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1.
J Arthroplasty ; 32(6): 1980-1983, 2017 06.
Article in English | MEDLINE | ID: mdl-28237216

ABSTRACT

BACKGROUND: Patients with hip osteoarthritis often temporize their symptoms with multiple intra-articular steroid hip injections (IASHIs) before undergoing total hip arthroplasty (THA). Although there is recent evidence to suggest that IASHI can lead to an increased risk of future periprosthetic joint infection (PJI), the potential increase in risk of PJI after multiple IASHIs compared with single IASHI remains largely unknown. The aim of the study was to evaluate whether multiple IASHIs are associated with increased risk of PJI compared with single IASHI in THA patients. METHODS: We evaluated 2 cohorts of patients consisting of 106 patients who received 2 or more IASHI in the year before THA and a matched group of 350 patients who received one IASHI in the 12 months before THA. RESULTS: The single and multiply-injected patient cohorts had an infection rate of 2.0% and 6.6% (7/350 and 7/106), respectively (P = .04, odds ratio 3.30) and average follow-up of 28.9 and 24.2 months. The 2 cohorts did not differ with regard to age, gender, American Society of Anesthesiologist score, presence of diabetes mellitus, or body mass index. CONCLUSION: In comparison with patients with single IASHI, multiple IASHIs are associated with an increased risk of PJI significantly higher than the elevated risk reported with single injection before THA. The present study findings would be clinically useful in counseling patients who are considering temporizing their symptoms with multiple IASHIs before undergoing THA.


Subject(s)
Arthritis, Infectious/etiology , Arthroplasty, Replacement, Hip/adverse effects , Injections, Intra-Articular/adverse effects , Prosthesis-Related Infections/etiology , Steroids/administration & dosage , Aged , Female , Humans , Male , Middle Aged , Osteoarthritis, Hip/surgery , Retrospective Studies
2.
J Arthroplasty ; 31(1): 103-6, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26476469

ABSTRACT

Reduced posterior tibial slope (PTS) and posterior tibiofemoral translation (PTFT) in posterior cruciate-retaining (PCR) total knee arthroplasty (TKA) may result in suboptimal flexion. We evaluated the relationship between PTS, PTFT, and total knee flexion after PCR TKA in a cadaveric model. We performed a balanced PCR TKA using 9 transfemoral cadaver specimens and changed postoperative PTS in 1° increments. We measured maximal flexion and relative PTFT at maximal flexion. We determined significant changes in flexion and PTFT as a function of PTS. Findings showed an average increase in flexion of 2.3° and average PTFT increase of 1mm per degree of PTS increase when increasing PTS from 1° to 4° (P<.05). Small initial increases in PTS appear to significantly increase knee flexion and PTFT.


Subject(s)
Arthroplasty, Replacement, Knee/methods , Knee Joint/surgery , Tibia/anatomy & histology , Tibia/surgery , Aged , Biomechanical Phenomena , Cadaver , Female , Humans , Male , Movement , Muscle, Skeletal/physiology , Orthopedics/methods , Posterior Cruciate Ligament/surgery , Postoperative Period , Range of Motion, Articular
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