The Journal of arthroplasty
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Recent literature has shown debonding of the tibial implant-cement interface as a potential cause for implant loosening. The purpose of this case series is to report this phenomenon in a historically well-performing implant when used with high-viscosity cement (HVC). ⋯ Given our institution's experience and previously reported data demonstrating excellent survivorship with this total knee arthroplasty prosthesis, we propose that the early failures seen in this case series may be associated with the use of HVC cement. In the setting of a negative infectious work-up and no radiographic evidence to suggest loosening, the surgeon should consider debonding of the tibial component as a potential cause for persistent pain if HVC cement was used with this prosthetic design.
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Osteonecrosis of femoral head is a serious relentlessly progressive and disabling complication in 20%-50% of sickle cell patients, majority of whom are in their second to third decades. High perioperative medical complications and short survivorship have historically discouraged arthroplasty surgeons in offering total hip arthroplasty to sickle cell patients in their 30s for the fear of inevitable technically demanding revision. In this retrospective study, the primary objective was to assess the impact of early intervention on quality of life (QOL) at midterm follow-up of mean 7.5 years using uncemented porous-coated total hip arthroplasty. The secondary objective of this study was the survival of the prostheses within the same follow-up period and discussion of surgical challenges faced in this cohort of patients. ⋯ We recommend early hip arthroplasty in sickle cell patients, if the hip has reached a stage of irreversible damage and patient's lifestyle is severely compromised to minimize chronic suffering and disability.