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2.1
Mechanical Complication of Prosthetic Joint

Presentation

Patients usually present with dyspnea, pelvic mass with or without a tender, distended abdomen and/or weight loss. [orpha.net]

The case of a 33 year-old female patient who presented rapid weight loss and a quickly increasing abdominal circumference is described. [obgyn.net]

Giles Scuderi and other leading experts from North America and Western Europe present their favored surgical procedures and post-surgical management strategies in this straightforward, heavily illustrated, video-intensive reference. [books.google.com]

The pleural effusion was diagnosed six months prior to presentation and yielded negative cytology on aspiration. The patient re‐presented with marked abdominal discomfort and bloating. [ncbi.nlm.nih.gov]

Entire Body System

  • Pain

    But if pain persists past six months after the procedure, it’s generally considered to be long-term, or chronic, pain. Several studies have looked at the frequency of chronic pain among total knee replacement patients. [drugwatch.com]

    It causes pain, stiffness, and swelling. Over time, the joint can become severely damaged. [icdlist.com]

    N50.812 Left testicular pain N50.819 Testicular pain, UNSPEC N50.82 Scrotal pain Chapter 15 – Pregnancy, childbirth and the puerperium Refer to the ICD-10-CM manual Chapter 16 ‐ Certain conditions originating in the perinatal period P05.09 Newborn light [aappublications.org]

    […] show pain and more subtle symptoms function deteriorates over time pain worsens over time Physical exam inspection sinus tract to the joint is a definite infection warmth, redness, or swelling low grade fever motion limited by pain and swelling Imaging [orthobullets.com]

    Painful Hardware ICD-10 T84.60XA Infection and inflammatory reaction due to internal fixation device of unspecified site, initial encounter T84.7XXA Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants and [eorif.com]

  • Fever

    […] procedures during pregnancy, childbirth and the puerperium ( O00-O9A ) • mechanical complication of respirator [ventilator] ( J95.850 ) • poisoning and toxic effects of drugs and chemicals ( T36-T65 with fifth or sixth character 1-4 or 6 ) • postprocedural fever [coding-pro.com]

    Chapter 13 – Diseases of the musculoskeletal system and connective tissue New codes added for autoinflammatory syndromes ( M04- ) including periodic fever syndromes ( M04.1 ) and cryopyrin‐associated periodic syndromes ( M04.2 ) New codes added for bunions [aappublications.org]

    […] procedures during pregnancy, childbirth and the puerperium ( O00-O9A ) mechanical complication of respirator [ventilator] ( J95.850 ) poisoning and toxic effects of drugs and chemicals ( T36 - T65 with fifth or sixth character 1-4 or 6) postprocedural fever [icd10data.com]

    Fever is an indication, and the presence of a red, inflamed joint confirms the diagnosis. [emedicine.medscape.com]

    This bacteria can then seed and infect a hip replacement, causing hip pain and fever. In the presence of a prosthetic infection, the surgeon will attempt to identify the organism (bacteria) that is causing the infection. [hss.edu]

  • Swelling

    It causes pain, stiffness, and swelling. Over time, the joint can become severely damaged. [icdlist.com]

    You might get pain or swelling in your leg, but usually, there aren’t any warning signs. [webmd.com]

    Symptoms and signs of prosthetic joint infectious arthritis may include pain, swelling, and limited motion; temperature may be normal. [msdmanuals.com]

    Clicking by itself is not a serious problem, but patients should let their doctor know if they experience pain, swelling or other noises along with the clicking. [drugwatch.com]

    Blood clots in the legs can occur after the surgery and may take several days after surgery to appear accompanied by swelling and pain in the legs. [recallcenter.com]

  • Fatigue

    G Bone Cement (with Gentamicin) 1 x 20G, 55=00-1121-140-01 Hi-Fatigue G Bone Cement (with Gentamicin) 1 x 40G, 56=00-1121-220-01 Hi-Fatigue G Bone Cement (with Gentamicin) 2 x 20G, 57=00-1121-240-01 Hi-Fatigue G Bone Cement (with Gentamicin) 2 x 40G, [shpr.registercentrum.se]

    & Rungruanganunt, P., Fatigue behavior of computer-aided design/computer-assisted manufacture ceramic abutments as a function of design and ceramics processing, International Journal of Oral and Maxillofacial Implants, 31/3 (2016), 601–9. [nobelbiocare.com]

