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[PMID]:28470462
[Au] Autor:Grundei H; Timmermann A
[Ad] Endereço:Fa. Eska Orthopaedic Handels GmbH, Osterweide 2c, 23562, Lübeck, Deutschland. info@eskaorthopaedic.de.
[Ti] Título:[Connecting adapter for coupling exoprostheses to endoshafts : Demands on orthopedic technicians with respect to planning and application].
[Ti] Título:Anschlussadapter zur Ankopplung der Exoprothese an den Endostiel : Anforderungen an den Orthopädietechniker hinsichtlich Planung und Anwendung..
[So] Source:Unfallchirurg;120(5):378-384, 2017 May.
[Is] ISSN:1433-044X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:INTRODUCTION: Transcutaneous, bone anchored prostheses have proved to be an alternative for amputees. In addition to the safe osseointegration of the implant, the correct prosthetic alignment is also important. Therefore, the interaction between prosthesis components and the prosthesis wearer is significant and the role of the certified prosthetist should not be underestimated. AIM: The aim of treatment is the best possible compensation of disability after limb loss with increase of physical abilities and comfort of the prosthesis wearer by means of bone anchored prosthesis. METHOD: Endoprosthesis inserted by the surgeon carrying out both surgery with the implant and a double-cone and 6 weeks later the exoprosthesis is fitted by the certified prosthetist orthotist (CPO). Mounting the external adaptors, assembly of the prosthesis. RESULTS: The long-term results with cementless implants and more than 35 years experience are presented. Clinical experience with the endo-exo prosthesis since 1999. A total of 135 patients treated after transfemoral amputation, 8 of them bilateral, 8 out of 135 were transtibial amputees and 1 of them bilateral. A total of 85% were amputated as a consequence of trauma and 12 out of 135 had a full range of motion at the beginning of the prosthetic work following osseointegration. In other cases, a hip flexion contracture between 3 and 12 ° had to be considered by corresponding posterior displacement adaptors. CONCLUSION: Bone anchored prostheses influence the skeleton and joints in a more direct way. This fact requires specific prosthetic measures concerning the connection between the endo-implant and the exoprosthesis. Therefore, specially matched adaptors and the prosthetic alignment are the focus of interest. Prostheses connected to an osseointegrated implant have many biomechanical advantages compared to socket-guided prostheses. Because the quality of rehabilitation is clearly affected by the prosthetic alignment, it has to be carried out extremely carefully and precisely if the prosthesis is connected to an osseointegrated implant. According to the survey, none of the prosthesis wearers wanted to return to a socket-guided prosthesis.
[Mh] Termos MeSH primário: Cotos de Amputação/cirurgia
Amputação/reabilitação
Artroplastia de Substituição/instrumentação
Membros Artificiais
Exoesqueleto Energizado
Prótese Articular
Perna (Membro)/cirurgia
[Mh] Termos MeSH secundário: Artroplastia de Substituição/métodos
Terapia Combinada/instrumentação
Terapia Combinada/métodos
Seres Humanos
Osseointegração
Desenho de Prótese
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s00113-017-0351-0


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[PMID]:29252736
[Au] Autor:Jones CM; Beredjiklian PK
[Ad] Endereço:Department of Hand & Upper Extremity Surgery, Rothman Institute, Philadelphia, Pennsylvania.
[Ti] Título:Radial Head Arthroplasty Understuffing in the Setting of Longitudinal Radioulnar Dissociation: A Case Report.
[So] Source:JBJS Case Connect;6(4):e81, 2016 Oct-Dec.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: We present a case in which underlengthening of the radius allowed proximal migration of the radius and ulnocarpal abutment in a patient with a comminuted radial head fracture and concomitant longitudinal forearm instability. CONCLUSION: Radial head arthroplasty is a common treatment for comminuted, displaced radial head fractures. Ideally, the dimensions of the radial head implant should match the native anatomy to restore elbow stability and kinematics. Underlengthening the radius by placing a small radial head implant can lead to carpal abutment at the wrist level.
