Reconstructive Review

http://reconstructivereview.org
Reconstructive Review is a peer-reviewed, open-access orthopaedic journal devoted to publishing papers in the areas of total hip and knee arthroplasty. Types of articles include original articles, basic science, case reports, clinical/surgical, commentary, controversy, historical reviews, letters to the editor, and surveys.

List of Papers (Total 149)

Search Engine Optimization for Medical Publishing

Search engine optimization is becoming increasingly important for medical publishing professionals. They know the value of writing papers and articles that help expand the knowledge of their specific area of expertise. They also know that in today’s online environment their publications need to be found in relevant web searches to be cited by fellow researchers. But if authors...

Elevated Lip Liner Positions Improving Stability in Total Hip Arthroplasty – An Experimental Study

Background: The use of elevated lip polyethylene liners with the acetabular component is relatively common in Total Hip Arthroplasty (THA). Elevated lip liners increase stability of the THA by increasing the jump distance in one direction. However, the elevated lip, conversely, also reduces the primary arc in the opposite direction and leads to early impingement of the neck on...

Femoral Head-Trunnion Dissociation in Metal-on-Polyethylene Total Hip Arthroplasty – A Unique Case Report

Background: Gross trunnion failure (GTF) after total hip arthroplasty is a rare complication and has only been reported in a few case series. Some of the associated risk factors have been described in the literature and include larger femoral heads, greater offset, and increased BMI. Despite this, the mechanism behind GTF is poorly understood and early diagnosis and treatment...

Periprosthetic Distal Femur Fractures: Review of Current Treatment Options

The geriatric population in general and specifically recipients of total knee arthroplasty (TKA) have increasing functional demands along with an increasing life expectancy. Certain intraoperative aspects of the index procedure, revision TKA, or the patient’s physiology (i.e.- osteoporosis, rheumatoid arthritis, neurologic disease) predispose the patient to post-operative...

Bio-Occlusive Gauze with Tegaderm: A Dressing for Surgical Wounds in Primary THA and TKA

Background: We introduce a simple, cost-effective bio-occlusive dressing to be used for primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA).Methods: The gauze-Tegaderm™ (GT) dressing consists of a 5cm wide 8-layered gauze covered by 3 to 5 medium-sized Tegaderm transparent films. We prospectively evaluated 100 consecutive primary THA’s and 107...

Native Patella Retention Versus Resurfacing in a Cohort of Staged Bilateral Total Knee Patients

Background: Patellar resurfacing in total knee arthroplasty remains a point of controversy within the literature and the generally followed paradigm varies among regions.Methods: In effort to elucidate a difference following the change from universal patellar resurfacing to universal non-resurfacing, 32 patients with bilateral TKA that included one resurfaced and one native...

Exploration of Serum 25-Hydroxy Vitamin D in Total Joint Arthroplasty within a Subtropical Climate

Background: The importance of appropriate serum 25-hydroxy vitamin D [25(OH)D] for multiple health measures is widely described, however, the prevalence of vitamin D deficiency remains remarkably high. The goal of our study is to explore the distribution of vitamin D deficiency among an elective total joint arthroplasty (TJA) population within a lower latitude climate with...

Mid-Term Follow Up Results of Mini-Subvastus Approach for Total Knee Arthroplasty in Obese Patients

Background: Use of mini-subvastus   approach for  total  knee  arthroplasty  (TKA )  in  obese  patients  is  still  debated . We had hypothesized in our  study published  in  July 2010 , that  obesity  should  not  be  considered  as  a  problem for  patients  undergoing  a  TKA  with  the  mini-subvastus  approach  as  the anatomy  of  the  quadriceps in  the  obese and  the...

The 16-Year Evolution of Proximal Modular Stem Design – Eliminating Failure of Modular Junction

Background: The complexity of hip reconstruction has been and continues to be a perplexing problem with restoring leg length, femoral offset, joint stability and overall hip implant fixation. These were contributing factors that lead to the development of a novel proximal femoral component design “Apex Modular Stem” (Omni, Raynham, MA). The basic stem geometry features a straight...

Simulator Study of MOM using Steep-cup Flexion - A Clinically Relevant Incorporation of Intermittent Edge-loading

Background: Adverse-wear phenomenon in metal-on-metal (MOM) arthroplasty has been attributed to “edge-loading” of the CoCr cups. Simulator studies of steeply-inclined cups run in the ‘Anatomic-cup’ model represented many variations in design and test parameters with no coherent rationale. We created an algorithm to synthesize MOM test parameters and noted that wear areas...

Dissemination of Pathogens by Mobile Phones in a Single Hospital

Background: Superficial wound complications are among the most prevalent problems associated with any surgical procedures.  Infection rates of the primary hip and knee joint arthroplasty have been reduced with modern aseptic techniques but this rate may reach 20% in some revision procedures.  Mobile phones are frequently used in the hospital and operating room settings...

Successes and Failures of a Freedom™ Constrained Cup Used in a Major Salvage Procedure

Background: This is a case report of a 36mm constrained cup (Freedom™, Biomet IN) that performed successfully for 7-years in a salvage case involving a total-femur implanted in a leg already short by 3-4 inches. The goal was to enhance hip motion and stability using a 36mm head instead of the usual 32mm size. Templating indications were for a 50mm cup (Freedom™; Arcom™ liner...

