Journal of long-term effects of medical implants
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J Long Term Eff Med Implants · Jan 2014
Comparative StudyPrevalence of post-traumatic osteoarthritis in morbidly obese patients after acetabular fracture fixation.
Morbid obesity and osteoarthritis are conditions that place a significant burden on the US healthcare system. Acetabular fracture is a known cause of post-traumatic osteoarthritis (PTOA) and morbid obesity contributes to the development of osteoarthritis. This study aimed to determine the prevalence of PTOA in morbidly obese patients who underwent acetabular fracture fixation. ⋯ Morbid obesity appears to pose a significantly increased risk for the development of PTOA after fixation of acetabular fractures.
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J Long Term Eff Med Implants · Jan 2013
Viscosupplementation for knee osteoarthritis: current evidence and recommendations.
Osteoarthritis (OA) is the most common joint disorder worldwide and is a leading cause of pain and disability. Appropriate management of younger patients with milder disease remains a challenging area of intense research. Viscosupplementation attempts to restore the biomechanical and biochemical functions of normal synovial fluid hyaluronic acid. ⋯ Major clinical guidelines provide inconclusive recommendations. Viscosupplementation may be a viable option in younger patients with milder OA where other non-operative modalities are also only modestly successful, but further investigation is clearly warranted. Limitations due to study heterogeneity, outcome reporting, and bias can each be addressed with improved research methodology.
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J Long Term Eff Med Implants · Jan 2013
Comparative StudyCost-effectiveness of unicompartmental knee arthroplasty, high tibial osteotomy, and KineSpring® Knee Implant System for unicompartmental osteoarthritis of the knee.
Osteoarthritis (OA) of the knee is a condition that causes pain and disability. Numerous non-surgical and surgical interventions are available for individuals with OA that result in good pain relief and return of function. The purpose of this economic analysis was to determine the cost-effectiveness of high tibial osteotomy (HTO), unicompartmental knee arthroplasty (UKA) and the KineSpring® Knee Implant System in the treatment of unicompartmental OA of the knee 10 years post-surgery, considering the costs of revisions, conversions, removals, and complications. ⋯ Our analysis demonstrates that the KineSpring System, despite a greater initial cost in surgery, has significantly smaller conversion and complication costs compared to UKA and HTO. The 10 years overall expected cost for the KineSpring System ($12,559) is significantly less compared with that of UKA ($17,570) and HTO ($22,825). Future economic analyses regarding this topic should also consider the cost-effectiveness of these procedures on younger, more active individuals who are still working and should take into account productivity loss.
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J Long Term Eff Med Implants · Jan 2013
Comparative StudyPatient activity after total hip arthroplasty: a comparison of three different bearing surfaces.
Patients who receive hip arthroplasty today desire prostheses that not only have great longevity, but are also suitable for a very active lifestyle. Advances in metallurgy, tribologic behavior, surgical technique, as well as improvements in strength and microstructure, have made ceramic-on-ceramic and metal-on-metal bearings available for young patients requiring a great deal of mobility. The purpose of this study was to assess if the bearing surface had an effect, if any, on postoperative activity levels and clinical outcomes in patients receiving three different types of hip arthroplasty. ⋯ The mean postoperative Harris hip scores (94 vs 92 vs 91 points), patient satisfaction scores (9 vs 8.4 vs 8.3 points), aseptic revision (3% vs 0% vs 0%), and complication rates (3% vs 3% vs 3%) were similar between resurfacing, ceramic-on-ceramic, and metal-on-polyethylene bearing groups, respectively. This study showed that in cohorts of similarly matched arthroplasty patients in multiple demographics factors and preoperative activity levels, metal-on-metal resurfacing arthroplasty may offer higher postoperative activity levels. For patients with higher activity levels, resurfacing arthroplasty may be advantageous compared to other types of bearings.
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J Long Term Eff Med Implants · Jan 2012
ReviewInstrumentation related complications in spine surgery.
Spinal instrumentation constructs are frequently necessary for the surgical management of patients with variable spinal pathology. However, surgical complications may appear. These should be detected early and managed to achieve recovery and good functional outcome for the patient. This article provides an in-depth analysis of the most common instrumentation-related complications of spine surgery as well as a diagnostic plan and treatment options for the management of these challenging entities once they occur.