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[PMID]:29437058
[Au] Autor:Lam Tin Cheung K; Lanting BA; McCalden RW; Yuan X; MacDonald SJ; Naudie DD; Teeter MG
[Ad] Endereço:Schulich School of Medicine and Dentistry, Western University, 1151 Richmond Street, London, Ontario N6A 5C1, Canada.
[Ti] Título:Inducible displacement of cemented tibial components ten years after total knee arthroplasty.
[So] Source:Bone Joint J;100-B(2):170-175, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to evaluate the long-term inducible displacement of cemented tibial components ten years after total knee arthroplasty (TKA). PATIENTS AND METHODS: A total of 15 patients from a previously reported prospective trial of fixation using radiostereometric analysis (RSA) were examined at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine RSA examinations were acquired at one week, one year, and two years postoperatively and at final follow-up. Weight-bearing RSA examinations were also undertaken with the operated lower limb in neutral and in maximum internal rotation positions. Maximum total point motion (MTPM) was calculated for the longitudinal and inducible displacement examinations (supine standing, standing internal rotation, and supine standing with internal rotation). RESULTS: All patients showed some inducible displacement. Two patients with radiolucent lines had greater mean standing-supine MTPM displacement (1.35; sd 0.38) compared with the remaining patients (0.68; sd 0.36). These two patients also had a greater mean longitudinal MTPM at ten years (0.64; sd 0.50) compared with the remaining patients (0.39; sd 0.13 mm). CONCLUSION: Small inducible displacements in well-fixed cemented tibial components were seen ten years postoperatively, of a similar magnitude to that which has been reported for well-fixed components one to two years postoperatively. Greater displacements were found in components with radiolucent lines. Cite this article: 2018;100-B:170-5.
[Mh] Termos MeSH primário: Artroplastia do Joelho
Prótese do Joelho
Falha de Prótese
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Estudos Longitudinais
Masculino
Meia-Idade
Postura
Estudos Prospectivos
Desenho de Prótese
Análise Radioestereométrica
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0428.R2


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[PMID]:29212682
[Au] Autor:Dunbar MJ; Laende EK; Collopy D; Richardson CG
[Ad] Endereço:Dalhousie University, Division of Orthopaedics, Department of Surgery, Dalhousie University, and Halifax Infirmary, QEII Health Sciences Centre, Nova Scotia Health Authority, 1796 Summer St, Halifax NS B3H 3A7, Canada.
[Ti] Título:Stable migration of peri-apatite-coated uncemented tibial components in a multicentre study.
[So] Source:Bone Joint J;99-B(12):1596-1602, 2017 Dec.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Hydroxyapatite coatings for uncemented fixation in total knee arthroplasty can theoretically provide a long-lasting biological interface with the host bone. The objective of this study was to test this hypothesis with propriety hydroxyapatite, peri-apatite, coated tibial components using component migration measured with radiostereometric analysis over two years as an indicator of long-term fixation. PATIENTS AND METHODS: A total of 29 patients at two centres received uncemented PA-coated tibial components and were followed for two years with radiostereometric analysis exams to quantify the migration of the component. RESULTS: While there was significant variation in individual migration patterns, the overall migration of the tibial component in the study group demonstrated a pattern of initial migration followed by stabilisation after one year, with mean maximum total point motion (MTPM) of 0.02 mm (standard deviation (sd) 0.20) between one and two years post-operatively. The direction of greatest motion was subsidence, which stabilised at three months post-operatively (mean translation of 0.21 mm, sd 0.40). CONCLUSION: The tibial component migration pattern of stabilisation in the second post-operative year is indicative of successful long-term fixation for this PA-coated tibial component. Cite this article: 2017;99-B:1596-1602.