Patient Factors Affecting Surgeon Selection and the Decision to Delay Total Knee Arthroplasty

Background: Delaying total knee arthroplasty (TKA) carries an increased likelihood of poor rehabilitation outcomes.  Reasons behind choosing to delay surgery are under investigated. This study explores potential factors related to the decision to delay a TKA procedure and preferences for post-surgical pain management.Methods: A cross-sectional online survey was conducted among...

Health Care Regulation Spending Trap

Our health care system has faced many challenges over the past 40 plus years. Now these challenges have forced us into a complicated situation that makes it confusing on how best to proceed. Today third party insurance payers make most health care payments. Our premiums are paid into a risk pool-on medical services for other people. Consumers are disconnected from knowing the...

Return to Work Following Total Knee Replacement

The length of time to return to work after Total Knee Replacement is often treated as a monolithic entity.  Figures produced under such an assumption are interesting but have little practical value in individual cases.Numerous factors most of which are not under medical control are involved.  What is clear however is that the timing of surgery is of considerable importance in a...

Posterior Femoral Single Limb Osteotomy for the Removal of Well-Fixed Modular Femoral Neck Components

Modular neck femoral components were introduced to optimize femoral neck anteversion, leg length, offset, and stability in total hip arthroplasty. However, concerns have been raised in recent years regarding early failure of these implants due to corrosion, pseudotumor, as well as fracture of the modular neck. Removing modular neck femoral implants is challenging as removal of...

Anterolateral Oblique Distal Femoral Osteotomy for the Removal of Well Fixed Cemented Femoral TKA Components

In the setting of periprosthetic joint infection, the complete removal of implants and cement can be challenging with well-fixed, cemented implants about the knee. This can get especially complex in the setting of long cemented femoral component stems. Osteotomies are well described in the proximal femur and tibia for removal of implants and cement. There is little information...

The Effect of Patellar Denervation by Circumpatellar Electrocautery on Anterior Knee Pain Following Total Knee Replacement – An Experimental Study

ABSTRACTOBJECTIVESAnterior knee pain is a common problem in patients who have undergone TKR which causes dissatisfaction among them. There are Various methods for prevention of anterior knee pain following TKR .The  objective of this study is to determine the  effect of circumpatellar electrocautery on anterior knee pain following TKR and to compare the results with that of those...

A Single Surgeon, 10 Year Experience with the Oxford Partial Knee System: What a Difference Experience, Instruments, Implants, and Technique Can Make

Partial knee (unicompartmental) arthroplasty (PKA) for medial compartment disease of the knee has a long and well documented history of successful results over long periods of follow up. The Oxford Partial Knee Replacement has been available in the U.S. since 2004. After completing an FDA required instructional course, surgeons may use the device. Both the implant and the...

The Performance of Mixed Manufacturer Metal On Metal Total Hip Replacements

Using a femoral head from one manufacturer on the stem of another manufacturer poses the risk that the taper interface between the components may not contact correctly and the performance of the joint will be impaired. The cohorts in this study are a combination of modular Birmingham Hip Resurfacing (BHR) and Adept femoral heads on CPT stems. The study reviews the geometry of the...

Leg and Femoral Neck Length Evaluation Using an Anterior Capsule Preservation Technique in Primary Direct Anterior Approach Total Hip Arthroplasty

BackgroundAchieving correct leg and femoral neck lengths remains a challenge during total hip arthroplasty (THA).  Several methods for intraoperative evaluation and restoration of leg length have been proposed, and each has inaccuracies and shortcomings.  Both the supine positioning of a patient on the operating table during the direct anterior approach (DAA) THA and the...

Total Hip Arthroplasty Loosening Due to Mycobacterium Tuberculosis: A Case Report and Review of the Literature

Context:Prosthetic joint infection due to Mycobacterium tuberculosis with no previous history of pulmonary or extra pulmonary tuberculosis is an extremely rare complication.AimsTo report the case of a patient with tuberculous mycobacterial prosthetic hip infection, 14 years after surgery for post traumatic osteoarthritis, with no previous history of tuberculosis.MethodsA 46-year...

Diagnosing and Treating Popliteal Tendinopathy After Total Knee Arthroplasty

The following office tip describes four patients that underwent primary total knee arthroplasty and developed posterolateral knee pain at a mean follow-up duration of 1.6 months postoperatively. The first patient in this series noted substantial pain lying in bed (in a lateral decubitus position with the operative leg up) while attempting to abduct her leg to adjust her sheet in...

Thigh Pain Occurrence Rate in a Short, Tapered, Porous, Proximally-Coated Cementless Femoral Stem - Clinical and Radiological Results at 2-Year Follow-Up

Abstract Introduction: Short stems have been designed with the purpose of preserving bone tissue, decreasing the incidence of thigh pain and facilitating surgical techniques. The aim of our study was to assess whether a shortened tapered conventional stem was able to reduce the incidence of thigh pain.Methods:Between March 2010 and December 2012, 200 patients were enrolled in the...

Medial Tibial Reduction Osteotomy is Associated with Excellent Outcomes and Improved Coronal Alignment

Background:The medial tibial reduction osteotomy (MTRO) was introduced to achieve coronal ligamentous balance in total knee arthroplasty (TKA) patients with substantial preoperative varus deformity. Limited data exists on the outcomes of patients requiring an MTRO. This study compares outcomes of a matched cohort of patients that either required or did not require an MTRO during...