Cementless and Cemented Dual-Pivot Total Knee Arthroplasty: A Matched Comparison With a Minimum Two-Year Follow-Up.

Background: With the use of newer biomaterials, many authors have reported similar results between cementless and cemented total knee arthroplasty (TKA). The purpose of this study was to compare the early clinical and radiographic outcomes of cementless and cemented TKA using the same dual-pivot articulation.

Methods: A consecutive series of 806 TKAs were implanted by a single surgeon using the same dual-pivot articulation.

Custom Triflange Acetabular Implants: Average 10-Year Follow-Up.

Background: Acetabular reconstruction options in the setting of substantial bone deficiency (Paprosky 3A and 3B) remain limited. Custom triflange acetabular implants are one choice for this challenging problem. However, few studies have reported on survivorship beyond 3 to 5 years.

Does design change in total knee arthroplasty implants affect patient-reported outcomes?

Purpose: The purpose of this study is to compare the early results of patient-reported outcomes between two generations of a total knee system.

Methods: Between June 2018 and April 2020, 121 first-generation, cemented TKAs (89 patients) and 123 s-generation, cemented TKAs (98 patients) were performed by a single surgeon. Demographic and surgical data were collected from all patients.

Instability After Primary Total Hip Arthroplasty: Dual Mobility Versus Jumbo Femoral Heads.

Background: The use of dual mobility (DM) articulations has grown substantially over the last decade to help minimize dislocation risk. The purpose of this study is to compare the results of DM articulations to jumbo femoral heads of equivalent sizes as they relate to postoperative dislocation.

Methods: This is a retrospective cohort study of primary total hip arthroplasties (THAs) performed at a single institution between 2005 and 2018.

Progressive Tibial Bearing Sagittal Plane Conformity in Cruciate-Retaining Total Knee Arthroplasty.

Background: We hypothesized that when the posterior cruciate ligament (PCL) is found deficient at total knee arthroplasty (TKA), using an anterior-stabilized (AS) tibial insert would provide similar function and survivorship when compared to using a more traditional cruciate-retaining (CR) bearing when the (PCL) is balanced.

Methods: A total of 1731 TKAs were performed using the same TKA design. Of them, 868 TKAs had a standard CR insert implanted (CR-S), 480 TKAs used a lipped CR insert (CR-L), and 383 TKAs used an AS insert.

The patient-specific Triflange acetabular implant for revision total hip arthroplasty in patients with severe acetabular defects: planning, implantation, and results.

Aims: Few reconstructive techniques are available for patients requiring complex acetabular revisions such as those involving Paprosky type 2C, 3A and 3B deficiencies and pelvic discontinuity. Our aim was to describe the development of the patient specific Triflange acetabular component for use in these patients, the surgical technique and mid-term results. We include a description of the pre-operative CT scanning, the construction of a model, operative planning, and surgical technique.

Bilateral Total Hip and Knee Arthroplasties: Average 10-Year Follow-Up.

Background: The present study investigates the clinical and radiographic outcomes in patients with all 4 major lower extremity joints replaced.

Methods: A retrospective review of our institution's database identified 125 patients in whom both hips and both knees were replaced. The mean time between the first and last arthroplasty was 6.

Residual Symptoms and Function After Unicompartmental and Total Knee Arthroplasty: Comparable to Normative Controls?

Background: Whether patient-reported symptoms and function after total knee arthroplasty (TKA) and medial unicompartmental knee arthroplasty (UKA) compare favorably to similar individuals without a diagnosis of knee pathology has not been investigated.

Methods: A retrospective, multicenter study was designed in which 4 centers contributed patients between ages 18 and 80 years undergoing knee arthroplasty. Data were collected by an independent, third-party survey center that administered a questionnaire assessing patient satisfaction and function.

Use of screws and cement in revision TKA with primary or revision specific prosthesis with up to 17 years followup.

The purpose of this study was to investigate the use for screws and cement, and primary and revision specific prosthesis for revision TKA. Between July 1989 and February 2010, 839 consecutive revision TKAs were performed, with 609 knees meeting inclusion criteria. At 17 years followup, Kaplan-Meier survivorship was 0.

The Surgeon's Role in Relative Success of PCL-Retaining and PCL-Substituting Total Knee Arthroplasty.

Background: The orthopedic literature has not shown a universal and replicated difference, outside of flexion, in clinical results between posterior cruciate ligament retention and posterior cruciate ligament substitution in total knee arthroplasty.

Questions/purposes: This study was performed to compare the restoration of flexion and knee function in a large series of cruciate-retaining and cruciate-substituting total knee arthroplasties (TKRs). In addition, we aimed to study how other variables, such as those unique to each surgeon, may have affected the results.

