Arthroplasty Today最新文献_第4页

Blood Metal Ion Levels After Hip Resurfacing: A Comparison of 2 Different Implants 髋关节置换术后血液中的金属离子水平：两种不同植入物的比较

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-30 DOI: 10.1016/j.artd.2024.101555

Renee Ren BA, Ryan Cheng BA, Andrew Jordan MS, Jonathan Spaan MS, Rachelle Hornick MPH, Walter L. Taylor IV MPhil, Edwin P. Su MD

Background

While hip resurfacing arthroplasty has been shown to be an effective prosthetic solution for end-stage osteoarthritis, prior studies have also reported an increasing concern regarding blood metal ion levels following the use of metal-on-metal articulations. The purpose of this study was to compare early and midterm blood metal ion levels to functional outcomes and implant survivorship for patients treated with the Birmingham Hip Resurfacing (BHR) implant system and the ReCap Magnum.

Methods

A retrospective review identified 104 patients who underwent 134 hip resurfacing arthroplasties using BHR (n = 67) and ReCap (n = 67) at a single institution between 2006 and 2018. ReCap and BHR patients were matched 1:1 by sex, femoral head and acetabular cup sizes, age, and year of surgery. The primary outcome of interest was cobalt (Co) and chromium (Cr) ion levels.

Results

The ReCap cohort had lower median metal ion levels compared to the BHR cohort at 1-2 y (Co: 1.5 vs 1.9 parts per billion [ppb], P = .018; Cr: 1.3 vs 2.8 ppb, P = .008) and 3-5 y (Co: 1.1 vs 1.9 ppb, P = .001; Cr: 1.2 vs 2.2 ppb, P = .003) after surgery. Correlation analysis showed no significant associations between Co and Cr ion levels and pre- and postoperative patient-reported outcomes. Indications for revision differed between groups. Three BHR hips were revised due to adverse reactions to metal debris, whereas 2 ReCap hips required revisions: one for instability and another for periprosthetic fracture.

Conclusions

BHR patients had higher metal ion levels than ReCap patients at 1-2 and 3-5 y after surgery, though these metal levels are still low and in line with prior studies. Indications for revision differed between patients treated with BHR and ReCap. Surgeons should be aware of these outcomes when counseling patients regarding these metal-on-metal articulations.

背景虽然髋关节置换术已被证明是治疗终末期骨关节炎的有效假体解决方案，但之前的研究也报告称，使用金属关节后，血液中的金属离子水平越来越令人担忧。本研究的目的是比较使用伯明翰髋关节置换术（BHR）植入系统和 ReCap Magnum 治疗的患者的早期和中期血液金属离子水平、功能预后和植入物存活率。方法回顾性研究确定了 2006 年至 2018 年期间在一家机构使用 BHR（n = 67）和 ReCap（n = 67）进行了 134 例髋关节置换关节置换术的 104 名患者。ReCap和BHR患者按性别、股骨头和髋臼杯尺寸、年龄和手术年份1:1配对。研究的主要结果是钴离子（Co）和铬离子（Cr）水平。结果ReCap队列与BHR队列相比，1-2岁时的金属离子水平中位数较低（Co：1.5 vs 1.9 parts per billion [ppb]，P = .018；Cr：1.3 vs 2.8 ppb，P = .018）：手术后 1-2 年（Co：1.5 vs 1.9 十亿分之一 [ppb]；Cr：1.3 vs 2.8 十亿分之一，P = .008）和 3-5 年（Co：1.1 vs 1.9 十亿分之一，P = .001；Cr：1.2 vs 2.2 十亿分之一，P = .003），与 BHR 队列相比，中位金属离子水平较低。相关性分析表明，Co 和 Cr 离子水平与术前和术后患者报告的结果之间没有明显关联。各组的翻修指征不同。结论BHR患者在术后1-2年和3-5年的金属离子水平高于ReCap患者，但这些金属离子水平仍然较低，与之前的研究结果一致。BHR和ReCap患者的翻修指征不同。外科医生在向患者提供有关这些金属对金属关节的咨询时应注意这些结果。

