Early Tibial Component Fractures in a Cementless, 3D-Printed, Titanium Implant.

Fracture of the tibial baseplate in total knee arthroplasty is a rare occurrence, particularly in short- and mid-term follow-up. This case series documents the first known report in the literature of fatigue fracture of a cementless, 3D-printed, highly porous titanium tibial component. We recommend regular follow-up visits with radiographs to confirm adequate total knee arthroplasty component positioning and alignment.

A new technique for articulated cement spacers in infected total knee arthroplasty.

Chronically infected total knee arthroplasty (TKA) represents a surgical challenge with many potential complications. The standard of care is a 2-stage reimplantation. This report describes a modification of the first stage using the protocol described by Hofmann and colleagues in 1995.

Maximizing surgeon and hospital total knee arthroplasty volume using customized patient instrumentation and swing operating rooms.

To meet the needs of increasing demand for total knee arthroplasty, the individual surgeon must focus on improving proficiency and volume. Improved efficiencies in total joint arthroplasty (TJA) have many benefits beyond meeting the increasing demand by patients for joint replacement, however. Surgeons and institutions that perform a higher volume of TJAs have lower rates of mortality, complications, and readmissions compared with surgeons and institutions that perform a lower volume of TJAs.

Fracture of a cross-linked polyethylene liner due to impingement.

We report a case of fracture at 2 years after implantation of a 50-kGy moderately cross-linked ultrahigh molecular weight polyethylene liner with an extended lip (Marathon, DePuy, Warsaw, IN). The extended lip section had fractured. The liner showed no oxidation.

Hip resurfacing arthroplasty: risk factors for failure over 25 years.

Unlabelled: Many early metal-on-polyethylene hip resurfacing arthroplasty designs were abandoned after reports of high short-term and midterm failure rates. To investigate factors associated with failure, we retrospectively reviewed our experience with early-design hip resurfacing implants in 75 patients during a 25-year period (median followup, 7.9 years; range, 0.

Use of a custom stemless anatomic femoral component for an incarcerated femoral reamer.

Most modern femoral components used in total hip arthroplasty have stems that engage a certain length of the femoral diaphysis. Retained hardware can pose a problem with placement of the femoral component during total hip arthroplasty and often require removal. A patient presented for total hip arthroplasty with a retained reamer in the proximal femur from a previous revision knee arthroplasty.

Impaction grafting using a cemented porous-coated modular acetabular component.

Reconstruction of major acetabular defects continues to challenge surgeons. There are many surgical options for these situations, including oversized hemispherical cups, oblong cups, acetabular cages, bulk allografts, and impaction allografting. We present the case of a modification to the impaction grafting technique for acetabular reconstruction.

Hybrid total knee arthroplasty analysis of component failures at an average of 15 years.

Hybrid total knee arthroplasty in which the femoral component is cementless and the tibial component is cemented remains controversial. We report on the long-term results of 65 total knee arthroplasties followed for an average of 15 years. There were 18 revisions (27%); of these, 11 were femoral component revisions.

Cemented total knee arthroplasty using a modern prosthesis in young patients with osteoarthritis.

Fifty-two consecutive cemented total knee arthroplasties were performed using the Press-Fit Condylar (DePuy, Warsaw, Ind) knee system on patients aged 55 years or younger at Mayo Clinic Rochester from 1988 to 1994. Patients were followed for a minimum of 10 years, with an average follow-up of 12 years (range, 10-15 years). There were 8 total revisions (15%), including 2 revisions before 10 years, one for sepsis at 1 year, and one for instability at 8 years.

Fatigue failure of the GAP ring.

This study reports the results and early failures using the Graft Augmentation Prosthesis ring in the reconstruction of acetabular defects encountered during total hip arthroplasty. Seventeen consecutive Graft Augmentation Prosthesis rings were used during 7 complex primary and 10 revision hip arthroplasties. Five patients died during the follow-up period.

Case report: Endometrioma of the abdominal wall.

We present the case of a 39-year-old woman with a 2- to 3-month history of a soft tissue mass involving the abdominal wall and increasing symptoms that fluctuated relative to her menses. Magnetic resonance imaging showed a hemorrhagic multiloculated mass within the rectus abdominus muscle. Correlation of the clinical history and imaging finding suggested a preoperative diagnosis of endometrioma of the abdominal wall.

Polished vs rough femoral components in grade A and grade C-2 cement mantles.

The ideal surface for cemented femoral components remains controversial. Six polished stems were compared with 6 rough stems both with good cement mantle and also with poor cement mantles in a stair-climbing model. With good cement mantles, both the polished and the rough stems were loose by 6 million cycles.

Surgical planning of total hip arthroplasty: accuracy of computer-assisted EndoMap software in predicting component size.

Purpose: The purpose of our study was to assess the accuracy of a computer-assisted templating in the surgical planning of patients undergoing total hip arthroplasty utilizing EndoMap software (Siemans AG, Medical Solutions, Erlangen, Germany). Endomap Software is an electronic program that uses DICOM images to analyze standard anteroposterior radiographs for determination of optimal prosthesis component size.

Methods: We retrospectively reviewed the preoperative radiographs of 36 patients undergoing uncomplicated primary total hip arthroplasty, utilizing EndoMap software, Version VA20.

Long-term results of total knee arthroplasty in young patients with rheumatoid arthritis.

Forty-seven cemented total knee arthroplasties in 32 patients with rheumatoid arthritis who were 55 years or younger (average, 43) were followed until death or a minimum of 15 years. The average follow-up was 18 years. There were 6 revisions; 5 of 6 revisions had severe polyethylene wear and osteolysis.

Primary uncemented Harris-Galante acetabular components in patients 50 years old or younger: results at 10 to 12 years.

Seventy-three patients (84 hips) 50 years or younger were treated with primary total hip arthroplasty using the Harris-Galante uncemented acetabular component. At a median followup of 10 years, there were seven acetabular metal shell revisions: five for osteolysis and one each for aseptic loosening and dislocation. There were 10 polyethylene exchanges without metal acetabular shell removal.