This study is reporting the long term clinical and radiographic results of a group of 45 patients who underwent total hip arthroplasty following acetabular fractures. The study included 39 males and 6 females. The age of the patients ranged from 32 to 61 with a mean of 46.4 years. The indication for surgery was secondary osteoarthritis in 35 patients and avascular necrosis of the femoral head in the remaining ten. The follow up period ranged from 7 to 15 years with a median of 10.3 years. Uncemented total hip prostheses were used in 37 cases while 8 cases had hybrid prostheses with cemented cups and uncemented stems. Thirty patients (66.7%) needed autogenous acetabular bone grafting. There has been a statistically significant improvement from a preoperative mean Oxford hip score of 16 to a postoperative mean score of 39.8 (p < 0.001). At the end of follow up, two cases had revision for cup loosening. The complications included one case of transient sciatic nerve palsy, and two cases of heterotopic ossification. Currently, total hip replacement remains the best option for end stage post traumatic arthritis. There are technical challenges associated with this replacement surgery which the surgeon should be aware of.

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Background:The use of computer navigation in total knee replacements represents one of its most important applications in orthopaedics. It can be used either with conventional or minimally invasive techniques to improve accuracy when positioning prosthetic components. Many studies, however, have associated computer navigation with increased operative time compared with the conventional methods, which makes many surgeons reluctant to use this technique. Methods:Presented is a proposed method to reduce the operative time when using computer navigation in total knee arthroplasty. Results:Total surgical time was reduced from a mean of 86.5 min to 57.7 min. The number of bony cuts and repetition were significantly reduced. No statistically significant difference was noted in the mean preoperative and the mean 2-year postoperative Oxford Knee Scores between the first 10 navigated knee replacement cases and the last 11 cases. Conclusions:The proposed method is effective, reproducible, and reduces operative time of computer navigated knee replacement. FIGURE 4. (A) Battery operated cutting saw with an extramedullary tibial guide for the tibial cut. (B) Prismatic saw blade on the left compared with the regular one on the right.