Background: Total hip arthroplasty is a commonly performed procedure in the United States and Canada that associated with definite risk of postoperative infection. Moreover, diagnosing an infection after total can present challenge as there are no preoperative tests consistently sensitive specific for patients who need revision arthroplasty. The prospective study was to evaluate variety investigations diagnosis at site previous order determine if any combination diagnostic studies could be...

Lateral instability of the knee is less frequent but more disabling than medial a comparable amount. At same time diagnostic tests for lateral are subtle and frequently misinterpreted. Posterolateral rotatory subluxation demonstrated by an apparently positive posterior drawer test with tibia in neutral rotation or external rotation-recurvatum extension. Anterolateral present when anterior demonstrates that tibial condyle appears to become prominent both condyles appear equally prominent.

Using a three-dimensional analysis, the internal forces in joints and soft tissues of thumb during pinch grasp were calculated. To do this, mechanical equivalents ascribed to anatomical system, joint orientation tendon locations determined from biplanar roentgenograms five marked normal cadaver specimens, magnitudes tendons, intrinsic muscles, contact surfaces, constraining ligaments calculated based on assumed loads applied tip various types grasp. These results are direct extension...

Resurfacing arthroplasty has become an attractive option for young patients who want to maintain a high activity level. One recent study reported modestly increased levels with resurfacing compared standard total hip (THA). We conducted prospective randomized clinical trial compare outcomes of versus large-head metal-on-metal arthroplasty. 107 deemed eligible have either or THA. Patients were assessed quality-of-life using the PAT-5D index, WOMAC, SF-36, and UCLA score. The minimum followup...

Background: Despite the widespread use of several diagnostic tests, there is still no perfect test for diagnosis infection at site a total knee arthroplasty. The purpose this study was to evaluate characteristics erythrocyte sedimentation rate and C-reactive protein level assessment in patients presenting revision Methods: One hundred fifty-one knees 145 arthroplasty were evaluated prospectively presence with measurement level. these tests assessed two different techniques: first,...

The PROSTALAC functional spacer is made of antibiotic-loaded acrylic cement but has a small metal-on-polythene articular surface. We have used it as an interim in two-stage exchange arthroplasty for infected total knee replacement. allows continuous rehabilitation between stages maintains good alignment and stability the reasonable range movement. It also helps to maintain soft-tissue planes, which facilitates second-stage procedure. reviewed 45 consecutive patients, treated over period nine...

The PROSTALAC functional spacer is made of antibiotic-loaded acrylic cement but has a small metal-on-polythene articular surface. We have used it as an interim in two-stage exchange arthroplasty for infected total knee replacement. allows continuous rehabilitation between stages maintains good alignment and stability the reasonable range movement. It also helps to maintain soft-tissue planes, which facilitates second-stage procedure. reviewed 45 consecutive patients, treated over period nine...

Background: Periprosthetic femoral fractures around hip replacements are increasingly common. When the component is stable, open reduction and internal fixation recommended in all but exceptional cases. The purpose of this study was to evaluate outcome treatment stable implants with cortical onlay strut allografts or without a plate. Methods: A survey our four centers identified forty patients fracture well-fixed stem treated revision component. There were fourteen men twenty-six women, an...

The cause of recently reported pseudotumor formation in patients with metal-on-metal hip replacements is unknown. It has been postulated that there an association between elevated levels serum metal ions and formation. primary purpose this study was to assess the prevalence asymptomatic a total replacement after minimum duration follow-up two years. A secondary whether correlation exists ion formation.In present study, formation, as detected ultrasound, evaluated for thirty-one arthroplasty,...

Background Dislocation after revision THA is a common complication. Large heads have the potential to decrease dislocation rate, but it unclear whether they do so in THA. Questions/purposes We therefore determined large femoral head (36 and 40 mm) resulted decreased rate compared standard (32 mm). Methods randomized 184 patients undergoing receive either 32-mm (92 patients) or 36- 40-mm stratified by surgeon. The two groups had similar baseline demographics. primary end point was...

We report the outcome at ten to 15 years of two-stage revision for hip infection in 99 patients using Prostalac articulated spacer system. All were contacted determine their current functional and status Oxford-12, Short form-12, Western Ontario McMaster University Osteoarthritis Index questionnaires. A total 11 had a further infection, whom seven responded repeat surgery with no sequelae. The mean interval between stages was five months (1 36). able review 48 living patients, age 72 (46...

Previous studies have indicated poor outcomes in patients having revision of hip resurfacing resulting from adverse local tissue reaction and pseudotumor.We reviewed all at our institution who had failed large-head metal-on-metal total arthroplasty to determine (1) complications including reoperations; (2) radiologic outcomes; (3) changes serum ions after removal the metal bearing.From research database, we identified 32 hips 30 patients. Revisions were performed through a posterior...

A two-stage revision total knee arthroplasty is recognized as the gold standard in treatment of infection. However, traditional spacers limit function interval between two stages and may cause instability, scarring, bone erosion. The PROSTALAC spacer an antibiotic-loaded cement articulating that allows some movement stages. Whether motion enhances long-term unknown.We therefore identify rate control infection using exchange to assess clinical outcome after implantation with a definitive...

Methicillin-resistant hip infections are increasingly common. Reports of the surgical management these patients using two-stage THA show variable control infection, but all reports used static spacers.We therefore determined (1) rate successful infection and (2) function in with methicillin-resistant treated a an articulated cement spacer during first stage.We retrospectively reviewed 50 who had revision for Staphylococcus aureus or epidermidis infection. Twelve died, leaving 38 review. All...

Large acetabular defects can be reconstructed with various methods depending on size and location of the defect. We prospectively followed our first 37 patients in whom we acetabulum a trabecular metal augment combined shell. Three died before completing minimum 24 months followup while remaining 34 were (mean, months; range, 24-55 months). All classified according to Paprosky. Radiographic signs osseointegration Moore. Quality life was measured SF-12, WOMAC, Oxford Hip Score. There 15 men...