The Journal of arthroplasty
-
Multicenter Study
Revision of unicompartmental arthroplasty to total knee arthroplasty: not always a slam dunk!
As the number of UKA performed in the world continues to increase, so will the number of failures. A better understanding of the outcomes after revision UKAto TKA is warranted. The objective of this study is to report the outcomes of modern UKA revised to TKA in three US centers. ⋯ In the present series, the re-revision rate after revision TKA from UKA was 4.5 % at an average of 75 months or 1.2 revisions per 100 observed component years. Compared to published individual institution and national registry data, re-revision of a failed UKA is equivalent to revision rates of primary TKA and substantially better than re-revision rates of revision TKA. These data should be used to counsel patients undergoing revision UKA to TKA.
-
Multicenter Study
Are metal ion levels a useful trigger for surgical intervention?
The purpose of this study was to determine if cobalt and chromium ion levels can predict soft tissue damage at total hip revision. This study included 90 metal-on-metal total hip patients with preoperative cobalt and chromium ion levels. Tissue damage noted at revision surgery was graded on a 4-point scale. ⋯ The area under the curve was 0.37 for cobalt and 0.44 for chromium. The length of time to revision significantly correlated with tissue damage (P = .001). Ion levels are unreliable predictors of periarticular soft tissue damage and should not be used in isolation as surgical intervention triggers.
-
Multicenter Study
Clinical outcome of the metal-on-metal hybrid Corin Cormet 2000 hip resurfacing system: an up to 11-year follow-up study.
This report extends the follow-up for the largest center of the first multicenter US Food and Drug Administration investigational device exemption study on metal-on-metal hip resurfacing arthroplasty up to 11 years. A single surgeon performed 373 hip resurfacing arthroplasties using the hybrid Corin Cormet 2000 system. The Kaplan-Meier survivorship at 11 years was 93% when revision for any reason was used as an end point and 91% if radiographic failures were included. ⋯ Loosening of the cemented femoral components was the most common source of failure and occurred at all follow-up intervals. A learning curve that persisted for at least 200 cases was confirmed. All femoral neck fractures occurred before 6 months postoperatively.
-
Multicenter Study Comparative Study
Early return to function after hip resurfacing: is it better than contemporary total hip arthroplasty?
Our hypothesis was that return of function for young patients undergoing resurfacing total hip arthroplasty (THA) with metal-on-metal bearings or contemporary THA with ceramic bearings would be comparable. Results from 337 unilateral hip resurfacing patients were compared with results from 266 unilateral ceramic-on-ceramic THA patients. ⋯ However, the public perception of improved functional capabilities was not demonstrated in this patient population. Resurfacing patients may be more impaired (slightly higher pain scores/lower function scores) than their THA counterparts in the early postoperative period, but these differences disappear by 24 months when both groups report Harris Hip Scores in the excellent range.
-
Multicenter Study Comparative Study
Hospital outcome after emergent vs elective revision total hip arthroplasty.
This is a retrospective review of inpatient outcomes, based upon emergent or elective admission for revision total hip arthroplasty (THA) procedures performed between 2000 and 2006. Three hundred forty-two revision THA procedures (291 elective, 51 emergent) were identified. ⋯ We identified 2 basic outcome measures suggesting that patients undergoing emergent revision will have a more complex hospitalization and require more assistance at discharge. Clarifying emergent vs elective THA at admission may assist in better planning and assessment of patient needs regarding rehabilitation, hospital management, and discharge planning.