Osteochondroma of mandibular ramus and condylar neck: simultaneous resection and reconstruccion with personalized alloplastic joint prosthesis / Osteocondroma de la rama mandibular y cuello del cóndilo: resección y reconstrucción simultánea con prótesis articular personalizada aloplástica

Osteochondromas are benign osteogenic tumors that can attain great size, which may require resection and additional treatment to restore the jaw's shape and function. In this report, an osteochondroma located on the mandibular ramus and neck of the condyle was resected and reconstructed simultaneously through a total joint replacement. After the surgery, the patient remains asymptomatic and recovers opening and closing ranges, phonation and the masticatory function. The immediate reconstruction after resection is a good alternative to avoid a second operation and the presurgical virtual planning ensures the complete removal of the lesion using cutting guides and covering the entire defect with a customized alloplastic joint prosthesis.

Los osteocondromas son tumores osteogénicos benignos que pueden alcanzar grandes tamaños, los cuales requieren de resección quirúrgica y generalmente de algún tratamiento adicional para restaurar la forma y la función mandibular. En este caso, un osteocondroma localizado en la rama mandibular y el cuello del cóndilo fue reseccionado y reconstruido simultáneamente a través de un reemplazo articular total. Después de la cirugía, el paciente permanece asintomático y recupera los intervalos de apertura y cierre, la fonación y la función masticatoria. La reconstrucción inmediata después de la resección es una buena alternativa para evitar una segunda operación, y la planificación virtual prequirúrgica garantiza la eliminación completa de la lesión utilizando guías de corte y cubriendo todo el defecto con una prótesis articular aloplástica personalizada.

Advancements in temporomandibular joint total joint replacements (TMJR)

The goal of this paper is to review the advantages and disadvantages of the various treatment options of temporomandibular joint (TMJ) total joint replacement (TJR). TMJ articles published within the last 20 years were reviewed to collect the information on non-invasive and invasive TMD treatment methods. Recent technological advancements helped the evolution of treatment methods and offered significant value to TMD patients and surgeons. Considering the TMD levels, the therapeutic procedures can involve general health examiniations, physical therapy, medication, oral rehabilation or as an end stage clinical invention, temporomandibular joint replacement. In fact when intra-articular TMD is present, the effective treatment method appears to be TJR. However, concern for infection, material hypersensitivity, device longevity and screws loosening issues still exists. Further combined research utilizing the knowledge and expertise of, surgeons, material scientists, and bioengineers is needed for the development of improved TMD therapeutic treatment.

Protocol for Administration of Prophylactic Antibiotics within One Hour before the Surgical Incision in Total Hip and Knee Replacement / 대한정형외과학회잡지

PURPOSE: We aimed that compliance could be improved by new protocol ensuring the adequate timing of intravenous antibiotic delivery onto an already existing time out system used to ensure exact surgical site. MATERIALS AND METHODS: A group of 150 patients was administered prophylactic antibiotics just before entering operation room and performed only time-out protocol. Other group of 150 patients was administered prophylactic antibiotics directly after anesthetic induction and perfomed new protocol inclusive of checklist ensuring appropriate timing of antimicrobial prophylaxis. We compared mean time from prophylactic administration to surgical incision and compliance. RESULTS: The average time from administration of the antimicrobial prophylaxis to the surgical incision for patients who was performed only time-out protocol was 43 minutes and compliance was 60.6%. The average time from administration of the antimicrobial prophylaxis to the surgical incision for patients who was performed new protocol was 18 minutes and compliance was 100%. There was a significant difference in compliance of two groups. CONCLUSION: New protocol ensuring the adequate timing of intravenous antibiotic delivery combined with administration of the antimicrobial prophylaxis directly after anesthetic induction were effective and easily adaptable method to ensure compliance with appropriate timing of prophylactic antibiotics.

Risk Factor and Prevention of Wound Infection after Total Joint Replacement / 中华医院感染学杂志

OBJECTIVE To analyze the reason of wound infection after total joint replacement and to present the prophylactic management measures.METHODS Totally 632 total joint replacements in 587 patients between Jul 2002 and Jun 2005 were retrospectively reviewed.There were 445 cases with total hip replacements and 187 cases with total knee replacements.The specimens for bacterial culture were taken from the hands of the surgical staffs,the medical devices and the air flow in the operation theater monthly.RESULTS In this series,5 cases developed wound infections,with 2 cases of total hip replacement and 3 cases of total knee replacement,where 4 cases with deep infections and one case with superficial infection.The total infection rate was 0.79%(5/632).In the 5(infection) cases,there were 2 cases having the same bacterial culture as the air culture.CONCLUSIONS(Improvement) of the management in the operation theater,check of the laminar air flow device regularly,sufficient drainage and prevention of other medical iatrogenic infections are crucial for prevention of the infection after total joint replacement.