The aim of the study was to analyze effectiveness and safety of packing the medullary canal of the tibia and femur with Herafill (Heraeus Medical GmbH, Wehrheim, Germany), a void filler and antibiotic carrier, during second stage revision total knee arthroplasty(TKA) for periprosthetic joint infection (PJI). We used hybrid cementation technique for the fixation of TKA components with antibiotic-loaded bone cement for femoral and tibial component and cementless stem extensions. Two groups of 27 consecutive patients each were matched for gender and age. The study group received Herafill, while the control group did not. Otherwise, the treatment protocol remained the same for both groups. The average follow-up was 48 months (minimum of 34 months).Background
Methods
The aim of the study was to assess the results of treating knee osteoarthrosis with total knee arthroplasty (TKA) after previous tibia and/or femur fractures resulting in axial limb deformities. Thirty-six knees (34 patients) were operated on. At the most recent follow-up, 4.8 years after surgery, all but one patient demonstrated an improvement in both clinical and functional KSS. This male patient required revision after 2 years due to tibial component aseptic loosening. Improved range of motion was generally noted, especially extension, however, two patients with both tibia and femur fractures had worse results. TKA is an effective method of treatment for patients with arthrosis after a previous femur or tibia fractures. When deformity is severe semi-constrained or constrained, implants with extensions may be necessary.
Over the last 15 years there has been a series of publications reporting the beneficial effects of elbow arthrolysis, with considerable variation in operative technique and post-operative management. Many advocate the use of passive stretching techniques in the early post-operative period if range of motion fails to improve satisfactorily. The purpose of this study was to assess our results of open elbow arthrolysis in patients who did not receive any passive stretching after discharge from hospital. Prospectively collected data of 55 patients with a minimum follow-up of 1 year after arthrolysis were analysed. All procedures were performed by the same surgeon (LR), achieving as much improvement in elbow motion as possible at operation. All patients had continuous brachial plexus blocks and continual passive motion for 2-3 days post-operatively but none received any passive stretching after discharge. At review, a senior physiotherapist (BD) formally assessed all the patients.Aim
Methods
Over the last 15 years there have been a series of publications reporting the beneficial effects of elbow arthrolysis, with considerable variation in operative technique and post-operative management.
Ischemic necrosis of the femoral head occurring after the treatment of congenital dysplasia of the hip can negatively affect the long-term prognosis of the involved hip. The purpose of the study was to evaluate a number of clinical and radiological risk factors for AVN after non-operative treatment of DDH. Clinical data and radiographs of 77 patients with103 abnormal hips treated because of developmental dysplasia of the hip by closed reduction followed by cast immobilization were reviewed retrospectively. The average age of patients at the time of reduction was 16 months (ranged, 4 to 28) and the average final follow up was 22,4 years (ranged from 13 to 47 years). Kalamchi and MacEwen classification system was used for evaluation of the AVN. Avascular necrosis was found in 35,9% of the treated hips. We established the influence of several radiological and clinical data on the incidence and severity of AVN. Conclusion: In our analysis the degree of initial dislocation according to Tönnis classification is an important risk factor for AVN. Age at the onset of treatment, presence and size of ossific nucleus, the use and period of preliminary traction, previous treatment with Frejka pillow or Pavlik splint, sex and side were not associated with the incidence and severity of ischemic necrosis. The results have been analysed statistically.