[Mh] Termos MeSH primário: Artroplastia/efeitos adversos
Articulação do Cotovelo/cirurgia
Fraturas Cominutivas/cirurgia
Prótese Articular/efeitos adversos
Fraturas do Rádio/cirurgia
[Mh] Termos MeSH secundário: Artroplastia/instrumentação
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.15.00258


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[PMID]:29369186
[Au] Autor:Gao X; Yang Y; Liu H; Meng Y; Zeng J; Wu T; Hong Y
[Ad] Endereço:Department of Orthopedics, West China Hospital, Sichuan University.
[Ti] Título:Cervical disc arthroplasty with Prestige-LP for the treatment of contiguous 2-level cervical degenerative disc disease: 5-year follow-up results.
[So] Source:Medicine (Baltimore);97(4):e9671, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of this study is to present the long-term results and to evaluate the safety and effectiveness of the Prestige-LP cervical disc replacement in treatment of patients with symptomatic 2-level cervical degenerative disc disease.Twenty-four patients with 48 Prestige-LP disc were analyzed before surgery and at 1 week, 3 months, 6 months, 12 months, 24 months, and 60 months after surgery. Clinical assessments included 36-Short Form (SF-36), Japanese Orthopedic Assessment (JOA), visual analog scale (VAS), and Neck Disability Index (NDI) scores. Radiographic assessments included cervical lordosis (CL), disc height (DH), range of motion (ROM) of the total cervical spine, functional spinal unit (FSU) as well as upper and lower operated segment. Complications at the 5-year follow-up were collected as well.Mean follow-up period was 64.22 months. There was clinical improvement in terms of SF-36, JOA, NDI, and VAS from the preoperative to the final follow-up (P < .05). Overall, ROM of the total cervical spine, FSU, and upper and lower operated segment were maintained during the follow-up. Statistically significant (P < .05) improvements in the trend of CL and DH were noted at the follow-up. Eight patients were observed an appearance of heterotopic ossification at the 5-year follow-up, with 6 patients appeared at Class II and 2 patients at Class III. Adjacent segment degeneration assessed by radiographic evidence was found in 2 patients.Two-level cervical disc arthroplasty with Prestige-LP showed significant improvement in clinical outcomes at 5 years. It not only effectively preserves the motion of both total cervical spine and operated segments, but also restores normal CL and DH up to 5 years postoperation.
[Mh] Termos MeSH primário: Artroplastia de Substituição/instrumentação
Vértebras Cervicais/cirurgia
Degeneração do Disco Intervertebral/cirurgia
Prótese Articular
[Mh] Termos MeSH secundário: Adulto
Artroplastia de Substituição/métodos
Vértebras Cervicais/fisiopatologia
Avaliação da Deficiência
Feminino
Seguimentos
Seres Humanos
Degeneração do Disco Intervertebral/fisiopatologia
Masculino
Meia-Idade
Medição da Dor
Dor Pós-Operatória/etiologia
Período Pós-Operatório
Amplitude de Movimento Articular
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009671


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[PMID]:28463204
[Au] Autor:Lee JD; Mooney LM; Rouse EJ
[Ti] Título:Design and Characterization of a Quasi-Passive Pneumatic Foot-Ankle Prosthesis.
[So] Source:IEEE Trans Neural Syst Rehabil Eng;25(7):823-831, 2017 07.
[Is] ISSN:1558-0210
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The majority of commercially available passive prosthetic feet are not capable of providing joint mechanics that match that of the intact human ankle. Due to their cantilever design, their stiffness characteristics contrast with what has been observed in the biological ankle, namely, an increase in stiffness during the stance phase of walking. In this paper, we introduce the design and control of a pneumatic foot-ankle prosthesis that attempts to provide biomimetic mechanics. The prosthesis is comprised of a pneumatic cylinder in series with a fiberglass leaf spring, and a solenoid valve to control the flow of air between the two sides of the cylinder. The solenoid valve acts as a mechanical clutch, enabling resetting of the ankle's equilibrium position. By adjusting the pressure inside the cylinder, the prosthesis can be customized to provide a range of ankle mechanics. A mechanical testing machine is used to compare the torque-angle curve of the pneumatic prosthesis with a low-profile passive prosthetic foot. Finally, data are presented of one transtibial amputee walking with the prosthesis at 1.2 m/s. The testing shows that the pneumatic prosthesis is capable of providing an appropriate range of motion as well a maximum torque of 94 Nm, while returning approximately 11.5 J of energy.
