Merrill A Ritter

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..rheumatoid arthritis). The success also continued over time with an estimated survival rate of 94.8% at 12 years. Total knee arthroplasty is an effective operation in patients younger then 55 years old...

..The purpose of this study was to determine the effect of tibiofemoral alignment, femoral and tibial component alignment, and body-mass index (BMI) on implant survival following total knee replacement...

..The purpose of the present study was to compare the infection rates following joint replacement procedures performed by one orthopaedic surgeon with and without the use of ultraviolet lighting...

..This study was designed to determine the optimal range of motion for knee function after total knee arthroplasty with a posterior cruciate-retaining prosthesis...

..These data should be considered in the context of growing enthusiasm for resurfacing with new bearing surfaces and cementless fixation...

..Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence...

..The choice of either alignment system should be determined by the patient's anatomy; however, the overall alignment is not as precise using the extramedullary system...

..Changes in loading patterns in specimens with increased tibial resection depths have not previously been described...

..When comparing the results of this study to the results of a similar study of primary total knee arthroplasties, flexion improved less following revision than following primary total knee arthroplasty...

..Osteolysis was observed in one knee after secondary evaluation. Hybrid fixation in a selected patient population can result in excellent results in middle to long-term followup...

..Limiting stress concentrations in the periphery of the proximal tibia by considering sizing relationships between femoral and tibial components may decrease osseous strains and the likelihood of bony overload in TKA...

..0024). The average age in our infection cohort was 64.3 and 68.4 in the noninfected cohort. In this retrospective review study, obesity, diabetes, and younger age were found to be risk factors for joint arthroplasty infection...

..The purpose of this study was to assess the outcomes of manipulation following total knee arthroplasty...

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

..The purpose of the present study was to evaluate the effect of stuffing the patellofemoral compartment on the outcome of primary total knee arthroplasty...

..0001). Cups initially placed at an angle of 45.0 degrees to 50.5 degrees had the highest survival rate compared with all possible angle ranges (P < .0158)...

..The significant influence of this often-unrecognized surgical variable has not been previously reported and must be carefully considered during TKA...

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..The purpose of this study was to analyze the effect of preoperative knee alignment on implant survival after total knee arthroplasty...

..This study demonstrates the role that metal backing plays on generating an even loading distribution while diminishing the development localized regions of excessive loading across the medial tibial cortex...

..9%). Preoperative range of motion is an important variable that should be taken into consideration during operative planning to help reduce the risk of dislocation...

..Higher observed strains in the proximal tibia observed with all-polyethylene tibial components could possibly explain increased clinical failure rates observed with this TKA design...

..We correlated this with high, average, or poor postoperative Harris hip scores. Hip motion was found to be correlated with postoperative hip function and may be more useful than previously thought in evaluating hip outcome...

..76 years. There were no failures attributable to aseptic loosening at the cement-bone interface. This study supports the use of a satin finish, tapered femoral component in cemented total hip arthroplasty...

..Gender, body mass index, and age accounted for the greatest amount of the explained variance in volumetric wear (57.5%, 21.6%, and 14.4, respectively), followed by angle of wear (3.4%), and sterilization and production technique (3.2%)...

..4684). We conclude that improvement after TKA is similar for men and women, with few clinically significant differences. Sex-specific implants would appear to offer no clinical advantage...

..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...

..Routine use of the TEA is recommended for determining femoral component rotation in TKA...

..At a mean of 6.6-year follow-up, the survivorship of the revised tibial components and retained femoral components, with aseptic loosening as the end point, was 100%...

..In our series, knees that failed by medial tibial collapse had more significant bone defects and required more complex reconstructions than is currently reported in the literature...

..We found an increased rate of tibial component loosening and implant migration in patients with a higher mass and smaller tibial component size...

..Survival rates for loosening or revision of any component for any reason were 98.9%, 97.5%, 95.1%, and 93.2% at 5-, 10-, 15-, and 18-years, respectively...

..0004 and 0.0081, respectively). There was no effect of the ISR upon ROM, Knee Society Score, or pain scores. Optimal outcomes occurred in patients where the ISR was not decreased after TKA, with superior stair and function scores...

..The purpose of the present study was to evaluate the minimum ten-year results of primary total hip arthroplasty performed with use of a proximally porous-coated, plasma-sprayed, straight-stemmed, titanium-alloy femoral component...

..LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence...