[Mh] Termos MeSH primário: Artroplastia do Joelho/instrumentação
Migração de Corpo Estranho/diagnóstico por imagem
Prótese do Joelho
Osteoartrite do Joelho/cirurgia
[Mh] Termos MeSH secundário: Idoso
Artroplastia do Joelho/efeitos adversos
Cimentos para Ossos
Cimentação
Materiais Revestidos Biocompatíveis
Durapatita
Feminino
Migração de Corpo Estranho/etiologia
Seres Humanos
Articulação do Joelho/diagnóstico por imagem
Articulação do Joelho/cirurgia
Masculino
Meia-Idade
Osteoartrite do Joelho/diagnóstico por imagem
Desenho de Prótese
Falha de Prótese
Análise Radioestereométrica
Cirurgia Assistida por Computador
Tíbia/diagnóstico por imagem
Tíbia/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Bone Cements); 0 (Coated Materials, Biocompatible); 91D9GV0Z28 (Durapatite)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B12.BJJ-2016-1118.R2


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[PMID]:28872526
[Au] Autor:Shareghi B; Johanson PE; Kärrholm J
[Ad] Endereço:1Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
[Ti] Título:Wear of Vitamin E-Infused Highly Cross-Linked Polyethylene at Five Years.
[So] Source:J Bone Joint Surg Am;99(17):1447-1452, 2017 Sep 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In an earlier study with a 2-year follow-up of uncemented cups, we had reported low femoral-head penetration of vitamin E-infused highly cross-linked polyethylene liners (E1) compared with highly cross-linked liners without vitamin E (ArComXL). We studied the penetration rate of E1 compared with that of ArComXL, with a focus on changes occurring between 2 and 5 years after total hip arthroplasty. METHODS: In this randomized controlled study, we performed radiostereometric analysis of the penetration rate up to 5 years in 63 hips. RESULTS: During the total period of observation, the median proximal penetration for E1, 0.13 mm (mean, 0.11 mm [95% confidence interval (CI), 0.08 to 0.14 mm]), was lower than that for ArComXL, 0.20 mm (mean, 0.22 mm [95% CI, 0.17 to 0.26 mm]). The median proximal penetration rate between 2 and 5 years was 0.02 mm/yr (mean, 0.01 mm/yr [95% CI, 0.01 to 0.02 mm/yr]) for E1 and 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr) for ArComXL. The corresponding median total (i.e., 3-dimensional resultant) penetration rates were 0.04 mm/yr (mean, 0.04 mm/yr [95% CI, 0.03 to 0.05 mm/yr]) for E1 and 0.07 mm/yr (mean, 0.08 mm/yr [95% CI, 0.06 to 0.10 mm/yr]) for ArComXL. CONCLUSIONS: From years 2 to 5, we observed increased penetration in both groups. The penetration rate was higher for ArComXL, resulting in more proximal and total penetration at 5 years than for E1. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Prótese de Quadril
Osteoartrite do Quadril/cirurgia
Polietileno
Desenho de Prótese
Vitamina E
[Mh] Termos MeSH secundário: Adulto
Idoso
Antioxidantes
Feminino
Fêmur
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Falha de Prótese
Análise Radioestereométrica
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antioxidants); 1406-18-4 (Vitamin E); 9002-88-4 (Polyethylene)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00691


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[PMID]:28730988
[Au] Autor:Gascoyne TC; McRae SMB; Parashin SL; Leiter JRS; Petrak MJ; Bohm ER; MacDonald PB
[Ad] Endereço:From the Orthopaedic Innovation Centre, Concordia Hip and Knee Institute, Winnipeg, Man. (Gascoyne, Parashin, Petrak); the Concordia Joint Replacement Group, Concordia Hip & Knee Institute, Winnipeg, Man. (Gascoyne, Parashin, Petrak, Bohm); the Pan Am Clinic, Winnipeg, Man. (McRae, Leiter, MacDo
[Ti] Título:Radiostereometric analysis of keeled versus pegged glenoid components in total shoulder arthroplasty: a randomized feasibility study.
[So] Source:Can J Surg;60(4):273-279, 2017 Aug.
