Infection prevention in total knee arthroplasty.

Periprosthetic joint infections are devastating complications that are difficult and expensive to treat and have a substantial mortality rate. A major goal of modern joint arthroplasty is to minimize these infections. Preoperative factors associated with increased risk of infection include malnutrition, diabetes mellitus, obesity (body mass index >40 kg/m(2)), and rheumatoid arthritis.

Gap balancing vs. measured resection technique in total knee arthroplasty.

A goal of total knee arthroplasty is to obtain symmetric and balanced flexion and extension gaps. Controversy exists regarding the best surgical technique to utilize to obtain gap balance. Some favor the use of a measured resection technique in which bone landmarks, such as the transepicondylar, the anterior-posterior, or the posterior condylar axes are used to determine proper femoral component rotation and subsequent gap balance.

Management of bone defects in revision total knee arthroplasty.

Many treatment options are available to manage bone loss associated with revision total knee arthroplasty. Selection of the best treatment method is based on many factors, including defect size and location and the patient's age, health, and ability to participate in the necessary postoperative rehabilitation. Metaphyseal sleeves and cones appear to be a promising addition in dealing with large, central, contained and noncontained defects.

The importance of acetabular component position in total hip arthroplasty.

Correct acetabular cup position is critical to successful total hip replacement. Unfortunately, malposition of acetabular cups is common and leads to increased rates of dislocation, wear, and ion toxicity. Despite the popularity of Lewinnek's safe zone, the exact target of acetabular abduction and version remains elusive.

VEPTR™ growing rods for early-onset neuromuscular scoliosis: feasible and effective.

Background: The Vertical Expandable Prosthetic Titanium Rib (VEPTR™; Synthes North America, West Chester, PA) reportedly controls spinal deformity associated with constrictive chest wall conditions.

Questions/purposes: We asked whether spine-to-spine constructs using VEPTR™ instrumentation in combination with standard spinal instrumentation could be deployed to salvage failed rib-to-spine constructs used originally in patients with constricted chest walls and to primarily treat progressive spinal deformity without chest wall abnormalities.

Patients And Methods: Fifty patients were treated with VEPTR™ constructs for thoracic insufficiency syndrome at our center between 2001 and 2007.