..This study demonstrates the important role that bearing movement plays in load distribution throughout the tibia after UKA and may illuminate a biomechanical process of tibial remodeling that influences pain and implant loosening...

..Knee extension deformities play a substantial detrimental role in the functional outcome of primary total knee arthroplasty...

..We believe our data should raise doubts about the use of patellofemoral arthroplasty in any patient. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence...

..8% for uncemented stems and 91.7% for cemented stems. In the absence of fracture, stem survivorship was 98.6% for cemented stems and 100% for circumferentially coated tapered titanium uncemented stems...

..Simultaneous bilateral total hip arthroplasty has advantages where both hips are symptomatic and has less risk in younger patients with understanding of the increased risk of pulmonary complications...

..Lower strains were observed with coronally dished implants in key regions corresponding to the clinical overload of the tibia leading to aseptic loosening...

..Knees that had severe angular deformities performed as well as deformity-free TKAs. Patients with excessive deformity should not be excluded from surgical correction solely based on this deformity...

..8% at 20 years. There were no femoral component failures. After eliminating patella failures, this cementless monoblock tibial component without screws demonstrated excellent 20-year survivorship...

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..7). Total knee arthroplasties without lateral patellar contact had a 1.61 times odds of experiencing postoperative pain compared with those TKAs with lateral patellar contact (P = .0025)...

..The Luque wires, which cost 29.79 US dollars each, performed equally to the cables, which cost 275.40 US dollars each, suggesting that wiring may be the preferred cerclage technique...

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..LEVEL OF EVIDENCE: Level IV, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence...

..These findings indicate excellent short-term clinical and radiographic results can be achieved with an extended trochanteric osteotomy and proximally porous-coated calcar replacement prosthesis...

..The results of this study indicate increased interface stability in porous titanium-coated cups without significantly increasing the necessary force and energy required for full seating...

..No revisions were performed. The placement of screws beneath the medial tibial plateau to fill large defects is an excellent precaution against collapse of the medial tibia...

..There was only 1 death within 3 months of the operation. The severity of these patients' deformity may necessitate these procedures be done at 1 operation with consideration of mortality and morbidity risks...

..Given the experiential learning curve that most orthopedic surgeons face with cemented fixation of the acetabular cup component, the role of the cemented socket in THA today is limited...

..Patients identified with an increased risk of perioperative cardiac problems were those with a preoperative diagnosis of valvular heart disease (P = .0077), congestive heart failure (P = .0093), or diabetes mellitus (P = .0187)...

..Designs neglecting to adequately address deformational changes in vivo could be susceptible to diminished cup survival, increased wear, and premature revision...

..The family of a patient with dementia syndrome must be actively involved in all aspects of care after total joint replacement...

..Even for experienced surgeons, there is at least a 10% chance of a radiolucent line. Therefore, clinicians should work to develop better bearing surfaces so that cementless technology can be used extensively...

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..Cultural effects may play an effect. Until found clinically different, the range of motion after a total knee arthroplasty is dependent primarily upon preoperative range of motion...

..In these 2 cases, the rigid fixation and multiple attempts to impact and subsequently to remove the prosthesis may have caused fat embolism syndrome...

..The following are 5 case presentations of interesting and challenging patients with hip pathology...

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..The historical and current result of using these different types of prostheses are discussed, and the indications, contraindications, and recommendations for each type are delineated...

..5 years following surgery. With careful patient selection and patient care to minimize medical complications, total joint arthroplasty can be an excellent option for patients who are age 89 and older...

..Care must be taken between the first and second stage (when the spacer is in place), and attention must be paid to the management of the surgical wound to avoid secondary contamination...

..We review the available literature on vascular injury in hip arthroplasty and illustrate the great care necessary when placing cerclage wires and the importance of prompt recognition of these potentially devastating complications...

..52%, and 50.15%. CMW1 had better elution characteristics than the other cements when treated with vancomycin alone; the elution of Palacos R and Simplex P was better than that of CMW1 when vancomycin was combined with imipenem-cilastatin...

..While these differences are statistically significant, the clinical significance is unknown and linked to the duration that they persist...

..4599), range of motion (P = .7361), Knee Society Score (P = .7247), or function scores (P = .6786). Patients whose fat pad had been removed were nearly twice as likely to experience postoperative pain (P = .0005)...

..02). Obtaining flexion greater than 125 degrees after TKA does not offer a benefit in overall knee function. However, obtaining a high degree of flexion appears to optimize stair climbing...