[Is] ISSN:1488-2310
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to assess differences in the fixation and functional outcomes between pegged and keeled all-polyethylene glenoid components for standard total shoulder arthroplasty. METHODS: Patients were randomized to receive a keeled or pegged all-polyethylene glenoid component. We used model-based radiostereometric analysis (RSA) to assess glenoid fixation and subjective outcome measures to assess patient function. Follow-up examinations were completed at 6 weeks and 6, 12 and 24 months after surgery. Modifications to the RSA surgical, imaging and analytical techniques were required throughout the study to improve the viability of the data. RESULTS: Stymied enrolment resulted in only 16 patients being included in our analyses. The RSA data indicated statistically greater coronal plane migration in the keeled glenoid group than in the pegged group at 12 and 24 months. Functional outcome scores did not differ significantly between the groups at any follow-up. One patient with a keeled glenoid showed high component migration after 24 months and subsequently required revision surgery 7 years postoperatively. CONCLUSION: Despite a small sample size, we found significant differences in migration between glenoid device designs. Although clinically these findings are not robust, we have shown the feasibility of RSA in total shoulder arthroplasty as well as the value of a high-precision metric to achieve objective results in a small group of patients.
[Mh] Termos MeSH primário: Artroplastia do Ombro/métodos
Cavidade Glenoide
Avaliação de Processos e Resultados (Cuidados de Saúde)
Polietileno
Desenho de Prótese/normas
Falha de Prótese
Análise Radioestereométrica/métodos
Reoperação
Prótese de Ombro/normas
[Mh] Termos MeSH secundário: Artroplastia do Ombro/efeitos adversos
Estudos de Viabilidade
Seguimentos
Seres Humanos
Desenho de Prótese/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
9002-88-4 (Polyethylene)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE


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[PMID]:28663392
[Au] Autor:Mohaddes M; Shareghi B; Kärrholm J
[Ad] Endereço:Swedish Hip Arthroplasty Register, Gothenburg, Sweden.
[Ti] Título:Promising early results for trabecular metal acetabular components used at revision total hip arthroplasty: 42 acetabular revisions followed with radiostereometry in a prospective randomised trial.
[So] Source:Bone Joint J;99-B(7):880-886, 2017 Jul.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to compare the incidence of aseptic loosening after the use of a cemented acetabular component and a Trabecular Metal (TM) acetabular component (Zimmer Inc., Warsaw, Indiana) at acetabular revision with bone impaction grafting. PATIENTS AND METHODS: A total of 42 patients were included in the study. Patients were randomised to receive an all- polyethylene cemented acetabular component (n = 19) or a TM component (n = 23). Radiostereometric analysis and conventional radiographic examinations were performed regularly up to two years post-operatively or until further revision. RESULTS: The proximal migration was significantly higher in the cemented group. At two years, the median proximal migration was 1.45 mm and 0.25 mm in the cemented and TM groups, respectively (p = 0.02). One cemented component was revised due to dislocation. There were no revisions in the TM group. CONCLUSION: Lower proximal migration in the TM group suggests that this design might be associated with a lower risk of aseptic loosening in the long term compared with an all polyethylene cemented component. Longer follow-up is required to confirm the clinical advantages of using this component at acetabular revision. Cite this article: 2017;99-B:880-6.
[Mh] Termos MeSH primário: Artroplastia de Quadril/instrumentação
Prótese de Quadril
[Mh] Termos MeSH secundário: Acetábulo
Adulto
Idoso
Transplante Ósseo
Feminino
Seres Humanos
Masculino
Metais
Meia-Idade
Polietileno
Estudos Prospectivos
Desenho de Prótese
Falha de Prótese
Análise Radioestereométrica
Reoperação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Metals); 9002-88-4 (Polyethylene)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B7.BJJ-2016-1241.R1


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[PMID]:28314889
[Au] Autor:Stentz-Olesen K; Nielsen ET; de Raedt S; Jørgensen PB; Sørensen OG; Kaptein B; Søballe K; Stilling M
[Ad] Endereço:Orthopedic Research Unit, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus C, Denmark. kasperstentz@gmail.com.
[Ti] Título:Reconstructing the anterolateral ligament does not decrease rotational knee laxity in ACL-reconstructed knees.
[So] Source:Knee Surg Sports Traumatol Arthrosc;25(4):1125-1131, 2017 Apr.
