Revision surgery for implant failure after PSO.
Ontology highlight
ABSTRACT:
SUBMITTER: Brayda-Bruno M
PROVIDER: S-EPMC3940808 | biostudies-literature | 2014 Mar
REPOSITORIES: biostudies-literature
Publications
Revision surgery for implant failure after PSO.
Brayda-Bruno Marco M Luca Andrea A Gobetti Franco F Lovi Alessio A
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society 20140301 3
Similar Datasets
Project description:BackgroundNipple- or skin-sparing mastectomy and immediate implant-based breast reconstruction (IBR) is potentially associated with long-term unfavorable outcomes, such as revision surgery and reconstruction failure. This large patient cohort study aimed to provide long-term data on the incidence of these outcomes and to identify predictive risk factors.MethodsBetween 2012 and 2019, 1989 mastectomies with IBR were performed in 1512 women in the authors' institute. A direct-to-implant method was used in 93% and a 2-staged method with tissue expander in 7%. Logistic regression analysis was used to identify patient- and treatment-related risk factors associated with revision surgery or reconstructive failure.ResultsThe mean follow-up was 62.2 months. IBR failed in 6.7% of all breasts; thus, a breast was present in 93.3%. Age older than 44 years yielded a 2.6-fold, and radiotherapy, a 1.7-fold increased risk for reconstruction failure. Revision surgery was performed in 60% of all breasts. The mean number of revisions of all IBRs was 1.2 (range, 0 to 8; SD, 1.37). Factors associated with significantly higher rates of revision surgery were age older than 44 years (OR, 1.23), smoking (OR, 1.53), specimen weight greater than 492 g (OR, 1.39), implant volume greater than 422 g (OR, 1.95), and radiotherapy (OR, 1.51). Nipple preservation was protective for both outcomes (OR, 0.71 and 0.42, respectively). Direct-to-implant procedures did not require any surgical revision in 43% of these patients.ConclusionsDespite the necessity of revision surgery in the majority of IBRs, nearly half of the breasts did not require any revision surgery, and long-term reconstruction failure rates are extremely low. Therefore, IBR should be offered to all eligible women undergoing mastectomy, while understanding the risks.Clinical question/level of evidenceRisk, III.
| S-EPMC11845074 | biostudies-literature
Project description: Not available
| S-EPMC10914432 | biostudies-literature
Project description:BackgroundMetal component failure in total ankle arthroplasty (TAA) is difficult to treat. Traditionally, conversion to an arthrodesis has been advocated. Revision TAA surgery has become more common with availability of revision implants and refinement of bone-conserving primary implants. The goal of this study was to analyze the clinical results and patient-reported outcomes for patients undergoing revision total ankle arthroplasty.MethodsWe retrospectively reviewed prospectively collected data on 52 patients with a mean age of 63.5 ± 9.6 years who had developed loosening or collapse of major metal components following primary TAA. These patients were compared to a case-matched control group of 52 primary TAAs performed at the host institution with a minimum of 2 years' follow-up. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, Short Form 36 (SF-36), Short Musculoskeletal Function Assessment (SMFA), and pain scores were prospectively collected. Clinical data was collected through review of the electronic medical record to identify reasons for clinical failure, where clinical failure was defined as second revision or conversion to arthrodesis or amputation.ResultsThe identified causes of failure of primary TAA were aseptic loosening of both components (42%), talar component subsidence/loosening (36%), coronal talar subluxation (12%), tibial loosening (8%), and talar malrotation (2%). Thirty-one patients (59.5%) underwent revision of all components, 20 (38.5%) just the talar and polyethylene components, and one (2%) the tibial and polyethylene components. The average time to revision was 5.5 years ± 5.4 with a follow-up of 3.1 years ± 1.5 after revision. Eleven (21.2%) revision arthroplasties required further surgery: 6 required conversion to arthrodesis and 5 required second revision TAA. Pain scores, SF-36 scores, SMFA scores, and AOFAS Hindfoot scores all improved after revision surgery but never reached the same degree of improvement seen after primary TAA.ConclusionsClinical and patient-reported outcomes of revision ankle arthroplasty after metal component failure significantly improved after surgery, although the recovery time was longer. In this series, 21.2% of revision TAAs required a second revision TAA or arthrodesis surgery. Various prostheses performed similarly when used for revision surgery. Revision TAA can offer significant improvements postoperatively.Level of evidenceLevel III, therapeutic.
