Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review.

Introduction: This study aimed to systematically review the literature and identify the surgical management strategy for fixed flexion contracture in primary total knee arthroplasty (TKA) surgery, pre-, intra-, and post-operatively. Secondary endpoints were etiologies and factors favoring flexion contracture.

Materials And Methods: Searches were carried out in November 2023 in several databases (Pubmed, Scopus, Cochrane, and Google Scholar) using the following keywords: "flexion contracture AND TKA", "fixed flexion deformity AND TKA", "posterior capsular release AND TKA", "posterior capsulotomy in TKA", "distal femoral resection AND TKA".

Should trochanteric fractures in elderly patients be treated by arthroplasty or internal fixation?

Most trochanteric fractures are treated by fixation, most often intramedullary. Nevertheless, the desire to have patients walk as soon as possible and the fear of fixation failure has driven some surgeons to carry out an arthroplasty instead, especially for unstable fractures and/or in patients with severe osteoporosis, in order to avoid the difficult conversion to arthroplasty later on if the fixation fails. The aim of this review was to specify the role, technique and results of performing arthroplasty in this context.

Preoperative flexion contracture does not affect outcome in total knee arthroplasty: A case-control study of 2,634 TKAs.

Background: One issue in total knee arthroplasty (TKA) is management of preoperative flexion contracture, which may be associated with poor functional outcome.

Aim: The aim of this study was to compare functional results in TKA with or without preoperative flexion contracture, treated according to a standardized algorithm of tissue release and bone cut.

Patients And Method: A single-center retrospective case-control study was performed on prospectively collected data for the period 1987-2016.

Is hybrid fixation in revision TKA using LCCK prostheses reliable?

Introduction: The optimal technique for component fixation in revision total knee arthroplasty (rTKA) remains controversial: full cementation (FC) versus hybrid fixation (HF), which involves press-fit stem with cement fixation in the metaphyseal and epiphyseal zones. Previous series have either demonstrated the superiority of one or the other of these techniques or their equivalence. However, few studies have compared these 2 methods for rTKA using the Legacy® Constrained Condylar Knee (LCCK) prosthesis (Zimmer, Warsaw, Indiana, USA).

Development of a dosing-adjustment tool for fluoroquinolones in osteoarticular infections: The Fluo-pop study.

Fluoroquinolones efficacy depend on both the drug exposure and the level of drug resistance of the bacteria responsible for the infection. Specifically for the Staphylococcus species, which is the microorganism mainly involved in osteoarticular infections (OAI), in-vitro data reported that an AUC/MIC ratio above 115 h maximizes drug efficacy. However, data on OAI patients are lacking and a simple approach to access AUCs is still a clinical issue.

Techniques and outcomes of hip abductor reconstruction following tumor resection in adults.

The function of the abductor mechanism (AM) of the hip can be disturbed, or even compromised, following tumor resection in the hip area. The consequences are instability (limping, dislocation), pain and altered walking ability. Several reconstruction techniques can be used for the same AM sacrifice.

Techniques for filling tibiofemoral bone defects during revision total knee arthroplasty.

There are a variety of options for filling defects during revision total knee arthroplasty: cement with or without screws, structural or morselized allograft, highly porous cones and sleeves, massive bone allograft or megaprostheses. Our goal is to describe the techniques for these procedures and their indications. Any necrotic bone, fibrous tissue or granulomas must be excised, and the bone freshened.

Role of MRI in the assessment of interbody fusion with tantalum intervertebral implant.

Introduction: Radiologic assessment of interbody fusion (IF) is controversial; thin-slice CT is the present gold standard despite artifacts due to the metal implant that hinder interpretation. The present study aimed to assess the contribution of MRI in IF assessment after instrumented posterior lumbar interbody fusion (PLIF) using tantalum intervertebral implants. The study hypothesis was that fusion following PLIF can be assessed on MRI.

Tantalum implants for posterior lumbar interbody fusion: A safe method at medium-term follow-up?

Introduction: Intervertebral implants increase stability and improve results in lumbar interbody fusion (LIF). The aim of the present study was to assess clinical and radiological results of posterior lumbar interbody fusion (PLIF) using a tantalum intervertebral implant without associated interbody bone graft.

