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Abstract: When facing a Vancouver B2 periprosthetic fracture, the most recommended treatment is the prosthesis replacement. Current tests do not provide enough reliability to identify whether the fracture has been produced on a septic or an aseptic loosened prosthesis. Our aim was to evaluate the usefulness of the histology for the diagnosis of infection in these cases. A total of 11 hip revision procedures were performed (mean age: 78.1years, 8 women and 3 men). Sensitivity, specificity, positive predictive value and negative predictive value of the histology were 100%, 55.5%, 33.3% and 100% respectively. Of the six patients presenting with a positive histology, four of them had negative cultures (66.6% of false positives). Our results suggest that periprosthetic fractures are a cause of false-positive histology results for the diagnosis of infection during revision of a hip prosthesis for the treatment of Vancouver B2 periprosthetic fractures. [Copyright &y& Elsevier]

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The objective of our study is to evaluate our preliminary results after changing from a 2-stage revision arthroplasty protocol to a 1-stage revision arthroplasty protocol using cementless arthroplasty for all patients with chronic infected hip replacements.Methods: Prospective study of all hip arthroplasties that were diagnosed with chronic infection and were treated using the 1-stage revision without taking into account the traditional criteria used to determine the use of a 1-stage revision was conducted. There were 2 main variables evaluated: infection control and costs. The definitive diagnosis of infection of the revision was determined using the criteria proposed by the Musculoskeletal Infection Society. The costs were calculated using average cost in USD, excluding social expenses, as described by Klouche (2010) for 1-stage or 2-stage revisions.Results: Nineteen patients were included in the study and the infection was controlled in 18 patients. The total economic savings for our hospital for these 19 patients was 391.609 USD.Conclusion: This clinical success has led to an important change in our hospital in treating chronic infected hip replacements and an important cost reduction from an economic point of view. [ABSTRACT FROM AUTHOR]

Antibiotic-loaded cement spacers are used in two- stage hip replacement. The aim of our study was to compare our results using a Spacer-G with previous results reported in the literature. From June 2002 to April 2010, all patients treated with a two-stage revision were retrospectively reviewed. On the basis of the results of the first-stage procedure, 52 patients underwent the second stage, six developed a dislocation, in eight the spacer was maintained, and five patients developed an acute infection of the spacer or the infection was not resolved. With regard to the second-stage procedure the revision was successful in 44 patients, a re-infection developed in four patients and the definitive prosthesis presented a mechanical complication in four more. The literature results reported that 97.5% of the spacers were reimplanted, although 12.09% of them developed a dislocation. Surgeons must assess several aspects so as to avoid mechanical complications like dislocation and re- infections during the two stages of the procedure.

Introduction: Psoas abscess associated with hip arthroplasty infection is a rare entity. The aim of this report was to review our experience., Material and Methods: Patients with computerized tomography (CT) diagnosis of psoas abscess associated with a hip arthroplasty infection from 2004 to 2009 were retrospectively reviewed. Demographics, microbiological data, CT results and outcome of each patient were recorded., Results: Seven patients out of 214 evaluated by CT due to hip infection suspected were identified. Three women and 4 men, with a mean age of 69 years (range 46-89). Mean abscess diameter was of 62 x 47 mm. In all cases, a direct communication between abscess and prosthesis was observed. The most commonly isolated microorganisms were grampositive cocci. All patients were treated with two-stage revision surgery. After a mean follow-up of 65 months (28-113), six patients were in remission., Conclusions: The use of CT in the study of suspected infection of a hip arthroplasty identified a psoas abscess in 7 cases out of 214 evaluated. Patients treated with two-stage revision surgery and large debridement was associated with a good clinical outcome.