Twenty-year followup of an uncemented stem in primary THA.

Background: Uncemented stems have been used in THA for well over two decades, but there are relatively few studies reporting on the results after 20 years.

Questions/purposes: The purpose of this study was to evaluate at a minimum followup of 20 years (1) hip scores; (2) radiographic findings, including stem fixation and osteolysis; (3) reoperations; and (4) survivorship free from aseptic loosening in a group of patients who underwent primary THA using a proximally porous-coated, plasma-sprayed, straight-stemmed, titanium-alloy femoral component.

Methods: Between 1987 and 1993, we performed 1517 primary THAs, of which 447 were cementless, and 157 used the implant under study here (representing 10% of the THAs during the period in question).

Use of screws and cement in primary TKA with up to 20 years follow-up.

The purpose of this study was to investigate screws and cement for large tibial bone defects during primary TKA. Of 14,686 consecutive primary TKAs performed between December 1988 and February 2010, 256 received screws and cement for tibial defects. Cox regression was used for the analysis.

Meeting increased demand for total knee replacement and follow-up: determining optimal follow-up.

The strain on clinic and surgeon resources resulting from a rise in demand for total knee replacement (TKR) requires reconsideration of when and how often patients need to be seen for follow-up. Surgeons will otherwise require increased paramedical staff or need to limit the number of TKRs they undertake. We reviewed the outcome data of 16 414 primary TKRs undertaken at our centre to determine the time to re-operation for any reason and for specific failure mechanisms.

Preoperative malalignment increases risk of failure after total knee arthroplasty.

Background: Implant survival after total knee arthroplasty has historically been dependent on postoperative knee alignment, although failure may occur when alignment is correct. Preoperative knee alignment has not been thoroughly evaluated as a possible risk factor for implant failure after arthroplasty. The purpose of this study was to analyze the effect of preoperative knee alignment on implant survival after total knee arthroplasty.

Heterotopic bone formation following resurfacing total hip arthroplasty.

Heterotopic bone (HO), a rare association with total hip arthroplasty (THA), has recently been shown to be more of a problem with resurfacing hip arthroplasty (RHA). It has been speculated to be the result of greater soft tissue dissection required for this procedure. HO most commonly develops in males and patients with bilateral disease.

Pain relief and functional improvement remain 20 years after knee arthroplasty.

Background: TKA provides demonstrable pain relief and improved health-related quality of life. Yet, a decline in physical function may occur over the long term despite the absence of implant-related problems.

Questions/purposes: (1) Does pain relief diminish over 20 years after TKA? (2) Does function decline over 20 years in terms of Knee Society function, knee, and walking scores? And (3) what is the patient-reported activity level at most recent followup?

Patients And Methods: We retrospectively identified 1471 patients with 1757 primary cruciate-retaining TKAs implanted between 1975 and 1989 and identified 128 living patients (8.

Low incidence of groin pain and early failure with large metal articulation total hip arthroplasty.

Background: Large-diameter metal-on-metal articulations reportedly improve stability and wear in THAs. However, some reports suggest some patients have unexplained hip and early failures with these implants. Thus, the potential benefits may be offset by these concerns.

Does high tibial osteotomy affect the success or survival of a total knee replacement?

Background: Whether a previous high tibial osteotomy (HTO) influences the long-term function or survival of a total knee arthroplasty (TKA) is controversial.

Questions/purposes: We compared long-term functional scores and survival of bilateral TKAs in patients who had a previous HTO in one of the knees.

Patients And Methods: From 1980 to 1995, we performed 5043 primary TKAs; 39 of these patients had bilateral TKAs at an average of 8.

Acetabular UHMWPE survival and wear changes with different manufacturing techniques.

Background: Polyethylene wear may be affected by the type of polyethylene resin, manufacturing technique, degree of thermal stabilization, and sterilization technique.

Questions/purposes: We therefore compared femoral head penetration into the PE and cup survival using the same cup system with different PE resins, manufacturing, and sterilization techniques.

Methods: Our study group consisted of 1912 THAs performed using the same uncemented cup and identical 28-mm cobalt-chrome heads.

High survival of uncemented proximally porous-coated titanium alloy femoral stems in osteoporotic bone.

Unlabelled: Because the initial fixation of an uncemented stem may be compromised in patients with osteoporotic bone (Class C, Dorr et al.), many surgeons prefer a cemented stem in this setting. We therefore determined the survival of an uncemented, proximally porous-coated, straight-stemmed, titanium alloy femoral component in patients with Class C bone when compared with Class A and B bone.