Similar risks of complications and reoperation rates in proximal femur megaprostheses for oncological and non-oncological indications.

Purpose: Proximal femur megaprostheses (PFMPs) are used to manage large bone defects in both non-oncological indications (NOI) and oncological indications (OI). However, little is known about the comparative risks of reoperation and functional outcomes between these groups. This study aimed to evaluate the cumulative incidences of reoperation and functional results of PFMPs between NOI and OI.

No Difference in Dislocation Rates Comparing DMC-THA for Displaced Femoral Neck Fracture and for Osteoarthritis-A Matched-Pair Analysis.

Background: We hypothesized the risk of prosthetic instability would be similar in patients treated for femoral neck fracture (FNF) comparatively to patients treated for osteoarthritis (OA) using a dual-mobility cup-total hip arthroplasty (DMC-THA).

Methods: One hundred and nine patients (109 hips), with a mean age of 69.6 ± 3 years (65-75 years), underwent DMC-THA using a posterolateral approach for a FNF (study group).

Targeted resequencing of the 13q13 spondyloarthritis-linked locus identifies a rare variant in FREM2 possibly associated with familial spondyloarthritis.

Objectives: The strong heritability of spondyloarthritis remains poorly explained, despite several large-scale association studies. A recent linkage analysis identified a new region linked to SpA on 13q13. Here we searched for variants potentially explaining this linkage signal by deep-sequencing of the region.

Applications of artificial intelligence and machine learning for the hip and knee surgeon: current state and implications for the future.

Background: Artificial Intelligence (AI)/Machine Learning (ML) applications have been proven efficient to improve diagnosis, to stratify risk, and to predict outcomes in many respective medical specialties, including in orthopaedics.

Challenges And Discussion: Regarding hip and knee reconstruction surgery, AI/ML have not made it yet to clinical practice. In this review, we present sound AI/ML applications in the field of hip and knee degenerative disease and reconstruction.

Rotationplasty Salvage Procedure as an Effective Alternative to Femoral Amputation in an Adult With a History of Osteosarcoma: A Case Report and Review.

Rotationplasty or Borggreve-Van Ness surgery is lower limb salvage surgery, indicated mainly in the management of femoral bone sarcoma and congenital femur malformations in children. It can also be an interesting surgery option for managing chronic osteoarticular infections, or in cases of non union when curative therapy is no longer an option, as an alternative to femoral amputation. The principle of this surgery is to remove the affected knee and to apply a rotation of 180° to the distal part of the lower limb in order to give the ankle the function of a neo-knee.

A novel and secure technique of stemmed acetabular cup implantation in complex hip reconstructions: a comparative study and technical note.

Purpose: The stemmed acetabular cup (SAC) can be considered in several complicated situations. This type of prosthesis uses the iliac isthmus, which is most often preserved, thus allowing solid anchorage. Its implantation is prone to mechanical complications intraoperatively, such as extra-isthmic effraction, fracture, and early aseptic loosening.

Fracture Risk of Long Bone Metastases: A Review of Current and New Decision-Making Tools for Prophylactic Surgery.

Long bone pathological fractures very much reflect bone metastases morbidity in many types of cancer. Bearing in mind that they not only compromise patient function but also survival, identifying impending fractures before the actual event is one of the main concerns for tumor boards. Indeed, timely prophylactic surgery has been demonstrated to increase patient quality of life as well as survival.

A Short-Course Antibiotic Prophylaxis Is Associated with Limited Antibiotic Resistance Emergence in Post-Operative Infection of Pelvic Primary Bone Tumor Resection.

Resections of primary pelvic bone tumors are frequently complicated by surgical site infections (SSIs), thereby impairing the functional prognosis of patients, especially in case of implant removal. Although prophylactic antibiotics play an essential role in preventing SSIs, there are presently no recommendations that support their appropriate use. This study aimed to assess the impact of a 24 h prophylactic protocol on the bacterial ecology, the resistance pattern, and the SSI healing rate.

Treatment of bone and joint infections by ceftazidime/avibactam and ceftolozane/tazobactam: a cohort study.

Objectives: Ceftazidime/avibactam (C/A) and ceftolozane/tazobactam (C/T) are two novel antibacterials with known efficacy against Gram-negative bacteria (GNB). We aimed to describe the efficacy and safety of surgical management combined with C/A or C/T treatment for bone and joint infections (BJIs).

Methods: We conducted an observational, bicentric study of patients treated with C/A or C/T for a BJI between May 2016 and June 2019.

Perioperative complications and causes of 30- and 90-day readmission after direct anterior approach primary total hip arthroplasty.

