Orthopaedics Research 
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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 24.
[Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis].
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CONCLUSION: The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.
PMID: 23158944 [PubMed - in process]
Source: Zhong xi yi jie he xue bao : Journal of Chinese Integrative Medicine. - November 1, 2012 Category: Complementary Medicine Authors: Li DT, Wang J, Jiang HY, Shi FL, Li FY, Liu JH, Cheng YM, Yan N, Hu AH, Zhang MZ, Li J, Wei LB, Jiang RQ Tags: Zhong Xi Yi Jie He Xue Bao Source Type: research
Exercise for Patients With Osteoporosis: Management of Vertebral Compression Fractures and Trunk Strengthening for Fall PreventionEmail this article to a colleague.
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Abstract:
Maintenance of bone health and quality requires mechanical strain, but the mechanical force needs to be within the bone's biomechanical competence. In osteoporosis, compression of vertebral bodies can be insidious. Therefore, absence of pain does not necessarily indicate absence of vertebral microfracture and deformity. Further, patients with previous vertebral fractures are at risk for further vertebral fractures and their associated morbidity. Exercise is a part of the comprehensive management of patients with osteoporosis and has been associated with improvement of quality of life and lowered risk of future f...
Source: PM and R - November 1, 2012 Category: Rehabilitation Authors: Mehrsheed Sinaki Tags: Disease and Disability Source Type: research
Result of extracorporeal irradiation and re‐implantation for malignant bone tumors: A review of 30 patientsEmail this article to a colleague.
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ConclusionOur results are encouraging in terms of the orthopedic and oncological outcomes. This indicates that ECI offers a good alternative method for reconstruction in limb salvage surgery.
Source: Asia-Pacific Journal of Clinical Oncology - November 1, 2012 Category: Cancer & Oncology Authors: Olarn Arpornchayanon, Taninnit Leerapun, Dumnoenson Pruksakorn, Phonthakorn Panichkul Tags: ORIGINAL ARTICLE Source Type: research
[Giant-cell arteritis : Update: diagnosis and therapy].Email this article to a colleague.
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[Giant-cell arteritis : Update: diagnosis and therapy].
Z Rheumatol. 2012 Nov;71(9):754-9
Authors: Schirmer M, Dejaco C, Schmidt WA
Abstract
Giant-cell arteritis (GCA) is the most common form of vasculitis in patients over 50 years old. Loss of vision is the most common severe complication but involvement of extracranial arteries including the aorta is more frequent than previously assumed. The role of dendritic and T-cells indicates the presence of an antibody but a clear association with underlying infections has not yet been demonstrated. Even if the inflammation parameters in blood are mostly increased ...
Source: Zeitschrift fur Rheumatologie - November 1, 2012 Category: Rheumatology Authors: Schirmer M, Dejaco C, Schmidt WA Tags: Z Rheumatol Source Type: research
Penile imaging.Email this article to a colleague.
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Abstract
In Peyronie disease, magnetic resonance (MR) imaging is better than ultrasound in detecting impalpable plaques and plaque dimensions, whereas calcified plaques are better visualized on ultrasound. Ultrasound with color Doppler technique is superior to MR imaging in evaluating vascular causes of erectile dysfunction. In penile fractures, MR imaging should be performed with the patient in the erect position to avoid kinking between the pendulous and fixed parts and thus enable better demonstration of the site of tunica albuginea disruption for surgical planning. MR imaging is better than ultrasound in deline...
Source: Radiologic Clinics of North America - November 1, 2012 Category: Radiology Authors: Shenoy-Bhangle A, Perez-Johnston R, Singh A Tags: Radiol Clin North Am Source Type: research
Bone health in endurance athletes: runners, cyclists, and swimmers.Email this article to a colleague.
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This article reviews the variable effects of distance running, cycling, swimming, and triathlons on bone health; the evaluation of stress and fragility fractures; and the diagnosis, management, and prevention of low BMD in endurance athletes.
