Search

Acute dislocation of the patella is a very common injury of the knee. In more than 90% of the cases the medial patellofemoral ligament (MPFL) is injured. Reconstruction of the MPFL has become a popular soft tissue procedure, which reduces hospitalization and the rehabilitation period. Bioabsorbable materials, in form of screws and anchors are ideal for soft fixation to bones in orthopedics. We would like to present our experience and short-term results after MPFL reconstruction with semitendinous autograft and bioabsorbable fixation devices. 10 patients were involved in this study with PF joint instability, who underwent to MPFL reconstruction. In order to evaluate the functional outcome of the procedure we applied the Tegner Lysholm scoring system before and after 3 Months of surgery. MPFL reconstruction significantly improved the functionality of the PF joint. Gender distribution of the studied group was: 7 female with an average age of 25 5,03 SD and 3 male patients with an average age of 29 1 SD. The key for the success in MPFL reconstruction is the positioning of the femoral tunnel, followed by an isometric tensioning of the graft. Bioabsorbable materials reduce inflammatory, and foreign body response facilitating biointegration of the autograft.

Hallux valgus represents an acquired foot deformity characterized by lateral deviation of the hallux and medial deviation of the first metatarsal. Pain during gait is the main complain and is caused by reduction of plantar pressure under the first ray leading to insufficiency of the first ray and overload of the lesser rays. Treatment can be nonoperative or surgical with more than one hundred surgical techniques described so far. The scope of this study was to assess the short term reliability and stability of fixed loop suspension systems used for surgical treatment of this pathology using radiological evaluation of hallux valgus angle and the intermetatarsal angle. Our results show good stability of the reduction and good reliability of the suspension system, with a six months follow-up. Only one specific complication (failure of the wiring material) is highlighted by our conclusions and the need for biomechanical testing in controlled laboratory studies.

Bone cement has been used for over half a century, to successfully anchor artificial joints. From its emergence there have appeared a number of types of bone cement, with the 2 major classes being bone cement with or without active substances. The one with the added antibiotics is used primarily in the treatment and revision surgery of infected total hip arthroplasty (THA), as well as a prophylactic method in primary THA in patients with high risks for this complication. The purpose of this study is to determine the mechanical properties of bone cement with added antibiotics. Over a period of 2 years, a number of 41 cases were chosen for this study: 25 with revision surgery for THA, where bone cement with antibiotics was used, and 16 with primary THA, where regular bone cement was used. A number of studies have been performed on the mechanical properties of the 2 types of cement, which determined that the cement with antibiotics presents a slightly lower compressive strength, tensile strength, elastic modulus and fatigue strength compared with regular cement. These variations, however, become more pronounced as the quantity of the antibiotic goes up. The mechanical properties of the cement with antibiotics are similar with those of the regular cement, when low doses of antibiotics are used and become more evident as the doses go up. In conclusion, the antibiotic bone cement is a trustworthy tool in the surgeon’s arsenal against infection, with minimal detriments from the mechanical view.

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

Introduction. Implant-associated infections in orthopedics represent a major challenge for diagnosis and treatment. Sonication is an alternative method for the diagnosis in prosthetic infections, with a higher sensitivity compared to the conventional periprosthetic cultures. Our aim was to compare the results of conventional culturing and sonication process in per prosthetic joint infections. Material and method. We followed up in a period of 7 years (2007-2014) patients who underwent to total joint arthroplasty, and fracture fixation with internal fixation in the University Emergency Hospital of Bucharest. Conventional and sonication fluid culturing was performed in order to compare the results of it. In 3 cases the cultures after sonication was negative in 9 cases Methicilin resistant (MR) staphylococcus was isolated. Sonication Results Our study involved 34 patients with an average age of 63.08 ±10.65SD. In 3 cases the cultures after sonication was negative in 9 cases Methicilin resistant (MR) staphylococcus was isolated, in 1 case Serratia Marcescens and another case with Staphylococcus Warmei. Discussion Our study underlines the importance of the etiological diagnosis with the application of sonication Coclusions The sonication technique is simple and can be performed in the most of microbiological laboratories. Sonication has the benefit of the etiological diagnosis either in mono-microbial and poli-microbial implant-associated infections, with a higher sensitivity than standard culturing.