Osteogenesis imperfecta (OI) is a rare congenital disease characterized by alterations in bone quality, with susceptibility to fractures, instability, deformities, and osteoarthrosis. Prosthetic surgery in these patients is associated with an abnormally high rate of implant failures. On the other hand, abnormal bone fragility adds to the complexity of revision surgery in such individuals-thus representing a genuine challenge for the orthopaedic surgeon. We present a case of femoral reconstruction in a patient with OI and prosthetic loosening after reconstruction secondary to femoral septic pseudoarthrosis. Intramedullary total femoral reconstruction was carried out after exceeding the biological reconstruction limits. This is the first reported instance of the use of an intramedullary total femur arthroplasty as salvage technique in an OI patient. This technique should be considered when we have exceeded biological limits for femoral fixation.
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http://dx.doi.org/10.1016/j.artd.2017.01.001 | DOI Listing |
Knee
December 2024
Orthopedic Surgery and Traumatology, Hospital Clínic de Barcelona, Barcelona, Spain.
Distal femoral replacement (DFR) with megaprostheses is a salvage revision total knee arthroplasty (rTKA) procedure indicated in cases with massive bone defects in the distal femur. As long as these implants achieve fixation only in the diaphysis, the high aseptic loosening rate reported in some series is probably related to a lack of rotational stability. Two patients with extensive distal femoral bone defects with preservation of the metaphyseal-diaphyseal junction underwent rTKA.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Washington University in St Louis, Saint Louis, Missouri, USA.
Background: Consequences of osteochondral fractures associated with patellar dislocation can be severe for younger patients. Precise 3-dimensional characterization of fracture location, size, frequency, and radiographic associations remain undefined in this population.
Purpose: (1) To define the topographic characteristics of osteochondral fractures in pediatric and adolescent patients with first-time patellar dislocations and (2) to determine the relationship between these characteristics and radiographic and patient factors.
Injury
January 2025
Temple University Hospital, Department of Orthopaedic Surgery, USA.
Objectives: Long bone fractures with concomitant vascular injury have the potential to be life and limb threatening injuries, with increased risk for limb loss. There is currently no established surgical order of operations for orthopaedic and vascular intervention. This study compares injury classification, warm ischemia time and patient outcomes in patients with long bone fractures and associated vascular injury after orthopaedic versus vascular primary intervention.
View Article and Find Full Text PDFThe current study aimed to objectively evaluate the fit of a rectangular, tapered stem to the severely dysplastic hips on the basis of the proximal femoral anatomy and the dimensional properties of the stem. It was hypothesized that the stem size planned with accordance to the diaphyseal canal width alone can accommodate the distal femur successfully with no sizing mismatch. Forty-six patients (53 hips) suffering from secondary osteoarthritis due to hip dysplasia scheduled for total hip arthroplasty (THA) with a subtrochanteric transverse shortening osteotomy were included.
View Article and Find Full Text PDFDislocation is the second most common indication for revision total hip arthroplasty (THA). In revision cases the dislocation rate can be as high as 5-30%. The aim of this study was to assess the outcome, specifically the dislocation rate in revision THA where a dual mobility cup was used.
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