RESUMEN
BACKGROUND: Periprosthetic joint infection has been the leading cause of failure following TKA surgery. The gold standard for infection control has been a two-staged revision TKA. There have been few reports on mid- to long-term survivorship, functional outcomes, and fate of patients with a failed two-stage revision TKA. QUESTIONS/PURPOSES: Therefore, we determined (1) the mid-term survivorship of two-stage revision TKA, (2) the function of patients in whom infection was controlled, and (3) the outcome of patients with a failed two-stage revision due to recurrent infection. METHODS: We retrospectively reviewed 239 patients who underwent 253 two-stage revision TKAs for periprosthetic infection. There were 239 patients (253 knees), 104 men and 135 women, with a mean age of 70 ± 10 years at the time of two-stage revision and a mean BMI of 31.53 ± 6.74 kg/m2. During followup, we obtained WOMAC and The Knee Society Clinical Rating Scores and radiographs. The minimum followup was 1 year (median, 4 years; range, 1-17 years). RESULTS: Thirty-three patients experienced a failed two-staged TKA. Sixteen patients experienced failure due to recurrent sepsis. There were 17 failures for aseptic causes. CONCLUSION: The overall infection-free survivorship for two-stage revision TKA was 85% at 5 years and 78% at 10 years. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Asunto(s)
Artroplastia de Reemplazo de Rodilla/métodos , Prótesis de la Rodilla/efectos adversos , Infecciones Relacionadas con Prótesis/cirugía , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Reoperación/métodos , Estudios RetrospectivosRESUMEN
A 47-year-old woman presented with a disabling fixed flexion deformity of the knee and an equinus deformity of the ankle following treatment in a cast for a minor flexion deformity following a tibial plateau fracture. Two years later, the cause was identified as an isolated ischaemic contracture involving the medial head of gastrocnemius. She made a good recovery following extensive corrective surgery and rehabilitation.
Asunto(s)
Contractura/complicaciones , Isquemia/etiología , Músculo Esquelético/irrigación sanguínea , Contractura/fisiopatología , Contractura/cirugía , Femenino , Humanos , Isquemia/cirugía , Extremidad Inferior/fisiopatología , Extremidad Inferior/cirugía , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Músculo Esquelético/cirugía , Necrosis/etiología , Necrosis/cirugíaRESUMEN
We present an unusual case of immediate bilateral acute carpal tunnel syndrome that followed combined pancreatic and renal transplantation and responded to decompression after failed conservative treatment.
