Cementing technique for total knee arthroplasty in cadavers using a pastry bone cement.

Background: In cemented primary total knee arthroplasty (TKA), aseptic loosening remains a major cause for failure. Cementing techniques and characteristics of a chosen cement play a key role for good fixation and implant survival. A pastry bone cement was developed to facilitate the cement preparation and to rule out most of preparation-associated application errors.

The influence of biomechanical stability on bone healing and fracture-related infection: the legacy of Stephan Perren.

Bone healing is a complicated process of tissue regeneration that is influenced by multiple biological and biomechanical processes. In a minority of cases, these physiological processes are complicated by issues such as nonunion and/or fracture-related infection (FRI). Based on a select few in vivo experimental animal studies, construct stability is considered an important factor influencing both prevention and treatment of FRI.

Orthoplastics in Periprosthetic Joint Infection of the Knee: Treatment Concept for Composite Soft-tissue Defect with Extensor Apparatus Deficiency.

: Reconstruction of composite soft-tissue defects with extensor apparatus deficiency in patients with periprosthetic joint infection (PJI) of the knee is challenging. We present a single-centre multidisciplinary orthoplastic treatment concept based on a retrospective outcome analysis over 20 years. : One-hundred sixty patients had PJI after total knee arthroplasty.

Clostridial Infection After Open Fractures of the Lower Extremity - Report of Two Cases and Discussion of Pathomechanism and Treatment.

Background: Management of post-traumatic open fractures resulting from severe injuries of the lower extremity continues to challenge orthopedic and reconstructive surgeons. Moreover, post-traumatic osteoarticular infections due to Clostridium species are rare, with few reports in the literature. We describe possible pathomechanisms and propose treatment options for cases of delayed diagnosis of osteoarticular infections with Clostridium spp.

Long-term results of revision total hip arthroplasty with a cemented femoral component.

Introduction: In revision total hip arthroplasty (THA), the cancellous bone is normally completely removed out of the femoral canal during stem extraction. This situation is comparable to primary THA following the shape-closed concept, with some authors advocating to remove the metaphyseal cancellous bone to enhance press-fit stability ("French paradox"). The aim of this study was to investigate the long-term outcome, regarding survival and radiological results, of a cemented straight stem when used for revision THA and to compare these results to the results of the same stem in primary THA.

Long-term survival of the cemented Müller CDH stem: a minimum follow-up of 10 years.

Introduction: Total hip arthroplasty in patients with altered anatomy of the hip and femur, such as in congenital dysplasia of the hip, is challenging and often requires specially designed stems. Müller straight stems have shown excellent long-term results; however, long-term data on the analogous cemented Müller CDH stem are still missing. The aim of this study was to analyze long-term survival, identify potential risk factors for aseptic loosening, and analyze radiological outcome of the cemented Müller CDH stems.

Excellent long-term results of the Müller acetabular reinforcement ring in primary cup revision.

Background and purpose - The original Müller acetabular reinforcement ring (ARR) was developed to be used for acetabular revisions with small cavitary and/or segmental defects or poor acetabular bone quality. Long-term data for this device are scarce. We therefore investigated long-term survival and radiographic outcome for revision total hip arthroplasty using the ARR.

Eradication of infection, survival, and radiological results of uncemented revision stems in infected total hip arthroplasties.

Background and purpose - The use of uncemented revision stems is an established option in 2-stage procedures in patients with periprosthetic joint infection (PJI) after total hip arthroplasty (THA). However, in 1-stage procedures, they are still rarely used. There are still no detailed data on radiological outcome after uncemented 1-stage revisions.

Similar effect of stem geometry on radiological changes with 2 types of cemented straight stem: The Müller stem and the Virtec stem compared in 711 hips.

Background And Purpose: There are 2 basic principles in cemented stem fixation: shape-closed and force-closed. We investigated 2 shape-closed straight stems, the Müller (MSS) and the Virtec (VSS), which differ only in geometrical cross section, to determine whether the difference in stem shape would affect the radiological results or long-term survival.

Patients And Methods: We included 711 hips (in 646 patients) that were operated on between July 1996 and July 2003.

Excellent long-term results of the Müller acetabular reinforcement ring in primary total hip arthroplasty: A prospective study on radiology and survival of 321 hips with a mean follow-up of 11 years.

Background And Purpose: The original Müller acetabular reinforcement ring (ARR) shows favorable medium-term results for acetabular reconstruction in total hip arthroplasty, where it is used when the acetabular bone stock is deficient. However, there are no data regarding long-term survival of the device. We therefore investigated long-term survival and analyzed radiological modes of failure.

One-stage revision of infected hip arthroplasty: outcome of 39 consecutive hips.

