The use of mega-joint prostheses has become common practice in the field of reconstructive orthopedic surgery. These new implants are considered as the gold standard for reconstruction after joint and periarticular tumor and bone resections. The placement of these prostheses makes it possible, compared to an amputation, to preserve the pathological limb, but also to be able to ensure a solid assembly allowing immediate support and a quick functional recovery. However, the incidence of various complications following the placement of these implants remains higher compared to conventional joint replacement surgery. The most frequent can be classified into two distinct categories: mechanical and non-mechanical complications.
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J Arthroplasty
January 2025
Department of Orthopaedic Surgery, Division of Lower Limb Reconstruction, University of British Columbia, Vancouver, British Columbia, Canada.
Background: Pelvic discontinuity (PD) poses a difficult challenge in revision total hip arthroplasty (rTHA). There is a paucity of evidence assessing five- to ten-year outcomes of cup cages for PD. This study aimed to review the survivorship and outcomes of cup-cage constructs for PD.
View Article and Find Full Text PDFJ Biomech
January 2025
Radboudumc, Orthopaedic Research Lab, PO Box 9101, 6500 HB Nijmegen, the Netherlands.
Aseptic loosening is the primary cause of revision in cementless total knee arthroplasty (TKA), emphasizing the importance of strong initial stability for long-term implant success. Pre-clinical evaluations are crucial for understanding implant fixation mechanics and improving implant designs. Finite element (FE) analysis models often use linear elastic bone material models, which do not accurately reflect bone's mechanical behavior.
View Article and Find Full Text PDFKnee
December 2024
Orthopedic Surgery and Traumatology, Hospital Clínic de Barcelona, Barcelona, Spain.
Distal femoral replacement (DFR) with megaprostheses is a salvage revision total knee arthroplasty (rTKA) procedure indicated in cases with massive bone defects in the distal femur. As long as these implants achieve fixation only in the diaphysis, the high aseptic loosening rate reported in some series is probably related to a lack of rotational stability. Two patients with extensive distal femoral bone defects with preservation of the metaphyseal-diaphyseal junction underwent rTKA.
View Article and Find Full Text PDFJSES Rev Rep Tech
February 2025
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Background: Revision reverse total shoulder arthroplasty (rTSA) of a previously cemented humeral component is challenging. In hip arthroplasty, the cement-within-cement (CwC) technique has been well described as an effective option. However, for shoulder arthroplasty there remains a paucity of data investigating this technique.
View Article and Find Full Text PDFJ Orthop Surg Res
January 2025
Department of Industrial Engineering, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
Background: Transfemoral osseointegrated prostheses, like other uncemented prostheses experience the risk of aseptic loosening and post-operative periprosthetic fractures, with an incidence between 3% and 30%. To date, however, osseointegrated off-the-shelf prostheses are manufactured in a limited number of sizes, and some patients do not meet the strict eligibility criteria of commercial devices. A customized osseointegrated stem was developed and a pre-clinical in vitro investigation of the stem was performed, to evaluate its biomechanical performance.
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