Zirconia ageing is related to total hip arthroplasty aseptic loosening. A study of 45 retrieved zirconia heads.

Background: Y-TZP zirconia heads were recalled by the Food and Drug Administration (FDA) in 2001 and zirconia alone was no longer used in orthopedics. Tunnel furnace sintering was suspected of producing defects responsible for early material failure. As Zirconia Toughened Alumina (ZTA) matrices are widely used as bearing material and contain zirconia grains, there remains a need to better understand the in vivo ageing process of zirconia and its clinical implications when the material is produced by batch furnace sintering, the validated sintering process.

Optimized decision algorithm for the microbiological diagnosis of osteoarticular infections in adults using synovial fluid samples: a prospective study in two French hospitals including 423 samples of synovial fluid.

No consensus exists about the techniques to use for microbiological diagnosis of bone and joint infections (BJIs). The objective herein was to define an algorithm to optimize BJI diagnosis in adults using various bacteriological methods on synovial fluid samples. This prospective multi-center study included 423 synovial fluids collected from adult patients with suspected BJIs.

Antibiotic Prophylaxis in One-Stage Revision of Septic Total Knee Arthroplasty: A Scoping Review.

Background: Total knee replacement (TKA) is becoming a routine procedure in orthopedic surgery. One of the possible complications of this surgery is periprosthetic joint infection (PJI). The purpose of this study is to identify, through a literature review, which antibiotic is used as prophylaxis for septic one-stage revision TKA and what is the rationale for its use.

Masquelet's induced membrane technique associated with Reamer Irrigation Aspiration grafting and intramedullary Nailing (MaRIAN) for chronic diaphyseal osteomyelitis of the lower limb.

Introduction: Masquelet's induced membrane technique offers a definitive contribution to the treatment of diaphyseal osteomyelitis. To overcome its drawbacks while maintaining its principles, technical modifications have been proposed: antibiotic cement, femoral intramedullary autograft harvested by RIA (Reamer Irrigation Aspiration) and interlocking nails.

Material And Method: This retrospective study gathered patients with chronic osteomyelitis of the femur or tibia.

Optimal Combination of Femoral Tunnel Orientation in Anterior Cruciate Ligament Reconstruction Using an Inside-out Femoral Technique Combined With an Anterolateral Extra-articular Reconstruction.

Background: The optimal orientation of the anterolateral extra-articular reconstruction (ALLR) femoral tunnel to avoid collision with the anterior cruciate ligament reconstruction (ACLR) femoral tunnel is not clearly defined in the literature.

Purpose: To define the optimal combination of orientations of the ALLR femoral tunnel and the ACLR femoral tunnel using an inside-out technique to minimize risk of collision between these tunnels.

Study Design: Descriptive laboratory study.

Survival and complications of total hip arthroplasty using third-generation dual-mobility cups with non-cross-linked polyethylene liners in patients younger than 55years.

Background: In younger patients, total hip prostheses are subjected to wide motion ranges and wear-inducing forces. Dual-mobility cups (DMCs) are effective in decreasing the risk of dislocation. However, wear and osteolysis have been reported with first-generation DMCs.

What Are the Sonographic Outcomes of Acute Achilles Tendon Rupture? Nonoperative Versus Surgical Repair?

Introduction: The objective was to compare the two-year ultrasonographic outcomes in a consecutive series of patients with acute Achilles tendon rupture (ATr), either treated surgically or nonoperatively.

Materials And Methods: This is a prospective, single-center, consecutive series. All patients presenting with acute ATr were included and divided into two groups: surgical or nonoperative groups.

infection after anterior cruciate ligament reconstruction: A case report.

Background: Infections after anterior cruciate ligament reconstruction (ACLR) are rare. No cases of infection have been described to our knowledge.

Case Summary: We describe a rare case of infection in a 23-year-old patient following an ACLR.

Methods and probability of success after early revision of prosthetic joint infections with debridement, antibiotics and implant retention.

Prosthetic joint infection (PJI) is a rare-and dreaded-complication of arthroplasty requiring multidisciplinary care. Given the dual goal of treating the infection and maintaining satisfactory function, it is preferable to determine how and when the implanted components can be retained. Bacteria and fungi organize themselves into biofilms that shield them from antibiotics and the immune system.

Dual mobility cups for total hip arthroplasty: tips and tricks.

Since its creation in 1974, the Dual Mobility Cup (DMC) has been gaining in popularity, especially in the past decade. This intensive use could lead to inappropriate use and consequently to an increased complication rate. Compliance with conceptual requirements and surgical techniques will prevent the occurrence of complications that can be wrongly attributed to implants.

What are the influencing factors on hip and knee arthroplasty survival? Prospective cohort study on 63619 arthroplasties.

Background: Body mass index is used by the World Health Organization to classify obesity. While obesity influences the onset of arthritis and type-2 diabetes, its effect on implant survival is still open to debate, with conflicting results from clinical and registry studies, as well as meta-analyses. Other known factors such as gender or diabetes status could ponderate or mask the effect of BMI on implant survival.

Low Revision Rates at More Than 10 Years for Dual-Mobility Cups Cemented Into Cages in Complex Revision Total Hip Arthroplasty.

