Resistant organisms are difficult to eradicate in infected total knee arthroplasty, and treatment of methicillin-resistant Staphylococcus aureus (MRSA) is especially challenging. Whereas most surgeons use antibiotic-impregnated cement during revision to treat infection, the delivery of the drug in adequate doses is limited in penetration and duration. This study presents the 2- to 8-year prospective results of one-stage revision and intraarticular antibiotic infusion protocol used to treat MRSA. Eighteen knees (18 patients) with methicillin-resistant Staphylococcus aureus were treated between January 2001 and January 2007 with one-stage revision protocol that included débridement, uncemented revision of total knee components, and intraarticular infusion of 500 mg vancomycin via Hickman catheter once or twice daily for 6 weeks. (Figure 1) No intravenous antibiotics were used after the first 24 hours. Serum vancomycin levels were monitored to maintain levels between 3 and 10 μg/mL. The mean serum vancomycin peak concentration was 6 ± 2 μg/mL and the mean serum vancomycin trough concentration was 3 ± 1 μg/mL at 2 weeks postoperative.Introduction
Methods
Recent clinical studies found no apparent reduction in wear using yttria-stabilized zirconia (Y-TZP) instead of cobalt chromium alloy femoral heads bearing against cross-linked UHMWPE. The purpose of this study was to compare the surface topography of retrieved Y-TZP and magnesia-stabilized zirconia (Mg-PSZ) femoral heads and evaluate the influence of time Y-TZP (n = 18) and Mg-PSZ (n = 17) femoral heads were retrieved from revision THA. Heads were cleaned and scanned by optical profilometry (magnification = 10x) at three locations per specimen. After subtracting the curvature of the heads, roughness statistics (Sa, Ssk) were calculated and averaged for each specimen and then correlated to age Introduction
Materials and Methods
