Trephine Use During Revision Total Hip Arthroplasty Resulting in Diaphyseal Osteonecrosis and Stress Fracture: A Case Report.

Case: A fifty-three-year-old woman presented with a fracture of an extensively porous-coated femoral component. Revision was performed with use of trephine reamers to remove the distal portion of the stem. Despite radiographs that showed an acceptable position of the revision stem, she experienced substantial thigh pain at four months postoperatively, which persisted at twelve months.

Patellofemoral crepitus after total knee arthroplasty: etiology and preventive measures.

Patellofemoral crepitus and clunk syndrome are infrequent, yet troublesome complications of total knee arthroplasty with a reported incidence of 0%-18%. They are primarily associated with implantation of posterior cruciate substituting designs. These entities are the result of peripatellar fibrosynovial hyperplasia at the junction of the superior pole of the patella and the distal quadriceps tendon which becomes entrapped within the superior aspect of the intercondylar box of the femoral component during knee flexion.

Large-head metal-on-metal total hip arthroplasty using the Durom acetabular component at minimum 1-year interval.

Large-head metal-on-metal total hip arthroplasty represents novel technology, and outcome data are lacking. We prospectively compared the performance of a nonmodular metal-on-metal acetabular component (Durom; Zimmer, Warsaw, IN) with a modular titanium component (Trilogy, Zimmer). All Durom components placed at our institution with minimum 1-year follow up (n = 63) were compared with an age- and sex-matched Trilogy control group (n = 100).

A prospective evaluation of novel methods to intraoperatively distinguish parathyroid tissue utilizing a parathyroid hormone assay.

Background: Frozen section analysis has traditionally been used to confirm the identity of parathyroid tissue intraoperatively; however, it is time-consuming and costly and requires the excision of a significant portion of tissue. An intraoperative biopsy and analysis with a parathyroid hormone (PTH) assay is a possible alternative; however, this technique has not been perfected.

Methods: Two hundred twenty-three tissue specimens were collected prospectively from patients undergoing neck exploration.