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引用次数: 0

Is Wear Still a Concern in Total Knee Arthroplasty With Contemporary Conventional and Highly Crosslinked Polyethylene Tibial Inserts in the mid- to Long-Term? 使用当代传统和高交联聚乙烯胫骨假体进行全膝关节置换术的中长期磨损问题仍然存在吗？

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-30 DOI: 10.1016/j.artd.2024.101550

Devin P. Asher BS , Jennifer L. Wright MS , Deborah J. Hall BS , Hannah J. Lundberg PhD , Douglas W. Van Citters PhD , Joshua J. Jacobs MD , Brett R. Levine MD, MS , Robin Pourzal PhD

Background

Modern literature has brought into question if wear of tibial inserts made from conventional or highly crosslinked polyethylene (HXL PE) is still a factor limiting longevity of total knee arthroplasty (TKA) in the mid- to long-term. It is the objective of this study to determine: 1) most common causes of mid- to long-term TKA failure, 2) the prevalence of delamination, and 3) the medial/lateral linear wear rates of conventional and HXL PE tibial inserts retrieved in the mid- to long-term.

Methods

A tibial insert retrieval cohort of 107 inserts (79 conventional, 28 HXL PE) with a minimum time in situ of 6.5 years (mean 11.7 ± 4) was studied. Failure causes were determined from chart-review, delamination presence was assessed microscopically, and medial/lateral linear wear was determined by minimal thickness changes measured with a dial-indicator.

Results

The most common mid-to long-term etiologies for failure were instability (44.9%), PE wear 15%), aseptic loosening (14%), and infection (13.1%). Delamination occurred in 70% of inserts (72.1% conventional, 64.3% HXLPE). Gross material loss due to delamination appeared to be the underlying reason for at least 33.3% of cases exhibiting instability. Of the cases removed for infection, 75% exhibited no histopathological hallmarks of acute infection. The medial/lateral wear rates were 0.054/0.051 (conventional) and 0.014/0.011 (HXL) mm/y, respectively.

Conclusions

Polyethylene wear still appears to be a major primary and secondary cause for TKA revision in the mid- to long-term. Wear may manifest as destabilizing delamination or as continuous release of fine wear particles potentially resulting in inflammatory responses and subsequent failure.

背景现代文献对传统或高交联聚乙烯（HXL PE）制成的胫骨假体的磨损是否仍然是限制全膝关节置换术（TKA）中长期使用寿命的一个因素提出了质疑。本研究的目的在于确定1) 中长期 TKA 失败的最常见原因；2) 分层的发生率；3) 中长期取回的传统和 HXL PE 胫骨假体的内侧/外侧线性磨损率。方法研究了一组取回的胫骨假体，共 107 个假体（79 个传统假体，28 个 HXL PE 假体），假体在原位的时间最短为 6.5 年（平均为 11.7 ± 4）。研究结果最常见的中长期失效原因是不稳定性（44.9%）、PE 磨损（15%）、无菌性松动（14%）和感染（13.1%）。70%的插入物出现分层（72.1%为传统插入物，64.3%为 HXLPE 插入物）。至少有 33.3% 的病例显示出不稳定性，其根本原因似乎是分层导致的材料大面积流失。在因感染而被移除的病例中，75%的病例没有表现出急性感染的组织病理学特征。内侧/外侧磨损率分别为0.054/0.051（传统）和0.014/0.011（HXL）毫米/年。磨损可能表现为不稳定的分层或细小磨损颗粒的持续释放，可能导致炎症反应和随后的失败。

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引用次数: 0

Spinal Anesthesia in Total Hip Arthroplasty is Associated With Improved Outcomes in the American Joint Replacement Registry Population 全髋关节置换术中的脊髓麻醉与美国关节置换注册人口的疗效改善有关

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-30 DOI: 10.1016/j.artd.2024.101566

Sagar Telang BS , Nathanael D. Heckmann MD , Adam Olsen MD , Ayushmita De PhD , Jeffrey B. Stambough MD

Background

Despite previous studies showing benefits of spinal anesthesia (SA) for patients undergoing elective total hip arthroplasty (THA), most THA procedures throughout the United States still utilize general anesthesia (GA). Using the American Joint Replacement Registry data, our study explored outcome difference for patients undergoing THA administered SA vs GA.

