Notes

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Community use of reamers will cause variations in depth of penetration and increased temperatures at a clinically generated force vs new reamers. When community reamers were forced to the same depths the new reamers achieved, a significantly greater amount of heat was generated, and an increased amount of time was needed, both of which are known risk factors for osteonecrosis.
Community use of reamers will cause variations in depth of penetration and increased temperatures at a clinically generated force vs new reamers. When community reamers were forced to the same depths the new reamers achieved, a significantly greater amount of heat was generated, and an increased amount of time was needed, both of which are known risk factors for osteonecrosis.
Total hip arthroplasty (THA) is one of the most successful procedures in orthopedic surgery. The most frequent THA indications are osteoarthritis and avascular necrosis, whereas symptomatic aseptic loosening is the most common indication to revision surgery. Chondrosarcoma (CS) is the most frequent bone sarcoma in adults, and proximal femur is the most prevalent location. Wide resection is the treatment of choice.We report 3 cases of unrecognized high-grade CS in the setting of primary or revision THA and reviewed the literature on this rare clinical presentation.

A systematic literature review on CS in the setting of THA, published between 1980 and 2020, was performed on PubMed, Embase, Medline, Ovid SP, and Web of Science, using the guidelines set in the Preferred Reporting Items for Systematic Reviews and Mata-analyses (PRISMA).

Case series Three patients were referred to our sarcoma center after failure of THA due to unrecognized high-grade CS. All 3 had rapid fatal outcome. Literature review Fifty-may lead to poor or even fatal outcome.
Managing severe periarticular bone loss poses a major challenge in complex primary and revision total knee arthroplasty (TKA). Impaction bone graft, structural allografts, metal augments, and mega prosthesis are some of the methods used to address major bone loss. I-BET151 datasheet Tantalum metal (TM) Cones (Zimmer, Warsaw, IN) were introduced as an alternative to address this cohort of patients. The advantages of these cones include excellent biocompatibility, high porosity with osteoconductive potential, and a modulus of elasticity between cortical and cancellous bone. In addition, it is bioactive and offers an intrinsically high friction fit.

A cohort of 62 patients with severe distal femoral and proximal tibial bone loss were operated for primary and revision TKA between January 2007 and December 2014 and followed up for a mean period of 108.5 months (range 60-156 months). Preoperative and postoperative range of motion and Knee Society score were documented. Postoperatively long leg X-rays were performed at each follow-up visit to determine osteointegration, evidence of loosening, and migration.

The range of motion and Knee Society score improved considerably from preoperative a value of 63.9 ± 13.9° and 52 ± 14.9 to 102.1 ± 9.9° and 76.1 ± 10.03, respectively, at the final follow-up visit in the primary cohort and 52.14 ± 13.3° and 38.1 ± 9.1 to 92 ± 8° and 68.5 ± 4.3, respectively, in the revision cohort. Serial radiographs demonstrated complete osteointegration of the TM cones at the final follow-up.

Our study demonstrates excellent midterm survivorship of TM cones with predictable osteointegration and good outcomes (clinical and radiological) in treatment of severe femoral and tibial metaphyseal bone defects in complex primary and revision TKAs.
Our study demonstrates excellent midterm survivorship of TM cones with predictable osteointegration and good outcomes (clinical and radiological) in treatment of severe femoral and tibial metaphyseal bone defects in complex primary and revision TKAs.
Prosthetic joint infection (PJI) of total hip (THA) or total knee arthroplasty (TKA) after dental procedures is uncommon, and antibiotic prophylaxis remains controversial. For high-risk patients, the American Academy of Orthopedic Surgeons recommends amoxicillin prophylaxis. However, no systematic review of the literature of PJIs associated with dental procedures explores if amoxicillin is suitable for the reported organisms.

A librarian-assisted search of the major databases (PubMed, Medline, Embase, Scopus) identified 954 articles. Only case reports, case series, and reviews with patient level data were included. After exclusions, 79 articles were fully reviewed.

Forty-four PJIs after dental procedures were identified, 22 in primary THA, 20 in primary TKA, one in revision THA, and one in a hip resurfacing procedure. Antibiotic prophylaxis was documented for 5 patients. The dental procedure was invasive in 35 (79.5%). Comorbidities were present in 17 patients (38.7%). The organisms reported were
. intients. Insufficient data exist to recommend the optimal treatment for patients with PJI in THA and TKA associated with dental procedures.
Failure of cementless acetabular osseointegration is rare in total hip arthroplasty. Nevertheless, new fixation surfaces continue to be introduced. Novel implants may lack large diameter, constrained bearings, or dual mobility (DM) bearings to address instability. We compared clinical and radiographic outcomes for acetabular components with differing fixation surfaces and bearing options, focusing on the relationship between fixation surface and osseointegration and the relationship between bearing options and dislocation rate.

We retrospectively reviewed 463 total hip arthroplasties implanted with 3 different acetabular components between 2012 and 2016. Records were reviewed for demographics, clinical scores, and complications. Radiographs were examined for evidence of acetabular osteointegration. Analysis of variance and chi-square tests were used to compare cohorts.

All cohorts had 100% survivorship free of acetabular fixation failure with no differences in clinical scores. Dislocation occurred in 1.d" acetabular components without options for large diameter, constrained bearings, or DM bearings, even when enabling technology makes component positioning reliable.
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