[Is] ISSN:1433-7347
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Little is known about the anterolateral ligament's (ALL) influence on knee laxity. The purpose of this study was to investigate rotational knee laxity against a pure axial rotational stress using radiostereometric analysis (RSA) after cutting and reconstructing both the anterior cruciate ligament (ACL) and the ALL. METHODS: Eight human donor legs were positioned and stereoradiographically recorded at 0°, 30° and 60° of knee flexion using a motorised fixture, while an internally rotating force of 4 Nm was applied to the foot. Anterior-posterior and rotational laxity were investigated for knees with intact ligaments and compared with those observed after successive ACL and ALL resection and reconstruction. RESULTS: After cutting the ALL in ACL-deficient knees, the internal rotation was increased in all three knee flexion angles, 0° (p = 0.04), 30° (p = 0.03) and 60° (p < 0.01) by 1.0°, 1.6° and 2.5°, respectively. However, no decrease in laxity was found after reconstructing the ALL in ACL-reconstructed knees. CONCLUSIONS: The ALL was confirmed as a stabiliser of internal rotation in ACL-deficient knees. However, reconstructing the ALL using a gracilis autograft tendon did not decrease the internal rotation laxity in the ACL-reconstructed knee. Based on the results of this study, we do not recommend reconstructing the ALL in ACL-reconstructed knees to decrease internal knee laxity.
[Mh] Termos MeSH primário: Ligamento Cruzado Anterior/cirurgia
Instabilidade Articular/fisiopatologia
Articulação do Joelho/fisiopatologia
Ligamentos Articulares/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Cadáver
Feminino
Seres Humanos
Articulação do Joelho/diagnóstico por imagem
Masculino
Meia-Idade
Análise Radioestereométrica
Rotação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE
[do] DOI:10.1007/s00167-017-4500-3


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[PMID]:28287044
[Au] Autor:Ledin H; Good L; Johansson T; Aspenberg P
[Ad] Endereço:a Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Medicine , Linköping University , Linköping.
[Ti] Título:No effect of teriparatide on migration in total knee replacement.
[So] Source:Acta Orthop;88(3):259-262, 2017 Jun.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Teriparatide, a recombinant parathyroid hormone (PTH), stimulates osteoblasts and has been suggested to improve cancellous bone healing in humans. This might also be relevant for prosthesis fixation. We used radiostereometric analysis (RSA) to investigate whether teriparatide influences prosthesis fixation. Early migration as measured by RSA can predict future loosening. Patients and methods - In a randomized controlled trial with blind evaluation, 50 patients with osteoarthritis of the knee were allocated to a teriparatide treatment group (Forsteo, 20 µg daily for 2 months postoperatively) or to an untreated control group. RSA was performed postoperatively and at 6 months, 12 months, and 24 months. The primary effect variable was maximal total point motion (MTPM) from 12 to 24 months. Results - Median maximal total point motion from 12 to 24 months was similar in the 2 groups (teriparatide: 0.14 mm, 10% and 90% percentiles: 0.08 and 0.24; control: 0.13 mm, 10% and 90% percentiles: 0.09 and 0.21). [Authors: this is perhaps better than using "10th" and "90th", which looks ugly in print./language editor] The 95% confidence interval for the difference between group means was -0.03 to 0.04 mm, indicating that no difference occurred. Interpretation - We found no effect of teriparatide on migration in total knee replacement. Other trials using the same dosing have suggested a positive effect of teriparatide on human cancellous fracture healing. Thus, the lack of effect on migration may have been due to something other than the dose. In a similar study in this issue of Acta Orthopaedica, we found that migration could be reduced with denosumab (Ledin et al. 2017 ). The difference in response between the anabolic substance teriparatide and the antiresorptive denosumab suggests that resorption has a more important role during the postoperative course than any deficit in bone formation.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Conservadores da Densidade Óssea/farmacologia
Prótese do Joelho
Falha de Prótese/efeitos dos fármacos
Teriparatida/farmacologia
[Mh] Termos MeSH secundário: Idoso
Artroplastia do Joelho/efeitos adversos
Cimentação
Feminino
Seres Humanos
Masculino
Meia-Idade
Movimento (Física)
Osteoartrite do Joelho/cirurgia
Cuidados Pós-Operatórios/métodos
Falha de Prótese/etiologia
Análise Radioestereométrica
Método Simples-Cego
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 10T9CSU89I (Teriparatide)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1300745


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[PMID]:28287004
[Au] Autor:Ledin H; Good L; Aspenberg P
[Ad] Endereço:a Orthopedics, Department of Clinical and Experimental Medicine, Faculty of Medicine , Linköping University , Linköping.
