Midlevel constraint prostheses have provided increased varus/valgus and rotational stability for patients with severe deformity or ligamentous instability undergoing total knee arthroplasty (TKA). Here we present a series of 5 patients, 2 in detail, who underwent a primary TKA with a midlevel constraint articular surface and a primary femoral component without stem extension who all suffered isolated medial femoral condyle insufficiency fractures. All 5 TKAs were performed in females with both preoperative valgus deformity and flexion contractures. Patients had an average age of 74.4 years, height 62.4 in, and weight 156.2 lbs. Revision TKA was performed in 4 of 5 cases. As a result of these cases, we now routinely consider implanting a stemmed femoral component in this population with osteoporotic medial femoral condyles.
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http://dx.doi.org/10.1016/j.artd.2021.12.002 | DOI Listing |
Indian J Orthop
January 2025
Department of Orthopaedics, Apollo Hospitals, Greams Road, Chennai, 600006 India.
Background: Ultracongruent (UC) total knee replacement (TKR) designs, serving as alternatives to posterior stabilized (PS) and cruciate retaining (CR) designs, lack conclusive evidence regarding posterior femoral rollback. This study aimed to compare intraoperative posterior femoral rollback and maximal knee flexion between UC and PS inserts, addressing the paucity of literature on femoral rollback achieved with UC designs in total knee replacement.
Methods: A consecutive cohort of 20 patients undergoing robotic-assisted primary total knee replacement, posterior femoral rollback and maximal intraoperative knee flexion were assessed.
Arthroplast Today
December 2024
Northshore University Hospital at Northwell Health, Manhasset, NY, USA.
This report describes a medial calcar episiotomy with partial anterior transfemoral osteotomy of the proximal femur to aid in removal of a femoral component in setting of revision total hip arthroplasty through a direct anterior approach. Revision total hip arthroplasty is challenging, labor-intensive, and carries high complication rates. Previously described techniques such as extended trochanteric osteotomies can be utilized to facilitate removal of fixed femoral stems.
View Article and Find Full Text PDFBone
December 2024
Neurobehavioral Pharmacology Laboratory, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India. Electronic address:
Medium chained triglycerides (MCT) ketogenic diet is being extensively investigated for its neuroprotective effects against adverse effects associated with aging and neurodegenerative disorders. Aging is a common risk factor for the development of both osteoporosis and neurological disorders. Hence, suppression of aging and age-related neurodegeneration might contribute to delaying skeletal aging.
View Article and Find Full Text PDFClin Biomech (Bristol)
December 2024
Department of Orthopedic Surgery, Hiroshima University Hospital Graduate School of Biomedical and Health Sciences, Hiroshima City, Hiroshima Prefecture, Japan.
Background: Total hip arthroplasty is the preferred treatment for advanced hip osteoarthritis, yet complications like hip dislocation (0.2 %-10 %) persist due to factors such as implant design, positioning, surgical technique, and patient-specific conditions. Impingement between prosthetic components or the acetabulum and proximal femur is a primary cause of instability.
View Article and Find Full Text PDFJ Funct Biomater
December 2024
Adult Spine Orthopaedics Department, W. Dega Orthopaedic and Rehabilitation Clinical Hospital, Poznan University of Medical Sciences, 28 Czerwca 1956 Street 135/147, 61-545 Poznan, Poland.
The prototype of a biomimetic multi-spiked connecting scaffold (MSC-Scaffold) represents an essential innovation in the fixation in subchondral trabecular bone of components for a new generation of entirely cementless hip resurfacing arthroplasty (RA) endoprostheses. In designing such a functional biomaterial scaffold, identifying the microstructural and mechanical properties of the host bone compromised by degenerative disease is crucial for proper post-operative functioning and long-term maintenance of the endoprosthesis components. This study aimed to explore, depending on the occurrence of obesity, changes in the microstructure and mechanical properties of the subchondral trabecular bone in femoral heads of osteoarthritis (OA) patients caused by the MSC-Scaffold embedding.
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