| S-EPMC8500383 | biostudies-literature
Project description:BackgroundMetal component failure in total ankle arthroplasty (TAA) is difficult to treat. Traditionally, conversion to an arthrodesis has been advocated. Revision TAA surgery has become more common with availability of revision implants and refinement of bone-conserving primary implants. The goal of this study was to analyze the clinical results and patient-reported outcomes for patients undergoing revision total ankle arthroplasty.MethodsWe retrospectively reviewed prospectively collected data on 52 patients with a mean age of 63.5 ± 9.6 years who had developed loosening or collapse of major metal components following primary TAA. These patients were compared to a case-matched control group of 52 primary TAAs performed at the host institution with a minimum of 2 years' follow-up. Cases of isolated polyethylene exchange, infection, or extra-articular realignment procedures were excluded. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, Short Form 36 (SF-36), Short Musculoskeletal Function Assessment (SMFA), and pain scores were prospectively collected. Clinical data was collected through review of the electronic medical record to identify reasons for clinical failure, where clinical failure was defined as second revision or conversion to arthrodesis or amputation.ResultsThe identified causes of failure of primary TAA were aseptic loosening of both components (42%), talar component subsidence/loosening (36%), coronal talar subluxation (12%), tibial loosening (8%), and talar malrotation (2%). Thirty-one patients (59.5%) underwent revision of all components, 20 (38.5%) just the talar and polyethylene components, and one (2%) the tibial and polyethylene components. The average time to revision was 5.5 years ± 5.4 with a follow-up of 3.1 years ± 1.5 after revision. Eleven (21.2%) revision arthroplasties required further surgery: 6 required conversion to arthrodesis and 5 required second revision TAA. Pain scores, SF-36 scores, SMFA scores, and AOFAS Hindfoot scores all improved after revision surgery but never reached the same degree of improvement seen after primary TAA.ConclusionsClinical and patient-reported outcomes of revision ankle arthroplasty after metal component failure significantly improved after surgery, although the recovery time was longer. In this series, 21.2% of revision TAAs required a second revision TAA or arthrodesis surgery. Various prostheses performed similarly when used for revision surgery. Revision TAA can offer significant improvements postoperatively.Level of evidenceLevel III, therapeutic.
| S-EPMC8500383 | biostudies-literature
Project description:PURPOSE:The Xen® Gel Stent (Allergan, Irvine, CA, USA) is a minimally invasive glaucoma surgery device implanted to reduce intra-ocular pressure (IOP) in glaucoma. The stents can fail to drain post-operatively due to scarring of the conjunctiva around the stent opening. Data on the success rates of revision surgery in patients with Xen stent failure are scarce. We present the first detailed report of the steps, outcomes and complications of Xen revision surgery with 12 months of follow-up data. METHODS:We share our experiences on the circumstances in which to perform Xen revision surgery, the steps of the surgery and the results of a retrospective interventional case series of all Xen revisions performed at a single centre from 2013 to 2018. RESULTS:A total of 151 Xen implants were inserted into eyes at our tertiary centre during the study period, of which 21 eyes (patients) underwent revision surgery. Mean pre-operative IOP was 26.1 (standard deviation 8.3) mmHg with the patient on two drops of anti-glaucoma medication. Four patients were excluded from the analysis due to incomplete data (medical records were unavailable for 2 patients; 1 patient died shortly after surgery; and 1 patient moved to another area). A non-functioning Xen implant was identified in another patient during revision surgery, and the procedure was converted to a trabeculectomy. The remaining 16 patients were included in the analysis, all of whom had a minimum follow-up of 12 months, with the longest follow-up being 4 years following revision surgery. Of these 16 patients, four required needling and 5-fluorouracil injection in the first 12 months following revision surgery, three required further glaucoma drainage surgery due to the failure of the revision surgery to control IOP in the first year and one suffered bleb-related endophthalmitis at the site of previous trabeculectomy surgery. Mean IOP at 12 months following revision surgery was 16.3 (standard deviation 3.7) mmHg on 0.7 drops of anti-glaucoma medication, which equates to a 37.5% reduction in IOP and a 65% reduction in the amount of IOP-lowering drops required. CONCLUSION:Our study shares experience on when to perform Xen revision surgery and the steps required. The results of our small cohort are the first in the literature and show that revisions can achieve promising IOP and medication reductions. Some patients still require needling in the post-operative period to optimise outcomes.
