The development of a model for in vitro testing of femoral stems in impaction bone grafting.

Comprehension of the biomechanical behaviour of orthopaedic implants is essential. This paper describes the development of an in vitro model to investigate the behaviour of femoral implants in the revision setting. The development of a femoral model and a bone graft substitute is described. The properties of human, bovine, ovine morselized bone graft, and a graft substitute were compared. On measuring hoop strain after impaction bone grafting there was no significant difference between the ovine bone graft and graft substitute with the size 1 Exeter stem. The results suggest that this bone graft substitute is a viable alternative for in vitro testing. The authors recommend the use of the graft substitute and the femoral model to predict femoral stem biomechanics.

Extracting the tip of a fractured DHS wire from the hip joint.

Dynamic Hip Screw fixation is a very commonly performed operation, but one not without complications (1-3). To stabilise the fixation the guide wire can be advanced into the subchondral bone. An unusual complication of this, and one not previously documented in the literature, is that the tip of the guide wire can fracture. We describe a simple method of removing the tip of the guide wire.

Bacterial contamination of surgical gloves by water droplets spilt after scrubbing.

Wound infection and deep sepsis can have disastrous consequences, particularly in orthopaedic surgery. Strict protocols, ultra-clean air, prophylactic antibiotics, and impervious gowns and drapes, have all been shown to diminish wound infection. However it remains a common and significant problem. The water droplets spilt from the surgeons hands after meticulous scrubbing with povidone iodine were cultured. The permeability of the surgical glove packaging to Gram-positive bacteria was also investigated. The water droplets from the surgeon's arms contained environmental and potentially pathogenic bacteria including a micrococcus, a coliform and coagulase-negative staphylococci. The paper packaging for the range of sterile surgical gloves tested was discovered to be permeable to Gram-positive bacteria. In conclusion accidental water droplet contamination of surgical gloves is a potential source of infection. Alternative recommendations are made.