Fracture of two successive Ring TiMESH cemented hip prostheses.

We report the unfortunate case of a man who experienced stem failures of both his primary and revision hip arthroplasties. As far as we are aware this is the only reported case of a patient to suffer the misfortune of multiple femoral implant failures.

Is epidural anaesthesia acceptable at total hip arthroplasty? A study of the rates of urinary catheterisation.

Epidural anaesthesia, with and without opiate, is widely used in total hip arthroplasty (THA). It may cause urinary retention, leading to catheterisation, and a subsequent increase in the likelihood of deep infection. We investigated prospectively the rate of urinary catheterisation in patients after THA performed under general anaesthesia, with or without peri-operative fentanyl and bupivacaine opiate epidural anaesthesia. Of 173 patients, 75 received general anaesthesia alone and 98 both general and epidural management. The post-operative rate of catheterisation was 14.7% in those who received general anaesthesia alone and 13.3% in those who received both. Our findings suggest that the rate of post-operative urinary catheterisation does not increase when general anaesthesia is supplemented by epidural anaesthesia using fentanyl and bupivicaine.