scholarly journals The Diagnostic Accuracy of Radionuclide Arthrography for Prosthetic Loosening in Hip and Knee Arthroplasty

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Timothy H. French ◽  
Nicholas Russell ◽  
Anand Pillai
Keyword(s):  
Knee Arthroplasty ◽  
Predictive Value ◽  
Diagnostic Tools ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Hip And Knee Arthroplasty ◽  
Prosthetic Loosening ◽  
Total Knee ◽  
Mean Time

Purpose of Study. Diagnosis of prosthetic loosening in hip and knee arthroplasty remains a challenge. Although there are a number of diagnostic tools, no single test or combination is 100% sensitive or specific. There has been a recent interest in the use of radionuclide arthrography (RNA) for detection of prosthetic loosening.Methods. A retrospective review of 45 consecutive RNA scans from 2005 to 2010 was conducted. RNA findings were compared with intraoperative findings at revision and/or serial radiographic examinations to confirm loosening. A component was considered loose if sequential radiographs demonstrated macromotion, gross subsidence, or progressive radiolucency.Results. There were 26 females and 17 males, with mean age at RNA of 71 years (range of 53–89 years) and mean time from index surgery, 6.4 years (range of 0.5–23 years). There were 23 total knee replacements (TKR) (19 primary and 4 revision) and 20 total hip replacements (THR) (11 primary and 9 revision). 15 patients underwent revision surgery following RNA. Strict inclusion criteria allowed 27 patients for further analysis. Sixteen RNA scans were suggestive of loosening, of which 14 were confirmed loose. Eleven scans were suggestive of a stable prosthesis, of which 10 were confirmed well fixed. RNA had a sensitivity of 93%, specificity of 83%, positive predictive value of 88%, and negative predictive value of 91%.Conclusion. Radionuclide arthrography should be considered a useful adjunct in the diagnosis of prosthetic loosening in the challenging patient.

The Wear of UHMWPE in Total Knee Replacements: Experimental and Finite Element Analysis of Contact Behaviour

2001 ◽  
Author(s):  
Dorothy M. Murphy ◽  
Alan Kavanagh ◽  
Tim M. McGloughlin
Keyword(s):  
Molecular Weight ◽  
Finite Element Analysis ◽  
Element Analysis ◽  
Total Knee Replacements ◽  
Total Hip Replacements ◽  
Contact Behaviour ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
Ultra High Molecular Weight

Abstract Upon examination of failed total knee replacements, it has been concluded that it is the performance of the ultra high molecular weight polyethylene (UHMWPE) tibial component that governs the useful lifespan of such a joint. Severe wear of UHMWPE is associated more with tibial components of the knee than with the acetabular cups of total hip replacements. This is due to a notable lack of congruity between the articulating surfaces which leads to the presence of significant localised stresses in the femoro-tibial interface.

Polyethylene Wear Debris Produced in a Knee Simulator Model: Effect of Crosslinking and Counterface Material

2007 ◽  
Author(s):  
Paul A. Williams ◽  
Cindy M. Brown ◽  
Riichro Tsukamoto ◽  
Takashi Nakamura ◽  
Ian C. Clarke
Keyword(s):  
Wear Debris ◽  
Polyethylene Wear ◽  
Total Hip ◽  
Total Knee Replacements ◽  
Knee Simulator ◽  
Total Hip Replacements ◽  
Gravimetric Measurements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee

Polyethylene (PE) debris has been examined in total hip replacements from clinical retrievals and laboratory simulator studies, but little is known about PE debris from total knee replacements. In this study we investigated the effects of crosslinking PE and the counterface material. Mildly and highly crosslinked PE were studied in combination with CoCr and Zirconia femoral components. Wear was determined by gravimetric measurements and the wear debris was isolated and morphologically characterized. Although the zirconia counterface with 7 Mrad PE did not exhibit measurable wear, wear debris was found. This indicated that wear occurred below the limits of the gravimetric approach. This study showed that the amount of crosslinking of PE and the counterface material were important factors in the wear of PE in a knee simulator model.

