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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_III | Pages 15 - 15
1 Feb 2012
Iyengar K Nadkarni J Vinjamuri S
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Aim

To assess the role of Tc-99m labelled anti granulocyte monoclonal antibody Fab' fragment (Sulesomab) in the diagnosis of bone and joint infections.

Methods

We analysed the results of 95 patients referred with a clinical suspicion of bone and joint infections. There were 47 male and 48 female patients with a mean age of 60 years (range=16 to 89). Referrals were made for suspected infection of prosthetic total joint replacements (38), long bones (32), primary joints (12) and feet (13). Sulesomab imaging was done with 650 MBq of 99mTcSulesomab. The final diagnosis was determined by conclusive microbiology, culture and/or histology, intra-operative findings, aspiration, complementary investigations like CT/MRI and long term clinical follow-up. The findings of 99mTcSulesomab images were compared with the clinical outcome to arrive at the decision of True Positive/ False positive/ True negative/ False negative results. Using the above definitions sensitivity, specificity and diagnostic accuracy of 99mTcSulesomab for suspected bone and joint infection were calculated.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 207 - 207
1 May 2009
Iyengar K Nadkarni J
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Purpose of study: To evaluate the results Biomet® Retrograde Closed Intramedullary nailing in the treatment of femoral shaft fractures and femoral fractures below a pre-existing hip implant in elderly patients.

Patients and Methods: 25 patients were treated with closed Biomet® Retrograde Femoral Nail between February 2003 and January 2004. Eight of these had occurred below a previous hip implant. There were 19 female patients and 6 male with a mean age of 72 years. Mechanism of injury, demographics and AO fracture pattern were recorded. Pre-fracture mobility, operative details, post-operative management, complications if any, was noted. Time to clinical and radiological union, outcome using the Wilde modification of the Neer scoring system after mean follow-up of 1 year was evaluated.

Results: 2 patients were lost to follow-up and 4 patients died following unrelated medical conditions. 19 patients were available for final review. Most patients had an excellent outcome with a mean clinical and radiological union at around 15.8 weeks (range 11–20 weeks). 4 patients had backing out of a distal locking screw, which were removed. There were no implant failures. 15/19 patients achieved their pre-injury mobility status.

Conclusion: We conclude that displaced fractures of the femur and those below a hip implant can be effectively managed with closed Biomet® Retrograde Femoral intramedullary nail. Surgery is less traumatic, safe, and allows early mobilization, resulting in a good functional recovery.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 255 - 256
1 May 2006
Pradhan N Iyengar K Gambhir A Kay P Porter M
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Aim: To undertake clinical and radiological assessment of the TCIII prosthesis for Revision total knee arthroplasty with survivorship analysis.

Methods: We reviewed the clinical and radiological outcome of 57 Total Condylar III (TCIII) prostheses used for revision knee arthroplasty performed between December1995 and December1997 at Wrightington hospital. Twelve patients (12 knees) had died. At a mean follow-up of 6.75 years (range, 5–8years) 45 knees in 43 patients were available for review. None were lost to follow-up. There were 23 women and 20 men, with a mean age of 73 years. Radiographs were analysed for component position, alignment and bone-cement radio-lucencies.

Results: The reason for revision was instability in 38 knees, infection in 4 knees, pain in 2 knees and stiffness in one knee. The mean preoperative Hospital for Special Surgery HSS score was 36, improving to 70 after revision at latest review(p=< 0.001). The mean postoperative range of movement was 95 degrees. 2 prostheses were revised, one for infection and another for instability, Survival analysis using the Kaplan Meier method provided a cumulative survival rate of 95.56 % at 8 years.

Conclusion: The clinical and radiological results of our study support the continued use of the TCIII prostheses in revision total knee arthroplasty with satisfactory outcome in the medium term.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 99 - 99
1 Mar 2006
Pradhan N Iyengar K Gambir A Kay P Porter M
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Aim: To undertake clinical and radiological assessment of the TCIII prosthesis for Revision total knee arthroplasty with minimum 5 year follow-up.

Methods: We reviewed 57 Total Condylar III (TCIII) prostheses used for revision knee arthroplasty performed between December1995 and December1997 at Wrightington hospital. Twelve patients (12 knees) had died. At a mean follow-up of 6.75 years (range, 5–8years) 45 knees in 43 patients were available for review. None were lost to follow-up. There were 23 women and 20 men, with a mean age of 73 years. Radiographs were analyzed for component position, alignment and bone-cement radiolucencies.

Results: The reason for revision was instability in 38 knees, infection in 4 knees, pain in 2 knees and stiffness in one knee. The mean preoperative Hospital for Special Surgery HSS score was 36, improving to 70 after revision at latest review (p=< 0.001). The mean postoperative range of movement was 95 degrees. 2 prostheses were revised; one for infection and another for instability. Survival analysis using the Kaplan Meier method provided a cumulative survival rate of 95.56 % at 8 years.

Conclusion: Our study supports the continued use of the TCIII prostheses in revision total knee arthroplasty, wherein the ligaments can be balanced, with satisfactory outcome in the medium term.