Long-term outcomes of acetabular impaction grafting with cemented cups and trabecular metal for revision hip arthroplasty: a follow-up study.

Introduction: Revision hip arthroplasty in the presence of complex acetabular deficiencies is challenging. Cement, allograft, reconstruction rings and porous trabecular metal now provide versatile options for acetabular fixation and restoration of acetabular offset. We compare acetabular impaction bone grafting (AIBG) and trabecular metal (TM) cups at long-term follow-up.

High rate of tibial debonding and failure in a popular knee replacement : a follow-up review.

Aims: Total knee arthroplasty (TKA) is a common and safe orthopaedic procedure. Zimmer Biomet's NexGen is the second most popular brand of implant used in the UK. The primary cause of revision after the first year is aseptic loosening.

High rate of tibial debonding and failure in a popular knee replacement: A cause for concern.

Background: Total knee arthroplasty (TKA) is a common orthopedic procedure with 975,739 performed in the UK between 2003 and 2016. The two most common prosthetics used are P.F.

Streptococcus gordonii-a rare cause of prosthetic joint infection in a total hip replacement.

A 69-year-old female with a history of bilateral total hip replacements presented with rigors, fever and sudden onset left groin pain. A pelvic X-ray showed well-fixed implants. Blood results revealed a leucocytosis (white cell count 22.

Uncemented total hip arthroplasty in osteoarthritis of hip secondary to low and high dislocated hips: A mid-term follow-up study.

Background: Performing successful total hip replacement (THR) in dysplastic, subluxed, and dislocated hip is a challenging task. Here, we assessed midterm clinical and radiological outcomes of uncemented total hip arthroplasty in osteoarthritis (OA) of hip secondary to Hartofilakidis low and high-dislocated hips with a mean follow-up of 8.8 years.

Synchronous quadriceps tendon rupture and unilateral ACL tear in a weightlifter, associated with anabolic steroid use.

Synchronous quadriceps tendon rupture is rare. A 29-year-old man, an amateur weight lifter, taking androgenic-anabolic steroids (AAS), developed sudden onset bilateral pain and swelling of his anterior thighs when attempting to squat 280 kg (620 lb). Examination revealed gross swelling superior to the patella and palpable gaps in both quadriceps tendons.

A comparison of acetabular impaction grafting and trabecular metal for revision arthroplasty.

Background: Acetabular defect reconstruction in revision hip arthroplasty may be achieved with acetabular impaction bone grafting (AIBG) or porous trabecular metal (TM) implantation. We sought to compare clinical and radiological outcomes of both methods at a single institution.

Methods: 36 patients that were revised using AIBG and 17 patients that were revised with TM were retrospectively reviewed from local joint registry data.

Atraumatic Fracture of a BIOLOX Delta Ceramic Femoral Head Articulating with a Polyethylene Liner: A Case Report.

Case: We describe the case of a forty-one-year-old man who underwent total hip arthroplasty with a 32-mm BIOLOX delta ceramic head articulating with a polyethylene liner. The patient did not suffer any trauma postoperatively, and his only symptom was of a "clicking" noise from the operatively treated hip. At his six-week postoperative review, fracture of the femoral head was diagnosed.

The significance of hand dominance in hip osteoarthritis.

Objectives: Hip arthroplasty registries, encompassing all-cause end-stage hip degeneration, have shown that slightly more right hip replacements are performed than left. Given that greater than 85% of individuals are right-handed, we sought to investigate the association between side of hand dominance and side of hip osteoarthritis.

Methods: This Level III observational study evaluated exclusively end-stage osteoarthritis of the hip, using 3 independent centres totalling 386 consecutive arthroplasty patients.

A commentary on the disparate perspectives of clinical microbiologists and surgeons: ad hoc antimicrobial use.

Prosthetic joints and other orthopedic implants have improved quality of life for patients world-wide and the use of such devices is increasing. However, while infection rates subsequent to associated surgery are relatively low (<3%), the consequences of incidence are considerable, encompassing morbidity (including amputation) and mortality in addition to significant social and economic costs. Emphasis, therefore, has been placed on mitigating microbial risk, with clinical microbiologists and surgeons utilizing rapidly evolving molecular laboratory techniques in detection and diagnosis of infection, which still occurs despite sophisticated patient management.

A commentary on the disparate perspectives of clinical microbiologists and surgeons: Ad hoc antimicrobial use.

Prosthetic joints and other orthopedic implants have improved quality of life for patients world-wide and the use of such devices is increasing. However, while infection rates subsequent to associated surgery are relatively low (<3%), the consequences of incidence are considerable, encompassing morbidity (including amputation) and mortality in addition to significant social and economic costs. Emphasis, therefore, has been placed on mitigating microbial risk, with clinical microbiologists and surgeons utilizing rapidly evolving molecular laboratory techniques in detection and diagnosis of infection, which still occurs despite sophisticated patient management.

Surgeon delivered psoas compartment block in total hip arthroplasty.

Total hip arthroplasty is associated with significant postoperative pain. A psoas compartment block is superior to other regional techniques in analgesia post THA. However, traditional methods of delivery are associated with serious complications.

