The aim of this study is to evaluate the long-term outcome after posterior spinal stabilization surgery for the management of de novo non-tuberculous bacterial spinal infection. Patients presenting to a single tertiary referral spinal centre between August 2011 and June 2014 were included in the study. 21 patients with nontuberculous bacterial infection were identified and included in the study. All patients were managed surgically with posterior stabilisation, with or without neural decompression, without debridement of the infected tissue. Neurological state was assessed using the frankel grading system before and after urgery. Long-term follow-up data was collected using SpineTango COMI questionnaires and Euro Qol EQ-5D system with a mean follow-up duration of 20 months postoperatively. The mean improvement in neurological deficits was 0.92 Frankel grade (range 0–4). At final followup, at a mean of 20 months, mean COMI score was 4.59, average VAS for back pain was 4.28. These symptoms were having no effect or only minor effect on the work or usual activities in 52%. 38% of patients reported a good quality of life. The average EQ-5D value was 0.569. There were no problems with mobility in 44% of patients. In 72% there were no problems with self-care.Back ground:
Method and Result:
Approximately 700 TKRs (Total Knee Arthroplasty) were performed in our department from 1992–2000. In 13 cases, patellar dislocation occurred post-operation - 12 with no trauma and one following a fall and trauma to the medial aspect of the knee. Dislocation occurred from 2 months following the operation until 1 year postoperative (average 4.5 months). None of the patients had malalignment of the components. The average femorotibial angle was 5° (range 8° valgus to 3° varus). No patient had preoperative valgus deformity. Postoperative range of motion was 105° (range 90–125°). All dislocations were treated by operative lateral relapse and medial capsular implication followed by 6 weeks of immobilization with a brace in full extension and then physiotherapy, range of motion, patellar taping and Vastus medialis strengthening. The patella stabilized in 11 cases following the operation. In 2 cases, dislocation recurred following the operation and they were operated on again where medialization of the tibial tubercle was performed. Both cases stabilized following the second operation. One case developed a stress fracture of the tibia at the end of the tubercle osteotomy which healed conservatively. All dislocations occurred in the IBII prosthesis. During the past 3 years since using the PFC Sigma and Legacy prosthesis, we have had no dislocations of the patella, probably for the following reasons:
Use of the mid vastus exposure. Geometry of the prosthesis. In only 10% of the replacements, patellar resurfacing was performed.
