Total Hip Arthroplasty in Patients With Avascular Necrosis After Hematopoietic Stem Cell Transplantation.

The immunosuppressive regimens required for hematopoietic stem cell transplantation predispose recipients to complications, including avascular necrosis. Cancer-related comorbidities, immunosuppression, and poor bone quality theoretically increase the risk for perioperative medical complications, infection, and implant-related complications in total joint arthroplasty. This study reviewed 20 primary total hip arthroplasties for avascular necrosis in 14 patients.

Same Day Total Hip Arthroplasty Performed at an Ambulatory Surgical Center: 90-Day Complication Rate on 549 Patients.

Background: There is an increasing interest in outpatient total hip arthroplasty (THA), as there are perceived benefits to the patient, insurer, and overall healthcare system. However, the safety of outpatient total joint arthroplasty has not been studied.

Methods: Five hundred forty-nine patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center (ASC) were reviewed.

The economic recession and its effect on utilization of elective total joint arthroplasty.

The United States economy entered a recession in December 2007. This study aims to determine whether the utilization of elective orthopedic surgeries has been impacted by this recession. From January 2007 to December 2009 at a single private practice in New Jersey, 4820 total joint replacement procedures were scheduled, of which 649 of those were cancelled.

Fracture of the proximal tibia after revision total knee arthroplasty with an extensor mechanism allograft.

Extensor mechanism reconstruction with an extensor mechanism allograft (EMA) remains one of the most reliable methods for treating the extensor mechanism deficient total knee arthroplasty. We report 3 patients who were treated with an EMA who sustained a proximal tibial shaft fracture. In all 3 cases, a short tibial component was present that ended close to the level of the distal extent of the bone block.

Early clinical results of a high-flexion, posterior-stabilized, mobile-bearing total knee arthroplasty: a US investigational device exemption trial.

Between May 2001 and June 2004, 388 total knee arthroplasty cases were enrolled in a prospective, randomized, multicenter investigational device exemption trial. Patients received either the investigational high-flexion mobile-bearing knee or a fixed-bearing control. At 2 to 4 years of follow-up, results in 293 patients with degenerative joint disease were compared using Knee Society Assessment and Function scores, radiographic results, complications analysis, and survival estimates.

Clinical results of a modular neck hip system: hitting the "bull's-eye" more accurately.

In this article, we present 2-year clinical results of a modular neck tapered hip stem, based on 634 patients from a 2-center study. Nearly half of the patients in this series required use of a head center location offered by the modular neck stem but not available in a nonmodular stem with an identical body. The modular neck enabled femoral-first preparation, which facilitates establishing the desired total version of the reconstruction.

Survivorship of a low-stiffness extensively porous-coated femoral stem at 10 years.

Unlabelled: A novel low-stiffness extensively porous-coated total hip femoral component was designed to achieve stable skeletal fixation, structural durability, and reduced periprosthetic femoral stress shielding. In short- to intermediate-term clinical review, this implant achieved secure biologic fixation and preserved periprosthetic bone. We retrospectively reviewed all 102 prospectively followed patients (106 implants) with this implant to document the longer-term implant survivorship, clinical function, fixation quality, and periprosthetic bone preservation.

Gull-wing osteotomy for the treatment of the deficient patella in revision total knee arthroplasty.

Reconstruction of the deficient patella remains a challenge in revision total knee arthroplasty. Twelve consecutive patients who had a knee revision in which a nonresurfacable patella was treated with a gull-wing patellar osteotomy were followed using a computerized database. Radiographs revealed successful healing of the osteotomy in all patients with central tracking of the patella in the trochlear groove.

Total hip arthroplasty with a collarless, tapered, fiber metal proximally coated femoral stem: minimum 5-year follow-up.

The purpose of this study was to evaluate the midterm results, osteointegration potential, and implant-related complications of a cementless, collarless, proximally coated, distally tapered femoral hip prosthesis. The clinical and radiographic results for 129 hips in 116 patients after total hip arthroplasty with a Fiber Metal Taper (Zimmer, Inc ,Warsaw, Ind) femoral stem are reported. One hundred twenty-two (95%) hips were available for the minimum of 5 years clinical and radiographic follow-up.

Removal of a well-fixed trabecular metal monoblock tibial component.

The use of porous tantalum (Trabecular Metal; Zimmer, Inc, Warsaw, Ind) in hip and knee reconstruction has become increasingly popular over the past few years. Widespread clinical use of porous tantalum tibial components for primary total knee arthroplasty has been tempered in part by the perceived difficulty in removing this implant after bone ingrowth has occurred. We present an easy, reproducible, and inexpensive technique for removal of a well-fixed Trabecular Metal Monoblock Tibial Component (Zimmer), which has been used in 4 revision knees.

Posterolateral minimal incision for total hip replacement: technique and early results.

There presently exists in the arthroplasty community a new and heightened level of interest in minimally invasive techniques for total joint replacement. Several investigators have published their personal experience with differing techniques, all concluding that there are multiple advantages to this concept for total hip arthroplasty. The author's perception is that the advantages of minimally invasive posterolateral approach total hip arthroplasty are multiple.