Methods

All available THAs were identified using American Joint Replacement Registry data from 2017 to 2020. THA patients were categorized into 2 cohorts by anesthesia type. Demographics, hospital characteristics, and comorbidities were documented for each patient. Outcomes included operative time, length of stay, 30- and 90-day readmission, and 90-day all-cause revision. Chi-square analysis was used to assess categorical variables while multivariable regression analyzed the association between anesthesia type and outcomes of interest.

Results

A total of 217,124 THAs were identified, including 119,425 (55.0%) patients who received GA and 97,699 (45.0%) patients who received SA. Multivariable regression showed that SA was associated with a decreased risk of hospital length of stay >3 days (adjusted odds ratio [aOR] 0.4, 95% confidence interval [CI]: 0.34-0.36, P < .0001) and a lower likelihood of prolonged operative time (aOR 0.8, 95% CI: 0.79-0.82, P < .0001). Additionally, patients who received SA had lower rates of 90-day readmission (aOR 0.7, 95% CI: 0.67-0.78, P < .0001) and a decreased risk of 90-day all-cause revision (aOR 0.5, 95% CI: 0.47-0.54, P < .0001).

Conclusions

Patients receiving SA during THA had shorter operative time, reduced length of stay, and decreased rates of readmission and revision compared to patients who received GA. These findings add to the growing body of literature supporting the benefits of SA over GA for THA patients.

背景尽管之前的研究显示脊髓麻醉（SA）对接受择期全髋关节置换术（THA）的患者有好处，但美国的大多数 THA 手术仍采用全身麻醉（GA）。我们的研究利用美国关节置换登记处的数据，探讨了接受椎管内麻醉与全身麻醉的全髋关节置换术患者的预后差异。方法利用美国关节置换登记处 2017 年至 2020 年的数据确定了所有可用的全髋关节置换术。根据麻醉类型将 THA 患者分为 2 个队列。记录了每位患者的人口统计学特征、医院特征和合并症。研究结果包括手术时间、住院时间、30 天和 90 天再入院率以及 90 天全因翻修率。采用卡方分析法评估分类变量，同时采用多变量回归法分析麻醉类型与相关结果之间的关系。结果共确定了217124例 THAs，其中119425例（55.0%）患者接受了GA，97699例（45.0%）患者接受了SA。多变量回归显示，SA 与住院时间减少 3 天的风险相关（调整后的几率比 [aOR] 0.4，95% 置信区间 [CI]：0.34-0.36，P＜0.05）：0.34-0.36，P <.0001）和手术时间延长的可能性降低（aOR 0.8，95% 置信区间：0.79-0.82，P <.0001）。此外，接受 SA 治疗的患者 90 天再入院率较低（aOR 0.7，95% CI：0.67-0.78，P < .0001），90 天全因翻修风险较低（aOR 0.5，95% CI：0.47-0.54，P < .0001）。结论与接受 GA 治疗的患者相比，在 THA 期间接受 SA 治疗的患者手术时间更短、住院时间更短、再入院率和翻修率更低。越来越多的文献支持在 THA 患者中使用 SA 术比使用 GA 术更有益处，这些研究结果是对这一观点的进一步补充。

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引用次数: 0

Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes 通过直接前路为幼年特发性关节炎患者同时进行双侧全髋关节置换术：长期疗效

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-29 DOI: 10.1016/j.artd.2024.101557

Mohammadreza Razzaghof MD, MPH , Mohammad Vahedian Ardakani MD , Mohammad Poursalehian MD , Seyyed Hossein Shafiei MD , Mahlisha Kazemi MD , Seyed Mohammad Javad Mortazavi MD

Background

Juvenile idiopathic arthritis (JIA) often results in significant bilateral hip damage, necessitating total hip arthroplasty (THA). Simultaneous bilateral THA offers potential advantages, particularly when executed via the Direct Anterior Approach (DAA). This study aims to assess the functional, radiological, and patient-reported outcomes, along with the complications of bilateral uncemented THA performed via DAA in patients with JIA.