PMID: 23147022 [PubMed - in process]
Source: Current Sports Medicine Reports - November 1, 2012 Category: Sports Medicine Authors: Scofield KL, Hecht S Tags: Curr Sports Med Rep Source Type: research
Lead resistant Providencia alcalifaciens strain 2EA bioprecipitates Pb+2 as lead phosphateEmail this article to a colleague.
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Abstract
A lead resistant bacteria isolated from soil contaminated with car battery waste was identified as Providencia alcalifaciens based on biochemical characteristics, FAME profile and 16S rRNA sequencing and designated as strain 2EA. It resists lead nitrate up to 0.0014 mol l−1 by precipitating soluble lead as insoluble light brown solid. Scanning electron microscopy coupled with Energy dispersive X‐ray spectrometric analysis (SEM‐EDX) and X‐ray diffraction spectroscopy (XRD) revealed extracellular light brown precipitate as lead‐orthophosphate mineral i.e. Pb9 (PO4)6 catalysed by phosphatase enzyme. This le...
Source: Letters in Applied Microbiology - November 1, 2012 Category: Microbiology Authors: Milind Mohan Naik, Dnyanada S Khanolkar, Santosh Kumar Dubey Tags: Original Article Source Type: research
MRI of the penis.Email this article to a colleague.
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Abstract
MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and high-resolution T(2) sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in...
Source: The British Journal of Radiology - November 1, 2012 Category: Radiology Authors: Kirkham A Tags: Br J Radiol Source Type: research
Pediatric bone densitometry.Email this article to a colleague.
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This article discusses pediatric bone disease and current and emerging imaging options for assessing bone density in children and adolescents.
PMID: 23125379 [PubMed - in process]
Source: Radiologic Technology - November 1, 2012 Category: Radiology Authors: Havrda JB Tags: Radiol Technol Source Type: research
Intraoperative findings and procedures in culturally and geographically different patient and surgeon populations.Email this article to a colleague.
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Conclusions Baseline findings between the NKLR and the KP ACLRR were congruent regarding patient characteristics and most injury patterns, adding to the evidence that comparisons and collaborations between these registries will provide generalizable information to the international orthopedic community. The variation in the treatment, including graft and implant selection and meniscus procedures, between the 2 registries provides opportunities to explore the impact of treatment choices on the outcomes of ACLRs.
PMID: 23116436 [PubMed - as supplied by publisher]
Source: Acta Orthopaedica - November 1, 2012 Category: Orthopaedics Authors: Granan LP, Inacio MC, Maletis GB, Funahashi TT, Engebretsen L Tags: Acta Orthop Source Type: research
Reverse hybrid and cemented hip replacement compared using radiostereometry and dual-energy X-ray absorptiometry.Email this article to a colleague.
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Abstract
Background and purpose Total hip replacement (THR) with a reverse hybrid (RH), a combination of a cemented polyethylene cup and a cementless femoral stem, has been increasingly used in Scandinavia. In a randomized trial, we compared an RH THR with a proximal hydroxyapatite- (HA-) coated stem to a conventional cemented THR. Both groups received the same polyethylene cup. Patients and methods 51 patients (52 hips) were included. Radiostereometry (RSA) and dual-energy X-ray absorptiometry (DEXA) were performed postoperatively and after 6, 12, and 24 months. 42 patients (43 hips) were followed for 2 years. R...
Source: Acta Orthopaedica - November 1, 2012 Category: Orthopaedics Authors: Lindalen E, Dahl J, Nordsletten L, Snorrason F, Röhrl S Tags: Acta Orthop Source Type: research
10-year results of a new low-monomer cement.Email this article to a colleague.
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Abstract
Background and purpose The properties and performance of a new low-monomer cement were examined in this prospective randomized, controlled RSA study. 5-year data have already been published, showing no statistically significant differences compared to controls. In the present paper we present the 10-year results. Methods 44 patients were originally randomized to receive total hip replacement with a Lubinus SPII titanium-aluminum-vanadium stem cemented either with the new Cemex Rx bone cement or with control bone cement, Palacos R. Patients were examined using RSA, Harris hip score, and conventional radiog...
