Clinical Results and Survivorship of the GENESIS II Total Knee Arthroplasty at a Minimum of 15 Years.

Background: The purpose of this study was to examine the 15-year survivorship and long-term clinical outcomes of the GENESIS II total knee arthroplasty (TKA).

Methods: Patients who underwent TKA with the GENESIS II system between 1995 and 1999 were retrieved from our institutional database. We report a Kaplan-Meier survival analysis as well as Western Ontario and McMaster Universities Arthritis Index, the Short Form Health Survey-12 (SF-12), and the Knee Society Scores at a mean of 16 years.

Radiographic Evaluations of Revision Total Knee Arthroplasty: A Plea for Uniform Assessments.

Thorough radiographic evaluation is necessary for perioperative assessments in revision total knee arthroplasty. There has been a large degree of variability in reporting these findings within the peer-reviewed literature. Our purpose was to evaluate studies that radiographically assessed alignment in the coronal and sagittal plane, patella alignment and thickness, presence and characterization of implant interface, and radiolucency.

Development of a Modern Knee Society Radiographic Evaluation System and Methodology for Total Knee Arthroplasty.

To accompany the new clinical Knee Society Score, a committee was formed to develop an updated radiographic assessment and evaluation system. The purpose is to accumulate radiographic data in a standardized manner to facilitate more accurate interpretation, documentation and clinical correlation. We systematically reviewed the TKA radiographic evaluation literature as well as the original Knee Society Radiographic Evaluation and Scoring System.

The Knee Society Short Form Reduces Respondent Burden in the Assessment of Patient-reported Outcomes.

Background: The patient's own evaluation of function and satisfaction is a fundamental component of assessing outcomes after total knee arthroplasty (TKA). The new Knee Society Knee Score was introduced in 2012 and has been shown to be a valid and reliable instrument for measuring the outcome of TKA. This score combines an objective, physician-derived component and a patient-reported component to characterize the expectations, satisfaction, and functional activities of diverse lifestyles of contemporary patients undergoing TKA.

Ten-year results comparing posterior cruciate-retaining versus posterior cruciate-substituting total knee arthroplasty.

We compared the 10-year survival rates and clinical outcomes of posterior cruciate-retaining (CR) versus posterior cruciate-substituting (CS) total knee arthroplasty (TKA), using the Genesis II knee system (Smith and Nephew, Memphis, TN). Our institutional database identified patients undergoing a primary knee with the Genesis II system between 1995 and 2000. These patients were followed for an average of 12.

Feasibility, effectiveness and costs associated with a web-based follow-up assessment following total joint arthroplasty.

The purpose of this study was to assess the feasibility, effectiveness and costs of a web-based follow-up compared to in-person assessment following primary total hip or total knee arthroplasty. Patients who were at least 12 months postoperative were randomized to follow-up method. We excluded patients who had revision surgery, osteolysis, complications or identified radiographic issues.

The fate of the remaining knee(s) or hip(s) in osteoarthritic patients undergoing a primary TKA or THA.

The purpose of this study was to determine the fate of the remaining hip(s) and knee(s) following an initial total hip or knee arthroplasty in 5352 patients with idiopathic osteoarthritis who were followed for a minimum ten years (mean 17.8 ± 5.7 years).

Joint replacement recipients' views about health information privacy.

Background: Researchers are concerned about the possibility of restricted access to data as a result of specific consent requirements in privacy legislation, potentially resulting in smaller samples and a lack of representativeness which could bias results. In addition, there is uncertainty about what influences individuals to give consent for the use of their personal health information.

Objective: To measure joint replacement recipients' health information privacy views and to assess potential predictors of these views.

A randomized trial comparing acetabular component fixation of two porous ingrowth surfaces using RSA.

Several new porous ingrowth surfaces for acetabular component fixation have recently been developed. The purpose of this study was to compare the in vivo fixation achieved by two different porosity ingrowth surfaces using radiostereometric analysis (RSA). Sixty-two patients undergoing primary total hip arthroplasty (THA) were randomized to receive a cementless acetabular component with either a 61% high porosity asymmetric titanium porous surface (StikTite, Smith and Nephew, TN, USA) or a 45% low porosity sintered bead porous surface (Roughcoat, Smith and Nephew, TN, USA).

Measurement of joint kinematics using a conventional clinical single-perspective flat-panel radiography system.

Purpose: The ability to accurately measure joint kinematics is an important tool in studying both normal joint function and pathologies associated with injury and disease. The purpose of this study is to evaluate the efficacy, accuracy, precision, and clinical safety of measuring 3D joint motion using a conventional flat-panel radiography system prior to its application in an in vivo study.

Methods: An automated, image-based tracking algorithm was implemented to measure the three-dimensional pose of a sparse object from a two-dimensional radiographic projection.

Twenty-three-year outcome of the porous coated anatomic total hip replacement: a concise follow-up of a previous report.

We previously reported the ten to fourteen-year results for 311 Porous Coated Anatomic total hip replacements that had been inserted by two surgeons in 279 patients. The purpose of the present report is to update that study and to report the outcome beyond twenty years. The patients were followed prospectively with clinical assessment with use of the Harris hip score and radiographic analysis, and the results were collected in a database.

