scholarly journals Serum Metal Ion Concentrations in Paediatric Patients following Total Knee Arthroplasty Using Megaprostheses

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Jörg Friesenbichler ◽  
Patrick Sadoghi ◽  
Werner Maurer-Ertl ◽  
Joanna Szkandera ◽  
Mathias Glehr ◽  
...  

The purpose of this study was to determine the concentrations of cobalt, chromium, and molybdenum in the serum of paediatric tumour patients after fixed hinge total knee arthroplasty. Further, these metal ion levels were compared with serum metal ion levels of patients with other orthopaedic devices such as hip and knee prostheses with metal-on-metal or metal-on-polyethylene articulation to find differences between anatomical locations, abrasion characteristics, and bearing surfaces. After an average follow-up of 108 months (range: 67 to 163) of 11 paediatric patients with fixed hinge total knee arthroplasty, the mean concentrations for Co and Cr were significantly increased while Mo was within the limits compared to the upper values from the reference laboratory. Furthermore, these serum concentrations were significantly higher compared to patients with a standard rotating hinge device (P=0.002andP<0.001) and preoperative controls(P<0.001). On the other hand, the serum levels of patients following MoM THA or rotating hinge arthroplasty using megaprostheses were higher. Therefore, periodic long-term follow-ups are recommended due to the rising concerns about systemic metal ion exposure in the literature. Upon the occurrence of adverse reactions to metal debris the revision of the fixed hinge implant should be considered.

2021 ◽  
Vol 87 (3) ◽  
pp. 449-451
Author(s):  
Lucas Petitqueux ◽  
Karen Verhulst ◽  
Jan Dauwe ◽  
Dirk Dauwe

Rotating-hinge knee implants are fully constrained knee prostheses commonly used for revision total knee arthroplasty. Nevertheless, rotating-hinge devices have been increasingly utilized in primary setting. Complications are inevitable in orthopedic surgery, however, implant breakage after RHK arthroplasty has been rarely described in medical literature. We present a rare case of 70-year-old Caucasian, male patient who suffered an atraumatic femoral stem breakage in a primary NexGen ® Rotating Hinge Knee (Zimmer-Biomet ® , Warsaw, IN, USA).


The Knee ◽  
2022 ◽  
Vol 34 ◽  
pp. 34-41
Author(s):  
David M. Spranz ◽  
Kevin-Arno Koch ◽  
Tobias Reiner ◽  
Pit Hetto ◽  
Tobias Gotterbarm ◽  
...  

Coatings ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 442 ◽  
Author(s):  
Georg Hauer ◽  
Lukas Leitner ◽  
Marc C. Ackerl ◽  
Sebastian Klim ◽  
Ines Vielgut ◽  
...  

Background: The impact of titanium nitride (TiN) coating on implant components is controversial. TiN coating is proposed as having superior biomechanical properties compared to conventional cobalt-chromium (CoCr) alloy. This study compared long-term clinical data as well as meteoro-sensitivity in patients who underwent total knee arthroplasty (TKA), with either CoCr alloy or TiN coating. Methods: In this retrospective observational study, the clinically approved cemented “low contact stress” (LCS) TKA with conventional CoCr coating, was compared to un-cemented TiN-coated “advanced coated system” (ACS) TKA. Propensity score matching identified comparable patients based on their characteristics in a one-to-one ratio using the nearest-neighbor method. The final cohort comprised 260 knees in each cohort, with a mean follow-up of 10.1 ± 1.0 years for ACS patients and 14.9 ± 3.0 years for the LCS group. Physical examinations, meteoro-sensitivity, and knee scoring were assessed. Results: The clinical and functional Knee Society Score (KSS) (82.6 vs. 70.8; p < 0.001 and 61.9 vs. 71.1; p = 0.011), the postoperative Visual Analogue Scale (VAS) (2.9 vs. 1.4; p = 0.002), and the postoperative Tegner Score (2.6 vs. 2.2; p = 0.001) showed significant intergroup differences. The postoperative Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) was similar (79.9 vs. 81.3; p = 0.453) between groups. Meteoro-sensitivity of the artificial joint was significantly more prevalent in the ACS patient cohort (56% vs. 23%; p < 0.001). Conclusion: This study suggests that TiN coating does not provide improved clinical outcomes in this patient cohort after a long-term follow-up. Interestingly, sensitivity to weather changes were more correlated with un-cemented ACS implants.