[Mh] Termos MeSH primário: Amputados/reabilitação
Articulação do Tornozelo/fisiopatologia
Membros Artificiais
Biomimética/instrumentação
Exoesqueleto Energizado
Prótese Articular
Robótica/métodos
[Mh] Termos MeSH secundário: Pressão do Ar
Projeto Auxiliado por Computador
Desenho de Equipamento
Análise de Falha de Equipamento
Seres Humanos
Meia-Idade
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1109/TNSRE.2017.2699867


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[PMID]:29305453
[Au] Autor:Suen K; Keeka M; Ailabouni R; Tran P
[Ad] Endereço:Western Health, 160 Gordon St, Footscray, Victoria 3011, Australia.
[Ti] Título:Synovasure 'quick test' is not as accurate as the laboratory-based α-defensin immunoassay: a systematic review and meta-analysis.
[So] Source:Bone Joint J;100-B(1):66-72, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: α-defensin is a biomarker which has been described as having a high degree of accuracy in the diagnosis of periprosthetic joint infection (PJI). Current meta-analyses are based on the α-defensin laboratory-based immunoassay rather than the quick on-table lateral flow test kit. This study is the first meta-analysis to compare the accuracy of the α-defensin laboratory-based immunoassay and the lateral flow test kit for the diagnosis of PJI. MATERIALS AND METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were all clinical studies where the diagnosis of PJI was uncertain. All studies selected used the Musculoskeletal Infection Society (MSIS) or modified MSIS criteria. Two independent reviewers reviewed the studies and extracted data. A meta-analysis of results was carried out: pooled sensitivity, specificity, positive and negative likelihood ratio, heterogeneity and areas under curves are reported. RESULTS: Ten studies (759 patients) were included. Of these, seven studies (640 patients) evaluated the laboratory-based α-defensin immunoassay and three (119 patients) the lateral flow test. The pooled sensitivity and specificity of the qualitative α-defensin laboratory immunoassay was 0.953 (95% confidence interval (CI) 0.87 to 0.984) and 0.965 (95% CI 0.943 to 0.979) respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 34.86 (95% CI 19.34 to 62.85) and 0.02 (95% CI 0.00 to 0.11). The pooled sensitivity and specificity of the lateral flow test were 0.774 (95% CI 0.637 to 0.870) and 0.913 (95% CI 0.828 to 0.958), respectively. The pooled PLR and NLR were 8.675 (95% CI 4.229 to 17.794) and 0.248 (95% CI 0.147 to 0.418), respectively. CONCLUSION: The pooled sensitivity and specificity of the lateral flow test were lower than those of the α-defensin laboratory-based immunoassay test. Hence, care must be taken with interpretation of the lateral flow test when relying on its results for the intra-operative diagnosis of PJI. Cite this article: 2018;100-B:66-72.
[Mh] Termos MeSH primário: Prótese Articular/efeitos adversos
Infecções Relacionadas à Prótese/diagnóstico
Kit de Reagentes para Diagnóstico
Líquido Sinovial/química
alfa-Defensinas/análise
[Mh] Termos MeSH secundário: Biomarcadores/análise
Seres Humanos
Imunoensaio
Falha de Prótese/etiologia
Reoperação
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); 0 (Reagent Kits, Diagnostic); 0 (alpha-Defensins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0630.R1


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[PMID]:27770632
[Au] Autor:Zhao D; Witte F; Lu F; Wang J; Li J; Qin L
[Ad] Endereço:Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China. Electronic address: zhaodewei2000@163.com.
[Ti] Título:Current status on clinical applications of magnesium-based orthopaedic implants: A review from clinical translational perspective.
