Septic arthritis caused by Staphylococcus caprae following arthroscopic meniscus tear repair in a patient without any foreign device / Artritis séptica causada por Staphylococcus caprae tras reparación artroscópica de menisco en paciente sin material protésico

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Anatomic shoulder replacement for primary osteoarthritis in patients over 80 years: outcome is as good as in younger patients.

BACKGROUND AND PURPOSE: Anatomic total shoulder arthroplasty (TSA) gives good outcome in the treatment of primary osteoarthritis, but it is not known whether this also applies to patients over 80 years old. PATIENTS AND METHODS: We retrospectively assessed outcome in patients over the age of 80 after anatomic TSA, performed for primary osteoarthritis with a preoperative intact rotator cuff (group O, n = 32). We compared it with outcome in a group of patients under the age of 70 (group Y, n = 32). Subjective outcome, Constant score, and radiological findings were analyzed. RESULTS: At a mean follow-up time of 7 years, there were no statistically significant differences between the groups. In group O, 24 patients were very satisfied and in group Y, 23 patients were very satisfied; the subjective shoulder value was 81% in both groups. Mean Constant score was 65 in group O and 67 in group Y. Moderate or severe radiological upper migration of the humeral head was detected in 1 patient in group O and in 3 patients in group Y. One patient in group Y was revised for glenoid loosening. INTERPRETATION: Good to excellent results can be expected after anatomic TSA in patients over the age of 80. Our findings suggest that they have similar results to those in patients around 70 years of age.

Alignment of the tibial component of the unicompartmental knee arthroplasty, assessed in the axial view by CT scan: does it influence the outcome?

BACKGROUND: The ideal position of the unicompartmental knee arthroplasty (UKA) in the axial plane remains undefined the medical literature. The aim of this study was to observe how tibial components are placed in the axial plane and identify whether this could influence the postoperative clinical outcome. METHODS: A retrospective transversal study of 101 UKA was performed in 88 patients by a single surgeon. Postoperative CT scans were performed at a mean follow-up period of 71 months (36 to 150), and clinical and functional outcomes were assessed by the WOMAC and the KSS scores. Patients were divided several times in two groups depending on a different WOMAC or KSS value each time, and differences in axial angulation were analyzed in every comparison. Distribution of data and influence on outcomes were also analyzed. RESULTS: The tibial component was positioned with a mean angulation of 11.9° (-1 to 32) of external rotation (ER). A lower angle of ER was observed in all comparisons in the groups with better outcomes. Differences between groups were statistically significant when a good result was defined as a WOMAC score lower than 10. CONCLUSIONS: Variability in axial positioning (33°) is higher than in other planes due to the free-hand technique. A trend towards better outcomes is observed when the tibial component is placed in a lower angle of ER. Rotational alignment in UKA should be investigated in subsequent studies with larger sample sizes. LEVEL OF EVIDENCE: Level III, retrospective comparative study.