Careful patient selection together with optimal implant positioning may reduce but does not eliminate the risk of elevated serum cobalt and chrome levels following metal-on-metal hip resurfacing.

Background: Elevated serum chrome (sCr) and cobalt (sCo) concentrations are associated with local tissue adverse reactions to metal debris following metal-on-metal hip resurfacing (MoM-HR). Serum metal ions <2 µg/l are probably of little clinical relevance and a pragmatic "safe" threshold <5 µg/l has been suggested.The primary aim of this study was to evaluate if a careful selection of patients combined with optimal implant positioning could eliminate cases with "unsafe" serum metal ion levels.

EPOS trial: the effect of air filtration through a plasma chamber on the incidence of surgical site infection in orthopaedic surgery: a study protocol of a randomised, double-blind, placebo-controlled trial.

Introduction: There is controversy regarding the importance of air-transmitted infections for surgical site infections (SSIs) after orthopaedic surgery. Research has been hindered by both the inability in blinding the exposure, and by the need for recruiting large enough cohorts. The aim of this study is to investigate whether using a new form of air purifier using plasma air purification (PAP) in operating rooms (ORs) lowers the SSI rate or not.

99mTc-HMPAO-WBC SPECT/CT versus 18F-FDG-WBC PET/CT in chronic prosthetic joint infection: a pilot study.

Purpose: The aim of this study was to compare 99mTc-HMPAO-WBC-SPECT/CT combined with 99mTc-nanocollloid SPECT/CT and 18F-FDG-WBC-PET/CT combined with 99mTc-Nanocollloid SPECT/CT for the diagnosis and treatment evaluation of chronic prosthetic joint infection (PJI).

Methods: Patients with suspected chronic PJI were examined with 99mTc-HMPAO-WBC SPECT/CT, 18F-FDG-WBC PET/CT, and 99mTc-nanocolloid SPECT/CT (to visualize bone marrow). The location and patterns of uptake were noted and compared between the two leukocyte examinations.

Dual-tracer approach vs. dual time-point approach in leukocyte scintigraphy in treatment evaluation of persistent chronic prosthetic joint infection.

Background: Both dual time-point 99mTc-hexamethylpropylene amine oxime (HMPAO)-leukocyte scintigraphy and dual-tracer 99mTc-HMPAO-leukocyte scintigraphy (with the addition of 99mTc-nanocolloid bone marrow scintigraphy) have been used to diagnose prosthetic joint infection (PJI). A treatment evaluation of persistent PJI using these imaging protocols has yet to be presented.

Objective: The purpose of this study was to compare the accuracy of dual time-point 99mTc-HMPAO-leukocyte scintigraphy to the dual-tracer alternative of single time-point 99mTc-HMPAO-leukocyte scintigraphy or single-photon emission computed tomography/computed tomography (SPECT/CT) combined with a 99mTc-nanocolloid bone marrow scintigraphy or SPECT/CT, for treatment evaluation of PJI.

Is 99mTc-HMPAO-leukocyte imaging an accurate method in evaluating therapy result in prosthetic joint infection and diagnosing suspected chronic prosthetic joint infection?

Background: To investigate the sensitivity and specificity of 99mTc-HMPAO-leukocyte imaging in evaluating therapy result in patients with prosthetic joint infection (PJI) and in diagnosing suspected chronic PJI.

Methods: Sixty-two patients (63 joints) with microbiologically verified PJI were examined by leukocyte imaging to evaluate therapy result during or at the end of antibiotic treatment or if the patient had a chronic PJI after treatment. Group 1 consisted of 49 patients with on-going or within less than 14 days of ending antibiotic treatment examined to evaluate response.

Patient-reported outcomes in hip resurfacing versus conventional total hip arthroplasty: a register-based matched cohort study of 726 patients.

Background and purpose - The theoretical mechanical advantages of metal-on-metal hip resurfacing (MoM-HR) compared with conventional total hip arthroplasty (THA) have been questioned. Studies including measures of patient-reported function, physical activity, or health-related quality of life have been sparse. We compared patient-reported outcomes in MoM-HR patients with a matched group of patients with conventional THA at 7 years post-surgery.

Early gain in pain reduction and hip function, but more complications following the direct anterior minimally invasive approach for total hip arthroplasty: a randomized trial of 100 patients with 5 years of follow up.

Background and purpose - The minimally invasive direct anterior (DA) approach for total hip arthroplasty (THA) is supposed to reduce surgical tissue trauma. We hypothesized that patients operated with the DA technique would have less postoperative pain and better hip function compared with a group operated with a conventional direct lateral (DL) approach. Patients and methods - 100 patients with hip osteoarthritis scheduled for THA were equally randomized to surgery through either DA or DL.

The direct anterior approach: initial experience of a minimally invasive technique for total hip arthroplasty.

Background: Less invasive approaches for hip arthroplasty have been developed in order to decrease traumatisation of soft tissue and shorten hospital stay. However, the benefits with a new technique can be at the expense of a new panorama of problems. This manuscript describes, with emphasis on postoperative complications, our experience from the first 200 cases of unilateral hip replacement using the direct anterior minimally invasive (MIS) approach.