[So] Source:Biomaterials;112:287-302, 2017 01.
[Is] ISSN:1878-5905
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:As a new generation of medical metallic material, magnesium (Mg) and its alloys with or without surface coating have attracted a great deal of attention due to its biodegradability and potential for avoiding a removal operation after the implant has fulfilled its function for surgical fixation of injured musculoskeletal tissues. Although a few clinical cases on Mg-based orthopaedic implants were reported more than a century ago, it was not until recently that clinical trials using these implants with improved physicochemical properties were carried out in Germany, China and Korea for bone fracture fixation. The promising results so far suggest a bright future for biodegradable Mg-based orthopaedic implants and would warrant large scale phase II/III studies. Given the increasing interest on this emerging biomaterials and intense effort to improve its properties for various clinical applications, this review covers the evolution, current strategies, and future perspectives in the development of Mg-based orthopaedic implants. We also highlight a few clinical cases performed in China that may be unfamiliar to the general orthopaedic community.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/química
Fixadores Internos/tendências
Prótese Articular/tendências
Magnésio/química
[Mh] Termos MeSH secundário: Animais
Análise de Falha de Equipamento
Seres Humanos
Desenho de Prótese/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biocompatible Materials); I38ZP9992A (Magnesium)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180106
[Lr] Data última revisão:
180106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:28455729
[Au] Autor:Haskell A
[Ad] Endereço:Department of Orthopaedic Surgery, Palo Alto Medical Foundation, 301 Industrial Road, San Carlos, CA, 94070, USA. haskela@pamf.org.
[Ti] Título:CORR Insights : Can a Three-component Prosthesis be Used for Conversion of Painful Ankle Arthrodesis to Total Ankle Replacement?
[So] Source:Clin Orthop Relat Res;475(9):2295-2297, 2017 09.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Tornozelo/cirurgia
Artroplastia de Substituição do Tornozelo
[Mh] Termos MeSH secundário: Articulação do Tornozelo/cirurgia
Artrodese
Artroplastia de Substituição
Seres Humanos
Prótese Articular
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5372-z


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[PMID]:29068934
[Au] Autor:Giacalone F; di Summa PG; Fenoglio A; Sard A; Dutto E; Ferrero M; Bertolini M; Garcia-Elias M
[Ad] Endereço:Turin, Italy; Lausanne, Switzerland; and Barcelona, Spain From the Department of Hand Surgery, CTO-Maria Adelaide Trauma and Orthopaedic Hospital; the Department of Plastic, Reconstructive, and Hand Surgery, Centre Hospitalier Universitaire Vaudois; and the Institut Kaplan.
[Ti] Título:Resurfacing Capitate Pyrocarbon Implant versus Proximal Row Carpectomy Alone: A Comparative Study to Evaluate the Role of Capitate Prosthetic Resurfacing in Advanced Carpal Collapse.
[So] Source:Plast Reconstr Surg;140(5):962-970, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Resurfacing Capitate Pyrocarbon Implant associated with proximal row carpectomy has been used to treat symptomatic advanced carpal collapse, widening the indications of proximal row carpectomy to patients with capitate head arthritis. The authors retrospectively compared their case series of implant versus carpectomy alone, analyzing whether prosthetic implant outcomes could be similar to those of proximal row carpectomy even with a higher stage of osteoarthritis. METHODS: Fifty-seven patients who underwent surgery for wrist osteoarthritis (minimum follow-up, 2 years) were selected retrospectively. Twenty-five patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage III to IV and Kienböck disease stage IV) underwent proximal row carpectomy plus Resurfacing Capitate Pyrocarbon Implant (group A); 32 patients (scapholunate advanced collapse/scaphoid nonunion advanced collapse stage I to II and Kienböck disease stage III) underwent carpectomy alone (group B). Mean follow-up was 33 months. Patients were evaluated clinically and radiographically. Patient-Rated Wrist Evaluation and Disabilities of the Arm, Shoulder, and Hand questionnaire scores were assessed. RESULTS: Group A showed consistent pain relief (visual analogue scale score of 2), while preserving wrist mobility (flexion, 27 degrees; extension, 33 degrees) and grip strength (54 percent compared with the contralateral side). Average Disabilities of the Arm, Shoulder, and Hand questionnaire score was 20, and average Patient-Rated Wrist Evaluation score was 28. No statistically significant difference was observed between groups for all outcomes, except for better extension (p < 0.05) in group B. CONCLUSIONS: Even starting from a higher grade of osteoarthritis, Resurfacing Capitate Pyrocarbon Implant plus proximal row carpectomy showed satisfying results, compared with those obtained with just carpectomy. Data show that indications for proximal row carpectomy can be widened by using the implant, without worsening outcomes. The implant could be a useful alternative to more aggressive salvage procedures in case of capitate head and lunate fossa osteoarthritis involvement. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
