The
This study aimed to analyze the effect of two different techniques of
In North America, cementless femoral replacement has all but replaced
The first rule in properly
Introduction.
Questions/purposes:. What factors influence tibial tray-cement interface bond strength? We developed a laboratory model to investigate this issue with the goal of providing technical recommendations to mitigate the risk of tibial tray-cement loosening. Methods:. Forty-eight size 4 Triathlon® tibial trays were
Introduction. The use of stems in TKA revision surgery is well established. Stems off-load stress over a broad surface area of the diaphysis and help protect the metaphyseal interface areas from failure. Stems can provide an area of extra fixation. Uncemented Stems: Advantages – Expeditious; Compatible with intramedullary based revision instrumentation; Easy to remove if necessary; By filling diaphysis they help guarantee axial alignment. Disadvantages - They help off load stress, but how much fixation do they really provide?; They don't fit all canal deformities, and under some circumstances can actually force implants into malalignment; ? potential for end of stem pain. Cemented Stems: Advantages - Cemented stem adds fixation in fresh metaphyseal and diaphyseal bone; Proven 10-year track record; Allow the surgeon to adjust for canal geometry abnormalities. Disadvantages - More difficult to remove if required; They don't fill the canal so they don't guarantee alignment as well under most circumstances. Results:. Favorable results with uncemented and
Introduction. The use of stems in TKA revision surgery is well established. Stems off-load stress over a broad surface area of the diaphysis and help protect the metaphyseal interface areas from failure. Stems can provide an area of extra fixation. Uncemented Stems. Pros and Cons. Advantages. (1) Expeditious, (2) Compatible with intramedullary based revision instrumentation (3) Easy to remove if necessary (4) By filling diaphysis they help guarantee axial alignment. Disadvantages. (1) They help off load stress, but how much fixation do they really provide? (2) They don't fit all canal deformities, and under some circumstances can actually force implants into malalignment. (3) ? potential for end of stem pain. Cemented Stems. Pros and Cons. Advantages. (1) Cemented stem adds fixation in fresh metaphyseal and diaphyseal bone. (2) Proven 10-year track record. (3) Allow the surgeon to adjust for canal geometry abnormalities. Disadvantages. (1) More difficult to remove, if required. (2) They don't fill the canal so they don't guarantee alignment as well under most circumstances. Results. Favorable results with uncemented and
Revision of the humeral component in shoulder arthroplasty is frequently necessary during revision surgery. Newer devices have been developed that allow for easy extraction or conversion at the time of revision preserving bone stock and simplifying the procedure. However, early generation anatomic and reverse humeral stems were frequently
Total joint arthroplasty has proven to be efficient to relieve pain and regain mobility. In fact, most patients undergoing a total knee arthroplasty (TKA) are satisfied with their surgery (80 to 90%), yet 4 to 7% still complain of unexplainable pain and stiffness. Several authors have proposed that reactivity to the implant could explain this phenomenon. Still, no strong evidence supports this theory as of today. We aimed to determine the prevalence of metal and
Introduction. Implant-cement debonding at the knee has been reported previously [1]. The strength of the mechanical interlock of bone
To report a rare case of successfully treated synchronous shoulder septic arthritis, total knee replacement infection and lumbar spondylodiscitis in a patient with rheumatoid arthritis. Fifty-six year old woman, with a history of rheumatoid arthritis diagnosed at twenty-five year old, and total knee replacement at fifty-four. Recently treated with etanercept, presented with acute inflammatory signs of the right shoulder in addition to right knee and lumbar back pain for 6 months. After a shoulder and knee arthrocentesis the diagnosis suspicion of shoulder septic arthritis and total knee replacement infection was confirmed. Therefore it was performed shoulder arthroscopic irrigation and debridement and the first of two stages knee revision, with implantation of antibiotic
Small canals are usually in small people, but occasionally some normal-sized people have huge cortical thickness with a corresponding small canal. To give adequate strength to the
The well-fixed
Clearly uncemented hip stems are becoming more popular. They are working relatively well and avoiding the step of
Purpose of Study. To assess the results of Revision Hip Surgery in which a less invasive technique was utilized in situations where a number of different options was available. Method. The authors rely on an experience of 3,445 hip arthroplasties by a single surgeon over a period of 20 years, of which approximately 20% were revision cases. Of these 617 cases, we report on 175 in which a minimally invasive option was taken. This does not apply to the skin incision, as all cases were adequately exposed. We have adopted this term to describe cases in which a surgical options was taken that resulted in the least morbidity and the shortest surgical time. We postulated that would lead to the best outcomes with the least complications. Acetabular revisions: 1) Isolated polyethylene exchange. 2) Liner revision with
Fixation of
When fixing a mid or distal periprosthetic femoral fracture with an existing hip replacement, creation of a stress-riser is a significant concern. Our aim was to identify the degree of overlap required to minimise the risk of future fracture between plate and stem. Each fixation scenario was tested using 4th generation composite femoral Sawbones®. Each sawbone was implanted with a collarless polished
The well-fixed
The amount of bone loss due to implant failure, loosening, or osteolysis can vary greatly and can have a major impact on reconstructive options during revision total knee arthroplasty (TKA). Massive bone loss can threaten ligamentous attachments in the vicinity of the knee and may require use of components with additional constraint to compensate for associated ligamentous instability. Classification of bone defects can be helpful in predicting the complexity of the reconstruction required and in facilitating preoperative planning and implant selection. One very helpful classification of bone loss associated with TKA is the Anderson Orthopaedic Research Institute (AORI) Bone Defect Classification System as it provides the means to compare the location and extent of femoral and tibial bone loss encountered during revision surgery. In general, the higher grade defects (Type IIb or III) on both the femoral and tibial sides are more likely to require stemmed components, and may require the use of either structural graft or large augments to restore support for currently available modular revision components. Custom prostheses were previously utilised for massive defects of this sort, but more recently have been supplanted by revision TKA component systems with or without special metal augments or structural allograft. Options for bone defect management are: 1) Fill with