The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2014
Multicenter Study Comparative StudyIntermediate-term results of total ankle replacement and ankle arthrodesis: a COFAS multicenter study.
Surgical treatments for end-stage ankle arthritis include total ankle replacement and ankle arthrodesis. Although arthrodesis is a reliable procedure, ankle replacement is often preferred by patients. This prospective study evaluated intermediate-term outcomes of ankle replacement and arthrodesis in a large cohort at multiple centers, with variability in ankle arthritis type, prosthesis type, surgeon, and surgical technique. We hypothesized that patient-reported clinical outcomes would be similar for both procedures. ⋯ Intermediate-term clinical outcomes of total ankle replacement and ankle arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; rates of reoperation and major complications were higher after ankle replacement.
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J Bone Joint Surg Am · Jan 2014
Risk of total knee arthroplasty after operatively treated tibial plateau fracture: a matched-population-based cohort study.
The aims of operative treatment of displaced tibial plateau fractures are to stabilize the injured knee to restore optimal function and to minimize the risk of posttraumatic arthritis and the eventual need for total knee arthroplasty. The purpose of our study was to define the rate of subsequent total knee arthroplasty after tibial plateau fractures in a large cohort and to compare that rate with the rate in the general population. ⋯ Ten years after tibial plateau fracture surgery, 7.3% of the patients had had a total knee arthroplasty. This corresponds to a 5.3 times increase in likelihood compared with a matched group from the general population. Older patients and those with more severe fractures are also more likely to need total knee arthroplasty after repair of a tibial plateau fracture.
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J Bone Joint Surg Am · Jan 2014
Calcaneal stress fracture: an adverse event following total hip and total knee arthroplasty: a report of five cases.
Stress fractures have been reported to occur in the pubis, femoral neck, proximal part of the tibia, and fabella during the postoperative period following total knee or total hip arthroplasty. However, to our knowledge, calcaneal stress fractures after total hip or total knee arthroplasty have not been reported in the English-language literature. Most orthopaedic surgeons are not familiar with calcaneal stress fractures that may occur in elderly patients after a total knee or total hip arthroplasty. ⋯ Calcaneal stress fractures during the postoperative period following total knee or total hip arthroplasty may not be as rare as previously thought. Because clinical symptoms of the fracture appear insidiously and radiographic findings are absent or subtle in the early stage, a high index of suspicion is needed for orthopaedic surgeons to make the correct diagnosis. Magnetic resonance imaging or repeated radiographs may be necessary to make the correct diagnosis when no abnormality is apparent on the initial radiograph.
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J Bone Joint Surg Am · Jan 2014
Gain in spinal height from surgical correction of idiopathic scoliosis.
A relationship between spinal distraction and correction of the curvature of scoliosis has long been recognized. While attempts have been made to define the height that is lost with progression of scoliosis, much less information is available to define the height that is gained as a result of surgical correction of the curve and to quantify additional spinal growth after spine fusion. ⋯ Patients undergoing surgical correction of idiopathic scoliosis gain substantial height related to the magnitude of surgical correction, the number of levels fused, and preoperative stature. Continued spine growth by two years after surgery is associated with shorter fusions, skeletal immaturity, young age, and male sex. Height gain is a quantifiable outcome of the surgical correction of scoliosis.
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J Bone Joint Surg Am · Jan 2014
One-stage exchange arthroplasty for chronic periprosthetic hip infection: results of a large prospective cohort study.
Exchange arthroplasty of one or two stages is required for the treatment of chronic periprosthetic joint infections. Two-stage exchange is costly and has high morbidity with limited patient mobility between procedures. One-stage exchange has been promoted by several European teams as the preferred alternative. The aim of this study was to prospectively analyze the outcome of patients with a periprosthetic hip infection treated with one-stage exchange arthroplasty. ⋯ One-stage exchange arthroplasty is an effective surgical procedure in patients with periprosthetic hip infection who have good bone quality. Precise identification of the microorganism(s) and prolonged administration of appropriate intravenous antibiotic therapy are key factors for successful treatment.