scholarly journals Clinical and radiological outcomes in three-dimensional printing assisted revision total hip and knee arthroplasty: a systematic review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rui Zhang ◽  
Jiajun Lin ◽  
Fenyong Chen ◽  
Wenge Liu ◽  
Min Chen
Keyword(s):  
3D Printing ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Cochrane Library ◽  
Control Group ◽  
Total Hip ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Abstract Background This study investigates whether three-dimensional (3D) printing-assisted revision total hip/knee arthroplasty could improve its clinical and radiological outcomes and assess the depth and breadth of research conducted on 3D printing-assisted revision total hip and knee arthroplasty. Methods A literature search was carried out on PubMed, Web of Science, EMBASE, and the Cochrane Library. Only studies that investigated 3D printing-assisted revision total hip and knee arthroplasty were included. The author, publication year, study design, number of patients, patients’ age, the time of follow-up, surgery category, Coleman score, clinical outcomes measured, clinical outcomes conclusion, radiological outcomes measured, and radiological outcomes conclusion were extracted and analyzed. Results Ten articles were included in our review. Three articles investigated the outcome of revision total knee arthroplasty, and seven investigated the outcome of revision total hip arthroplasty. Two papers compared a 3D printing group with a control group, and the other eight reported 3D printing treatment outcomes alone. Nine articles investigated the clinical outcomes of total hip/knee arthroplasty, and eight studied the radiological outcomes of total hip/knee arthroplasty. Conclusion 3D printing is being introduced in revision total hip and knee arthroplasty. Current literature suggests satisfactory clinical and radiological outcomes could be obtained with the assistance of 3D printing. Further long-term follow-up studies are required, particularly focusing on cost-benefit analysis, resource availability, and, importantly, the durability and biomechanics of customized prostheses using 3D printing compared to traditional techniques.

scholarly journals 3D Printed Acetabular Cups for Total Hip Arthroplasty: A Review Article

Metals ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. 729 ◽  
Author(s):  
Dall’Ava ◽  
Hothi ◽  
Di Laura ◽  
Henckel ◽  
Hart
Keyword(s):  
3D Printing ◽  
Total Hip Arthroplasty ◽  
Clinical Outcomes ◽  
Hip Arthroplasty ◽  
Three Dimensional ◽  
Total Hip ◽  
3D Printed ◽  
Key Variables ◽  
End Use ◽  
Acetabular Components

Three-dimensional (3D) printed titanium orthopaedic implants have recently revolutionized the treatment of massive bone defects in the pelvis, and we are on the verge of a change from conventional to 3D printed manufacture for the mass production of millions of off-the-shelf (non-personalized) implants. The process of 3D printing has many adjustable variables, which taken together with the possible variation in designs that can be printed, has created even more possible variables in the final product that must be understood if we are to predict the performance and safety of 3D printed implants. We critically reviewed the clinical use of 3D printing in orthopaedics, focusing on cementless acetabular components used in total hip arthroplasty. We defined the clinical and engineering rationale of 3D printed acetabular cups, summarized the key variables involved in the manufacturing process that influence the properties of the final parts, together with the main limitations of this technology, and created a classification according to end-use application to help explain the controversial and topical issues. Whilst early clinical outcomes related to 3D printed cups have been promising, in-depth robust investigations are needed, partly because regulatory approval systems have not fully adapted to the change in technology. Analysis of both pristine and retrieved cups, together with long-term clinical outcomes, will help the transition to 3D printing to be managed safely.

Imatinib Plasma Levels and Its Correlation with Response in Chronic-Phase Chronic Myeloid Leukemia: Experience of One Centre.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4284-4284
Author(s):  
J. Valentin Garcia. Gutierrez ◽  
Jesús Odriozola ◽  
Pilar Herrera ◽  
Javier Lopez ◽  
Maria Calbacho ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Plasma Levels ◽  
Myeloid Leukemia ◽  
Conflicts Of Interest ◽  
Plasma Concentrations ◽  
Chronic Phase ◽  
Control Group ◽  
Treatment Optimisation ◽  
Number Of Patients

Abstract Abstract 4284 Introduction Imatinib (IM), 400 mg/d. induces durable responses in chronic myeloid leukaemia (CML) in chronic phase (CP). However, although IM-biodisponibility is fairly good, its plasma levels are variable and can not be predicted. Recently, these plasma concentrations have been related both to the dose being administrated and to the cytogenetic and molecular responses. Thus, Imatinib pharmacokinetics could be an issue towards treatment optimisation in CML patients. Recent studies suggest that therapeutic IM plasma levels should be above 1040 ng/dl. Aims To evaluate the association between IM dose and throughout plasma levels with different clinical outcomes. Results In this study, we looked for an association between plasma concentrations and clinical outcomes in 16/86 CML chronic phase patients who did not achieve optimal responses following the European Leukemia Net guidelines (ELN) (table 1). Patients with optimal responses and treated with the same standard doses were also analysed as a control group. Patients receiving doses above 400 mg showed throughout plasma levels considered as appropriate. In 7 of 16 patients (47.5%) not achieving optimal responses (ELN criteria), plasma levels were below the supposed therapeutic ranges. We have found no evidence for a correlation between clinical risk factors at diagnosis and the measurement of optimal plasma levels. Conclusions IM plasma levels are well correlated with IM dose administrated in the patients studied. In almost 50% of patients who did not achieve optimal responses, IM plasma levels were under the ranges considered therapeutic. Probably these are the patients who may benefit of a dose increase. Obviously, to learn more about the practical value of these measurements a longer follow up with a larger number of patients is needed. Disclosures: No relevant conflicts of interest to declare.

