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Challenges and Advances in Revision Total Joint Arthroplasty

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Revision total joint arthroplasty (TJA) is increasing in frequency over time and is associated with a higher risk of morbidity and mortality compared to primary TJA.  Common indications for revision TJA include periprosthetic joint infection, aseptic loosening, component malposition, periprosthetic fracture, instability/dislocation, total knee arthroplasty (TKA) stiffness, and total hip arthroplasty (THA) prosthetic taper corrosion.  These are challenging clinical scenarios, often with limited treatment options.  It is thus important to develop techniques through clinical and basic science investigation for the prevention of these conditions, when possible, or administration of more effective, durable treatments. 

We welcome original research and review articles addressing current dilemmas in revision TJA. The potential topics include, but are not limited to, the following:

  • Debridement, antibiotics, and implant retention (DAIR) for acute infection; 
  • Single-stage, 1.5-stage, or two-stage revision for chronic infection;
  • Reconstruction of bone defects, prosthesis selection, and survival;
  • Surgical approaches and intraoperative techniques;
  • Medical preoperative optimization and postoperative management;
  • Risks factors for reoperation or other adverse events;
  • Biomechanical analysis of implant-bone constructs;
  • Basic science elucidation of infection, arthrofibrosis, osteolysis, or adverse local tissue reaction pathogenesis.

This special issue was published in Arthroplasty.

  1. The second-generation metaphyseal cone was useful in managing bone defects in revision knee arthroplasty. However, due to the anatomical constraints in Asian osteometry, the authors utilized a novel free-hand ...

    Authors: Thomas Ka Chun Leung, Ping Keung Chan, Henry Fu, Amy Cheung, Michelle Hilda Luk, Lawrence Chun Man Lau and Kwong Yuen Chiu
    Citation: Arthroplasty 2024 6:35
  2. Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Although some risk factors of PJI were well studied, the association between trauma and PJI remains unknown ...

    Authors: Hao Li, Qingyuan Zheng, Erlong Niu, Jiazheng Xu, Wei Chai, Chi Xu, Jun Fu, Libo Hao, Jiying Chen and Guoqiang Zhang
    Citation: Arthroplasty 2024 6:8
  3. Extensive acetabular bone loss and poor bone quality are two key challenges often encountered in revision total hip arthroplasty. A new 3D-printed porous acetabular shell has been made available with the optio...

    Authors: Shahril R. Shaarani, Monketh Jaibaji, Khaled M. Yaghmour, Georges Vles, Fares S. Haddad and Sujith Konan
    Citation: Arthroplasty 2023 5:24
  4. Primary total knee arthroplasty (TKA) is a preferred treatment for end-stage knee osteoarthritis. In the setting of a failed TKA, revision total knee arthroplasty (rTKA) acts as a salvage procedure and carries...

    Authors: Fong H. Nham, Ishan Patel, Abdul K. Zalikha and Mouhanad M. El-Othmani
    Citation: Arthroplasty 2023 5:18