| S-EPMC7054468 | biostudies-literature
Project description:ImportanceUnderstanding the reasons for cochlear implant (CI) revision surgery and device failure rates is important for clinicians when counseling patients who are considering CI.ObjectivesTo analyze the revision surgery rate, reasons for revision surgery, and device failure and survival rates of different device models in recipients of CIs.Design, setting, and participantsIn this cohort study, cochlear implants at Samsung Medical Center, a tertiary referral center, were retrospectively reviewed. Patients who underwent CI surgery from October 2001 to March 2019 were included. In the device survival analysis, the first revision surgery was considered the primary event, and the end point of observation was June 1, 2019.InterventionsTherapeutic and rehabilitative CI surgery.Main outcomes and measuresThe revision surgery rate, reasons for revision surgery, and the failure and survival rates of different device models were analyzed. The Kaplan-Meier method and the log-rank test were used to present both the device survival and cumulative survival curves with rates.ResultsIn this study, 43 of 925 patients with CIs (4.6%) underwent a revision surgery. Device failure was the most common reason (28 of 43 patients [65%]). Flap-associated problems and migration of the inner device were the next most important reasons (4 of 43 [9.3%] each). Overall, the 10-year cumulative survival rate of CI surgery was 94.4%, and the device survival rate was 96.0%. Thirteen different CI devices from 4 different manufacturers were implanted, and no meaningful differences in device failure were found among CI manufacturers or devices (hazard ratios for cumulative survival: Cochlear, 1.67 [95% CI, 0.72-3.88]; Advanced Bionics, 1.67 [95% CI, 0.61-4.53]; Med-El, reference; hazard ratios for device survival: Cochlear, 1.65 [95% CI, 0.55-4.99]; Advanced Bionics, 1.93 [95% CI, 0.56-6.74]; Med-El, reference). Several recalls were issued by manufacturers during the study period, and after excluding the recalled devices, the device survival rates for 5, 10, and 15 years were 98.2%, 97.7%, and 94.9%, respectively.Conclusions and relevanceGenerally, implanted devices remain safe and stable for a long time, and no significant differences in survival rates were found between device types or manufacturers. Device failure was the main reason for CI revision, followed by flap-associated problems and migration of the inner device.
| S-EPMC7059107 | biostudies-literature
Project description:Implant failure is common in small animal orthopedics, but risk factors are rarely reported. Our objective was to determine whether abnormal fracture healing was associated with implant failure after fracture fixation in dogs and cats in a consecutive series of cases. Thirty-seven client-owned animals (thirty-two dogs, five cats) diagnosed with implant failure after fracture treatment from January 2013-September 2018 were studied. Medical and radiographic records were retrospectively reviewed to identify patients that underwent fracture fixation using open reduction and internal fixation with subsequent radiographic evidence of implant failure. Area moment of inertia (AMI), plate working length, and bone screw density were determined. Implant failure was found in 39 fractures in 37 animals, representing 23% of fracture cases during the study period. Cases of implant failure were at increased risk of delayed union, malunion, or non-union (p < 0.0001). The most common cause of implant failure was loosening (54%); the second most common was plate failure that included low AMI locking plates (28%). Major complications found in 22/39 fractures (56%) were associated with delayed union (p < 0.01). Surgical revision was performed in 49% of implant failure cases. Complications were most frequently identified after treatment of humeral fractures (26%). We conclude mechanical failure of implants increases the risk for delayed or abnormal fracture healing and often requires revision surgery. Implant AMI should be considered during preoperative planning. Locking plates are associated with implant failure if plate bending stiffness is not sufficient, based on findings from this case series.