VP13 Relation Between Magnetic Resonance Imaging Use And Hip Or Knee Replacements In The Organisation For Economic Co-operation And Development

2017 ◽  
Vol 33 (S1) ◽  
pp. 151-152
Author(s):  
Robert Emprechtinger
Keyword(s):  
Hip Replacement ◽  
The Other ◽  
Resonance Imaging ◽  
Inappropriate Use ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Hip Replacements ◽  
Total Knee ◽  
The Relationship ◽  
Primary Hip Replacement

INTRODUCTION:A high degree of geographic variation in the use of medical interventions is usually considered as a sign for inappropriate use. However, the plain geographic variation has the disadvantage that the variation might also be appropriate due to differences in the regions. Hence, we conducted a more comprehensive analysis on Magnetic Resonance Imaging (MRI) use and the relationship to hip or knee replacements. We evaluated whether there is evidence that guideline recommendations regarding hip replacements and total knee replacements are being followed. Additionally, we tried to assess whether the use of MRI is related to subsequent interventions.METHODS:We extracted recommendations of the American College of Radiology (ACR) on the use of MRI relevant to hip replacements and total knee replacements. Subsequently, we created three hypotheses on MRI for hip or total knee replacements on what to expect from the data when these recommendations are being followed.For each hypothesis we calculated a multiple linear regression to analyze Organisation for Economic Co-operation and Development (OECD) data. This was necessary to control for other important variables that might have had an influence on the number of interventions despite the MRI use (for example, healthcare spending, or Computed Tomography (CT) use).RESULTS:The initial results on (primary) hip replacement and secondary hip replacement were heavily influenced by outliers. After the exclusion of the outliers (Turkey and Belgium), (primary) hip replacements were related to MRI use but not secondary hip replacements. The results on MRI and (primary) hip replacement suggest that the relationship between MRI and hip replacement in Turkey is lower than in the other OECD nations.Regarding knee replacements, we detected a relationship between the MRI use and total knee replacement. An increase of 10 MRI examinations per 1,000 population would, according to our model, result in 9.8 additional total knee replacements per 100,000 population.CONCLUSIONS:The relationship of MRI and (primary) hip replacement hints to inappropriate use of MRI in Turkey since the data shows a substantial deviation in the relationship compared to the other OECD nations. Apart from this, we found no evidence for inappropriate use of MRI in connection with hip replacements.However, our results suggest that MRI is inappropriately used in relation to total knee replacements. This might contribute to potentially unnecessary total knee replacements.

scholarly journals Study of factors affecting range of motion after total knee arthroplasty in Indian patients

2021 ◽  
Vol 9 (2) ◽  
pp. 56-63
Author(s):  
Ravindra GR ◽  
Kulkarni M ◽  
Patil S
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Age Groups ◽  
Important Indicator ◽  
Factors Affecting ◽  
Total Knee Replacements ◽  
Knee Replacements ◽  
Total Knee

Background: Range of motion is an important indicator of the success of total knee arthroplasty. To our knowledge there are no studies assessing the factors affecting the range of motion after total knee arthroplasty on Indian population which prompted us to undertake this study. Method: The present prospective study for all those patients with advanced arthritis of knee satisfying inclusion criteria, between August 2009 to June 2011. A total of 430 total knee replacements were done among 327 patients during this period out of which 354 primary total knee replacements among 254 patients were included in the study. Follow ups were done at 3 months, 6 months, one year and 2 years following procedure. Result: The average age was 63.8 years with a range of 50 – 80 years. 66.1% of the patients were female and 33.9% were male. The preoperative diagnosis was osteoarthritis in 81.1% of patients and 18.9% had rheumatoid arthritis. All poly implant was used in 83.1% of patients and in 16.9% of patients metal backed was used. The posterior tibial slope had no correlation with the postoperative range of motion at all the points of follow up. The preoperative range of motion had a statistical correlation with the postoperative range of motion at all the points of follow up and in all the age groups, p <0.0001. Conclusion: A more keen watch has to be kept in all young female patients with early onset of arthritis and mange them aggressively with conservative therapy.

Experience in 500 Total Knee Replacements

2012 ◽  
Vol 19 (2) ◽  
pp. 40-47
Author(s):  
G. A Chryagin ◽  
N. V Zagorodniy ◽  
V. I Nuzhdin ◽  
O. A Kudinov ◽  
V. M Bachiashvili ◽  
...  
Keyword(s):  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Replacement ◽  
Excellent Result ◽  
Total Knee Replacements ◽  
Joint Pathology ◽  
Knee Replacements ◽  
Total Knee ◽  
Optimum Construction

Experience of CITO joint replacement department in knee arthroplasty with implants from various manufacturers was analyzed. Implants of three modifications were used: basic, with posterior stabilizer and "semiconstrained" one. Tactics for a choice of optimum construction depending on a disease, gender, degree and type of contracture, degree and type of limb axis curvature was demonstrated and substantiated on the example of 500 operations performed to 426 patients with various knee joint pathology during the period from 2000 to 2010. By the data of clinical and roentgenologic analysis excellent result was achieved in 90 (21%), good inv 277 (65%), satisfactory in 51 (12%) and poor in 8 (2%) patients. This treatment tactics may be considered as an adequate one.

Sign in / Sign up

Export Citation Format

Share Document