The safety implications of achieving high flexion after TKA and the use of high flexion prostheses remain issues of concern. It is possible that different designs have different clinical and radiological results and complications, such as, early aseptic loosening. However, little information is available on the clinical results of TKAs performed using single-radius, high-flex posterior stabilized design. Accordingly, this study was undertaken to document results of single-radius, high-flex posterior stabilized TKAs with minimum 7-year follow-up. From April 2003 to February 2006, 308 patients (455 knees) underwent TKA using single-radius, high-flex posterior stabilized design and among those patients, 251 patients (388 knees) included in this study who were able to be followed up for a minimum 7 year. Clinical results were evaluated using Knee Society Knee scores (KSKS) and Knee Society Function scores (KSFS) at last follow-up. The passive knee flexion was measured using a goniometer before and after surgery. The survival rate of the implants and implant-specific complications such as osteolysis or loosening were investigated. The osteolysis or loosening around the components was recorded according to the Knee Society Radiological scoring System.Background:
Methods:
The robot-assisted cementless total hip arthroplasty has theoretical advantages of providing better fit and mechanical stability of the stem. However, no previous study has been reported on a short stem implantation using surgical robot. We compared early clinical and radiographic results between robotic milling and manual rasping in short stem total hip arthroplasty. We designed a prospective randomized controlled trial to determine whether robot-assisted short stem total hip arthroplasty improves the implant position represented by stem alignment, leg length equality, and reduces the intraoperative and early postoperative complications. A total of 40 patients were enrolled with informed consents and randomly assigned to robotic milling group (20 hips) and manual rasping group (20 hips) by means of a computer-generated random number table. There were no statistically significant differences in the demographics of the patients between the two groupsIntroduction:
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The outcome of previous cemented total hip arthroplasty has been reported to be inferior in renal transplant patients because of poor bone stock resulting from long-term steroid use. Moreover, as renal transplant patients remain on immunosuppressant therapy for life, higher levels of overall morbidity must be considered. We evaluated the mid-term results of cementless total hip arthroplasty in renal transplant recipients with osteonecrosis of the femoral head, and compared those with age and sex matched osteonecrosis patients that had not undergone organ transplantation or been treated with long-term steroid. Between October 1997 and October 2008, 45 consecutive primary cementless total hip arthroplasties were performed in 30 patients with advanced osteonecrosis of the femoral head after renal transplantation. There were 18 males (27 hips) and 12 females (18 hips) of overall mean age 44 years (22 to 68). The clinical and radiographic results of cementless total hip arthroplasty in these 45 hips were compared with those of 96 sex and age-matched osteonecrotic hips of 72 patients that had not undergone organ transplantation or long-term steroid use. Patients were evaluated at surgery and at a mean of 7.2 years (range, 2–13 years) postoperatively.Introduction:
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Ceramic head with titanium-alloy sleeve offers a modular ceramic head solution for the damaged taper in revision total hip arthroplasty (THA). It can also be used in primary THA to reduce the risk of ceramic head fracture. The purpose of the present study was to report the intermediate-term outcomes of primary ceramic-on-ceramic THA with use of ceramic head with titanium-alloy sleeve. We evaluated 244 patients (271 hips) who had undergone primary ceramic-on-ceramic THA with use of BIOLOX® forte 32 mm ceramic head with titanium-alloy sleeve between November 2005 and August 2009. There were 158 males (175 hips) and 86 female (96 hips) patients with a mean age of 55.5 years. Clinical and radiographic evaluation was performed at a mean of 4.6 years (range, 2–7 years) postoperatively.Introduction:
Materials & Methods:
The management strategy regarding optimally addressing polyethylene wear with a well-fixed acetabular shell remains controversial. The purpose of the present study was to document outcomes of cementation of a highly cross-linked polyethylene (PE) liner into a well-fixed acetabular metal shell in 36 hips We identified 37 patients (39 hips) who had undergone revision THA by cementation of a highly cross-linked PE liner into a well-fixed metal shell between June 2004 and April 2009. Of these patients, one (1 hip) died before the end of the 3-year evaluation and another was lost to follow-up. Thus, the study cohort consisted of 35 patients (36 hips). There were 23 males (24 hips) and 12 female (12 hips) patients with a mean age at time of revision surgery of 57.6 years (range, 38–79 years). All operations were performed by a single surgeon using only one type of liner. Clinical and radiographic evaluation was performed at a mean of 6.1 years (range, 3–8 years) postoperatively.Introduction:
Materials & Methods:
We compared the accuracy of the growth remaining
method of assessing leg-length discrepancy (LLD) with the straight-line
graph method, the multiplier method and their variants. We retrospectively
reviewed the records of 44 patients treated by percutaneous epiphysiodesis
for LLD. All were followed up until maturity. We used the modified Green–Anderson
growth-remaining method (Method 1) to plan the timing of epiphysiodesis.
Then we presumed that the other four methods described below were
used pre-operatively for calculating the timing of epiphysiodesis. We
then assumed that these four methods were used pre-operatively.
Method 2 was the original Green–Anderson growth-remaining method;
Method 3, Paley’s multiplier method using bone age; Method 4, Paley’s
multiplier method using chronological age; and Method 5, Moseley’s
straight-line graph method. We compared ‘Expected LLD at maturity
with surgery’ with ‘Final LLD at maturity with surgery’ for each
method. Statistical analysis revealed that ‘Expected LLD at maturity
with surgery’ was significantly different from ‘Final LLD at maturity
with surgery’. Method 2 was the most accurate. There was a significant
correlation between ‘Expected LLD at maturity with surgery’ and
‘Final LLD at maturity with surgery’, the greatest correlation being
with Method 2. Generally all the methods generated an overcorrected
value. No method generates the precise ‘Expected LLD at maturity
with surgery’. It is essential that an analysis of the pattern of
growth is taken into account when predicting final LLD. As many
additional data as possible are required. Cite this article: