Joint preservation in revision arthroplasty and intercalary tumour implants using custom stem solutions.

Background: Off-the-shelf stems offer a wide variety of fixation methods for revision arthroplasty and intercalary tumour implants. However, in extensive defects or needed resection with minimal bone stock left, solid fixation is often not feasible with these implants. Custom-made stem solutions (CSS) offer a viable alternative in these cases to achieve joint preservation.

Monoflange custom-made partial pelvis replacements offer a viable solution in extensive Paprosky III defects.

Aims: Custom-made partial pelvis replacements (PPRs) are increasingly used in the reconstruction of large acetabular defects and have mainly been designed using a triflange approach, requiring extensive soft-tissue dissection. The monoflange design, where primary intramedullary fixation within the ilium combined with a monoflange for rotational stability, was anticipated to overcome this obstacle. The aim of this study was to evaluate the design with regard to functional outcome, complications, and acetabular reconstruction.

The Modified Harrington Procedure for Metastatic Peri-Acetabular Bone Lesion Using a Novel Highly Porous Titanium Revision Shell with Long Lever Arm Screw.

: Peri-acetabular metastases often lead to significant pain and functional impairment. Surgical interventions, including the Harrington procedure, aim to address these challenges. This study evaluates a modified Harrington procedure using the MUTARS PRS (Pelvic Revision Shell) with an 8 mm fixation screw for severe acetabular defects resulting from metastatic lesions.

Mouldable Collagen-Tricalciumphosphate Is a Safe Carrier for Local Antibiotics-Short-Term Results in Revision Hip Arthroplasty.

Background: Improving local antibiotic delivery is a promising approach to improve infection control and potentially shorten systemic treatment in periprosthetic joint infection (PJI). This study investigates the use of an antibiotic-loaded, mouldable collagen-tricalciumphosphate composite in treatment of hip PJI.

Methods: 124 application cases in 79 patients were included from a referral centre; systemic adverse infects, local complications, and infection control were analysed.

The Megaendoprosthesis in Revision Arthroplasty - a Cost-revenue Analysis in the aG-DRG System.

Megaendoprosthesis offer a viable treatment in complex revision arthroplasty cases with good functional outcome. In the context of a neoplastic indication, the diagnosis-related group (DRG) I95A is usually assigned with a relative weight of 4.906 (2021).

[Customized partial pelvis replacement: three-dimensional planning and management concepts].

The planning and implantation of a customized partial pelvis replacement places high demands on both the surgeon and the entire team (engineer, assistants, surgical team). Thanks to careful preoperative planning and meticulous perioperative execution, customized partial pelvic replacement represents a complex but reliable procedure for defect reconstruction even with highly complex acetabular bone defects or after multiple previous surgeries.

Custom-Made Metaphyseal Sleeves in "Beyond" AORI III Defects for Revision Knee Arthroplasty-Proof of Concept and Short-Term Results of a New Technique.

Background: While off-the-shelf cones and sleeves yield good results in AORI type 2 and 3 defects in revision knee surgery, massive longitudinal defects may require a proximal tibia replacement. To achieve the best anatomical as well as biomechanical reconstruction and preserve the tibial tuberosity, we developed custom-made metaphyseal sleeves (CMSs) to reconstruct massive defects with a hinge knee replacement.

Methods: Between 2019 and 2022, 10 patients were treated in a single-center study.

Beyond type III Paprosky acetabular defects: are partial pelvic replacements with iliosacral fixation successful?

Purpose: Supra-acetabular bone loss close beyond the sciatic notch is one of the most challenging defect types for stable anatomical reconstruction in revision arthroplasty. Using reconstruction strategies from tumour orthopaedic surgery, we adapted tricortical trans-iliosacral fixation options for custom-made implants in revision arthroplasty. The aim of the present study was to present the clinical and radiological results of this extraordinary pelvic defect reconstruction.

[Resection arthroplasty and arthrodesis in revision shoulder arthroplasty].

Shoulder arthrodesis and resection arthroplasty can be used as salvage procedures to treat severe complications after shoulder prosthesis failure. for both procedures, the indication and patient selection must be very strict. Shoulder arthrodesis after prosthesis failure can be indicated in young patients in case of chronic neuromuscular dysfunction.

Reconstruction of Paprosky III defects with custom-made implants: do we get them in the correct position? : short-term radiological results.

