ABSTRACT
BACKGROUND AND AIM OF THE WORK: The KineSpring System is an alternative treatment offered in selected symptomatic patients suffering from mild to moderate medial knee osteoarthritis (OA). This device reduces medial compartment loads in the OA knee without compromising the integrity of the lateral or patellofemoral knee compartments, maintaining the normal knee anatomy. Currently, papers about KineSpring System installation show promising results. The current authors describe a case of unicompartmental knee arthroplasty (UKA) employed to treat medial knee OA after Kinespring system failure. METHODS: A 64-year old male patient presented to our hospital after failure of a Kinespring system implantation into his left knee at an external hospital, where the outcomes obtained were not satisfactory. The surgical options discussed with the patient were the TKA or medial UKA. A medial UKA was preferred by the patient. RESULTS: One year from UKA, the patient complained of frequent joint effusions and weight bearing pain despite a good ROM without radiographic signs of implant loosening. Therefore, after two years we replaced UKA with total knee arthroplasty (TKA). CONCLUSIONS: Further experience is needed to provide reliable clinical data about the results of the UKA after KineSpring System discharge.
Subject(s)
Arthroplasty, Replacement, Knee/adverse effects , Arthroplasty, Replacement, Knee/instrumentation , Knee Prosthesis , Osteoarthritis, Knee/surgery , Prosthesis Failure/adverse effects , Reoperation , Humans , Male , Middle Aged , Osteoarthritis, Knee/diagnostic imagingABSTRACT
BACKGROUND AND AIM OF THE WORK: Cuff tear arthropathy (CTA) is a well-defined degenerative pathology of the shoulder. When conservative treatments are unable to permit a good quality of life, the reverse shoulder arthroplasty (RSA) can guarantee a good restitution of range of motion, function and strength of the shoulder without pain. In this paper we show our clinical, functional and radiological outcomes, as well as complications of RSA in patients with CTA. METHODS: We analyzed 31 patients who underwent to reverse shoulder replacement with Modular Shoulder System (SMR, Systema Multiplana Randelli; Lima-LTO, San Daniele del Friuli, Italy) reverse shoulder system, between August 2010-July 2014. RESULTS: A significant improvement in ROM and functional scores (Constant Shoulder Score and UCLA score) were observed in our cases series. At the time of follow-up pain relief was detected in 28 patients and 3 patients declared mild pain. Overall, 90.3% of patients rated their satisfaction as good or excellent. Although complications occur in a high percentage of patients in literature, no postoperative complications was observed in our cases series. CONCLUSIONS: Our results showed how reverse shoulder arthroplasty is a real solution to improve quality of life, to restore pain-free ROM, function and strength of the shoulder in patients where cuff tear arthropathy occurs.
Subject(s)
Arthroplasty, Replacement, Shoulder/methods , Rotator Cuff Injuries/surgery , Aged , Aged, 80 and over , Arthroplasty, Replacement, Shoulder/adverse effects , Female , Humans , Male , Middle Aged , Range of Motion, Articular , Retrospective Studies , Rotator Cuff Injuries/physiopathologyABSTRACT
BACKGROUND AND AIM OF THE WORK: Periprosthetic knee infection is a rare complication associated with prosthetic failure; incidence change from 0,4-2% of primary total knee replacement and 5.6% in revisions. Indications for debridment, antibiotics and implant retention (DAIR) are early acute infections or acute delayed infection. Aim of the work is to check if this technique is still a successful in early infections. METHODS: We have analyzed recent literature data on DAIR and all DAIR procedures in our clinic in the last 10 years, the mean time between onset of symptoms and surgery, the mean antibiotic therapy duration and results we have obtained. We evaluate the diagnostic process and different treatments in early knee periprosthetic infections, especially the DAIR approach. RESULTS: If correct indications are followed, DAIR has a success rate in 31-100% of the cases; if it is applied in late chronic infection the success rate is 28-62%. In our experience DAIR has an 80% success rate: in 20 patients treated with DAIR we had 4 failures. CONCLUSIONS: DAIR can be considered a successful treatment, but it depends from individual patient factors, from the microorganisms involved, from the duration of antibiotic therapy and from correct choice in timing and in execution of DAIR by the orthopedic surgeon.
