Implant-related infection is one of the most devastating complications in orthopaedic surgery. Many surface and/or material modifications have been developed in order to minimise this problem; however, most of the We describe a method for the study of bacterial adherence in the presence of preosteoblastic cells. For this purpose we mixed different concentrations of bacterial cells from collection and clinical strains of staphylococci isolated from implant-related infections with preosteoblastic cells, and analysed the minimal concentration of bacteria able to colonise the surface of the material with image analysis.Objectives
Methods
We present in this work our experience with the sural fasciocutaneous flap to treat coverage defects following a lower limb posttraumatic lesion. This work is a review of the fasciocutaneous sural flaps carried out in different centres between 2000 and 2005. The series consist of 14 patients, 12 men and 2 women with an average age of 38 years (23–54) and with a medium follow-up time of 2 years (12–48 months). In all of the cases, aetiology was a lower limb injury being the most frequent the distal tibial fracture (eight patients), followed by sequelae from Achilles tendon reconstruction (two patients), fracture of the calcaneus (two patients) and osteomyelitis of the distal tibia (two patients) secondary to an open fracture. Associated risk factors in the patients for performing a fasciocutaneous flap were diabetes (1 case) and cigarette smoking (4 cases). The technique is based on the use of a reverse-flow island sural flap with the superficial sural artery dependent on perforators of the peroneal arterial system. The anatomical structures which constitute the pedicle are the superficial and deep fascia, the sural nerve, external saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The flap was viable in 13 of 14 patients. Only in one case, a diabetic patient, the graft failed. No patient showed signs of infection. Slight venous congestion of the flap occurred in two cases. No further surgical intervention of the donor site was required because of morbidity. In two cases partial necrosis of the skin edges occurred which resolved satisfactorily with conservative treatment. The sural fasciocutaneous flap is useful for the treatment of complex injuries of the lower limbs. Its technical advantages are: easy dissection with preservation of more important vascular structures in the limb, complete coverage of the soft tissue defect in just one operation without the need of microsurgical anastomosis. All of that results in a well vascularised cutaneous islet and thus a reliable flap
CLS Spotorno cotyle consists of an expansible hemispheric external component with troncoconic internal thin thread of Protasul Titanium. It also has a polyethylene UHMW internal threaded element which adapts prosthesic femoral heads (28–32 mm of diameter). The implant procedure is technically simple. First of all, the acetabulum is prepared by milling the cartilaginous surface with hemispheric mills. The external element is inserted pressthorn;t, later it is expanded with a troncoconic thread, the high density polyethylene is threaded inside the expanded component. The aim of this comunication is to expose the clinical and radiological outcome of 50 patients whom a CLS Spotorno expansible cotyle were implanted with a mean clinical follow up of 14 years. The indications are exposed considering the age, cotyle morphology and bone quality. The evaluation included both clinical and radiographic parameter. Test of Postel and Merle DñAubigne were assessed for this clinical outcome. Radiological evaluation included: Acetabular angle desviation, periprosthesic osteolysis, proximal and medial migration of the cotyle and polyethylene wear. The primary stability of the acetabular stems were found excellent. Good osteointegration and biocompatibility were demostrated by serial radiographic and funtional scores. We also present the surgical procedure, the complications and the conclusions of the study.