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PubMed1982

[Knee prosthesis].

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Bacterial Infections↗
PubMed1992

[BCG osteoarthritis on knee prosthesis after intra-vesical BCG therapy].

A case of Calmette-Guérin bacillus (BCG) infection of a knee implant during intravesical BCG-therapy is reported. The course was favorable after replacement of the implant and administration of antituberculous agents. This case of septic osteoarthritis due to the BCG is different from cases of reactive polyarthritis reported after intravesical instillations of BCG. It probably resulted from diffusion of the BCG via the bloodstream.

Administration, Intravesical↗
PubMed2006

A mobile-bearing knee prosthesis can reduce strain at the proximal tibia.

Mobile and fixed-bearing knee prostheses are likely to generate distinct strain gradients in the proximal tibia. The resulting strain distribution in the proximal tibia governs bone remodeling and affects implant integration and stability. We determined the effects of fixed and mobile-bearing total knee prostheses on strain distribution at the proximal tibia. This mobile-bearing prosthesis was evaluated in cadaveric specimens under axial and torsional loading. Strain on the proximal tibial cortex was measured with rosette strain gages and an optical full-field strain acquisition system. Tibial torsion in response to combined axial and torsional loading was documented. There was no difference in cortex strain between the fixed and the mobile-bearing prostheses under 1.5 kN axial loading. Superimposing 10 degrees tibial internal rotation induced 22% less compressive strain in the mobile-bearing prosthesis compared with the fixed-bearing prosthesis. Under 10 degrees tibial external rotation, the mobile-bearing prosthesis induced 33% less compressive strain than the fixed-bearing prosthesis. Optically acquired strain fields showed peak compressive strain at the anteromedial aspect 30 mm below the joint line. The mobile-bearing prosthesis reduced torque in the proximal tibia during knee rotation by 68-73% compared with the fixed-bearing prosthesis. Our data suggest that the particular mobile-bearing prosthesis tested potentially reduces elevated strain levels in the proximal tibia.

Aged↗
PubMed1986

The total condylar knee prosthesis: a review of 71 operations.

Seventy-one operations are reviewed, in which knees were replaced with the total condylar prosthesis. The follow-up period ranged between 1 and 7 years, with an average of 3.25 years. Osteoarthritis was diagnosed preoperatively in 53 knees and rheumatoid arthritis in 18. The results obtained in cases of osteoarthritis were better than those in cases of rheumatoid arthritis. The prognosis was adversely affected by obesity, preoperative flexion contracture of 30 degrees or more, wound-healing problems, wound infection, and postoperative manipulation under general anesthesia. The overall results were excellent in 48% of cases (34 knees), good in 28% (20 knees), fair in 11.3% (eight knees), and poor in 4.3% (three knees). Failure was experienced in 8.4% of cases (six knees).

Adult↗
PubMed2005

[Septic loosing of hip and knee prosthesis].

Loosening of an artificial joint is a common complication in orthopedic surgery. It is estimated that bacteriological implant contamination is responsible for its loosening in 2-5 percent of cases, and in most cases aseptic loosening takes place. Despite low percentage of positive microbiological studies, histopathological examinations and modern laboratory techniques, including PCR (Polymerase Chain Reaction) allow to diagnose the bacterial contamination of the loose implant to ca 70 percent. Those observations point out to the high coincidence of bacterial contamination with implant loosening strongly suggesting its influence on activation of the inflammatory process destabilizing an implant. But the question, why in those cases bacterial contamination does not lead to clinically obvious suppuration, remains unknown. The possibility to activate the immune system by the subcellular elements of the bacterial cells leading to persistent inflammation with granulation tissue formation is likely. Presented paper discusses the process of orthopedic prosthesis loosening, the role of bacterial contamination in it. and the newest techniques for their examination.

Arthroplasty, Replacement, Hip↗
PubMed1994

[Posterior luxation of the tibia on total knee prosthesis: apropos of 6 cases].

PURPOSE OF THE STUDY: Posterior dislocation of Total knee arthroplasty is an infrequent but serious complication. Six cases of this complication were treated from 1979 to december 1993, all occurring on primary arthroplasties. MATERIAL AND METHODS: Knee arthroplasty was performed once for rheumatoid arthritis, five times for osteoarthritis. All cases occurred with a semi constrained prosthesis sacrifying posterior cruciate ligament: 2 Total condylar without posterior stabilisation, and 4 posterior stabilised prosthesis. In one case the dislocation occurred on a very severe rheumatoid arthritis: the patient, confined in a wheel chair, was not reoperated. In two patients, the dislocation was due to rotatory malposition of the tibial component. In the last three cases, we did not found any cause to the dislocation, except ligament laxity: 2 of these patients had, pre operatively, a valgus deformity. In 6 cases, we found only 2 problems on extensor system (one patellar dislocation and one patellectomy). RESULTS: 5 patients required a surgical treatment In 2 cases, we used a more constrained prosthesis, with poor results, but the knee was stable. Once, by changing the position of the tibial component, and using a thicker plate. In 2 patients we only put a thicker tibial polyethylene component. These 3 patients had a good stability: 2 have an excellent result with H.S.S. rating system, the third one has a poor result explained by patellar pseudoarthrosis occurring after traumatic patellar fracture. DISCUSSION: With our patients and cases published in North American works, we have studied the different mechanisms of such a posterior dislocation: rotatory disorder on tibial component, ligament laxity in flexion, extensor system deficiency, valgus deformity with important postero lateral release. CONCLUSION: The causes of posterior dislocation on Total knee arthroplasties must be known: we have to try to prevent such a complication. If it occurs, a precise analysis will permit a logical curative treatment, which must avoid constrained prosthesis.

Aged↗
PubMed1982

Postoperative results of Yoshino total knee prosthesis. A report of 264 arthroplasties performed between 1974 and 1980.

A review was made of 264 Yoshino total knee arthroplasties performed on 154 patients between February 1974 and July 1980. The average duration of the follow-up was 3 years and 2 months. Eighty-six percent were rheumatoid patients. Complications occurred in seven patients. The evaluation results indicated excellent relief of pain and improvement in walking ability. However, pain of the patellofemoral joint was noted in a number of osteoarthritic patients. This implies that a patella implant is necessary in the case of osteoarthritis. In addition, a new surgical technique was performed on "stiff" knees to improve their degree of movement; the average range of movement achieved in these patients was 70 degrees.

Adult↗
PubMed2005

Primary total knee arthroplasty using the Genesis I total knee prosthesis: a 5- to 10-year follow-up study.

This study analyzed the data from 82 primary total knee arthroplasties performed in 74 patients using the Genesis Total Knee Arthroplasty System. Ten men and 64 women with a mean age of 78 years were evaluated at a mean follow-up of 7 years. Seventy procedures used cemented femoral and tibial components, and 12 used cementless femoral and tibial components. The preoperative mean HSS score was 39. At the most recent follow-up, the mean HSS score increased to 92. The mean preoperative range of motion was 82 degrees and increased to 108 at the most recent follow-up. Clinically, there were 63 excellent (77%), 14 good (17%), 4 fair (5%), and 1 poor (1%) result.

Aged↗