Total knee arthroplasty with distal femoral replacement is associated with an important complication rate. A case series.

Background: With the aging population and an increasing number of total knee arthroplasties (TKAs) performed yearly worldwide, revision surgeries for many causes (septic or aseptic loosening, periprosthetic femoral fractures (PDFF), non-unions, malunions) are more frequent and challenging. Distal femoral replacement (DFR) is sometimes the only option to restore knee function and quality of life. DFR in non-oncologic patient is still a rare indication and few reports are published on this topic, with a non-consistent variety of functional results, complication rates and survivorship.

Up to seven years' follow-up of short cemented stems in complex primary total knee arthroplasty: A prospective study.

Background: Although primary total knee arthroplasty (TKA) shows good clinical, functional and radiological results, it can be complicated by certain conditions or pathologies. The main objective of this study was to evaluate the global performance of short cemented metaphyseal stem components in patients undergoing complex primary TKA.

Methods: This is a single-surgeon prospective case series of 91 patients who underwent complex primary TKA requiring short stem fixation between January 2009 and October 2014.

Instability of the proximal tibiofibular joint associated with total knee arthroplasty.

To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA). We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis.

Traffic in the operating room during joint replacement is a multidisciplinary problem.

Background: Door openings disrupt the laminar air flow and increase the bacterial count in the operating room (OR). We aimed to define the incidence of door openings in the OR during primary total joint arthroplasty (TJA) surgeries and determine whether measures were needed and/or possible to reduce OR staff traffic.

Methods: We recorded the number of door openings during 100 primary elective TJA surgeries; the OR personnel were unaware of the observer's intention.

The Effect of Porous Tantalum Cones on Mechanical Alignment and Canal-Fill Ratio in Revision Total Knee Arthroplasty Performed with Uncemented Stems.

In revision total knee arthroplasty (TKA), the internal diameter of metal cones may limit the ability of the stem to properly fill the medullary canal. We prospectively studied 115 patients who underwent revision TKA with uncemented stems to evaluate the effect of metal cones on mechanical alignment and stem positioning. Correction on the mechanical alignment was well achieved in all patients, regardless of whether a metal cone was used.

Internal rotation of the tibial component is frequent in stiff total knee arthroplasty.

Background: Stiffness complicating TKA is a complex and multifactorial problem. We suspected internally rotated components compromised motion because of pain, patellar maltracking, a tight medial flexion gap, and limited femoral rollback on a conforming lateral tibial condyle.

Questions/purposes: We sought to determine: (1) the incidence of internal rotation of the femoral and tibial components in stiff TKAs; (2) if revision surgery that included correction of rotational positioning improved pain, ROM, and patellar tracking; and (3) if revision altered nonrotational radiographic parameters.

Metabolic priorities during starvation: enzyme sparing in liver and white muscle of Atlantic cod, Gadus morhua L.

Atlantic cod, Gadus morhua, respond to starvation first by mobilising hepatic lipids, then muscle and hepatic glycogen and finally muscle proteins. The dual role of proteins as functional elements and energetic reserves should lead to a temporal hierarchy of mobilisation where the nature of a function dictates its conservation during starvation. We examined (1) whether lysosomal and anti-oxidant enzymes in liver and white muscle are spared during prolonged starvation, (2) whether the responses of these enzymes in muscle vary longitudinally.