Methods

A retrospective review of 39 patients with JIA who underwent bilateral THA via DAA from January 2006-January 2015 was conducted. Inclusion and exclusion criteria were defined, focusing on a minimum of 7 years of post-THA follow-up. Functional outcomes were assessed using the Harris Hip Score.

Results

Data were available for 33 patients (66 hips). The mean age at surgery was 21.3 years, and the average follow-up was 11.3 years. All patients reported severe bilateral hip pain presurgery, which was alleviated post-THA. The mean preoperative Harris Hip Score improved from 49.6-79.7 postoperatively. Complications included 3 calcar cracks, 2 greater trochanter fractures, and 1 superficial wound dehiscence. No instances of dislocation, postoperative periprosthetic fracture, or any revision surgery were recorded.

Conclusions

Simultaneous bilateral THA using DAA is an effective and safe surgical approach for patients with JIA with bilateral end-stage hip involvement, providing notable improvements in functional and radiological outcomes while maintaining a favorable complication profile.

Level of evidence

IV.

背景青少年特发性关节炎（JIA）常常导致双侧髋关节严重受损，因此必须进行全髋关节置换术（THA）。同时进行双侧全髋关节置换术具有潜在的优势，尤其是通过直接前路（DAA）进行手术时。本研究旨在评估 JIA 患者通过 DAA 实施双侧非骨水泥 THA 的功能、放射学和患者报告结果以及并发症。方法回顾性研究了 2006 年 1 月至 2015 年 1 月期间通过 DAA 实施双侧 THA 的 39 例 JIA 患者。界定了纳入和排除标准，重点关注THA术后至少7年的随访。结果 33 名患者（66 个髋关节）的数据可用。手术时的平均年龄为21.3岁，平均随访时间为11.3年。所有患者术前均报告有严重的双侧髋关节疼痛，THA术后疼痛有所缓解。术前的平均哈里斯髋关节评分在术后从49.6分提高到79.7分。并发症包括3处髋臼钙裂、2处大转子骨折和1处浅表伤口裂开。结论对于双侧髋关节终末期受累的JIA患者来说，使用DAA同时进行双侧THA是一种有效而安全的手术方法，在保持良好并发症情况的同时，明显改善了患者的功能和放射学结果。

{"title":"Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes","authors":"Mohammadreza Razzaghof MD, MPH , Mohammad Vahedian Ardakani MD , Mohammad Poursalehian MD , Seyyed Hossein Shafiei MD , Mahlisha Kazemi MD , Seyed Mohammad Javad Mortazavi MD","doi":"10.1016/j.artd.2024.101557","DOIUrl":"10.1016/j.artd.2024.101557","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile idiopathic arthritis (JIA) often results in significant bilateral hip damage, necessitating total hip arthroplasty (THA). Simultaneous bilateral THA offers potential advantages, particularly when executed via the Direct Anterior Approach (DAA). This study aims to assess the functional, radiological, and patient-reported outcomes, along with the complications of bilateral uncemented THA performed via DAA in patients with JIA.</div></div><div><h3>Methods</h3><div>A retrospective review of 39 patients with JIA who underwent bilateral THA via DAA from January 2006-January 2015 was conducted. Inclusion and exclusion criteria were defined, focusing on a minimum of 7 years of post-THA follow-up. Functional outcomes were assessed using the Harris Hip Score.</div></div><div><h3>Results</h3><div>Data were available for 33 patients (66 hips). The mean age at surgery was 21.3 years, and the average follow-up was 11.3 years. All patients reported severe bilateral hip pain presurgery, which was alleviated post-THA. The mean preoperative Harris Hip Score improved from 49.6-79.7 postoperatively. Complications included 3 calcar cracks, 2 greater trochanter fractures, and 1 superficial wound dehiscence. No instances of dislocation, postoperative periprosthetic fracture, or any revision surgery were recorded.</div></div><div><h3>Conclusions</h3><div>Simultaneous bilateral THA using DAA is an effective and safe surgical approach for patients with JIA with bilateral end-stage hip involvement, providing notable improvements in functional and radiological outcomes while maintaining a favorable complication profile.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"30 ","pages":"Article 101557"},"PeriodicalIF":1.5,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Epidemiology of the Revision Total Hip Arthroplasty in the United States From 2016 to 2022 2016 至 2022 年美国翻修全髋关节置换术的流行病学研究