[Ti] Título:Denosumab reduces early migration in total knee replacement.
[So] Source:Acta Orthop;88(3):255-258, 2017 Jun.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - Aseptic loosening is a main cause of late revision in total knee replacement (TKR). Migration of implants as measured by radiostereometric analysis (RSA) can predict future loosening. This migration is associated with bone resorption. Denosumab is a human monoclonal antibody that binds to receptors on osteoclast precursors and osteoclasts. This prevents osteoclast formation, resulting in less bone resorption in cortical and trabecular bone. We investigated whether denosumab can reduce migration of TKR, as measured with RSA. Patients and methods - In this 2-center, randomized, double-blind placebo-controlled trial, 50 patients with osteoarthritis of the knee were treated with an injection of either denosumab (60 mg) or placebo 1 day after knee replacement surgery and again after 6 months. RSA was performed postoperatively and after 6, 12, and 24 months. The primary effect variable was RSA maximal total point motion (MTPM) after 12 months. We also measured other RSA variables and the knee osteoarthritis outcome score (KOOS). Results - The primary effect variable, MTPM after 12 months, showed that migration in the denosumab group was statistically significantly less than in the controls. Denosumab MTPM 12 months was reduced by one-third (denosumab: median 0.24 mm, 10% and 90% percentiles: 0.15 and 0.41; placebo: median 0.36 mm, 10% and 90% percentiles: 0.20 and 0.62). The secondary MTPM variables (6 and 24 months) also showed a statistically significant reduction in migration. There was no significant difference in MTPM for the period 12-24 months. KOOS sub-variables were similiar between denosumab and placebo after 12 and 24 months. Interpretation - Denosumab reduces early migration in total knee replacement, as in previous trials using bisphosphonates. As migration is related to the risk of late loosening, denosumab may be beneficial for long-term results.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Conservadores da Densidade Óssea/uso terapêutico
Denosumab/uso terapêutico
Prótese do Joelho
Falha de Prótese/efeitos dos fármacos
[Mh] Termos MeSH secundário: Idoso
Artroplastia do Joelho/efeitos adversos
Conservadores da Densidade Óssea/farmacologia
Reabsorção Óssea/prevenção & controle
Denosumab/farmacologia
Método Duplo-Cego
Feminino
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Joelho/cirurgia
Cuidados Pós-Operatórios/métodos
Falha de Prótese/etiologia
Análise Radioestereométrica/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4EQZ6YO2HI (Denosumab)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170314
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1300746


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[PMID]:28266241
[Au] Autor:Gudnason A; Adalberth G; Nilsson KG; Hailer NP
[Ad] Endereço:a Department of Orthopedics , Institute of Surgical Sciences, Uppsala University Hospital , Uppsala.
[Ti] Título:Tibial component rotation around the transverse axis measured by radiostereometry predicts aseptic loosening better than maximal total point motion.
[So] Source:Acta Orthop;88(3):282-287, 2017 Jun.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - Maximal total point motion (MTPM) measured by radiostereometry (RSA) is widely used as a predictor of total knee arthroplasty (TKA) loosening. We compared the ability of different RSA measurements at different time points to predict loosening of tibial TKA components in the long term. Patients and methods - 116 TKAs in 116 patients were included in our analysis. 16 (14.8-17.4) years after surgery, 5 tibial components had been revised due to aseptic loosening. Receiver operating characteristic curves were calculated in order to investigate the specificity and sensitivity of different RSA parameters at different thresholds. Results - Rotation around the transverse (x-) axis measured 2 years postoperatively had the best predictive value of all parameters, with an area under the curve (AUC) of 80%. Using a threshold of 0.8 degrees, a specificity of 85% and a sensitivity of 50% were reached. The AUC for tibial component distal translation was 79% and it was 77% for proximal translation, whereas it was only 68% for MTPM. Interpretation - Rotation of the cemented tibial component around the transverse axis, proximal translation, and distal translation are slightly better at predicting aseptic loosening than MTPM, and tibial component migration measured after 2 years gives a good prediction of aseptic loosening up to 15 years.