Materiel And Methods: A single-center retrospective study included 52 cases of single-level PLIF, using 2 tantalum intervertebral cages, without interbody bone graft: 42 for degenerative disc disease, 10 for isthmic spondylolisthesis.

Extraction of total knee arthroplasty intramedullary stem extensions.

Intramedullary stem extensions will need to be extracted during total knee arthroplasty (TKA) revisions, especially repeated ones. These stems have various designs and lengths, can be straight or offset, cemented (partially or totally) or cementless, smooth or rough. This diversity adds to the difficult of extracting them, which the surgeon must anticipate before starting the revision procedure.

Risk factors for dislocation after revision total hip arthroplasty with a dual-mobility cup. Matched case-control study (16 cases vs. 48 controls).

Background: Reports of high dislocation rates after revision total hip arthroplasty (THA) have encouraged the widespread use of dual-mobility cups. Dislocation has been less common but not fully abolished with dual-mobility cups, and its causes have remained unidentified. The objectives of this retrospective matched case-control study were: 1) to identify risk factors for dislocation, 2) and to assess dislocation outcomes.

Acetabular reconstruction using porous metallic material in complex revision total hip arthroplasty: A systematic review.

Bone defects during acetabular revision of total hip arthroplasty raise a problem of primary fixation and of durable reconstruction. Bone graft with direct cemented fixation or in a reinforcement cage was long considered to be the gold standard; however, failures were reported after 10 years' follow-up, especially in segmental defect of the roof or pelvic discontinuity. In such cases, metallic materials were proposed, to ensure primary fixation by a roughness effect with added screws, and especially to avoid failure due to bone resorption in the medium term.

Five to thirteen year results of a cemented dual mobility socket to treat recurrent dislocation.

Purpose: Dual mobility (DM) socket has been associated with a low rate of dislocation following both primary and revision total hip arthroplasty (THA). However, little is known about the long-term efficiency of DM in the treatment of THA instability. The purpose of this retrospective study was to evaluate the outcome of a cemented DM socket to treat recurrent dislocation after a minimum of five year follow-up.

How can we optimize anterior iliac crest bone harvesting? An anatomical and radiological study.

Purpose: Anterior iliac crest bone is a widely used donor site for bone harvesting. It provides an autologous bone graft consisting of cancellous bone that can be packed or cortical bone with greater structural support. Uses include spinal fusion and fracture non-union surgery.

The use of a cemented dual mobility socket to treat recurrent dislocation.

Background: The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation.

Questions/purposes: We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation.

Anatomical study of the lateral femoral cutaneous nerve with special reference to minimally invasive anterior approach for total hip replacement.

Background: Lesion of the lateral femoral cutaneous nerve (LFCN) represents the main complication during minimally invasive anterior approach dissection to the hip joint. The aim of this anatomical study was to describe the different presentation features of the LFCN at the thigh and particularly to determine the potential location of damage during minimally invasive anterior approach for total hip replacement.

Methods: The LFCN was dissected bilaterally at the thigh under the inguinal ligament in 17 formalin-preserved cadavers.

The composite meniscal-capsular-fat pad flap in a lateral approach to the fixed valgus knee: an anatomical study.

We present an anatomical study on the vascular supply to the patellar fat pad. Forty knees from fresh cadavers were dissected after injecting the femoral artery with colored latex. In all cases, the vascular supply to the fat pad depended essentially on the lateral inferior genicular artery, which enters this structure at its posterolateral extent.

Inability of 99mTc-ciprofloxacin scintigraphy to discriminate between septic and sterile osteoarticular diseases.

Unlabelled: Ciprofloxacin labeled with (99m)Tc specifically binds to various bacteria. Thus, it potentially constitutes a specific marker allowing discrimination between septic arthritis/osteomyelitis and aseptic osteoarticular diseases. The aim of this prospective study was to evaluate such properties in patients with skeletal diseases.

Lumboradiculopathy due to epidural varices: two case reports and a review of the literature.

Lumbar radicular pain caused by epidural varices is rare. Its incidence is evaluated at 4.5% of operations for disc herniation.