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Zhongguo Xiu Fu Chong Jian Wai Ke Za... Oct 2019To summarize the research progress in artificial metacarpophalangeal joint and interphalangeal joint prostheses.
OBJECTIVE
To summarize the research progress in artificial metacarpophalangeal joint and interphalangeal joint prostheses.
METHODS
The research literature on artificial metacarpophalangeal joint and interphalangeal joint prostheses at home and abroad was reviewed and summarized from anatomy, prosthesis design, and material development.
RESULTS
The artificial joint replacement can correct deformity, relieve pain, and improve function immediately. In the past 50 years, many researches have focused on the design and material of prostheses and surgical technique of joint replacement. There are three types of prostheses, including hinged limit-type-prosthesis, semi-limit-type-prosthesis, and non-limit-type-prosthesis. The prostheses have their own advantages and disadvantages, the long-term effectiveness of joint replacement is not ideal.
CONCLUSION
The metacarpophalangeal joint and interphalangeal joint prostheses with more anatomical structure and biocompatible materials are needed.
Topics: Arthroplasty, Replacement; Artificial Limbs; Joint Prosthesis; Metacarpophalangeal Joint; Prosthesis Design
PubMed: 31544447
DOI: 10.7507/1002-1892.201902015 -
Clinical Orthopaedics and Related... Aug 2015Aseptic loosening is the most common cause for revisions after lower-extremity total joint arthroplasties, however studies differ regarding the degree to which host... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Aseptic loosening is the most common cause for revisions after lower-extremity total joint arthroplasties, however studies differ regarding the degree to which host factors influence loosening.
QUESTIONS/PURPOSE
We performed a systematic review to determine which host factors play a role in the development of clinical and/or radiographic failure from aseptic loosening after (1) THA and (2) TKA.
METHODS
Two searches on THA and TKA, respectively, using four electronic databases (EMBASE, CINAHL Plus, PubMed, and Scopus) were conducted. We identified a total of 209 reports that encompassed nine potential host factors affecting aseptic loosening. Inclusion criteria for consideration of scientific clinical reports were that 20 or more patients were involved, with more than 1-year followup, with at least three studies pertaining to each factor, and at least six of the Methodological Index for Non-randomized Studies criteria met, and with raw data for odds ratio (OR) calculations. Twenty-one studies (16 THA studies with 45,779 hips and five TKA studies with 288 knees, respectively) were used to calculate weighted OR and CIs (using the random effects theory) and study heterogeneity for four different host factors in THAs (male sex, high activity level, obesity defined as BMI≥30 kg/m2, and current or former tobacco use) and one factor in TKA (BMI≥30 kg/m2), which were placed in a forest plot.
RESULTS
For THA, male sex (OR, 1.39; 95% CI, 1.22-1.58; p=0.001) and high activity level (University of California Los Angeles [UCLA] activity score≥8 points; OR, 4.24; 95% CI, 2.46-7.31; p=0.001) were associated with aseptic loosening. However, obesity (OR, 1.01; 95% CI, 0.73-1.40; p=0.96), and tobacco use (OR, 1.96; 95% CI, 0.43-8.97; p=0.39) were not associated with an increased risk of aseptic loosening after THA with the numbers available. For TKA, we found no host factors associated with loosening. In particular, obesity (BMI≥30 kg/m2) was not associated with aseptic loosening with the numbers available (OR, 2.28; 95% CI, 0.60-8.62; p=0.22).
CONCLUSIONS
Patients undergoing a lower-extremity total joint arthroplasty who engage in impact sports should be counseled regarding their potential increased risk of aseptic loosening; however, given the weak evidence available, we believe that higher-level studies are necessary to clearly define the risk factors, particularly with newer-generation constructs.
LEVEL OF EVIDENCE
Level IV, therapeutic study.