Haemodynamic performance of neuromuscular electrical stimulation (NMES) during recovery from total hip arthroplasty.

Background: Patients post total hip arthroplasty (THA) remain at high risk of developing Deep Vein Thrombosis (DVT) during the recovery period following surgery despite the availability of effective pharmacological and mechanical prophylactic methods. The use of calf muscle neuromuscular electrical stimulation (NMES) during the hospitalised recovery period on this patient group may be effective at preventing DVT. However, the haemodynamic effectiveness and comfort characteristics of NMES in post-THA patients immediately following surgery have yet to be established.

Optimizing the fat and water content of impaction bone allograft.

Fresh morselized impacted bone graft usually fails due to shear forces. The presence of fat, water, and marrow particles act as interparticle lubricants, reducing the interlocking of particles and allowing the graft to move more freely. Furthermore, the presence of this incompressible fluid damps and resists compressive forces during impaction, preventing the graft particles from moving into a closer formation.

Infection of a total hip arthroplasty with actinomyces israelii: Report of a case.

Context: Infection of following total hip arthroplasties can be classified based on the timing of infection. Late infections with Actinomyces israelii are extremely rare with only 3 previously reported cases in literature. We present another case of a late infection with Actinomyces israelii in a total hip arthroplasty 9 years following implantation.

Hemodynamic performance of NMES in the early post operative period following orthopaedic surgery.

Patients post total hip arthroplasty (THA) remain at high risk of developing Deep Vein Thrombosis (DVT) during the recovery period following surgery. The use of calf muscle neuromuscular electrical stimulation (NMES) during the hospitalized recovery period on this patient group may be effective at preventing DVT. However, the haemodynamic effectiveness and comfort characteristics of NMES in post-THA patients immediately following surgery has yet to be demonstrated.

Another string.... but no bow.

Based on a positive personal experience, the authors advocate the use of a wound protector/retractor such as the Alexis system in total hip arthroplasty, to avoid intra-operative bacterial contamination from the skin, while avoiding damage to the skin and other soft tissues.

A cadaveric study of injectate spread in the psoas compartment with a direct iliopsoas injection suggested for use during surgery.

Total hip replacement produces significant postoperative pain. Psoas compartment block is the most effective block of the lumbar plexus in terms of pain relief and reduced blood loss. It is a proven regional technique for analgesia and anaesthesia during and after total hip replacement conferring a number of benefits to the patient.

Two-stage revision of infected hip arthroplasty using a shortened post-operative course of antibiotics.

Introduction: We present a series of 30 consecutive patients with 31 infected total hip arthroplasties treated by a single surgeon over a 4-year period in whom a shortened post-operative course of antimicrobial chemotherapy was used.

Methods: The treatment protocol consisted of a two-stage exchange with removal of infected components, insertion of an interim antibiotic eluting cement spacer and re-implantation of an extensively coated uncemented prosthesis on the femoral side. Systemic antibiotic treatment following each stage consisted of an abridged course of 5 days post-operative intra-venous administration followed by complete cessation of anti-microbial therapy.

The 22-mm vs the 32-mm femoral head in cemented primary hip arthroplasty long-term clinical and radiological follow-up study.

A retrospective clinical and radiological analysis was performed on 117 patients (138 hips) with a mean age of 75 years and a mean follow-up of 11 years. The prostheses used were 2 similar monoblock femoral components with 22- and 32-mm head sizes; their effects on the wear of the high-density polyethylene cup were studied. Wear of component was determined by evaluating the standardized initial and follow-up radiographs.

Suture-button syndesmosis fixation: accelerated rehabilitation and improved outcomes.

Syndesmosis screws have significant problems including loosening, breakage, the need for removal, and late diastasis. A new technique of syndesmosis fixation is proposed in this study, in which a heavy suture is placed across the syndesmosis, which has been looped and tightened through cortical button anchors on either side of the ankle. Indirect placement of the medial button avoids a medial incision.

Routine recovery room radiographs after total hip arthroplasty: ineffective for screening and unsuitable as baseline for longitudinal follow-up evaluation.

To assess the usefulness of traditional recovery room check radiographs after total hip arthroplasty, we retrospectively analysed 2,065 consecutive hip arthroplasty patients. We found a 0.1% rate of radiologic diagnosis of dislocation in the population screened.

Femoral neck ostectomy: an alternative to hip replacement in acetabular metastatic disease.

A 68 year old man underwent a femoral neck ostectomy as a palliative procedure for pain in the right hip secondary to an extensive acetabular metastasis from renal cell carcinoma. Excellent pain relief was achieved and he remained mobile until shortly before his death 8 months later.

The first intermetatarsal angle in hallux valgus: an analysis of measurement reliability and the error involved.

In view of the importance placed on the first intermetatarsal angle in the assessment of surgical intervention in hallux valgus, we assessed the reliability with which one measures this angle. The study involved 10 observers of varying experience measuring the angle using a standard technique on 10 weightbearing AP X-rays of the foot on three separate occasions. The margin of error in measuring the angle was +/-3.