Early Diagnosis of Periprosthetic Joint Infection of the Hip-Current Status, Advances, and Perspectives.

Periprosthetic joint infection (PJI) has devastating consequences on joint function and the morbidity and mortality rate of patients who are victims of this serious complication. Although early diagnosis is one of the consensuses with well-established importance, routine workup is still conducted on an empirical, inconsistent, and nonobjective basis in many centers around the world. The present article seeks to contextualize the current state of knowledge about the early diagnosis of PJIs, as well as to discuss the advances and perspectives, within a scenario of its routine use by the healthcare team responsible for managing this dreaded complication.

Advantages and limitations of national arthroplasty registries. The need for multicenter registries: the Rempro-SBQ.

While the value of national arthroplasty registries (NAR) for quality improvement in total hip arthroplasty (THA) has already been widely reported, some methodological limitations associated with observational epidemiological studies that may interfere with the assessment of safety and efficacy of prosthetic implants have recently been described in the literature. Among the main limitations of NAR, the need for at least 80% compliance of all health institutions covered by the registry is emphasized; completeness equal or greater than 90% of all THA performed; restricted data collection; use of revision surgery as the sole criterion for outcome; and the inability of establishing a definite causal link with prosthetic dysfunction. The present article evaluates the advantages and limitations of NAR, in the light of current knowledge, which point to the need for a broader data collection and the use of more structured criteria for defining outcomes.

Migration and strains induced by different designs of force-closed stems for THA.

Objectives: Subtle differences in stem design can result in different mechanical responses of the total hip arthroplasty. Tests measuring migration of the stem relative to the femur, as well as the strains in the cement mantle and on the femur can detect different mechanical behavior between stems.

Methods: In this article, conical, double and triple tapered stems were implanted in composite femurs and subjected to static and cyclic loads.

Effect of removal and reinsertion of force-closed stems on deformation of total hip arthroplasty.

Objectives: This study investigated removal of a force-closed stem, done in order to improve acetabular exposure during revision, with reinsertion afterwards. It is unknown how much this procedure modifies the stem/cement interface.

Methods: Three tapered stem models were implanted into composite femurs.