Background: Instability and aseptic loosening are the two main complications after revision total hip arthroplasty (rTHA). Dual-mobility (DM) cups were shown to counteract implant instability during rTHA. To our knowledge, no study evaluated the 10-year outcomes of rTHA using DM cups, cemented into a metal reinforcement ring, in cases of severe acetabular bone loss.

Outcomes of Augmented Dual Mobility Acetabular Cups.

Introduction: Total hip arthroplasty (THA) in patients with acetabular bone defects is associated with a high risk of dislocation and aseptic loosening. No studies to date have examined the use of uncemented and augmented dual mobility cups (DMC) in patients with acetabular defects. We hypothesized that the use of augmented DMC under these conditions would reduce the dislocation rate and lead to satisfactory bone integration in the medium term despite acetabular bone defects.

Contemporary rotating hinge arthroplasty can safely be recommended in complex primary surgery.

Purpose: The objective was to evaluate clinical and radiological outcomes, survival rate and complications of primary contemporary rotating hinged total knee arthroplasty (CRH-TKA).

Methods: Through a national multicenter retrospective study (14 centers), 112 primary CRH-TKA performed between 2006 and 2011 were included. Indications were: severe frontal plane deformity (55%), inflammatory, constitutional, congenital or post-trauma arthritis (26%), ligament laxity (10%), primary osteoarthritis (9%).

Use of morselized allografts for acetabular reconstruction during THA revision: French multicenter study of 508 cases with 8 years' average follow-up.

Background: In the context of acetabular reconstruction, bone defects can be filled with processed or unprocessed bone allografts. Published data are often contradictory on this topic and few studies have been done comparing processed allografts to fresh-frozen ones. This led us to conduct a large study to measure the factors impacting the survival of THA revision: (1) type of allograft and cup, (2) technical factors or patient-related factors.

Unilateral versus bilateral total knee arthroplasty: A registry study on survival and risk factors.

Background: Bilateral cases, representing at least 25% of total knee arthroplasties (TKA), could convey a statistical bias linked to dependency. Registries allow exploring this issue, susceptible to question surgeon validated protocols. Do bilateral total knee arthroplasties behave differently than unilateral knees in terms of implant survival?

Hypothesis: Bilateral TKA have a better survival than unilateral TKA.

Dual mobility cups in total hip arthroplasty after failed internal fixation of proximal femoral fractures.

Introduction: Performing total hip arthroplasty (THA) following failed internal fixation of proximal femur fractures is associated with an elevated risk of implant dislocation. We hypothesized that using a dual mobility (DM) cup will help to reduce the risk of postoperative instability in this specific context.

Material And Methods: This was a retrospective study of 33 consecutive patients who underwent DM THA following failed internal fixation of a proximal femur fracture.

Dual mobility acetabular cups for total hip arthroplasty: advantages and drawbacks.

Introduction: The dual mobility cup (DMC) concept was proposed by Professor Gilles Bousquet in 1974. Its' aims were to prevent postoperative dislocation, restore the physiological range of motion of the hip, and reduce the stresses at the interface. Since it was created, this design has been modified multiple times to reduce the complication rate, improve implant survival, and expand the indications.

Medial patellofemoral ligament reconstruction with or without tibial tubercle transfer is an effective treatment for patellofemoral instability.

Purpose: The hypotheses were that medial patellofemoral ligament reconstruction (MPFLr) would improve the long-term symptoms of patellofemoral Instability (PFI) and control patellar tilt, based on computed tomography (CT), and that the addition of a TT transfer, when it is necessary, would not deteriorate the outcome. The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of a large series of MPFLr, either isolated or associated with a TT transfer.

Methods: From 133 MPFLr with a minimum of 4 years postoperatively, three groups were defined: isolated MPFLr, MPFLr with tibial tubercle (TT) medialisation or MPFLr with TT medialisation and distalisation.

Correction to: Intraprosthetic dislocation of dual mobility total hip arthroplasty: still occurring?

The published online version contains mistake in the author list for the author name "Di Iorio Alexandre" was incorrectly presented.

Intraprosthetic dislocation of dual mobility total hip arthroplasty: still occurring?

Purpose: The objective was to identify predictive factors for intraprosthetic dislocation (IPD) and to understand how improvements in dual mobility cups (DMC) have helped to reduce dramatically the occurrence of this complication.

Methods: DM mobile inserts retrieved from 93 hips were divided into three groups: first-generation DMC with IPD ("firstDMC-IPD"), first-generation DMC with over 15 years of implantation without IPD ("firstDMC-noIPD"), and latest-generation DMC ("newDMC"). The predictive factors for IPD based on clinical, prosthetic, radiological and intraoperative characteristics were analysed by multivariate analysis.

Anterolateral Ligament of the Knee: What we Know About its Anatomy, Histology, Biomechanical Properties and Function.

To better control anterolateral rotational instability (ALRI) after anterior cruciate ligament reconstruction (ACLR), many recent studies have examined the anterolateral ligament (ALL). Although some inconsistencies have been reported, anatomic studies demonstrated that the ALL runs on the lateral side of the knee from the femoral lateral epicondyle area to the proximal tibia, between Gerdy's tubercle and the fibula head. Histologic research has characterized the ALL structure, which is more than a simple capsular thickening; it shows a dense collagen core, typical bony insertions and mechanoreceptor function.