    Fatigue. Dyspnoea (initially on exertion). Pelvic pain or bloating, constipation. Swollen abdomen with associated weight gain or weight loss. Non-productive cough. Amenorrhoea or irregular menstruation. [patient.info]

    Joint replacement failure may be due to the failure of structural materials, such as fatigue fracture of a metal prosthetic stem or the rapid destruction of a polyethylene cup. [link.springer.com]

    A 44-year-old Chinese female presented to our hospital in January 2018 with three months history of painless abdominal distension accompanied by watery diarrhea 5 to 6 times daily, shortness of breath, fatigue, lower limb swelling, and 10 kg weight loss [journals.lww.com]

  • Disability

    This application is not fully accessible to users whose browsers do not support or have Cascading Style Sheets (CSS) disabled. For a more optimal experience viewing this application, please enable CSS in your browser and refresh the page. [medicare.gov]

    Abstract Replacement of diseased or injured joints with artificial prosthetic components is commonly employed to reduce the pain and disability associated with many orthopedic conditions including arthritis, congenital deformities, trauma and other diseases [link.springer.com]

    The use of the term “disabling” peripheral neuropathy was also felt to be problematic, since this is a subjective term and it might be misinterpreted to mean that the patient qualified for medical disability. [bok.ahima.org]

Musculoskeletal

  • Fracture

    CodeDescriptionM96.621 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, right armM96.622 Fracture of humerus following insertion of orthopedic implant, joint prosthesis, or bone plate, left armM96.629 Fracture [medicalterminology.guide]

    The Analysis of Osteoporotic Fracture Risk In Turkish Population By Using FRAX®. [scholar.google.com.pk]

    Component fracture Component fracture is uncommon. The case on the left is probably secondary to severe polyethylene wear resulting in cup and cement fracture. [radiologyassistant.nl]

    T84041DPeriprosthetic fracture around internal prosthetic left hip joint, subsequent encounter T84042APeriprosthetic fracture around internal prosthetic right knee joint, initial encounter T84042DPeriprosthetic fracture around internal prosthetic right [cms.gov]

    […] and subcategories) for Salter-Harris Type physeal fractures of ankle or foot specified by bone, type of fracture and encounter type (S99.0-, S99.1, S99.2-) New codes added under “complications of cardiac and vascular prosthetic devices, implants and grafts [aappublications.org]

  • Hip Pain

    This bacteria can then seed and infect a hip replacement, causing hip pain and fever. In the presence of a prosthetic infection, the surgeon will attempt to identify the organism (bacteria) that is causing the infection. [hss.edu]

  • Knee Pain

    pain 7 months following total knee arthroplasty. [orthobullets.com]

  • Joint Swelling

    It causes pain, stiffness, and swelling. Over time, the joint can become severely damaged. [icdlist.com]

Urogenital

  • Urinary Retention

    Other possible complications include: Adverse effects of anesthesia and post-operative analgesia include the following: 1 Intense Itching sensation Hypotension Urinary retention Nausea Vomiting Airway Problems due to intubation Epidural hematoma (rare [recallcenter.com]

    Urinary Obstruction/Retention Code 599.6, Urinary obstruction, unspecified, must currently be used even when the urinary obstruction is due to a specified cause. [bok.ahima.org]

Neurologic

  • Stroke

    Q66.22 Congenital metatarsus adductus Q87.82 Arterial tortuosity syndrome Chapter 18 ‐ Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified New codes added for more specificity for the National Institutes of Health Stroke [aappublications.org]

    Risks related to anesthesia such as reaction to the anesthesia, heart attacks, strokes, pneumonia and blood clots in the legs. The older you are and the more medical issues you have may contribute to these risks. [recallcenter.com]

    These include anesthesia reactions, blood clots, heart attack and stroke. There are also some risks specific to the procedure, such as nerve damage and nerve block complications. [drugwatch.com]

Treatment

Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery. [icdlist.com]

However, several other complications might also occur during a two-stage treatment protocol for late hip joint infections which can also lead to prolonged treatment courses and endanger the functional outcome. [medsci.org]

In the treatment of musculoskeletal infections, antibiotic-loaded cement by means of beads or spacers is impregnated with higher doses (usually 4 g antibiotics/40 g PMMA) for infection treatment [ 1 ]. [jbji.net]