The minimum 10-year results of a second-generation cementless acetabular shell with a polished inner surface.

The purpose of this prospective study was to evaluate the minimum 10-year outcomes and survivorship of the Reflection shell with a polished inner surface and an improved locking mechanism. Three hundred sixty-three total hip replacements with a mean follow-up of 11.6 years (range, 10.

Development of a new Knee Society scoring system.

Background: The Knee Society Clinical Rating System was developed in 1989 and has been widely adopted. However, with the increased demand for TKA, there is a need for a new, validated scoring system to better characterize the expectations, satisfaction, and physical activities of the younger, more diverse population of TKA patients.

Questions/purposes: We developed and validated a new Knee Society Scoring System.

How do CAD models compare with reverse engineered manufactured components for use in wear analysis?

Background: To accurately quantify polyethylene wear in retrieved arthroplasty components, the original geometry of the component must be estimated accurately using a reference geometry such as a computer-aided design (CAD) model or a never-implanted insert. However, differences may exist between the CAD model and manufactured inserts resulting from manufacturing tolerances.

Questions/purposes: We quantified the deviations between CAD models and newly manufactured inserts and determined how these deviations compared with using a never-implanted insert as a reference geometry.

Comparison of total hip arthroplasty performed with and without cement: a randomized trial. A concise follow-up, at twenty years, of previous reports.

Total hip arthroplasty has been associated with excellent implant survival rates, but debate remains concerning the best fixation method for the components. A randomized controlled trial, which included 250 patients (mean age, sixty-four years) with osteoarthritis who were managed with total hip arthroplasty between October 1987 and January 1992, was conducted to compare the results of fixation with and without cement. Patients were followed for a mean of twenty years (range, seventeen to twenty-one years).

Retrieval analysis of modular total knee replacements: factors influencing backside surface damage.

Retrieved knee implants were examined to investigate the influence of patient and implant related factors on backside damage. Fifty-two implants of three different models were examined that all had cemented tibial trays without screw holes. A semi-quantitative grading system supplied backside damage scores (BDS) for each polyethylene (PE) tibial insert.

Results of cemented femoral revisions for periprosthetic femoral fractures in the elderly.

The treatment goals of Vancouver type B2 periprosthetic femoral fractures in elderly patients with a limited life expectancy are early weight bearing without compromising the fracture healing. Thirty-one patients with a mean age of 82 years were treated with a long cemented stem with additional allograft or plate fixation, followed by immediate full weight bearing. Seven major complications occurred within the first 3 months postoperatively.

Posterior condyle surface damage on retrieved femoral knee components.

Twenty-two retrieved femoral knee components were identified with posterior condyle surface damage on average at 99° flexion (range, 43°-135° flexion). Titanium alloy material transfer and abrasive surface damage were evident on cobalt-chromium alloy femoral components that were in contact with titanium alloy tibial trays. Surface damage on the retrieved Oxinium femoral components (Smith and Nephew, Inc, Memphis, Tenn) that were in contact with titanium alloy tibial trays showed gouging, associated with the removal and cracking of the oxide and exposure of the zirconium-niobium alloy substrate.

Midterm results of 506 solid trispiked reflection cementless acetabular components for primary total hip arthroplasty.

The purpose of this prospective study was to evaluate the outcomes and survivorship of a trispiked, sintered bead-coated titanium shell with a polished inner surface, no screw holes, and an improved locking mechanism. A total of 506 total hip arthroplasties with a minimum 5-year follow-up were available for review at a mean of 7 years (range, 5-11 years). Three sockets (0.

Total knee arthroplasty following medial opening wedge tibial osteotomy: technical issues early clinical radiological results.

Medial opening wedge high tibial osteotomy is a popular treatment option for medial compartment osteoarthritis of the knee. One of the proposed advantages is easier conversion to a total knee replacement compared to lateral closing wedge osteotomies, although there are few studies to support this. We reviewed the technical considerations in 36 knees in which conversion of a medial opening wedge osteotomy to total knee arthroplasty was performed, and contrasted these to previously reported studies of knee arthroplasty after closing lateral wedge or dome osteotomies.

Cemented versus cementless stems: a verdict is in.

The purpose of this randomized clinical trial was to compare the >20-year outcomes of cemented (n=124) versus cementless (n=126) total hip replacements (THRs) in patients with end-stage, unilateral hip osteoarthritis. At 20 years, 168 patients (67%) were available for follow-up, 78 (31%) had died, and 4 (2%) were lost. A power analysis was performed to determine the number of patients needed in each study cohort.

What works best, a cemented or cementless primary total hip arthroplasty?: minimum 17-year followup of a randomized controlled trial.

Background: Total hip arthroplasty (THA) has been associated with high survival rates, but debate remains concerning the best fixation mode of THA.

Questions/purposes: We conducted a randomized controlled trial (RCT) with 250 patients with a mean age of 64 years between October 1987 and January 1992 to compare the results of cementless and cemented fixation.

Patients And Methods: Patients were evaluated for revision of either of the components.