ABSTRACT
In 1984 and 1985, 352 hips were randomly assigned to total hip arthroplasty with either low- or high-viscosity cement at 5 Swedish orthopedic departments. Of the 267 hips finally included in the study, 226 were examined clinically and radiographically after 54-77 months. Radiographically, 21 definite stem loosenings and 1 probable stem loosening were observed (10 percent) and 4 additional stems had been exchanged before the 5-year examination. In the survivorship analysis, 261 stem prostheses were included and using this method, 7 percent were radiographically loose after 5 years. There were 4 definitely loose and 8 probably loose acetabular cups. No difference was found between cement of high and low viscosity with regard to prosthetic fixation.
Subject(s)
Bone Cements , Hip Joint , Aged , Aged, 80 and over , Female , Follow-Up Studies , Hip Joint/diagnostic imaging , Humans , Male , Middle Aged , Prospective Studies , Prosthesis Failure , Radiography , Random AllocationABSTRACT
One hundred two of 110 infected hip arthroplasties revised with the protection of gentamicin-loaded cement were followed for a minimum of two years. In 77 of 102 hips the infection healed after one revision operation and in five of eight hips after a second revision operation, representing a final healing rate of 80%. No significant difference in healing rate could be demonstrated with regard to individual bacterial species. However, in infections with a mixed flora, the healing rate was only 27% (p less than .01). After an average of six years, 33 of 82 healed hips had signs of roentgenographic loosening, nine of which had been revised. The modified Merle d'Aubigne and Postel score averaged 5.3 for pain, 3.7 for walking ability, and 4.0 for range of motion (ROM) in patients with healed infections.
Subject(s)
Hip Prosthesis , Surgical Wound Infection/surgery , Adult , Aged , Aged, 80 and over , Bone Cements/therapeutic use , Female , Follow-Up Studies , Gentamicins/therapeutic use , Humans , Male , Middle Aged , Prosthesis Failure , Reoperation , Time Factors , Wound HealingABSTRACT
Fifty cases of chronic osteomyelitis, associated with septic arthritis in five cases, were treated with radical surgery, systemic antibiotics, and insertion of gentamicin-PMMA beads. Seven cases were lost to follow-up. The remaining 43 cases were followed up for an average of 14 months. All but four cases healed.