[Mh] Termos MeSH primário: Artroplastia de Substituição/métodos
Carbono
Ossos do Carpo/cirurgia
Prótese Articular
Osteoartrite/cirurgia
Articulação do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Substituição/instrumentação
Ossos do Carpo/diagnóstico por imagem
Ossos do Carpo/patologia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Osteoartrite/diagnóstico por imagem
Osteoartrite/patologia
Radiografia
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (pyrolytic carbon); 7440-44-0 (Carbon)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003759


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[PMID]:28721601
[Au] Autor:Gil JA; Kamal RN; Cone E; Weiss AC
[Ad] Endereço:Department of Orthopaedics, Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, USA.
[Ti] Título:High Survivorship and Few Complications With Cementless Total Wrist Arthroplasty at a Mean Followup of 9 Years.
[So] Source:Clin Orthop Relat Res;475(12):3082-3087, 2017 Dec.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Total wrist arthroplasty (TWA) has been described as traditionally being performed with fixation in the radius and carpus with cement. The TWA implant used in our series has been associated with promising results in studies with up to 6 years followup; however, studies evaluating survivorship, pain, and function with this implant are limited. QUESTION/PURPOSE: (1) To report ROM and pain scores after wrist reconstruction with cementless fourth-generation TWA at a mean followup of 9 years (range, 4.8-14.7 years). (2) To report complications of a cementless fourth-generation TWA and the cumulative probability of not undergoing a revision at a mean followup of 9 years. METHODS: This is a retrospective case series of 69 patients who were treated for pancarpal wrist arthritis between 2002 and 2014. Of those, 31 had inflammatory arthritis (rheumatoid arthritis [n = 29], juvenile rheumatoid arthritis [n = 1], and psoriatic arthritis [n = 1]); all of these patients received TWA with the cementless implant studied in this investigation. Another 38 patients had osteoarthritis or posttraumatic arthritis; in this subgroup, 28 patients were 65 years or younger, and all underwent wrist fusion (none were offered TWA). Ten patients with osteoarthritis were older than 65 years and all were offered TWA; of those, eight underwent TWA, and two declined the procedure and instead preferred and underwent total wrist arthrodesis. The mean age of the 39 patients who had TWA was 56 ± 8.9 years (range, 31-78 years) at the time of surgery; 36 were women and three were men. The patients who underwent TWA were seen at a minimum of 4 years (mean, 9 years; range, 4-15 years), and all had been examined in 2016 as part of this study except for one patient who died 9 years after surgery. The dominant wrist was involved in 60% (25) of the patients. All patients were immobilized for 4 weeks postoperatively and then underwent hand therapy for 4 to 6 weeks. Pain and ROM were gathered before surgery as part of clinical care, and were measured again at latest followup; at latest followup, radiographs were analyzed (by the senior author) for evidence of loosening, defined as any implant migration compared with any previous radiograph with evidence of periimplant osteolysis and bone resorption. Subjective pain score was assessed by a verbal pain scale (0-10) and ROM was measured with a goniometer. Complications were determined by chart review and final examination. Kaplan Meier survival analysis was performed to estimate the cumulative probability of not undergoing a revision. RESULTS: The mean preoperative active ROM was 34 ± 18° flexion and 36° ± 18° extension. Postoperatively, the mean active ROM was 37° ± 14° flexion and 29° ± 13° extension. The mean difference between the preoperative pain score (8.6 ± 1.2) and postoperative pain score (0.4 ± 0.8) was 8.1 ± 1.9 (p < 0.001). Implant loosening occurred in three (7.7%) patients. No other complications occurred in this series. Kaplan-Meier survivorship analysis estimated the cumulative probability of remaining free from revision as 78% (95% CI, 62%-91%) at 15 years. CONCLUSION: Cementless fourth-generation TWA improves pain while generally preserving the preoperative arc of motion. The cumulative probability of remaining free from revision at 14.7 years after the index procedure is 77.7% (95% CI, 62.0%-91.4%). Future studies should compare alternative approaches for patients with endstage wrist arthritis; such evaluations-which might compare TWA implants, or TWAs with arthrodesis-will almost certainly need to be multicenter, as the problem is relatively uncommon. LEVEL OF EVIDENCE: Level IV, therapeutic study.
