Posterior bone block for footdrop - A report of two cases

A posterior bone-block operation is one of the few treatment options in cases of paralytic footdrop. A case with a flail ankle and no bony deformity is ideal for this approach. Two cases of acquired flail ankle with equinus deformity were treated using a new modification of the bone-block technique that does not interfere with subtalar joint motion. A bone block harvested from the iliac crest was fixed at the posterior talus after partial resection of the posterior tubercle. The graft was in contact with the posterior malleolus of the tibia. Satisfactory correction was achieved, and both patients could walk without the use of external splints

The Evaluation of Protein C Activity and Some Inflammatory Markers in Synovia of Patients Undergoing Total Knee Arthroplasty

Objective: Total knee arthroplasty (TKA) is a major risk factor for thrombosis in patients over 40 years of age and this risk persists for several weeks after the surgery. Since inflammatory mechanisms affect coagulation and the natural anticoagulant system, we aimed to investigate protein C activities and inflammatory markers in patients undergoing TKA surgery

The results of monoblock stem with step-cut femoral shortening osteotomy for developmentally dislocated hips

Introduction: The main objective of this study was to evaluate the midterm results of cementless THA with the use of monoblock stems combined with step-cut femoral shortening derotational osteotomy for DDH

Comparison of microbiological results of superficial swab cultures vs deep tissue samples and aspiration fluids cultures in patients with chronic osteomyelitis and prosthetic joint infections

Prosthetic joint infections and chronic osteomyelitis are hard to treat infections, generally requiring surgical intervention with a high morbidity and financial cost. Besides surgical interventions, at least six-eight weeks of antibiotherapy is required. The cost of antibiotherapy, hospitalization and side effects which are requiring laboratory studies are high. The real etiologic agent is to be identified as much as possible, providing rational therapy. Rational therapy, even, can effect the type of surgical intervention. In this study, microbiologic results of superficial swabs were compared with the results of deep tissue cultures (tru-cut biopsy and/or curettage materials). A total of 107 patients, 58 women (54%) and 49 men (46%), were included. Of 107 patients, 54 (50.5%) had prosthetic joint infection and 53 (49.5%) had chronic osteomyelitis. While in 77 patients the etiologic agent was identified, it was not identified in one third of the cases. Of the agents identified, 59 (76%) were Gram-positive cocci, 19 (24%) were Gram-negative bacilli. Gram-positive cocci were identified in 32 (86.5%) cases of prosthetic joint infection, and in 27 (65.8%) cases of chronic osteomyelitis. 93.2% of Gram-positive cocci was staphylococci. In 66 patients (61.7%) there was a discordance between the culture results of superficial swabs and deep tissue/pus materials. In 37 (34.6%) patients, an agent was identified in deep tissue/pus material, but not in superficial swab cultures. In nine (8.4%) patients, no agent was identified in tissue/pus culture but identified in superficial swab culture. In 20 (18.7%) patients, different isolates were identified between the deep tissue/pus material and superficial swabs. In 41 (28.4%) patients, the results were in accordance. Of these, in 19 (17.8%) patients, the same agent was obtained. In 22 patients (20.6%), no isolate was identified in superficial swab nor deep tissue/pus cultures. As a result, superficial swab cultures are not in accordance with the deep tissue/pus cultures. It would not be wise to direct the treatment via only superficial swab cultures

The cementless fibre mesh coated anatomic femoral stem: 12 to 23 years clinical and radiological outcome study

Introduction: The aim of this study was to assess the long-term clinical and radiographic results, and possible reasons for failure of two versions of the cementless fibre-metal coated anatomical femoral component

Midterm results of the cylindrical fully porous-coated uncemented femoral stem in revision patients with Paprosky I-IIIA femoral defects

Introduction: The aim of this study was to analyze the survival of the Echelon (R) femoral stems in revision hip surgeries in patients with Paprosky I-IIIA femoral defects. Patients and methods: Sixty-six patients (70 hips) who underwent revision hip surgery with at least 3 years of follow-up data were included in the study between 2000 and 2013. The mean patient age was 64.5 (32-83) years, and the mean follow-up period was 93 (45-206) months. The reasons for revision were aseptic loosening in 55 (78.6%) patients, periprosthetic joint infection in 9 (12.9%) patients, periprosthetic fracture in 4 (5.7%) patients, and stem fracture in 2 (2.9%) patients. The preoperative and postoperative follow-up X-rays and functional scores were evaluated. Results: Five patients died in an average of 70 (45-86) months after surgery due to non-related diseases. We encountered sciatic nerve palsy in two patients and early hip dislocation in two patients, whereas 54 patients were able to walk without any assistive device. The remaining 12 patients required an assistive device to walk. The mean Harris hip score significantly increased from 34 (7-63) preoperatively to 72 (43-96) postoperatively. Aseptic loosening was observed in one patient. The survival of the porous-coated anatomical uncemented femoral stem was 98.4% over 10 years. Conclusion: This study showed that good clinical outcomes and survival can be obtained when using porous-coated anatomical uncemented femoral stems