Speciality
Spotlight

 



 


Orthopaedics


 

 


Arthroplasty
       

  • Bierbaum BE, Callaghan JJ, Galante JO, et al (New England Baptist Hosp, Chestnut Hill, Mass; Univ of Iowa, Iowa City; Rush-Presbyterian-St Luke’s Med Ctr, Chicago; et al))

    An Analysis of Blood Management in Patients Having a Total Hip or Knee Arthroplasty

    J Bone Joint Surg Am 81-A: 2-10, 1999



    Purpose- Total hip and knee joint replacement can be associated with substantial blood loss, requiring transfusion. Allogenic transfusion is associated with certain health risks, autologous in a popular alternative but carries its own drawbacks.



    Methods- 330 orthopedic surgeons practicing in 235 centers in USA gave data. Total number was 9482 out of which 3920 were THA and 5562 were TICA.



    57% required blood transfusion for THA and 39% of TKA.



    2/3 of patients received autologous and 1/3 allogenic blood.



    61% predonated autologous blood but 45% of collected blood went unused.

       

  • Total Hip Arthroplasty



    Yee AJM, Kreder HK, Bookman I, et al (Toronto Hosp; Sunnybrook Health Science Ctr, North York, Ont)

    A Randomized Trial of Hydroxyapatite Coated Prostheses in Total Hip Arthroplasty

    Clin Orthop 366: 120-132, 1999



    Bioactive ceramics are of increasing interest is improving bone ingrowth in cementless THA. Advantages of hydroxyapatite coatings include a strong bond to host bone, increased bone ingrowth, osteoconductive potential, and decreased time to achieve fixation strength.



    To determine whether these advantages translate into increased clinical benefit, the clinical and radiographic performance of hydroxyapatite-coated femoral prostheses was compared with that of non-hydroxyapatite-coated prostheses in a prospective, randomized trial.

       

  • Sporer SM, Callaghan JJ, Olejniczak JP, et al (Iowa Methodist Med Ctr, Des Moines; Univ of Iowa, Iowa City)

    Hybrid Total Hip Arthroplasty in Patients Under the Age of Fifty: A Five-to Ten-Year Follow-up

    J Arthroplasty 13: 485-491, 1998



    The durability of uncemented Harris-Galante acetabular components in younger patients is excellent. The failure of femoral components is probably caused by the rough-surface finish, although the polymethyl methacrylate proximal precoating and femoral component design may also contribute to femoral failures.

       

  • Results in Patients Younger Than 30 and Younger Than 50 

    Sochart DH, Porter ML, (Wrightington Hosp, Wigan, England)

    Long-term Results of Cemented Charnley Low-Friction Arthroplasty in Patients Aged Less Than 30 Years

    J Arthroplasty 13: 123-131, 1998



    Cemented Charnley low-friction arthroplasty is beneficial in patients younger than 30 years. Long-term outcome analysis showed low complication rates and a component survivorship exceeding that reported previously.

       

  • Knee



    Unicompartmental Disease 

    Bert JM (Univ of Minnesota, St Paul)

    10-Year Survivorship of Metal-backed, Unicompartmental Arthroplasty

    J Arthroplasty 13: 901-905, 1998



    It is very controversial procedure and it has been practiced in very few places, as there is a substantial risk of long-term failure.



    Failure rate increases every 5 years and produces arthrosis in nonoperated compartment.



    This should be reserved for highly selected patients, such as younger patients who require better knee function than that provided by a total knee
    arthroplasty.

       

  • Hasegawa Y, Ooishi Y, Shimizu T, et al (Nagoya Univ, Japan; Toyohashi Municipal Hosp, Aichi, Japan; Tokyo Kosei Nenkin Hosp)

    Unicompartmental Knee Arthroplasty for Medial Gonarthrosis: 5 to 9 Years Follow-up Evaluation of 77 Knees

    Arch Orthop Trauma Surg 117: 183-187, 1998



    It is excellent alternative to high tibial osteotomy in patients 70 years of age.

       

  • Toksvig-Larsen S, Magyar G, Onsten I, et al (Univ Hosp, Lund, Sweden; Univ Hosp, Malmo, Sweden)

    Fixation of the Tibial Component of Total Knee Arthroplasty After High Tibial Osteotomy: A Matched Radiostereometric Study

    J Bone Joint Surg Br 80-B: 295-297, 1998



    Effects of high tibial osteotomy on success rate of TKA are unclear. High tibial osteotomy is a valuable procedure in young patients with osteoarthritis of the knee and does not preclude later revision to TKA.



    As it is not advisable to do TKR in young patients, High tibial osteotomy should be done from the age of 45-60 years. Pain is relieved for 10-15 years.



