The Journal of arthroplasty
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Comparative Study
Conversion of hip arthrodesis to total hip arthroplasty: survivorship and clinical outcome.
This study evaluated survivorship and clinical outcomes of patients undergoing conversion of a hip arthrodesis to a total hip arthroplasty (THA) and compared them to 2 patient cohorts: primary THA and first-time revision THA. Patients completed 5 standardized outcome questionnaires. The study cohort was compared to matched groups of primary THA and first-time revision THA patients. ⋯ A 10-year survivorship of 74.2% and complication rate of 54% were noted. All outcome scores were lower for the study cohort: clinically significant difference vs revision THA group and statistically significant difference vs primary THA group. Takedown arthrodesis patients experience poor clinical outcomes and high complication rates compared to primary and even revision THA.
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Case Reports
Peroneal nerve dysfunction after total knee arthroplasty: characterization and treatment.
The purpose of this study was to report on the presentation, evaluation, treatment, and outcome of patients who had a peroneal nerve dysfunction after total knee arthroplasty. Six patients were unable to achieve adequate range of motion after physical therapy, and the remaining 5 patients had sensory symptoms that interfered with daily activities despite adequate range of motion. ⋯ All patients with dominant sensory symptoms had a resolution of leg and foot pain after treatment. Orthopedic surgeons should be aware of peroneal nerve dysfunction as a possible cause of unsatisfactory rehabilitation and/or persistent atypical lateral leg pain after total knee arthroplasty.
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We present results of 12 type B1 periprosthetic femoral fractures treated with locking compression plate and cerclage band from January 2003 to June 2007. The average follow-up was 30.1 months. Twelve fractures united in an average period of 4.8 months. ⋯ Unfortunately, 1 month later, she sustained a type C fracture during a slipping injury and treated with cast immobilization. The fracture united after 4 months. None had complications of loss of reduction, plate break, and wound infection.
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Pain after total hip arthroplasty can be due to a variety of causes, one of the less common being iliopsoas tendonitis. We report an unusual case of iliopsoas tendonitis caused by overhang of the femoral calcar by a collared femoral prosthesis resulting in impingement on the iliopsoas tendon. An ultrasound-guided corticosteroid and local anesthetic diagnostic injection to the site of impingement confirmed the diagnosis with temporary symptom relief. Revision of the femoral stem to a collarless prosthesis resulted in immediate and complete resolution of symptoms.
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Fracture of the neck of the femoral component after total hip arthroplasty is an infrequent complication. We present a report of 2 cases of trunnion fractures of fully porous-coated femoral stems (AML A Plus, DePuy International, Leeds, England), which had been implanted for 6 and 7 years after the index procedures. ⋯ Although this is the first report of trunnion fractures in this particular implant design, a close monitoring of prostheses with this specific trunnion should be considered. In addition, further analysis of clinical results and complications with this implant is warranted.