Unlabelled: We aimed to report causes of readmission 30 and 90 days following a total hip arthroplasty (THA) using the direct anterior approach (DAA).

Methods: Three hundred and two patients (335 hips) underwent a DAA-THA for primary osteoarthritis.

Results: The main reasons for 30 and 90-day readmission were wound related problems, dislocation (rate: 0.

Efficacy of cotrimoxazole (Sulfamethoxazole-Trimethoprim) as a salvage therapy for the treatment of bone and joint infections (BJIs).

Introduction: Cotrimoxazole (Sulfamethoxazole-Trimethoprim, SXT) has interesting characteristics for the treatment of bone and joint infection (BJI): a broad spectrum of activity with adequate bone diffusion and oral and intravenous formulations. However, its efficacy and safety in BJIs are poorly documented and its use remains limited.

Methods: We conducted a retrospective study in 2 reference centers for BJIs from 2013 to 2018 among patients treated with SXT for a BJI.

Outcomes after revision of metal on metal hip resurfacing to total arthroplasty using the direct anterior approach.

Background: Function after revision total hip arthroplasty (THA) in failed metal-on-metal (MoM) hip resurfacing arthroplasty (HRA) is variable, but post-operative complication rates are reportedly high. We hypothesized HRA conversion to THA using the direct anterior approach (DAA) would be associated with optimal outcome.

Methods: Seventeen MoM-HRAs in 15 patients (seven males, eight females) were revised through the DAA.

Case of femoral pseudarthrosis due to Scedosporium apiospermum in an immunocompetent patient with successful conservative treatment and review of literature.

Scedosporium apiospermum is a ubiquitous filamentous fungus, commonly found in soil, sewage and polluted waters. It is rarely pathogenic but can cause a broad spectrum of clinical diseases, which can be localised or disseminate to distant organs. The disseminated form of the disease is mostly seen among immunocompromised patients.

Fatty infiltration of stage 1 or higher significantly compromises long-term healing of supraspinatus repairs.

Background: Fatty infiltration (FI) compromises outcomes of rotator cuff repairs. Most clinicians consider FI of the infraspinatus, whether it is torn or intact, because it is most rapidly affected. The purpose of this study was to report long-term outcomes of isolated supraspinatus repairs and to determine their associations with FI of the infraspinatus and supraspinatus.

The Role of Macrophages in the Biological Reaction to Wear Debris from Artificial Joints.

Normal usage of total joint replacements results in the production of wear debris and other byproducts. In particular, polyethylene particles are heavily involved in the stimulation of local and systemic biological reactions resulting in chronic inflammation, periprosthetic bone resorption (osteolysis), and eventually implant loosening. As sentinels of the innate immune system, cells of the monocyte/macrophage lineage initiate the inflammatory cascade that lead to osteolysis.

Do Dual-Mobility Cups Reduce the Risk of Dislocation in Total Hip Arthroplasty for Fractured Neck of Femur in Patients Aged Older Than 75 Years?

Background: Total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture remains debatable as it is associated with higher rates of dislocation, notably in the older part of the population. We hypothesized this risk could be limited using dual-mobility cups (DMCs).

Methods: Eighty-two patients (83 hips) aged older than 75 years underwent DMC-THA using a posterolateral approach for an intracapsular NOF fracture.

Biological reaction to polyethylene particles in a murine calvarial model is highly influenced by age.

Particle-induced osteolysis is driven by multiple factors including bone metabolism, inflammation, and age. The objective of this study was to determine the influence of age on polyethylene (PE) particle-induced osteolysis in a murine calvarial model comparing 2-month-old (young) versus 24-month-old (old) mice. After PE particle implantation, calvaria were assessed at days (D) 3, D7, D14, and D21 via chemoluminescent imaging for inflammation (L-012 probe).

Dramatic reduction of clindamycin serum concentration in staphylococcal osteoarticular infection patients treated with the oral clindamycin-rifampicin combination.

Objectives: Pharmacokinetics of clindamycin in combination with rifampicin or levofloxacin were prospectively evaluated for the oral treatment of severe staphylococcal osteo articular infections.

Methods: Thirty-four patients (25 males, 9 females), with a mean age of 52.4 ± 17 years (range, 24-81 years), were randomly assigned either to the clindamycin-rifampicin or to the clindamycin-levofloxacin arm (control), following surgical debridement and intravenous adapted treatment.

Innate immunity sensors participating in pathophysiology of joint diseases: a brief overview.

The innate immune system consists of functionally specialized "modules" that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis.