Open Access This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited. DOI 10.3109/17453674.2013.814013 Sir—I have read the Acta article: Retaining well-fixed cementless stem in the treatment of infected hip arthroplasty” by Lee et al. (2...

BACKGROUND AND PURPOSE Two-stage reconstruction, reimplantation after removal of an infected prosthesis, has been considered to be the gold standard for treatment of infected hip arthroplasty. However, during the removal of a well-fixed femoral stem, the proximal femur can be damaged and a sequestrum can be formed, which might lead to chronic osteomyelitis and difficulty in reimplantation. We w...

Introduction : When treating periprosthetic joint infection with a two-stage procedure, antibiotic-impregnated spacers can be used in the interval between prosthetic removal and reimplantation. In our experience, cultures of sonicated spacers are most often negative. The objective of the study was to assess whether that sonication causes an elution of antibiotics, leading to elevated antibiotic...

We report an 85-year-old woman with dementia and dependent for normal life activities who was admitted due to a left periprosthetic tibial fracture. The tibial component was replaced by one with a long stem and she was discharged. Four weeks after the intervention the patient was re-admitted due to an acute prosthetic joint infection. All the components were removed and a bone-cement spacer wit...

Infection following total knee arthroplasty can be difficult to diagnose and treat. Diagnosis is multifactorial and relies on the clinical picture, radiographs, bone scans, serologic tests, synovial fluid examination, intra-operative culture and histology. Newer techniques including ultrasonication and molecular diagnostic studies are playing an expanded role. Two-stage exchange arthroplasty wi...

Many concepts have been devised for the treatment of late periprosthetic infections of total hip prostheses. A two-stage revision with a temporary antibiotic-impregnated cement spacer and a cemented prosthesis appears to be the most preferred procedure although, in recent times, there seems to be a trend towards cementless implants and a shorter period of antibiotic treatment. Because of the di...

Total femur arthroplasty procedures have previously been used after tumor excision and as a last resort for failed revision arthroplasty. The patient in this case presented with massive loss of femoral bone stock, a periprosthetic fracture, and recurrent Staphylococcus epidermidis infection. A specially designed total femoral spacer impregnated with antibiotics was created for a 2-stage revisio...

BACKGROUND AND PURPOSE Interspinous spacers are implanted to treat symptomatic lumbar stenosis. Posterior vertebral element fractures can occur during or after interspinous spacer implants, especially in patients with osteopenia. The purpose of our study was to assess the biomechanical rationale, safety, feasibility, and effectiveness of posterior vertebral arch cement augmentation (spinoplasty...

Multiple total knee arthroplasty (TKA) failure resulting from a recurrent infection is a challenging problem. Knee arthrodesis is one treatment option that normally involves the application of an external fixator, plate fixation, and intramedullary nailing. However, these approaches are not always successful, and a reinfection is a risk, particularly in older, medically compromised patients. Th...

BACKGROUND Deep infections are devastating complications of TKA often treated with component explantation, intravenous antibiotics, and antibiotic-impregnated cement spacers. Historically, the spacers have been static, which may limit patients' ROM and ability to walk. Several recent reports describe dynamic spacers, which may allow for improved ROM and make later reimplantation easier. However...