Two-stage revision with the removal of all prosthesis has been considered to be the gold standard for treatment of periprosthetic joint infection. However, removal of well-fixed femoral stem is technically challenging and may cause excessive bone loss. The aim of this study was to compare the results between retention and removal of femoral stem when performing two-stage revision total hip arthroplasty for periprosthetic joint infection. From 2007 to 2014, ninety-four patients with infection after hip arthroplasty were treated by using two-stage exchange protocol with temporary articulating spacers. Among them, 38 patients completed the planned second stage reimplantation. Stem was exchanged in 15 patients (group I) and retained in 23 patients (group II). We retrospectively investigated the clinical and radiographic results after an average 39.9 months follow upPurpose
Materials & Methods
The purpose of the present study was to compare functional outcomes of medial unicompartmental knee arthroplasty (UKA) in patients with lateral meniscal lesion (LM (+) group) in the preoperative MRI and those without lateral meniscal pathology (LM (−) group) and to evaluate the effect of lateral meniscus lesion in preoperative MR on functional outcomes after UKA. The outcomes of 66 knees (LM (+) group) were compared to the outcomes of 54knees(LM (−) group)with a median follow-up of 28 month(range 24–36 months). Clinical outcomes including KS object score, KS pain score, lateral side pain, physical exam for lateral meniscal lesion and squatting ability. Radiological parameters (mechanical axis and component position) were compared and their effects on functional outcomes were evaluated at the final follow-up visits.Purpose
Methods
The purpose of this study was to evaluate the postoperative maximal flexion of Robotic assisted TKA which does not increase the posterior condylar offset after surgery and compare CT and conventional radiography in measuring the posterior condylar offset changes. 50 knees of 37 patients who underwent Robotic TKA and underwent follow-up minimal one year were evaluated. CT based preoperative surgical planning system was designed not to increase posterior condylar offset (PCO) after surgery. Maximal flexion angle of the knee was evaluated at 1 year after surgery. The change in PCO and joint line on x-ray and CT were evaluated.Purpose
Materials and method
a simple insertion, a partial/full cementation, the “glove”-technique, and, a cement bridge in case of large osseous defects of the proximal femur. To our knowledge, it is still unknown which of these methods provides the best stability. Between 01.01.1999–31.12.2008, 84 hip spacer implantations in 78 patients have been performed in our department. All patients have been treated with the same kind of spacer. 24 spacers have been fixed with the “glove”-technique, 18 with a partial cementation onto the proximal femur, 21 with a simple insertion, and 4 with a cement bridge. In 17 cases with an isolated septic loosening of the acetabular cup, only a spacer head has been placed onto the well-fixed prosthesis stem. The overall dislocation rate between stages was 21.4 % (18/84). The lowest dislocation rate was observed in the “spacer head” group with 5.8 % (1/17), followed by the “glove”-technique with 12.5 % of the cases (3/24). In the “partial cementation” group the dislocation rate was 22.2 % (4/18), whereas in the “insertion” group spacer dislocations occurred in 9 out of 21 cases (42.8 %). In the latter group, in 3 cases the spacer rotated primarily in the femur and dislocated subsequently out from the acetabulum. From the 4 patients having been treated with a cement bridge, 2 patients suffered from a spacer dislocation. From these 18 cases, 15 patients have been treated conservatively by reduction and immobilization in a hip orthesis during the remaining time between stages. The other three cases underwent further surgical procedures; in one case (combined spacer dislocation and -fracture), the spacer had been exchanged, whereas the other two cases had been treated by resection arthroplasty after recurrent spacer dislocations and unsuccessful conservative treatment. The “glove”-technique seems to be the most effective method for femoral fixation fixation of hip spacers regarding the prevention of dislocations between stages. Further advantages of this technique include a safe and easy spacer explantation in one piece without cement debris at the second stage.
