Do Clinical Parameters Reflect Local Bone Metabolism in Heterotopic Ossification After Septic or Aseptic THA?

Background: Heterotopic ossification (HO) is a common complication after THA. Although current research primarily focuses on treatment and prevention, little is known about the local bone metabolism of HO and clinical contributing factors.

Questions/purposes: We aimed to assess bone remodeling processes in HO using histomorphometry, focusing on the effects of inflammation and prior NSAID treatment.

Long-term outcomes of total hip arthroplasty in patients with developmental dysplasia of the hip: a minimum 21-year follow-up.

Purpose: Early osteoarthritis (OA) due to developmental dysplasia of the hip (DDH) is a known indication for total hip arthroplasty (THA). Though screening tools and joint-preserving procedures have been established successfully, there still is a relevant number of patients suffering DDH. Due to the lack of long-term outcome studies, we like to close this gap and present the results of a highly specialized center.

What is the rate of successful closed reduction of dislocated dual mobility cups following complex revision hip arthroplasty?

Purpose: The aim of this study was to assess the difference in success rates of closed reduction in septic and aseptic revision total hip arthroplasty (THA) performed with a dual mobility (DM) implant. Our objective was to answer the following questions: (1) Is there a difference in success rates of closed reduction between septic and aseptic revision THA with a DM implant? (2) Is closed or open reduction more successful in preventing re-dislocation?

Methods: Between January 2009 and October 2021, 924 revisions were performed with a DM implant. All patients presenting to our institution with a dislocation following septic or aseptic revision THA using a cemented DM cup were included in this study.

Total knee arthroplasty and patelloplasty in a patient with phocomelia caused by thalidomide.

The treatment of osteoarthritis in patients with phocomelia with total knee arthroplasty is challenging due to the unusual anatomy and severe deformities. The authors present a case of phocomelia caused by thalidomide with end-stage osteoarthritis and grossly medialized patella. The patient was treated with a cemented constrained non-hinged prosthesis and patelloplasty.

The influence of 3D printing on inter- and intrarater reliability on the classification of tibial plateau fractures.

Purpose: Tibial plateau fractures continue to be a challenging task in clinical practice and current outcomes seem to provide the potential for further improvement. Especially presurgical understanding of the orientation of fracture lines and fracture severity is an essential key to sufficient surgical treatment. The object of this study was to evaluate the reliability of modern axial CT-based classification systems for tibial plateau fractures.

What is the failure rate of constrained liners in complex revision total hip arthroplasty?

Background: Recurrent hip dislocation after multiple revision total hip arthroplasty is a severe complication. Therefore, constrained acetabular liners (CL) have been used during salvage procedures. We report our experience of constrained liners in a re-revision setting with focus on re-dislocation.

Dislocation of a McMinn-Like Prosthesis with Distinctive Metallosis and Fracture of the Os Ilium.

Osteoarthritis of the hip joint (coxarthrosis) is the most common hip disease in adults. Since the 1960s, total hip arthroplasty (THA) has made great progress and is nowadays one of the most frequently used procedures in orthopedic surgery. Different bearing concepts exist in various implant designs.

The Clinical Outcome of Different Total Knee Arthroplasty Designs in One-Stage Revision for Periprosthetic Infection.

Background: Despite the growing number of studies reporting on the best surgical treatment in the management of periprosthetic joint infection, there are no robust data regarding the type of infected prosthesis before any kind of exchange arthroplasty. To overcome these shortcomings, we asked the following questions: (1) What is the survivorship of nonhinged and hinged knee implants after one-stage exchange arthroplasty and (2) what is the functional outcome after one-stage exchange procedure focusing on knee prostheses and the type of prior infected knee implant. In a secondary radiographic analysis, we also investigated if (3) the type of femoral bone morphology measured by the inner femoral diameter influences the rate of aseptic failures also in patients with periprosthetic joint infection.

Focal cartilage defects of the lateral compartment do influence the outcome after high tibial valgus osteotomy.

Introduction: High tibial medial open-wedge valgus osteotomy (HTO) is a well-established procedure for unicompartimental medial osteoarthritis of the young and active patient. However, the influence of cartilage defects of the lateral compartment on the total outcome remains obscure.

Methods: From 2005 to 2012, a total of 63 patients underwent HTO for medial osteoarthritis of the knee at a single university orthopaedic center.

What Is the Mid-term Survivorship of Infected Rotating-hinge Implants Treated with One-stage-exchange?

Background: Despite the growing number of studies reporting on periprosthetic joint infection (PJI), there is little information on one-stage exchange arthroplasty for the revision of infected rotating-hinge prostheses, which can be among the most difficult PJI presentations to treat.

Questions/purposes: After one-stage direct exchange revision for an infected rotating-hinge TKA prosthesis, and using a multimodal approach for infection control, we asked: (1) What is the survivorship free from repeat revision for infection and survivorship free from reoperation for any cause? (2) What is the clinical outcome, based on the Oxford Knee Score, of these patients at the latest follow-up?

Methods: Between January 2011 and December 2017, we treated 101 patients with infected rotating-hinge knee prostheses at our hospital. All patients who underwent a one-stage exchange using another rotating-hinge implant were potentially eligible for this retrospective study.

