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  1. Article ; Online: Medial Meniscus Posterior Root Repair Reduces but Does Not Avoid Histologic Progression of Osteoarthritis: Randomized In Vivo Experimental Study in a Rabbit Model.

    Dzidzishvili, Lika / Calvo, Emilio / López-Torres, Irene Isabel

    The American journal of sports medicine

    2023  Volume 51, Issue 11, Page(s) 2964–2974

    Abstract: Background: The optimal treatment option for meniscus root tears is still challenging, and whether the meniscus root repair ultimately can arrest or delay osteoarthritic changes is still a concern.: Purpose/hypothesis: The purpose of this study was 2- ...

    Abstract Background: The optimal treatment option for meniscus root tears is still challenging, and whether the meniscus root repair ultimately can arrest or delay osteoarthritic changes is still a concern.
    Purpose/hypothesis: The purpose of this study was 2-fold: (1) to describe and compare histopathologic findings of 3 different therapeutic options for medial meniscus posterior root tear: nonoperative management, partial meniscectomy, and meniscus root repair; and (2) to test the hypothesis that meniscus root tears treated nonoperatively predispose to a lower risk of osteoarthritic progression compared with partial meniscectomy.
    Study design: Controlled laboratory study.
    Methods: Posteromedial meniscus root tears were carried out in 39 New Zealand White rabbits. Animals were randomly assigned into 3 experimental groups: partial meniscectomy after root tear (PM; n = 13), root tears treated conservatively (CT; n = 13), and transtibial root repair (RR; n = 13). Contralateral limbs were used as healthy controls. The animals were euthanized at 16 weeks postoperatively; tissue samples of femoral and tibial articular cartilage were collected and processed for macro- and microscopic assessment to detect signs of early osteoarthritis (OA). Each sample was histopathologically assessed using the Osteoarthritis Research Society International grading and staging system.
    Results: Osteoarthritic changes were the hallmark in all 3 experimental groups. The RR group had the lowest scores for cartilage damage (mean, 2.5; range, 2-3), and the PM group exhibited higher and more severe signs of OA (mean, 16; range, 9-16) compared with the CT group (mean, 5; range, 4-6). The between-group comparison revealed significant differences, as the PM group showed a significantly higher rate of macro- and microscopic osteoarthritic changes compared with the RR (
    Conclusion: Meniscus root repair cannot completely arrest the histopathologic progression of knee OA but leads to significantly less severe degenerative changes than partial meniscectomy and nonoperative treatment. Partial meniscectomy leads to the most severe osteoarthritic progression, while stable radial tears left in situ have lower progression compared with partial meniscectomy.
    Clinical relevance: Histologic assessment is an essential tool and metric for guiding and understanding osteoarthritic features, providing insight into the disease development and progression. This study provides histopathologic evidence on osteoarthritic progression after medial meniscus posterior root repair. This knowledge can help to set more realistic expectations and can lead to the future development of augmented techniques.
    MeSH term(s) Animals ; Rabbits ; Arthroplasty, Replacement, Knee ; Lacerations ; Meniscectomy ; Menisci, Tibial/surgery ; Osteoarthritis, Knee ; Tibia
    Language English
    Publishing date 2023-08-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 197482-8
    ISSN 1552-3365 ; 0363-5465
    ISSN (online) 1552-3365
    ISSN 0363-5465
    DOI 10.1177/03635465231188527
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  2. Article ; Online: High-resolution magnetic resonance imaging can predict osteoarthritic progression after medial meniscus posterior root injury: randomized in vivo experimental study in a rabbit model.

    Dzidzishvili, Lika / Fernández-Valle, Maria Encarnación / Moreno Molera, David / Calvo, Emilio / López-Torres, Irene Isabel

    Journal of ISAKOS : joint disorders & orthopaedic sports medicine

    2024  

    Abstract: Importance: The field of meniscal root preservation has undergone significant advancement over the past decades; however, the challenge remains to fully understand whether meniscal root repair can ultimately arrest or delay osteoarthritic changes.: ... ...

