Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Clin Orthop Relat Res ; 469(11): 3164-71, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21678098

ABSTRACT

BACKGROUND: Addressing bone loss in revision TKA is challenging despite the array of options to reconstruct the deficient bone. Biologic reconstruction using morselized loosely-packed bone graft potentially allows for augmentation of residual bone stock while offering physiologic load transfer. However it is unclear whether the reconstructions are durable. QUESTIONS/PURPOSES: We therefore sought to determine (1) survivorship and complications, (2) function, and (3) radiographic findings of cementless revision TKA in combination with loosely-packed morselized bone graft to reconstruct osseous defects at revision TKA. PATIENTS AND METHODS: We retrospectively reviewed 56 patients who had undergone revision TKAs using cementless long-stemmed components in combination with morselized loose bone graft at our institution. There were 26 men and 30 women with a mean age of 68.3 years (range, 56-89 years). Patients were followed to assess symptoms and function and to detect radiographic loosening, component migration, and graft incorporation. The minimum followup was 4 years (mean, 7.3 years; range, 4-10 years). RESULTS: Cumulative prosthesis survival, with revision as an end point, was 98% at 10 years. The mean Oxford Knee Scores improved from 21 (36%) preoperatively to 41 (68%) at final followup. Five patients (9%) had reoperations for complications. CONCLUSIONS: Our observations suggest this technique is reproducible and obviates the need for excessive bone resection, use of large metal augments, mass allografts, or custom prostheses. It allows for bone stock to be reconstructed reliably with durable midterm component fixation. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.


Subject(s)
Arthroplasty, Replacement, Knee/methods , Knee Joint/surgery , Knee Prosthesis , Osteoporosis/surgery , Activities of Daily Living , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee/instrumentation , Bone Transplantation , Cementation , Female , Health Status , Humans , Kaplan-Meier Estimate , Knee Joint/diagnostic imaging , Knee Joint/physiopathology , Male , Middle Aged , Osteoporosis/diagnostic imaging , Osteoporosis/physiopathology , Prosthesis Design , Prosthesis Failure , Radiography , Recovery of Function , Reoperation/statistics & numerical data , Retrospective Studies , Survival Analysis
2.
Int Orthop ; 33(1): 111-5, 2009 Feb.
Article in English | MEDLINE | ID: mdl-18084758

ABSTRACT

Mobile-bearing knee arthroplasty (MBKA) is an alternative to fixed-bearing knee arthroplasty. This was a retrospective study of the Rotaglide Total Knee System. We present the results of the monitoring of 77 patients (85 knees) with a median duration to failure or end of follow up of 8.5 years (range 0.4 to 10.1 years). Patients were clinically and radiologically assessed at dedicated follow up clinics. The Hospital for Special Surgery (HSS) and Knee Society Score (KSS) systems were used to describe the clinical and radiological findings. The prosthesis had an estimated survival probability of 93.5% (standard error 3.4%) at 9 years. It is associated with good rates of patient satisfaction and high scores on the HSS and KSS systems. No knees were revised for aseptic loosening. This knee replacement has a survival rate equivalent to other prostheses. It is a safe and reliable prosthesis associated with good clinical outcome.


Subject(s)
Arthroplasty, Replacement, Knee/instrumentation , Arthroplasty, Replacement, Knee/methods , Knee Prosthesis , Osteoarthritis, Knee/surgery , Prosthesis Failure , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Knee/adverse effects , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Knee Joint/diagnostic imaging , Knee Joint/surgery , Male , Middle Aged , Polyethylene , Radiography , Retrospective Studies , Treatment Outcome
3.
Int Orthop ; 33(4): 933-7, 2009 Aug.
Article in English | MEDLINE | ID: mdl-18551293

ABSTRACT

The purpose of this study was to evaluate the mid- to long-term survivorship of Bimetric cementless total hip replacement and assess how it is affected by the acetabular design. This was a retrospective analysis of 127 Bimetric cementless total hip replacements in 110 patients with a follow-up of 7-18 years. A single design stem and three different cementless metal-backed acetabular designs were used. Patients were assessed clinically using the Harris hip score and radiologically by independent review of current hip radiographs. There was only one case of aseptic loosening of the femoral stem. The earliest acetabular design showed a high failure rate whilst the latter two designs showed a 96% survivorship at a mean of 9.5 years. We conclude that a combination of the bimetric stem with either of the latter acetabular cup designs has a good mid- to long-term performance.


