Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ARTHROPLASTY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,351 records · Page 75Linked to original sources
PubMed2005

Comparison of mobile-bearing and fixed-bearing total knee arthroplasty: a prospective randomized study.

The purpose of this prospective randomized study was to compare the postoperative recovery and early results of 2 groups of patients undergoing total knee arthroplasty: 107 patients received an established fixed-bearing posterior-stabilized prosthesis (Legacy Posterior Stabilized [LPS]), and 103 patients the meniscal-bearing prosthesis (Meniscal Bearing Knee [MBK]). Surgical procedures were the same for both groups except for posterior cruciate ligament management, which was sacrificed in the LPS group and spared but completely released from the tibia in the MBK group. At an average follow-up of 36 months, knee, function, and patellar scores were comparable in both groups. The LPS group showed a significantly higher maximum flexion than the MBK group (112 degrees vs 108 degrees). Using a fixed-bearing or a mobile-bearing design did not seem to influence the short-term recovery and early results after knee arthroplasty. Key words: total knee arthroplasty, mobile bearing, knee prosthesis, meniscal-bearing knee, posterior stabilized, prospective randomized.

Aged↗
PubMed2005

Leg axis after computer-navigated total knee arthroplasty: a prospective randomized trial comparing computer-navigated and manual implantation.

To compare the alignment after computer-navigated total knee arthroplasty, 52 patients were randomly allocated to 2 groups. Twenty-seven patients received a total knee arthroplasty with the aid of a kinematic computer-navigation system, and 25 patients received a total knee arthroplasty with the conventional method. Both groups were well balanced concerning demographic data and preoperative scores. At 3-month follow-up, the mechanical alignment of the leg reached the desired straight axis in more cases with the computer-navigated implantation. This difference was statistically significant. The femoral and tibial mechanical anteroposterior axis and the femoral and tibial sagittal tilt (slope) measured on sagittal x-rays were not significantly improved in this patient group.

Aged↗
PubMed2005

Functional results after revision of well-fixed components for stiffness after primary total knee arthroplasty.

Between 1990 and 2001, 16 well-fixed, aseptic, primary total knee arthroplasties were revised in 15 patients for a diagnosis of stiffness. Patients were followed for a mean of 42 months (range, 2-6 years). Of 15 patients, 10 (66%) were satisfied with the results of the procedure. The mean Knee Society pain score improved from 28 to 65 points, and the mean functional score improved from 45 to 58 points. The mean arc of motion improved from 40 degrees preoperatively to 73 degrees postoperatively. Recurrent stiffness required additional intervention in 4 knees (3 patients, 25%). The results of revision of a well-fixed, stiff, primary total knee arthroplasty were mixed in our hands and provided only modest improvements in pain, function, and arc of motion. Key words: knee, arthroplasty, stiffness, revision, arthrofibrosis.

Aged↗
PubMed2005

Simultaneous bilateral versus unilateral total hip arthroplasty an outcomes analysis.

This study compared the morbidity, mortality, and outcomes of 900 simultaneous bilateral total hip arthroplasties in 450 patients and 450 unilateral total hip arthroplasties. Pulmonary complications were significantly higher in the simultaneous bilateral group (1.6% vs 0.7%; P < .0312). Fourteen (3.1%) patients in the simultaneous bilateral group and 18 (4%) patients in the unilateral group died within the first postoperative year. Patients with mortality in the first postoperative year were significantly older (69.8 vs 62.3 years; P < .0012). Long-term patient survival, the prosthetic survival, and functional outcomes were not significantly different between groups. Simultaneous bilateral total hip arthroplasty has advantages where both hips are symptomatic and has less risk in younger patients with understanding of the increased risk of pulmonary complications.

Aged↗
PubMed2005

Perioperative blood loss in cementless or hybrid total knee arthroplasty without patellar resurfacing: a prospective, randomized study.

