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The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 2 | Pages 225 - 227
1 Feb 2008
Reigstad O Siewers P

An 86-year-old male presented with a loose total hip replacement (THR) ten years after implantation. At revision for anticipated aseptic loosening, watery pus was found in the joint and Bacille-Calmette-Guérin (BCG) was seen on culture. The bacterial strain was identified and was identical to the BCG used in the intravesicular treatment of superficial bladder carcinoma in this patient ten months earlier. After revision he received a full course of antituberculous treatment.

The clinical and radiological results were excellent after follow-up for 30 months with his uncemented THR showing satisfactory incorporation. His inflammatory markers were normal and his Harris hip score was 95 points.

The diagnosis of a tuberculous infection can be easily missed, but must be considered, especially if sterile pus is encountered.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 230 - 230
1 Mar 2004
Dimmen S Siewers P Madsen J
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Aims: The complications and functional long time results after glenohumeral arthrodesis are described. Methods: 22 patients (9 men, 13 women) with a median age of 64 (19 – 75) years were operated with a glenohumoral arthrodesis between 1982 and 2000. The indications for surgery were fracture sequelae (11), severe osteoarthritis (4), deltoid dysfunction (3), failed revision arthroplasty (1), chronic posterior dislocation (1), tuberculosis (1) and gunshot wound (1). Standard AO surgical technique with stable plating was used. 6 patients are dead and 1 refused examination. The remaining 15 patients were examined retrospectively after a mean of 7.8 years. The American Shoulder and Elbow Surgeons (ASES) score and Oxford score were registered and radiographs taken. Results: 8 patients had intermittent or continuous pain with a mean pain score (VAS) of 1.5 (0–8). 1 patient was reoperated after 4 months due to excessive pain and one was operated due to a humeral shaft fracture after 8 months. The implants had been removed in 5 patients and 1 had a lateral clavicle resection after 3 years. No patients had infections, but 1 had reflex sympathetic dystrophy. Radiologically all but two arthrodesis fused, the remaining 2 were painfree. Mean Oxford score was 33 (20 – 49), mean ASES score was 59 (15 – 95). Conclusions: The functional results after glenohumeral arthrodesis are comparable with results reported after shoulder arthroplasty. The he arthrodesis has a wide range of indications and the long time complications related to shoulder prosthesis may be avoided.