Comparison of Clinical Results and Injury Risk of Posterior Tibial Cortex Between Attune and Press Fit Condylar Sigma Knee Systems

Noncemented hip replacement using a conical titanium metal-backed screw-in cup to be implanted with precutting of the threads (TITAN-METAL-BACKED, AlloPro, Baar, Switzerland), in combination with a straight conical press-fit stem (Zweymüller-“hochgezogen”, AlloPro, Baar, Switzerland) was evaluated clinically and radiologically in 64 consecutive primary arthroplasties with an average 7.2 year follow-up. The clinical results compare very favourably with other cementless systems. The Harris hip score revealed an improvement from 45 to 84. The Merle d'Aubigné index showed an increase during the case-control period from 16 to 26. Thigh pain was practically absent except in one patient. A radiographic appearance of bone ingrowth around the acetabular component was found in nearly all cases. Only one cup migrated in a patient with a large cystic lesion in the acetabular roof, which was not grafted, with no other signs of loosening. Additionally this patient had chemotherapy. In all other cases there were no signs of cup migration, significant radiolucency, osteolysis or definite cup loosening. Around the stem, primary cortical contact was mainly located in the distal zones. Radiolucent lines appeared only proximally, with few exceptions, and were, except in four cases, always smaller than 2 mm. They were never circumferential and usually combined with sclerotic lines. Only one stem subsided, but the patient remained asymptomatic. There was a high incidence of proximal bone atrophy, distal cortical thickening and endosteal bone formation, not correlating with radiological loosening or clinical symptoms. Signs of femoral osteolysis were absent. No patient had to be revised.

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Body Mass Index, Modulated by Lateral Posterior Tibial Slope, Predicts ACL Injury Risk

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967116s00129 ◽

2016 ◽

Vol 4 (7_suppl4) ◽

pp. 2325967116S0012

Author(s):

Katherine M. Bojicic ◽

Melanie L. Beaulieu ◽

Daniel Imaizumi Krieger ◽

James A. Ashton-Miller ◽

Edward M. Wojtys

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Injury Risk ◽

Acl Injury ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial ◽

Lateral Posterior ◽

Acl Injury Risk

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Biplane Medial Opening-Wedge High Tibial Osteotomy Increases Posterior Tibial Slope more than Uniplane Osteotomy

The Journal of Knee Surgery ◽

10.1055/s-0040-1722659 ◽

2021 ◽

Author(s):

Dong Won Suh ◽

Kyung Wook Nha ◽

Seung Beom Han ◽

Kuhoang Cheong ◽

Bong Soo Kyung

Keyword(s):

High Tibial Osteotomy ◽

Tibial Slope ◽

Womac Score ◽

Clinical Results ◽

Lateral View ◽

Posterior Tibial Slope ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Posterior Tibial ◽

Wedge High Tibial Osteotomy

AbstractFew clinical studies have compared uniplane high tibial osteotomy (HTO) with biplane HTO. The study aim was to compare the radiological and clinical results of uniplane HTO and biplane HTO, especially in terms of the increase in the posterior tibial slope (PTS). Medial opening-wedge HTO patients' medical records and radiological results from a single institution were retrospectively reviewed. Pre- and postoperative serial radiographs, including the Rosenberg, lateral view, and standing anteroposterior view of the whole lower extremity, magnetic resonance imaging at postoperative day 2, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score at postoperative 2 years were reviewed to evaluate radiological and clinical results, including the change in PTS. A total of 61 knees, including 34 for uniplane and 27 for biplane HTOs, were enrolled. There were no significant differences in the pre- and postoperative mechanical angles or incidences of the lateral hinge fractures, and all patients showed complete union at postoperative 2 years. The PTS was increased more in the biplane group than in the uniplane group (3.1 ± 2.6 in biplane vs. 0.8 ± 1.7 in uniplane, p < 0.05). The WOMAC scores were 72 ± 9.3 in the uniplane and 75 ± 5.8 in the biplane group (not significant). The increase in PTS was lower in uniplane medial opening HTO than in biplane HTO.

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Correction of flatfoot deformity by subtalar arthrodesis through single medial approach

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000423 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0004

Author(s):

Guang-Rong Yu ◽

Mingzhu Zhang

Keyword(s):

