Complex Revision Arthroplasty Planning with Telemedicine Expert Advice

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Abstract

Relevance. An increase in the number of revisions is an inevitable consequence of the growth of primary arthroplasty number. The imperfection of implants and the lag in patient’s seeking medical help significantly increase the number of complex revisions. Extensive bone defects after removal of an unstable implant urge us to think about the better methods of these defects compensation and implants fixation. The purpose — was to assess the modern telemedicine opportunities for improving the preoperative planning of the complex revision arthroplasties. Materials and Methods. The study comprised 13 patients undergone revisions for implant instability in a regional orthopedic department using telemedicine differed advices including 11 hip and 2 knee arthroplasties. All patients had extensive bone defects. Results. In 12 cases, the surgeries were performed according to the recommendations from the expers of the Vreden National Medical Research Center of Traumatology and Orthopedics, St. Petersburg, Russian Federation. In one case, an individual system had been proposed as the main choice, but the preoperative plan was changed in favor of standard revision components. The short-term results of the surgeries were assessed as satisfactory. Conclusion. The use of modern information technologies for preoperative planning makes it possible to more accurately determine the indications for choosing implants. In particularly difficult cases, it becomes necessary to use individual implants. The right final choice depends on high-quality preoperative planning and effective interaction among medical hospitals of various levels.

About the authors

M. V. Belov

Clinical Emergency Hospital named after N.V. Solovyov; Yaroslavl State Medical University

Author for correspondence.
Email: micbelov@yandex.ru
ORCID iD: 0000-0001-7955-3625

Mikhail V. Belov — Cand. Sci. (Med), Head of the Orthopedic Department, Clinical Emergency Hospital named after N.V. Solovyov; Associate Professor of Traumatology and Orthopedics Department, yaroslavl State Medical University