The Knee ◽  
2021 ◽  
Vol 28 ◽  
pp. 72-80
Author(s):  
Warran Wignadasan ◽  
Justin S. Chang ◽  
Babar Kayani ◽  
Christina Kontoghiorghe ◽  
Fares S. Haddad

Author(s):  
Marco Rossoni ◽  
Daniele Regazzoni ◽  
Andrea Vitali ◽  
Giorgio Colombo ◽  
Luca Spandre ◽  
...  

Abstract Total Knee Arthroplasty is one of the most commonly performed orthopedic procedures and it is expected to grow in the next future. In the last past years, computer-assisted procedures represent one of the trends that are transforming the way of practicing medicine. Cornering the Total Knee Arthroplasty, digital models of the joints have been used to carry out simulation of their kinematics and mechanical performance. Whilst for the 3D digital reconstruction of the patient geometry several studies have been conducted, an approximated geometry of the prosthesis has been several times employed, with undeniable consequences on the final results. This paper aims at comparing two non-contact reverse engineering technologies to acquire the shape of femoral components employed for total knee arthroplasty. A high-level device (Konika Minolta Vivid 9i) and a mid-low cost laser (NextEngine) has been compared. For the comparison, a systematic procedure of acquisition and elaboration of the results has been adopted in order to have as unbiased as possible results. The procedure involves the use of the proprietary software of the scanners for the elaboration of the raw data and the meshing procedure has been kept the same for all the models. Since the as-is acquired mesh is of high-resolution, a decimation procedure has been carried out in order to make the 3D models lighter and easier to be handled. Once the decimation procedure has been evaluated comparing the original and the simplified models to one another, the digitalized models have been compared with the measurements taken from a coordinate measuring machines. As a preliminary result, the two lasers seem to be adequate to accomplish the reverse engineering process as required by this application. Of course, the mid-low cost laser would be preferable whether the performance will be confirmed to be (statistically) equal.


2019 ◽  
Vol 4 (6) ◽  
pp. 269-278 ◽  
Author(s):  
Gilles Pasquier ◽  
Matthieu Ehlinger ◽  
Didier Mainard

Hinged implants are the most constrained knee replacement prostheses. They are very useful in complex cases of total knee arthroplasty (TKA) revision. Hinged implants have evolved with rotating bearings and modularity that allows local joint reconstruction or segmental bone replacement. They are required when significant instability persists in cases with inadequate collateral ligaments and significant flexion laxity. They are now used when a large bone defect is reconstructed, or when bone fixation of the implant is questionable especially in the metaphyseal zone. The use of hinged implants in TKA revision is associated with high complication rates. Published outcomes differ based on the patients’ aetiology. The outcomes of rotating-hinged implants used in septic revisions or salvage situations are poorer than other types of revision and have a higher complication rate. The poor general health of these patients is often a limitation. Despite these relatively poor results, hinged implants continue to have a place in revision surgery to solve major instability or to obtain stable bone fixation of an implant when the metaphysis is filled with bone grafts or porous devices.Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180070


2019 ◽  
Vol 34 (7) ◽  
pp. S271-S276 ◽  
Author(s):  
Joshua S. Bingham ◽  
Brandon R. Bukowski ◽  
Cody C. Wyles ◽  
Ayoosh Pareek ◽  
Daniel J. Berry ◽  
...  

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0216004
Author(s):  
Jung-Ro Yoon ◽  
Ji-Young Cheong ◽  
Jung-Taek Im ◽  
Phil-Sun Park ◽  
Jae-Ok Park ◽  
...  

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