Source: Acta Orthopaedica - November 1, 2012 Category: Orthopaedics Authors: Söderlund P, Dahl J, Röhrl S, Nivbrant B, Nilsson KG Tags: Acta Orthop Source Type: research
Dual-mobility cups for revision due to instability are associated with a low rate of re-revisions due to dislocation.Email this article to a colleague.
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Abstract
Background and purpose Revision total hip arthroplasty (THA) due to recurrent dislocations is associated with a high risk of persistent instability. We hypothesized that the use of dual-mobility cups would reduce the risk of re-revision due to dislocation after revision THA. Patients and methods 228 THA cup revisions (in 228 patients) performed due to recurrent dislocations and employing a specific dual-mobility cup (Avantage) were identified in the Swedish Hip Arthroplasty Register. Kaplan-Meier survival analysis was performed with re-revision due to dislocation as the primary endpoint and re-revision fo...
Source: Acta Orthopaedica - November 1, 2012 Category: Orthopaedics Authors: Hailer NP, Weiss RJ, Stark A, Kärrholm J Tags: Acta Orthop Source Type: research
The type of surgical approach influences the risk of revision in total hip arthroplasty.Email this article to a colleague.
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Abstract
Background and purpose The most common surgical approaches in total hip arthroplasty in Sweden are the posterior and the anterolateral transgluteal approach. Currently, however, there is insufficient evidence to prefer one over the other regarding risk of subsequent surgery. Patients and methods We searched the Swedish Hip Arthroplasty Register between the years 1992 and 2009 to compare the posterior and anterolateral transgluteal approach regarding risk of revision in the 3 most common all-cemented hip prosthesis designs in Sweden. 90,662 total hip replacements met the inclusion criteria. We used Cox reg...
Source: Acta Orthopaedica - November 1, 2012 Category: Orthopaedics Authors: Lindgren V, Garellick G, Kärrholm J, Wretenberg P Tags: Acta Orthop Source Type: research
Dawn of a new day.Email this article to a colleague.
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PMID: 23118369 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Greenwald AS Tags: J Bone Joint Surg Br Source Type: research
Current guidelines for total joint VTE prophylaxis: dawn of a new day.Email this article to a colleague.
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Abstract
Venous thromboembolism (VTE) remains an immediate threat to patients following total hip and knee replacement. While there is a strong consensus that steps should be taken to minimise the risk to patients by utilising some forms of prophylaxis for the vast majority of patients, the methods utilised have been extremely variable. Clinical practice guidelines (CPGs) have been published by various professional organisations for over 25 years to provide recommendations to standardise VTE prophylaxis. Historically, these recommendations have varied widely depending in underlying assumptions, goals, and ...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Barrack RL Tags: J Bone Joint Surg Br Source Type: research
Minimising blood loss and transfusion in contemporary hip and knee arthroplasty.Email this article to a colleague.
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The objective of this article is to present two practical and effective approaches to minimising blood loss and transfusion rates in hip and knee arthroplasty: the use of antifibrinolytic medications such as tranexamic acid and the adoption of more conservative transfusion indications.
PMID: 23118371 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Watts CD, Pagnano MW Tags: J Bone Joint Surg Br Source Type: research
If hip implant retrievals could speak, what would they tell us?Email this article to a colleague.
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Abstract
Hip implant retrieval analysis is the most important source of insight into the performance of new materials and designs of hip arthroplasties. Even the most rigorous in vitro testing will not accurately simulate the behavior of implant materials and new designs of prosthetic arthroplasties. Retrieval analysis has revealed such factors as the effects of gamma-in-air sterilisation of polyethylene, fatigue failure mechanisms of polymethylmethacrylate bone cement, fretting corrosion of Morse taper junctions, third body wear effects of both hard-on-hard and hard-on-soft bearing couples, and the effects...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Cuckler JM Tags: J Bone Joint Surg Br Source Type: research
The Hip Society: algorithmic approach to diagnosis and management of metal-on-metal arthroplasty.Email this article to a colleague.
