Preformed Articulating Knee Spacers in 2-Stage Total Knee Revision Arthroplasty: Minimum 2-Year Follow-Up

2012 ◽  
Vol 27 (10) ◽  
pp. 1879
Author(s):  
Stephen J. Incavo ◽  
Kenneth B. Mathis
Keyword(s):  
Revision Arthroplasty ◽  
Total Knee ◽  
Knee Revision

Extended Routine Follow-up of Primary Uncomplicated Hip and Knee Arthroplasty is not Necessary

2019 ◽  
Vol 13 (1) ◽  
pp. 266-271
Author(s):  
Georgina Kakra Wartemberg ◽  
Thomas Goff ◽  
Simon Jones ◽  
James Newman
Keyword(s):  
Aseptic Loosening ◽  
Revision Surgery ◽  
Revision Arthroplasty ◽  
Cost Effective ◽  
Face To Face ◽  
Primary Surgery ◽  
Effective System ◽  
Knee Revision Surgery ◽  
Knee Revision

Aims: To create a more effective system to identify patients in need of revision surgery. Background: There are over 160,000 total hip and knee replacements performed per year in England and Wales. Currently, most trusts review patients for up to 10 years or more. When we consider the cost of prolonged reviews, we cannot justify the expenditure within a limited budget. Study Design & Methods: We reviewed all patients' notes that underwent primary hip and knee revision surgery at our institution, noting age, gender, symptoms at presentation, referral source, details of the surgery, reason for revision and follow up history from primary surgery. Results: There were 145 revision arthroplasties (60 THR and 85 TKR) that met our inclusion criteria. Within the hip arthroplasty group, indications for revision included aseptic loosening (37), dislocation (10), and infection (3), periprosthetic fracture, acetabular liner wear and implant failure. All thirty-seven patients with aseptic loosening presented with pain. Twenty-five were referred from general practice with new symptoms. The remaining were clinic follow-ups. The most common reason for knee revision was aseptic loosening (37), followed by infection (21) and then progressive osteoarthritis (8). Most were referred from GP as a new referral or were clinic follow-ups. All patients were symptomatic. Conclusion: All the patients that underwent revision arthroplasty were symptomatic. Rather than yearly follow up, we recommend a cost-effective system. We are implementing a 'non face-to-face' system. Patients would be directly sent a questionnaire and x-ray form. The radiographs and forms will be reviewed by an experienced arthroplasty surgeon. The concerning cases will be seen urgently in a face-to-face clinic.

scholarly journals Clinical and radiological results of a stemmed medial pivot revision implant in aseptic total knee revision arthroplasty

The Knee ◽  
2020 ◽  
Vol 27 (4) ◽  
pp. 1190-1196
Author(s):  
Eugenio Vecchini ◽  
Mattia Berti ◽  
Gian Mario Micheloni ◽  
Tommaso Maluta ◽  
Bruno Magnan ◽  
...  
Keyword(s):  
Revision Arthroplasty ◽  
Radiological Results ◽  
Medial Pivot ◽  
Total Knee ◽  
Clinical And Radiological Results ◽  
Knee Revision

scholarly journals Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty

2018 ◽  
Vol 7 (10) ◽  
pp. 570-579 ◽  
Author(s):  
R. Kallala ◽  
W. Edwin Harris ◽  
M. Ibrahim ◽  
M. Dipane ◽  
E. McPherson
Keyword(s):  
Lower Limb ◽  
Safety Profile ◽  
Revision Arthroplasty ◽  
Bone Substitutes ◽  
Calcium Sulphate ◽  
Complication Rates ◽  
Number Of Patients ◽  
Total Knee ◽  
Hip Arthroplasties

Aims Calcium sulphate has traditionally been used as a filler of dead space arising during surgery. Various complications have been described following the use of Stimulan bio-absorbable calcium sulphate beads. This study is a prospective observational study to assess the safety profile of these beads when used in revision arthroplasty, comparing the complication rates with those reported in the literature. Methods A total of 755 patients who underwent 456 revision total knee arthroplasties (TKA) and 299 revision total hip arthroplasties (THA), with a mean follow-up of 35 months (0 to 78) were included in the study. Results A total of 32 patients (4.2%) had wound drainage, and this was higher with higher bead volumes and in McPherson grade C patients. There was also a significantly higher bead volume in the 41 patients who developed hypercalcaemia, two of which were symptomatic (p < 0.0001). A total of 13 patients (1.7%) had heterotopic ossification (HO). There was no statistically significant relationship between the development of HO and bead volume (p > 0.05). Conclusion The strength of this study lies in the large number of patients and the detailed data collection, making it the most comprehensive report available in the literature on the use of calcium sulphate-based bone substitutes. Cite this article: R. Kallala, W. Edwin Harris, M. Ibrahim, M. Dipane, E. McPherson. Use of Stimulan absorbable calcium sulphate beads in revision lower limb arthroplasty: Safety profile and complication rates. Bone Joint Res 2018;7:570–579. DOI: 10.1302/2046-3758.710.BJR-2017-0319.R1.

