Complex Acetabular Prosthetic Revisions. Comparison of modern materials in treatment strategies

The increasing number of total hip arthroplasty (THA) operations has inevitably led to an increase in the number of revisions for aseptic, septic or traumatic mobilization. The surgical treatment of these lesions is a demanding challenge for the surgeon: the primary objective is a stable osterexesis of the fracture that allows an early mobilization of the patient, therefore a careful evaluation of the materials to be implanted is also necessary. The aim of our study is to demonstrate the usefulness and limitations of new revision surgery technologies in cotiprosteal fractures. We enrolled 54 patients who underwent hip acetabular revision. The criteria chosen for the evaluation of outcomes: the visual analogue scale of pain in the traumatized hip (VAS); the subjective score of the Harris HIP Score; quality of life measured with The Short Form (12) Health Survey (SF-12); the average time of cup integration and complications. The evaluation endpoint was set at 24 months. The results, assessed with the aforementioned parameters, were on average good. Complications are the same as those described in the literature. The advantages of the new generation of acetabular components are: excellent integration and ductility of materials during revision of hip arthroplasty

Interprosthetic and interimplant femoral fractures: is bone strut allograft augmentation with ORIF a validity alternative solution in elderly?

Background Nowadays orthopedic surgeons have a new challenge to treat the interimplants fractures. Although fixation strategies exist for periprosthetic hip and knee fractures, there is no standard of care regarding the more complex interprosthetic and interimplants fractures. Objective The aim of our study is targeting the focus on the bone strut grafting to avoid the metal hardware failure and to achieve the bone healing in these injuries. Methods A prospective case note review of all interprosthetic or interimplants femoral fractures admitted to our trauma center. There were 11 patients (2 males and 9 females) with a mean age over 85 years old. We treated all the patients by ORIF and medial graft strut allograft to reduce the main complication leading to re-operations and morbidity or mortality is the nonunion or delayed union. The criteria to evaluate the patients during the follow-up were: the survival and complication after the surgery; the objective quality of life measured by Activities of Daily Living Score (ADL). The bone healing was measured by X-rays control as the alignment was measured by radiographic UNION SCORE, and postoperative complications. Results All the patients reduced their ADL. In the most of cases we had a good x-rays reduction. We had not: No nonunion or Not delayed union. All patients died within 2 years from the surgery but not due by surgical complications. Conclusions According us, the purpose of this surgery is to limit comorbidities and early mortality not to improve optimal restoration of lower limb function