The use of antibiotic-impregnated cement lowered the infection rate by approximately 50% in primary hip arthroplasty. For revisions of previously infected hips, combinations or culture-dependent antibiotics lowered infection rates by approximately 40%.
The present study highlights the commonly held opinion that a modular kinematic rotating hinged total knee prosthesis has a role for salvage reconstruction of the knee. In light of the relatively high rate of complications, we believe that this salvage procedure should be reserved primarily for elderly and sedentary patients.
Patients with hepatitis C undergoing joint arthroplasty had a higher rate of surgical complications and a longer hospital stay. The reason for the higher rate of complications in this group of patients is unknown, and further investigation is needed. Patients with hepatitis C should be counseled about the potential for a higher incidence of postoperative complications prior to undergoing joint arthroplasty.
The patients in this study had a wide variety of medical conditions that left their bone osteopenic or osteoporotic. This study demonstrated that using a modified locking plate for a TTC arthrodesis results in a high rate of bony union and alignment correction stability. The locking plate provides fixation by acting as a fixed angle device, with the locking screws providing multiplanar fixation. The use of a locking plate has not been previously reported, and it may hold promise as a means of achieving a TTC fusion.
Revision total hip arthroplasty can provide substantial clinical benefit to patients over eighty years of age. The medical complication rate for octogenarians may not differ significantly from that for patients seventy years of age or younger, and the prevalence of technical complications and dislocations can be expected to be lower than that for younger patients.
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