Search results for "Replacement"
showing 10 items of 561 documents
Posterior stability in posterior-stabilized vs medially congruent total knee replacement: A radiological comparison of two polyethylene designs in a …
2020
Objective:The purpose of this radiological study was to assess the posterior laxity of a single model of a total knee arthroplasty design (TKA) having a medially constrained (MC) or a Posterior-Stabilized (PS) polyethylene insert using a well-documented stress x-ray. To the authors knowledge, this is the first report evaluating MC TKA outcomes according to the “kneeling view.”Materials and Methods:Sixty patients with non-traumatic primary knee osteoarthritis undergoing TKA were first matched by age, sex, BMI and diagnosis and then divided in two groups: group A (37 knees) received a MC TKA and group B (23 knees) a PS implant made by the same manufacturer. In all cases the posterior cruciate…
Kinematics of the ulna during pronation and supination in a cadaver study: implications for elbow arthroplasty
2003
Objective. Aim of this study was to exactly describe and quantify kinematics of the ulna during pro- and supination. Design. Biomechanical study in fresh frozen cadavers. Background. A previous MRI study revealed a varus/valgus motion of the ulna averaging 7.1° during pro-/supination. Axial rotation, however, could not be quantified. Methods. Sixteen arms were examined in a new apparatus that fixed the humerus on a template and allowed forearm rotation. Motion of a Kirschner wire placed in the ulna was recorded in steps of 30° by two perpendicularly arranged charge coupled device cameras during pro- and supination. Results. From supination to pronation the ulna showed a semi-lunar evasive m…
The PROMISE study protocol: a multicenter prospective study of process optimization with interdisciplinary and cross-sectoral care for German patient…
2021
Background and purpose — Knee and hip replacement are common and increasing procedures, and an optimized care process that could be implemented in different settings would be useful. The PROMISE trial investigates whether a new care process works equally in different German settings and how the results compare with current non-standardized care. Patients and methods — This multi-center prospective mixed-method study includes 2,000 German patients receiving arthritis-related hip or knee endoprostheses. An interdisciplinary and cross-sectoral care process was developed and implemented in 3 German hospitals with different levels of care, and corresponding rehabilitation centers were included t…
The Epidemiology of Hip and Knee Primary and Revision Arthroplasties during the COVID-19 Pandemic
2021
Background: The purpose of this study was to provide a comprehensive assessment of the impact of the COVID-19 pandemic on the epidemiology of primary and revision arthroplasties of the hip and knee joint. Methods: This study compared the data on knee and hip arthroplasty procedures from 2 hospitals (primary and revision) conducted in two periods: the period of the COVID-19 pandemic in Poland (from 4 March 2020 to 15 October 2020) and the corresponding period prior to the pandemic (from 4 March 2019 to 15 October 2019). We compared the epidemiological data, demographic data, and hospital stay duration data from these two periods. Results: Our analysis demonstrated that the total number of hi…
Optimal positioning of the humeral component in the reverse shoulder prosthesis.
2014
Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert. The main goal o…
Two different posterior-stabilized mobile-bearing TKA designs: navigator evaluation of intraoperative kinematic differences
2020
Purpose: The purpose of this study was to compare two types of posterior-stabilized (PS) mobile-bearing (MB) total knee arthroplasties (TKAs). The hypothesis was that no major differences were going to be found among the two TKA designs. Methods: Two cohorts of patients who were divided according to implant design (Cohort A, new design gradually reducing radius PS MB TKA; Cohort B, traditional dual-radius PS MB TKA) were analyzed by means of intraoperative navigation. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during the following kinematic tests: passive range of motion (PROM), varus–va…
Patient Specific Instrumentation for Total Knee Arthroplasty: a Literature Review
2014
During the past decade, total knee arthroplasty (TKA) has been markedly increased. Recently, patient-specific custom cutting guides have been commercially introduced in order to achieve an accurate component alignment during TKA. In fact, these cutting blocks are specific to a patient’s knee anatomy and should help the surgeons to perform bone cuts, reducing the complexity of conventional alignment and sizing tools. Nevertheless, there are critical arguments against patient-specific cutting guides for routine use, such as poor evidence and higher costs. Additionally, there are still no mild and long-term results available that describe the clinical outcomes following patient-specific instru…
Molekulare Signalwege der aseptischen Endoprothesenlockerung (Molecular pathways in aseptic loosening of orthopaedic endoprosthesis)
2008
Operative joint replacement to treat disabling joint conditions secondary to degenerative and inflammatory arthritides has become one of the most efficacious and cost-effective procedures to relieve pain and restore joint function. However, prosthetic implants are not built to last forever and osteolysis and aseptic loosening has been associated with prosthetic arthroplasties since their introduction. The functional life of a synthetic joint is influenced by many factors including the material of the implant, operation procedures and the surgeon involved, as well as patient-related factors. Although promising developments have been achieved in this field, more than 10% of all implants still…
Joint contractures in the absence of inflammation may indicate mucopolysaccharidosis
2009
Abstract Background Undiagnosed patients with the attenuated form of mucopolysaccharidosis (MPS) type I often have joint symptoms in childhood that prompt referral to a rheumatologist. A survey conducted by Genzyme Corporation of 60 European and Canadian rheumatologists and pediatric rheumatologists demonstrated that Bone and joint manifestations are prominent among most patients with MPS disorders. These life-threatening lysosomal storage diseases are caused by deficient activity of specific enzymes involved in the degradation of glycosaminoglycans. Patients with attenuated MPS disease often experience diagnostic delays. Enzyme replacement therapy is now commercially available for MPS I (l…
Total Elbow Replacement as Primary Treatment for Complex Fractures of the Distal Osteopenic Humerus
2003
Background: The use of hip and shoulder arthroplasty in elderly patients for grossly displaced intraarticular fractures is becoming more and more accepted. Total elbow replacement (TER) has not been considered an option for the treatment of extensively comminuted fractures of the distal humerus because surgeons feel the outcome is generally not predictable after TER. Evaluation of TER: On the basis of a MEDLINE literature search of this issue and the documented results based on the improvement of implant designs, operative technique and patient selection, TER has a definite role in the treatment of some fractures of the distal humerus.