The Journal of arthroplasty
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The purpose of this study was to evaluate the eventual publication rates of poster presentations at the annual meetings of the American Association of Hip and Knee Surgeons from 1996 to 2001 (47%). Common belief expects poster presentations to publish at a lower rate than podium presentations, the latter being typically believed to consist of studies of higher scientific value. ⋯ Comparisons from an earlier report confirmed our analysis. Also, poster studies that did survive the peer review process were found in a wide array of journals and were found to publish within a relatively short amount of time (mean, 23.6 +/- 15.7 months).
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This study reports the results and early failures using the Graft Augmentation Prosthesis ring in the reconstruction of acetabular defects encountered during total hip arthroplasty. Seventeen consecutive Graft Augmentation Prosthesis rings were used during 7 complex primary and 10 revision hip arthroplasties. Five patients died during the follow-up period. ⋯ Five cases were revised because of fatigue failure of the implant associated with allograft resorption. Two cases were revised for recurrent dislocations. Because of this high mechanical failure rate (5 of 12 cases at only 5 years follow-up), we have abandoned this device in favor of implants with more mechanical strength.
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Case Reports
Insufficiency fracture in the medial wall of the acetabulum after total hip arthroplasty.
Insufficiency fracture following total hip arthroplasty (THA) frequently occurs in the superior and inferior pubic ramus, the puboischial rami, or the ischium around the obturator foramen, while it rarely occurs in the medial wall of the acetabulum. Here, we report three cases showing insufficiency fracture in the medial wall of the acetabulum following THA. In our three cases, two fractures resulted from the development of bone fragility due to osteolysis at the prosthesis site, and the convergence of mechanical stress on the acetabular load bearing point due to loosening of the cup. We consider it appropriate to describe these fractures as another entity of stress fracture, namely, osteolytic fracture, rather than either pathologic fracture or insufficiency fracture.
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The aim of this investigation was to analyze the midterm results obtained with the metaphyseal fixation principle of the thrust plate prosthesis (TPP). Survival of 214 implants in 204 patients was analyzed. Clinical (Harris hip score) and radiologic examinations were carried out on 157 of 190 TPP with a postimplantation follow-up period of at least 5 years. ⋯ Eleven TPPs showed radiolucent lines not indicating prosthetic loosening. Thrust plate prosthesis is not an alternative to stemmed endoprostheses. It may be rarely indicated in very young patients where, because of their age, several revision operations can be expected.
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Some wound complications can be prevented with attention to patient, surgical, and postoperative factors; others develop despite all efforts. Some practices that affect wound healing, such as the use of drains and methods of thromboprophylaxis are contentious. Superficial wound problems must always be discriminated from deep infection, which is not the focus of this article. ⋯ As there is little morbidity from early irrigation and debridement of problem total knee arthroplasties (Weiss AP, Krackow KA. Persistent wound drainage after primary total knee arthroplasty. J Arthroplasty. 1993;8(3):285-9), early intervention is generally preferred.