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Introduction:Two-stage revision arthroplasty is the gold standard treatment for infected knee arthroplasty. The primary objectives of this treatment approach are to eradicate the infection and restore a pain-free and well-functional joint. In this retrospective study of case series from a single center, we aimed to evaluate the clinical and radiological results of patients who underwent two-stage revision knee replacement with the diagnosis of infected knee prosthesis and share the results.Methods:The data of patients between 2011 and 2016 were analyzed in this retrospective study. Twenty-four patients who were followed up for at least six months were included in the study. Infection markers, Knee Society Score (KSS), pain scores, range of motion (ROM), and flexion contractures were recorded before and after treatment. Radiologically, changes in the patellar tendon length, the Insall-Salvati (IS) ratio, and the joint line (JL) were evaluated.Results:Sixteen female and eight male patients with a mean age of 68.0±8.6 years were studied. The patients were followed up for 31.0±18.9 months on average. The mean clinical KSS of the patients before and after treatment was 44.7 and 76.3, respectively, while the functional KSSs were 31.7 and 63.5, respectively. The patients had a mean ROM of 60.5° and 84.8°, pain score of 8 and 2.25, and knee flexion contracture of 1.38° and 0.21° before and after the treatment. Pre- and post-treatment IS and JL values did not have a statistically significant effect on the clinical and functional outcomes.Conclusion:The early- tomid-term results of patients who underwent two-stage knee revision arthroplasty were satisfactory in terms of clinical and functional results. Postoperative JL position and IS ratio had no significant effect on functional outcomes. The use of dynamic spacers and the short time between two stages had a positive effect on the results.

Introduction:The aim of this study was to evaluate the factors affecting the clinical and radiological results of the patients who underwent internal fixation due to femoral neck.Methods:Sixty-nine patients are included in this study. Follow-up periods were determined as a minimum of six months. Fractures were classified with Garden and Pauwel’s classifications. 12 hours was the cut-off limit between early and delayed fixation. The standard treatment was cannulated screw fixation. Trauma mechanism, reduction quality and patient dependent factors such as smoking and diabetes were evaluated. Non-union and avascular necrosis (AVN) was diagnosed with X-ray or computerized tomography if needed. Harris Hip score (HHS) was used as a functional scoring modality.Results:Twenty-five (36.2%) patients were female and 44 (63.8%) were male. Twenty-six patients (37.7%) were under 40 years old and 43 (62.3%) were older. Forty-two (60.9%) of these fractures were classified as Garden 1-2 (non-displaced) and 27 (39.1%) were classified as Garden 3-4 (displaced). While 39 patients (56.5%) were operated on before the 12-hour cut-off point; 30 patients (43.5%) were operated on later. Fourteen patients (20.3%) were diagnosed with non-union and 12 (17.4%) with AVN. Mean HHS was 88.7±14.2 (47-100). Displaced group (Garden 3-4) showed a higher incidence of non-union (40.7% vs.7.1%) and AVN (25.9% vs. 11.9%) compared to the non-displaced group (Garden 1-2). The timing of surgery did not have a statistically significant impact on outcome in terms of non-union and AVN. The complication rates were higher in patients with poor reduction.Conclusion:Our complication rates were similar to the literature. Age, gender, fracture side, smoking, and time to fixation were found as irrelevant with non-union and AVN rates. Non-union was significantly higher in the displaced group and no significant difference was found in AVN rates. The reduction quality was significantly associated with complications.