Protection of the Femoral Trunnion During Acetabular Revision Hip Surgery-A Novel Technique.

Revision of a failed acetabular component in the presence of an intact femoral prosthesis comprises approximately 20% of revision total hip replacements performed by the senior author. During this procedure, the femoral trunnion is at risk of damage because of scratching from retractors, reamers, or other instruments. Scratching can result in mechanically assisted crevice corrosion or adverse local-tissue reaction or trunnionosis leading to implant failure.

The Influence of Patellofemoral Degenerative Changes on the Outcome of the Unicompartmental Knee Replacement: A Prospective Study.

Unicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. Patellofemoral (PF) joint degeneration is widely considered to be a contraindication to medial compartment UKA. We examined the validity of this preconception using information gathered prospectively on 147 consecutive patients who underwent the Repicci II UKA for medial compartment osteoarthritis between July 1999 and September 2000 by the same surgeon.

Evaluation of lower limb axial alignment using digital radiography stitched films in pre-operative planning for total knee replacement.

Background: For patients with knee osteoarthritis, even slight anatomical variations in the femur or the tibia could affect total limb alignment during total knee replacement (TKR). Our hypothesis implies that the femoral valgus correction angle (VCA) in patients indicated for TKR, is variable and higher than the reported norm of 6° utilized in most intramedullary instrumentation systems, and that tibial bowing may result to a disparity of the tibial mechanical axis to the anatomical axis.

Methods: Our study is a retrospective review of 216 pre-operative arthritic knees, which investigated the lower limb axial alignment using digitally-stitched films.

Revision of minimal resection resurfacing unicondylar knee arthroplasty to total knee arthroplasty: results compared with primary total knee arthroplasty.

We compared a cohort of patients undergoing revision of a minimal resection resurfacing unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) with a cohort of patients undergoing primary TKA. Both cohorts were matched in terms of age, sex, and body mass index. We collected data on preoperative and postoperative range of motion, International Knee Society scores, and radiologic data.

The Repicci II® unicondylar knee arthroplasty: 9-year survivorship and function.

Background: Unicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. UKA using minimally invasive surgery (MIS) has the theoretical advantage of less bone resection and quicker rehabilitation. Whether the function of patients with UKA compares with that of patients with conventional TKA is unclear.

Periprosthetic stress fractures at the sleeve/stem junction of the Sivash-Range of Motion modular femoral stem.

We report on 13 cases of periprosthetic stress fracture at the sleeve/stem junction using the Sivash-Range of Motion femoral prosthesis. Radioisotope bone scans confirmed the incidence of fracture, and review of the lateral radiographs revealed anteromedial notching of the distal sleeve on the metaphyseal throat of the femur. Treatment in all cases was expectant with full resolution of symptoms.

Post Surgical Pain- The Transition from Acute to Chronic Pain.

Chronic pain after surgery is common.Surgery is widely performed therefore the at risk population is large.The mechanisms of chronic pain after surgery are complex.

Hypokalaemia with severe rebound hyperkalaemia after therapeutic barbiturate coma.

Severe disturbance of potassium balance is a rare but life-threatening complication of therapeutic barbiturate coma. A 14-yr-old patient was treated with a thiopental infusion for management of increased intracranial pressure after severe head injury. The patient had persistent hypokalaemia during the thiopental infusion.

A single-centre prospective study of clinical and haemostatic risk factors for venous thromboembolism following lower limb arthroplasty.

Previous studies report conflicting results concerning the potential significance of thrombophilic genotypes in postarthroplasty venous thromboembolism (VTE). This study assessed thrombophilic genotypes, haemostatic and clinical variables as independent risk factors for VTE postarthroplasty. A total number of 569 patients undergoing elective lower limb arthroplasty at a single centre were prospectively studied.