This paper is aimed to focus on the joint prosthesis failure event, to collect the statistic data about the failure of artificial joints issued by authoritative organizations at home and aboard, and to compare the functions of different types of the artificial joints. We generalized and compared current study analyzing the failure reason and type of joint prosthesis, and categorized the failure events according to the failure occurring time, i. e. short-term, medium-term and long-term. This paper could be helpful for improving and summarizing of artificial joint replacement surgery, and could put forward the requirements for the future artificial joints.
Arthroplasty, Replacement ; adverse effects ; statistics & numerical data ; Arthroplasty, Replacement, Hip ; adverse effects ; statistics & numerical data ; Arthroplasty, Replacement, Knee ; adverse effects ; statistics & numerical data ; Humans ; Joint Prosthesis ; Prosthesis Failure ; etiology

BACKGROUND: To date, there is no study comparing outcomes between post-total knee replacement genu recurvatum and fixed flexion. This study aims to provide data that will help in deciding which side to err on when neutral extension is not achieved. METHODS: A prospective cohort study of primary total knee arthroplasties was performed, which compared the 6-month and 2-year clinical outcomes between fixed flexion and genu recurvatum deformities at 6 months. RESULTS: At 6 months, knees in genu recurvatum did better than knees in fixed flexion deformity in terms of knee flexion. However, at 2 years, knees in fixed flexion deformity did better in terms of knee scores and showed better improvement in the degree of deformity. CONCLUSIONS: We conclude that it is better to err on the side of fixed flexion deformity if neutral alignment cannot be achieved.
Aged ; Arthroplasty, Replacement, Knee/*adverse effects/*statistics & numerical data ; Female ; Humans ; Knee Joint/*physiopathology/*surgery ; Male ; Middle Aged ; Prospective Studies ; Range of Motion, Articular ; Treatment Outcome

OBJECTIVE: To analyze the evaluation and treatment of blood loss during total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the aged . METHODS: We retrospectively surveyed the blood loss and the rehabilitation of 46 cases of TKA and 146 cases of THA older than 60. RESULTS: In the group younger than 70, the mean total blood loss of THA was 1425 mL and the hidden hemorrhage 729 mL (51%); following the TKA, the mean total loss was 1386 mL and the hidden hemorrhage was 890 mL (64%). In the group 70 and older, the mean total blood loss of THA was 1435 mL and the hidden hemorrhage was 769 mL (53%)û following the TKA, the mean total loss was 1380 mL and the hidden hemorrhage was 910 mL (65%). The difference of hidden hemorrhage between the THA and the TKA was both significant by different (p< 0.05). Age played an important part in the THA group (p< 0.05), but not in the TKA group (> 0.05). CONCLUSION The aged have poor resistance to blood loss. Hidden hemorrhage in the TKA or THA perhaps is the primary part of the blood loss. Prompt treatment is helpful for the rehabilitation.
Age Factors ; Aged ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Blood Loss, Surgical ; statistics & numerical data ; Female ; Hemorrhage ; blood ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; blood ; etiology ; Retrospective Studies

BACKGROUNDCurrently, various calculation methods for evaluating blood-loss in patients with total knee arthroplasty (TKA) are applied in clinical practice. However, different methods may yield different results. The purpose of this study was to determine the most reliable method for calculating blood-loss after primary TKA.

METHODSWe compared blood-loss in 245 patients who underwent primary unilateral TKA from February 2010 to August 2011. We calculated blood-loss using four methods: Gross equation, hemoglobin (Hb) balance, the Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) formula, and Hb-dilution. We determined Pearson's correlation coefficients for the four methods.

RESULTSThere were large differences in the calculated blood-loss obtained by the four methods. In descending order of combined correlation coefficient based on calculated blood-loss, the methods were Hb-balance, OSTHEO formula, Hb-dilution, and Gross equation.

CONCLUSIONSThe Hb-balance method may be the most reliable method of estimating blood-loss after TKA.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; Blood Loss, Surgical ; statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Retrospective Studies

OBJECTIVETo evaluate perioperative occult blood loss following total knee arthroplasty (TKA).

METHODSA retrospective analysis of 40 patients undergoing TKA was conducted to calculate the mean blood loss and occult blood loss according to Gross formula.

RESULTSThe mean total blood loss was 1538 ml in these cases with occult blood loss of 791 ml. In patients with autologous blood transfusion, the mean total blood loss was 1650 ml with occult blood loss of 786 ml. In patients without autologous blood transfusion, the mean total blood loss was 1370 ml with occult loss of 798 ml.

CONCLUSIONTKA often results in large volume of occult blood loss in the perioperative period which can not be fully compensated by autologous blood transfusion, and additional blood supply is needed for maintenance of the circulating volume.

Aged ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Blood Loss, Surgical ; statistics & numerical data ; Blood Transfusion, Autologous ; Female ; Hemoglobins ; analysis ; Humans ; Intraoperative Complications ; blood ; etiology ; Male ; Middle Aged ; Retrospective Studies

PURPOSE: Periprosthetic fracture (PPF) is a serious complication that occurs in 0.3%-2.5% of all total knee arthroplasties used to treat end-stage arthritis. To our knowledge, there are no studies in the literature that evaluate the association between time to surgery after PPF and early postoperative infections or deep vein thrombosis (DVT). This study tests our hypothesis that delayed time to surgery increases rates of postoperative infection and DVT after PPF surgery. METHODS: Our study cohort included patients undergoing PPF surgery in the American College of Surgeons National Surgical Quality Improvement Program database (2006-2015). The patients were dichotomized based on time to surgery: group 1 with time ≤2 days and group 2 with time >2 days. A 2-by-2 contingency table and Fisher's exact test were used to evaluate the association between complications and time to surgery groups, and multivariate logistic regression was used to adjust for demographics and known risk factors. RESULTS: A total of 263 patients (80% females) with a mean age of 73.9 ± 12.0 years were identified receiving PPF surgery, among which 216 patients were in group 1 and 47 patients in group 2. Complications in group 1 included 3 (1.4%) superficial infections (SI), 1 (0.5%) organ space infection (OSI), 1 (0.5%) wound dehiscence (WD), and 4 (1.9%) deep vein thrombosis (DVT); while complications in group 2 included 1 (2.1%) SI, 1 (2.1%) OSI, 1 (2.1%) DVT, and no WD. No significant difference was detected in postoperative complications between the two groups. However, patients in group 2 were more likely (p = 0.0013) to receive blood transfusions (57.5%) than those in group 1 (32.4%). CONCLUSION Our study indicates patients with delayed time to surgery have higher chance to receive blood transfusions, but no significant difference in postoperative complications (SI, OSI, WD, or DVT) between the two groups.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; adverse effects ; Blood Transfusion ; statistics & numerical data ; Cohort Studies ; Female ; Humans ; Infection ; epidemiology ; Logistic Models ; Male ; Middle Aged ; Periprosthetic Fractures ; etiology ; surgery ; Postoperative Complications ; epidemiology ; Risk Factors ; Surgical Wound Dehiscence ; epidemiology ; Surgical Wound Infection ; epidemiology ; Time Factors ; Venous Thrombosis ; epidemiology