High re-revision rate following one-stage exchange for streptococcal periprosthetic joint infection of the hip.

Introduction: This study was undertaken to analyse the outcome of 1-stage exchange in the management of streptococcal periprosthetic joint infection (PJI) of the hip at a single hospital.

Methods: We identified 30 patients with a streptococcal PJI of the hip who had been treated by 1-stage exchange at our hospital between 2002 and 2017. Postoperative complications and the need for any subsequent re-revision for infection or other reasons were analysed.

Objective assessment of patellar maltracking with 3 T dynamic magnetic resonance imaging: feasibility of a robust and reliable measuring technique.

Patellofemoral maltracking predisposes the patellofemoral joint to instability. The purpose of this study was to provide a reliable dynamic magnetic resonance imaging (MRI) measuring technique for patellofemoral maltracking, and to investigate the influence of anatomical risk factors (AF) on patellar maltracking. Ten patients (2 males,8 females, average 19 years) with clinical maltracking and 20 controls (10 males,10 females,average 28 years) were examined with a dynamic, multi-slice gradient-echo MRI sequence, during repetitive flexion(40°) and full extension, in an open-chain-active-movement.

Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury.

Study Design: Retrospective observational study.

Objectives: To analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI).

Methods: Between January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital.

Improved treatment strategies can result in better outcomes following one-stage exchange surgery for MRSA periprosthetic joint infection.

Periprosthetic joint infections caused by methicillin-resistant (MRSA-PJIs) are rare, with only a few studies reporting the treatment outcomes and even fewer reporting outcomes with one-stage exchange. This study aims to analyse the outcomes of one-stage exchange in the management of MRSA-PJIs. Patients with MRSA-PJI of the hip and knee, who were treated with a one-stage exchange between 2001 and 2018 were enrolled in this study.

Preliminary clinical results of coated porous tibia cones in septic and aseptic revision knee arthroplasty.

Purpose: To analyze the first results of calcium-phosphate-coated porous tibia cones.

Methods: Patients treated with TrabecuLink-CaP Cones were retrospectively recruited from January 2016 to December 2017. These custom-made cones were produced using titanium alloy Ti-6Al-4 V (Tilastan) and using additive manufacturing with a special calcium-phosphate coating (HX-coating).

Are Patients With a History of Septic Arthritis Undergoing Total Knee Arthroplasty at Higher Risk for Revision Surgery? A Single-Center Study.

Background: The decision to perform a total knee arthroplasty (TKA) on a previously infected knee is made complicated by the higher risk for both a periprosthetic joint infection (PJI) and early failure. There is currently no standard in the treatment strategy for this group of patients. We here report the outcomes of performing a primary TKA on patients with a prior septic knee arthritis.

Results at 10-24 years after single-stage revision arthroplasty of infected total hip arthroplasty in patients under 45 years of age.

Introduction: The management of periprosthetic joint infection (PJI) of the hip is a challenging procedure. One-stage exchange is carried out in specialist centres with comparable infection free survival rates. However, there is a paucity of long-term results of this approach in young patients.

Lipoma arborescens - Uncommon Diagnosis for Joint Swelling: Case Report and Review of the Literature.

Introduction: Soft tissue swelling of the knee joint can be caused by many diseases. Lipomas are one of the most reasonable differential diagnoses we have to consider. Therefore, we now present the uncommon case of a Lipoma arborescens (LA) and differentiate it from a quite similar manifesting spindle cell lipoma as follows.

The Impact of α-Defensin Test in Diagnosing Periprosthetic Infection After Total Ankle Arthroplasty.

Periprosthetic joint infection (PJI) after total ankle arthroplasty (TAA) is a serious complication, and a reliable diagnostic test to identify PJI is needed. The purpose of this study was to investigate the use of synovial α-defensin levels in identifying PJI of the ankle. Data from 33 patients were retrospectively collected between September 2015 and May 2018.

Clinical Survivorship of Aseptic Revision Total Knee Arthroplasty Using Hinged Knees and Tantalum Cones at Minimum 10-Year Follow-Up.

Background: The reconstruction of severe bone loss utilizing porous tantalum cones in patients undergoing revision total knee arthroplasty (TKA) has been established in the last years. However, reports on a long-term follow-up to assess the durability of such implants when combined with hinged knee designs are lacking. The current study aimed to evaluate the results of a previous study cohort at a minimum follow-up of 10 years.

Outcome of subtrochanteric femur resection in patients with spinal cord injuries.

Objective: To analyse the clinical outcome of subtrochanteric femur resection in patients with infected hip joints caused by pressure ulcers (PUs) in patients following spinal cord injury (SCI).

Method: A retrospective cohort study, carried out between January 2004 and December 2015. Only patients receiving a subtrochanteric femur resection were included.

Muscle localization of heterotopic ossification following spinal cord injury.

Background Context: Heterotopic ossification (HO) is a known complication especially in people with traumatic spinal cord injury (SCI). Although some risk factors have already been described, the pathophysiology of HO is still unknown. The pelvis is the most common region for HO occurrence.