Influence of posterior condylar offset on knee flexion after cruciate-sacrificing mobile-bearing total knee replacement: A prospective analysis of 410 consecutive cases

The range of motion of the knee joint after Total Knee Replacement (TKR) is a factor of great importance that determines the postoperative function of patients. Much enthusiasm has been recently directed towards the posterior condylar offset with some authors reporting increasing postoperative knee flexion with increasing posterior condylar offset and others who did not report any significant association. Patients undergoing primary total knee replacement were included in a prospective multicentre study and the effect of the posterior condylar offset on the postoperative knee flexion was assessed after adjusting for known influential factors. All knees were implanted by three senior orthopedist surgeons with the same cemented cruciate-sacrificing mobile-bearing implant and with identical surgical technique. Clinical data, active knee flexion and posterior condylar offset were recorded preoperatively and postoperatively at a minimal one year follow-up for all patients. Univariate and multivariate linear models were fitted to select independent predictors of the postoperative knee flexion.Four hundred and ten consecutive total knee replacements (379 patients) were included in the study. The mean preoperative knee flexion was 112°. The mean condylar offset was 28.3 mm preoperatively and 29.4 mm postoperatively. The mean postoperative knee flexion was 108°. No correlation was found between the posterior condylar offset or the tibial slope and the postoperative knee flexion. The most significant predictive factor for postoperative flexion after posterior-stabilized TKR without PCL retention was the preoperative range of flexion, with a linear effect.     

Impact of rapid multiplex PCR on management of antibiotic therapy in COVID-19-positive patients hospitalized in intensive care unit

European Journal of Clinical Microbiology & Infectious Diseases - Because the diagnosis of co/superinfection in COVID-19 patients is challenging, empirical antibiotic therapy is frequently...     

Genetic Analysis of Glycopeptide-Resistant Staphylococcus epidermidis Strains from Bone and Joint Infections

Glycopeptide-resistant Staphylococcus epidermidis (GRSE) strains are of increasing concern in bone and joint infections (BJIs). Using multilocus sequence typing and multilocus variable-number tandem repeat analysis, we show that BJI-associated GRSE strains are genetically diverse but arise from related, multiresistant hospital sequence types (STs), mostly ST2, ST5, and ST23.     

Infection following the use of porous hydroxyapatite ceramic as a bone defect filler in articular fractures

Summary This article is a preliminary report focussed on infection after implantation of porous hydroxyapatite (Endobon®) as a bone defect filler. Eighteen adults received Endobon® implants for cancellous bone defects after trauma, tumoral excision or for arthrodesis. Four patients exhibited osteoarthritis. Infections required debridementand removal of osteosynthesis material and implants. Relevant infectious organisms were Staphylococcus and Enterobacteria. The incidence of postoperative infection, the nature of the organisms and indications are discussed. Further investigations are required in order to understand the causes of infection and undertake their prophylaxis.     

Bleeding complications after ritual circumcision: about six children

Circumcision is the most common surgical procedure in boys. Even if the procedure is frequent, circumcision can have tragic complications. We report the cases of six children, seen over 1 year at the emergency department for bleeding complication or mutilation after ritual home circumcision. To avoid such complications, it is recommended that circumcision should be performed by doctors trained in this procedure. Parents have to be cautioned about the risks of possible complications after this procedure.     

Congenital esophageal stenosis

A series of 20 patients with congenital esophageal stenoses (CES), including 4 with tracheobronchial remnants, 6 with membranous diaphragm, and 10 with fibromuscular stenosis, is presented. The experience acquired by treating these patients is compared to 95 cases from the literature and a definition of CES is proposed. The 35% association of CES woth other anomalies, especially esophageal atresia, is analyzed and some difficulties in the treatment of this rare anomaly are discussed. Offprint requests to: C. Nihoul-Fékété     

Diagnosis of prosthetic joint infection by beadmill processing of a periprosthetic specimen

We report a microbiological process for the documentation of prosthetic joint infection (PJI). Intraoperative periprosthetic tissue samples from 92 consecutive patients undergoing revision surgery for PJI were submitted to mechanized beadmill processing: specimens were aseptically collected in polypropylene vials, filled with sterile water and glass beads and submitted to mechanized agitation with a beadmill. The documentation rate of PJI following culture on solid and liquid media was 83.7% and the contamination rate 8.7%. Final documentation was obtained after overnight culture for 51.9% of cases and with 7 days of broth culture for all documented cases.