Long-term followup of nonmodular total knee replacements.

The purpose of the current study was to evaluate and determine the mechanism and etiology of failure of components that failed in long-term followup of Anatomic Graduated Component total knee replacements. The authors previously reported the survivorship of 4583 Anatomic Graduated Component total knee arthroplasties done during a 17-year period. The current study was done to evaluate the etiology and cause of failure of the components that failed.

The clinical significance of vacuum mixing bone cement.

This controlled study compared the strength and porosity of 48 polymethylmethacrylate cement-implant constructs prepared with open bowl versus vacuum mix technique. Forty-eight blast finished stainless steel rods of 13 mm diameter were implanted with centralizers into 17-mm inner diameter tubes that had been retrograde filled with polymethylmethacrylate cement. The eight cement preparations used were open bowl and vacuum mixed Simplex, Osteobond, Zimmer Dough Type, or Palacos R.

Long-term survival of the T-28 versus the TR-28 cemented total hip arthroplasties.

Between 1974 and 1980, 550 total hip arthroplasties (THAs) (479 patients) were performed using T-28 and TR-28 cemented prostheses (TR-28 is shot-blast chrome and T-28 is polished stainless steel). There were 379 cemented THAs in 321 patients in the T-28 group and 171 cemented THAs in 158 patients in the TR-28 group. Average follow-up of the patients still alive at the end of the study was 20.

Total knee arthroplasty after high tibial osteotomy. A comparison study in patients who had bilateral total knee replacement.

Background: The outcome of total knee replacement after high tibial osteotomy remains uncertain. We hypothesized that the results of total knee replacement with or without a previous high tibial osteotomy are similar.

Methods: The results of a consecutive series of thirty-nine bilateral total knee arthroplasties performed with cement at an average of 8.

Determining the necessity for routine pathologic examinations in uncomplicated total hip and total knee arthroplasties.

Total hip and total knee arthroplasties (n = 951) were retrospectively reviewed to determine the cost-effectiveness of routine pathologic examination of surgical specimens in primary total hip and total knee replacements. Discrepancies between the postoperative diagnosis and the final pathologic diagnoses were recorded. Of the 951 cases reviewed, 27 (2.

Indomethacin-induced postoperative psychosis.

Indomethacin is used commonly for the prevention of postoperatively heterotopic ossification. There have been 3 reports in the pharmacologic literature of indomethacin-induced psychosis. We describe a case of indomethacin-induced psychosis in a patient in whom indomethacin was used for the prevention of postoperative heterotopic ossification after bilateral uncemented total hip replacements.

Intra-articular morphine and/or bupivacaine after total knee replacement.

The postoperative analgesic effects of intra-articular injections of bupivacaine and/or morphine were examined prospectively in 437 patients who had total knee replacement for osteoarthritis. They were divided randomly into four groups. Group I received 10 mg of morphine (1 ml) and 9 ml of saline, group II received 10 ml of bupivacaine (2.

The predictive power of baseline hemoglobin for transfusion risk in surgery patients.

Preoperative hemoglobin concentration may be an important predictor of transfusion risk in surgical procedures with significant expected blood loss. Contemporary studies investigating transfusion risk with regard to the relationship between perioperative administration of Epoetin alfa and baseline hemoglobin provide data to test this hypothesis. The predictive power of seven preoperative variables (hemoglobin concentration, age, erythropoietin level, ferritin concentration, serum iron, total iron-binding capacity, and predicted blood volume) on transfusion risk was examined via retrospective logistic regression analysis of 276 orthopedic surgical patients.

Assessment of postoperative vigor in patients undergoing elective total joint arthroplasty: a concise patient- and caregiver-based instrument.

Assessment of early postoperative recuperative power (i.e., vigor and functional ability) in surgery patients is considered to be important for optimizing patient rehabilitation, discharge planning, and health system resource utilization.

Radiographic analysis of a cemented titanium alloy femoral component.

Proximal femoral cortical bone remodeling was evaluated radiographically about a 1 piece cemented titanium alloy femoral prosthesis implanted with modern cement techniques and was compared with one described previously in which early cement techniques and a stainless steel stem were used. Two hundred twenty-six total hip replacements (196 patients) were observed for an average of 6.3 years (range, 5-10 years).

Early clinical results of hydroxyapatite-coated total hip arthroplasty.

A retrospective clinical and radiographic review of 25 conventional cementless total hip replacements (THRs) and 25 cementless hydroxyapatite-coated THRs was performed to evaluate early postoperative results. The hydroxyapatite-coated group had a higher incidence of pain-free arthroplasties compared with the standard cementless group (72% v 44%, P = .045) at the 2-month postoperative evaluation.