OBJECTIVE: Hip and knee joint replacement procedures are an effective therapeutic intervention in treating severe joint disorders. Its use has been increasingly performed worldwide, including the Philippines, with its techniques constantly evolving and the science behind it improving. This study aims to describe the demographics, clinical profiles, and outcomes of arthroplasty patients by the Arthroplasty Service, Department of Orthopedics, University of the Philippines – Philippine General Hospital (UP-PGH). METHODS: The study is a descriptive and retrospective review of patients who underwent joint replacement procedures, both primary and revision arthroplasty, from January 2012 to December 2018. Patient demographics and clinical data of patients who underwent total joint arthroplasty at the UP-PGH were collected and evaluated. RESULTS: Data from 279 patients with 306 primary joint replacement procedures were analyzed. There were 195 total hip arthroplasty procedures (THAs) and 111 total knee arthroplasty procedures (TKAs) done. The mean age for THA patients was 55.6 years old, with more females (68.2%) with the left hip being more commonly affected (54.9%). The most common indication for THA was an untreated femoral neck fracture (23.1%) followed by avascular necrosis (20.5%). Cementless fixation was the most commonly used technique (61.5%). Meanwhile, the mean age for TKA was 64.5 years old, with the majority having degenerative osteoarthritis, and using cemented TKA fixation for all knees. A total of 37 revision arthroplasty cases were performed, with 34 in the hip and three in the knee, with infection being the most common overall indication (53%). CONCLUSION: The demographics, clinical profiles, and outcomes of the UP-PGH Arthroplasty Service are comparable to other centers internationally, and further emphasizes the satisfactory outcomes of these procedures. Meanwhile, suggested explanations for the subtle differences are discussed in this study.
Arthroplasty, Replacement, Knee ; Arthroplasty, Replacement, Hip

Humans ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Knee*

Catastrophic failure of stemmed components in arthroplasty is an uncommon but a serious complication. Stem fractures and techniques for addressing these have been described following hip arthroplasty but much less so following total knee arthroplasty (TKA). We review three cases of catastrophic failure of the stem in rotating hinge revision TKA prostheses. We discuss the possible mechanism of failure and review the current literature addressing this topic. Metaphyseal support needs to be optimized in order to minimize load transfer to the stem and to the junction (and the risk of fracture) if a modular component is used. When constrained components are used, radiographs need to be carefully assessed for signs of proximal loosening. Nonmodular stems are also an option in this situation.
Arthroplasty ; Arthroplasty, Replacement, Knee* ; Hip ; Knee ; Prostheses and Implants

Periprosthetic joint infections are a major cause of morbidity and mortality following total joint arthroplasty. Two-stage arthroplasty, with the use of an antibiotic cement spacer, is an effective means of managing periperiprosthetic joint infections. There is a lack of data relating to the management, prognosis, and clinical outcomes associated with multiple peri-prosthetic joint infections. Here, we present a case report of a patient successfully treated for three synchronic peri-prosthetic joint infections of both knees and a single hip.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Hip ; Humans ; Joints ; Knee ; Mortality ; Prognosis

Total elbow arthroplasty is a relatively rare procedure compared with total knee or total hip arthroplasty. Total elbow arthroplasty for bony ankylosis is even rarer, and the results are often unsatisfactory. We report a patient who gained good mobility of the elbow after total elbow arthroplasty for the treatment of fractured arthrodesis site with which the patient had lived with for 12 years.
Ankylosis ; Arthrodesis* ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Elbow* ; Humans ; Knee

PURPOSE: Soft-tissue reconstruction in the knee area requires thin, pliable, and tough skin. The range of motion of the knee also acts as a limitation in using only local flaps for coverage. The author has successfully used various perforator flaps for soft tissue reconstruction around the knee while preserving its functional and cosmetic characteristics. MATERIALS AND METHODS: Out of the twenty patients assessed from April 2009 to March 2011, seven received anterolateral thigh perforator flaps, four received medial sural perforator island flaps, four received lateral supragenicular perforaor perforator flaps, and five received medial genicular artery flaps. The age of the patients ranged from 44 to 79 and the size of the defects ranged from 4x5 cm to 17x11 cm. Fifteen of the twenty patients had histories of total knee replacement (TKR) surgery. RESULTS: There were no flap losses in any of the twenty patients assessed. Two patients showed partial losses in the distal area of the flap, but were treated through careful wound care. One patient presented with pedicle adhesion at the drainage site from a past TKR, but it did not hinder the flap survival. Primary closure at the donor site was possible in nine patients, while split skin graft was necessary for the other 13. CONCLUSION: In soft tissue reconstruction of the knee, various perforator flaps can be used depending on the condition of the preoperation scar, wound site, and size. It also proved to provide better functional and cosmetic results than in primary wound closure or skin grafts.
Arteries ; Arthroplasty, Replacement, Knee ; Cicatrix ; Drainage ; Humans ; Knee ; Knee Prosthesis* ; Perforator Flap* ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; Skin ; Surgical Flaps ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

No abstract available.
Arthritis* ; Arthroplasty* ; Arthroplasty, Replacement, Knee*

Arthroplasty, Replacement ; Arthroplasty, Replacement, Knee ; Humans

No abstract available.
Arthroplasty, Replacement, Knee