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-29 DOI: 10.1016/j.artd.2024.101517

Sandeep S. Bains MD, DC, MBA, Jeremy A. Dubin BA, Christopher G. Salib MD, Rubén Monárrez MD, Ethan Remily DO, Daniel Hameed MD, Gabrielle N. Swartz BS, Reza Katanbaf MD, MBA, James Nace DO, MPT, Ronald E. Delanois MD

Background

The number of revision total hip arthroplasties (THAs) is projected to reach 572,000 cases annually by 2030 in the United States. This may be attributed to the successes of primary THAs combined with an aging population, patients desire to remain active, and expanded indications for younger patients. Given the evolving nature of revision THAs, an epidemiological analysis of (1) etiologies; (2) demographics, including age and region; and (3) lengths of stay (LOSs) may minimize the gap between appropriate understanding and effective intervention.

Methods

From 2016 to 2022, a national, all-payer database was queried. Incidences and indications were analyzed for a total of 102,476 patients who had revision THA procedures. Patients were stratified according to etiology of failure, age, US census region, primary payor class, and mean LOS.

Results

The most common etiologies for revision THA procedures were dislocation (16.7%) and infection (12.7%), followed by periprosthetic fracture (6.9%). The largest age group was 65-74 years (30.9%), followed by >75 years (28.6%), then 55-64 (26.5%). The South had the largest total procedure cohort (36.9%), followed by the Midwest (27.5%), then the Northeast (19.7%), and the West (15.9%). The mean LOS was 4.10 days (range, 1.0-20.0).

Conclusions

Dislocation and infection remain leading indications for revision THA. These findings can properly guide surgeons toward appropriate management as well as toward active steps to minimizing these outcomes.

背景预计到 2030 年，美国每年翻修全髋关节置换术（THA）的数量将达到 572,000 例。这可能归因于初次全髋关节置换术的成功、人口老龄化、患者希望保持活跃以及年轻患者适应症的扩大。鉴于翻修型 THAs 不断发展的性质，对以下方面进行流行病学分析可能会最大限度地缩小适当了解和有效干预之间的差距：(1) 病因；(2) 人口统计学，包括年龄和地区；以及 (3) 住院时间 (LOS)。共对 102,476 名接受翻修 THA 手术的患者的发病率和适应症进行了分析。根据失败病因、年龄、美国人口普查地区、主要付款人类别和平均住院日对患者进行分层。结果翻修THA手术最常见的病因是脱位（16.7%）和感染（12.7%），其次是假体周围骨折（6.9%）。最大的年龄组是65-74岁（30.9%），其次是75岁（28.6%），然后是55-64岁（26.5%）。南部地区的手术总数最多（36.9%），其次是中西部地区（27.5%），然后是东北部地区（19.7%）和西部地区（15.9%）。平均住院日为4.10天（1.0-20.0天）。结论脱位和感染仍是翻修THA的主要适应症。这些发现可以正确引导外科医生进行适当的管理，并采取积极措施尽量减少这些结果。

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引用次数: 0

Accuracy of a New Augmented Reality Assisted Technique for Total Knee Arthroplasty: An In Vivo Study 新型增强现实技术辅助全膝关节置换术的准确性：体内研究

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-29 DOI: 10.1016/j.artd.2024.101565

Jasper Lambrechts MD , Pieter Vansintjan MD , Cynthia Lapierre , Farah Sinnaeve , Wouter Van Lysebettens , Philippe Van Overschelde MD

Background

Total knee arthroplasty (TKA) remains the standard of care for treating end-stage osteoarthritis of the knee. Approximately 15%-20% of the patients are dissatisfied following surgery. To improve accuracy and outcomes of TKA, various assistive technologies have been introduced. For this study, an augmented reality (AR) system was explored and tested.

