Antibiotic Therapy for 6 or 12 Weeks for Prosthetic Joint Infection.

Background: The management of prosthetic joint infection usually consists of a combination of surgery and antimicrobial therapy. The appropriate duration of antimicrobial therapy for this indication remains unclear.

Methods: We performed an open-label, randomized, controlled, noninferiority trial to compare 6 weeks with 12 weeks of antibiotic therapy in patients with microbiologically confirmed prosthetic joint infection that had been managed with an appropriate surgical procedure.

Periprosthetic joint infection in aseptic total hip arthroplasty revision.

Purpose: There is no consensus regarding systematic screening for infection in aseptic revision total hip arthroplasty (THA). The rationale for systematic intra-operative samples is to increase the sensitivity of latent infections detection, which may require specific treatment. However, the incidence of occult infection in revision THAs is not precisely known.

Periprosthetic shoulder infection: an overview.

Periprosthetic shoulder infection (PSI) is rare but potentially devastating. The rate of PSI is increased in cases of revision procedures, reverse shoulder implants and co-morbidities. One specific type of PSI is the occurrence of low-grade infections caused by non-suppurative bacteria such as or .

Laterality and grip strength influence hand bone micro-architecture in modern humans, an HRpQCT study.

It is widely hypothesized that mechanical loading, specifically repetitive low-intensity tasks, influences the inner structure of cancellous bone. As such, there is likely a relationship between handedness and bone morphology. The aim of this study is to determine patterns in trabecular bone between dominant and non-dominant hands in modern humans.

BMI-related microstructural changes in the tibial subchondral trabecular bone of patients with knee osteoarthritis.

Overweight is a risk factor for osteoarthritis on the knees. Subchondral trabecular bone (SCTB) densification has been shown to be associated with cartilage degeneration. This study analyzed the microarchitectural changes in the SCTB of tibial plateaus to validate the hypothesis that the degree of remodeling is correlated with a patient's body weight.

Can the gracilis replace the anterior cruciate ligament in the knee? A biomechanical study.

Purpose: The purpose of this study was to determine whether a four-strand gracilis-only construct possesses the biomechanical properties needed to act as an anterior cruciate ligament (ACL) reconstruction graft.

Methods: This was a pilot study with 32 cadaver specimens. The biomechanical properties of three types of grafts were determined using validated tensile testing methods: patellar tendon (BTB), both hamstring tendons together (GST4) and gracilis alone (G4).

Biomechanical study of ACL reconstruction grafts.

There are no published studies describing the strength quadrupled gracilis tendon alone and quadrupled semitendinosus tendon alone in the configuration used for anterior cruciate ligament (ACL) reconstruction. The primary objective was to compare the mechanical properties of grafts used for ACL reconstruction during a tensile failure test. The secondary objective was to evaluate the effect of uniform suturing on graft strength.

Evaluation of the accuracy of patient-specific cutting blocks for total knee arthroplasty: a meta-analysis.

Purpose: Because published studies on the accuracy achieved with patient-specific guides during total knee arthroplasty (TKA) contradict each other, this systematic review and meta-analysis sought to compare radiological TKA outcomes when patient-specific cutting blocks (PSCB) were used to the outcomes when standard manual instrumentation was used.

Methods: The meta-analysis was implemented according to PRISMA Statement Criteria. The primary endpoint was the hip-knee-ankle (HKA) angle, which represents the leg's mechanical axis.

Reverse shoulder arthroplasty for malignant tumors of proximal humerus.

Background: Reverse shoulder arthroplasty (RSA) provides an alternative for shoulder girdle reconstruction after wide transarticular resection of the proximal humerus for malignant tumor. The aim of this study was to evaluate midterm outcomes of this therapeutic option.

Methods: Ten patients with RSA were included and reviewed with 24 months of minimum follow-up.

Osteoblast-derived sphingosine 1-phosphate to induce proliferation and confer resistance to therapeutics to bone metastasis-derived prostate cancer cells.

Sphingosine 1-phosphate (S1P) plays important roles in cell proliferation, differentiation or survival mainly through its surface G-protein-coupled receptors S1P1-5. Bone represents the major site of metastasis for prostate cancer (CaP) cells, which rely on bone-derived factors to support their proliferation and resistance to therapeutics. In the present work we have found that conditioned medium (CM) from the MC3T3 osteoblastic cell line or primary murine and human osteoblast-like cells, as well as co-culture with MC3T3 stimulate proliferation of CaP lines in S1P-dependent manner.

Traumax screw plate vs. Gamma nail. Blood loss in pertrochanteric fractures treated by minimally invasive osteosynthesis.

