Rotating-bearing total knee arthroplasty has been theorized to have some advantages in the kinematics and wear characteristics of total knee arthroplasty. A rare complication of rotating-bearing total knee arthroplasty is rotary dislocation, spinout, of the polyethylene component. When these dislocations occur, they typically result in a 90-degree dislocation in respect to the axial axis of the knee. This case is unique in that it presents a complete 180-degree polyethylene dislocation without trauma.
Background: Scapho-lunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) of the wrist are the most common types of wrist arthritis. We compared the union rate and complication profile of patients with SLAC and SNAC wrist undergoing 4 corner arthrodesis with partially threaded or fully threaded headless compression screws. Methods: A single-center retrospective review was conducted to identify all patients treated for SLAC and SNAC with 4 corner fusion using headless compression screws from 2016 to 2021. A total of 33 patients undergoing surgery on 35 wrists were identified and included in the study. Demographics, comorbidities, complication profile, and radiographs were collected and compared between groups. Results: One hundred percent (16/16) of partially threaded and 84.2% (16/19) of fully threaded screws demonstrated union by minimum 10-week follow-up. The total complication rate (avascular necrosis of lunate, screw loosening, etc.) was 31.4%; 52.6% of wrists implanted with fully threaded screws experienced complications compared with a 6.3% complication rate with partially threaded screws. The difference was statistically significant between the 2 groups ( P = .004). Conclusions: Four corner arthrodesis using antegrade compression screws is an effective, reproducible method to achieve fusion in the wrist. The use of fully threaded screws was associated with more complications than with partially threaded screws, although union rate was not significantly different. Future studies with larger sample sizes would be useful to fully elucidate differences between these 2 constructs.
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