Yaroslavl

Россия

S. V. Rassamakhin

Clinical Emergency Hospital named after N.V. Solovyov

Email: rassamahin@mail.ru
ORCID iD: 0000-0003-0154-7465

Sergey V. Rassamakhin — Orthopedic Surgeon

Yaroslavl

Россия

References

  1. Шубняков И.И., Тихилов Р.М., Денисов А.О., Ахмедилов М.А., Черный А.Ж., Тотоев З.А. и др. Что изменилось в структуре ревизионного эндопротезирования тазобедренного сустава в последние годы? Травматология и ортопедия России. 2019;25(4):9-27. doi: 10.21823/2311-2905-2019-25-4-9-27.
  2. Gwam С.U., Mistry J.B., Mohamed N.S., Thomas M., Bigart K.S., Mont M.A., Delanois R.E. Current epidemiology of revision total hip arthroplasty in the United States: National Inpatient Sample 2009 to 2013. J Arthroplasty. 2017;32(7):2088-2092. doi: 10.1016/j.arth.2017.02.046.
  3. Patel A., Pavlou G., Mújica-Mota R.E., Toms A.D. The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. J Bone Joint. 2015;97B(8):1076-1081. doi: 10.1302/0301-620x.97B8.35170.
  4. Kowalik T.D., DeHart M., Gehling H., Gehling P., Schabel K., Duwelius P., Mirza A. The Epidemiology of Primary and Revision Total Hip Arthroplasty in Teaching and Nonteaching Hospitals in the United States. J Am Acad Orthop Surg. 2016;24(6):393-398. doi: 10.5435/JAAOS-D-15-00596.
  5. Yoon P.W., Lee y.K., Ahn J., Jang E.J., Kim y., Kwak H.S. et al. Epidemiology of hip replacements in Korea from 2007 to 2011. J Korean Med Sci. 2014;29(6):852-858. doi: 10.3346/jkms.2014.29.6.852
  6. Bozic K.J., Kamath A.F., Ong K., Lau E., Kurtz S., Chan V. et al. Comparative Epidemiology of Revision Arthroplasty: Failed THA Poses Greater Clinical and Economic Burdens Than Failed TKA. Clin Orthop Relat Res. 2015;473(6);2131-2138. doi: 10.1007/s11999-014-4078-8.
  7. Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Черный А.Ж., Муравьева Ю.В., гончаров М.Ю. Данные регистра эндопротезирования тазобедренного сустава РНИИТО им Р.Р.Вредена за 2007–2012 гг. Травматология и ортопедия России. 2013;(3):167-190. doi: 10.21823/2311-2905-2013--3-167-190.
  8. Тихилов Р.М., Шубняков И.И., Коваленко А.Н., Денисов А.О., Билык С.С. Показания к ревизионному эндопротезированию тазобедренного сустава, планирование и техника ревизионной операции. В кн.: Руководство по хирургии тазобедренного сустава. Том II. Под ред. Р.М. Тихилова и И.И. Шубнякова. СПб. 2015. С. 285-350.
  9. Мурылев В.Ю., Петров Н.В., Рукин Я.А., Елизаров П.М., Калашник А. Д. Ревизионное эндопротезирование вертлужного компонента эндопротеза тазобедренного сустава. Кафедра травматологии и ортопедии. 2012;(1):20-25.
  10. Migaud H., Common H., Girard J., Huten D., Putman S. Acetabular reconstruction using porous metallic material in complex revision total hip arthroplasty: A systematic review. Orthop Traumatol Surg Res. 2019;105(1S):S53-S61. doi: 10.1016/j.otsr.2018.04.030.
  11. Taunton, M.J., Fehring, T.K., Edwards P., Bernasek T., Holt G.E., Christie M.J. Pelvic Discontinuity Treated With Custom Triflange Component. Clin Orthop Relat Res. 2012;470(2):428-434. doi: 10.1007/s11999-011-2126-1.
  12. Волокитина Е.А., Хабиб М.С.С. эндопротезирование тазобедренного сустава при деформациях и дефектах вертлужной впадины (обзор литературы). Уральский медицинский журнал.
  13. Коваленко А.Н., Джавадов А.А., Шубняков И.И., Билык С.С., Денисов А.О., Черкасов М.А., Мидаев А.И., Тихилов Р.М. Среднесрочные результаты использования индивидуальных конструкций при ревизионном эндопротезировании тазобедренного сустава. Травматология и ортопедия России. 2019;25(3):37-46. doi: 10.21823/2311-2905-2019-25-3-37-46.
  14. Бразовский К.С., Демкин В.П., Пеккер Я.С., Рязанцева Н.В. Технологии телемедицины — инструмент оптимизации ресурсов в здравоохранении. Вестник науки Сибири. 2012;2(3):117-122.
  15. Владзимирский А.В. Телемедицина. Донецк: Цифровая типография; 2011. С. 145.
  16. Gowda G.S., Manjunatha N., Kulkarni K., Bagewadi V.I., Shyam R.P., Basavaraju V. et al. A Collaborative Tele-Neurology Outpatient Consulation Service in Karnataka: Seven years of Experience From a TeleMedicine Center. Neurol India. 2020;68(2):358-363. doi: 10.4103/0028-3886.280644.
  17. Caffery L.J., Taylor M., North J.B., Smith A.C. Tele-orthopaedics: A snapshot of services in Australia. J Telemed Telecare. 2017;23(10):835-841. doi: 10.1177/1357633x17732800.
  18. Devadula S., Langbecker D., Vecchio P., Tesiram J., Meiklejohn J., Benham H. Tele-Rheumatology to Regional Hospital Outpatient Clinics: Patient Perspectives on a New Model of Care. Telemed J E Health. 2020;26(7):912-919. doi: 10.1089/tmj.2019.0111.
  19. Yadav S.K., Jha C.K., Mishra S.K., Mishra A. SmartphoneBased Application for Tele-follow-up of Patients with Endocrine Disorders in Context of a LMIC: A Compliance, Satisfaction, Clinical Safety and Outcome Assessment. World J Surg. 2020;44(2):612-616. doi: 10.1007/s00268-019-05212-7.
  20. Gnirke A., Beckers S.K., Gort S., Sommer A., Schröder H., Rossaint R., Felzen M. [Analgesia in the emergency medical service: comparison between tele-emergency physician and call back procedure with respect to application safety, effectiveness and tolerance]. Anaesthesist. 2019;68(10):665-675. [In German]. doi: 10.1007/s00101-019-00661-0.
  21. Kadel R., Evans-Lacko S., Tramarin A., Stopazzolo G. Cost-Effectiveness of Tele-Video-Consultation for the Neuro-Surgical Emergency Management at the General Hospitals in Italy. Front Neurosci. 2018;12:908. doi: 10.3389/fnins.2018.00908.
  22. Перхов В.И., Кураева В.М., Киреев С.А., Балуев Е.Е. О необходимости использования телеконсультаций при организации оказания высокотехнологичной медицинской помощи. Врач и информационные технологии. 2010;(1):21-29.
  23. Fröschen F.S., Randau T.M., Hischebeth G.T.R., Gravius N., Gravius S., Walter S.G. Mid-term results after revision total hip arthroplasty with custom-made acetabular implants in patients with Paprosky III acetabular bone loss. Arch Orthop Trauma Surg. 2020;140(2):263-273. doi: 10.1007/s00402-019-03318-0.

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