Begell House Inc.
Journal of Long-Term Effects of Medical Implants
JLT
1050-6934
22
4
2012
Instrumentation Related Complications in Spine Surgery
263-272
10.1615/JLongTermEffMedImplants.2013006800
Efstathios
Ballas
First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, Athens, Greece
Andreas F.
Mavrogenis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
Eirineos
Karamanis
First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, Athens, Greece
George
Mimidis
First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, Athens, Greece
Konstantinos
Tolis
First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, Athens, Greece
Konstantinos
Soultanis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Orthopaedic Research and Education Center (OREC) Panayotis N. Soucacos, Athens, Greece
Panayiotis J.
Papagelopoulos
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
spine surgery; complications
Spinal instrumentation constructs are frequently necessary for the surgical management of patients with variable spinal pathology. However, surgical complications may appear. These should be detected early and managed to achieve recovery and good functional outcome for the patient. This article provides an in-depth analysis of the most common instrumentation-related complications of spine surgery as well as a diagnostic plan and treatment options for the management of these challenging entities once they occur.
Hip Pain and Pseudo-Lengthening of the Leg Due to Iliopsoas Haematoma Following Implantation of an Uncemented Component in Acetabular Cotyloplasty Technique
273-279
10.1615/JLongTermEffMedImplants.2013007039
Alexandros P.
Apostolopoulos
Trauma and Orthopaedic Department, "Korgialenio-Benakio" Hellenic Red Cross Hospital, Athens, Greece; Trauma and Orthopaedic Department, Ealing Hospital, North West University Healthcare NHS Trust, London, United Kingdom
Raghavendra Prasad
Sidaginamale
Trauma and Orthopaedic Department, Prince Charles Hospital, Merthyr Tydfil; Department of Orthopaedics, Croydon University Hospital, Surrey; Metal on Metal Research Department, North Tees University Hospital, Stockton on Tees, United Kingdom
B.
McConnell
Trauma and Orthopaedic Department, Prince Charles Hospital, Merthyr Tydfil, United Kingdom
A.
Manta
Trauma and Orthopaedic Department, Prince Charles Hospital, Merthyr Tydfil, United Kingdom
G.
Zafiropoulos
Trauma and Orthopaedic Department, Prince Charles Hospital, Merthyr Tydfil; University of Glamorgan, Pontypridd, CF37 1DL, United Kingdom
iliopsoas haematoma
cotyloplasty
uncemented total hip replacement
We report early symptomatic (groin pain and apparent limb lengthening) findings in our 12 consecutive patients who underwent total hip replacements using a cementless acetabular cotyloplasty technique. This report is the first in the literature to mention such an early complication in a large number of patients and also to describe early detection and treatment in these cases. During the period of January 2007 to December 2010, 12 patients (seven female, five male) with dysplastic hip underwent total hip arthroplasty. The mean age of the patients was 57 years (range 52–61 years) and the mean follow-up time was 18 months (12–36 months). A cotyloplasty technique was performed and uncemented acetabular and femoral components were implanted in all these 12 patients. All patients were reviewed postoperatively for clinical and radiographic assessment at six weeks, three months, six months, and one year, and then annually thereafter. During the first one to two months (mean time 22 ± 16 days), all patients complained of a constant pain in the groin that started in the early postoperative period. A pseudo lengthening of the
operated hip and pelvic tilt was found on clinical examination at the three-month follow-up. The True length did not reveal a significant leg length discrepancy. Hip pain, pseudo lengthening, and pelvic tilt resolved within 123 ± 17 days post-op. A cotyloplasty technique using an uncemented acetabular implant can cause an intrapelvic hematoma of the iliopsoas muscle giving rise to temporary groin pain, pseudo lengthening on the operated side, and gait disturbances to the patient in the early postoperative period. Symptoms resolved completely in all of our cases. Iliopsoas physiotherapy could be useful and should be encouraged during the symptomatic period. Patients have to be informed during consenting and reassured about this symptomatology. Awareness of this likely complication would help surgeons to detect the
problem and initiate treatment early.
Treatment of Adhesive Capsulitis of the Shoulder with a Static Progressive Stretch Device: A Prospective, Randomized Study
281-291
10.1615/JLongTermEffMedImplants.2013007061
Mahmoud I.
Ibrahim
Physical Therapy Department, College of Health Care Sciences, Health Professions Division, Nova Southeastern University, Fort Lauderdale, Florida
Aaron J.
Johnson
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland
Robert
Pivec
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Kimona
Issa
School of Health and Medical Sciences, Department of Orthopaedics, Seton Hall University, 400 S Orange Ave, South Orange, New Jersey
Qais
Naziri
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University
Hospital Brooklyn, Brooklyn, NY
Bhaveen V.
Kapadia
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Michael A.
Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
Shoulder adhesive capsulitis; frozen shoulder; stiff shoulder; mobilization; physical therapy; static progressive stretch orthosis; SPS
Stress relaxation and static progressive stretch (SPS) are techniques that may be used to nonoperatively restore joint range of motion in the setting of adhesive capsulitis. The purpose of this study was to prospectively compare standard physical therapy alone to a combination of physical therapy with a static progressive stretch orthosis in the treatment of shoulder adhesive capsulitis. A prospective, randomized, blinded, controlled study was conducted with a total of 60 patients diagnosed with shoulder adhesive capsulitis (30 patients in the control group, 30 patients in the treatment group). The control group received physical therapy for 4 weeks, while the experimental group received physical therapy and were
treated with a static progressive stretch shoulder device for 4 weeks. Active and passive abduction, passive
external rotation, DASH scores, and VAS pain scores were recorded for all patients at 4, 12, and 24 weeks
follow-up. Use of a static progressive stretch orthosis compared to physical therapy alone demonstrated
a significantly greater mean improvement in all range-of-motion categories. Mean passive abduction was
162° with the orthosis versus 136° with physical therapy alone. Mean active abduction was 141° and 114°, respectively. Mean external rotation was 73° and 52°, respectively. DASH scores were significantly better when a static progression stretch orthosis was used (5 vs.15 points). Use of a static progressive stretch orthosis for patients with shoulder adhesive capsulities resulted in significantly better range of motion and
DASH scores within 1 month of beginning treatment than physical therapy alone.
Assessment of Static Progressive Stretch for the Treatment of Shoulder Stiffness: A Prospective Case Series
293-303
10.1615/JLongTermEffMedImplants.2013007133
Aaron J.
Johnson
Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, Baltimore, Maryland
Shelton A.
McKenzie
Howard University Department of Orthopaedic Surgery, 2041 Georgia Avenue, N.W., Washington, District of Columbia 20060
Slif D.
Ulrich
Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, Maryland 21215
Thorsten M.
Seyler
Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, Maryland 21215
Kimona
Issa
School of Health and Medical Sciences, Department of Orthopaedics, Seton Hall University, 400 S Orange Ave, South Orange, New Jersey
Robert
Pivec
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Michael A.
Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
static progressive stretch
orthosis
shoulder stiffness
Introduction: The purpose of this study was to evaluate the use of a patient-directed static
progressive stretch orthosis for the treatment of shoulder stiffness. Methods: Twenty-three patients who
had limitations in range of motion of the shoulder and who had failed conventional physical therapy methods were studied. This cohort included 15 women and 8 men with a mean age of 53 years. Treatment comprised one to three 30- to 60-minute sessions per day with a patient-controlled orthosis utilizing static progressive stretch. The patients adjusted the degree of stretch at 5-minute intervals as tolerated. Compliance, range of motion, patient satisfaction, and complications were assessed, and a two-way repeated measure ANOVA was performed to assess the effects of age or gender. Results: After a mean
treatment duration of 10 weeks (range, 4 to 19 weeks), the patients gained a mean of 22° (range, −47 to
57°) of external rotation, 18° (range, −19 to 55°) of internal rotation, 46° (range, 3 to 97°) of abduction, and 23° (range, 3 to 40°) of forward flexion. In total, 22 of 23 patients (96%) experienced increases in range of motion that were maintained at 1 year following treatment. Statistically significant increases in range of motion and clinical function scores were noted; age and gender did not appear to influence the outcomes. Discussion: This device compared favorably to other treatment methods for shoulder stiffness. An orthosis utilizing static progressive stretch was a useful adjunct for the treatment of shoulder stiffness refractory to conventional therapy.
Long-Term Survival of a Flat-on-Flat Total Condylar Knee Arthroplasty Fixed with a Hybrid Cementing Technique for Tibial Components
305-312
10.1615/JLongTermEffMedImplants.2013007289
Christian
Carulli
Orthopaedic Clinic, Univeristy of Florence, Florence, Italy
Fabrizio
Matassi
Orthopaedic Clinic, University of Florence, 50139 Florence, Italy
Lorenzo
Nistri
Orthopaedic Clinic, University of Florence, 50139 Florence, Italy
Roberto
Civinini
Orthopaedic Clinic, University of Florence, 50139 Florence, Italy
Massimo
Innocenti
Orthopaedic Clinic, University of Florence, 50139 Florence, Italy
total knee arthroplasty
hybrid fixation
Purpose: Total knee arthroplasty is one of the most successful procedures of modern orthopedics.
Several implants have been proposed over the years with different designs, kinematics, and cementing techniques, with good results. The aim of the study was to assess the clinical and radiographic long-term follow-up of a series of patients undergoing total knee replacement that used a specific design of knee implant with cemented femoral and patellar components, and a hybrid fixation technique for
tibial trays that used a cemented base plate and press-fit keels. Methods: A total of 145 implants in 135
patients were studied with clinical and radiologic evaluations. The mean follow-up was 17.1 years. Results: Seven failures for aseptic loosening and four failures for infection were registered. Twenty-nine implants showed nonprogressive radiolucencies, mostly at a single component, which did not need revision. The
overall survivorship at the mean follow-up of 15 years considering aseptic loosening as the endpoint was
92.1%. Conclusions: The authors confirm the good rates of success and the long-term survival of this specific implant and the effectiveness of the tibial hybrid cementing technique, which is still debated among
researchers.
