Objective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico(r) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness. Level of Evidence IV, Case Series.
Objective: The main objective of this study is to describe the preliminary results of modified osteotomy with elevation of the first metatarsal to repair cavovarus foot deformities. Methods: In a five-case series, radiographic findings related to the modified osteotomy with elevation of the first ray were analysed.Results: Five patients who underwent a modified osteotomy with elevation were followed up for a minimum of six months. One hundred percent consolidation rates were observed, with no complications related to the materials, such as screw breakage, screw loosening and/or pseudoarthrosis (0% of the cases), regardless of age and gender. Conclusion: The modified technique generates an osteotomy plane that is more horizontal, reducing the technical difficulty and resulting in less risk of loss of fixation during passage of the screw. Using a single screw for fixation reduces the cost of the procedure and pseudarthrosis rates.
Level of Evidence IV; Therapeutic Studies; Case series.
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