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Large acetabular defects remain a challenge in hip revision arthroplasty. Experience with Trabecular Titanium¿ (TT) cups (Limacorporate S.p.a.) has not been widely reported. Therefore, we assessed the survivorship and clinical and radiological outcomes of patients receiving TT cups, with or without supplementary trabecular titanium hemispherical modules for acetabular reconstruction, in primary and revision total hip arthroplasty (THA).~Background~Background~Between January 2009 and July 2014, we performed 67 revisions and 5 primary THAs using TT cups in 69 patients. To achieve stability and/or restore the hip's centre of rotation, hemispherical modules were used in 17 cases based on preoperative templating and/or intraoperative findings. Mean follow-up was 30.5 months. Acetabular bone defects were classified according to the Paprosky classification. Survivorship, functional outcomes (Merle d'Aubigné) and radiological outcomes were analysed.~Methods~Methods~8 patients underwent cup revision: 2 for loosening, 3 for infection, and 3 for hip dislocation. The remaining cases did not present radiological signs of loosening. None of the cases with Paprosky type I classifications needed revision, while 4 with type II and 4 with type III needed revision (p = 0.028). The respective mean values for pain, walking, and range of motion (Merle d'Aubigné scores ± standard deviation) were 3.6 ± 1.4, 3.7 ± 0.7, and 3.8 ± 0.6 preoperatively, and 5.7 ± 0.7, 5.3 ± 0.7, and 5.6 ± 0.7 at the latest follow-up (p<0.001).~Results~Results~In the short term, results with TT cups appear to be encouraging, with satisfactory survival rates for both simple and complex cases.~Conclusions~Conclusions [ABSTRACT FROM AUTHOR]

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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]

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.

Background and Objective: Avascular necrosis of femoral head (AVN) has been identified as a frequent complication after hematopoietic stem cell transplantation (HSCT). Advances in the treatment for haematological malignancies have improved survival after HSCT. The aim of this study was to report the short and medium-term results of total hip arthroplasty for the treatment of AVN., Patients and Method: We performed 12 consecutive total hip arthroplasties (THA) with at least 2 year follow up. The diagnosis was AVN in the context of HSCT. Except for one, in all the patients THA was the first surgical procedure., Results: On the Merle D'Augbigne and Postel grading system, 83% hips were good or excellent. There were no revisions for septic or aseptic loosening., Conclusions: We conclude that, in our experience, THA provided a good short and medium term follow up in patients with AVN after HSCT, and it seems to be a safe and effective treatment and the best option after conservative treatment failure.

Backgrounds and Objective: Direct exchange using antibiotic-impregnated cement is a treatment option for hip prosthesis infection (HPI). Nevertheless, a local antibiotic use is not always possible. We present our experience with direct exchange with and without antibiotic-impregnated cement., Patients and Method: Fourteen patients with a HPI were treated with direct exchange. The femoral component was cemented with an antibiotic in 7 cases and in 7 it was not cemented. The patients received antibiotic prophylaxis and antibiotic treatment for a mean of 3 months. Clinical evolution of the infection was prospectively assessed., Results: There were no differences with regard to the clinical and microbiologic characteristics between both groups. In the last control (minimum 2 years) all the patients were cured., Conclusions: Our results suggest that direct exchange without local antibiotic is an option in HPI. Further studies are needed to evaluate the usefulness of antibiotic loaded cement.