Purpose: There are various options for treating periprosthetic joint infection (PJI). Two-stage exchange has traditionally been the gold standard. However, if the appropriate surgical intervention is chosen according to a rational algorithm, the outcome is similar when using all types of interventions.

Phenotypic and genotypic characterisation of Staphylococcus aureus causing musculoskeletal infections.

One of the most common pathogens causing musculoskeletal infections remains Staphylococcus aureus. The aim of this multicentre study was to perform a phenotypic and genotypic characterisation of clinical S. aureus isolates recovered from musculoskeletal infections and to investigate differences between isolates cultured from Orthopaedic Implant Related Infections (OIRI) and those from Non-Implant Related Infections (NIRI).

The impact of pulmonary bone component embolism: an autopsy study.

Aims: Pulmonary bone marrow embolism (BME) and pulmonary bone fragment embolism (BFE) are two types of non-thrombotic pulmonary embolism (NTPE). While BME can be found consistently in autopsies, BFE is a rarely observed event. Both these conditions have bone lesions as source of embolism and are not considered to be causative for death.

Influence of leg length discrepancy on clinical results after total hip arthroplasty--a prospective clinical trial.

The effect of leg length differences on early clinical outcome after total hip arthroplasty remains uncertain. We performed a prospective study on 94 patients who were evaluated preoperatively and one year after surgery for clinical leg length differences, which were then compared with radiological measurements. The effect of leg length differences on walking ability, limp, pain and patient satisfaction was studied.

Osteointegration of orthopaedic devices.

The different properties of bone must be considered in order to understand the relation between orthopaedic devices and bone. The epi-/metaphyseal areas are defined by their rigidity, their high vascularity and their quick remodelling process. In contrast, the diaphyses of bone are rather elastic and built of dense, scarcely vascularised bone presenting slow remodelling.

Infectiological, functional, and radiographic outcome after revision for prosthetic hip infection according to a strict algorithm.

Background And Purpose: Successful treatment of prosthetic hip joint infection (PI) means elimination of infection and restored hip function. However, functional outcome is rarely studied. We analyzed the outcome of the strict use of a treatment algorithm for PI.

Accelerated healing of the rat Achilles tendon in response to autologous conditioned serum.

Background: Despite advances in the treatment of ruptured Achilles tendon, imperfections of endogenous repair often leave patients symptomatic. Local administration of autologous conditioned serum (ACS) in patients with inflammatory, degenerative conditions has shown beneficial effects.

Purpose: Because ACS also contains growth factors that should accelerate tendon healing, we studied the effect of ACS on the healing of transected rat Achilles tendon.

Classification of acetabular changes in osteoarthritis: a histological and radiological analysis of 122 consecutive drill biopsies routinely taken during THA.

Background: Aseptic acetabular loosening cannot be explained with a single theory and lots of studies deal with the influence of implant design and surgical technique on implant survival. Implant registers show the effect of demographic and patient-related parameters on acetabular loosening. There is little information about the influence of the acetabular bone quality on cup loosening.

Patient and surgery related factors associated with fatigue type polyethylene wear on 49 PCA and DURACON retrievals at autopsy and revision.

Background: Polyethylene wear is an important factor for longevity of total knee arthroplasty. Proven and suspicious factors causing wear can be grouped as material, patient and surgery related. There are more studies correlating design and/or biomaterial factors to in vivo wear than those to patient and surgery related factors.

Cement collar and longitudinal groove: the effects on mechanical stability with aseptic loosening in Müller straight-stem implants.

Introduction: The Müller straight-stem prosthesis (GS-77), in contrast to the Müller SL prosthesis (SL-88), is equipped with a cement collar and longitudinal grooves. Comparative observation of these prostheses suggests that cement collars protect against rapid subsidence and that longitudinal grooves prevent premature formation of a varus tilting deformity.

Method: Because loosening is often observed in the titanium-alloy models of these implants, this retrospective study focused on these models.

Propionibacterium spp. in prosthetic joint infections: a diagnostic challenge.

Introduction: Propionibacterium species are common inhabitants of the skin and usually non-pathogenic for humans. However, Propionibacterium spp. can occasionally cause infections, but are estimated to play a minor role in prosthetic joint infections (PJI).

The M.E Müller straight stem prosthesis: 15 year follow-up. Survivorship and clinical results.

The aim of the study was to document the long-term clinical and radiologic results as well as the 15 year survival of a single cemented straight stem. Our series consisted of consecutive patients with 161 straight stem prostheses implanted between 1984 and 1987 in 152 patients. Follow-up was performed prospectively at 1, 2, 5, 10 and 15 years post-operatively.