It has been reported that the tibial articular surface of coronal aligment is parallel to the floor in the whole-leg standing radiographs of the normal knee. The purposes of this study are to investigate the relationship between the tibial articular surface and the ground on the whole-leg standing radiographs after total knee arthroplasty(TKA). 20 knees after TKA were studied retrospectively. The 20 participants were mean age at 76.7 years; and 3 male and 17 female. Using whole-leg standing radiographs, we mesuared the pre- and postoperative hip-knee- ankle angle(HKA), the tibial joint line angle(TJLA), and the tibial component Coronal tibial angle(CTA). The difference in each parameter was compared and examined.Introduction
Sturdy Design and Methods
The goal of treating artificial joint infection is to relieve the infection quickly and re-establish joint function, but many patients have underlying diseases, and treatment is often made problematic by the diversity of the causative bacteria. In this study we assessed the factor that enabled revision arthroplasty in patients with infection after artificial hip arthroplasty, including bipolar hip arthroplasty, in our hospital. The subjects were the 16 patients (16 hips) with infection after hip arthroplasty who were treated in our hospital during the past 10 years. There were 7 males and 9 females, and their mean age was 69.8 years. Primary total hip arthroplasty had been performed in 6 hips, revision hip arthroplasty in 8 hips, and bipolar hip arthroplasty in 2 hips. Infected implants were removed as soon as possible and delayed reimplantations with an interval antibiotic spacer were attempted in all patients. 9 hips were successful in reimplantation (reimplantation group) and 7 hips were impossible (No reimplantation group). In this study we investigated age, complications, body mass index (BMI), body temperature, pain, rate of resistant bacteria, number of hip surgery prior to infection and clinical manifestations compared to two groups.Introduction
Subjectives and Methods
Excellent results with use of tapered wedged cementless stem have been reported. The purpose of this study was to clarify the indication of tapered wedged cementless stems for patients with poor bone quality. Sixty-five hemiarthroplasties in 79 patients with diagnosis of femoral neck fracture were performed between February 2004 and August 2011. 14 patients were lost to follow-up after surgery, and it is 19 patients among the leaving 65 patients had the stovepipe canal. There were 2 men and 16 women, with a mean age at time of surgery 85 years (range, 75–92 years). All components were tapered wedged cementless stem (LINEAR: Encore, Kinectiv: ZIMMER). Evaluation of patient followed includes radiographic analysis (canal flare index, canal fill rate, stem alignment, bone reaction, and stem stability) and recording complication.Background
Method
Aseptic loosening and osteolysis may cause significant periprosthetic femoral bone destruction, often necessitating bypass of the deficient proximal femur to obtain stable fixation in the distal diaphysis. The purpose of the present study was to report our results of femoral component revision using a distally locked revision femoral stem for the treatment of the severe proximal femoral bone loss. We evaluated 21 hips in 20 patients who underwent revision hip arthroplasty associated with Paprosky grade-IIIB or IV femoral deficiencies. Three hips were associated with a Vancouver type-B3 periprosthetic femoral fracture. The mean age at the time of revision was 70.8 (51–82) years old with 5 men and 15 women. The mean duration of follow-up was 5.1 years. The femoral implant used for the revision was the Cannulok Revision Prosthesis in 16 hips and the Huckstep interlocking stem in five. Gaps between the stem and the host bone were filled and impacted with bone chips and morselized bone prior to stem insertion. One femoral implants were resected because of deep infection Subsidence was absent and stable fixation was achieved in all patients. Non-progressive radiolucent lines in zones 1 and 7 according to Gruen’s classification were detected in five cases. Cortical hypertrophy around the interlocking screws were seen in ten cases. No disadvantages or complications of the interlocking screws were observed. All the fractures have united within three to five months. Intraoperative fractures in the diaphyseal area occurred in five hips in which trochanteric osteotomy was used. A diaphyseal fixation of the femoral stem with distal interlocking screws appears to provide primary axial and rotational stability of the prosthesis and early mobilization. This implant may provide a satisfactory alternative for the management of revision hip surgery in the presence of a loose femoral component with massive bone loss. Longer-term follow-up data from this study will be needed to confirm these outcomes.
Aseptic loosening and osteolysis may cause significant periprosthetic femoral bone destruction, often necessitating bypass of the deficient proximal femur to obtain stable fixation in the distal diaphysis. The purpose of the present study was to report our results of femoral component revision using a distally locked revision femoral stem for the treatment of the severe proximal femoral bone loss. We evaluated 21 hips in 20 patients who underwent revision hip arthroplasty associated with Paprosky grade-IIIB or IV femoral deficiencies. Three hips were associated with a Vancouver type-B3 periprosthetic femoral fracture. The mean age at the time of revision was 70.8 (51–82) years old with 5 men and 15 women. The mean duration of follow-up was 5.1 years. The femoral implant used for the revision was the Cannulok Revision Prosthesis in 16 hips and the Huckstep interlocking stem in five. Gaps between the stem and the host bone were filled and impacted with bone chips and morselized bone prior to stem insertion. One femoral implants were resected because of deep infection Subsidence was absent and stable fixation was achieved in all patients. Non-progressive radiolucent lines in zones 1 and 7 according to Gruen’s classification were detected in five cases. Cortical hypertrophy around the interlocking screws were seen in ten cases. No disadvantages or complications of the interlocking screws were observed. All the fractures have united within three to five months. Intraoperative fractures in the diaphyseal area occurred in five hips in which trochanteric osteotomy was used. A diaphyseal fixation of the femoral stem with distal interlocking screws appears to provide primary axial and rotational stability of the prosthesis and early mobilization. This implant may provide a satisfactory alternative for the management of revision hip surgery in the presence of a loose femoral component with massive bone loss. Longer-term follow-up data from this study will be needed to confirm these outcomes.
