RESUMEN
Remote monitoring of patient activity following total knee arthroplasty has grown in popularity over the past decade. Recent technological advances have allowed for implantation of accelerometry devices within the tibial stem for remote monitoring of mobility postoperatively. Remote monitoring is suggested to allow for intervention in the case of events that may occur outside of regular follow-up appointments or traditional patient questionnaires. This report details the ability of an implanted tibial sensor to continuously collect objective mobility data allowing the orthopaedic surgeon to intervene beyond the standard 90-day episode of care.
RESUMEN
This retrospective study investigated the modes of implant failure in 80 patients with modular oncology knee prostheses. Twenty patients (25%) required revision: 12 (60%) for stem loosening, 6 (30%) for bearing failure, and 2 (10%) for infection. Patients with bone sarcomas survived longer; however, long-term prosthetic survivorship was a problem. A higher failure rate was found in patients with tibial tumors and with adjuvant treatment of chemotherapy. This study demonstrates for improved long-term survivorship of modular oncology knee prostheses, there must be improvement in the methods of stem fixation, prosthetic materials, and bearing mechanics.
Asunto(s)
Artroplastia de Reemplazo de Rodilla/instrumentación , Artroplastia de Reemplazo de Rodilla/mortalidad , Neoplasias Óseas/mortalidad , Neoplasias Óseas/cirugía , Inestabilidad de la Articulación/mortalidad , Inestabilidad de la Articulación/cirugía , Prótesis de la Rodilla/estadística & datos numéricos , Falla de Prótesis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Illinois/epidemiología , Articulación de la Rodilla/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia , Tasa de Supervivencia , Adulto JovenRESUMEN
Metal-on-metal total hip resurfacing is a bone-conserving reconstructive option for patients with advanced articular damage. While intended to address several problems with conventional THA, the safety and efficacy is not well established. We therefore retrospectively compared the outcomes of 52 patients (57 hips) with resurfacing arthroplasty to 84 patients (93 hips) with cementless primary THAs. The patients had a minimum 2-year followup (mean 3 years). The patients with resurfacing arthroplasty had a mean age of 47 years (range, 22-64) while those with cementless primary THA had a mean age of 57 years (range, 17-92). After controlling for age, gender, and preoperative differences, the total Harris Hip Scores (HHS), function scores, and pain scores were similar between the two groups. However, the resurfacing group had higher activity scores (14 versus 13, p < 0.001) and range of motion (ROM) scores (5.0 versus 4.8, p < 0.001). The complication rates (5.3% for resurfacing versus 14.0% for THA) and reoperation rates (3.5% for resurfacing versus 4.3% for THA) were similar. The total hip arthroplasty and metal-on-metal resurfacing groups both showed improvement in HHS, pain, activity, and ROM and had similar early complication and reoperation rates.