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Abstract
Since 1996 more than one million metal-on-metal articulations have been implanted worldwide. Adverse reactions to metal debris are escalating. Here we present an algorithmic approach to patient management. The general approach to all arthroplasty patients returning for follow-up begins with a detailed history, querying for pain, discomfort or compromise of function. Symptomatic patients should be evaluated for intra-articular and extra-articular causes of pain. In large head MoM arthroplasty, aseptic loosening may be the source of pain and is frequently difficult to diagnose. Sepsis should be rule...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Lombardi AV, Barrack RL, Berend KR, Cuckler JM, Jacobs JJ, Mont MA, Schmalzried TP Tags: J Bone Joint Surg Br Source Type: research
Subcapital fractures: a changing paradigm.Email this article to a colleague.
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Abstract
Options for the treatment of subcapital femoral neck fractures basically fall into two categories: internal fixation or arthroplasty (either hemiarthroplasty or total hip arthroplasty). Historically, the treatment option has been driven by a diagnosis-related approach (non-displaced neck fractures versus displaced neck fractures). More recently, the traditional paradigm has changed. Instead of a diagnosis-related approach, it has become more of a patient-related approach. Treatment options take in to consideration the patient's age, functional demands, and individual risk profile. A simple algorith...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Callaghan JJ, Liu SS, Haidukewych GJ Tags: J Bone Joint Surg Br Source Type: research
Metastatic disease around the hip: maintaining quality of life.Email this article to a colleague.
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Abstract
Many tumors metastasise to bone, therefore, pathologic fracture and impending pathologic fractures are common reasons for orthopedic consultation. Having effective treatment strategies is important to avoid complications, and relieve pain and preserve function. Thorough pre-operative evaluation is recommended for medical optimization and to ensure that the lesion is in fact a metastasis and not a primary bone malignancy. For impending fractures, various scoring systems have been proposed to determine the risk of fracture, and therefore the need for prophylactic stabilisation. Lower score lesions c...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Haidukewych GJ Tags: J Bone Joint Surg Br Source Type: research
Intra-operative fractures during THA: see it before it sees us.Email this article to a colleague.
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Abstract
The purpose of this paper is to discuss the risk factors, prevention strategies, classification, and treatment of intra-operative femur fractures sustained during primary and revision total hip arthroplasty.
PMID: 23118376 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Mayle RE, Della Valle CJ Tags: J Bone Joint Surg Br Source Type: research
Femoroacetabular impingement: a resurfacing solution.Email this article to a colleague.
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Abstract
Femoroacetabular impingement (FAI) is commonly associated with early hip arthritis. We reviewed our series of 1300 hip resurfacing procedures. More than 90% of our male patients, with an average age of 53 years, had cam impingement lesions. In this condition, there are anterior femoral neck osteophytes, and a retroverted femoral head on a normally anteverted neck. It is postulated that FAI results in collision of the anterior neck of the femur against the rim of the acetabulum, causing damage to the acetabular labrum and articular cartilage, resulting in osteoarthritis. Early treatment of FAI invo...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Brooks P, Bershadsky B Tags: J Bone Joint Surg Br Source Type: research
Functional results and complications following conversion of hip fusion to total hip replacement.Email this article to a colleague.
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Abstract
Eighteen hip fusions were converted to total hip replacements. A constrained acetabular liner was used in three hips. Mean follow up was five years (two to 15). Two (11%) hips failed, requiring revision surgery and two patients (11%) had injury to the peroneal nerve. Heterotopic ossification developed in seven (39%) hips, in one case resulting in joint ankylosis. No hips dislocated. Conversion of hip fusion to hip replacement carries an increased risk of heterotopic ossification and neurological injury. We advise prophylaxis against heterotropic ossification. When there is concern about hip stabili...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Aderinto J, Lulu OB, Backstein DJ, Safir O, Gross AE Tags: J Bone Joint Surg Br Source Type: research
Strategies for the prevention of periprosthetic joint infection.Email this article to a colleague.
