scholarly journals Prosthesis survival after revision knee arthroplasty for “pain without loosening” versus “aseptic loosening”: a Danish nationwide study

2021 ◽  
pp. 1-7
Author(s):  
Kristine Bollerup Arndt ◽  
Henrik M Schrøder ◽  
Anders Troelsen ◽  
Martin Lindberg-Larsen
Keyword(s):  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Nationwide Study ◽  
Revision Knee Arthroplasty ◽  
Prosthesis Survival

scholarly journals Possibilities of latent PJI detection in revision knee arthroplasty

2021 ◽  
Vol 27 (5) ◽  
pp. 562-569
Author(s):  
A.N. Panteleev ◽  
◽  
S.A. Bozhkova ◽  
P.M. Preobrazhensky ◽  
A.V. Kazemirsky ◽  
...  
Keyword(s):  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Routine Screening ◽  
Screening Methods ◽  
Diagnostic Significance ◽  
Revision Knee Arthroplasty ◽  
Group 2 ◽  
Group 1

Abstract. Introduction The paper presents a comparative analysis of routine screening methods and the EBJIS 2021 algorithm in detection of latent periprosthetic joint infection in patients admitted for revision knee arthroplasty due to aseptic loosening and after spacer implantation. Materials and methods Group 1 included 49 patients who underwent revision knee arthroplasty due to aseptic loosening, group 2 were 47 patients with PJI after spacer implantation. Results and discussion There were no significant differences between patient groups in terms of age, gender, and preoperative ESR and CRP levels. In 62.2 % of all cases, the aspirate was inappropriate for cytological examination; this fact limited its diagnostic value. The most frequently intraoperatively isolated pathogen in both groups was coagulase-negative staphylococci. However, in 70 % of cases these results were not diagnostically significant, and infection was diagnosed only in 8.2 % of cases in group 1 and 12.8 % in group 2. Moreover, the chances of isolating the pathogen from tissue biopsies were 5.6 times higher than from intraoperative aspirate (OR = 5.6, 95 % CI = 1.2-26.4). In case of negative preoperative aspirate, in almost 25 % of cases, pathogens were isolated from intraoperative tissues, 40.9 % of them were diagnostically significant. The chances of its detection increased 4.7 times in combined increase in ESR and CRP blood level (OR = 4.686, 95 % CI = 0.765-28.700). Using EBJIS 2021 criteria, infection was confirmed in more than 10 % of cases in each group, and the diagnostic significance of the criteria exceeded the significance of using routine screening methods. At a follow-up period of more than 2 years, the effectiveness of treatment was 95.3 %, while signs of infection were detected in 4.7 % of cases, regardless of the group. Conclusion EBJIS 2021 criteria are characterized by high diagnostic sensitivity and specificity and enable to identify periprosthetic joint infection in knee revision cases even in its latent form and to correct treatment tactics in patients without a history of PJI.

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.

METAPHYSEAL SLEEVES IN REVISION KNEE ARTHROPLASTY

2020 ◽  
Author(s):  
M Girkalo ◽  
M Kozadayev ◽  
A Derevyanov ◽  
A Mandrov ◽  
A Kauts
Keyword(s):  
Knee Arthroplasty ◽  
Revision Knee Arthroplasty

Is Gelsolin a Biomarker for Aseptic Loosening After Total Knee Arthroplasty?

2015 ◽  
Vol 25 (4) ◽  
pp. 321-327 ◽  
Author(s):  
Clayton C. Bettin ◽  
William B. Sisson ◽  
Anita L. Kerkhof ◽  
William M. Mihalko
Keyword(s):  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Total Knee

scholarly journals Level of constraint in revision knee arthroplasty

2015 ◽  
Vol 8 (4) ◽  
pp. 390-397 ◽  
Author(s):  
Pier Francesco Indelli ◽  
Nick Giori ◽  
William Maloney
Keyword(s):  
Knee Arthroplasty ◽  
Revision Knee Arthroplasty

Long-term mortality rates and associated risk factors following primary and revision knee arthroplasty

2022 ◽  
Vol 104-B (1) ◽  
pp. 45-52
Author(s):  
Liam Zen Yapp ◽  
Nick D. Clement ◽  
Matthew Moran ◽  
Jon V. Clarke ◽  
A. Hamish R. W. Simpson ◽  
...  
Keyword(s):  
General Population ◽  
Knee Arthroplasty ◽  
Mortality Rates ◽  
Factors Associated ◽  
Revision Knee Arthroplasty ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Male Sex ◽  
Long Term Mortality

Aims The aim of this study was to determine the long-term mortality rate, and to identify factors associated with this, following primary and revision knee arthroplasty (KA). Methods Data from the Scottish Arthroplasty Project (1998 to 2019) were retrospectively analyzed. Patient mortality data were linked from the National Records of Scotland. Analyses were performed separately for the primary and revised KA cohorts. The standardized mortality ratio (SMR) with 95% confidence intervals (CIs) was calculated for the population at risk. Multivariable Cox proportional hazards were used to identify predictors and estimate relative mortality risks. Results At a median 7.4 years (interquartile range (IQR) 4.0 to 11.6) follow-up, 27.8% of primary (n = 27,474/98,778) and 31.3% of revision (n = 2,611/8,343) KA patients had died. Both primary and revision cohorts had lower mortality rates than the general population (SMR 0.74 (95% CI 0.73 to 0.74); p < 0.001; SMR 0.83 (95% CI 0.80 to 0.86); p < 0.001, respectively), which persisted for 12 and eighteight years after surgery, respectively. Factors associated with increased risk of mortality after primary KA included male sex (hazard ratio (HR) 1.40 (95% CI 1.36 to 1.45)), increasing socioeconomic deprivation (HR 1.43 (95% CI 1.36 to 1.50)), inflammatory polyarthropathy (HR 1.79 (95% CI 1.68 to 1.90)), greater number of comorbidities (HR 1.59 (95% CI 1.51 to 1.68)), and periprosthetic joint infection (PJI) requiring revision (HR 1.92 (95% CI 1.57 to 2.36)) when adjusting for age. Similarly, male sex (HR 1.36 (95% CI 1.24 to 1.49)), increasing socioeconomic deprivation (HR 1.31 (95% CI 1.12 to 1.52)), inflammatory polyarthropathy (HR 1.24 (95% CI 1.12 to 1.37)), greater number of comorbidities (HR 1.64 (95% CI 1.33 to 2.01)), and revision for PJI (HR 1.35 (95% 1.18 to 1.55)) were independently associated with an increased risk of mortality following revision KA when adjusting for age. Conclusion The SMR of patients undergoing primary and revision KA was lower than that of the general population and remained so for several years post-surgery. However, approximately one in four patients undergoing primary and one in three patients undergoing revision KA died within tenten years of surgery. Several patient and surgical factors, including PJI, were associated with the risk of mortality within ten years of primary and revision surgery. Cite this article: Bone Joint J 2022;104-B(1):45–52.

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