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The Outcome of Prosthetic Surgery of Large Joints—Hips, Shoulders, and...
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The Outcome of Prosthetic Surgery of Large Joints—Hips, Shoulders, and Knees

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Sports Medicine and Sports Traumatology".

Deadline for manuscript submissions: closed (20 April 2022) | Viewed by 6888

Special Issue Editor

Dr. Nahum Rosenberg

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Rambam Health Care Campus, P.O. Box 9602, Haifa, Israel
Interests: joint biomechanics; outcomes of orthopaedic surgery; arthroplasty; tissue regeneration
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Large joint prosthetic replacement surgery has been established as a standard treatment tool in disabling joint arthrosis. However, due to the basic problem of long-term loosening of the implanted devices, there is still an evolving process for the improvement of prosthetic devices and surgical techniques. The outcome studies are the main tools for understanding and evaluating the long-term survivorship of this surgical modality.

The emphasis of the Special Issue is placed on the rationale for newly developed endoprosthetic designs, as reflected in their short and long term clinical survivorship. Additionally, the description of the effect of new surgical techniques for prosthetic implanantion on the functional outcome following joint replacement is of high interest.

Currently, research efforts for improving prosthetic longevity are mainly focused in the area of material optimization, i.e., joint surfaces and 3D design. Additionally, research studies are also directed towards reducing aseptic loosening by the improvement of bone ingrowth by using tissue engineering and pharmacological approachs.

Follow-up research studies focusing on common and innovative joint replacements are of interest. Special emphasis is placed on survivorship analyses studies.

Dr. Nahum Rosenberg
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • endoprosthesis
  • shoulder
  • hip
  • knee
  • surgery outcome

Published Papers (3 papers)