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Abstract
Periprosthetic joint infection (PJI) is a devastating complication which can follow a total joint arthroplasty (TJA). Although rare, this ongoing threat undermines the success of TJA, a historically reputable procedure. It has haunted the orthopedic community for decades and several ongoing studies have provided insights and new approaches to effectively battle this multilayered problem.
PMID: 23118379 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Adeli B, Parvizi J Tags: J Bone Joint Surg Br Source Type: research
Short stems for total hip arthroplasty: Initial experience with the Fitmore™ stem.Email this article to a colleague.
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Abstract
The use of short stems has become more popular with the increased interest in less invasive approaches for total hip arthroplasty. The curved broaches and stem can be inserted along a curved track to avoid the abductor attachments. Short stems have the potential of being more bone conserving by allowing for higher neck retention, maintenance of the medial greater trochanter, and preferential stress transfer to the proximal femur. An initial experience with 500 new short stems (Fitmore, Zimmer Orthopedics) stems used for total hip arthroplasty is reported. No stems have been revised for aseptic loos...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Gustke K Tags: J Bone Joint Surg Br Source Type: research
Large diameter heads: is bigger always better?Email this article to a colleague.
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Abstract
Large femoral heads have been used with increasing frequency over the last decade. The prime reason is likely the effect of large heads on stability. The larger head neck ratio, combined with the increased jump distance of larger heads result in a greater arc of impingement free motion, and greater resistance to dislocation in a provocative position. Multiple studies have demonstrated clear clinical efficacy in diminishing dislocation rates with the use of large femoral heads. With crosslinked polyethylene, wear has been shown to be equivalent between larger and smaller heads. However, the stabili...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Rodriguez JA, Rathod PA Tags: J Bone Joint Surg Br Source Type: research
The painful hip: Diagnosis and Deliverance.Email this article to a colleague.
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Abstract
The differential diagnosis of the painful total hip arthroplasty (resurfacing or total hip) includes infection, failure of fixation (loosening), tendinitis, bursitis, synovitis, adverse local tissue reaction (ALTR) to cobalt-chromium alloys, and non-hip issues, such as spinal disorders, hernia, gynecologic, and other pelvic pain. Assuming that the hip is the source of pain, the first level question is prosthetic or non-prosthetic pain generator? The second level prosthetic question is septic or aseptic? The third level question (aseptic hips) is well-fixed or loose? ALTR is best diagnosed by cross...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Schmalzried TP Tags: J Bone Joint Surg Br Source Type: research
Role and results of tapered fluted modular titanium stems in revision total hip arthroplasty.Email this article to a colleague.
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Abstract
Tapered, fluted, modular, titanium stems have a long history in Europe and are increasing in popularity in North America. We have reviewed the results at our institution looking at stem survival and clinical outcomes. Radiological outcomes and quality of life assessments have been performed and compared to cylindrical non-modular cobalt chromium stems. Survival at five years was 94%. This fell to 85% at ten years due to stem breakage with older designs. Review of radiology showed maintenance or improvement of bone stock in 87% of cases. Outcome scores were superior in tapered stems despite worse p...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Munro JT, Garbuz DS, Masri BA, Duncan CP Tags: J Bone Joint Surg Br Source Type: research
Massive bone loss: Allograft-prosthetic composites and beyond.Email this article to a colleague.
