Timo Puolakka

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BACKGROUND AND PURPOSE Two-stage revision remains the gold standard in the treatment of infected knee arthroplasty. Lately, good long-term results of direct exchange arthroplasty have been reported. The purpose of this literature review is to compare the clinical outcome achieved with one-stage revision and two-stage revision with different types of(More)
Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register Open Access-This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use,(More)
BACKGROUND AND PURPOSE High age is associated with increased postoperative mortality, but the factors that predict mortality in older hip and knee replacement recipients are not known. METHODS Preoperative clinical and operative data on 1,998 primary total hip and knee replacements performed for osteoarthritis in patients aged ≥ 75 years in a single(More)
BACKGROUND AND PURPOSE Magnetic resonance imaging (MRI) is important for detecting extracapsular pseudotumors, but there is little information on the accuracy of MRI and appropriate intervals for repeated imaging. We evaluated the sensitivity and specificity of MRI for detecting pseudotumors in 155 patients (167 hips) with metal-on-metal (MoM) hip(More)
BACKGROUND Adverse soft-tissue reaction to metal debris (ARMD) continues to be major source of concern in metal-on-metal (MoM) hip replacements. In our earlier study we were able to establish several risk factors for ARMD in patients who had received a small-diameter (<50 mm) Articular Surface Replacement (ASR, DePuy, Warsaw, IN, USA). The aims of the(More)
BACKGROUND AND PURPOSE Ultrasound is used for imaging of pseudotumors associated with metal-on-metal (MoM) hips. Ultrasound has been compared with magnetic resonance imaging, but to date there have been no studies comparing ultrasound findings and revision findings. METHODS We evaluated the sensitivity and specificity of preoperative ultrasound for(More)
The patients Patient 1 (Figure 1) A 63-year-old woman (height 1.70 m, weight 92 kg, BMI 31) with developmental dysplasia of both hips underwent bilateral hybrid total hip replacement (THR) using the cemented Exeter V40 stem (offset 44 mm, size 3) and uncemented Trident PSL (Stryker) with alumina-on-alumina ceramic bearing (Biolox Forte; Ceramtec,(More)
BACKGROUND AND PURPOSE The US Food and Drug Administration and the UK Medicines and Health Regulation Agency recommend using MRI in the evaluation of patients with large-diameter metal-on-metal (LD-MoM) hips. Such recommendations do not take into account the relevance of repeated cross-sectional imaging. We therefore investigated the natural course of(More)
BACKGROUND Modern metal-on-metal hip resurfacing implants are being increasingly used for young and active patients, although the long-term outcome and failure mechanisms of these implants are still unknown. In this consecutive revision case series, early failures of femoral implants (at < 4 years) were studied. METHODS 3 revisions were done due to a(More)
BACKGROUND AND PURPOSE There are no international guidelines to define adverse reaction to metal debris (ARMD). Muscle fatty atrophy has been reported to be common in patients with failing metal-on-metal (MoM) hip replacements. We assessed whether gluteal muscle fatty atrophy is associated with elevated blood metal ion levels and pseudotumors. PATIENTS(More)