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Research

9 pages, 4989 KiB  
Article
MRI Findings of Muscle Damage after Total Hip Arthroplasty Using the Complete Muscle Preserving Anterolateral Supine Approach
by Shuhei Oda, Takashi Hisatome, Eiji Cho, Hirohisa Fujimaki and Kazuyoshi Nakanishi
Medicina 2022, 58(6), 713; https://doi.org/10.3390/medicina58060713 - 26 May 2022
Cited by 2 | Viewed by 2506
Abstract
Background and Objectives: We performed anterolateral total hip arthroplasty (ALS THA) with the purpose of complete muscle-tendon preservation without muscle-tendon dissection. This study aimed to evaluate muscle damage in the periprosthetic hip joint muscles of patients undergoing ALS THA at 1-year post-operative hip [...] Read more.
Background and Objectives: We performed anterolateral total hip arthroplasty (ALS THA) with the purpose of complete muscle-tendon preservation without muscle-tendon dissection. This study aimed to evaluate muscle damage in the periprosthetic hip joint muscles of patients undergoing ALS THA at 1-year post-operative hip magnetic resonance imaging (MRI). Materials and Methods: We evaluated changes in the muscle cross-sectional area (M-CSA) and fatty atrophy of the periprosthetic muscles. We also assessed the Harris hip score on pre-operative and 12-month post-operative MRI in 66 patients who underwent ALS THA. The grade of M-CSA atrophy was classified into no atrophy, slight atrophy, moderate atrophy, and severe atrophy. Fatty atrophy was classified as improved, no change, and worsened using the Goutallier classification. Results: More than 90% of patients’ M-CSA had no atrophy in the obturator internus (Oi), obturator externus (Oe), gluteus medius (Gmed), and gluteus minimus (Gmin), and some improvement was observed in terms of fatty atrophy. In contrast, M-CSA of the tensor fascia latae (TFL) muscle was clearly decreased, and there was no improvement in the TFL fatty atrophy. However, the presence or absence of TFL atrophy did not affect clinical outcome. Conclusions: We performed the complete muscle preserving procedure, ALS THA, with attention to preserving the Oi and Oe by direct visual confirmation and gentle treatment of the Gmed and Gmin with effective retraction. Post-operative M-CSA atrophy evaluation on MRI showed that the Oi, Oe, Gmed, and Gmin were satisfactorily preserved; however, the TFL was clearly atrophic. In the ALS approach, where entry is made between Gmed and TFL, atrophy of the TFL due to superior gluteal nerve injury must be tolerated to some extent. Full article
(This article belongs to the Special Issue The Outcome of Prosthetic Surgery of Large Joints—Hips, Shoulders, and Knees)
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8 pages, 3881 KiB  
Article
Knee Arthrodesis Affects Gait Kinematics More in the Ankle Than in the Hip Joint
by Nele Wagener, Sabrina Böhle, Julia Kirschberg, Sebastian Rohe, Markus Heinecke, Pietro Di Fazio, Georg Matziolis and Eric Röhner
Medicina 2022, 58(6), 696; https://doi.org/10.3390/medicina58060696 - 24 May 2022
Cited by 2 | Viewed by 2090
Abstract
Background and Objectives: No gold standard exists for treating persistent periprosthetic knee infections. Knee arthrodesis represents one treatment concept for extensive bone defects and extensor system insufficiencies. It has already been shown that knee arthrodesis leads to a significant reduction in one’s quality [...] Read more.
Background and Objectives: No gold standard exists for treating persistent periprosthetic knee infections. Knee arthrodesis represents one treatment concept for extensive bone defects and extensor system insufficiencies. It has already been shown that knee arthrodesis leads to a significant reduction in one’s quality of life. The aim of this survey was to assess the influence of knee arthrodesis on the neighboring joints on the basis of gait analysis data. Our hypothesis is that the hip and ankle joints are negatively influenced by knee arthrodesis in the process of walking. Materials and methods: We performed six pedobarographic and four gait analytical measurements in six patients 2.4 ± 1.6 years after receiving knee arthrodesis at the operating ages of 69.1 ± 9.2 years. Gait analysis consisted of time–distance parameters/minute (number of steps, double support, cycle time, standing phase, step length, gait speed). A healthy group of test subjects (n = 52) was included as the control cohort. Gait analysis was conducted using a three-dimensional movement system and three force-measuring platforms to determine the ground reaction force. Foot pressure was measured using a pedography platform. Results: Five of six patients presented an incomplete rolling movement over the toes on the side that was operated on, presenting with a gait line ending in the forefoot area. All of the patients bore less weight on the side that was operated on. Three of six patients demonstrated a pathological gait line with a healthy opposite side ending in the forefoot area. All of the patients exhibited a reduction in gait speed and step length and a lower number of steps. All of the patients had a prolonged double support/cycle time. Conclusions: Isolated knee arthrodesis is associated with reduced forefoot repulsion, restricted movement on the side receiving the operation, and reduced movement in the ankle/knee joint. The hip showed norm deviations in the hip moment/angle. Knee arthrodesis causes reduced gait kinetics/kinematics. Our survey shows that the relative joint moments of the ankle joint and hip are often reduced. The ankle joint is more affected compared to the hip. Full article
(This article belongs to the Special Issue The Outcome of Prosthetic Surgery of Large Joints—Hips, Shoulders, and Knees)
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11 pages, 1335 KiB  
Article
Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity—Retrospective and Prospective Follow-Up Studies
by Andrey Gritsyuk, Alexey Lychagin, Liu Yi and Nahum Rosenberg
Medicina 2021, 57(11), 1247; https://doi.org/10.3390/medicina57111247 - 15 Nov 2021
Cited by 2 | Viewed by 1745
Abstract
Background and objective: There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short-term complications after [...] Read more.
Background and objective: There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short-term complications after primary total hip arthroplasty (THA). We aimed to identify the range of Body Mass Index (BMI) values of patients with a significant risk for lower functional improvement after THA. Materials and methods: In Stage 1 of the study, we conducted a retrospective comparative analysis of the rate of complications and functional outcomes in patients treated by primary THA, with normal weight (BMI 19–25, N = 1205) vs. Class 1 (BMI 26–34, N = 450), Class 2 (BMI 35–39, N = 183), and Class 3 (BMI ≥ 40, N = 47) obese patients. After the statistical similarity rates of complications and 6- and 12-month functional outcomes (by Harris Hip and SF-36 scores) were revealed in Class 1 patients and patients with normal BMI, we conducted the Stage 2 prospective study, by the same comparison protocol, on the cohorts of Class 2 (N = 29) and Class 3 (N = 16) patients compared to the Class 1 patients (N = 37) as controls. Results: Stage 1: There was no difference in surgical complications and function on 6- and 12-month postoperative follow-up (physical and mental) between Class 1 and patients with normal BMI (p > 0.05). Surgical complications were significantly higher in Class 2 (p < 0.05) and Class 3 (p < 0.001) patients. Functional activity on the 12-month follow-up increased significantly in all study groups, but in the Class 3 patients, the functional parameters were significantly lower (0.001). The mental health status on the follow-up was similar in all study groups. Stage 2 study revealed similar to the retrospective study comparison of parameters, except for the significantly lower mental health scores in Class 2 and Class 3 patients (p < 0.05) and functional scores in Class 3 patients (p < 0.05). Conclusion: Although the functional ability increased in all patients, it was significantly lower in Class 3 patients (with morbid obesity). Therefore, the patients with Class 1 and Class 2 obesity should be conceptionally distinguished from Class 3 patients in the decision-making process for a primary THA because of the less favorable functional and mental health improvement in those with morbid obesity (Class 3). Full article
(This article belongs to the Special Issue The Outcome of Prosthetic Surgery of Large Joints—Hips, Shoulders, and Knees)
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