The purpose of this study, which involved 276 patients, was to report the importance of Propionibacterium acnes in shoulder infections. The proportion of patients with shoulder infection who had infection due to P. acnes was significantly greater than the proportion of patients with lower limb infection who had infection due to P. acnes (9 of 16 patients vs. 1 of 233 patients; P < .001). This bacterium requires a prolonged incubation period and should not be considered to be a contaminant.
In this study, we describe 13 patients with prosthetic infections due to Finegoldia magna (2% of our tested series). Patients presented with either polymicrobial infection after an open fracture or nosocomial infection after recent prosthesis implantation. Molecular techniques are critical for diagnosis, and recommended antibiotic prophylaxis has poor activity against F. magna.
Purpose Our goal was to evaluate the five-year follow-up results of the Scorpio single radius total knee arthroplasty. Method We performed a retrospective study based upon a multicentre database to evaluate the minimum five-year follow-up clinical and radiological results of 747 patients (831 knees) who underwent primary Scorpio single radius total knee arthroplasty. Results The mean age of the patients was 71.9 years. At a minimal five-year follow-up, 141 patients were lost to follow-up, 83 patients had died, eight patients had undergone revision of a component, and the remaining 589 patients (602 knees) had a complete clinical and radiological evaluation after a median of six years (range, 5-8). The mean clinical component of the knee score was 92.2 points, and the mean functional component of the knee score was 76.9 points. At last follow-up, 530 of the 602 knees were rated as excellent or good. Only four knees developed patellar complications requiring revision. The survival rate at six years was 95.2%±1.9% and 98.3%±0.6 with revision for any reason and revision for mechanical failure as the end point, respectively. Conclusion This medium-term study indicates favourable clinical and radiological results for this single flexionextension radius design arthroplasty, with a low complication rate on the patellar side.
Ilizarov's method of external fixation with compression or distraction for lesions of the limbs demonstrates new possibilities in osteogenesis. Its performance with double horizontal pinning on several external rings calls for precautions to avoid lesions of the vessels, nerves and joints. This study, based on anatomic sections radiographed after opacification of the arterial system, makes it possible to propose rules for insertion of the pins. Insertion of the anteromedial pins of the thigh should be made 2 cm in front of the line of projection of the femoral artery, between the middle of the inguinal ligament and the posterior margin of the medial condyle. Insertion of the posterolateral thigh pins should be made 2 cm lateral to the line of projection of the sciatic nerve, between the center of the ischiotrochanteric interval, the apex of the popliteal fossa and the posterior aspect of the head of the fibula.
Ilizarov's method of implanting an external circular fixator requires the placement of at least 8 transfixion pins. The neurovascular hazards and the need to leave the posterior and lateral compartments free motivated this study, based on serial radiographic sections after injection of the entire arterial system. Two reference pin-planes were determined, 1 posterolateral and 1 lateromedial. The sites of insertion of the pins rely on classical radiographs of the bones of the leg. The addition of beaded pins must be made on a realigned and stabilized limb. The imprecision of aim due to the bone structure and the shape of the pin leads to the definition of forbidden zones where any transfixion is dangerous. The concept of a neurovascular pyramid with its base at the distal metaphysis and of a periosseous tendinous circlet at that level implies a search for a compromise between the stability of the assembly and the dangers of the method.
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