates of humeral component-related complications ranged between 0 and 7.9 %. The studies reported only a few isolated cases of complications of the humeral component. Some arthroplasty systems are associated with radiological changes, but without any clinical relevance.
CONCLUSIONS
All of the published studies of canal-sparing respectively stemless shoulder arthroplasty reported promising clinical and radiological outcomes in short to midterm follow-up. Long-term studies are needed to demonstrate the long-term value of these kind of implants.
Topics: Arthroplasty, Replacement; Humans; Humerus; Joint Prosthesis; Osteoarthritis; Postoperative Complications; Prosthesis Design; Radiography; Shoulder Joint; Treatment Outcome
PubMed: 27577859
DOI: 10.1186/s12891-016-1235-0 -
Bulletin of the Hospital For Joint... 2014Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis much like its total hip and knee counterparts.... (Review)
Review
Total ankle arthroplasty was developed to reduce pain and retain motion of the ankle joint in patients with osteoarthritis much like its total hip and knee counterparts. Orthopaedic surgeons are well equipped to evaluate and treat patients with end-stage hip or knee arthritis; however, the management of patients with ankle arthritis represents a challenge to both general orthopaedic surgeons and to the foot and ankle surgeons to whom these patients are often referred. Although techniques for both hip and knee arthroplasty have evolved to provide long-term pain relief and functional improvement, neither ankle arthrodesis nor arthroplasty has demonstrated comparably favorable outcomes in long-term follow-up studies. Early ankle arthroplasty designs with highly constrained cemented components were abandoned due to unacceptably high failure rates and complications. While arthrodesis is still considered the "gold standard" for treatment of end-stage ankle arthritis, progression of adjacent joint arthrosis and diminished gait efficiency has led to a resurgence of interest in ankle arthroplasty. Long-term outcome studies for total ankle replacement found excellent or good results in 82% of patients who received a newer generation ankle device compared with 72% if undergoing ankle fusion. Continued long-term follow-up studies are necessary, but total ankle arthroplasty has become a viable option for surgical treatment of ankle arthritis.
Topics: Ankle Joint; Arthroplasty, Replacement, Ankle; Biomechanical Phenomena; Diffusion of Innovation; Humans; Joint Prosthesis; Osteoarthritis; Postoperative Complications; Prosthesis Design; Recovery of Function; Treatment Outcome
PubMed: 25150335
DOI: No ID Found -
Journal of Orthopaedic Research :... Mar 2019Many failures in total joint replacement are associated to prosthesis-to-bone mismatch. With recent additive-manufacturing, that is, 3D-printing, custom-made prosthesis...
Many failures in total joint replacement are associated to prosthesis-to-bone mismatch. With recent additive-manufacturing, that is, 3D-printing, custom-made prosthesis can be created by laser-melting metal powders layer-by-layer. Ankle replacement is particularly suitable for this progress because of the limited number of sizes and the poor bone stock. In this study a novel procedure is presented for subject-specific ankle replacements, including medical-imaging, joint modelling, prosthesis design, and 3D-printing. Three shank-foot specimens were CT-scanned, and corresponding 3D bone models of the tibia, fibula, talus, and calcaneus were obtained. From these models, specimen-specific implant sets were designed according to three different concepts, and 3D-printed from cobalt-chromium-molybdenum powder. Accuracy of the overall procedure was assessed via distance map comparisons between original anatomical and final metal implants. Restoration of natural ankle joint mechanics was check after implantation of each of the three sets. In a special rig, a manually-driven dorsi/plantar-flexion was applied throughout the passive arc. Additionally, at three different joint positions, joint torques were imposed in the frontal and axial anatomical planes. Mean manufacturing errors were found to be smaller than 0.08 mm. Consistent motion patterns were observed over repetitions, with the mean standard deviation smaller than 1.0 degree. In each ankle specimen, mobility, and stability at the replaced joints compared well with the original natural condition. For the first time, custom-made implants for total ankle replacements were designed, manufactured with additive technology and tested. This procedure is a first fundamental step toward the development of completely personalized prostheses. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Topics: Ankle Joint; Arthroplasty, Replacement, Ankle; Humans; Joint Prosthesis; Precision Medicine; Printing, Three-Dimensional; Prosthesis Design
PubMed: 30537247
DOI: 10.1002/jor.24198 -
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 -
Medicine Oct 2020To investigate the efficacy and complications that might be associated with pyrocarbon compared with silicone in patients undergoing joint replacement surgery. (Comparative Study)
Comparative Study Meta-Analysis
OBJECTIVE
To investigate the efficacy and complications that might be associated with pyrocarbon compared with silicone in patients undergoing joint replacement surgery.
METHODS
The full-text papers about the clinical efficacy of pyrocarbon and silicone were retrieved from multiple databases. Review Manager version 5.0 was adopted for meta-analysis and analyses of sensitivity and bias.
RESULTS
Ultimately, we studied 232 patients across eight studies that met the eligibility criteria. The meta-analysis suggested a significant difference between the pyrocarbon and silicone groups in terms of the Disabilities of the Arm, Shoulder, and Hand (DASH) score (standard mean difference (SMD) = 1.48; 95% CI [0.97, 1.99]; P = .009; P for Heterogeneity <0.00001; I = 63%); Visual Analogue Score (VAS) (SMD = 1.68; 95% CI [1.36, 1.99]; P < .00001; P for heterogeneity = 0.01; I = 61%), and the abnormal radiolucent line (RR = 6.66; 95% CI [3.19, 13.89]; P < .00001; P for heterogeneity = 0.87, I = 0%); and ossification development (RR = 0.90; 95% CI [0.56, 1.44], P = .66; P for heterogeneity = 0.94, I = 0%).
CONCLUSION
This study showed that pyrocarbon might be an efficient material compared with silicone for joint replacement surgery, but resulted in poorer functional and pain outcomes compared with silicone.
Topics: Arthroplasty, Replacement; Biocompatible Materials; Carbon; Disability Evaluation; Humans; Joint Prosthesis; Pain Measurement; Prosthesis Design; Silicones
PubMed: 33031299
DOI: 10.1097/MD.0000000000022548