Revision of Broken Knee Megaprostheses: New Solution to Old Problems

Agarwal, Manish; Gulia, Ashish; Ravi, B.; Ghyar, Rupesh; Puri, Ajay

doi:10.1007/s11999-010-1409-2

Cited by 15 publications

(19 citation statements)

References 18 publications

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“…One year after surgery, all the children were back to normal school and the mean MSTS after physical rehabilitation was 26.3 (21)(22)(23)(24)(25)(26)(27)(28)(29). Knee flexion was up to 100°in six cases and between 60°and 80°in one case.…”

Section: Resultsmentioning

confidence: 99%

“…Aseptic loosening, mechanical failure, metal fatigue, infections, soft tissue problems, dislocation, infection or periprosthetic fractures are the most common complications [1,2,6,15,21,22,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging can destroy the actuator device and should not be done on the prosthesis that we describe. Fatigue fracture of the prosthesis has also been described [25], and some authors recommend the conversion to a modular megaprosthesis at reaching skeletal maturity. In our experience the endoprosthesis replacement is not systematically necessary and could increase the risk of complications such as infection or loss of joint function.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Non-invasive expandable prosthesis in musculoskeletal oncology paediatric patients for the distal and proximal femur. First results

Torner

Segur

Ullot

et al. 2016

International Orthopaedics (SICOT)

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Non-invasive expandable prosthesis in musculoskeletal oncology paediatric patients for the distal and proximal femur. First results

Torner

Segur

Ullot

et al. 2016

International Orthopaedics (SICOT)

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“…Agarwal et al identified 28 breakages in 266 megaprosthetic knee arthroplasties [5]. In the great majority of the cases, the TMH-Nice (Tata Memorial Hospital new indigenous customized prosthesis) was affected.…”

Section: Discussionmentioning

confidence: 99%

“…This classification system was further specified including biological and expandable reconstructions by the International Society of Limb Salvage (ISOLS) [4]. With regard to structural failures, several reports have been published about different tumor prosthesis systems [2, 5–7]. …”

Section: Introductionmentioning

confidence: 99%

Structural Failure of a Modern Knee Tumor Megaendoprosthesis

Koch

Kohn

Anagnostakos

2017

Case Reports in Orthopedics

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Modular knee megaendoprotheses are commonly used devices for distal femur or proximal tibia replacement in tumor surgery as well as for treatment of some periprosthetic fractures around a loose or failed total knee arthroplasty. Structural failures of the prosthesis are well-known postoperative complications and have been reported for various prosthesis types. In the majority of the cases, the polyethylene parts fail. We would like to present an unusual case of a broken femoral component of an MRH® endoprosthesis four years after implantation.

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Determination of Bleb Capsule Porosity With an Experimental Glaucoma Drainage Device and Measurement System

Ross

Pandav

et al. 2015

JAMA Ophthalmol

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IMPORTANCE Control of intraocular pressure after implantation of a glaucoma drainage device (GDD) depends on the porosity of the capsule that forms around the plate of the GDD.OBJECTIVE To compare capsular porosity after insertion of 2 different GDDs using a novel implant and measurement system. DESIGN, SETTING, AND SUBJECTSWe performed an experimental interventional study at an eye research facility in a tertiary eye care center. Testing was performed on 22 adult New Zealand white rabbits that received the experimental GDD or an existing GDD.INTERVENTIONS A new experimental GDD, the Center for Eye Research Australia (CERA) implant, was created using computer-aided design and a 3-dimensional printer. The CERA GDDs were implanted in the eyes of rabbits randomized into 1 of the following 3 groups: with no connection to the anterior chamber (n = 7), with connection to the anterior chamber for 1 week (n = 5), and with connection to the anterior chamber for 4 weeks (n = 5). In a control group (n = 5), a pediatric GDD was implanted without connection to the anterior chamber. We measured the capsular porosity using a pressure-gated picoliter pump at a driving pressure of 12 mm Hg. The animals were killed humanely for histologic study. MAIN OUTCOMES AND MEASURESPorosity of the fibrous capsule around the implant. RESULTSWe found no difference in mean (SEM) capsular porosity between the CERA (3.39 [0.76; 95% CI, 1.43-5.48] μL/min) and pediatric (4.52 [0.52; 95% CI, 3.19-5.95] μL/min) GDDs (P = .28, unpaired t test) at 4 weeks without aqueous exposure. Mean (SEM) capsular porosity of CERA GDDs connected to the anterior chamber at 1 week was 2.46 (0.36; 95% CI, 1.55-3.44) μL/min but decreased to 0.67 (0.07; 95% CI, 0.49-0.86) μL/min at 4 weeks (P = .001, unpaired t test). CONCLUSIONS AND RELEVANCEOur experimental method permits direct measurement of capsular porosity of an in situ GDD. In a comparison between an experimental (CERA) and an existing GDD, no differences were identified in capsular porosity or histologic reaction between the implants. These results suggest that the CERA GDD model can be used to test key components of glaucoma surgery and implant design.

show abstract

Revision of Broken Knee Megaprostheses: New Solution to Old Problems

Cited by 15 publications

References 18 publications

Non-invasive expandable prosthesis in musculoskeletal oncology paediatric patients for the distal and proximal femur. First results

Non-invasive expandable prosthesis in musculoskeletal oncology paediatric patients for the distal and proximal femur. First results

Structural Failure of a Modern Knee Tumor Megaendoprosthesis

Determination of Bleb Capsule Porosity With an Experimental Glaucoma Drainage Device and Measurement System

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