Dataset Information

Implant Interface Debonding After Total Knee Arthroplasty: A New Cause for Concern?

ABSTRACT:

Background

Aseptic loosening has long been an associated etiology for revision total knee arthroplasty (TKA).

Methods

This case series investigates commonalities between 9 patients who underwent revision TKA and were found to have complete debonding at the cement-implant interface of a femoral and/or tibial component within the past 2 years.

Results

Only 3 preoperative radiographs were indicative of aseptic loosening, and all patients had an infectious etiology ruled out.

Conclusions

This case series and other similar reports suggest that there may be a growing concern for debonding as a modern form of aseptic loosening. Further research through American Joint Replacement Registry and other national databases will need to be conducted to better understand if this is truly a new cause for concern after TKA and how it may be best prevented.

SUBMITTER: Sadauskas A

PROVIDER: S-EPMC7772444 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Implant Interface Debonding After Total Knee Arthroplasty: A New Cause for Concern?

Sadauskas Alex A Engh Charles C Mehta Molly M Levine Brett B

Arthroplasty today 20201205 4

<h4>Background</h4>Aseptic loosening has long been an associated etiology for revision total knee arthroplasty (TKA).<h4>Methods</h4>This case series investigates commonalities between 9 patients who underwent revision TKA and were found to have complete debonding at the cement-implant interface of a femoral and/or tibial component within the past 2 years.<h4>Results</h4>Only 3 preoperative radiographs were indicative of aseptic loosening, and all patients had an infectious etiology ruled out.<h ...[more]

PMID: 33385035

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Project description:Total hip (THA) and knee arthroplasty (TKA) are common procedures in elderly persons, who are at potential increased risk of postoperative fall due to loss of muscle strength and impaired balance. Fast-track surgery with early mobilization and opioid-sparing analgesia have improved outcomes after these procedures, but early mobilization and short hospitalization length of stay (LOS) could potentially increase the risk of falls after discharge. We investigated injuries, circumstances, and the timing of fall-related hospital admissions 90 days after fasttrack THA and TKA.This was a prospective, descriptive multicenter study on fall-related hospital admissions, in 5145 elective fast-track THA and TKA patients, with complete 90-day follow up through the Danish National Patient registry and medical charts.Of 83 (1.6%) fall-related hospital admissions, 43 (51.8%) were treated in the Emergency Room and 40 (48.2%) were admitted to a regular ward. The median LOS after surgery was 3 days (interquartile range [IQR]: 2-3) in fallers versus (vs) 2 days (IQR: 2-3) (P=0.022) in patients without falls. Injuries were classified as "none" or minor in 39.8%, moderate in 9.6%, and major in 50.6%. Most falls (54.8%) occurred within 1 month of discharge. Falls due to physical activity (12.0%) and extrinsic factors (14.5%) occurred later than did surgery-related falls (73.5%), contributing to 40% of all falls >30 days after discharge. In multivariate analysis, age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.0-1.08) (P=0.001), living alone (OR: 2.09; 95% CI: 1.20-3.62) (P=0.009), and psychiatric disease (OR: 2.80; 95% CI: 1.42-5.50) (P=0.001) were associated with surgery-related falls, whereas the use of a walking aid (OR: 1.20; 95% CI: 0.67-2.16) (P=0.544) and LOS ?4 days (OR:1.19; 95% CI: 0.52-1.28) (P=0.680) was not.Hospital admissions due to falls are most frequent within the first month after fast-track THA and TKA. The overall incidence of surgery-related falls amongst these patients is low, declines after the first month, and is related to patient characteristics rather than short LOS. The effect of interventions aimed at surgery-related falls should focus on the first 30 days after surgery and differentiate between the causes of falling.

Dataset Information

Implant Interface Debonding After Total Knee Arthroplasty: A New Cause for Concern?

Background

Methods

Results

Conclusions

Publications

Implant Interface Debonding After Total Knee Arthroplasty: A New Cause for Concern?

Similar Datasets

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