The patient-reported outcomes after resection of a symptomatic Morton's neuroma are acceptable but may not be as good as earlier studies suggest. Surgery at several sites can be undertaken safely but caution should be exercised when considering revision surgery. Cite this article: Bone Joint J 2016;98-B:1376-81.
For citation purposes: Clement ND, Burnett R, Breusch SJ. Should single-or two-stage revision surgery be used for the management of an infected total knee replacement? A critical review of the literature. OA Orthopaedics 2013 May 01;1(1):2.
The results of this survey demonstrated that, in comparison to 1998, the current state of cemented THA, in particular cementing technique has significantly improved. Future emphasis should be on continued surgeon education and training, as the operative, i. e., cementing techniques are of utmost importance for long-term success.
Cement restrictors play an integral part in modern cementing technique in total hip arthroplasty. By sealing the femoral cavity, distal cement leakage is prevented and the intramedullary pressure is increased. Thus both the ability of the cement to interdigitate with bone and secondarily the shear strength of the cement bone interface are enhanced. For this purpose various plug models are available, which differ in design and material. Six different cement restrictors were investigated in a biomechanical model with regard to intramedullary implantation pressure, insertion force and in particular stability and sealing ability. We performed a pressure and stability measurement in artificial saw bones during the insertion and standardised cement application and pressurisation. The REX Cement Stop, which is the only intramedullary expandable cement restrictor, yielded the best results in all of the parameters investigated. The flexible gelatin plugs (Biostop G, IMSET, Plugin Tech) also reached a sufficient canal occlusion and stability, but with slightly higher insertion pressures and forces. However, the more rigid polyethylene restrictors (BUCK, Universal Cement Restrictor) showed a reduced stability and poor sealing ability. The latter devices cannot be recommended for use with modern cementing techniques.
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