Femoral stem disengagement in modular total knee revision arthroplasty

The Knee ◽  
1999 ◽  
Vol 6 (3) ◽  
pp. 221-223 ◽  
Author(s):  
G.E.D Howell ◽  
C.H Rorabeck
Keyword(s):  
Revision Arthroplasty ◽  
Femoral Stem ◽  
Total Knee ◽  
Knee Revision

scholarly journals Revision total knee arthroplasty longer term outcome and comparison between infection and aseptic loosening at mean follow-up of 10 years

2020 ◽  
pp. 221049172097183
Author(s):  
TST Tse ◽  
SHK Hui ◽  
CY To ◽  
MK Wong ◽  
WL Tsang
Keyword(s):  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Revision Arthroplasty ◽  
Term Outcome ◽  
Revision Knee Arthroplasty ◽  
Significant Difference ◽  
Total Knee ◽  
Arthroplasty Revision

Background: Although the majority of total knee arthroplasty cases have good outcome and survival, some arthroplasty eventually required revision. While early outcomes of revision knee arthroplasty are well reported, there is relatively fewer literatures reporting on the longer term outcome of revision knee arthroplasty. This study aims to review the outcome of revision knee arthroplasty for a longer term, and also make comparison between the two common indications for revision arthroplasty of infection and aseptic loosening. Methods: This study reviews all total knee arthroplasty revision performed at a single center over a 11 year period. Of the 48 cases found, 35 cases not lost to follow-up had a mean follow-up duration of 10.6 years (SD 2.9) for aseptic loosening, and 10.1 years (SD 2.6) for infection. Data of initial arthroplasty, revision arthroplasty, demographics, follow-up outcome were obtained, analyzed and compared. Results: Revision arthroplasty due to infection had more cases that required use of varus/valgus constraints (p ∼ 0.008) and extensile surgical exposure of quadriceps snip (p ∼ 0.005) compared to aseptic loosening. The survival at 10 years for this study is 91% overall (aseptic loosening 93.3%, infection 89.3%). Infection cases had significant initial improvement for range of motion (p ∼ 0.001) and use of walking aid (p ∼ 0.04) at post-operation 1 year, but no significant differences between the infection and aseptic loosening cases at 5 years and 10 years follow-up. Comparison between the two groups on other factors including initial arthroplasty, operative details, demographics, post-operative details and X-rays showed no statistically significant difference.

scholarly journals Expanding Robotic Arm-Assisted Knee Surgery: The First Attempt to Use the System for Knee Revision Arthroplasty

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Dimitrios Kalavrytinos ◽  
Christos Koutserimpas ◽  
Ioannis Kalavrytinos ◽  
Konstantinos Dretakis
Keyword(s):  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Total Shoulder Arthroplasty ◽  
Revision Arthroplasty ◽  
Robotic Arm ◽  
Uneventful Recovery ◽  
Total Hip ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
Knee Revision

Robotic arm-assisted arthroplasty was introduced in 2006 and has expanded its applications into unicompartmental knee, total knee, and total hip replacement. The first case of a revision surgery from conventional unicompartmental to total knee arthroplasty with the utilization of the robotic arm-assisted MAKO system is presented. An 87-year-old female presented with deteriorating left knee pain due to failure of medial unicompartmental knee arthroplasty at the outpatient clinic. The patient was advised to undergo revision surgery. Through medial parapatellar arthrotomy, the joint was exposed. With the use of the MAKO system, the estimated depth of the medial plateau according to CT planning was found to be 10 mm more distal than the lateral. The resection line of the remaining plateau was placed deliberately 2 mm more distal in order to achieve satisfactory replacement of the bony gap of the medial tibial condyle by a 10 mm augment. The patient had an uneventful recovery. A plethora of additional applications in the future, such as total shoulder or reverse total shoulder arthroplasty, megaprosthesis placement in oncological patients, and total hip or knee revision surgeries, may improve patient-related outcomes.

scholarly journals The role of antibiotic-loaded bone cement in complicated knee arthroplasty: relevance of gentamicin allergy and benefit from revision surgery, a case control follow-up study and algorithmic approach

2020 ◽  
Author(s):  
Benjamin Thomas ◽  
Maria Benedikt ◽  
Ali Alamri ◽  
Florian Kapp ◽  
Rainer Bader ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Cement ◽  
Knee Arthroplasty ◽  
Revision Surgery ◽  
Symptom Relief ◽  
Revision Arthroplasty ◽  
Positive Patch Test ◽  
Total Knee ◽  
Significant Symptom

Abstract Background Antibiotic-loaded (particularly gentamicin) bone cement (BC) is widely used in total joint arthroplasty (TJA) to prevent periprosthetic infections (PPIs), but may itself cause implant failure. In light of a complete lack in literature, the objective was to assess the clinical relevance of gentamicin allergy for failure of cemented total knee arthroplasties in 25 out of 250 patients with positive patch test reactions to gentamicin and otherwise unexplained symptoms by evaluating benefits from revision with change to gentamicin-free cement. Methods 15 of these 25 patients and their treating orthopaedic surgeons agreed to a re-assessment. They were surveyed regarding interim course of therapy and symptoms, including re-assessment of the Knee Injury and Osteoarthritis Outcome Score (KOOS), and underwent follow-up clinical and radiographic investigations. The initial use of gentamicin-loaded BC was reaffirmed by review of the primary implantation operative reports and respective implant passports. Primary and follow-up KOOS scores were analyzed regarding benefits from revision surgery by comparing nine patients with revision to six without revision. Results Mean follow-up time was 38 months. The entirety of patients experienced an improvement of self-reported symptoms, with revision surgery (i.e. switching to gentamicin-free BC or uncemented total knee arthroplasty) yielding significantly greater improvement (p=0.031): the nine revised patients reported a significant symptom relief (p=0.028), contrary to the six unrevised patients (p=0.14). Interestingly, the decision to proceed with revision surgery was significantly correlated with higher symptom severity (p=0.05). Conclusion In symptomatic total knee arthroplasty with gentamicin allergy, uncemented revision arthroplasty or change to gentamicin-free BC provides significant symptom relief.

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