Computer-Assisted Navigation in Knee Surgery
313-322
10.1615/JLongTermEffMedImplants.2013007080
George
Mimidis
First Department of Orthopaedics, Attikon University Hospital, Athens University Medical School, Athens, Greece
Andreas F.
Mavrogenis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
Olga D.
Savvidou
First Department of Orthopaedics, ATTIKON University Hospital, Athens, Greece
Christos
Markopoulos
First Department of Orthopaedics, ATTIKON University Hospital, Athens, Greece
John
Papanastasiou
First Department of Orthopaedics, ATTIKON University Hospital, Athens, Greece
Zinon T.
Kokkalis
Department of Orthopaedics, University of Patras, School of Medicine, University Hospital of Patras, Patras, Greece
Dimitrios
Koulalis
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
Panayiotis J.
Papagelopoulos
First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece
computer-assisted navigation
orthopaedic surgery
Although computer-assisted navigation has been used in clinical practice for more than 15 years, it has only recently started to gain acceptance in a variety of orthopedic procedures. Different types of computer-assisted navigation are available, which allow the surgeon to obtain real-time feedback and offer him the potential to decrease intraoperative errors. However, its increased cost and lacking evidence of long-term superiority have made many surgeons skeptical about its clinical usefulness. The scope of this article is to review the clinical applications of computer-assisted navigation in orthopedic surgery of the knee joint.
Dental Implantation: An Opportunity to Stop Smoking
323-328
10.1615/JLongTermEffMedImplants.2013007189
Mahdi
Kadkhodazadeh
Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Reza
Amid
Dentofacial Deformities Research Center, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Fatemeh
Mollaverdi
Operative Dentistry Department, Dental School, Shahed University, Tehran, Iran
Omid
Amirbandeh
Periodontics Department, Dental School, Qazvin University of Medical Sciences, Qazvin, Iran
dental implants
cigarette smoking
peri-implant disease
lifestyle
Cigarette smoking and tobacco consumption are serious hazards threatening the health of human beings. Several strategies have been proposed for smoking cessation in patients presenting to medical centers to seek treatment. Some believe that the dental profession plays a key role in quit smoking programs due to its extensive and long-term relationship with patients. Use of known strategies to create motivation for quitting smoking among patients has yielded relatively optimal results. However, it seems
that patients' attitudes toward smoking can be changed if we enhance their knowledge about the hazards of tobacco consumption and its adverse effects on dental and oral health and especially the health of dental
implants' surrounding structures. This study reports smoking cessation in two patients requiring dental
implant treatment. Twenty-eight months after loading of implants, treatment success was confirmed by use of clinical and radiographic indices. No sign of peri-implant disease was detected and the patients were eagerly following the smoking cessation program. It seems that contemporary dental treatments, especially dental implant therapy, can provide a good opportunity to create the motivation required for lifestyle changes in patients.
A Real-World Comparative Assessment of Complications Following Various Mid-Urethral Sling Procedures for the Treatment of Stress Urinary Incontinence
329-340
10.1615/JLongTermEffMedImplants.2013007383
Glenn
Magee
Premier Research Services, Charlotte, NC
Sanjoy
Roy
Ethicon (Johnson & Johnson), Somerville, New Jersey 08876
Piet
Hinoul
Johnson & Johnson Global Surgery Group, Somerville, NJ
Chad
Moretz
Premier Research Services, Charlotte, NC
Roumen
Kozarev
Premier Research Services, Charlotte, NC
Heidi
Waters
Johnson & Johnson Global Surgery Group, Somerville, NJ
Kristene
Whitmore
Pelvic and Sexual Health Institute, Philadelphia, PA
stress urinary incontinence
mid-urethral sling
surgical outcomes
Stress urinary incontinence affects a significant proportion of the adult female population in the United States with prevalence increasing with growing age. Mid-urethral slings are among surgical options offering important improvement in the condition. The aim of this study was to evaluate clinical outcomes of different mid-urethral sling products with respect to postsurgery complications. This retrospective study utilized data from the Premier Perspective Database for mid-urethral sling procedures between 2005 and 2009. Patients were grouped into retropubic or transobturator cohorts, and these cohorts were further divided by the sling utilized during the procedure. Surgical outcomes and 12-month
complication rates were assessed. In general, there were fewer complications noted for transobturator procedures than for retropubic procedures. In the retropubic category, Gynecare TVT had significantly lower rates of urinary obstruction/retention than other retropubic procedures. In the transobturator category, lower rates of overall pelvic complications as well as urologic complications, including urgency incontinence and urinary tract infections, were observed in the Gynecare TVTO subgroup than other transobturator procedures. Results of this study confirm the low overall rate of complications for midurethral sling procedures while at the same time suggesting that product choice may also have an impact
on complication rates.