Early Results of a Modular Cementless Tibial Component for Total Knee Arthroplasty

Cementless components in TKA have been used for almost 3 decades, despite mixed success rates. However, biologic fixation remains attractive, especially for younger patients, because of the potential of unlimited durability. This paper is the first to report results on a modular tibial base plate using trabecular metal as a fixation surface. Twenty-four primary TKAs were evaluated clinical and radiographically at mean 1.9 year followup. Excellent clinical results were obtained. There was no significant subsidence or change in orientation of any component. One component was probably loose radiographically but was insufficiently symptomatic to warrant revision. Five components showed nonprogressive radiolucent lines. One reoperation was performed for stiffness, at which time the components were well fixed. Thus, it would appear that excellent bony fixation can be achieved with a modular cementless tibial component with excellent short-term clinical results

Pyogenic spinal infections warrant a total spine MRI.

Study design: retrospective case series. Objective: the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal spinal infections is significantly higher compared to unifocal infections. The purpose of the current study was to analyse the risk factors for multifocal spinal infections. Methods: we conducted a retrospective review of all pyogenic non-tuberculous spinal infections treated surgically at a single tertiary care medical center from 2006-2020. The medical records, imaging studies, and laboratory data of 43 patients during this time period were reviewed and analysed after receiving Institutional Review Board approval. Univariate and multivariate analyses were performed to identify factors associated with a multifocal spinal infection. Results: 15 patients (35 %) had multifocal infections. In univariate analysis, there was a significant association with chronic kidney disease ( p = 0.040 ), gender ( p = 0.003 ), a white blood cell count ( p = 0.011 ), and cervical ( p < 0.001 ) or thoracic ( p < 0 .001) involvement. In multivariate analysis, both cervical and thoracic involvement remained statistically significant ( p = 0.001 and p < 0.001 , respectively). Conclusions: patients with infections in the thoracic or cervical region are more likely to have a multifocal infection. Multifocal pyogenic spinal infections remain a common entity and a total spine MRI should be performed to aid in prompt diagnosis