 

         

Speciality Spotlight

 

 

Arthroplasty
       

  • Bierbaum BE, Callaghan JJ, Galante JO, et al (New England Baptist Hosp, Chestnut Hill, Mass; Univ of Iowa, Iowa City; Rush-Presbyterian-St Luke’s Med Ctr, Chicago; et al))
    An Analysis of Blood Management in Patients Having a Total Hip or Knee Arthroplasty
    J Bone Joint Surg Am 81-A: 2-10, 1999

    Purpose- Total hip and knee joint replacement can be associated with substantial blood loss, requiring transfusion. Allogenic transfusion is associated with certain health risks, autologous in a popular alternative but carries its own drawbacks.

    Methods- 330 orthopedic surgeons practicing in 235 centers in USA gave data. Total number was 9482 out of which 3920 were THA and 5562 were TICA.

    57% required blood transfusion for THA and 39% of TKA.

    2/3 of patients received autologous and 1/3 allogenic blood.

    61% predonated autologous blood but 45% of collected blood went unused.
       

  • Total Hip Arthroplasty

    Yee AJM, Kreder HK, Bookman I, et al (Toronto Hosp; Sunnybrook Health Science Ctr, North York, Ont)
    A Randomized Trial of Hydroxyapatite Coated Prostheses in Total Hip Arthroplasty
    Clin Orthop 366: 120-132, 1999

    Bioactive ceramics are of increasing interest is improving bone ingrowth in cementless THA. Advantages of hydroxyapatite coatings include a strong bond to host bone, increased bone ingrowth, osteoconductive potential, and decreased time to achieve fixation strength.

    To determine whether these advantages translate into increased clinical benefit, the clinical and radiographic performance of hydroxyapatite-coated femoral prostheses was compared with that of non-hydroxyapatite-coated prostheses in a prospective, randomized trial.
       

  • Sporer SM, Callaghan JJ, Olejniczak JP, et al (Iowa Methodist Med Ctr, Des Moines; Univ of Iowa, Iowa City)
    Hybrid Total Hip Arthroplasty in Patients Under the Age of Fifty: A Five-to Ten-Year Follow-up
    J Arthroplasty 13: 485-491, 1998

    The durability of uncemented Harris-Galante acetabular components in younger patients is excellent. The failure of femoral components is probably caused by the rough-surface finish, although the polymethyl methacrylate proximal precoating and femoral component design may also contribute to femoral failures.
       

  • Results in Patients Younger Than 30 and Younger Than 50 
    Sochart DH, Porter ML, (Wrightington Hosp, Wigan, England)
    Long-term Results of Cemented Charnley Low-Friction Arthroplasty in Patients Aged Less Than 30 Years
    J Arthroplasty 13: 123-131, 1998

    Cemented Charnley low-friction arthroplasty is beneficial in patients younger than 30 years. Long-term outcome analysis showed low complication rates and a component survivorship exceeding that reported previously.
       

  • Knee

    Unicompartmental Disease 
    Bert JM (Univ of Minnesota, St Paul)
    10-Year Survivorship of Metal-backed, Unicompartmental Arthroplasty
    J Arthroplasty 13: 901-905, 1998

    It is very controversial procedure and it has been practiced in very few places, as there is a substantial risk of long-term failure.

    Failure rate increases every 5 years and produces arthrosis in nonoperated compartment.

    This should be reserved for highly selected patients, such as younger patients who require better knee function than that provided by a total knee arthroplasty.
       

  • Hasegawa Y, Ooishi Y, Shimizu T, et al (Nagoya Univ, Japan; Toyohashi Municipal Hosp, Aichi, Japan; Tokyo Kosei Nenkin Hosp)
    Unicompartmental Knee Arthroplasty for Medial Gonarthrosis: 5 to 9 Years Follow-up Evaluation of 77 Knees
    Arch Orthop Trauma Surg 117: 183-187, 1998

    It is excellent alternative to high tibial osteotomy in patients 70 years of age.
       

  • Toksvig-Larsen S, Magyar G, Onsten I, et al (Univ Hosp, Lund, Sweden; Univ Hosp, Malmo, Sweden)
    Fixation of the Tibial Component of Total Knee Arthroplasty After High Tibial Osteotomy: A Matched Radiostereometric Study
    J Bone Joint Surg Br 80-B: 295-297, 1998

    Effects of high tibial osteotomy on success rate of TKA are unclear. High tibial osteotomy is a valuable procedure in young patients with osteoarthritis of the knee and does not preclude later revision to TKA.

    As it is not advisable to do TKR in young patients, High tibial osteotomy should be done from the age of 45-60 years. Pain is relieved for 10-15 years.

 

By |2022-07-20T16:42:27+00:00July 20, 2022|Uncategorized|Comments Off on Arthroplasty

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