The use of cement is considered as an important way to control perioperative blood loss in knee arthroplasty. We prospectively randomized 57 patients (60 knees) who underwent total knee arthroplasty with (30 knees) or without (30 knees) tibial cement to evaluate perioperative blood loss. The measured total blood loss did not differ significantly between the 2 groups (with tibial cement, 731 +/- 288 mL; without cement, 731 +/- 331 mL; P = .9117). The red blood cell count, hemoglobin level, and hematocrit returned to the preoperative levels within 3 months in both groups. Therefore, tibial cement does not appear to affect perioperative blood loss. This finding has implications when planning blood replacement in cementless and hybrid-type arthroplasties.

Aged↗
PubMed2005

Periprosthetic fractures after total knee arthroplasty.

Fractures around total knee arthroplasties are challenging clinical problems and include the following: stress fractures of the pelvis and femoral neck, supracondylar femur fractures, fractures of the proximal tibial metaphysis and diaphysis, and patellar fractures. Treatment focuses on restoration of the patient's prefracture functional status. The etiology of supracondylar femur fractures is multifactorial and treatment includes immobilization, retrograde intramedullary nailing, open reduction and internal fixation, and revision arthroplasty. The "Less Invasive Stabilization System" plate has recently been added to the list of viable fixation options. Tibial metaphyseal and diaphyseal fractures are less common and usually treated with revision arthroplasty. In the absence of maltracking or component loosening, vertical patellar fractures often respond to immobilization. Disruption of the extensor mechanism may require cerclage wiring or even extensor mechanism allografting if chronic. Conventional tension band wiring usually fails. Patellar fractures are controversial and problematic.

Arthroplasty, Replacement, Knee↗
PubMed2005

The stiff total knee arthroplasty: causality and solution.

A stiff total knee arthroplasty is a disabling condition, which can be caused by technical errors, patient factors, and postoperative complications. The results of treatment are dependent on the cause of stiffness. The best treatment is prevention by providing preoperative patient education, aggressive postoperative rehabilitation, and avoidance of technical errors. Early manipulation may improve motion with a well-aligned component. Open arthrolysis and revision arthroplasty are indicated for chronic stiffness with component malposition or failure, incorrect component sizing, joint line displacement, or inadequate bone resection. When performing a revision arthroplasty, it is important to know the reason for failure and loss of motion because failure to identify the cause of stiffness may result in recurrence of the problem.

Arthroplasty, Replacement, Knee↗
PubMed2005

Preoperative planning for revision total knee arthroplasty:avoiding chaos.

Use of preoperative planning is important in avoiding an unstable revision total knee arthroplasty. Physical examination should determine the status of the collateral ligaments so that implants with appropriate constraint are made available. Radiographic examination should determine if bone loss is present and whether primary or revision implants will be needed. Preoperative determination of the joint line position will simplify the surgery and facilitate flexion/extension space balancing. Three hundred sixty-five revision total knee arthroplasty surgeries were performed from 1987 to 2003. Of those, 82% were performed with unconstrained implants. Ten percent of the knees required varus/valgus constraint and 8% knees used rotating hinge components. Use of preoperative planning techniques resulted in postoperative stability in 99% of the revision total knee arthroplasties performed.

Arthroplasty, Replacement, Knee↗
PubMed2006

Primary total knee arthroplasty in California 1991 to 2001: does hospital volume affect outcomes?

This study reports the relationship between hospital surgical volume and outcomes after total knee arthroplasty. Discharge data from 1991 to 2001 were obtained from California's Office of Statewide Health Planning and Development and linked to California death records. Multivariate logistic regression models were performed to examine the association between hospital volume and complications. The models were adjusted for patient age, sex, race/ethnicity, insurance type, Charlson comorbidity index, hospital type and size, year of surgery, and whether patients underwent bilateral procedures. A total of 222684 primary total knee arthroplasties were identified during the study period. Patients treated at low volume hospitals had a higher likelihood in the 90 days after discharge of death (rate 0.55% vs 0.49%, odds ratio [OR] 1.50, 95% confidence interval [CI] 1.14-1.98, P = .004), and readmission for infection (1.13% vs 0.65%, OR 1.60, 95% CI 1.21-2.12, P = .001), pulmonary embolism (0.48% vs 0.39%, OR 1.45, 95% CI 1.07-1.97, P = .016), and thrombophlebitis (0.49% vs 0.28%, OR 2.12, 95% CI 1.47-3.05, P </= .001). This study confirms the relationship of lower hospital volumes to a higher OR for complications after total knee arthroplasty.

