No abstract

HighlightsRemoval of a stable all-polyethylene cemented line in revision hip arthroplasty can cause bone fractures, excessive bleeding, as well as extended bone loss, namely in osteoporotic bone.One of the priorities of the surgeon must be the preservation of the remaining bone stock, and the reimplantation of a new acetabular prosthesis with no technical difficulties and risks.The surgical procedure described here contributes to this objective.

A major concern during revision hip arthroplasty is acetabular bone loss and bleeding during the extraction of well-fixed cementless acetabular cup, because no interface exists between the host bone and the cup. Forceful removal of such component using curved gouges and osteotomes often leads to extended bone loss and compromises reimplantation of a new socket.In the following case report, we removed a well-fixed polyethylene titanium-coated RM acetabular cup with 20 years of follow-up, by significant wear of the polyethylene layer. The isoelastic femoral stem was also removed by mechanical failure.We report a technique for removal of the cementless acetabular cup using powered acetabular reamers. The RM cup was sequentially reamed and when the polyethylene layer was thin enough, the remaining cup was removed easily by hand tools. The acetabular bone stock is preserved and the risks of bone fractures and bleeding are minimized. To our knowledge, these principles were applied only in cemented cups.We have used this technique in 10 cases with excellent results and no complications were noted. This is a simple, reproducible, non-costly, non-timing consuming, safe and successful technique to remove well-fixed titanium-coated RM acetabular cups.

We have investigated the effect of premilling elemental powders of Fe and Cu on the mixture mechanism of a Fe 50 Cu 50 alloy. The alloying process was compared and studied using electron probe microanalysis, X-ray diffraction, scanning electron microscopy and Mössbauer spectroscopy. In both processing routes (with and without premilling), a broad distribution of different local environments of the iron atoms was observed in the Mössbauer spectra of the fcc-FeCu phase. Mössbauer spectra show further that a fcc non magnetic Fe-rich phase is formed transiently besides the bcc-Fe phase. The reactions are slowed down when premilled powders are used as starting powders but similar fcc solid solutions are formed after 16 h and 32h in our milling conditions when as-received and premilled powders are used respectively as starting powders.

Bilateral patellar tendon rupture is a rare entity, often associated with systemic diseases and patellar tendinopathy. The authors report a rare case of a 34-year-old man with simultaneous bilateral rupture of the patellar tendon caused by minor trauma. The patient is a retired basketball player with no past complaints of chronic knee pain and a history of steroid use. Surgical management consisted in primary end-to-end tendon repair protected temporarily with cerclage wiring, followed by a short immobilization period and intensive rehabilitation program. Five months after surgery, the patient was able to fully participate in sport activities.