    Abstract Importance: The field of meniscal root preservation has undergone significant advancement over the past decades; however, the challenge remains to fully understand whether meniscal root repair can ultimately arrest or delay osteoarthritic changes.
    Objective: To assess longitudinal changes in articular cartilage, subchondral bone, and progression to meniscal extrusion (ME) using high-resolution magnetic resonance imaging (MRI).
    Methods: Medial meniscus posterior root tear was surgically induced in 39 New Zealand white rabbits. Animals were randomly assigned into three experimental groups: partial meniscectomy after root tear (PM, n ​= ​13); root tear left in situ (CT, n ​= ​13); and transtibial root repair (RR, n ​= ​13). Contralateral limbs were used as healthy controls. High resolution 4.7 Tesla MRI of the knee joint was performed at baseline, after 2-, and 4-months of post-surgery. Cartilage thickness was calculated in medial and lateral compartments. In addition, the evaluation of ME, subchondral bone edema and healing potential after root repair were assessed too.
    Results: Progressive cartilage thinning, ME, and subchondral bone edema were evident in all 3 study groups after 4-months of follow-up. The mean cartilage thickness in the PM group was 0.53 ​mm (±0.050), 0.57 ​mm (±0.05) in the CT group, and 0.60 ​mm (±0.08) in the RR group. The PM group exhibited significantly higher cartilage loss when compared to the CT and RR groups (p ​< ​0.001). Moreover, progressive ME and subchondral bone edema were associated with a more severe cartilage loss at the final follow-up.
    Conclusion: Meniscal root repair did not halt but rather reduced the progression of osteoarthritis (OA). Degenerative changes worsened at a rapid rate in the PM group compared to the RR and CT groups. Early cartilage swelling, persistent subchondral edema, and progressive ME predicted a more severe progression to knee OA in the CT and RR groups.
    Level of evidence: II.
    Language English
    Publishing date 2024-04-05
    Publishing country England
    Document type Journal Article
    ISSN 2059-7762
    ISSN (online) 2059-7762
    DOI 10.1016/j.jisako.2024.03.015
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  3. Article: Developing an experimental model of early knee osteoarthritis after medial meniscus posterior root release: an in vivo study.

    Dzidzishvili, Lika / López-Torres, Irene Isabel / Guerrero, Carlos Carnero / Calvo, Emilio

    Journal of experimental orthopaedics

    2022  Volume 9, Issue 1, Page(s) 66

    Abstract: Purpose: To develop a predictable and reproducible model of knee osteoarthritis after medial meniscus posterior root release.: Methods: Posteromedial meniscal root tears were created in 12 White New Zealand rabbit knees. The contralateral limbs were ... ...

    Abstract Purpose: To develop a predictable and reproducible model of knee osteoarthritis after medial meniscus posterior root release.
    Methods: Posteromedial meniscal root tears were created in 12 White New Zealand rabbit knees. The contralateral limbs were used as healthy controls. The animals were euthanized at 16 weeks postoperatively; tissue samples of femoral and tibial articular cartilage were collected and processed for macro and microscopic analyses to detect signs of early degeneration. Clinical evaluation of the weight-bearing status on the affected knee was conducted at 0-, 4-, 8-, and 16-weeks postoperatively.
    Results: Early and severe osteoarthritic changes were the hallmark and the main findings after 16-weeks post-surgery. Macroscopically, extensive osteoarthritic changes were observed across the femoral condyle and tibial plateau. Microscopic finding included ulcerations, fissures, fibrillations, pitting, and loss of the superficial layer. Cellularity was diminished, the normal pattern of distribution in columns was lost, and subchondral bone exposure was also evident.
    Conclusions: This study describes a novel model of knee osteoarthritis that may guide the development of tailored interventions to delay or prevent knee osteoarthritis. This knowledge could shift the current treatment paradigm toward more conservative and knee salvageable treatment options and increase surgeons' awareness of this injury pattern. Such considerations may have a positive impact on clinical decision-making and subsequent patient-reported clinical outcomes.
    Design: Controlled laboratory study.
    Level of evidence: II.
    Language English
    Publishing date 2022-07-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2780021-0
    ISSN 2197-1153
    ISSN 2197-1153
    DOI 10.1186/s40634-022-00501-y
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  4. Article: Prognostic Factors and Midterm Clinical Outcome of Transtibial Pullout and Partial Meniscectomy for Medial Meniscus Posterior Root Tears in Middle-Aged Patients.