Subject(s)
Acetabulum , Arthroplasty, Replacement, Hip/instrumentation , Prosthesis Design , Quality Assurance, Health Care , Adult , Aged , Aged, 80 and over , Equipment Failure Analysis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prosthesis Failure , Retrospective Studies , Time Factors
4.
Injury ; 37(8): 751-4, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16765961

ABSTRACT

We present the results of a technique of dynamic hip screw insertion through a very small incision, typically 2-2.5 cm. The technique is performed using a standard dynamic hip screw set and requires no additional equipment. We compared the results to those of an age and sex-matched group who had undergone the operation through a traditional approach. We compared the time spent in theatre, the pre- and post-operative haemoglobin concentration, haematocrit and prevalence of wound infection. Thirteen consecutive cases were performed by one surgeon using the percutaneous technique. There were nine females and four males with a mean age of 84 years (range 62-96 years). Each had a 135 degrees four-hole plate. The mean post-operative drop in haemoglobin concentration in the percutaneous group was 2.2 g/dl (range 0-4.4 g/dl) compared to 3.5 g/dl (range 1.2-5.4 g/dl) in the control group (p = 0.014). The mean haematocrit drop was 0.07 (range 0-0.12) in the percutaneous group compared to 0.10 (range 0.03-0.17) in the control group (p = 0.017). The mean theatre time with the percutaneous technique was 57 min (range 40-75 min) and in the control group, 60 min (range 30-95 min). There were no wound problems. It is likely that this minimally invasive technique offers a better clinical outcome at no extra expense and warrants further evaluation in a larger study.


Subject(s)
Bone Screws , Fracture Fixation, Internal/methods , Hip Fractures/surgery , Aged , Aged, 80 and over , Bone Plates , Female , Fracture Fixation, Internal/adverse effects , Hematocrit , Hemoglobins/metabolism , Hip Fractures/blood , Hip Fractures/diagnostic imaging , Humans , Male , Middle Aged , Radiography , Surgical Wound Infection/epidemiology , Treatment Outcome
5.
Acta Orthop Belg ; 63(2): 134-5, 1997 Jun.
Article in English | MEDLINE | ID: mdl-9265802

ABSTRACT

We report a case in which a complication of routine chemoprophylaxis with subcutaneous low-molecular-weight heparin led to the postponement of a total hip replacement. This unusual reaction reinforces the current debate regarding the use of chemoprophylaxis for joint replacement surgery.


Subject(s)
Anticoagulants/adverse effects , Enoxaparin/adverse effects , Hemorrhage/chemically induced , Thrombophlebitis/prevention & control , Aged , Anticoagulants/administration & dosage , Chemoprevention , Enoxaparin/administration & dosage , Female , Hip Joint/surgery , Hip Prosthesis , Humans , Injections, Subcutaneous/adverse effects
6.
Ann R Coll Surg Engl ; 75(6): 422-5, 1993 Nov.
Article in English | MEDLINE | ID: mdl-8285544

ABSTRACT

A prospective study in a single orthopaedic unit for one calendar year was carried out to examine the effect of continuing audit on arthroscopic practice. A standard proforma was introduced to record information and results were analysed using a system of audit codes. Two audit periods were examined, the first 3 months and the subsequent 9 months. Results after audit of the first period were compared with the second period; diagnostic accuracy and clarity had improved as had the accuracy of audit coding. The subset of patients with a preoperative diagnosis of a meniscal tear was analysed and the diagnostic accuracy for this group improved over the year. We found that the Audit Circle had been closed in the areas of diagnostic clarity, diagnostic accuracy of meniscal tears and the accuracy of audit coding.


Subject(s)
Arthroscopy/statistics & numerical data , Knee Injuries/diagnosis , Medical Audit , Tibial Meniscus Injuries , Adolescent , Adult , Aged , Child , Female , Humans , Knee Injuries/therapy , Male , Middle Aged , Predictive Value of Tests , Prospective Studies
7.
J Bone Joint Surg Br ; 75(4): 650-2, 1993 Jul.
Article in English | MEDLINE | ID: mdl-8331125

ABSTRACT

We report a prospective, randomised, controlled trial of the effect of either a non-steroidal anti-inflammatory drug (diclofenac sodium) or physiotherapy on the recovery of knee function after arthroscopy. At 42 days after surgery there was no significant benefit from either form of postoperative treatment compared with the control group. Complications attributable to the anti-inflammatory drug occurred in 9.6% of the patients so treated. Neither the routine administration of a non-steroidal anti-inflammatory agent nor routine physiotherapy is justified after arthroscopy of the knee.


Subject(s)
Arthroscopy , Diclofenac/therapeutic use , Knee Joint/surgery , Physical Therapy Modalities , Adolescent , Adult , Analysis of Variance , Arthroscopy/statistics & numerical data , Confidence Intervals , Diclofenac/adverse effects , Female , Follow-Up Studies , Humans , Male , Middle Aged , Physical Therapy Modalities/statistics & numerical data , Postoperative Complications/prevention & control , Prospective Studies
SELECTION OF CITATIONS
SEARCH DETAIL
...