Aims

Reverse shoulder arthroplasty (RSA) reliably improves shoulder pain and function for a variety of indications. However, the safety and efficacy of RSA in elderly patients is largely unknown. The purpose of this study was to report the mortality, morbidity, complications, reoperations, and outcomes of primary RSA in patients aged > 80 years.

Introduction and purpose: Two-stage reimplantation of a hip replacement is the treatment of choice for deep periprosthetic infections. The purpose of this study is to analyse the survival of the femoral component in two-stage hip replacement reimplantations and compare the results of cemented and cementless components.

Materials and methods: Between 1988 and 1998 our hospital carried out 169 two-stage reimplantations for treatment of first episodes of deep infection. The femoral component was cemented in 121 cases and cementless in 48. All patients were followed up clinically and radiologically for at least five years.

Results: The two-stage revision was associated with a significant clinical improvement. The reinfection rate was 9% (16/169), of which 11 patients underwent revision surgery and five received chronic suppressive antibiotic treatment. Eight patients required revision due to aseptic loosening and two for periprosthetic fracture. With the numbers available, fixation with or without cement showed no significant differences.

Conclusions: The two-stage revision of an infected hip prosthesis resolved the infection in 91% of the cases. An additional 5% required revision due to aseptic loosening. The surgical outcomes seem to be independent of the femoral component fixation (cemented or cementless).

Introduction and Objectives: Acute ruptures of the Achilles tendon are often treated surgically. The minimally-invasive technique of end-to-end suture has gained popularity in recent years. However, the use of reinforcing tendinous plasties can yield a more solid reconstruction, permit an earlier rehabilitation programme, and reduce the risk of re-rupture. The goal of this study is to determine the long-term results and complications of repairs using reinforcing plasties in the treatment of acute ruptures of the Achilles tendon.

Materials and Methods: Between 1995 and 2001, a total of 56 consecutive Achilles tendon ruptures were repaired using end-to-end suture and primary tendinous reinforcement. Average patient age was 35 years (range: 23–75), and 87% were males. Average time of postoperative immobilization was 4 weeks, and average time to discharge was 6 weeks. Average follow-up time was 4.7 years (range: 2–8 years).

Results: At the end of the follow-up period, 51 patients (89%) showed normal ankle function and had returned to their normal pre-injury activities. There were no complete re-ruptures. One patient presented with a partial traumatic re-rupture of the central area of the tendon, which did not require surgical treatment. There were 2 cases of deep infection, 10 patients with surgical wound problems, and 2 patients with transient paresthesia in the sural nerve area.

Discussion and Conclusions: Reconstruction of acute ruptures of the Achilles tendon using tendinous plasty for reinforcement gives satisfactory results in a high percentage of patients, permitting earlier rehabilitation with very low risk of subsequent re-rupture. However, the procedure is associated with a high rate of cutaneous complications and infection.