Adverse reactions to metal debris in metal-on-polyethylene total hip arthroplasty using a titanium-molybdenum-zirconium-iron alloy stem.

We report a series of three patients who underwent uncemented total hip arthroplasty with a modular titanium-molybdenum-zirconium-iron stem and a cobalt-chrome-molybdenum head on an ultra-high molecular weight highly cross-linked polyethylene liner bearing. All three cases subsequently developed pain and adverse reaction to metal debris, leading to revision of the implants within thirty-six months. They were subsequently found to have hypersensitivity to cobalt or chromium.

Peri-operative renal morbidity secondary to gentamicin and flucloxacillin chemoprophylaxis for hip and knee arthroplasty.

Introduction: This retrospective cohort study uses serum creatinine levels to assess the effect of gentamicin and flucloxacillin on renal function in hip and knee arthroplasty patients.

Methods: Serum creatinine levels were recorded pre-operatively and at two points post-operatively (sample 1 and sample 2) for all patients undergoing hip and knee arthroplasty. Either cefuroxime, or gentamicin and flucloxacillin were used for chemoprophylaxis.

Effect of acetabular orientation on stress distribution of highly cross-linked polyethylene liners.

Several case reports have documented the fracture of highly cross-linked polyethylene (HCLPE) liners used in total hip arthroplasty (THA). Although uncommon, fractured liners result in considerable morbidity for patients and require revision surgery. One postulated mechanism that leads to this type of implant failure is malorientation of the acetabular component.

Osteoid osteoma.

Osteoid osteomas consist of a nidus with surrounding sclerotic bone. The differential diagnosis covers a wide range of conditions due to the variable presentation of osteoid osteoma. The natural history is for regression to occur within 6 to 15 years with no treatment; however, this can be reduced to 2 to 3 years with the use of aspirin and non-steroidal anti-inflammatory drugs.

Total knee arthroplasty in the elderly: does age affect pain, function or complications?

Background: TKA is one of the most commonly performed procedures in the elderly, yet whether age influences postoperative pain, function, and complication rates is not fully understood for this group. This is because the current literature has limited followup, small sample sizes, and no comparator group.

Questions/purposes: We therefore asked if increasing age adversely affects postoperative pain, Knee Society Scores(©), and complication rates.

Outcomes of total hip arthroplasty in the octogenarian population.

Background: The outcomes of total hip arthroplasty (THA) in the elderly population are uncertain. With the rapid expansion of this population group, this study aims to determine whether increasing age affects the outcomes of THA by utilising the largest patient cohort and follow-up period within the literature.

Patients And Methods: All patients of 80 years and over who underwent primary THA between 1994 and 2004 at the authors' institution were compared to a cohort aged under 80 with the same diagnoses and during the same time period.

Effect of surgical approach for total hip replacement on hip function using Harris Hip scores and Trendelenburg's test. A retrospective analysis.

Objective: A retrospective analysis of osteoarthritis patients undergoing primary hip arthroplasty, to assess which surgical approach produces the best functional results at one-year post-operatively, using common clinical scoring systems and tests. The aim of this study was to compare the anterolateral and the posterior approaches to total hip arthroplasty using Harris Hip scores and Trendelenburg's test by looking at pre-operative results and comparing them to post-operative results.

Methods: Data from 3416 consecutive cases were extracted from a multicentre database, maintained by the Tayside Arthroplasty Audit Group (TAAG) situated in Tayside, using only patients who had undergone a primary hip arthroplasty and had a clinical diagnosis of osteoarthritis.

Management of periacetabular bone loss in revision hip arthroplasty.

The goals of acetabular revision surgery are to restore the anatomy and achieve stable fixation for the new acetabular component. The existing bone stock and the type of defect are determining factors in the surgical decision making. When necessary, and especially in younger patients, attempts should be made to restore the bone stock by grafting.

Proximal femoral allograft treatment of Vancouver type-B3 periprosthetic femoral fractures after total hip arthroplasty. Surgical technique.

Background: Periprosthetic femoral fractures following total hip arthroplasty are becoming more prevalent. When a fracture occurs in a femur with substantial proximal bone deficiency, the surgical options for revision are limited. One option includes the use of a proximal femoral allograft.

Surgical options for articular defects of the knee.

Cartilage and osteochondral defects of the knee can in most cases be treated with total knee replacement in the elderly population. However, these lesions pose a difficult treatment problem in the younger patient. A number of surgical options are available today to address this increasingly common condition and each has its own indications and limitations.

Offset acetabular cups: A solution to wear?

Change of tribological properties has been the main goal in the effort to augment the longevity of total hip arthroplasty, while the reduction of forces acting across the artificial joint space has received little attention. Spurred by recent reports of wear behaviour and good clinical results of the offset low friction arthroplasty cups, the authors, using the simplified free body technique, estimated the resultant hip joint reaction force and the angle of its application on 100 individual anteroposterior pelvic radiographs, by templating on the same hip a conventional concentric cup and an offset eccentric one. The results showed a highly significant reduction (p<0.

Calcitonin effects on cartilage and fracture healing.

The literature about the effects of systemically administered calcitonin on fracture healing and in the prevention of disuse osteoporosis after fracture are reviewed in this study. Fracture healing is a biological process of great importance for the survival of the injured animal. Endochondral ossification is augmented in the fracture site followed by fast remodeling of the produced woven bone.

Multiple level noncontiguous fractures of the spine.

From 1970 to 2000, 81 patients with noncontiguous fractures of the spine were evaluated. Of these 81 patients, 36 had a neurologic deficit. Sixty-six patients with stable injuries were treated conservatively, whereas 15 patients with unstable injuries required surgical stabilization.

Greek versions of the Oswestry and Roland-Morris Disability Questionnaires.

Disability questionnaires are increasingly used for clinical assessment, outcome measurement of treatment and research methodology of low back pain. Their use in different countries and cultural groups must follow certain guidelines for translation and cross-cultural adaptation. The translation of such an instrument must be tested for its reliability and validity to be applied and to allow comparability of data.

Prediction of Cobb angle in idiopathic adolescent scoliosis.

We did a prospective study of 291 children and adolescents with idiopathic scoliosis to identify possible correlations between clinical (scoliometer value, age, height) and radiographic (Cobb angle, Nash-Moe rotation, Risser iliac apophysis classification) parameters to predict the curve angle. There was a statistically significant correlation between thoracic, thoracolumbar, and lumbar scoliometer values and the thoracic, thoracolumbar, and lumbar Cobb angles, respectively (Pearson's r-0.685, 0.

Clinicopathologic features, diagnosis, and treatment of fibrosarcoma of bone.

Fibrosarcoma of bone is a relatively rare tumor; it accounts for less than 5% of bone sarcomas. The anatomical sites most commonly involved are the metaphyses of long tubular bones. Local pain, swelling, limitation of motion, and pathologic fracture are the common clinical signs and symptoms.

Degenerative spondyloarthropathy of the cervical and lumbar spine in jockeys.

This prospective study analyzed the long-term effects of horse riding on the cervical and lumbar spine of jockeys. Thirty-two jockeys were observed for 13 years. All jockeys had clinical and radiographic evaluation of the spine; three consecutive age groups were studied.