Cruciate ligament prosthesis vs. augmentation: A randomized, prospective 5-year follow-up of 41 cases

Dahlstedt, Lars; Dalén, Nils; Jönsson, Ulf; Adolphson, Per

doi:10.3109/17453679308993660

Cited by 10 publications

(14 citation statements)

References 8 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, previous studies have demonstrated that the Gore-Tex graft is not an inert material within the synovial cavity and amongst other complications results in synovitis and recurrent sterile effusions [1, 5, 9, 10]. The only previous case report on TKA in a patient with a Gore-Tex ACL graft in situ demonstrated early aseptic loosening within 2 years of the index TKA [11].…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty with Significant Osteolysis following Gore-Tex Anterior Cruciate Ligament Reconstruction: Recommendations on Reducing Risk of Arthroplasty Failure

Cosic¹,

Alexander²

2022

Case Rep Orthop Res

View full text Add to dashboard Cite

Synthetic substitutes for ligament reconstruction surgery have been widely used in orthopaedic surgery; however, many have been susceptible to mechanical failure and associated with osteolysis. A 58-year-old male underwent total knee arthroplasty (TKA) for valgus knee osteoarthritis on the background of a Gore-Tex anterior cruciate ligament reconstruction over 30 years prior. Radiographic imaging preoperatively demonstrated extensive osteolysis, particularly on the tibial side. At the time of arthroplasty, the extent of osteolysis was noted to be greater than that on the preoperative imaging. The patient underwent a robotic-assisted TKA with the use of a cemented stemmed tibial prosthesis and bone grafting. The patient was prescribed a period of protected weightbearing following the procedure. Our recommendations for undertaking arthroplasty with a Gore-Tex graft in situ are as follows: (1) thorough preoperative workup including computed tomography imaging to identify tunnel widening and osteolysis; (2) ensure that additional bone allograft is available for the procedure; (3) use of cemented implants where there has been significant osteolysis; (4) removal of the entire synthetic graft with copious irrigation post-removal to ensure the joint does not remain exposed to particulate debris; (5) grafting of the tunnels and bone defects post-removal of synthetic graft; (6) use of a stemmed prosthesis to bypass any cortical defects and reduce the risk of subsidence of the component.

show abstract

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty with Significant Osteolysis following Gore-Tex Anterior Cruciate Ligament Reconstruction: Recommendations on Reducing Risk of Arthroplasty Failure

Cosic¹,

Alexander²

2022

Case Rep Orthop Res

View full text Add to dashboard Cite

show abstract

“…Дедалі більше досліджень вказують на можливість розвитку реактивного артриту у відповідь на синтетичні матеріали, що застосовуються як трансплантат при пластиці ПХЗ [10,11,12]. Так, є багато повідомлень про високі рівні асептичного синовіту у відповідь на використання протезів ПХЗ із політетрафлуоретилену Gore-Tex (у середньому 26,6%) [12,13,14,15,16,17,18], менше інформації про стерильний синовіт -після застосування поліестерового Dacron -6,3% [19,20,21,22,23], поліпропіленового Kennedy LAD -4,7% [24] та поліпропілену терафталату LARS -0,2% [25]. Хоча C.J.…”

Section: матеріали і методиunclassified

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Kostrub

Котюк²,

Лютко

et al. 2020

HOTP

View full text Add to dashboard Cite

Summary. Relevance. Negative results of the anterior cruciate ligament (ACL) reconstruction occur in 10-20% of cases. The incidence of infectious arthritis can reach up to 1.7% and even up to 7.1%, according to the literature. However, ACL reconstruction can be complicated not only by infectious but also by reactive arthritis. Differential diagnosis between infectious and reactive arthritis is often hard to be done, but it is necessary for effective treatment. Objective: to determine the possible causes of the development of reactive and infectious arthritis after ACL reconstruction, peculiarities of their diagnostics and differential diagnostics. Materials and Methods. The literature data regarding the frequency of reactive and infectious arthritis after various methods of surgical treatment of ACL injury and the use of different types of implants, as well as laboratory indicators of the activity of the inflammatory process in the postoperative period and such indicators in reactive and infectious arthritis, were analyzed. We also analyzed literature data on the sensitivity and specificity of various methods of microbiological studies in patients with infectious synovitis or arthritis. Results. Numerous probable causes of a higher incidence of infectious arthritis in ACL reconstruction are suspected. Synthetic implants may be the cause of the development of reactive arthritis, according to a number of studies. Our experience in using different biodegradable fixators from various manufacturers suggest that the percentage of complications depends not only on the fact of the biodegradability of the implant, but on its composition, and even on the percentage of tricalcium phosphate or the manufacturer. Therefore, it is impossible to unambiguously state that biodegradable fixators are worse or better then metallic or non-biodegradable polymeric ones. However, on average, if we consider all existing fixators from various manufacturers, the number of complications when using biodegradable implants is higher. Diagnosis of reactive arthritis is often based on negative bacteriological findings. Given the not always high sensitivity of bacteriological inoculation of synovial fluid and the duration of the investigation, we cannot rely only on its results. Conclusions. The most difficult for differential diagnosis between infectious and reactive arthritis (synovitis) is acute synovitis after ACL reconstruction with normal results of bacteriological studies, but high biochemical parameters of inflammation. We suggest to suspect infectious arthritis after ACL reconstruction in the following hemogram values: 1) CRP >40-50 mg/l, 2) ESR >30-50 mm/h, 3) fibrinogen >800 mg/ml, 4) procalcitonin in blood plasma >0.5 ng/ml, 5) leukocytosis and left shift of the leukocyte formula, with the following synovial fluid test parameters: a) CRP >40-50 mg/l, b) leukocytosis with an increase in the percentage of polymorphonuclear leukocytes >75%.

