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and matching of implants from different manufacturers in total joint arthroplasty (‘mix & match’) and commenting on ‘mismatch’. The commentary and conclusions we have made are based on an extensive literature review and consensus meetings. We have
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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instability. One factor affecting stability is the radius of curvature mismatch between the humeral head and glenoid. Further, only 20 to 30% of the humeral head is in contact with the glenoid. 3 The rotator cuff acts as an essential dynamic stabilizing force
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cortical hypertrophy secondary to stress concentration at the distal screw. The reported incidence varies between 1.08% and 12.7%, and is higher with older nail models, if two distal screws are used, if there is a mismatch between the femoral canal and the
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standing (°) 54.2 ± 11.3 57.0 ± 12.6 0.260 –1.7 ± 6.3 55.3 ± 12.4 0.065 0.663 PI-LL (°) Standing –2.3 ± 11.6 1.4 ± 12.6 0.135 –2.2 ± 5.9 –0.7 ± 14.5 0.016 0.555 Mismatch > 10° ( n (%)) 6 (12
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Revision total knee arthroplasty (rTKA) is a challenging, complex procedure. A comprehensive understanding of the anatomy, challenges and pitfalls is essential to achieve a good outcome for the patient.
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This review discusses the determinants of good outcomes of rTKA. These include, among other factors, the choice of the surgical approach, removal of the components, adequate reconstruction of the joint line and posterior condylar offset and the use of offset stems, as well as choosing the appropriate level of constraint.
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The modularity of many modern knee revision systems can help to address such issues as anatomical mismatch, gap balancing and malalignment.
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A well-planned surgical approach must be used in rTKA. A thorough understanding of related knee anatomy is essential.
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The incidence of joint-line elevation after rTKA is high. Contralateral radiographs, as well as algorithms based on the relationship between bony landmarks and the joint line, can help to reconstruct a physiological joint line during rTKA.
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Modularity added to systems, such as offset stems, are useful enhancements that may further improve the reconstruction of the anatomy.
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There are several options for managing the patella, with the best choice depending on the status of the patellar component and residual bone stock.
Cite this article: Thienpont E. Revision knee surgery techniques. EFORT Open Rev 2016;1: 233-238. DOI: 10.1302/2058-5241.1.000024.
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lordosis (LL) and PI-LL mismatch prior and after fusion, are associated with an increased risk of developing ASD. 62 Concerning LL, previous studies have reported that failure to restore LL after lumbar fusion is a risk factor for ASD. 63 – 65 Djurasovic
Centre for Hip Surgery, Wrightington Hospital, UK
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Head of Health Registries, Northgate Public Services, Peoplebuilding 2, Hemel Hempstead, Hertfordshire, England
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Royal Derby Hospital, Derby, UK
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West Suffolk NHS Foundation Trust, UK
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University of Sheffield, Sheffield, UK
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, 25 appraisal 26 and implant mismatch notification. 27 Stakeholders (including purchasers, regulators, surgeon and hospital representatives and quality improvement teams) have been extensively consulted. For each topic there are a
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variably ( Table 3 ). 5 , 7 , 19 , 32 , 33 , 35 , 38 The patient may be over-optimistic regarding the functional outcomes of the prosthesis resulting in a mismatch with the actual possible outcomes. This leads to higher dissatisfaction rates (about 20
Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lund University, Skåne University Hospital, Department of Orthopedics, Malmö, Sweden
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
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Department of Surgery, Epworth HealthCare, University of Melbourne, Melbourne, Australia
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Centre for Hip Surgery, Wrightington Hospital, Wrightington, Wigan and Leigh NHS Trust, Lancashire, United Kingdom
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Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
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devices Providing data Beyond Compliance Daily Benchmarking Safe use of implants Providing data ODEP Annual Safety Component mismatch Web-based alerts NJR and Hospital Daily Service Development Service improvement
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rotational stability but, in cases of anatomical variability, sizing the stem may be very difficult. Conversely, ML tapered stems (Taperloc® stem being the first design) increase in size only in the coronal dimension, eliminating potential AP/ML mismatch, but