scholarly journals An Update on Venous Thromboembolism Rates and Prophylaxis in Hip and Knee Arthroplasty in 2020

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 416 ◽  
Author(s):  
Daniel C. Santana ◽  
Ahmed K. Emara ◽  
Melissa N. Orr ◽  
Alison K. Klika ◽  
Carlos A. Higuera ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
High Volume ◽  
Optimal Choice ◽  
Slight Reduction ◽  
Vte Prophylaxis ◽  
Prophylactic Agent ◽  
Total Hip ◽  
Number Of Patients ◽  
Hip And Knee Arthroplasty

Patients undergoing total hip and knee arthroplasty are at high risk for venous thromboembolism (VTE) with an incidence of approximately 0.6–1.5%. Given the high volume of these operations, with approximately one million performed annually in the U.S., the rate of VTE represents a large absolute number of patients. The rate of VTE after total hip arthroplasty has been stable over the past decade, although there has been a slight reduction in the rate of deep venous thrombosis (DVT), but not pulmonary embolism (PE), after total knee arthroplasty. Over this time, there has been significant research into the optimal choice of pharmacologic VTE prophylaxis for individual patients, with the objective to reduce the rate of VTE while minimizing adverse side effects such as bleeding. Recently, aspirin has emerged as a promising prophylactic agent for patients undergoing arthroplasty due to its similar efficacy and good safety profile compared to other pharmacologic agents. However, there is no evidence to date that clearly demonstrates the superiority of any given prophylactic agent. Therefore, this review discusses (1) the current prevalence and trends in VTE after total hip and knee arthroplasty and (2) provides an update on pharmacologic VTE prophylaxis in regard to aspirin usage.

scholarly journals Total femoral allograft with simultaneous revision total hip and knee arthroplasty: 18 year follow-up

2015 ◽  
Vol 1 (3) ◽  
pp. 59-63 ◽  
Author(s):  
Ryan N. Harris ◽  
Trevor M. Owen ◽  
Joseph T. Moskal
Keyword(s):  
Knee Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

Long-term follow-up care recommendations after total hip and knee arthroplasty

2003 ◽  
Vol 18 (8) ◽  
pp. 954-962 ◽  
Author(s):  
Steven M Teeny ◽  
Sally C York ◽  
J.Wesley Mesko ◽  
Ruth E Rea
Keyword(s):  
Knee Arthroplasty ◽  
Total Hip ◽  
Follow Up Care ◽  
Hip And Knee Arthroplasty ◽  
Long Term Follow Up

scholarly journals African American Patients Have Improved Functional Gains and Comparable Clinical Outcomes to Caucasian Patients After Total Hip and Knee Arthroplasty

2021 ◽  
Vol 36 (1) ◽  
pp. 88-92
Author(s):  
Emanuele Chisari ◽  
Matthew J. Grosso ◽  
Charles L. Nelson ◽  
Elie Kozaily ◽  
Javad Parvizi ◽  
...  
Keyword(s):  
African American ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Caucasian Patients ◽  
Functional Gains

Safety of In-Hospital Only Thromboprophylaxis after Fast-Track Total Hip and Knee Arthroplasty: A Prospective Follow-Up Study in 17,582 Procedures

2018 ◽  
Vol 118 (12) ◽  
pp. 2152-2161 ◽  
Author(s):  
Pelle Petersen ◽  
Henrik Kehlet ◽  
Christoffer Jørgensen ◽  
Keyword(s):  
Cohort Study ◽  
Knee Arthroplasty ◽  
Fast Track ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Co Morbidity ◽  
National Patient ◽  
Hip And Knee Arthroplasty ◽  
Associated Risk Factors

AbstractMost international guidelines recommend pharmacological thromboprophylaxis after total hip and knee arthroplasty (THA/TKA) for 10 to 35 days. However, a recent cohort study on fast-track THA and TKA questioned the need for prolonged thromboprophylaxis when length of stay (LOS) is ≤ 5 days. We aimed at re-investigating the incidence of venous thromboembolism (VTE) in fast-track THA and TKA with in-hospital only thromboprophylaxis when LOS was ≤ 5 days. Prospective cohort study from 1 December 2011 to 30 October 2015 on elective unilateral THA/TKA with in-hospital only thromboprophylaxis if LOS was ≤ 5 days. Prospective information on co-morbidity and complete 90-day follow-up through the Danish National Patient Registry and medical records. Patients with pre-operative use of anticoagulants were excluded. In per protocol analysis, 17,582 (95.5%) had LOS of ≤ 5 days (median, 2 [interquartile range, 2–3]) and in-hospital thromboprophylaxis only. Incidence of symptomatic VTE was 0.40%, consisting of 28 (0.16%) pulmonary embolisms (PEs), 38 (0.22%) deep vein thrombosis (DVT) and 4 (0.02%) combined DVT and PE. Two PEs (0.01%) were fatal. VTE-associated risk factors with in-hospital only thromboprophylaxis were age > 85 years, odds ratio (OR) of 3.74 (95% confidence interval: 1.15–12.14, p = 0.028), body mass index (BMI) of 35 to 40, OR of 2.55 (1.02–6.35, p = 0.045) and BMI > 40, OR of 3.28 (1.02–10.56, p = 0.046). In conclusion, 90-day incidence of VTE after fast-track THA and TKA with in-hospital thromboprophylaxis only was 0.40%. Prolonged thromboprophylaxis may be reserved for LOS > 5 days or specific high-risk patients, but requires further studies regarding optimal type and duration of thromboprophylaxis.

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