show abstract

“…Ο ΠΧΣ επομένως λειτουργεί ως ένα συστατικό μέσα σε αυτό το εκτενές και δυναμικό σύστημα που μπορεί να τραυματιστεί και να αντιμετωπιστεί σε πολλά επίπεδα. Στο πλαίσιο του ίδιου του γόνατος, ο ΠΧΣ λειτουργεί σε συντονισμό με όλες την κίνηση αλλά και για να διατηρήσει τη στατική και τη δυναμική ισορροπία (1,77,111 (13,14,17,36,55,65,69,114,121,126,135,159,167,168). Κάθε μια από αυτές τις επιλογές έχει γίνει αντικείμενο σημαντικής σκέψης και προβληματισμού (52,58,65,74,91,114,120).…”

Section: συζήτησηunclassified

“…J Bone Joint Surg, 1996, 78-A:524-537) χρόνια μετεγχειρητικά, οι κλινικές εκβάσεις της αποκατάστασης των τραυματισμένων ΠΧΣ με αλλομοσχεύματα είναι παρόμοιες με εκείνες της αποκατάστασης με αυτόλογα μοσχεύματα.Οι συνθετικοί σύνδεσμοι είναι μακριά από την τελειότητα(114). Τα βραχυπρόθεσμα κλινικά και εργαστηριακά αποτελέσματα όλων σχεδόν των συνθετικών συνδέσμων που χρησιμοποιούνται για την αντιμετώπιση της μεμονωμένης αστάθειας του ΠΧΣ είναι ενθαρρυ ντικά(14,36,114,159), όμως συνεχίζουν να συνδέονται με προβλήματα(13,126,135).Όπως τα αλλομοσχεύματα, έτσι κι αυτά είναι λιγότερο επιτυχή στην αντιμετώπιση της σύνθετης συνδεσμικής αστάθειας, ενώ οι καταστάσεις διάσωσης είναι αυτές στις οποίες οι χειρουργοί θα τους έβρισκαν πιο χρήσιμους(159).Στοιχεία που προκύπτουν από διάφορες μελέτες, δείχνουν ότι ποσοστό 40-78 %, από προσθετικούς συνδέσμους που εμφυτεύθηκαν και μελετήθηκαν στη διάρκεια μιας περιόδου 15 ετών απέτυχαν στη διάρκεια του χρόνου(38,47). Εμφανίστηκαν επίσης να προκαλούν συχνό τερα επιπλοκές από τα βιολογικά αντίστοιχό τους.…”

unclassified

Συγκριτική Μελέτη Σταθεροποιήσεως Των Μοσχευμάτων Της Πλαστικής Δ Με Την Πλαστική Μονής Δέσμης

Σούρλας¹

View full text Add to dashboard Cite

Cruciate ligament prosthesis vs. augmentation: A randomized, prospective 5-year follow-up of 41 cases

Cited by 10 publications

References 8 publications

Total Knee Arthroplasty with Significant Osteolysis following Gore-Tex Anterior Cruciate Ligament Reconstruction: Recommendations on Reducing Risk of Arthroplasty Failure

Total Knee Arthroplasty with Significant Osteolysis following Gore-Tex Anterior Cruciate Ligament Reconstruction: Recommendations on Reducing Risk of Arthroplasty Failure

Differential Diagnosis of Reactive and Infectious Arthritis after Anterior Cruciate Ligament Reconstruction

Συγκριτική Μελέτη Σταθεροποιήσεως Των Μοσχευμάτων Της Πλαστικής Δ Με Την Πλαστική Μονής Δέσμης

Contact Info

Product

Resources

About