    Dzidzishvili, Lika / López-Torres, Irene Isabel / Arguello, José Manuel / Sáez, David / Calvo, Emilio

    Indian journal of orthopaedics

    2022  Volume 56, Issue 8, Page(s) 1457–1463

    Abstract: Purpose: The purpose of this study was to compare clinical and radiological outcomes of transtibial pullout technique and partial meniscectomy, and to establish prognostic factors in middle-aged patients with mild knee osteoarthritis.: Methods: A ... ...

    Abstract Purpose: The purpose of this study was to compare clinical and radiological outcomes of transtibial pullout technique and partial meniscectomy, and to establish prognostic factors in middle-aged patients with mild knee osteoarthritis.
    Methods: A comparative case-control analysis was conducted. 65 patients between 40 and 60 years of age were included into two groups: 30 patients who underwent transtibial pullout technique (group 1) and 35 patients who underwent partial meniscectomy (group 2). Mean follow-up was set at 27.2 months. Primary clinical outcomes included Knee injury and Osteoarthritis Outcome Score and Lysholm Knee Questionnare. Preoperative MRI and intraoperative arthroscopic findings were recorded. The correlation between these findings and patient-reported subjective outcome were assessed.
    Results: The transtibial pullout group exhibited significantly greater improvement in clinical outcomes. A univariate model revealed that the presence of preoperative meniscal extrusion, body mass index (> 30), osteochondral defect, and female gender were predictors of poor clinical outcome. Multivariate regression analysis showed meniscal extrusion and osteochondral defect as significant prognostic factors for both study groups.
    Conclusion: Medial meniscus root repair leads to significantly improved clinical outcomes compared to partial meniscectomy in middle-aged patients with mild knee osteoarthritis. Presence of meniscal extrusion, osteochondral defect, BMI > 30, and female gender were deemed as predictors of poor postoperative patient-reported outcome.
    Level of evidence: III therapeutic case-control study.
    Language English
    Publishing date 2022-06-14
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 603194-8
    ISSN 0019-5413
    ISSN 0019-5413
    DOI 10.1007/s43465-022-00650-3
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  5. Article: A comparison of the transtibial pullout technique and all-inside meniscal repair in medial meniscus posterior root tear: Prognostic factors and midterm clinical outcomes.

    Dzidzishvili, Lika / López-Torres, Irene Isabel / Sáez, David / Arguello, José Manuel / Calvo, Emilio

    Journal of orthopaedics

    2021  Volume 26, Page(s) 130–134

    Abstract: Introduction: There is a paucity of comparative clinical data between arthroscopic all-inside end-to-end meniscal root suture and transtibial pullout technique in medial meniscus posterior root tears (MMPRT). Therefore, this study aimed to compare ... ...

