Search

Background The aim of our prospective multicentre study is to evaluate the five-year follow-up outcomes of primary reverse shoulder replacement utilizing two different designs of glenoid baseplates. Methods There were 159 reverse shoulder replacements (91 cemented and 68 uncemented stems, 67 Trabecular Metal baseplates and 92 Anatomical Shoulder baseplates in 152 patients (99 women) with a mean age of 74.5 (58–90) years. The principal diagnosis was rotator cuff arthropathy in 108 shoulders. Results Clinical and functional results improved significantly overall; the adjusted Constant Murley score improved from 28.2 ± 13.3 pre-operatively to 75.5 ± 22.8 ( p Conclusions Reverse total shoulder arthroplasty restores the function in shoulder with significant improvements in function and moderate complications with minor differences between both designs of baseplates that were not reflected clinically.

INTRODUCTION Haemophilic ankle arthropathy is caused by recurrent spontaneous joint haemorrhaging and leads to pain, deformity and loss of function. In the presence of advanced articular deterioration, therapeutic options are confined to either arthroplasty or arthrodesis, the latter still being referred to as the procedure of choice. However, total ankle replacement (TAR) has recently gained acceptance as an alternative. AIM To investigate the mid- to long-term results of TAR in haemophilic ankle arthropathy. MATERIALS AND METHODS Seventeen TARs in 14 male patients (mean age: 43 years [range, 27.4-57.6]), implanted between 1998 and 2012, were retrospectively analysed. Implant survival was estimated using Kaplan-Meier analysis. Haemophilic/viral status, complications and revision surgeries were recorded. Follow-up assessment of 12 TARs was performed 9.6 years (range, 3.3-17.8) postoperatively, including clinical examination, pain and satisfaction scales, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and the SF-36. Radiographic evaluation of pre- and follow-up radiographs was conducted. RESULTS Estimated implant survival was 94% at 5, 85% at 10 and 70% at 15 years, respectively. Three cases required revision surgery. At follow-up, 9.6 years (range, 3.3-17.8) postoperatively, the level of satisfaction was 76% (range, 50-100) and of pain 2/10 (range, 0-6) on the VAS. Range of motion had increased significantly (P = .037). The SF-36 summary scores were comparable to those of a matched standard population. The AOFAS hindfoot score averaged 81 points (range, 73-90). All radiographs revealed component loosening or periprosthetic radiolucency. CONCLUSION Total ankle replacement in the presence of advanced haemophilic arthropathy is a viable treatment option with favourable mid-/long-term results, maintaining mobility of the ankle joint.

BACKGROUND Anatomic factors associated with static posterior translation of the humeral head with or without glenohumeral osteoarthritis are unknown. We tested the hypothesis that there is an association between glenoid wear, glenoid version, and/or anteroposterior acromial tilt. METHODS Ninety-nine patients with glenohumeral joint degeneration involving advanced glenoid cartilage wear and/or rotator cuff disease scheduled for anatomic or reverse total shoulder replacement underwent standardized conventional radiographic and computed tomographic shoulder imaging. Measurements included glenoid version, humeral torsion, posterior acromial slope, and critical shoulder angle. The glenoid shape was classified according to Walch et al, and the integrity of the rotator cuff was assessed. RESULTS Patients with glenoid type B2 or C had a median of 4° more glenoid retroversion (P = .022), a 5° less steep acromion (posterior acromial slope, 61° vs 56°; P = .004), and a higher combined score (glenoid version minus slope; odds ratio, 0.93 [95% confidence interval, 0.89-0.97]; P

Injection drug users are at high risk for both infection with blood-borne pathogens, namely, human immune deficiency virus (HIV), hepatitis-B, -C virus, various bacterial infections, as well as early primary and secondary joint degeneration. When total knee arthroplasty (TKA) is anticipated the risk of septic complications is a major concern. The purpose of this study was to assess the clinical and radiographic outcome of patients with a history of intravenous drug use after total knee arthroplasty. The primary outcome was revision rate. Secondary outcomes were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Knee Society Score (KSS) and radiographic loosening. We retrospectively reviewed the records of 1,692 TKA performed or revised in our institution. Data of 18 TKA in 12 patients (11 male, 1 female; average age 42, range 23–62 years) with a history of intravenous opioid abuse were available for final analysis. The mean follow up was 125 (range 25–238) months. Seven patients required revision surgery due to periprosthetic joint infection after 62 months (range 5–159): one two staged revision, three arthrodesis and three amputations. The median prosthesis survival was 101 (95%-CI 48–154) months. Total knee arthroplasty in patients with a history of intravenous drug abuse is associated with major complications, including above-the-knee amputation. If permanent abstinence from intravenous drug abuse is doubtful, other therapeutic options including primary arthrodesis should be considered.

Category: Ankle Arthritis Introduction/Purpose: Hemophilia is a rare hematological disease associated with spontaneous joint hemorrhaging causing hemophilic arthropathy. Symptoms comprise joint pain and deformity, paired with loss of function. In the presence of advanced joint deterioration, therapeutic options are confined to either arthroplasty or arthrodesis. For the ankle, the latter is still referred to as the procedure of choice. However - in light of its capacity to reduce pain while preserving ankle motion - total ankle replacement (TAR) has recently gained acceptance as an alternative. The aim of this study was to investigate the mid- to long-term results of TAR in hemophilic ankle arthropathy. Methods: Seventeen TARs were implanted between 1998 and 2012 (mean age: 43 years). Preoperative demographic and disease specific data, complications and revision surgeries were recorded. With a mean follow-up of 9.3 years (range, 2.2-17.8) implant survival was estimated using Kaplan-Meier analysis. Follow-up assessment of 12 TARs was performed after 9.6 years (5 lost to follow-up). Satisfaction and pain scales, the AOFAS hindfoot-score, and the SF-36 were obtained to assess clinical outcome. Radiographic evaluation of pre- and follow-up radiographs was conducted. Results: Three cases (17.6%) had undergone TAR removal secondary to loosening at an average interval of 7.5 years. The estimated implant survival was 94% at 5, 85% at 10, and 70% at 15 years (95% CI, 11.9-17.7). The mean estimated implant survival was 14.77 years (95% CI, 11.9-17.7). The mean level of satisfaction was 76%, and of pain 2/10 (VAS). ROM had increased significantly (p=0.037). The SF-36 summary scores were comparable to those of a matched standard population. The AOFAS hindfoot-score averaged 81/100 points. Conclusion: TAR is a viable treatment option for advanced hemophilic ankle arthropathy. Based on the herein presented follow- up, implant survival compares to that of non-hemophilic populations. Clinical mid- to long-term results are favorable. However, the majority of follow-up radiographs revealed component loosening and/or periprosthetic lucency. Considering the study population’s young age and specific risk factors, need for revision surgery secondary to symptomatic component loosening may arise.