Methods

The Knee + system (Pixee Medical, Besancon, France) was used to guide TKA. It uses a combination of quick response-code labeled instruments and AR glasses to guide tibial and femoral cuts. The primary research goal was to evaluate its accuracy by direct comparing the planned angular values for lateral distal femoral angle, medial proximal tibial angle, hip-knee-ankle axis, and tibial slope to the intraoperative obtained values and the measured angles on postoperative full leg radiographs. The secondary research goal was to assess its feasibility.

Results

This retrospective study evaluated 124 patients, with a follow-up of at least 1 year. The average absolute difference between planned and measured postop values were 1.39° for lateral distal femoral angle, 1.03° for medial proximal tibial angle, 2.16° for tibial slope, and 1.51° for hip-knee-ankle axis. Within the follow-up period, 8 complications were observed. The average surgical time was 83 minutes.

Conclusions

This study has demonstrated a high accuracy, comparable to robotic-assisted total knee arthroplasty, of the Knee + AR system. It has shown to be a safe, cheap and time-efficient assistive technology for patients undergoing medial pivot TKA.

背景全膝关节置换术（TKA）仍是治疗终末期膝关节骨性关节炎的标准疗法。大约 15%-20%的患者对术后效果不满意。为了提高膝关节置换术的准确性和疗效，人们引入了各种辅助技术。本研究对增强现实（AR）系统进行了探索和测试。方法 Knee + 系统（Pixee Medical，法国贝桑松）用于指导 TKA。该系统结合使用快速反应代码标记的器械和 AR 眼镜来引导胫骨和股骨切口。主要研究目标是通过直接比较股骨外侧远端角度、胫骨内侧近端角度、髋膝踝轴线和胫骨斜度的计划角度值与术中获得的角度值以及术后全腿X光片上测量的角度值，评估其准确性。这项回顾性研究对 124 名患者进行了评估，随访时间至少 1 年。股骨远端外侧角的计划值与术后测量值的平均绝对差值为1.39°，胫骨近端内侧角为1.03°，胫骨斜度为2.16°，髋-膝-踝轴线为1.51°。在随访期间，共观察到 8 例并发症。结论这项研究表明，Knee + AR 系统具有很高的准确性，可与机器人辅助全膝关节置换术相媲美。对于接受内侧枢轴 TKA 的患者来说，它是一种安全、廉价、省时的辅助技术。

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引用次数: 0

Periprosthetic Hip Fracture due to Ballistic Injuries 弹道损伤导致的髋关节假体周围骨折

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-25 DOI: 10.1016/j.artd.2024.101547

Felipe Sandoval MD , Joaquin Valenzuela MD , Maximiliano Carmona MD , Bénjamin Guiloff MD , Martin Salgado MD

Periprosthetic hip fractures are a common cause for revision. To date, however, there are no reports of periprosthetic fractures (PFs) in total hip arthroplasty caused by ballistic injury (BI). There are no current recommendations on the management of this pathology in the literature. The objective of this paper is to report on 2 successfully treated cases of PF caused by BIs. Additionally, a brief review of the literature regarding open fracture secondary to BIs is carried out. What we consider appropriate initial and definitive management for these patients is outlined. According to our clinical results and current evidence, adequate management for a BI Vancouver B1 femoral PF consists of early antibiotic therapy, surgical debridement, osteosynthesis with variable angle locking plate, structural allograft, cerclage wires, and negative pressure wound therapy.

