• Title/Summary/Keyword: Revision, joint

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Reduction of the Femoral Head First, and Assembly of the MUTARS® Device in Case of Impossible Reduction during Total Hip Arthroplasty

  • Jee Young Lee;Ye Jun Lee;Gyu Min Kong
    • Hip & pelvis
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    • v.35 no.4
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    • pp.277-280
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    • 2023
  • Dislocation after a total hip arthroplasty occurs in approximately 1% of patients; however, the frequency is much higher after revision surgery. To prevent dislocation, use of a larger femoral head is recommended, and a dual mobility femoral head has been introduced. However, reducing the dual mobility femoral head to the acetabular component is difficult in cases involving contracture in the soft tissue around the joint. A 72-year-old male patient who developed a periprosthetic joint infection underwent two-stage revision surgery using MUTARS®. Two months after the revision, the hip joint became dislocated and manual reduction was attempted; however, dislocation occurred again. During another revision using a dual mobility bearing, the soft tissue around the hip joint was too tight to reduce. The problem was overcome by first repositioning the dual mobility head into the acetabular socket, followed by assembly of the diaphyseal portion of the implant.

Comparative Analysis of the Stress and Strain of Material for Revision Total Hip Replacement (고관절 재치환술시 재료의 응력과 변형률의 비교 분석)

  • Shim D.H.;Kim J.H.;Ko S.H.;Kim K.H.;Kim D.Y.;Choi M.J.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2006.05a
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    • pp.511-512
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    • 2006
  • According to development of medical science and engineering, people has made efforts to solve tile discomfort of body accident as well as the life span. Many cases that reduce pain of a hip joint or limitation of motion using Revision Total Hip Replacement are getting increased. However it has not proved which material is the most appropriate. Scientists are still studying about materials of the artificial joint. In accordance with advance of science, the materials are Betting better. Recently, when Revision Total Hip Replacement is performed, typical materials are Ti-alloys Ceramics. We have studied materials of artificial joints and analyzed which one is better for human's body.

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The Dome Technique for Managing Massive Anterosuperior Medial Acetabular Bone Loss in Revision Total Hip Arthroplasty: Short-Term Outcomes

  • Tyler J. Humphrey;Colin M. Baker;Paul M. Courtney;Wayne G. Paprosky;Hany S. Bedair;Neil P. Sheth;Christopher M. Melnic
    • Hip & pelvis
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    • v.35 no.2
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    • pp.122-132
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    • 2023
  • Purpose: The dome technique is a technique used in performance of revision total hip arthroplasty (THA) involving intraoperative joining of two porous metal acetabular augments to fill a massive anterosuperior medial acetabular bone defect. While excellent outcomes were achieved using this surgical technique in a series of three cases, short-term results have not been reported. We hypothesized that excellent short-term clinical and patient reported outcomes could be achieved with use of the dome technique. Materials and Methods: A multicenter case series was conducted for evaluation of patients who underwent revision THA using the dome technique for management of Paprosky 3B anterosuperior medial acetabular bone loss from 2013-2019 with a minimum clinical follow-up period of two years. Twelve cases in 12 patients were identified. Baseline demographics, intraoperative variables, surgical outcomes, and patient reported outcomes were acquired. Results: The implant survivorship was 91% with component failure requiring re-revision in only one patient at a mean follow-up period of 36.2 months (range, 24-72 months). Three patients (25.0%) experienced complications, including re-revision for component failure, inter-prosthetic dual-mobility dissociation, and periprosthetic joint infection. Of seven patients who completed the HOOS, JR (hip disability and osteoarthritis outcome score, joint replacement) survey, five patients showed improvement. Conclusion: Excellent outcomes can be achieved using the dome technique for management of massive anterosuperior medial acetabular defects in revision THA with survivorship of 91% at a mean follow-up period of three years. Conduct of future studies will be required in order to evaluate mid- to long-term outcomes for this technique.

A Study on the Direction for Revision of Korea Shipping Act and Monopoly Regulation and Fair Trade Act (선화주 균형발전을 위한 해운법 및 독점규제법의 개정방향에 관한 연구)

  • Park, Kwang-So
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.49
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    • pp.213-236
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    • 2011
  • Korea Shipping Act admits shipping conferences' joint actions like rate agreement, sailing agreement in some degree for development of shipping transport industries for decades. Meanwhile, EU has prohibited all kinds of shipping conferences' joint actions since October 2008, and many advanced countries also have similar position on shipping conference. The balance development between shippers and ship owners is very important in terms of national economic growth. So it is appropriate time to revise related laws such as Shipping Act and Monopoly Regulation and Fair Trade Act. First, It is direction for revision of Korean Shipping Act. The act has to define precisely the criteria of "unfairness" in case of admitting of shipping conferences' joint actions. Shipping conferences have a conference with shipper or shipper's delegation substantially on freight and transport conditions and so on. Second, It is direction for revision of Monopoly Regulation and Fair Trade Act. The fair trade commission has to perform fair roles between shippers and ship owners. The judgement of fairness has to confirm according to the spirit of not Korea Shipping Act but Korea Monopoly Regulation and Fair Trade Act itself.

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Analysis of revision anterior cruciate ligament reconstruction (전방 십자인대 재재건술의 분석)

  • Park, Chan-Hee;Song, Eun-Kyoo;Seon, Jong-Keun;Yim, Ji-Heoun;Kang, Kyung-Do;Lee, Tae-Min
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.47-53
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    • 2011
  • Purpose: As the number of the anterior cruciate ligament (ACL) reconstruction has increased, the incidence of revision of ACL reconstruction due to reconstruction failure has been also increased. Therefore, authors analyzed the reason of the failure of ACL reconstruction and the clinical result of the ACL revision. Materials and methods: From February 1998 to July 2010, we selected 36 cases which was followed at least 12months after the ACL reconstruction failure. Duration from reconstruction to revision, the average duration was 60 months (5~334) and on first reconstruction, we used allograft on 23 cases (63.9%) and autograft on 13 cases (36.1%). For the main symptom of ACL reconstruction failure, instability was the most common symptom, and 35 cases (97.5%) were undergone only one reconstruction and 1case (2.5%) was undergone two reconstruction. Clinical results were evaluated by Lysholm knee joint score, pivot shift test, and Telos device. Results: Average follow-up duration of the patients was 21 months (12~40), and the reason for the ACL reconstruction failure, trauma was most common by 19 cases (52.8%), malposition of the femoral tunnel was 13 cases (36.1%), malposition of the tibia tunnel was 1case (2.8%), and failure of osteointegration was 3 cases (8.4%). On performing the ACL revision, we used allograft on 34 cases (94%) and autograft on 2 cases (6%), and 21 cases accompanied injury of the meniscus (medial meniscus 14 cases, lateral meniscus 7 cases). Lysholm knee joint score was improved from 66.5 points, preoperatively to 92 points on last follow-up (p<0.01). In most cases, patients were satisfied (92%) with the operation results. Tegner activity score was also improved from 2.0 points preoperatively to 6.2 points on the last follow-up. On Lachman and pivot sift test, 33 cases and 30 cases were improved to grade I respectively, and on stability test using Telos device, the bilateral difference was improved from mean 15.5 mm preoperatively to 4.5 mm on the last follow-up. Conclusion: After 1 year follow-up, Revision of ACL had a little anterior instability but it showed satisfactory result on clinical result and patient's subjective satisfaction.

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The Recent Trends of AACR2R 2002 Revision (AACR2R 2002 개정판의 개정내용과 특성분석)

  • 김정현
    • Journal of the Korean Society for information Management
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    • v.20 no.1
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    • pp.251-270
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    • 2003
  • Due to rapid internet supply and the increase of electronic resources including network resources, there has been a sudden change in cataloguing fields. To deal with rapid changes, IFLA revised cataloguing rules for electronic and continuing resources; ISBD(ER) and ISBD(CR), JSC(Joint Steering Committee for Revision of AACR) has published the 2002 revision of Anglo-American Cataloguing Rules, Second Edition. Major changes in both content and format make the release of the 2002 revision momentous. This study is to analyze activities of JSC and rule revisions of AACR2R 2002 edition, expecially in regards with concepts of change to rule 0.24, new categories of bibliographic materials, changes to chapter 3(cartographic materials), chapter 9(electronic materials), chapter 12(continuing materials), definition of a new terminologies, changes in MARC 21 coding, and issues concerned with revision of KORMARC.

Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?

  • Nemandra Amir Sandiford;Scott M. Bolam;Irrum Afzal;Sarkhell Radha
    • Hip & pelvis
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    • v.35 no.1
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    • pp.40-46
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    • 2023
  • Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

Primary versus revision total shoulder arthroplasty: comparing relative value and reimbursement trends

  • Carney, John Joseph;Gerlach, Erik;Plantz, Mark;Swiatek, Peter Raymond;Marx, Jeremy;Saltzman, Matthew;Marra, Guido
    • Clinics in Shoulder and Elbow
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    • v.25 no.1
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    • pp.42-48
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    • 2022
  • Background: Total shoulder arthroplasty (TSA) has been demonstrated to be an effective treatment for multiple shoulder pathologies. The purpose of our study was to compare the relative value units (RVUs) per minute of surgical time for primary and revision TSA. Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify patients that underwent primary TSA, one-component revision TSA, and two-component revision TSA between January 1, 2015 and December 31, 2017 using current procedure terminology codes. RVUs were divided by mean operative time for each procedure to determine the amount of revenue generated per minute. Rates were compared between the groups using a one-way analysis of variance with post-hoc Tukey test. Statistical significance was set at p<0.05. Results: When dividing compensation by surgical time, we found that two-component revision generated more compensation per minute compared to primary TSA (0.284±0.114 vs. 0.239±0.278 RVU per minute or $10.25±$4.11 vs. $8.64±$10.05 per minute, respectively; p=0.001). Conclusions: The relative value of revision TSA procedures is weighted to account for the increased technical challenges and time associated with these procedures. This study confirms that reimbursement is higher for revision TSA compared to primary TSA.

Stenotrophomonas maltophilia Periprosthetic Joint Infection after Hip Revision Arthroplasty

  • Valentino Latallade;Carlos Lucero;Pablo Slullitel;Martin Buttaro
    • Hip & pelvis
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    • v.35 no.2
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    • pp.142-146
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    • 2023
  • Stenotrophomonas maltophilia, a well-established opportunistic bacterium, primarily impacts healthcare settings. Infection of the musculoskeletal system with this bacterium is rare. We report on the first known case of hip periprosthetic joint infection (PJI) caused by S. maltophilia. The potential for development of a PJI caused by this pathogen should be considered by orthopaedic surgeons, particularly in patients with multiple severe comorbidities.

Functional Outcome after Reimplantation in Patients Treated with and without an Antibiotic-Loaded Cement Spacers for Hip Prosthetic Joint Infections

  • Michele Fiore;Claudia Rondinella;Azzurra Paolucci;Lorenzo Morante;Massimiliano De Paolis;Andrea Sambri
    • Hip & pelvis
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    • v.35 no.1
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    • pp.32-39
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    • 2023
  • Purpose: A staged revision with placement of a temporary antibiotic-loaded cement spacer after removal of the implant is the "gold standard" for treatment of chronic prosthetic joint infection (PJI). It enables local delivery of antibiotics, maintenance of limb-length and mobility, easier reimplantation. However, bacterial colonization of spacers and mechanical complications can also occur. The aim of this study is to evaluate functional results and infection control in two-stage treatment of total hip arthroplasty (THA) PJI with and without a spacer. Materials and Methods: A retrospective review of 64 consecutive patients was conducted: 34 underwent two-stage revision using a cement spacer (group A), 30 underwent two-stage revision without a spacer (group B). At the final follow-up, functional evaluation of patients with a THA in site, without PJI recurrence, was performed using the Harris hip score (HHS). Measurement of limb-length and off-set discrepancies was performed using anteroposterior pelvic X-rays. Results: Most patients in group B were older with more comorbidities preoperatively. Thirty-three patients (97.1%) in group A underwent THA reimplantation versus 22 patients (73.3%) in group B (P<0.001). No significant differences in limb-length and off-set were observed. The results of functional evaluation performed during the final follow-up (mean, 41 months) showed better function in patients in group A (mean HHS, 76.3 vs. 55.9; P<0.001). Conclusion: The use of antibiotic-loaded cement spacer seems superior in terms of functional outcomes and reimplantation rate. Resection arthroplasty might be reserved as a first-stage procedure in patients who are unfit, who might benefit from a definitive procedure.