To explore the effect of different types of articulating antibiotic-loaded cement spacers in two-stage revision for chronic hip prosthetic joint infection (PJI). A retrospective cohort study was performed involving 36 chronic PJI patients treated with different types of articulating antibiotic-loaded cement spacers between January 2014 and December 2017. The incidence of complications and the therapeutic effects of different types of antibiotic-loaded articulating cement spacers were compared.Aims
Methods
There is continued debate as to whether cemented or cementless implants should be utilized in particular cases based upon chronological age. This debate has been rekindled in the UK and other countries by directives mandating certain forms of acetabular and femoral component fixation based exclusively on the chronological age of the patient. This editorial focuses on the literature-based arguments to support the use of cementless total hip arthroplasty (THA), while addressing potential concerns surrounding safety and cost-effectiveness. Cite this article:
Previous studies have evidenced cement-in-cement techniques as reliable in revision arthroplasty. Commonly, the original cement mantle is reshaped, aiding accurate placement of the new stem. Ultrasonic devices selectively remove cement, preserve host bone, and have lower cortical perforation rates than other techniques. As far as the authors are aware, the impact of ultrasonic devices on final cement-in-cement bonds has not been investigated. This study assessed the impact of cement removal using the Orthosonics System for Cemented Arthroplasty Revision (OSCAR; Orthosonics) on final cement-in-cement bonds. A total of 24 specimens were manufactured by pouring cement (Simplex P Bone Cement; Stryker) into stainless steel moulds, with a central rod polished to Stryker Exeter V40 specifications. After cement curing, the rods were removed and eight specimens were allocated to each of three internal surface preparation groups: 1) burr; 2) OSCAR; and 3) no treatment. Internal holes were recemented, and each specimen was cut into 5 mm discs. Shear testing of discs was completed by a technician blinded to the original grouping, recording ultimate shear strengths. Scanning electron microscopy (SEM) was completed, inspecting surfaces of shear-tested specimens.Objectives
Methods
Objectives. Orthopaedic surgeons use stems in revision knee surgery to obtain
stability when metaphyseal bone is missing. No consensus exists
regarding stem size or method of fixation. This in vitro study
investigated the influence of stem length and method of fixation
on the pattern and level of relative motion at the bone–implant
interface at a range of functional flexion angles. Methods. A custom test rig using differential variable reluctance transducers
(DVRTs) was developed to record all translational and rotational
motions at the bone–implant interface. Composite femurs were used.
These were secured to permit variation in flexion angle from 0°
to 90°. Cyclic loads were applied through a tibial component based
on three peaks corresponding to 0°, 10° and 20° flexion from a normal
walking cycle. Three different femoral components were investigated
in this study for cementless and cemented interface conditions. Results. Relative motions were found to increase with flexion angle. Stemmed
implants reduced relative motions in comparison to stemless implants
for uncemented constructs. Relative motions for cemented implants
were reduced to one-third of their equivalent uncemented constructs. Conclusions. Stems are not necessary for cemented implants when the metaphyseal
bone is intact. Short
