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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_10 | Pages 3 - 3
23 May 2024
Patel A Sivaprakasam M Reichert I Ahluwalia R Kavarthapu V
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Introduction

Charcot neuroarthropathy (CN) of foot and ankle presents significant challenges to the orthopaedic foot and ankle surgeon. Current treatment focuses on conservative management during the acute CN phase with offloading followed by deformity correction during the chronic phase. However, the deformity can progress in some feet despite optimal offloading resulting ulceration, infection, and limb loss. Our aim was to assess outcomes of primary surgical management with early reconstruction.

Methods

Between December 2011 and December 2019, 25 patients underwent operative intervention at our specialist diabetic foot unit for CN with progressive deformity and or instability despite advanced offloading. All had peripheral neuropathy, and the majority due to diabetes. Twenty-six feet were operated on in total - 14 during Eichenholtz stage 1 and 12 during stage 2. Fourteen of these were performed as single stage procedures, whereas 12 as two-stage reconstructions. These included isolated hindfoot reconstructions in seven, midfoot in four and combined in 14 feet. Mean age at the time of operation was 54. Preoperative ulceration was evident in 14 patients.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_I | Pages 46 - 46
1 Jan 2011
Sivaprakasam M Chana R Divekar A Dunnet W Zahn H
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Aim: The aim of this study is to analyse the peri-operative complications of the Bimetric femoral hip prosthesis (Biomet UK Ltd) and to evaluate the osteo-conductive and osteo-inductive performance of HA coatings in this implant.

Materials and Methods: This is an ongoing randomised control study (retrieval) over a period of 4 years at William Harvey Hospital, Ashford, Kent. Three types of HA coatings were used – plasma sprayed HAC 60μm, bonemaster dense HAC 3μm, bonemaster graded HAC 7μm. Three retrieved implants were sent for histological examination at The Royal National Orthopaedic Hospital, Stanmore.

Results: Fifty Four patients with mean age of 77 years (66–89) were evaluated. There were 12 (22%) surgical complications- 9 (7.4%) periprosthetic fractures, 2 stems subsided, 1 stem cemented. There was 5.5 % (3/54) risk of revision in 4 years (p< 0.001). The histological photomicrograph with the three different coatings examined showed Bone master 3–7μm coating had excellent bony in growth (osteo-integration).

Conclusion: In our series there was 5.5% risk of revision rate. The periprosthetic fracture and early mortality rates are within national limits. Revision surgery is the most significant aspect and this should be our primary concern. Hydroxyapatite coated stems with newer technique coating promotes good osteo-integration.