Simulated large joint fluid model for evaluating intra-articular antibiotic delivery systems: initial evaluation using antibiotic-loaded calcium sulfate beads.

: Local antimicrobial delivery via calcium sulfate (CaSO ) beads is used as an adjunctive treatment for periprosthetic joint infection. There is limited clinical information describing the performance of antimicrobial-loaded CaSO (ALCS) in large-scale applications. We developed a simulated large joint model to study properties of eluting ALCS.

Fabrication of antibiotic-loaded dissolvable calcium sulfate beads: an in vitro mixing lab utilizing various antibiotic mixing formulas.

Chronic periprosthetic joint infection (PJI) is a devastating complication that requires an aggressive eradication protocol. Local antimicrobial delivery via dissolvable calcium sulfate (CaSO ) using small-sized beads (3-8 mm) has been utilized as an adjunctive treatment combined with implant exchange, radical debridement, and antimicrobial loaded acrylic spacers. The non-exothermic setting of CaSO theoretically allows for any antimicrobial agent to be used, so long as mixing methods provide a consistent fabrication within a reasonable set time.

Use of an offset head center acetabular shell in difficult primary total hip arthroplasties.

Several conditions may predispose patients to development of antero-lateral acetabular bone deficiency, including developmental dysplasia of the hip, osteonecrosis, or septic arthritis, among others. This may compromise the ability to gain acetabular component stability and impair reliable fixation. Large acetabular shells have often been used to achieve adequate fixation in scenarios of severe bone loss, however, these techniques have been shown to elevate the center of rotation (COR) of the hip and alter hip biomechanics.

Does femoral neck to cup impingement affect metal ion levels in hip resurfacing?

Background: Impingement of the femoral neck with the acetabular component after metal-on-metal hip resurfacing arthroplasty (HRA) is a possible cause of edge loading and accelerated bearing wear. No attempt has been made to correlate radiographic impingement signs and blood metal ion levels.

Questions/purposes: We (1) compared serum cobalt (CoS) and chromium (CrS) concentrations between patients with and without radiographic impingement signs treated with unilateral HRA, (2) determined whether divot depth on the femoral neck correlated with CoS and CrS, and (3) assessed the predictive value of radiographic impingement signs for high levels of CoS and CrS.