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Clinical Orthopaedics and Related... Jan 2016
Topics: Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Humans; Knee Joint; Knee Prosthesis; Recovery of Function; Treatment Outcome
PubMed: 26407700
DOI: 10.1007/s11999-015-4567-4 -
Clinics in Orthopedic Surgery Sep 2016Different implant designs are utilized in reverse shoulder arthroplasty. The purpose of this systematic review was to evaluate the results of reverse shoulder... (Review)
Review
BACKGROUND
Different implant designs are utilized in reverse shoulder arthroplasty. The purpose of this systematic review was to evaluate the results of reverse shoulder arthroplasty using a traditional (Grammont) prosthesis and a lateralized prosthesis for the treatment of cuff tear arthropathy and massive irreparable rotator cuff tears.
METHODS
A systematic review of the literature was performed via a search of two electronic databases. Two reviewers evaluated the quality of methodology and retrieved data from each included study. In cases where the outcomes data were similar between studies, the data were pooled using frequency-weighted mean values to generate summary outcomes.
RESULTS
Thirteen studies met the inclusion and exclusion criteria. Demographics were similar between treatment groups. The frequency-weighted mean active external rotation was 24° in the traditional group and 46° in the lateralized group (p = 0.0001). Scapular notching was noted in 44.9% of patients in the traditional group compared to 5.4% of patients in the lateralized group (p = 0.0001). The rate of clinically significant glenoid loosening was 1.8% in the traditional group and 8.8% in the lateralized group (p = 0.003).
CONCLUSIONS
Both the traditional Grammont and the lateralized offset reverse arthroplasty designs can improve pain and function in patients with diagnoses of cuff tear arthropathy and irreparable rotator cuff tear. While a lateralized design can result in increased active external rotation and decreased rates of scapular notching, there may be a higher rate of glenoid baseplate loosening.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement; Female; Humans; Male; Middle Aged; Postoperative Complications; Prosthesis Design; Rotator Cuff; Shoulder Prosthesis; Treatment Outcome
PubMed: 27583112
DOI: 10.4055/cios.2016.8.3.288 -
Foot and Ankle Clinics Mar 2019Avascular necrosis tends to occur in the talus because of poor blood supply caused by the extended coverage to the articular cartilage on its surface. Treatment is... (Review)
Review
Avascular necrosis tends to occur in the talus because of poor blood supply caused by the extended coverage to the articular cartilage on its surface. Treatment is conservative in the earlier stage of this disease; however, surgical treatment is usually indicated in the advanced stage. Nonunion, leg length discrepancy, or hindfoot instability may occur in patients treated with ankle or tibio-talo-calcaneal fusion. Arthroplasty using a customized total talar prosthesis designed using the computed tomography image of contralateral talus has the potential advantages of weightbearing in the earlier postoperative phase, prevention of lower extremity discrepancy, and maintenance of joint function.
Topics: Aluminum Oxide; Ankle Joint; Arthrodesis; Arthroplasty, Replacement, Ankle; Humans; Joint Prosthesis; Osteonecrosis; Prosthesis Design; Talus
PubMed: 30685009
DOI: 10.1016/j.fcl.2018.10.004 -
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 -
The Journal of Bone and Joint Surgery.... Jan 2008This paper considers the increased risk of the development of lymphoma in patients with chronic inflammatory disease who undergo metal-on-metal arthroplasty. (Review)
Review
This paper considers the increased risk of the development of lymphoma in patients with chronic inflammatory disease who undergo metal-on-metal arthroplasty.
Topics: Arthroplasty, Replacement; Chromium; Chronic Disease; Cobalt; Denmark; Female; Finland; Heavy Metal Poisoning; Humans; Inflammation; Joint Prosthesis; Leukocyte Disorders; Lymphocytes; Lymphoma; Male; New Zealand; Risk Assessment; Sweden
PubMed: 18160491
DOI: 10.1302/0301-620X.90B1.19823 -
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 -
Clinical Orthopaedics and Related... Jan 2009The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing... (Review)
Review
UNLABELLED
The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short- and midterm clinical results (1- to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review, we believe the best candidates for hip resurfacing are men under age 65 with osteoarthritis and relatively normal bony morphology.
LEVEL OF EVIDENCE
Level V, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Topics: Arthroplasty, Replacement, Hip; Hip Prosthesis; Humans; Joint Diseases; Patient Selection; Risk Factors
PubMed: 18941859
DOI: 10.1007/s11999-008-0558-z -
Acta Orthopaedica Dec 2013
Topics: Arthroplasty, Replacement; Consensus Development Conferences as Topic; Humans; International Cooperation; Joint Prosthesis; Prosthesis-Related Infections
PubMed: 24286568
DOI: 10.3109/17453674.2013.867399 -
Clinical Orthopaedics and Related... Dec 2014WHERE ARE WE NOW?: Biological treatments, defined as any nonsurgical intervention whose primary mechanism of action is reducing the host response to wear and/or... (Review)
Review
WHERE ARE WE NOW?: Biological treatments, defined as any nonsurgical intervention whose primary mechanism of action is reducing the host response to wear and/or corrosion products, have long been postulated as solutions for osteolysis and aseptic loosening of total joint arthroplasties. Despite extensive research on drugs that target the inflammatory, osteoclastic, and osteogenic responses to wear debris, no biological treatment has emerged as an approved therapy. We review the extensive preclinical research and modest clinical research to date, which has led to the central conclusion that the osteoclast is the primary target. We also allude to the significant changes in health care, unabated safety concerns about chronic immunosuppressive/antiinflammatory therapies, industry's complete lack of interest in developing an intervention for this condition, and the practical issues that have narrowly focused the possibilities for a biologic treatment for wear debris-induced osteolysis. WHERE DO WE NEED TO GO?: Based on the conclusions from research, and the economic, regulatory, and practical issues that limit the future directions toward the development of a biologic treatment, there are a few rational approaches that warrant investigation. These largely focus on FDA-approved osteoporosis therapies that target the osteoclast (bisphosphonates and anti-RANK ligand) and recombinant parathyroid hormone (teriparatide) prophylactic treatment to increase osseous integration of the prosthesis to overcome high-risk susceptibility to aseptic loosening. The other roadblock that must be overcome if there is to be an approved biologic therapy to prevent the progression of periprosthetic osteolysis and aseptic loosening is the development of radiological measures that can quantify a significant drug effect in a randomized, placebo-controlled clinical trial. We review the progress of volumetric quantification of osteolysis in animal studies and clinical pilots. HOW DO WE GET THERE?: Accepting the aforementioned rigid boundaries, we describe the emergence of repurposing FDA-approved drugs for new indications and public (National Institutes of Health, FDA, Centers for Disease Control and Prevention) and private (universities and drug and device manufactures) partnerships as the future roadmap for clinical translation. In the case of biologic treatments for wear debris-induced osteolysis, this will involve combined federal and industry funding of multicenter clinical trials that will be run by thought leaders at large medical centers.
Topics: Animals; Arthroplasty, Replacement; Biological Products; Biomechanical Phenomena; Corrosion; Humans; Joint Prosthesis; Joints; Osteolysis; Prosthesis Design; Prosthesis Failure; Stress, Mechanical; Treatment Outcome
PubMed: 24993143
DOI: 10.1007/s11999-014-3765-9 -
The Bone & Joint Journal Aug 2017
Topics: Arthroplasty, Replacement, Hip; Ceramics; Hip Prosthesis; Humans; Prosthesis Design; Prosthesis Failure
PubMed: 28768773
DOI: 10.1302/0301-620X.99B8.BJJ-2017-0771