[Mh] Termos MeSH primário: Artroplastia de Substituição/instrumentação
Prótese Articular
Osteoartrite/cirurgia
Articulação do Punho/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Artralgia/etiologia
Artrometria Articular
Artroplastia de Substituição/efeitos adversos
Fenômenos Biomecânicos
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Osteoartrite/diagnóstico por imagem
Osteoartrite/fisiopatologia
Medição da Dor
Dor Pós-Operatória/etiologia
Desenho de Prótese
Amplitude de Movimento Articular
Recuperação de Função Fisiológica
Reoperação
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Articulação do Punho/diagnóstico por imagem
Articulação do Punho/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5445-z


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[PMID]:28639846
[Au] Autor:Rademacher WMH; Walenkamp GHIM; Moojen DJF; Hendriks JGE; Goedendorp TA; Rozema FR
[Ad] Endereço:a Department of Oral Medicine , Academic Centre for Dentistry Amsterdam (ACTA).
[Ti] Título:Antibiotic prophylaxis is not indicated prior to dental procedures for prevention of periprosthetic joint infections.
[So] Source:Acta Orthop;88(5):568-574, 2017 Oct.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - To minimize the risk of hematogenous periprosthetic joint infection (HPJI), international and Dutch guidelines recommended antibiotic prophylaxis prior to dental procedures. Unclear definitions and contradictory recommendations in these guidelines have led to unnecessary antibiotic prescriptions. To formulate new guidelines, a joint committee of the Dutch Orthopaedic and Dental Societies conducted a systematic literature review to answer the following question: can antibiotic prophylaxis be recommended for patients (with joint prostheses) undergoing dental procedures in order to prevent dental HPJI? Methods - The Medline, Embase, and Cochrane databases were searched for randomized controlled trials (RCTs), reviews, and observational studies up to July 2015. Studies were included if they involved patients with joint implants undergoing dental procedures, and either considered HPJI as an outcome measure or described a correlation between HPJI and prophylactic antibiotics. A guideline was formulated using the GRADE method and AGREE II guidelines. Results - 9 studies were included in this systematic review. All were rated "very low quality of evidence". Additional literature was therefore consulted to address clinical questions that provide further insight into pathophysiology and risk factors. The 9 studies did not provide evidence that use of antibiotic prophylaxis reduces the incidence of dental HPJI, and the additional literature supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures. Interpretation - Prophylactic antibiotics in order to prevent dental HPJI should not be prescribed to patients with a normal or an impaired immune system function. Patients are recommended to maintain good oral hygiene and visit the dentist regularly.
[Mh] Termos MeSH primário: Antibioticoprofilaxia/métodos
Assistência Odontológica/métodos
Prótese Articular/efeitos adversos
Infecções Relacionadas à Prótese/prevenção & controle
[Mh] Termos MeSH secundário: Antibioticoprofilaxia/normas
Assistência Odontológica/efeitos adversos
Assistência Odontológica/normas
Seres Humanos
Prótese Articular/microbiologia
Países Baixos
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171001
[Lr] Data última revisão:
171001
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1340041



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