Purpose: This study is aimed to determine whether the Traumax dynamic hip screw reduces perioperative blood loss and transfusion rate compared to the Gamma nail in the treatment of pertrochanteric fractures.

Materials And Methods: A series of 331 patients were followed prospectively in a cohort study between February 2008 and October 2011 after a pertrochanteric fracture. Two types of fixation were used, 163 patients were treated with a Gamma nail and 168 patients with a minimally invasive screw plate Traumax.

Prospective study comparing functional outcomes and revision rates between hip resurfacing and total hip arthroplasty: preliminary results for 2 years.

There is a need of independent prospective studies about modern generation of hip resurfacing implants. The aim of this propective observational study was to compare the functional outcomes and revision rates with hip resurfacing arthroplasty and total hip arthroplasty and to present the preliminary results at 2 years. Patients included were recruited prospectively in the Partial Pelvic Replacement Hip Project by a single surgeon between January 2007 and January 2010.

Massive Proximal Extravasation as a Complication during Arthroscopic Anterior Cruciate Ligament Reconstruction.

Extra-articular extravasation of irrigation fluid is relatively common around entry incisions and is usually limited to the subcutaneous tissue. Very rarely, extravasation occurs above the knee, in the thigh and even up into the pelvis. We are reporting the second case of irrigation fluid extravasation during a knee arthroscopy, which spread up to the thigh, groin and perineum during anterior cruciate ligament reconstruction, whilst the tourniquet was inflated.

Radiological validation of a fluoroscopic guided technique for femoral implant positioning during hip resurfacing.

Purpose: The positioning of the femoral cup in hip resurfacing is essential for the survival of the implant. We described a technique in 2005 to position the femoral cup guided by fluoroscopy independent of the approach performed. The main objectives were to study the positioning of the femoral components of the implant and the accuracy of the technique.

Hip resurfacing: a systematic review of literature.

Purpose: We conducted a systematic review of the literature in order to take stock of hip resurfacing according to the principle of "evidence based medicine". Our main objective was to compare the rate of revision of resurfacing implants with survival limits set by the National Institute of Clinical Excellence (NICE).

Methods: A systematic review was undertaken of all published (Medline, Cochrane, EMBASE) literature research databases up to July 2012 as recommended by the PRISMA statement.

Anatomy of the bands of the hamstring tendon: how can we improve harvest quality?

Background: The hamstring tendons, gracilis and semitendinosus are widely used in ligament and reconstructive surgery. Their accessory bands or insertions are technical pitfalls during harvesting.

Methods: Thirty fresh cadaver knees have been studied, in order to 1) determine the anatomy of the bands of the gracilis and semitendinosus tendons, and, 2) to identify risk factors for failure during harvesting.

Experimental study of an original radiographic view for diagnosis of cam-type anterior femoroacetabular impingement.

Purpose: Primary paraclinical investigation to look for femoral morphological abnormality consistent with cam-type anterior femoroacetabular impingement (FAI) must include specific radiographic projections of the hip from the following: cross-table, frog-leg or Dunn (90° and 45° flexion). We use a frog-leg type view with fixed angles as described by Chiron, obtained with the patient in a supine position, with the hip in 45° flexion-abduction and 30° external rotation. The X-ray beam is anteroposterior and centred on the femoral head.

Monteggia equivalent fracture associated with Salter I fracture of the radial head.

Monteggia fracture is an infrequent lesion, which associates ulna fracture and radial head dislocation. Equivalent Monteggia can occur by associated lesions such as olecranon fracture or radial neck or head fracture. We report an unusual case of Monteggia equivalent lesion associating a fracture of the proximal third of the ulnar shaft and a growth plate fracture Salter I of proximal-radial physis and divergent displacement due to a bottle-opener effect of the radial head over the capitellum during trauma.

Reconstruction and anticipatory Langenskiöld procedure in traumatic defect of tibial medial malleolus with type 6 physeal fracture.

Traumatic osteoarticular or ligament defect of the tibial medial malleolus is a rare entity in children. Associated lesions may include soft tissue and joint defect, subsequent instability of the ankle, and growth arrest. We report here, the case of an 11-year-old boy, a victim of a severe trauma to the ankle, managed by an original technique.

Hypesthesia after anterolateral versus midline skin incision in TKA: a randomized study.

Background: The anterior midline skin incision in a TKA provides excellent surgical exposure. However, it usually requires sectioning the infrapatellar branch of the saphenous nerve which may be associated with lateral cutaneous hypesthesia and neuroma formation.

Questions/purposes: We asked whether an anterolateral skin incision to the knee would decrease the area of skin hypesthesia and associated postoperative discomfort.