假体周围骨折是髋关节翻修的常见原因。但迄今为止，还没有关于弹道损伤（BI）导致全髋关节置换术假体周围骨折（PF）的报道。目前的文献中也没有关于这种病理处理的建议。本文旨在报告两例成功治疗的由 BI 引起的 PF 病例。此外，本文还简要回顾了有关继发于 BI 的开放性骨折的文献。本文概述了我们认为适合这些患者的初始和最终治疗方法。根据我们的临床结果和目前的证据，对 BI 范库弗 B1 股骨 PF 的适当治疗包括早期抗生素治疗、手术清创、使用可变角度锁定钢板进行骨合成、结构性同种异体移植、Cerclage 钢丝和负压伤口治疗。

引用次数: 0

Corrigendum to 'Small-colony variant of Staphylococcus lugdunensis in prosthetic joint Infection' [Arthroplasty Today. Volume 4, Issue 3, September 2018, Pages 257-260].

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-19 eCollection Date: 2024-12-01 DOI: 10.1016/j.artd.2024.101542

Mohamed Askar, Benjamin Bloch, Roger Bayston

[This corrects the article DOI: 10.1016/j.artd.2018.06.003.].

引用次数: 0

Corrosion of Modular Dual-Mobility Acetabular Components Leading to Acetabular Bone Loss and Protrusio 模块化双活动髋臼组件的腐蚀导致髋臼骨质流失和前突

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-18 DOI: 10.1016/j.artd.2024.101543

JaeWon Yang MD, Suhas P. Dasari MD, Howard A. Chansky MD, Nicholas M. Hernandez MD

Dual-mobility bearings are being increasingly utilized in total hip arthroplasty. Contemporary modular designs often feature inner cobalt-chromium liners that are seated in outer titanium acetabular shells. However, mating of these 2 dissimilar metals may lead to complications. We present a case report of a patient who was found to have osteolysis and acetabular protrusio due to an adverse local tissue reaction from corrosion between a cobalt-chromium liner and titanium acetabular shell that appeared to be well-seated clinically and radiographically. This case suggests that implant failure and associated adverse local tissue reactions may occur even in seemingly well-seated modular dual-mobility implants.

在全髋关节置换术中，越来越多地使用双活动度轴承。当代的模块化设计通常将钴铬内衬装入钛髋臼外壳中。然而，这两种异种金属的配合可能会导致并发症。我们报告了一例患者的病例，该患者因钴铬衬垫和钛髋臼壳之间的腐蚀引起局部组织不良反应，导致骨溶解和髋臼突出，而临床和影像学检查显示该衬垫和钛髋臼壳的结合良好。该病例表明，即使是看似固定良好的模块化双活动度植入体，也可能出现植入失败和相关的局部组织不良反应。

引用次数: 0

Robotic Total Hip Arthroplasty for Traumatic Acetabular Fracture Using an Image-free Second-Generation System 使用无图像第二代系统进行机器人全髋关节置换术治疗创伤性髋臼骨折

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today

Pub Date : 2024-10-18 DOI: 10.1016/j.artd.2024.101485

Justin Leal BS, David N. Kugelman MD, Rahul K. Goel MD, Niall H. Cochrane MD, Thorsten M. Seyler MD, PhD

Complex traumatic acetabular fractures with concomitant hip dislocations are an orthopaedic emergency often requiring open reduction and internal fixation; however, total hip arthroplasty (THA) for acute acetabular fractures may be indicated in certain scenarios. This study reports the case of a 65-year-old male who had a motor vehicle collision that resulted in acetabular fracture dislocation with concomitant femoral head fracture. The patient underwent acute image-free robotic THA. At 6-month follow-up, the patient had good pain management and was doing well after surgery. With the reported technique using a reamer basket, an image-free robotic system can be used in acute THA in patients to achieve appropriate cup positioning.

复杂的外伤性髋臼骨折同时伴有髋关节脱位是骨科急症，通常需要切开复位和内固定；但在某些情况下，急性髋臼骨折可能需要进行全髋关节置换术（THA）。本研究报告了一例 65 岁男性患者的病例，该患者因机动车碰撞导致髋臼骨折脱位，同时伴有股骨头骨折。患者接受了急性无图像机器人全髋关节置换术。在6个月的随访中，患者疼痛控制良好，术后情况良好。通过所报告的使用铰刀篮的技术，无图像机器人系统可用于患者的急性髋臼置换术，以实现适当的髋臼杯定位。

引用次数: 0