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Abstract
Revision total hip arthroplasty (THA) is projected to increase by 137% from the years 2005 to 2030. Reconstruction of the femur with massive bone loss can be a formidable undertaking. The goals of revision surgery are to create a stable construct, preserve bone and soft tissues, augment deficient host bone, improve function, provide a foundation for future surgery, and create a biomechanically restored hip. Options for treatment of the compromised femur include: resection arthroplasty, allograft prosthetic composite (APC), proximal femoral replacement, cementless fixation with a modular tapered fl...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Mayle RE, Paprosky WG Tags: J Bone Joint Surg Br Source Type: research
Osteolysis in the well-fixed socket: Cup retention or revision?Email this article to a colleague.
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Abstract
Osteolysis remains a common reason for revision after total hip arthroplasty (THA). For osteolysis associated with loose cups, revision is indicated. For osteolysis around a well-fixed cup, the decision is more controversial. The data available data support retention of the cupwith lesional treatment, working through screw holes and access channels for debridement and grafting. The choice of graft material to fill defects, if any, remains controversial. Several studies demonstrate good survivorship with cup retention strategies. Complete revision allows more complete debridement of the lesion and ...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Haidukewych GJ Tags: J Bone Joint Surg Br Source Type: research
What would you do?: challenges in hip surgery.Email this article to a colleague.
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Abstract
A moderator and panel of five experts led an interactive session in discussing five challenging and interesting patient case presentations involving surgery of the hip. The hip pathologies reviewed included failed open reduction internal fixation of subcapital femoral neck fracture, bilateral hip disease, evaluation of pain after metal-on-metal hip arthroplasty, avascular necrosis, aseptic loosening secondary to osteolysis and polyethylene wear, and management of ceramic femoral head fracture.
PMID: 23118386 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Lombardi AV, Cameron HU, Della Valle CJ, Jones RE, Paprosky WG, Ranawat CS Tags: J Bone Joint Surg Br Source Type: research
Metal-on-metal hip arthroplasty: going, going, gone... - affirms.Email this article to a colleague.
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This study presents the results of a single center's 15-year experience with metal-on-metal total hip arthroplasty as strong evidence that metal-on-metal is going, going, gone.
PMID: 23118387 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Berend KR, Morris MJ, Adams JB, Lombardi AV Tags: J Bone Joint Surg Br Source Type: research
Metal-on-metal hip arthroplasty: going, going, gone... - opposes.Email this article to a colleague.
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Abstract
In this paper, we will consider the current role of metal-on-metal bearings by looking at three subtypes of MoM hip arthroplasty separately: Hip resurfacing, large head (> 36 mm) MoM THA and MoM THA with traditional femoral head sizes.
PMID: 23118388 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Benjamin-Laing H, Haddad FS Tags: J Bone Joint Surg Br Source Type: research
Cementless fixation in total knee arthroplasty: down the boulevard of broken dreams - affirms.Email this article to a colleague.
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Abstract
There has been a recent increase in interest for non-cemented fixation in total knee arthroplasty (TKA), however the superiority of cement fixation is an ongoing debate. Whereas the results based on Level III and IV evidence show similar survivorship rates between the two types of fixation, Level I and II evidence strongly support cemented fixation. United Kingdom, Australia, Sweden, and New Zealand registry data show lower failure rates and greater usage of cemented than non-cemented fixation. Case series studies have also indicated greater functional outcomes and lower revision rates among cement...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Ranawat CS, Meftah M, Windsor EN, Ranawat AS Tags: J Bone Joint Surg Br Source Type: research
Cementless fixation in total knee arthroplasty: down the boulevard of broken dreams - opposes.Email this article to a colleague.
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In this study we present our experience with four generations of uncemented total knee arthroplasty (TKA) from Smith & Nephew: Tricon M, Tricon LS, Tricon II and Profix, focusing on the failure rates correlating with each design change. Beginning in 1984, 380 Tricon M, 435 Tricon LS, 305 Tricon 2 and 588 Profix were implanted by the senior author. The rate of revision for loosening was 1.1% for the Tricon M, 1.1% for the Tricon LS, 0.5% for the Tricon 2 with a HA coated tibial component, and 1.3% for the Profix TKA. No loosening of the femoral component was seen with the Tricon M, Tricon LS or Tricon 2, with n...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Drexler M, Dwyer T, Marmor M, Abolghasemian M, Sternheim A, Cameron HU Tags: J Bone Joint Surg Br Source Type: research
Simultaneous-bilateral TKA: Double trouble - affirms.Email this article to a colleague.
