Success treating AIS with bracing is related to time worn and scoliosis severity. Temperature monitoring can help patients comply with their orthotic prescription. Routinely collected temperature data from the start of first brace treatment was reviewed for 14 patients. All were female with an average age of 12.4 years (range 10.3–14.6) and average 49o Cobb angle (30–64).

Our current service recommendation is brace wear for 20 hours a day. Patients complied with this prescription 38.0% of the time, with four patients averaging this or more. Average brace wear was 16.3 hours per day (3.5–22.2).

There were 13 patients who had completed brace treatment. The majority had surgery (7/13; 54%) or were considering surgery (1/13; 8%). There were 5 who did not wish surgery at discharge (5/13; 38%); 1 achieved a 40o Cobb angle, with 4 larger (53o;53o;54o;68o). The Bracing in AIS Trial (BrAIST) study measured “success” as less than a 50o Cobb angle, so using this metric our cohort has had a single “success”.

Temperature monitors allowed an analysis of when patients were achieving their brace wear. When comparing daywear (8am-8pm) to nightwear (8pm-8am), patients wore their brace an average of 7.6 hours a day (2.5–11.2) and 8.7 hours a night (0.4–11.5).

We conclude the minority of our patients comply with our current 20 hour orthotic prescription. The “success” of brace treatment is lower than comparison studies despite higher average compliance but starting with a larger scoliosis. Brace wear is achieved during both the day and night.

Introduction: The histology of prosthetic tissue is a gold standard for the diagnosis of prosthetic joint infection. However, the specificity and sensitivity of histology has never been 100% and this could be due to several causes. A possible cause for inconsistencies in histological results could be the type of specimen submitted to laboratory. The majority of authors obtain specimens from pseudocapsule, interface membrane and any tissue area suspicious of infection.

Aim: The objective of our study was to elucidate which is the most accurate specimen for histological diagnosis of prosthetic joint infection.

Methods: Prospective study including all revision arthroplasties performed in Hospital Clinic of Barcelona (Spain) from January 2007 to June of 2009. Specimens from pseudocapsule and from interface membrane were obtained from each patient. Definitive diagnosis of infection was considered when ≥2 cultures were positive for the same microorganism or the presence of pus around the prosthesis. Patients were classified in two groups:

patients submitted to hip revision arthroplasty due to an aseptic loosening in whom cultures (at least 5) obtained during surgery were negative and

Results: A total of 69 revisions were included in the study; 57 were classified in the group A and 12 were classified in the group B. The percentage of positive interface membrane histology in patients with prosthetic joint infection (group B) was significantly higher than the percentage of positive pseudocapsule histology (83.3% vs 41.6%, p=0.04, Fisher exact test).

Conclusion: The results suggest that the best specimen of periprosthetic soft tissue for histological study to diagnose the chronic periprosthetic infection in a revision total hip arthroplasty is the periprosthetic interface membrane.

Introduction: A hip replacement is an usually procedure in patients with chronic renal failure (CRF) affected of osteoarthritis, avascular necrosis of the femoral head or femoral neck fracture. The infection of the prosthesis is the most severe and important complication related to hip arthroplasty (HA). Patients with CRF have a immunosupression status, that increases the infection risk. The aim of the study was to evaluate the results of HA in patients on renal replacement therapy (RRT) through haemodialysis (HD) or renal transplantation (RT) .

Material and methods: Between 1990 and 2002, 23 HA have been performed in 18 patients on RRT (9 patients on HD and 9 RT). There were 9 women and 9 men, with an average age of 56 years old (range 30–83). In 5 patients the procedure was bilateral. The average time on RRT was 13.1 years (range 4–28). Preoperative diagnostic was: avascular necrosis of the femoral head (15 hips), femoral neck fracture (6 hips) and hip dysplasia (2 hips).

Results: The average follow-up was 59 months (range 3–140). All patients received antibiotic prophylaxis. Bleeding was the most frequent complication (74%, n=17). Infectious complications occurred in 33% of HA (n=6) in the early postoperative period and in 9% of HA (n=2) during the long-term follow-up. Early infections were: urinary tract infection (n=2 – Pseudomona species) and deep wound infection [n=4 – Pseudomona aeruginosa (n=1), Candida parapsilosis (n=1), Entero-coccus faecalis (n=1) and unknown aetiology (n=1), that required surgical debridement. Two patients had later infection of the prostheses (9%), and a two-stage revision in one case and resection arthroplasty in the other was performed. In-hospital mortality was 5.5% (n=1) and long-term mortality was 16.6% (n=3).

Conclusions: Infectious morbidity associated with HA in patients with chronic renal failure is important. The priority in this patients is individualize the surgical indication. An intensive medical control is needed.