    Abstract Introduction: There is a paucity of comparative clinical data between arthroscopic all-inside end-to-end meniscal root suture and transtibial pullout technique in medial meniscus posterior root tears (MMPRT). Therefore, this study aimed to compare treatment failure, mid-term clinical and radiological outcomes of all-inside meniscus root repair versus the transtibial pullout technique and to analyze prognostic factors of postoperative clinical and radiological outcomes.
    Material and methods: Forty-four patients were included in two therapeutic group: arthroscopic all-inside meniscal suture (MS: 13 knees) and transtibial pullout technique (TP: 31 knees).Primary clinical outcomes at a minimum of 27.2 months postoperatively included Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm Knee Questionnare (LKQ). Radiographic assessment of the knee was performed to determine osteoarthritis severity using the Kellgren-Lawrence (KL) grading system.In addition, pre and postoperative MRI scans and intraoperative arthroscopic findings were recorded and the correlations between these findings, as outcome predictors and postoperative patients reported subjective outcome were assessed.
    Results: No significant differences in postoperative KOOS and LKQ scores were found between the MS and TP group (p = 0.38 and 0.17, respectively).During follow-up one patients (7.7%) in the MS group and two (6.5%) in the TP group underwent total knee arthroplasty. The difference did not reach the statistical significance (p = 0.88).No differences were observed in postoperative MRI findings such as meniscal extrusion, osteochondral defect, chondromalacia patella, and bone morrow edema (p = 0.25, 0.97, 0.97, and 0.88, respectively).A univariate model revealed that the presence of postoperative meniscal extrusion; osteochondral defect; chondromalacia patella; increased BMI; age (>40 years) and longer time lapse between clinical onset to surgery (>6 months) were predictors of poor clinical outcome. The presence of meniscal extrusion, osteochondral defect and chondropatia patella portended worst postoperative outcomes in a multiple linear regression model.
    Conclusions: It can be concluded that both techniques can reach good results when performed properly and if the injury pattern allows meniscal suture may be considered a treatment option for the management of MMPRT in well-selected patients.Patients with increased BMI, preoperative meniscal extrusion, chondromalacia patella, and osteochondral defect were at higher risk of poor clinical outcomes.
    Language English
    Publishing date 2021-08-06
    Publishing country India
    Document type Journal Article
    ZDB-ID 2240839-3
    ISSN 0972-978X
    ISSN 0972-978X
    DOI 10.1016/j.jor.2021.08.001
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  6. Article ; Online: Improvement of surgical time and functional results after do-it-yourself 3D-printed model preoperative planning in acetabular defects Paprosky IIA-IIIB.

    Dos Santos-Vaquinhas, Alex / López-Torres, Irene Isabel / Matas-Diez, José Antonio / Calvo-Haro, José Antonio / Vaquero, Javier / Sanz-Ruiz, Pablo

    Orthopaedics & traumatology, surgery & research : OTSR

    2022  Volume 108, Issue 6, Page(s) 103277

    Abstract: Introduction: The correct positioning of the implant in revision total hip arthroplasty (rTHA) is critical to obtaining substantial functional outcomes, and to avoiding complications. Current literature supports three-dimensional (3D)-printed models as ... ...