Aged↗
PubMed2006

The practical limitations of resurfacing hip arthroplasty.

Resurfacing hip arthroplasty has recently experienced a resurgence in popularity, associated with an unprecedented amount of coverage in the media. This article assesses what proportion of a consecutive series of young adults presenting for total hip arthroplasty would have been suitable for resurfacing arthroplasty. Retrospective review of the preoperative radiographs was performed, with templating for the resurfacing prostheses. The hips were divided into those appropriate and those inappropriate for the procedure, and those in whom the procedure would be technically challenging. Sixty-one hips in 57 patients were reviewed, with ages ranging from 17 to 49 years. Twenty-eight hips were assessed as suitable, 26 as unsuitable, and 7 as technically challenging. Reasons for unsuitability included collapse and/or cystic degeneration of the femoral head.

Adolescent↗
PubMed2005

Differences in patient and procedure characteristics and hospital resource use in primary and revision total joint arthroplasty: a multicenter study.

A multicenter retrospective cost-identification cohort study was undertaken to analyze clinical, demographic, and economic data for 4533 consecutive total hip arthroplasty (THA) and 3508 consecutive total knee arthroplasty (TKA) procedures performed during a 3-year period in 1 of 3 hospitals. Statistically significant differences were found between primary and revision procedures with respect to patient age, sex, payer type, mean total operative time, use of allograft, average length of hospital stay, discharge disposition, and hospital costs. Significant differences were also found between different types of revision total joint arthroplasty (TJA) procedures. Our findings could be used to help improve the accuracy of administrative claims data related to primary and revision TJA procedures to identify relevant differences in patient characteristics, procedure characteristics, and hospital resource use.

Aged↗
PubMed2005

Does shortened length of hospital stay affect total knee arthroplasty rehabilitation outcomes?

Rehabilitation outcomes were compared after primary total knee arthroplasty between patients who participated in a hospital joint arthroplasty program implemented to decrease length of stay and patients who did not. Once inclusion criteria were met, purposive sampling was used to select subjects for retrospective medical records review. Range of motion and Knee Society scores at preoperative and 3-, 6-, and 12-month postoperative intervals were then compared. Preoperatively, there were no significant differences between groups. Program implementation reduced length of hospital stay by a mean of 1.3 days, which resulted in a decreased range of motion at discharge. No significant differences were found between groups postoperatively at all intervals. Primary total knee arthroplasty rehabilitation outcomes were not compromised by reduced length of hospital stay.

Adult↗
PubMed2006

Distal femoral allograft reconstruction for massive osteolytic bone loss in revision total knee arthroplasty.

Massive osteolytic bone loss in revision total knee arthroplasty has been an uncommon challenge. From 2001 to 2002, 11 knees in 10 patients underwent revision of failed modular PFC (Johnson and Johnson Orthopaedics, Raynham, Mass) total knee arthroplasties with distal femoral allografts and long-stemmed revision implants for massive osteolytic induced femoral bone loss. The mean follow-up was 42 months (range, 36-48 months). Radiographic graft incorporation was demonstrated in all 11 knees with no cases of loosening. The Knee Society Pain Scores improved by an average of 25.4 points, and the function scores improved by an average of 23.3 points. The outcomes of distal femoral allografts in the reconstruction of massive osteolytic bone loss associated with failed modular PFC (Johnson and Johnson Orthopaedics) total knee arthroplasties are favorable.

Aged↗
PubMed2006

The effect of the "mini" incision in total hip arthroplasty on component position.

This study compares cemented and uncemented total hip arthroplasties performed through either a standard or mini incision. The parameters evaluated were dislocation rates, Gruen and DeLee zones, Barrack cement grading, component positioning, and heterotopic bone levels. There were no statistically significant differences found between the mini and standard incision groups except in 2 parameters. Analysis of femoral stems not in neutral position revealed statistically significant differences between cemented and uncemented stems. The mean anteversion of the mini incision cup was also significantly less than the standard group, although probably not clinically significant. In conclusion, the mini incision does not compromise total hip arthroplasty results on the acetabular side, but varus positioning of the cemented femoral component nearing 2 degrees is concerning for the long-term success of these arthroplasties.

