Search

Outcome data beyond 11 years of follow-up is not available for the third-generation Zweymuller femoral stem in combination with a polyethylene bearing. We report ten to 15-year results with this total hip arthroplasty (THA) combination in a young population. A retrospective, observational, non-randomised, single-centre, clinical observational study was conducted in which 311 primary THAs were performed in 276 patients between 1996 and 2000 using a third-generation Zweymuller stem. The mean age of the patients at operation was 47.4 years (range 18–77 years). Stem survival for any reason was 93.5 % after ten years and 89.6 % after 13 years, and the probability of aseptic stem loosening was 98.7 % at both ten and 13 years. The occurrence of femoral radiolucent lines was low, at just 17.2 %. Minor femoral osteolysis was identified in 30 % of patients and was attributed to polyethylene liner wear. Clinical and patient satisfaction outcomes were in line with previous investigations, and the rate of adverse events was low. The third-generation Zweymuller stem shows good radiographic and clinical results and good longevity, including in the younger osteoarthritic patient. The use of low-wear bearings may further reduce the rate of osteolysis and wear-related revision in young and active patients.

Background. Musculoskeletal sepsis is a region of orthopaedic surgery focused on the diagnosis and treatment of infections involving the bones, joints, muscles, and skin. The objective of our study was to point out things that should be taken into account by physicians faced with probable musculoskeletal sepsis. Materials and methods. A retrospective study was carried out and included all of the orthopaedic patients with positive blood culture between January 1, 2009 and March 31, 2012 who were admitted to the Hospital of Traumatology and Orthopaedics. Results. In total, thirty five patients were hospitalized. Thirty one patients met the criteria for admission to the ICU. The median time spent in the ICU was 8 days with a range from 1 to 70. The source of infection was recognized in twenty five patients, it was not obvious for six patients. Moderate or severe septic shock developed in nineteen (61.3%) patients, twenty four (77.4%) required invasive monitoring, five PICCO monitoring, three of them required continuous haemodialysis. Overall mortality was 19.4% (six patients). 58.1% were artificially ventilated from 1 to 46 days. The main microbial culture was Staphylococcus aureus (45.2%), the second one was Clebsiella pneumoniae (12.9%), the third microbial cultures were Escherichia coli and Enterobacter cloacae (6.5%). More prevalent risk factors were diabetes mellitus, oncologic disease, ischemic heart disease and adipositas. Conclusions. Patients with a history of pain, swollen and tender joints, extremities or back with restriction of movement should be regarded as having septic inflammation until proven otherwise. We should always take into account orthopaedic sepsis if any other source is not obvious.