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Numerous studies have reported on the adverse outcome of patients who sustain job-related injuries. In addition, studies have reported poor outcomes in patients receiving Workers' Compensation who undergo elective surgery. This study sought to determine the influence of Workers' Compensation on the outcome of patients who had undergone primary total hip arthroplasty. Between January 1984 and December 1996, 44 patients (48 hips) were studied. Of these, 17 were men and five were women with a mean age of 45 years (range, 27-76 years) at the time of surgery. These patients were receiving compensation benefits and were matched directly with a group of 22 patients who had 24 arthroplasties and were not receiving compensation. After a mean final followup of 77 months (range, 25-125 months), the compensation group had a mean Harris hip score of 86 points (range, 54-95 points). The matched control group had a mean Harris hip score of 92 points (range, 79-100 points) at a mean final duration of followup of 80 months. Two patients (9%) had undergone revision surgery for aseptic loosening at 28 and 67 months. The percentage of patients with good or excellent results did not differ significantly between the two groups. Based on these findings, the authors think that Workers' Compensation does not negatively influence the outcome of total hip arthroplasty.

Enigmatic thigh pain remains a difficult problem to treat after total hip arthroplasty. This article reports on the use of strut cortical allografting for the treatment of recalcitrant enigmatic thigh pain following total hip arthroplasty in patients with a well-fixed cemented or cementless femoral component.

Sixteen patients with infected total knee arthroplasties (4 postoperative and 12 late hematogenous) were treated by arthroscopic irrigation and debridement. All patients had < or = 7 days of knee symptoms, and there were no radiographic signs of osteitis or prosthetic loosening. Six of the 16 original total knee arthroplasties (38%) did not need prosthesis removal at a mean follow-up of 64 months (range, 36-151 months). Ten other knees were treated with irrigation, debridement, and hardware removal within 7 weeks of the latest procedure used to try to retain components. Two (13%) of these cases ultimately required an arthrodesis for persistent infection. Although we still believe that this method is preferable to resorting immediately to implant removal for acute infections, arthroscopic debridement was less efficacious for most situations when compared with open treatment. We would use arthroscopic irrigation and debridement only under selected circumstances (medically unstable or anticoagulated patients).