Osseointegration Implant Failure and Surgical Revision in Persons with Bone-Anchored Prosthesis after Transfemoral Amputation

2021 ◽  
Author(s):  
Jamal Mohamed
Keyword(s):  
Surgical Revision ◽  
Implant Failure ◽  
Transfemoral Amputation

scholarly journals Total Hip Arthroplasty for Hip Fractures: Time to Surgery With Respect to Surgical Revision, Failure, and Mortality

2019 ◽  
Vol 10 ◽  
pp. 215145931881816 ◽  
Author(s):  
Franz Müller ◽  
Michael Galler ◽  
Michael Zellner ◽  
Christian Bäuml ◽  
Stephan Grechenig ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Total Hip Arthroplasty ◽  
Hip Fractures ◽  
Hip Arthroplasty ◽  
Surgical Revision ◽  
Implant Failure ◽  
Total Hip ◽  
Time To Surgery ◽  
Outcome Measurements ◽  
Intracapsular Hip Fracture

Introduction: There are increasing demands to perform surgery of hip fractures without delay. However, few studies have assessed the time to surgery in relation to outcome measurements. Methods: A total of 643 consecutive patients with a minimum age of 60 years underwent total hip arthroplasty (THA) for an intracapsular hip fracture. For this retrospective case series, demographic data and the outcome measurements—(1) any surgical revision, (2) implant failure, and (3) mortality—were documented from a prospective clinical database. The time from admission to surgery was also documented prospectively and then data were divided into 4 groups according to the time of surgery: (1) within 12 hours, (2) >12 to 24 hours, (3) >24 to 48 hours, and (4) later than >48 hours. The study end point was 2 years after surgery. Final evaluation was conducted for any missing data through a telephone interview. Results: The patients comprised 456 women (70.9%) and 187 men (29.1%) with a mean age of 80.2 years (range 60-104 years; standard deviation ±7.4). Descriptive data were without effect in all 4 groups. Time to surgery did not significantly influence revision for any reason ( P = .323), implant failure ( P = .521), and mortality ( P = .643). Cox regression analysis identified male sex ( P < .001; 95% confidence interval (CI), 1.27-2.44), American Society of Anesthesiologists score ≥3 ( P < .001; 95% CI, 2.12-21.59), C-reactive protein level >21 mg/L ( P < .018; 95% CI, 1.09-2.60), hemoglobin level <12.0 g/dL ( P = .033; 95% CI, 1.04-2.68), and dementia ( P < .000; 95% CI, 1.50-2.86) as independent significant risk factors for mortality. Conclusion: Time to surgery had no effect on revision for any reason, implant failure, and mortality in patients undergoing THA for an intracapsular hip fracture.

2408How can we improve the success of cardiac resynchronization therapy implantation?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Nunes Ferreira ◽  
P Antonio Silverio ◽  
J R Agostinho ◽  
I Aguiar-Ricardo ◽  
J Rigueira ◽  
...  
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Standard Technique ◽  
Surgical Revision ◽  
Implant Failure ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Major Complications ◽  
Implantation Techniques ◽  
Procedure Duration ◽  
Technique Failure

Abstract Introduction The left ventricular (LV) lead implantation in cardiac resynchronization therapy (CRT) is one of the most important and complex steps, leading to implantation failure in 10–15% of cases. New LV lead implantation techniques are needed to allow better resynchronization and decrease mortality and hospitalizations. Objectives To evaluate the efficacy and safety of the snare technique in the LV lead implantation in cases of standard technique failure. Methods Prospective, single-center study of patients undergoing CRT implantation since 2015. Demographic, clinical, and CRT implantation techniques were evaluated, taking into account the vessel with the best resynchronization capacity. The snare technique, through the active traction of the lead to the target vessel, was used in cases of standard technique failure. Time to surgical revision and mortality were evaluated by the Cox regression and Kaplan-Meier methods. Major complications, defined as reasons for prolonged hospitalization or potentially fatal, were evaluated. Results 486 CRTs were implanted since 2015 (73.9% males, 73 years (IQR 66–79), median follow-up of 487 days (IQR 175–749), 91% for heart failure, dilated cardiomyopathy in 55.4%. In 17.3% of these patients (n=84), LV lead was implanted through the snare technique, 94% of the cases in a lateral vein, 100% efficacy in the positioning in the intended vessel. Comparing the snare technique with the standard technique, patients implanted with snare presented a lower all-cause surgical revision (HR 0.31, 95% CI 0.094–0.98, p=0.035), with a number needed to treat of 25 patients to prevent one surgical revision, and a lower revision rate due to LV lead implant failure/dislodgement (Log Rank 5.1, p=0.024). There were no surgical revisions for LV lead repositioning in patients undergoing the snare technique. The rate of major complications (4.8% vs 3.0%, p=0.41), 30-day mortality (3.5% vs 1.8%, p=0.28) and all-cause mortality (13.1% vs 13.9%, p=0.47) were similar to the standard procedure. Major complications in both groups were pericardial effusion and contrast nephropathy. The snare technique presented a longer procedure duration (104 vs 78 min, p<0.01) and fluoroscopy time (26.6 vs 15.5 min, p<0.01). Over time, there was a learning curve with reduction in procedure duration and fluoroscopy time. Conclusion The snare technique allows LV lead implantation in the vein with the best resynchronization characteristics, increasing the success rate in the implantation of CRT. It also reduced all-cause surgical revisions and surgical revisions due to LV lead implant failure/dislodgement, with a favourable safety profile similar to the standard technique.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

Is perioperative antibiotic necessary in straightforward implant placement procedures?

2020 ◽  
Author(s):  
Elçin Bedeloğlu ◽  
Mustafa Yalçın ◽  
Cenker Zeki Koyuncuoğlu
Keyword(s):  
Clavulanic Acid ◽  
Dental Implant ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Implant Failure ◽  
Control Group ◽  
Implant Placement ◽  
Significant Difference ◽  
Amoxicillin Clavulanic Acid ◽  
Experimental Group

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p &gt;0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p &lt;0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

scholarly journals Cochlear implant failure following COVID 19: Report of two cases

2021 ◽  
Vol 42 (3) ◽  
pp. 102910
Author(s):  
Nader Saki ◽  
Majid Karimi ◽  
Arash Bayat
Keyword(s):  
Cochlear Implant ◽  
Implant Failure
Sign in / Sign up

Export Citation Format

Share Document