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Abstract
In this paper, we will consider the current role of simultaneous-bilateral TKA. Based on available evidence, it is our opinion that simultaneous bilateral TKA carries a higher risk of morbidity and mortality and should be reserved for select few.
PMID: 23118391 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Parvizi J, Rasouli MR Tags: J Bone Joint Surg Br Source Type: research
Simultaneous-bilateral TKA: Double trouble - opposes.Email this article to a colleague.
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Abstract
In this paper, we will consider the current role of simultaneous-bilateral TKA. Based on available evidence, it is our opinion that bilateral one stage TKR is a safe and efficacious treatment for patients with severe bilateral arthritic knee disease but should be reserved for selected patients without significant medical comorbidities.
PMID: 23118392 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Sculco TP, Sculco PK Tags: J Bone Joint Surg Br Source Type: research
Patient specific cutting blocks are currently of no proven value.Email this article to a colleague.
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Abstract
Patient specific cutting guides generated by preoperative Magnetic Resonance Imaging (MRI) of the patient's extremity have been proposed as a method of improving the consistency of Total Knee Arthroplasty (TKA) alignment and adding efficiency to the operative procedure. The cost of this option was evaluated by quantifying the savings from decreased operative time and instrument processing costs compared to the additional cost of the MRI and the guide. Coronal plane alignment was measured in an unselected consecutive series of 200 TKAs, 100 with standard instrumentation and 100 with custom cutting ...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Barrack RL, Ruh EL, Williams BM, Ford AD, Foreman K, Nunley RM Tags: J Bone Joint Surg Br Source Type: research
The influence of obesity on total joint arthroplasty.Email this article to a colleague.
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Abstract
Obesity is an epidemic across both the developed and developing nations that is possibly the most important current public health factor affecting the morbidity and mortality of the global population. Obese patients have the potential to pose several challenges for arthroplasty surgeons from the standpoint of the influence obesity has on osteoarthritic symptoms, their peri-operative medical management, the increased intra-operative technical demands on the surgeon, the intra- and post-operative complications, the long term outcomes of total hip and knee arthroplasty. Also, there is no consensus on...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Vasarhelyi EM, Macdonald SJ Tags: J Bone Joint Surg Br Source Type: research
The stiff total knee arthroplasty: Causes and cures.Email this article to a colleague.
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Abstract
Seven stiff total knee arthroplasties are presented to illustrate the roles of: 1) manipulation under general anesthesia; 2) multiple concurrent diagnoses in addition to stiffness; 3) extra-articular pathology; 4) pain as part of the stiffness triad (pain and limits to flexion or extension); 5) component internal rotation; 6) multifactorial etiology; and 7) surgical exposure in this challenging clinical problem.
PMID: 23118395 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Vince KG Tags: J Bone Joint Surg Br Source Type: research
Fixed flexion deformity and total knee arthroplasty.Email this article to a colleague.
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Abstract
Fixed flexion deformities are common in osteoarthritic knees that are indicated for total knee arthroplasty. The lack of full extension at the knee results in a greater force of quadriceps contracture and energy expenditure. It also results in slower walking velocity and abnormal gait mechanics, overloading the contralateral limb. Residual flexion contractures after TKA have been associated with poorer functional scores and outcomes. Although some flexion contractures may resolve with time after surgery, a substantial percentage will become permanent. Therefore, it is essential to correct fixed fle...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Su EP Tags: J Bone Joint Surg Br Source Type: research
Management of extensor mechanism rupture after TKA.Email this article to a colleague.
