Aim. Septic arthritis (SA) is considered a medical emergency. The most common etiological agents are glucose consuming bacteria, so we evaluated the clinical utility of synovial fluid (SF) glucose levels and other biochemical parameters for supporting the diagnosis of the disease and their association with a positive bacteria culture and joint destruction. Methods. Adult patients with SA diagnose were enrolled prospectively between July 2018 and October 2019. As control group, adults with knee osteoarthritis, meniscus and/or
Background:. Different surgical approaches have been proposed for the treatment of chondral lesions. However surgical management of osteochondral defects of the knee joint involving subchondral bone are still under debate. Purpose:. The aim of this prospective non-randomized uncontrolled clinical investigation is to confirm the effectiveness of a commercially available biomimetic osteochondral scaffold in regenerating cartilage and subchondral bone of severe osteochondral lesions of the knee joint with one step surgery. Methods:. The biomimetic scaffold has a multilayer structure consisting of a combination of type I collagen and type I collagen/hydroxyapatite, mimicking the osteochondral connective tissue of the knee joint. From 2009 to 2011, sixty-one patients affected by grade III or IV osteochondral lesions of the knee, according to Outerbridge Classification, were admitted to three centers and received the biomimetic scaffold. Four-nine patients were evaluated using the International Knee Documentation Committee (IKDC), Tegner and VAS scores, and MRI at 1-, 2- and 3-year follow-ups. Biopsies were carried out in 5 patients at an average time of 19.2 months to histologically evaluate the quality of the newly-formed tissue. Results:. All patients tolerated the surgery well; no major adverse events were observed in the early postoperative period. Clinical evaluation of the 49 patients showed a statistically significant improvement in all scores at 1- 2- and 3-year follow-ups as compared to preoperative baseline scores. Improvement in the scores and functional recovery seemed to reach a plateau after 2 years; no significant improvement was seen between the 2- and the 3-year follow-up. Conclusions:. A synthetic biomimetic scaffold used in one-step surgery for the treatment of severe osteochondral
Introduction. Ceramic total knee arthroplasty (TKA) was introduced as a new-generation of knee prostheses in clinical practice, and are expected to reduce polyethylene wear due to its resistance to abrasion and lubrication. In 1992, we developed a cruciate retaining LFA-I total knee prosthesis (KYOCERA Medical Co., Japan), which comprises an alumina ceramic femoral component and a titanium-alloy tibial component with a polyethylene insert. The purpose of this study was to evaluate clinical results in rheumatoid patients who were treated with the alumina-ceramic LFA-I prosthesis with a minimum 15-year follow-up period. Methods. A total of 70 primary TKAs were performed in 51 patients between 1993 and 1996 using the cemented alumina-ceramic LFA-I prosthesis. Sixteen of these patients (20 knees) had died by the time of this study, of causes unrelated to the index arthroplasty, and 11 patients (16 knees) were lost to the follow-up. The remaining 34 knees were clinically and radiographically evaluated in the present study. The average follow-up time was 16.7 years. The average age of the patients was 58.2 years at the time of the operation. The clinical assessment was conducted with the Hospital for Special Surgery Knee rating score and the Knee Society scoring system. The component alignment and bone-implant interface were evaluated according to the Knee Society Roentgenographic Evaluation System. Results. The cumulative survival rate for revision for any reason at 15 years was 94.1%. The mean postoperative range of motion was 115.3 degrees at the time of the most recent follow-up. The mean postoperative knee score was 90.1 and 84.7 using the Knee Society and the Hospital for Special Surgery rating systems, respectively. Reoperations had been required on two knees due to loosening and on one knee due to infection. Periprosthetic radiolucencies or osteolysis were present in six