Radiolucent lines around knee arthroplasty components : a narrative review.

Radiolucent lines around knee arthroplasty components : a narrative review. Acta Orthop Belg. 2020 Mar;86(1):82-94 Authors: Wautier D, Ftaïta S, Thienpont E Abstract Aseptic loosening of total knee arthroplasty (TKA) components is one of the frequent reasons for early revision together with infection and instability. Aseptic loosening is usually preceded by the observation of radiolucent lines (RLL) on radiographs. Radiolucent lines have conventionally been considered a sign of osteolysis due to particles disease of either polyethylene or cement wear. However, RLL can be observed quite early after TKA, way before wear and osteolysis can even occur. Immediate postoperative RLL are secondary to surgical technique with either inadequate cement penetration in sclerotic bone, insufficient preparation of the bone or malpositioning of the component relative to the bone cuts. This type of RLL can be observed radiologically but remains often without clinical symptoms. Early development of RLL, on an initially satisfying radiograph, is secondary to changes to the cement-bone interface. These are most often related to micromotion because of constraint, malalignment, remaining mechanical deformity, erroneous bone cuts or osteoporosis. This type of RLL are observed progressively on follow-up radiographs and can be accompanied by pain complaints despite of initial good outcome. Young age, male sex or osteoporotic bones often found in elderly females, are all risk ...
Source: Acta Orthopaedica Belgica - Category: Orthopaedics Tags: Acta Orthop Belg Source Type: research

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Background: It is currently controversial whether unilateral or bilateral balloon kyphoplasty (BKP) is superior in terms of postoperative outcomes in treatment of osteoporotic vertebral compression fracture (OVCF). In this context, the aim of this study was to prospectively evaluate and compare the radiographic and clinical outcomes of BKP using unilateral and bilateral approaches. Methods: This was a randomized controlled study and was approved by the Severance Institutional Review Board in our hospital. The study protocol was designed in accordance with the Declaration of Helsinki guidelines. Patients who complained...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Clinical Trial Source Type: research
Conclusion. Although spinopelvic malalignment is considered as a preexisting factor for LBP, VKA exacerbated by nonunion predominantly led to LBP after a new OVF. Each incidence of OVF should be treated to limit further morphological changes to the fractured vertebra. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research
Abstract OBJECTIVE: A consequence of anterior cervical discectomy and fusion (ACDF) is graft subsidence, potentially leading to kyphosis, nonunion, foraminal stenosis, and recurrent pain. Bone density, as measured in Hounsfield units (HUs) on CT, may be associated with subsidence. The authors evaluated the association between HUs and subsidence rates after ACDF. METHODS: A retrospective study of patients treated with single-level ACDF at the University of California, San Francisco, from 2008 to 2017 was performed. HU values were measured according to previously published methods. Only patients with preoperati...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
This article aims to evaluate the outcomes of restoring the body height of the compressed thoracic vertebrae in patients undergoing BKP. Methods: We prospectively enrolled 65 consecutive patients with thoracic VCFs (73 vertebrae) due to osteoporosis who were treated with BKP between June 2018 and May 2019. Results: A trocar was inserted through the pedicle in 84.9% (62/73) and beside the pedicle in 15.1% (11/73). The mean amount of mixed cement injected was 4.1 ± 1.1 mL (range, 1.5-7 mL). Cement leakage was radiographically confirmed in 30.8% of 65 patients. Among patients with complications caused by cement...
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
A 44-year-old woman with a history of hypertension and partial gastrectomy presented to the emergency department with low thoracic back pain of 2  days' duration without red flag symptoms. The physical examination was significant for point tenderness to palpation in the lower thoracic spine without overlying skin changes or neurologic symptoms. Considering her large body habitus and history of gastrectomy, a thoracic radiograph was obtained to rule out compression fracture due to osteoporosis (Figure 1).
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research
CONCLUSIONS: A high index of suspicion is needed to diagnose sacral insufficiency fracture after LS arthrodesis. A trial of conservative management is reasonable for select patients; potential surgical indications include refractory pain, neurological deficit, fracture nonunion with anterolisthesis or kyphotic angulation, L5-S1 pseudarthrosis, and spinopelvic malalignment. Lumbopelvic fixation with iliac screws may be effective salvage treatment to allow fracture healing and symptom improvement. High-risk patients may benefit from prophylactic lumbopelvic fixation at the time of index LS arthrodesis. PMID: 32217798 [P...
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
ConclusionsIn contrast to the well ‐established association between black race and knee or hip OA, odds of hand OA are lower in black versus nonblack subjects, which is not mediated by known hand OA risk factors. Future mechanistic works are warranted to determine the mediating protective factors for hand OA among the black subject s.
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: FULL LENGTH Source Type: research
Authors: Tobert DG, Schwab JH Abstract Vertebral compression fractures commonly occur as sequelae to osteoporosis, malignancy, infection, or trauma. Although all compression fractures have an underlying pathology, the term pathologic vertebral compression fracture (pVCF) is traditionally reserved for fractures that result from primary or metastatic spine tumors. Discriminating a pVCF from osteoporotic vertebral compression fractures is important because the subsequent diagnostic workup and therapeutic plan differ substantially between the two etiologies. A carefully obtained history inquiring about high-risk sympto...
Source: Instructional Course Lectures - Category: Orthopaedics Tags: Instr Course Lect Source Type: research
CONCLUSIONS: Our exploratory estimate of the effect of exercise on functional leg muscle strength was consistent in direction and magnitude with other trials in individuals with vertebral fractures. Declining adherence to home exercise suggests that strategies to enhance long-term adherence might be important in future confirmatory trials. PMID: 31899499 [PubMed - as supplied by publisher]
Source: Physical Therapy - Category: Physiotherapy Authors: Tags: Phys Ther Source Type: research
This study aimed to present a rare case of pathological fracture of femur in Alagille syndrome patient and its management in our hospital.Six-year-old male with pain on his right thigh came to our ER after fell down while putting on his pants. He had been diagnosed with biliary atresia at the age of 3 months and underwent surgical bile duct reconstruction. In addition, he also suffered from congenital hypothyroidism and consequently, stunted growth. The pathological fracture of the femur was treated conservatively with hemispica cast. At 2 months follow up, there is already radiographic evidence of fracture healing occurre...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
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