Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 2011
Risk factors for revision of hip arthroplasties in patients younger than 30 years.
Numerous reports of THAs in patients younger than 30 years indicate a high risk of revision. Although risk factors for revision have been reported for older patients, it is unclear whether these risk factors are the same as those for patients younger than 30 years. ⋯ Level III, therapeutic study, case control study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Durable infection control and function with the PROSTALAC spacer in two-stage revision for infected knee arthroplasty.
A two-stage revision total knee arthroplasty is recognized as the gold standard in the treatment of infection. However, traditional spacers limit function in the interval between the two stages and may cause instability, scarring, and bone erosion. The PROSTALAC knee spacer is an antibiotic-loaded cement articulating spacer that allows some movement of the knee between stages. Whether motion enhances long-term function is unknown. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Intraoperative molds to create an articulating spacer for the infected knee arthroplasty.
Chronic infections in TKA have been traditionally treated with a two-stage protocol incorporating a temporary antibiotic-loaded cement spacer. The use of a static as opposed to an articulating spacer is controversial. Some surgeons believe a static spacer results in a higher rate of infection eradication, whereas others believe an articulating spacer provides equivalent rates of infection control with improved function between stages and the potential for better eventual range of motion. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Is intraoperative CT of posterior cervical spine instrumentation cost-effective and does it reduce complications?
Symptomatic multilevel cervical myelopathy is often addressed using posterior decompression using two-dimensional fluoroscopy. Intraoperative three-dimensional fluoroscopy provides more accurate information on the position of instrumentation to prevent screw-related complications. ⋯ Level III, economic and decision analyses. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Apr 2011
Two-stage total hip arthroplasty: how often does it control methicillin-resistant infection?
Methicillin-resistant hip infections are increasingly common. Reports of the surgical management of these patients using two-stage THA show variable control of infection, but all reports used static spacers. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.