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Female; Hip Prosthesis; Humans; Knee Prosthesis; Male; Odds Ratio; Prosthesis Design; Prosthesis Failure; Risk Factors; Sex Factors; Time Factors; Treatment Outcome
PubMed: 25716213
DOI: 10.1007/s11999-015-4220-2 -
The Bone & Joint Journal Oct 2015Partial knee arthroplasty (PKA), either medial or lateral unicompartmental knee artroplasty (UKA) or patellofemoral arthroplasty (PFA) are a good option in suitable... (Review)
Review
Partial knee arthroplasty (PKA), either medial or lateral unicompartmental knee artroplasty (UKA) or patellofemoral arthroplasty (PFA) are a good option in suitable patients and have the advantages of reduced operative trauma, preservation of both cruciate ligaments and bone stock, and restoration of normal kinematics within the knee joint. However, questions remain concerning long-term survival. The goal of this review article was to present the long-term results of medial and lateral UKA, PFA and combined compartmental arthroplasty for multicompartmental disease. Medium- and long-term studies suggest reasonable outcomes at ten years with survival greater than 95% in UKA performed for medial osteoarthritis or osteonecrosis, and similarly for lateral UKA, particularly when fixed-bearing implants are used. Disappointing long-term outcomes have been observed with the first generation of patellofemoral implants, as well as early Bi-Uni (i.e., combined medial and lateral UKA) or Bicompartmental (combined UKA and PFA) implants due to design and fixation issues. Promising short- and med-term results with the newer generations of PFAs and bicompartmental arthroplasties will require long-term confirmation.
Topics: Arthroplasty, Replacement, Knee; Hemiarthroplasty; Humans; Knee Prosthesis; Osteoarthritis, Knee; Prosthesis Design; Treatment Outcome
PubMed: 26430081
DOI: 10.1302/0301-620X.97B10.36426 -
International Journal of Oral and... Apr 2021Total joint replacement (TJR) with a prosthesis can be indicated for patients with severe temporomandibular joint (TMJ) dysfunction. Surgical accuracy is necessary for...
Total joint replacement (TJR) with a prosthesis can be indicated for patients with severe temporomandibular joint (TMJ) dysfunction. Surgical accuracy is necessary for correct translation of the preoperatively predicted functional outcome, wear, and biomechanical behaviour of the patient-specific TMJ-TJR prosthesis. This study describes the first clinical applications of the patient-specific TMJ-TJR prosthesis according to the Groningen principles (G-TMJ-TJR), which was developed and validated in a prior human cadaver test study. The aim of this study was to validate the accuracy of placement of the patient-specific G-TMJ-TJR in the clinical setting. It was hypothesized that a virtual surgical plan (VSP) combined with guided placement of the patient-specific G-TMJ-TJR would be performed as predictably and accurately as in the prior cadaver series. All patients who received a VSP-based patient-specific G-TMJ-TJR between December 2017 and March 2020 were included in this study. The accuracy analysis was based on postoperative cone beam computed tomography (CBCT) data. All 11 prostheses could be inserted using routine pre-auricular and retromandibular surgical approaches. Analysis of the VSPs and postoperative CBCTs showed an average three-dimensional deviation of 1.07mm (standard deviation 0.46mm, range 0.33-1.91mm) for all of the fossa and mandibular components. The patient-specific G-TMJ-TJR can be applied predictably and accurately in a clinical setting.
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Mandible; Mandibular Prosthesis; Prosthesis Design; Temporomandibular Joint
PubMed: 32943309
DOI: 10.1016/j.ijom.2020.08.012 -
Clinical Orthopaedics and Related... Aug 2013
Topics: Animals; Arthroplasty, Replacement; Coated Materials, Biocompatible; Humans; Joint Prosthesis; Musculoskeletal Diseases; Nanomedicine; Nanostructures; Orthopedics; Prosthesis Design; Tissue Engineering
PubMed: 23657882
DOI: 10.1007/s11999-013-3044-1 -
Hand (New York, N.Y.) May 2023The purpose of this study was to investigate the outcomes of surface replacement arthroplasty (SRA) for noninflammatory arthritis of the metacarpophalangeal (MCP) joint.
BACKGROUND
The purpose of this study was to investigate the outcomes of surface replacement arthroplasty (SRA) for noninflammatory arthritis of the metacarpophalangeal (MCP) joint.
METHODS
Records from 20 SRAs performed between 1995 and 2017 in 17 patients with noninflammatory arthritis affecting the MCP joint were retrospectively reviewed. The mean follow up was 6.6 years.
RESULTS
Three arthroplasties (15%) underwent 4 revision operations. The 2-, 5-, 10-, and 15-year rates of survival from surface replacement implant revision were 90%, 90%, 79%, and 79%, respectively. Major complications occurring in revised joints included arthrodesis (n = 1) and amputation (n = 1). The overall reoperation rate was 35%. The 2-, 5-, 10-, and 15-year rates of overall reoperation-free survival were 75%, 69%, 60%, and 60%, respectively.
