One hundred forty-nine medial prostheses were implanted in 140 patients between 1988 and 1996. After a mean of 67 months 28 patients had died, without the need for revision. Seventeen prostheses were lost to follow-up. Revision surgery using a total knee prosthesis was performed in 16 cases. In four others, a lateral prosthesis was implanted subsequently to a medial one. One of these four was revised to a total knee prosthesis 6 years later. In another four cases, late complications of the meniscal bearing were treated with replacement of this bearing. The surviving prostheses were seen back after a mean of 126 months. The cumulative survival rate at 10 years was 82% for the whole population and 84% when knees with a previous high tibial osteotomy were excluded. Since these results compare poorly to the survival of total knee arthroplasty, this prosthesis is not the first-choice implant. Because it preserves a maximum of bone stock and is revised to a total prosthesis almost without difficulty, it is the first-choice implant for medial unicompartmental osteoarthritis in patients younger than 65. Further research is mandatory to confirm that this prosthesis very rarely needs revision in patients older than 75. It should not be used in osteotomized knees.

Introduction: Bone implant related infection is still one of the biggest challenges in bone and joint surgery. Antibiotic impregnated bone grafts seem to be promising in both treatment and prevention of these infections. However, great variance in methodology predominates this field of research. This paper gives an overview of the published literature.Methods: The PRISMA-flowchart was used as protocol for article selection. Medline was searched and articles were selected in accordance with predetermined exclusion criteria.Results: Forty-eight articles were included in the synthesis. Topics including bone graft type, manipulations of the graft, elution profile, bacterial inhibition, osteotoxicity, incorporation, special impregnation methods, clinical use and storage were investigated.Therapeutically, high initial levels seem appropriate for biofilm eradication. A single stage procedure in the treatment of bone implant related infection seems feasible. Prophylactically, the literature indicates a reduction of postoperative infections when using antibiotic impregnated bone grafts.Conclusion: Bone grafts are a suitable carrier for local antibiotic application both therapeutically and prophylactically.

No abstract

TURP is a widespread urologic procedure that is performed by many urologists. This report describes a rare complication that causes serious morbidity because it is not recognized in time. This is also the first report of a prostatosymphyseal fistula treated without major surgery. Eventually diagnosis is made by a MRI 5 months after surgery. Decompressive surgery was necessary to treat pubic osteïtis with invalidating pain. Culture results revealed Escherichia coli but eventually the diagnosis was made by fistulography. Treatment consisted of bladder drainage and long-term antibiotic treatment and these could eventually heal the fistula.

No abstract