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Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 254 - 254
1 Sep 2005
Navarro S Madrigal J Najarro F Santos F Pérez R Huesa F Rodriguez S Romero-Candau F
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Introduction: To introduce a unit of bone and joint infections and to show the first result after a-two-year clinic experience.

Material and Methods: The bone and joint infections represent the most fearsome difficulty for surgeons. In order to deal with this kind of patient a multidiciplinary team work is required. In our Health Centre, in the year 2001, it has been made up a unit, directed by an Orthopedic surgeon, Head doctor of the Centre, and which is formed by two more Orthopedic surgeons; belonging the first one to the unit of plastic surgery and the second to the infection commission; furthermore, there is a specialist in internal medicine, a specialist in family and community medicine, a specialist in rehabilitation, a specialist in laboratory and clinic analysis and a nurse. Five beds of restricted entry and a monographic consult are also available. The way of work consists of two-day-a-week combined visists to floors and a weekly clinic session. Outpatients are seen by Orhtopedic surgeons of the unit, the internist doctor, the rehabilitators in their everyday consults and the monographic consult of the enfermary. Patients who are admitted in the unit are affected with bone and joint infection: Only exceptionally, patients in need of hospital isolation and with tissue infections caused by germs, are admitted; namely, Acinetobacter baumannii, Staphylococcus methicillm-resistant.

Results: Results of the unit after two-year clinic experience are presented:

We have treated a total of 82 patients, 78 of them where men and 4 women, between 18 and 58 years old. Most of the patients were included in, first in the 40–50 (21 patients) and second in the 30-40 (26 patients) years-old range. Out of the 82 patients, 64 had ostheomyelitis, 10 arthritis and 8 soft tissue infection. The first localization for the ostheomyelitis has been in tibia (30 cases) and in femur (8 cases). The etiology is distributed in: 32 infections after osteosynthesis and 27 after an open fracture. The germs mostly isolated were Gram positives: Staphylococcus coagula negatives (21), staphylococcus methicillin-sensitive(14) y enterococcus (5); Gram negatives: Pseudomona aeruginosa (14), Serratia (3), Enterobacter (2).

Conclusions: In our opinion a unit of bone and joint infections as a multidiciplinary medical team work improves the clinic quality.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 138 - 138
1 Feb 2004
Ramírez-Barragán A Pérez-Ochagavia F Martín-Rodríguez P Persson I Devesa-Cabo F Hernández-Morales J Juan-Vidal AS Terròn-Chaparro M Domínguez-Hernández J Martín-Gòmez E Ruano-Pérez R García-Talavera JR de Pedro-Moro JA
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Introduction and Objectives: The goal of cementless endoprosthetic hip surgery is to improve bone attachment. The gold standard method for evaluating periprosthetic bone characteristics is densitometry. This study was designed to compare periprosthetic bone mass in 2 groups of patients: less than 3 years and more than 3 years after implantation.

Materials and Methods: A total of 195 type ABG-II total hip prostheses were implanted from November 1997 to March 2003. This implant is a hemispheric cup coated with hydroxyapatite, which can additionally be anchored with screws and a short anatomic stem with metaphyseal fixation. DeLee and Gruen zones were analysed.

Results: During the study period, patients with implants less than 3 years old showed no significant changes in bone mineral density around the stem or the cup. In area 7, a statistically significant reduction was noted after 3 years (0.5218g/cm3, p< 0.001). In Gruen’s zones 3 and 4 a non-significant gain was observed after 3 years (1.1618g/cm3).

Discussion and Conclusions: In cup studies, a statistically insignificant increase in density was observed in zone I after 3 years. Noteworthy findings included a loss of function in DeLee zone III and Gruen zones 1 and 7, which has not yet had clinical consequences (at a maximum 6 year follow-up time).