Floating Knee Arthrodesis After Prosthetic Knee Infection: A Report of 48 Cases.

BACKGROUND: Knee arthrodesis is a means of avoiding above-knee amputation after a prosthetic joint infection (PJI). The objective of this study was to analyze the results of floating knee arthrodesis in patients who had a history of aprosthetic knee infection. The analysis consisted of determining reinfection rates, functional results, and the survival of arthrodesis. METHODS: There were 48 patients who underwent a cemented floating knee arthrodesis in cases of PJI retrospectively included in the study, having been operated on between 2012 and 2020. In addition to being evaluated clinically, analytically, and radiographically, the patients were assessed functionally by means of a newly-created scale. RESULTS: At a mean follow-up of 4 years (1 year to 9 years), 7 patients suffered reinfection (14.6%). The recurrence of infection was not observed to be significantly affected by sex (P = .16), age(P = .09), or the type of surgery previously undergone (P = .18), nor was the McPherson Host Grade (P = .4) observed to have a significant effect. Patients who had a McPherson Limb Grade 3 were more likely to suffer reinfection than those with a McPherson Limb Grade 2 (P = .034). There were 26 patients (54%)fully evaluated and scored on the Knee Arthrodesis Functional Scale(BAOR). For 11 patients (42%), the results were evaluated as excellent, for 11 (42%) acceptable, for 3 (12%) low, and for 1(4%) poor. CONCLUSION: The arthrodesis nail is an effective and safe procedure for patients who have a recurrent PJI, providing an effective alternative when the criteria for a new revision total knee arthroplasty are not met.

Radial Nerve Paralysis in Diaphyseal Fractures of the Humerus.

One of the most common complications associated with a diaphyseal humeral fracture is the development of a radial nerve injury. We conducted a study to analyze the degree of recovery and prognostic factors associated with radial nerve palsy in patients with diaphyseal humerus fractures. We retrospectively analyzed 28 patients who presented to the Hospital La Fe, Valencia, Spain, with a diaphyseal humerus fracture associated with radial nerve injury between 2010 and 2020. A total of 14.3% (n = 4) of the patients in our cohort had open fractures and 85.7% (n = 24) had closed fractures. There were no statistically significant differences between the type of treatment and the type of fracture (p = .13). There were also no significant differences between the type of treatment and recovery time (p = .42). There was a statistically significant difference (p = .04) in the mean recovery time for patients with preoperative radial nerve injuries (11.9 months) compared with patients who sustained a radial nerve injury secondary to surgical repair of the fracture (8.6 months). The difference in recovery time between patients with open and closed fractures was not statistically significant (p = .3). Results of the study showed that the type of fracture (i.e., open or closed) did not affect radial nerve palsy recovery time. Patients who sustain radial nerve injuries secondary to a surgical repair have a shorter recovery time than patients who sustain primary radial nerve injuries.