| S-EPMC10177280 | biostudies-literature
Project description:Two-stage implant-based reconstruction after mastectomy may require secondary revision procedures to treat complications, correct defects, and improve aesthetic outcomes. Patients should be counseled on the possibility of additional procedures during the initial visit, but the likelihood of requiring another procedure is dependent on many patient- and surgeon-specific factors. This study aims to identify patient-specific factors and surgical techniques associated with higher rates of secondary procedures and offer a machine learning model to compute individualized assessments for preoperative counseling. A training set of 209 patients (406 breasts) who underwent two-stage alloplastic reconstruction was created, with 45.57% of breasts (185 of 406) requiring revisional or unplanned surgery. On multivariate analysis, hypertension, no tobacco use, and textured expander use corresponded to lower odds of additional surgery. In contrast, higher initial tissue expander volume, vertical radial incision, and larger nipple-inframammary fold distance conferred higher odds of additional surgery. The neural network model trained on clinically significant variables achieved the highest collective performance metrics, with ROC AUC of 0.74, sensitivity of 84.2, specificity of 63.6, and accuracy of 62.1. The proposed machine learning model trained on a single surgeon's data offers a precise and reliable tool to assess an individual patient's risk of secondary procedures. Machine learning models enable physicians to tailor surgical planning and empower patients to make informed decisions aligned with their lifestyle and preferences. The utilization of this technology is especially applicable to plastic surgery, where outcomes are subject to a variety of patient-specific factors and surgeon practices, including threshold to perform secondary procedures.
| S-EPMC10950123 | biostudies-literature
Project description:BackgroundThe use and effect of most infection control measures (ICMs) in breast implant surgery are still debated, likely resulting in undesired variation in current practices.ObjectivesThis study investigated the relationship between the number and combinations of ICMs used and the infection-related revision incidence after breast implant surgery. Additionally, national variation between Dutch healthcare institutions in ICM use was evaluated.MethodsFor this multicentre, population-based study, all patients who received a primary breast implant or tissue expander for breast augmentation or reconstruction between 2015 and 2019 were identified from the Dutch Breast Implant Registry. Seven prospectively collected ICMs were investigated: preoperative antibiotics, implant and/or pocket irrigation, glove change, nipple guards, insertion sleeve, postoperative drains, and postoperative antibiotics.ResultsThis study included 52,415 implants (85% augmentation, 15% reconstruction).The median (IQR) number of ICMs used was 3 (3-4) for augmentation and 4 (4-5) for reconstruction. Median follow-up was 30 months for augmentation and 34 months for reconstruction. Infection-related revision incidence was 0.1% for augmentation and 2.1% for reconstruction. Most infection-related revisions occurred within 2 months for augmentation and 2.5 months for reconstruction. The impact of ICM use on infection-related revision incidence remained unclear, given its low incidence. A significant variation was observed between institutions in the use of postoperative antibiotics and drains.ConclusionsAlthough the use of different ICMs varied considerably between institutions, the infection-related revision incidence after breast implant surgery was generally low. Most surgeons used four ICMs for breast reconstruction and three ICMs for breast augmentation. Further studies on the causes and effects of the observed variation are needed.
| S-EPMC9713279 | biostudies-literature
Project description:Aseptic loosening is the most common cause for total hip arthroplasty revision. Acetabular cup revision is a significant challenge in the presence of a large bone defect. One of the options for cup revision in the presence of a large bone defect is the recently introduced customised three-dimensional (3D)-printed reconstruction. We present the case of a 68-year-old woman successfully treated with a customised revision acetabular implant for the failure of triflange cup in the presence of large acetabular defect. The modern orthopaedic surgeon must have full knowledge of customised 3D-printed reconstruction to have as a reserve solution for difficult hip revision surgery.
| S-EPMC7253004 | biostudies-literature