Early Polyethylene Failure in a Modern Total Hip Prosthesis: A Note of Caution.

Background: Historically, there has been excellent survivorship of total hip arthroplasty with newer implants expected to outperform prior generations. Review of our institutional database identified problems with one particular cross-linked polyethylene liner in mid-term follow-up, which has not been reported in the literature. We report on the technical aspects of this liner, as well as the clinical and radiographic factors associated with early failure of this bearing in our practice.

Clinical Evaluation of Synovial Alpha Defensin and Synovial C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection.

Background: Diagnosing periprosthetic joint infection after total joint arthroplasty is often challenging. The alpha defensin test has been recently reported as a promising diagnostic test for periprosthetic joint infection. The goal of this study was to determine the diagnostic accuracy of alpha defensin testing.

Staged treatment of pilon fractures.

Aim: To evaluate outcomes following staged anterolateral plating of pilon fractures.

Methods: Over a 5 year period, patients with pilon fractures received four treatment regimens (staged anterolateral plating, staged medial plating, definitive external fixation, early total care). We defined five outcomes (reduction, soft tissue complications, infection, non-union, malunion) and assessed the outcome of fractures treated by these interventions.

Perioperative and acute care outcomes in morbidly obese patients with acetabular fractures at a Level 1 trauma center.

Background: Controversy exists regarding obesity-related injury severity and clinical outcomes after orthopedic trauma.

Purpose: The purposes of this study were to expand our understanding of the effect of morbid obesity on perioperative and acute care outcomes after acetabular fracture.

Methods: This was a retrospective review of patients with acetabular fracture after trauma.

An indirect reduction technique for percutaneous fixation of calcaneus fractures.

We describe a positioning and indirect reduction method that allows for earlier fixation of some displaced calcaneus fractures. Minimally invasive surgery with this technique can provide good results in high-risk patients while minimizing soft-tissue complications.

Obesity and long term functional outcomes following elective total hip replacement.

Introduction: Obesity rates continue to rise and more total hip arthroplasty procedures are being performed in progressively younger, obese patients. Hence, maintenance of long term physical function will become very important for quality of life, functional independence and hip prosthesis survival. Presently, there are no reviews of the long term efficacy of total hip arthroplasty on physical function.

Impending aortic penetration following thoracolumbar spinal fixation: a case study.

Spinal instrumentation is a commonly performed procedure in modern surgery. Potential injury to the large vessels in the chest is a known complication of these procedures. We present a case of aortic impingement identified on a CT scan one year following a thoracic spinal procedure.