This study aimed to evaluate if total knee arthroplasty (TKA) femoral components aligned in either mechanical alignment (MA) or kinematic alignment (KA) are more biomimetic concerning trochlear sulcus orientation and restoration of trochlear height. Bone surfaces from 1,012 CT scans of non-arthritic femora were segmented using a modelling and analytics system. TKA femoral components (Triathlon; Stryker) were virtually implanted in both MA and KA. Trochlear sulcus orientation was assessed by measuring the distal trochlear sulcus angle (DTSA) in native femora and in KA and MA prosthetic femoral components. Trochlear anatomy restoration was evaluated by measuring the differences in medial, lateral, and sulcus trochlear height between native femora and KA and MA prosthetic femoral components.Aims
Methods
The French registry for complex bone and joint infections (C-BJIs) was created in 2012 in order to facilitate a homogeneous management of patients presented for multidisciplinary advice in referral centres for C-BJI, to monitor their activity and to produce epidemiological data. We aimed here to present the genesis and characteristics of this national registry and provide the analysis of its data quality. A centralized online secured database gathering the electronic case report forms (eCRFs) was filled for every patient presented in multidisciplinary meetings (MM) among the 24 French referral centres. Metrics of this registry were described between 2012 and 2016. Data quality was assessed by comparing essential items from the registry with a controlled dataset extracted from medical charts of a random sample of patients from each centre. Internal completeness and consistency were calculated.Aims
Methods
There is great variability in acetabular component
orientation following hip replacement. The aims of this study were
to compare the component orientation at impaction with the orientation
measured on post-operative radiographs and identify factors that
influence the difference between the two. A total of 67 hip replacements
(52 total hip replacements and 15 hip resurfacings) were prospectively
studied. Intra-operatively, the orientation of the acetabular component
after impaction relative to the operating table was measured using
a validated stereo-photogrammetry protocol. Post-operatively, the
radiographic orientation was measured; the mean inclination/anteversion
was 43° ( This study demonstrated that in order to achieve a specific radiographic
orientation target, surgeons should implant the acetabular component
5° less inclined and 8° more anteverted than their target. Great
variability (2 Cite this article:
The revised Tokuhashi, Tomita and modified Bauer
scores are commonly used to make difficult decisions in the management
of patients presenting with spinal metastases. A prospective cohort
study of 199 consecutive patients presenting with spinal metastases,
treated with either surgery and/or radiotherapy, was used to compare
the three systems. Cox regression, Nagelkerke’s R2 and
Harrell’s concordance were used to compare the systems and find their
best predictive items. The three systems were equally good in terms
of overall prognostic performance. Their most predictive items were
used to develop the Oswestry Spinal Risk Index (OSRI), which has
a similar concordance, but a larger coefficient of determination
than any of these three scores. A bootstrap procedure was used to
internally validate this score and determine its prediction optimism. The OSRI is a simple summation of two elements: primary tumour
pathology (PTP) and general condition (GC): OSRI = PTP + (2 – GC). This simple score can predict life expectancy accurately in patients
presenting with spinal metastases. It will be helpful in making
difficult clinical decisions without the delay of extensive investigations. Cite this article:
At the Orthopedic Hospital Vienna Speising 7.857 surgeries were performed in 2008. 2.211 of these surgeries required implants. The number of performed Total Hip Arthroplasties (THA) was 836. All of these surgeries were elective. Approximately 0,5% of the patients who underwent a surgery at our institution had a postoperative infection, 0,8% were admitted because of an already existing infection, which required treatment at our department. In order to achieve a basis for international compatibility and to meet the legal postulations the Orthopedic Hospital Vienna Speising actively participates in ANISS (Austrian Nosocomial Infection Surveillance System)/HELICS (Hospital in Europe Link for Infection Control through Surveillance). In 2008 a survey on incidences for Total Hip Arthroplasties was started. So the possibility of specific measures is given when interventions should be necessary. The stuff unit for Hospital Hygiene gathers data from clinical records and conducts an evaluation by means of a standardised (equivalent surgeries) and stratified (differentiation of the patients after ASA-score- American Society of Anaesthesiologists, duration of the surgery, etc) procedure. Three times a week the stuff unit for Hospital Hygiene visits the wards and collect selected indicator-surgeries, which are entered in a specific program for registering infections. By finding noticeable problems, a detailed analysis is continued with the examination of microbiologic, histological and radiologic data as well as questions to the surgeon or attending staff and ward rounds for inspecting for instance changes of dressing. The infectdiagnoses, based upon CDC (Center of Desease Control) definitions for nosocomial infections, are encrypted and sent to the control center quarterly. In turn our hospital receives an analysis and feedback once a year. A biannual exchange of experiences on behalf of the active members including an interpretation of the data allows to settle discrepancies and dubieties in evaluation. This data on surveillance allows a detailed analysis of information gathered in recent years as well as a discussion with authorities. As a result specific consequences could already been deducted like written guidelines for
