Biological fixation of cementless femoral implants requires primary stability by optimal fit in the proximal femur. The anatomy of the bone must then be known precisely. We analysed in vitro the accuracy of bone measurements of 32 femurs and compared the dimensions obtained from radiographs and CT scans with the true anatomical dimensions. Standard radiographs gave only a rough approximation of femoral geometry (mean difference: 2.4 +/- 1.4 mm) insufficiently accurate to allow selection of the best fitting prosthesis from a range of sizes and altogether inadequate to design a custom-made prosthesis. CT scans give greater accuracy (mean difference: 0.8 +/- 0.7 mm) in our experimental conditions, but in clinical practice additional sources of error exist.

The French version of KOOS is a valid, reliable, and responsive instrument to capture specific aspects of functional disability affecting quality of life of knee OA patients.

No abstract

We examined the effectiveness and safety of the combination of rifampin plus ofloxacin given orally for treating prosthetic orthopedic implants infected with staphylococci. The prospective cohort study was conducted in a referral public hospital with ambulatory care services between 1985 and 1991. Consecutive patients from whom Staphylococcus organisms susceptible to the study drugs were isolated from their orthopedic implants and who had no contraindication to the treatment were eligible for the study. All patients were treated orally with rifampin, 900 mg/day, plus ofloxacin, 600 mg/day. Patients with hip prosthesis infection were treated for 6 months, with removal of any unstable prostheses after 5 months of treatment; patients with knee prosthesis infection were treated for 9 months, with removal of the prosthesis after 6 months of treatment; and patients with infected bone plates were treated for 6 months, with removal of the plate after Infection complicates 0.5 to 1% of hip prostheses (13,14) and 1 to 2% of knee prostheses (6, 13). Staphylococcus species are the cause of 45 to 55% of these infections (1, 7), regardless of the type of implant. The functional prognosis for these types of infections remains poor, despite long-term intravenous antibiotic therapy combined with a one-or two-stage replacement of the orthopedic implant. The availability of fluoroquinolones prompted physicians to propose treatment protocols that included those drugs as alternatives to conventional intravenous treatment. Encouraging preliminary data regarding these trials and data from animal models were published as the present study was being conducted (2). We report herein the results of a prospective study carried out by a single protocol that included rifampin and a fluoroquinolone. The present study included the largest series of Staphylococcus species-infected orthopedic implants that has been known to be treated.