Replacement Arthroplasty: Harwin SF

Harwin SF. · No affiliation provided · J Knee Surg. · Pubmed #18979930 No free full text.

This publication has no abstract.

Harwin SF. · No affiliation provided · Orthopedics. · Pubmed #16295186 No free full text.

This publication has no abstract.

Math KR, Zaidi SF, Petchprapa C, Harwin SF. · Division of Musculoskeletal Imaging, Beth Israel Medical Center, New York, NY 10010, USA. · Semin Musculoskelet Radiol. · Pubmed #16514580 No free full text.

Abstract: Painful total knee arthroplasty (TKA) represents a diagnostic challenge for the clinician and radiologist, as there is a wide variety of potential etiologies, with a broad range of clinical presentations, and the abnormalities on imaging studies are often subtle, absent, or nonspecific. Imaging findings of normal TKA are reviewed, in addition to a variety of complications such as loosening, infection, instability, osteolysis, heterotopic ossification, extensor mechanism disruption, and fracture. Although imaging evaluation of painful TKA is usually limited to conventional radiographs and nuclear imaging, examples of the utility of computed tomography are also illustrated, and suggested imaging strategies and algorithms are discussed.

Harwin SF. · Department of Orthopedic Surgery, Beth Israel Medical Center, and Associate Clinical Professor of Orthopedic Surgery, Albert Einstein College of Medicine, New York, NY, USA. · J Knee Surg. · Pubmed #12568266 No free full text.

This publication has no abstract.

Harwin SF, Greene KA, Hitt K. · Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY, USA. · J Knee Surg. · Pubmed #18979936 No free full text.

Abstract: The 4-year outcomes of a prospective study of patients undergoing Triathlon total knee arthroplasty (TKA) are presented. There were 2035 consecutive cemented TKAs performed on 1688 patients. Mean follow-up was 21 months, including 713 knees with a follow-up of > or =2 years. In a subgroup of 239 patients, the coverage of the patella cut surface by the patella component was analyzed. To our knowledge, this is the first article to study this issue. Mean Knee Society pain scores improved from 48 to 96, function improved from 63 to 85, and range of motion improved from a mean of -5 degrees to 104 degrees to a mean of -2 degrees to 126 degrees. Coverage of the patella by the prosthesis was full from medial to lateral in 88% and full from proximal to distal in 91% of knees. The implant system has performed well within the follow-up period, with no implant- or design-related failures.

Harwin SF. · Department of Orthopedic Surgery, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY, USA. · Orthopedics. · Pubmed #17375548 No free full text.

Abstract: During preparation for uncemented femoral arthroplasty, a phenomenon has been observed that indicates thinning of anterior metaphyseal bone to a critical level. Light can be seen from within the canal passing through the anterior cortex. This skylight sign alerts the surgeon that a cortical defect or fracture can occur on reaming, broaching, or component insertion. In 420 consecutive arthroplasties, a skylight sign was noted in 97 (23%) hips. In 5 of those hips an oval cortical defect was created and in 3 hips a fracture occurred during broaching or insertion. Loosening developed in 1 hip with fracture. No fractures or defects occurred in hips without a skylight sign. If a skylight sign is present, the femur is at risk and preventive measures should be taken.

Harwin SF. · Adult Reconstructive Surgery, Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY, USA. · Knee. · Pubmed #16466919 No free full text.

Abstract: The results of revision total knee arthroplasty using the Kinemax Plus Superstabilizer prosthesis at a minimum of 10 years are reviewed. The implant was designed specifically for revision surgery with integral distal and posterior femoral build-ups and a modular metal reinforcement rod within the tibial polyethylene post. Eighteen consecutive knees revised for aseptic loosening or instability were studied prospectively and reviewed at 10-13 years (mean 11.6 years). Mean HSS scores improved from 51 to 86, KS knee scores from 40 to 83 and KS function scores from 48 to 82, with 83% good and excellent results. There was one re-revision for recurrent instability. Additional distal femoral add-ons were needed in 33% and posterior add-ons were needed in 22% of cases. No post breakage or deformation occurred. The design rationale has proven successful with satisfactory clinical and radiographic outcomes.

Harwin SF. · Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York, USA. · J Arthroplasty. · Pubmed #16446192 No free full text.

Abstract: Although bone anchors can help to repair soft tissues to bone, they are not without potential problems. A group of 214 consecutive total hip arthroplasties performed through a direct lateral approach using bone anchors for abductor mechanism repair was evaluated at 8 to 12 (mean 10.2) years. Complications included anchor migration from the bone in 18 (8.4%) patients, a unique pattern of symptomatic progressive osteolysis involving the lateral aspect of the greater trochanter in 8 (3.7%) patients, and pathological fracture of the greater trochanter in 1 (0.5%) patient. Three patients (1.4%) with trochanteric osteolysis required surgical intervention including removal of the anchors, debridement and reattachment of the abductor mechanism and repair of a pathological fracture. Considering these complications, as well as the significant cost, bone anchors are not recommended for abductor mechanism repair when using the direct lateral approach for total hip arthroplasty.

Harwin SF. · Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY, USA. · J Arthroplasty. · Pubmed #16124962 No free full text.

Abstract: A unique pattern and location of symptomatic heterotopic ossification (HO) was observed in patients having total hip arthroplasty (THA) performed using a direct lateral approach, situated outside the hip capsule, distal, lateral, and anterior to the greater trochanter, designated as trochanteric heterotopic ossification (THO). Radiographs of 1420 consecutive primary total hip arthroplasties were reviewed. Three hundred and seventy hips (26%) developed HO around the hip and greater trochanter. One hundred of these hips (27%) demonstrated THO, without classic HO. Of the 270 cases containing a Brooker component, 110 hips exhibited additional HO (THO). Thus, THO occurred in 210 (14.8%) of 1420 THAs. Two patients required surgical excision of the HO after maturity, gaining full relief without recurrence. Trochanteric heterotopic ossification should be considered as a possible cause of early postoperative pain after THA performed using a direct lateral approach.

Harwin SF. · Department of Orthopedic Surgery, Beth Israel Medical Center and Albert Einstein College of Medicine, New York, NY, USA. · Orthopedics. · Pubmed #16119737 No free full text.

Abstract: Yoke collar autograft is a successful means of achieving calcar-collar contact in cementless collared total hip arthroplasty.

Maestro A, Harwin SF, Delvalle M, Caballero D, Murcia A. · Department of Orthopedic Surgery, Cabuenes Hospital, Gijon, Spain. · Am J Knee Surg. · Pubmed #11277250 No free full text.

This publication has no abstract.

Harwin SF. · No affiliation provided · Orthopedics. · Pubmed #15058449 No free full text.

Abstract: Dr Steven F. Harwin, Surgical Director of The New York Center for Bloodless Medicine and Surgery at the Beth Israel Medical Center, shares his expertise on blood conservation in total joint arthroplasty. Initially launched in 1997, The New York Center for Bloodless Medicine and Surgery is the first comprehensive clinical program of its kind in New York City.