Aim

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

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.

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.

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.