CONCLUSIONS
Pain ratings and MCP arc of motion significantly improved following arthroplasty. Metacarpophalangeal SRA for noninflammatory arthritis can improve arc of motion and pain. Revision is uncommon; however, 1 in 3 joints requires reoperation.
Topics: Humans; Joint Prosthesis; Retrospective Studies; Arthroplasty, Replacement; Arthritis; Metacarpophalangeal Joint
PubMed: 34330177
DOI: 10.1177/15589447211028917 -
The Journal of Bone and Joint Surgery.... May 2011
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Prosthesis Failure; Survival Analysis; Treatment Outcome
PubMed: 21511918
DOI: 10.1302/0301-620X.93B5.26687 -
Clinical Orthopaedics and Related... Nov 2015
Topics: Arthroplasty, Replacement; Evidence-Based Medicine; Humans; Joint Prosthesis; Prosthesis Design; Registries; Risk Factors; Treatment Outcome
PubMed: 26189004
DOI: 10.1007/s11999-015-4435-2 -
Journal of Orthopaedic Surgery and... Jul 2021The benefits and risks of fixed-bearing and mobile-bearing designs for total knee arthroplasty (TKA) were compared, and long-term functional, clinical and radiological... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
The benefits and risks of fixed-bearing and mobile-bearing designs for total knee arthroplasty (TKA) were compared, and long-term functional, clinical and radiological outcomes were analysed.
METHODS
A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane Central databases was conducted to identify randomized controlled trials (RCTs) comparing fixed-bearing and mobile-bearing designs with no less than 9 years of follow-up. Primary outcome measures were Knee Society Scores (KSSs), range of motion (ROM) in knee joint values, complication rates and revision rates. The final search was performed on 23 April 2021.
RESULTS
Six RCTs were included. A total of 451 patients with 612 knees met the inclusion criteria. The mobile-bearing design, in contrast to the fixed-bearing design, can clearly increase the KSFSs, especially with posterior cruciate retention. There was no significant difference in the KSKSs, ROM values, revision rates or complication rates between the two bearing design groups.
CONCLUSION
After approximately 10 years of follow-up, the mobile-bearing design has advantages in KSFSs over the fixed-bearing design. The mobile-bearing design may also have advantages in the revision rates over the fixed-bearing design when the posterior cruciate ligament is substituted. There may be no clear difference in KSKSs, ROM values or complication rates between these two designs.
Topics: Arthroplasty, Replacement, Knee; Follow-Up Studies; Humans; Knee Prosthesis; Prosthesis Design; Randomized Controlled Trials as Topic
PubMed: 34229702
DOI: 10.1186/s13018-021-02560-w -
Chinese Medical Journal Jan 2015The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics...
BACKGROUND
The goal of total knee arthroplasty (TKA) is to restore knee kinematics. Knee prosthesis design plays a very important role in successful restoration. Here, kinematics models of normal and prosthetic knees were created and validated using previously published data.
METHODS
Computed tomography and magnetic resonance imaging scans of a healthy, anticorrosive female cadaver were used to establish a model of the entire lower limbs, including the femur, tibia, patella, fibula, distal femur cartilage, and medial and lateral menisci, as well as the anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligaments. The data from the three-dimensional models of the normal knee joint and a posterior-stabilized (PS) knee prosthesis were imported into finite element analysis software to create the final kinematic model of the TKA prosthesis, which was then validated by comparison with a previous study. The displacement of the medial/lateral femur and the internal rotation angle of the tibia were analyzed during 0-135° flexion.
RESULTS
Both the output data trends and the measured values derived from the normal knee's kinematics model were very close to the results reported in a previous in vivo study, suggesting that this model can be used for further analyses. The PS knee prosthesis underwent an abnormal forward displacement compared with the normal knee and has insufficient, or insufficiently aggressive, "rollback" compared with the lateral femur of the normal knee. In addition, a certain degree of reverse rotation occurs during flexion of the PS knee prosthesis.
CONCLUSIONS
There were still several differences between the kinematics of the PS knee prosthesis and a normal knee, suggesting room for improving the design of the PS knee prosthesis. The abnormal kinematics during early flexion shows that the design of the articular surface played a vital role in improving the kinematics of the PS knee prosthesis.
Topics: Adult; Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Female; Humans; Knee Prosthesis
PubMed: 25591565
DOI: 10.4103/0366-6999.149205