Periprosthetic fractures about total knee arthroplasty.

Periprosthetic fracture after total knee arthroplasty presents a difficult complication for many orthopaedic surgeons. These fractures occur most frequently around the distal femur followed by the patella and then tibia. These fractures are frequently complicated by poor bone quality or compromised bone due to the presence of the implants. Surgical treatment is typically necessary and requires varied techniques of open fixation, intramedullary fixation, or revision arthroplasty. Outcomes of these injuries vary widely. This review aims to describe the epidemiology, classification, treatment options and outcomes for periprosthetic fractures following total knee arthroplasty.

[Intestinal infarctions. A re-evaluation of prognostic factors of postoperative mortality]. / Les infarctus intestinaux. Une ré-évaluation des facteurs pronostiques de mortalité post-opératoire.

The aim of this study, based on a series of 67 patients, was to assess the prognostic factors of postoperative mortality of intestinal infarctions (small and large bowel). Known risk factors were studied (age, sex, shock, Concomitant disease, use of arteriography and vasodilators), together with less studied factors, such as recent vascular or cardiac surgery less than 4 months before the infarction and length of bowel infarction. Postoperative mortality was defined as any death occurring within 45 days after surgery. The risk factors were assessed by univariate and multivariate analysis with logistic regression. The postoperative mortality was 63%. Age, shock, other medical diseases, recent cardiovascular surgery, and length of bowel infarction were significant predictive factors of postoperative mortality on univariate analysis. Shock, age greater than 70 years and recent cardiovascular surgery were three independent risk factors selected on multivariate analysis with equivalent weights.