Acetabulum↗
PubMed2006

Long-term results of the cementless ALLOCLASSIC hip arthroplasty system using a 28-mm ceramic head: with a retrospective comparison to a 32-mm head.

One hundred twenty-four total hip arthroplasties in 119 patients, all performed with the cementless ALLOCLASSIC hip arthroplasty system (SL stem and CSF cup; Centerpulse, Winterthur, Switzerland), were analyzed retrospectively. In all hips, a 28-mm head and an ultrahigh-molecular-weight polyethylene inlay were used. Of the 124 hips, 81 could be investigated clinically and radiologically after an average of 150.6 months (range, 133-169 months). Twenty-six patients (26 hips) died in the interim. One of these patients had septic cup loosening. Seventeen hips (16 patients) were not available for follow-up because of health reasons (12 hips in 11 patients), lack of cooperation (3 hips in 3 patients), or loss to follow-up (2 hips in 2 patients). Of the 124 total hip arthroplasties, 4 cups were removed (2 aseptic and 2 septic loosening). No stem had to be removed. If aseptic loosening is defined as the end point, the survival rate is 98.4% (95% confidence interval, 93.8%-99.6%) for the cup and 100% for the stem after 157 months. If revision for any reason is defined as the end point, the survival rate is 95.6% (95% confidence interval, 90.1%-98.3%). Before operation, the average Harris Hip Score was 36.4 points (21-46). At time of follow-up, the average Harris Hip Score was 89.7 points (54-100). Radiolucent lines and osteolyses were found only seldom (mostly in the proximal stem zones).

Adult↗
PubMed2006

The value of patient activity level in the outcome of total hip arthroplasty.

Commonly used total hip arthroplasty scores take into account pain, function, walking, and range of motion. The purpose of this study was to evaluate the value of patient activity level as part of the outcome of total hip arthroplasty. Using linear regression analysis, the relationship between patient activity level (University of California Los Angeles activity score), the Harris Hip Score, and the Short Form-12 health survey was evaluated in 152 patients (mean age, 58.7 years) with a mean follow-up 5.2 years (range, 2-21 years). The University of California Los Angeles activity scale had an R(2) value of 0.39 and 0.19 to the Short Form-12 physical and mental components, respectively, and 0.32 to the Harris Hip Score. By evaluating patient activity level, one obtains important qualitative information in assessing the clinical outcome after total hip arthroplasty.

Arthroplasty, Replacement, Hip↗
PubMed2006

Relationship between total arthroplasty case volume and patient outcome in an acute care payment system in Japan.

We examined the relationship between hospital case volume and patient outcome (ie, length of hospital stay and hospital charges) for both total hip arthroplasty (THA) and total knee arthroplasty (TKA). The study included 1561 patients who had total joint arthroplasty from April 1, 2001, to March 31, 2003. Using the mean values of THA or TKA surgical case volumes, the participating hospitals were divided into high-volume and low-volume groups. Based on this categorization, the association between hospital surgical case volume and the patient outcome measures was tested. Hospital patient case volume has significant effects on the total length of hospital stay for both THA and TKA and on the total cost for THA. Implications of the findings for practice are considered.

Arthroplasty, Replacement↗
PubMed2006

Component asymmetry in simultaneous bilateral total knee arthroplasty.

Component size asymmetry and knee scores were determined in a review of 253 patients undergoing simultaneous or same-day, bilateral total knee arthroplasty (TKA). Asymmetry in component sizes was found in 22 (8.7%) pairs of femoral components, 17 (6.7%) pairs of tibial components, and 13 (5.1%) pairs of patellar components. Asymmetric and symmetric total knee arthroplasties were seen equally in men and women, and there was no statistical difference in knee scores and range of motion between patients with symmetric or asymmetric arthroplasties. Asymmetry rates for anterior referenced femoral components were significantly higher than posterior referenced components, an unexpected finding of unknown significance. Awareness of the incidence of component asymmetry and the practice of independent sizing of each knee during bilateral TKA is important to continue the success of bilateral TKA in a growing patient population.

Adult↗