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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 27 - 27
1 Jun 2012
Cipriano C Brown N Valle CD Sporer S
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Introduction

Modular tapered implants have been suggested as the optimal treatment in patients with severe femoral bone loss undergoing revision total hip arthroplasty (THA). The purpose of this study is to describe minimum 2 year follow up of patients treated with modular tapered prostheses for Paprosky type IIIB and IV femoral bone loss in revision THA.

Methods

44 Consecutive patients with Paprosky type IIIB (23) or IV (21) femurs undergoing revision total hip arthroplasty to cementless modular tapered prostheses were studied. Harris Hip Scores were obtained prior to revision on all patients except those presenting with acute implant failure or periprosthetic fracture. 10 Patients were deceased within 2 years of surgery; the remaining 18 were followed for an average of 42 months (range 25-69 months). Clinical outcomes were measured using the Harris Hip Score, and radiographs were assessed for signs of stem loosening or subsidence >4mm.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 28 - 28
1 Jun 2012
Cipriano C Brown N Jacofsky M Sporer S Valle CD
Full Access

Introduction

When using press-fit stems in revision total knee arthroplasty (TKA), diaphyseal engagement optimizes stability. Attempts to maximize press fit may lead to periprosthetic fracture; however, the literature offers no guidance regarding the prevalence or management of this complication. The purpose of this study is to report the incidence, risk factors, and outcomes of these fractures.

Methods

634 Stemmed implants (307 femoral and 327 tibial) from 413 consecutive revision TKAs were reviewed. Immediate and 6 week post-operative radiographs were examined. Patient age, gender, stem length, diameter, and offset were evaluated as potential risk factors for fracture occurrence using a paired t-test for continuous and a chi-square analysis for categorical variables.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 29 - 29
1 Jun 2012
Cipriano C Brown N Michael A Moric M Sporer S Valle CD
Full Access

Introduction

Serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and synovial fluid white blood cell (WBC) count and differential are effective in diagnosing periprosthetic joint infection (PPJI); however their utility in patients with inflammatory arthritis is unknown. The purpose of this study is to determine the utility of these tests in patients with inflammatory arthritis.

Methods

934 Consecutive revision hip and knee arthroplasties were prospectively evaluated for PPJI. 202 Cases were excluded due to acute post-operative or hematogenous infection. 690 Patients had non-inflammatory and 42 had inflammatory arthritis. Receiver operating characteristic (ROC) curves were used to establish optimal ESR, CRP, WBC, and % neutrophil values for diagnosis of PPJI, and the area under the curve (AUC) was calculated to determine the overall accuracy.