    Abstract Introduction: The correct positioning of the implant in revision total hip arthroplasty (rTHA) is critical to obtaining substantial functional outcomes, and to avoiding complications. Current literature supports three-dimensional (3D)-printed models as potentially useful tools for preplanning, as well as the "do it yourself (DIY)" methodology to reduce both the time and costs of this procedure. However, no study has determined the efficacy of both methods combined in a cohort of patients with severe acetabular defects. In the lack of bibliography, we performed rTHA after preoperative planning by DIY-3D-printed models to evaluate its influence in: 1) the surgical time, 2) the functional scores, 3) the intra and postoperative complications, and 4) the reconstruction of the center of rotation (COR) of the hip.
    Hypothesis: Preoperative planning through 3D-DIY printed models will both improve the accuracy of the implant positioning, and the surgical time, leading the latter to improved functional scores and reduced complications.
    Materials & methods: A comparative study of 21 patients with Paprosky IIB to IIIB acetabular defects who underwent rTHA after 3D-printed model preoperative planning by the DIY method between 2016 and 2019 was conducted. A historical cohort of 24 patients served as the comparator. Surgical time, reconstruction of the COR, functional scores, and complications were analyzed.
    Results: The mean follow-up was 32.4 (range, 12 to 60) months. All the patients showed significant improvement of the Harris hip score (HHS) after the operation (3D group: 26.58±10.73; control group 22.47±15.43 (p=0.00)). In the 3D-printed model preoperative planning group the mean operation time and the intraoperative complications were significantly lower (156.15±43.03min vs 187.5±54.38min (p=0.045); and 19% vs 62.5% (p=0.003), respectively), and the HHS and patient satisfaction score (PSS) were significantly greater (83.74±8.49 vs 75.59±11.46 (p=0.019); and 8.17±0.88 vs 7.36±1.17 (p=0.023), respectively). No differences were found in the postoperative complications, nor in the restoration of the COR as determined from the acetabular index, verticalization or horizontalization, although the acetabular index was closer to the intended one in the 3D-printed model planning group (46.67°±7.63 vs 49.22±8.1 (p=0.284)).
    Conclusion: Preoperative planning of severe acetabular defects through 3D-printed models shortens the surgical time, leading to a decrease in complications and thus to better functional outcomes and greater patient satisfaction. Moreover, the DIY philosophy could decrease both the time and costs of traditional 3D planning.
    Level of evidence: III, retrospective case matched study.
    MeSH term(s) Acetabulum/surgery ; Arthroplasty, Replacement, Hip/methods ; Hip Prosthesis ; Humans ; Operative Time ; Postoperative Complications/surgery ; Printing, Three-Dimensional ; Reoperation ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2022-03-21
    Publishing country France
    Document type Journal Article
    ISSN 1877-0568
    ISSN (online) 1877-0568
    DOI 10.1016/j.otsr.2022.103277
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  7. Article ; Online: Is a greater degree of constraint really harmful? Clinical biomechanical comparative study between condylar constrained knee and rotating hinge prosthesis.

    León-Román, Víctor-Estuardo / García-Mato, David / López-Torres, Irene Isabel / Vaquero-Martín, Javier / Calvo-Haro, José Antonio / Pascau, Javier / Sanz-Ruíz, Pablo

    Clinical biomechanics (Bristol, Avon)

    2023  Volume 111, Page(s) 106149

    Abstract: Background: The real degree of constraint of rotating hinge knee and condylar constrained prostheses is a matter of discussion in revision knee arthroplasty. The objective of this study is to compare the tibial rotation between implants in the clinical ... ...

    Abstract Background: The real degree of constraint of rotating hinge knee and condylar constrained prostheses is a matter of discussion in revision knee arthroplasty. The objective of this study is to compare the tibial rotation between implants in the clinical settings.
    Methods: An investigator blinded experimental study was designed including 20 patients: in 10 of them a rotating hinge knee prosthesis (Endomodel®, LINK) was implanted and in the remaining 10 a constrained condylar knee prosthesis (LCCK®, Zimmer) was used. A medial parapatellar approach was performed and implantation was performed according to conventional surgical technique. Tibial rotation was measured with two accelerometers in full extension and at 30°, 60° and 90° of flexion. Pre and postoperative Knee Injury and Osteoarthritis Outcome Score was recorded.
    Findings: Both groups were homogenous in age (73.4 years in rotating hinge knee prosthesis vs 74 years in constrained condylar knee group), sex, laterality and preoperative Knee Injury and Osteoarthritis Outcome Score (p > 0.05). The postoperative Knee Injury and Osteoarthritis Outcome Score was significantly higher in the rotating hinge knee prosthesis group (80.98 vs 76.28). The degrees of tibial rotation measured by inertial sensors in the rotating hinge knee prosthesis group were also significantly higher than those measured in the constrained condylar knee group (5.66° vs 2.1°) with p = 0.001.
    Interpretation: Rotating hinge knee prosthesis appears to represent a lower rotational constraint degree than constrained condylar knee systems in clinical practice and it may increase the clinical satisfaction. The clinical significance: Rotating hinge knee prosthesis appears to represent a lower constraint degree than constrained condylar knee systems in clinical practice.
    MeSH term(s) Humans ; Aged ; Knee Prosthesis ; Prosthesis Design ; Knee Joint/surgery ; Osteoarthritis, Knee/surgery ; Reoperation ; Knee Injuries/surgery ; Treatment Outcome ; Prosthesis Failure ; Retrospective Studies
    Language English
    Publishing date 2023-11-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632747-3
    ISSN 1879-1271 ; 0268-0033
    ISSN (online) 1879-1271
    ISSN 0268-0033
    DOI 10.1016/j.clinbiomech.2023.106149
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  8. Article ; Online: The tale of microencapsulated rifampicin: is it useful for the treatment of periprosthetic joint infection?