Aims: The aim of this study was to examine the implant accuracy of custom-made partial pelvis replacements (PPRs) in revision total hip arthroplasty (rTHA). Custom-made implants offer an option to achieve a reconstruction in cases with severe acetabular bone loss. By analyzing implant deviation in CT and radiograph imaging and correlating early clinical complications, we aimed to optimize the usage of custom-made implants.

Erratum to 'Conversion From Knee Arthrodesis Back to Arthroplasty: A Particular Challenge in Combination With Fungal Periprosthetic Joint Infection' [Arthroplasty Today 6 (2020) 1038-1044].

[This corrects the article DOI: 10.1016/j.artd.

Does the Implementation of the PRO-IMPLANT Foundation Treatment Algorithm Improve the Outcome of Chronic Periprosthetic Knee Infections? Mid-Term Results of a Prospective Study.

Background: Several treatment options for chronic periprosthetic joint infections have been published in the current literature, with an on-going discussion to determine effective management algorithms.

Objectives: To compare outcomes of the two-stage exchange procedure in revision TKA prior to and after implementation of the PRO-IMPLANT Foundation treatment algorithm. The primary endpoints were defined as (i) revisions during the interval time, (ii) duration of the interval time and (iii) successful PJI eradication.

Three-stage revision arthroplasty for the treatment of fungal periprosthetic joint infection: outcome analysis of a novel treatment algorithm : a prospective study.

Aims: Fungal periprosthetic joint infections (fPJIs) are rare complications, constituting only 1% of all PJIs. Neither a uniform definition for fPJI has been established, nor a standardized treatment regimen. Compared to bacterial PJI, there is little evidence for fPJI in the literature with divergent results.

Accuracy of radiographic measurement techniques for the Taylor spatial frame mounting parameters.

Aim: The correction accuracy of the Taylor Spatial Frame (TSF) fixator depends considerably on the precise determination of the mounting parameters (MP). Incorrect parameters result in secondary deformities that require subsequent corrections. Different techniques have been described to improve the precision of MP measurement, although exact calculation is reportedly impossible radiologically.

Tibiocalcaneal arthrodesis using the Ilizarov fixator in compromised hosts: an analysis of 19 patients.

Introduction: Salvage of joint destruction of the tibiotalar and subtalar joint with necrosis or infection of the talus in compromised hosts is a challenging problem. In these cases, tibiocalcaneal arthrodesis using the Ilizarov external fixator represents a possible alternative to amputation. This retrospective study presents the results and complications of this salvage procedure.

Conversion From Knee Arthrodesis Back to Arthroplasty: A Particular Challenge in Combination With Fungal Periprosthetic Joint Infection.

A 58-year-old female treated at an outside facility with knee arthrodesis due to persistent periprosthetic joint infection fulfilled all prerequisites for a conversion back to arthroplasty, as part of a 2-stage revision. Owing to the detection of , the treatment concept was converted to a three-stage procedure. A scheduled spacer exchange with additional amphotericin B-loaded polymethylmethacrylate was conducted as an intermediate revision before reimplantation.

Facing multidrug-resistant pathogens in periprosthetic joint infections with self-administered outpatient parenteral antimicrobial therapy-A prospective cohort study.

A key factor in the successful management of periprosthetic joint infection (PJI) besides the surgical regime is a consistent antimicrobial therapy. Recently, oral versus intravenous (IV) antibiotics for bone and joint infection trial demonstrated the noninferiority of oral antimicrobial therapy compared to IV, implying that an early transition to oral administration is reasonable. It is likely that the international consensus meeting of musculoskeletal Infections and the European Bone and Joint Infection Society will consider these findings.

Persistent Fistula for Treatment of a Failed Periprosthetic Joint Infection: Relic From the Past or a Viable Salvage Procedure?

Background: New treatment algorithms for periprosthetic joint infections (PJIs) show high success rates in achieving permanent infection eradication with some degree of failure. Different salvage procedures are described, but there is no evidence for persistent fistula (PF). The purpose of this study was to analyze PF as a salvage procedure in patients with therapy-resistant PJIs.

Outpatient Parenteral Antibiotic Therapy (OPAT) with Peripherally Inserted Central Catheter in Patients with Periprosthetic Joint Infection.

Background: A key factor in the successful treatment of periprosthetic joint infection is the consistent antimicrobial therapy. Depending on the pathogen antimicrobial susceptibility, intravenous (i. v.