Two-stage revision for treatment of periprosthetic infection following hip arthroplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy and optimal re-implantation time of two-stage revision for management of periprosthetic infection following hip arthroplasty.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 15 patients (15 hip joints) undergoing two-stage ipsilateral total hip arthroplasty (THA) revision from January, 2006 to January, 2010. In the first stage, after surgical debridement and thorough removal of all the implants, a self-made Vancomycin-loaded cement spacer was implanted. The second stage operation was performed 3-6 months later for debridement and removal of the antibiotic-loaded spacer, followed by re-implantation of Vancomycin-loaded bone cement prosthesis in 9 cases and cementless prosthesis in 6 cases. The patients were followed up for 9-46 months (mean 25 months) after the operation.</p><p><b>RESULTS</b>No reinfection or prosthesis loosening/displacement was found in these cases after the operation. The Harris score increased from 40.3 before the operation to 54.0 after the first-stage operation, and to 88.2 at the last follow-up.</p><p><b>CONCLUSION</b>Two-stage revision is effective for treatment of periprosthetic infection following hip arthroplasty, and 3-6 months can be the optimal interval between the two the first-stage and second-stage operation for re-implantation.</p>

Factors related to anterior knee pain after total knee arthroplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the incidence rate of anterior knee pain after total knee arthroplasty (TKA) and identify the related factors.</p><p><b>METHODS</b>This prospective, double-blind clinical trial involved a total of 128 patients scheduled for primary ipsilateral cemented three-component TKA for osteoarthrosis. The patients were randomized into two groups to receive operations for TKA with patellar resurfacing (experimental group) or not (control). The incidence of anterior knee pain was observed in these patients and the factor affecting the occurrence of anterior knee pain and knee was analyzed.</p><p><b>RESULTS</b>The patients were followed up for a mean of 16.5 months (range 6~24 months). The incidence rate of anterior knee pain was 10.9% (7/64) in the experimental group, showing no significant difference from the rate of 14.1% (9/64) in the control group. But the 52 patients with varus or valgus knee showed a significantly higher incidence rate of anterior knee pain (21.2%, 11/52).</p><p><b>CONCLUSION</b>TKA with patellar resurfacing can not decrease the incidence of anterior knee pain, and varus or valgus before the operation is associated with a higher risk of anterior knee pain.</p>

Application of arthroscope-assisted surgical technique in treating knee or knee peripheral fractures / 中华创伤杂志

Objective To evaluate the effectiveness of arthroscope-assisted surgical technique in treating knee fractures and knee peripheral fractures.Methods From September 2000 to December 2005,there were 46 cases with knee or knee peripheral fractures,in whom artbroseope-assisted surgical technique was performed in 36 cases including 24 males and 12 females,with mean age of 30.5 years (18-52 years).Of 36 cases,26 cases with patella fractures were treated by internal fixation of tension band using cancellous bone screws,four with distal end femoral fractures by retrograde interlocking using intramedullary nail and six with fractures of tibial plateau and tibial condyle crista by internal fixation u- sing cancellous bone screws.Results The mean hospitalization was eight days.A follow up for 3-36 months(average 14 months)in 36 cases showed fracture healing.Of 36 cases,32 cases regained full knee range of motion,four left with terminal flexion,with mean loss of 15?,and had thigh circumference (10 cm above knee)1.1 cm(range 0.6-2.0 cm)shorter than health side and two had slight pain in the knee joint.Lysholm knee joint function score was 86.5+7.6 for patellar fractures,tibial plateau frac- tures and condylar crista fractures.Conclusion As for knee or knee peripheral fractures,arthroscope- assisted surgical technique can provide fine monitoring,decrease trauma and complications,fixate inter- nally and help early ground exercise.