In women of reproductive age, unilateral salpingo‐oophorectomy is the treatment of choice, whereas in post‐menopausal women treatment is total abdominal hysterectomy with bilateral salpingo‐oophorectomy. [ncbi.nlm.nih.gov]

Prognosis

Treatment and prognosis The condition is benign and the ascites and pleural effusion resolve after resection of the primary pelvic tumor. [radiopaedia.org]

Prognosis Within weeks to months of operation the ascites and pleural effusion resolve and the CA 125 returns to normal. Postoperative resolution of the fluid is part of the definition of the disease. [patient.info]

Mortality/Morbidity: Meigs syndrome, being a benign condition, has a very good prognosis if properly managed, though it mimics a malignant condition. Life expectancy after surgical removal of the tumor is the same as in the general population. [csh.org.tw]

Although the detection of malignant cells is a marker of malignant disease and a sign of poor prognosis, the benign effusions don't affect neither the stage of the disease nor the prognosis of the patient.13 Some authors emphasize that an ovarian mass [obgyn.net]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Pathophysiology:   Etiology of ascitic fluid: The pathophysiology of ascites in Meigs syndrome is speculative. [csh.org.tw]

[…] disease) Function (functional disorders in the patho-physiological sense) Topography (anatomy) Morphology (pathologic anatomy/disease process) Etiology (agents causing disease) Etiology (agents causing disease) Classification component Procedural category [quizlet.com]

Origin of pleural effusion The etiology of pleural effusion is unclear. Efskind and Terada et al theorize that ascitic fluid is transferred via transdiaphragmatic lymphatic channels. [emedicine.medscape.com]

Epidemiology

Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]

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Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ.(2009) The epidemiology of revision total hip arthroplasty in the United States. [journals.sfu.ca]

Epidemiology[2, 3] Meigs' syndrome is rare. Fibromas account for around 3% of all ovarian tumours, and Meigs' syndrome for 1-2% of those. It tends to occur most often in postmenopausal women, with an average age of presentation of around 50 years. [patient.info]

Epidemiology Meigs' syndrome accounts for about 1% of ovarian tumours, and ovarian fibromata are found in 2–5% of surgically removed ovarian tumours. About 10–15% of women with an ovarian fibroma have ascites, and 1% has hydrothorax. [ncbi.nlm.nih.gov]

Pathophysiology

Other primary tumors include: ovarian fibrothecoma ovarian thecoma granulosa cell tumors of the ovary Brenner tumor: rare The pathophysiology of ascites in Meigs syndrome is speculative. [radiopaedia.org]

Pathophysiology:   Etiology of ascitic fluid: The pathophysiology of ascites in Meigs syndrome is speculative. [csh.org.tw]

Dentistry (71) Surgery, Traumatology and Orthopaedics (51) Pathology and Forensic Medicine (39) Internal Medicine (36) Paediatrics, Neonatology (23) Oncology, Radiation Therapy (21) Biophysics (17) Physiology and Pathophysiology (16) Cardiology, Angiology [portal.mefanet.cz]

Pseudo-pseudo Meigs syndrome includes patients with systemic lupus erythematosus and enlarged ovaries. [5] Pathophysiology Ascites is present in 10-15% of cases, and hydrothorax is found in only 1% of cases. [6, 7] Etiology of ascitic fluid The pathophysiology [emedicine.medscape.com]

Pathophysiology The exact pathogenesis of the ascites is still unknown. A possible theory is that there is filtration of interstitial liquid into the peritoneum through the ovarian tumour capsule. [ncbi.nlm.nih.gov]

Prevention

Some of the above-mentioned forms of failure can be prevented. Dislocations can be prevented by following the surgeon’s instructions. [hss.edu]

There are a few preventative measures that you and your doctor can discuss: Blood thinning medications. [healthline.com]

See guidelines from the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) for the prevention of orthopedic implant infection in patients undergoing dental procedures. [msdmanuals.com]

(6) Ophthalmology and Optometry (6) Otorhinolaryngology (6) Psychiatry, Psychology, Sexology (6) Histology, Embryology (5) Immunology, Allergology (5) Anatomy (4) Biology (4) Diabetology, Dietetics (4) Rheumatology (4) Haematology (3) Epidemiology, Preventive [portal.mefanet.cz]

First-line treatment is with thrombolysis and stenting 2, which removes the clot and relieves the compression to prevent recurrence. [radiopaedia.org]

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2.1
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