    López-Torres, Irene Isabel / Vaquero-Martín, Javier / Torres-Suárez, Ana-Isabel / Navarro-García, Federico / Fraguas-Sánchez, Ana-Isabel / León-Román, Víctor Estuardo / Sanz-Ruíz, Pablo

    International orthopaedics

    2022  Volume 46, Issue 4, Page(s) 677–685

    Abstract: Purpose: Microencapsulation techniques have allowed the addition of rifampicin to bone cement, but its in vivo efficacy has not been proven. The aim of our study is to determine the superiority of cement containing gentamicin and rifampicin ... ...

    Abstract Purpose: Microencapsulation techniques have allowed the addition of rifampicin to bone cement, but its in vivo efficacy has not been proven. The aim of our study is to determine the superiority of cement containing gentamicin and rifampicin microcapsules in the treatment of PJI versus cement exclusively containing gentamicin.
    Methods: An S. aureus PJI was induced in 15 NZW rabbits. A week after inoculation, the first stage of replacement was carried out, and the animals were divided into two groups: group R received a spacer containing gentamicin and rifampicin microcapsules, and group C received a spacer containing gentamicin. Intra-articular release curve of rifampicin and infection and toxicity markers were monitored for four weeks post-operatively, when microbiological analysis was performed.
    Results: The microbiological cultures showed a significantly lower growth of S. aureus in soft tissue (2.3·10
    Conclusion: The in vivo analyses demonstrated the superiority of cement containing gentamicin and rifampicin microcapsules versus the isolated use of gentamicin in the treatment of PJI in the rabbit model without serious side effects due to the systemic absorption of rifampicin. Given the increasing incidence of staphylococci-related PJI, the development of new strategies for intra-articular administration of rifampicin for its treatment has a high clinical impact.
    MeSH term(s) Animals ; Anti-Bacterial Agents/therapeutic use ; Bone Cements/therapeutic use ; Humans ; Prosthesis-Related Infections/microbiology ; Rabbits ; Rifampin/therapeutic use ; Staphylococcus aureus
    Chemical Substances Anti-Bacterial Agents ; Bone Cements ; Rifampin (VJT6J7R4TR)
    Language English
    Publishing date 2022-01-06
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80384-4
    ISSN 1432-5195 ; 0341-2695
    ISSN (online) 1432-5195
    ISSN 0341-2695
    DOI 10.1007/s00264-021-05290-0
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  9. Article ; Online: Experimental reproduction of periprosthetic joint infection: Developing a representative animal model.

    López-Torres, Irene Isabel / Sanz-Ruíz, Pablo / Navarro-García, Federico / León-Román, Victor Estuardo / Vaquero-Martín, Javier

    The Knee

    2020  Volume 27, Issue 3, Page(s) 1106–1112

    Abstract: Background: Infection after arthroplasty (prosthetic joint infection; PJI) is a devastating complication that can lead to functional loss of the affected limb. The purpose of the present study is to develop an animal model of PJI using a three- ... ...

