[Show abstract][Hide abstract] ABSTRACT: Pseudotumors associated with total hip arthroplasty have been associated with metal-on-metal and metal-on-polyethylene total hip arthroplasties due to a granulomatous foreign-body reaction to methyl methacrylate, polyethylene, or metal ion release, but they have not been related to prosthetic joint infections. In this paper, we report an unusual case of
total hip arthroplasty infection, causing a large inflammatory pseudotumor of the hip joint. Fungal periprosthetic joint infections are a rare clinical entity and difficult to diagnose, and a pseudotumor may be part of their clinical presentation. They should be suspected in immunodeficient host patients when clinical symptoms of prosthetic joint infections are observed.
[Show abstract][Hide abstract] ABSTRACT: The application of modular femoral stems is constantly increasing in revision hip surgery. From March 2001 to March 2006, we employed the Profemur R modular stem in 35 cases of femoral component revision (31 first revisions and 4 re-revisions). The reasons for revision surgery included aseptic loosening in 17 cases, periprosthetic femoral fracture in 8 cases, stem fracture in 3 cases, septic loosening in 2 cases and recurrent dislocation in 1 case. According to the Merle d'Aubugne-Postel score clinical results were very good in 11 cases, good in 9 cases, medium in 5 cases, fair in 4 cases and poor in 4 cases. The main complications included 2 intraoperative diaphyseal fractures treated with multiple cerclage wires and 2 early infections treated with debridement and prolonged antibiotic therapy. One fracture healed in association with temporary wound discharge, and the other resulted in non-union with a femoral varus deformity. This required revision with internal fixation (LCP plate) at 3 months, with a successful result. In one case of stem subsidence femoral revision with a larger Profemur R implant was required. In our retrospective study the Profemur R modular stem has been an effective prosthetic system for femoral reconstruction in case of loosening with Paprosky grade III bone loss and following periprosthetic femoral fractures.
Hip international: the journal of clinical and experimental research on hip pathology and therapy 02/2011; 21(1):39-42. DOI:10.5301/HIP.2011.6272 · 0.76 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Knee arthrodesis was a common procedure before development of prosthetic replacement surgery. At present the most important
indication for this intervention is septic failure of knee prosthesis. Several techniques can be used and each procedure may
offer advantages and disadvantages which have to be analyzed before surgery according to the patient. Intramedullary nailing
and external fixation are the most common techniques used for knee arthrodesis and both procedures show favorable results
in most patients. Persistent infection and incomplete bone fusion are the main complications of knee arthrodesis. Because
of residual functional impairment, all the candidates to knee arthrodesis should be informed about the results expected after
the operation and possible alternative methods of treatment.
LO SCALPELLO-OTODI Educational 12/2009; 23(3):204-209. DOI:10.1007/s11639-009-0047-5