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Abstract
Disruption of the extensor mechanism in total knee arthroplasty may occur by tubercle avulsion, patellar or quadriceps tendon rupture, or patella fracture, and whether occurring intra-operatively or post-operatively can be difficult to manage and is associated with a significant rate of failure and associated complications. This surgery is frequently performed in compromised tissues, and repairs must frequently be protected with cerclage wiring and/or augmentation with local tendon (semi-tendinosis, gracilis) which may also be used to treat soft-tissue loss in the face of chronic disruption. Quadr...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Rosenberg AG Tags: J Bone Joint Surg Br Source Type: research
Single stage revision: regaining momentum.Email this article to a colleague.
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Abstract
In this paper we make the case for the use of single-stage revision for infected knee arthroplasty.
PMID: 23118398 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Gulhane S, Vanhegan IS, Haddad FS Tags: J Bone Joint Surg Br Source Type: research
Articulating antibiotic impregnated spacers in two-stage revision of infected total knee arthroplasty.Email this article to a colleague.
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Abstract
Antibiotic impregnated articulating spacers are used in two-stage revision total knee arthroplasty to deliver local antibiotic therapy while preserving function. We have observed infection control in greater than 95% of cases with functional outcomes approaching those seen in revision for aseptic loosening. Higher failure has been observed with methicillin resistant organisms.
PMID: 23118399 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Munro JT, Garbuz DS, Masri BA, Duncan CP Tags: J Bone Joint Surg Br Source Type: research
Wound closure: healing the collateral damage.Email this article to a colleague.
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Abstract
In this paper, we consider wound healing after total knee arthroplasty.
PMID: 23118400 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Vince KG Tags: J Bone Joint Surg Br Source Type: research
The evolving incidence and reasons for re-operation after fixed-bearing PCL retaining total knee arthroplasty.Email this article to a colleague.
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Abstract
PCL retaining fixed-bearing TKA is a highly successful operation with the need for more surgery occurring at the rate of approximately 0.4% per year over the first 27 years. The most common cause for revision surgery is related to polyethylene insert failure and accounts for approximately 50% of re-operations. Late metastatic infection is the next most frequent cause followed by patellar problems, late instability and component loosening in decreasing frequency. A myriad of rare miscellaneous problems can also occur.
PMID: 23118401 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Scott RD Tags: J Bone Joint Surg Br Source Type: research
Alternatives to revision total knee arthroplasty.Email this article to a colleague.
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Abstract
Most problems encountered in complex revision total knee arthroplasty can be managed with the wide range of implant systems currently available. Modular metaphyseal sleeves, metallic augments and cones provide stability even with significant bone loss. Hinged designs substitute for significant ligamentous deficiencies. Catastrophic failure that precludes successful reconstruction can be encountered. The alternatives to arthroplasty in such drastic situations include knee arthrodesis, resection arthroplasty and amputation. The relative indications for the selection of these alternatives are recurre...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Jones RE, Russell RD, Huo MH Tags: J Bone Joint Surg Br Source Type: research
A primer in cartilage repair.Email this article to a colleague.
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This article reviews the basic science structure and function of articular cartilage, and techniques that are presently available to effect repair and their expected outcomes.
PMID: 23118403 [PubMed - in process]
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Minas T Tags: J Bone Joint Surg Br Source Type: research
Use of smart trials for soft-tissue balancing in total knee replacement surgery.Email this article to a colleague.
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Abstract
Smart trials are total knee tibial trial liners with load bearing and alignment sensors that will graphically show quantitative compartment load-bearing forces and component track patterns. These values will demonstrate asymmetrical ligament balancing and misalignments with the medial retinaculum temporarily closed. Currently surgeons use feel and visual estimation of imbalance to assess soft-tissue balancing and tracking with the medial retinaculum open, which results in lower medial compartment loads and a wider anteroposterior tibial tracking pattern. The sensor trial will aid the total knee rep...
Source: The Journal of Bone and Joint Surgery. British volume - November 1, 2012 Category: Orthopaedics Authors: Gustke K Tags: J Bone Joint Surg Br Source Type: research