[Mh] Termos MeSH primário: Artroplastia do Joelho/métodos
Prótese do Joelho
Falha de Prótese/etiologia
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Artroplastia do Joelho/efeitos adversos
Cimentos para Ossos
Cimentação
Feminino
Seguimentos
Seres Humanos
Masculino
Movimento (Física)
Prognóstico
Desenho de Prótese
Curva ROC
Análise Radioestereométrica/métodos
Reoperação/estatística & dados numéricos
Medição de Risco/métodos
Rotação
Sensibilidade e Especificidade
Tíbia/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Cements)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1297001


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[PMID]:28249970
[Au] Autor:Schilcher J; Palm L; Ivarsson I; Aspenberg P
[Ad] Endereço:Linköping University, Linköping, Sweden.
[Ti] Título:Local bisphosphonate reduces migration and formation of radiolucent lines adjacent to cemented acetabular components.
[So] Source:Bone Joint J;99-B(3):317-324, 2017 Mar.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Post-operative migration of cemented acetabular components as measured by radiostereometric analysis (RSA) has a strong predictive power for late, aseptic loosening. Also, radiolucent lines predict late loosening. Migration has been reduced by systemic bisphosphonate treatment in randomised trials of hip and knee arthroplasty. Used as a local treatment, a higher local dose of bisphosphonate can be achieved without systemic exposure. We wished to see if this principle could be applied usefully in total hip arthroplasty (THA). PATIENTS AND METHODS: In this randomised placebo-controlled, double-blinded trial with 60 participants, we compressed gauze soaked in bisphosphonate solution (ibandronate) or saline against the acetabular bone bed immediately before cementing the acetabular component. RSA, classification of radiolucent lines, the Harris Hip Score (HHS) and the Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) were carried out at three-, six-, 12-, and 24-month follow-up. RESULTS: Migration of the cemented acetabular component relative to the pelvis was reduced by movement almost half in the ibandronate group, when measured as maximum total point or as movement of the femoral head (p = 0.001 and 0.004, respectively). Radiolucent lines after one year were classified as absent, partial or complete, and correlated with treatment (rho 0.37; p = 0.004). Only three of 30 patients in the ibandronate group had complete lines, compared with 13 of 28 in the placebo group (p = 0.002). There were no significant effects on HHS or WOMAC score. CONCLUSION: Considering the power of RSA to predict loosening of cemented acetabular components, and the likelihood that radiolucent lines indicate risk of loosening, these data suggest that local treatment with a bisphosphonate can reduce the risk of late aseptic loosening. Cite this article: 2017;99-B:317-24.
[Mh] Termos MeSH primário: Acetábulo/cirurgia
Artroplastia de Quadril/instrumentação
Conservadores da Densidade Óssea/uso terapêutico
Difosfonatos/uso terapêutico
Migração de Corpo Estranho/prevenção & controle
Prótese de Quadril/efeitos adversos
[Mh] Termos MeSH secundário: Acetábulo/diagnóstico por imagem
Administração Tópica
Idoso
Artroplastia de Quadril/métodos
Cimentos para Ossos
Conservadores da Densidade Óssea/administração & dosagem
Conservadores da Densidade Óssea/efeitos adversos
Cimentação
Difosfonatos/administração & dosagem
Difosfonatos/efeitos adversos
Método Duplo-Cego
Feminino
Migração de Corpo Estranho/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/cirurgia
Desenho de Prótese
Falha de Prótese/efeitos dos fármacos
Análise Radioestereométrica
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Bone Cements); 0 (Bone Density Conservation Agents); 0 (Diphosphonates); UMD7G2653W (ibandronic acid)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170417
[Lr] Data última revisão:
170417
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B3.BJJ-2016-0531.R1



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