    Abstract Background: Infection after arthroplasty (prosthetic joint infection; PJI) is a devastating complication that can lead to functional loss of the affected limb. The purpose of the present study is to develop an animal model of PJI using a three-dimensional printed species-specific implant, which is a step forward for future research to develop new therapeutic strategies.
    Methods: Fifteen New Zealand White rabbits were employed to reproduce PJI by intra-articular inoculation of 10
    Results: All animals recovered from surgery and all displayed full weight-bearing four days postoperatively. Fourteen of the 15 tested animals (93.3%) presented positive microbiological cultures. A statistically significant increase was found in the number of platelets and leukocytes, as well as a significant decrease in the percentage of lymphocytes, with P = 0.0001 in all cases.
    Conclusions: An experimental model faithfully reproducing the periprosthetic infection environment and achieving a high rate of infection has been designed. The use of three-dimensional printed species-specific implants allows rapid postoperative recovery of animals and the development of a stable biofilm. These characteristics make it an interesting model to study its pathogenesis and possible therapeutic strategies.
    MeSH term(s) Animals ; Arthritis, Infectious/etiology ; Arthroplasty, Replacement/adverse effects ; Arthroplasty, Replacement/instrumentation ; Disease Models, Animal ; Joint Prosthesis/adverse effects ; Printing, Three-Dimensional ; Prosthesis-Related Infections/etiology ; Rabbits ; Staphylococcal Infections/etiology ; Tibia/surgery
    Language English
    Publishing date 2020-01-22
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1200476-5
    ISSN 1873-5800 ; 0968-0160
    ISSN (online) 1873-5800
    ISSN 0968-0160
    DOI 10.1016/j.knee.2019.12.012
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  10. Article ; Online: A new biarticular cement spacer technique for infected total hip and knee arthroplasty with massive bone loss.

    Sanz-Ruiz, Pablo / Matas-Diez, Jose Antonio / Villanueva-Martinez, Manuel / Carbo-Laso, Esther / Lopez-Torres, Irene Isabel / Vaquero-Martín, Javier

    Hip international : the journal of clinical and experimental research on hip pathology and therapy

    2019  Volume 31, Issue 2, Page(s) 242–249

    Abstract: Introduction: The management of massive femoral bone defects following prosthetic infection remains a surgical challenge, particularly when the entire femur is affected.: Methods: We present the first results of a new biarticular cement spacer with ... ...

    Abstract Introduction: The management of massive femoral bone defects following prosthetic infection remains a surgical challenge, particularly when the entire femur is affected.
    Methods: We present the first results of a new biarticular cement spacer with antibiotic technique using a cephalomedullary nail for the treatment of infected hip arthroplasty involving complete femoral bone loss.
    Results: 5 patients with a minimum follow-up of 1 year were included. In all cases 2-stage replacement due to hip periprosthetic infection was carried out, with the need for a biarticular complete femoral spacer in view of the magnitude of the bone defect. The infection was resolved in all patients, with no complications (spacer fracture or dislocation) associated to spacer use, and the patients were all able to maintain the sitting position with active knee movements between the 2 surgical stages. Improvement with respect to preoperative functional status was observed in all cases, as evidenced by the Harris Hip Score (HHS) (from 24.2 to 73;
    Discussion: The described technique offers a possible solution to a number of complications observed with the use of spacers in massive defects, affording greater patient comfort and autonomy while waiting to receive total femoral replacement.
    MeSH term(s) Anti-Bacterial Agents ; Arthritis, Infectious/surgery ; Arthroplasty, Replacement, Hip/adverse effects ; Arthroplasty, Replacement, Knee ; Bone Cements ; Humans ; Prosthesis-Related Infections/diagnosis ; Prosthesis-Related Infections/surgery ; Reoperation
    Chemical Substances Anti-Bacterial Agents ; Bone Cements
    Language English
    Publishing date 2019-11-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1162513-2
    ISSN 1724-6067 ; 1120-7000
    ISSN (online) 1724-6067
    ISSN 1120-7000
    DOI 10.1177/1120700019884557
    Database MEDical Literature Analysis and Retrieval System OnLINE

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