Subtalar Joint ◽

Clinical Results ◽

Posterior Tibial Tendon ◽

Triple Arthrodesis ◽

Medial Approach ◽

Posterior Tibial ◽

Duration Of Surgery ◽

The Mean ◽

Mean Time ◽

Neurovascular Structures

Category: Hindfoot Introduction/Purpose: To study the clinical results using isolate medial approach to correct flatfoot deformity in subtalar joint arthrodesis. Methods: 14 patients with flatfoot deformity were treated using isolated subtalar joint arthrodesis from March 2011 to March 2014. There were 3 males and 11 females with an average age of 60.81 years (ranged from 51 to 75 years). They are all cases of posterior tibial tendon dysfunctions, 9 of Myerson type Ⅲ, 3 of Ⅱ(b) and 2 of Ⅱ(c). Results: The mean duration of surgery was 100.54 minutes (range, 91-124 minutes). 12 patients were followed up for 20.25 months in average (range from 12 to 48 months). All of the cases have healed well, and the mean time of bone union was 9.53 weeks (ranged from 8 to 17 weeks). No infection was found in any cases. A complication was observed 1 patient which is painful ﬁxation. None of the patients experienced a nonunion or an adverse event related to the medial neurovascular structures. The mean Kitaoka score increased from 43.67 to 80.81 Conclusion: Based on our experience with the procedure, the isolate subtalar joint arthrodesis is a useful alternative to triple arthrodesis for the correction of mild and some moderate flatfoot deformity.

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Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

The Bone & Joint Journal ◽

10.1302/0301-620x.104b1.bjj-2021-0325.r2 ◽

2022 ◽

Vol 104-B (1) ◽

pp. 19-26

Author(s):

Kirsti Sevaldsen ◽

Otto Schnell Husby ◽

Øystein Bjerkestrand Lian ◽

Kamel Mohamed Farran ◽

Vigdis Schnell Husby

Keyword(s):

Mixed Model ◽

Femoral Stem ◽

Clinical Results ◽

Primary Outcome Measure ◽

Randomized Controlled ◽

Press Fit ◽

Early Migration ◽

Minimal Thickness ◽

The Difference

Aims Highly polished stems with force-closed design have shown satisfactory clinical results despite being related to relatively high early migration. It has been suggested that the minimal thickness of cement mantles surrounding the femoral stem should be 2 mm to 4 mm to avoid aseptic loosening. The line-to-line cementing technique of the femoral stem, designed to achieve stem press-fit, challenges this opinion. We compared the migration of a highly polished stem with force-closed design by standard and line-to-line cementing to investigate whether differences in early migration of the stems occur in a clinical study. Methods In this single-blind, randomized controlled, clinical radiostereometric analysis (RSA) study, the migration pattern of the cemented Corail hip stem was compared between line-to-line and standard cementing in 48 arthroplasties. The primary outcome measure was femoral stem migration in terms of rotation and translation around and along with the X-, Y-, and Z- axes measured using model-based RSA at three, 12, and 24 months. A linear mixed-effects model was used for statistical analysis. Results Results from mixed model analyses revealed a lower mean retroversion for line-to-line (0.72° (95% confidence interval (CI) 0.38° to 1.07°; p < 0.001), but no significant differences in subsidence between the techniques (-0.15 mm (95% CI -0.53 to 0.227; p = 0.429) at 24 months. Radiolucent lines measuring < 2 mm wide were found in three and five arthroplasties cemented by the standard and line-to-line method, respectively. Conclusion The cemented Corail stem with a force-closed design seems to settle earlier and better with the line-to-line cementing method, although for subsidence the difference was not significant. However, the lower rate of migration into retroversion may reduce the wear and cement deformation, contributing to good long-term fixation and implant survival. Cite this article: Bone Joint J 2022;104-B(1):19–26.

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Use of a revision cup for treatment of Zurich cementless acetabular cup loosening

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-13-02-0029 ◽

2013 ◽

Vol 26 (05) ◽

pp. 408-415 ◽

Cited By ~ 10

Author(s):

L. Vezzoni ◽

V. Montinaro ◽

A. Vezzoni

Keyword(s):

Postoperative Complications ◽

Clinical Results ◽

Variable Number ◽

Outer Shell ◽

Acetabular Cup ◽

Press Fit ◽

Titanium Screws ◽

Successful Clinical Outcome ◽

Hip Luxation

SummaryLoosening of the acetabular cup is one of the most common complications following total hip replacement and has an incidence rate of 1.8% to 36.8%. The objective of this study was to describe the surgical technique for the application of a cementless acetabular component specifically designed for treatment of cup loosening and preliminary clinical experience. The Kyon revision cup is composed of two components; the first is a perforated titanium outer shell with holes for 2.4 mm titanium screws, which is impacted into the acetabulum after removal of the loose cup and reaming of the acetabulum. It is secured with a variable number of screws. The second component is an inner plain titanium cup with an ultra-high-molecular-weight polyethylene insert, which is impacted into the outer shell to obtain press-fit stability. This revision cup was used in 31 dogs with cup loosening and a minimum follow-up period of six months. There were four intra-operative complications and two postoperative complications. The main intra-operative complication was difficulty inserting the inner cup into the outer shell. Postoperative complications included craniodorsal hip luxation in one dog, which was successfully managed, and cup loosening in another dog, which required explantation of the prosthesis. The main advantage of the revision cup appears to be increased implant stability afforded by screw fixation. Our initial clinical results in 31 dogs were promising; all but one dog had a successful clinical outcome.

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