Outcome after tantalum rod implantation for treatment of femoral head osteonecrosis: 26 hips followed for an average of 3 years

Background and purpose Tantalum rod implantation has recently been proposed for treatment of early stages of femoral head osteonecrosis. The purpose of our study was to report the early results of its use in pre- and post-collapse stages of the disease

Multiple Recurrences and Late Metastasis of Adamantinoma in the Tibia: A Case Report

Adamantinoma is a rare, low-grade, malignant bone tumour. We report on a 46-year-old woman who had early multiple recurrences of adamantinoma of the right tibia and late metastasis to the lung and ribs 13 years after the first surgical treatment. She underwent multiple complete tumour excisions and eventually below-knee amputation and removal of the left lung and sixth to eighth ribs. </jats:p

Use of ^99mTc-Sulesomab for the Diagnosis of Prosthesis Infection after Total Joint Arthroplasty

This study aimed to evaluate the diagnostic efficacy of antigranulocyte scintigraphy using the antibody fragment 99mTc-sulesomab (LeukoScan®) for the diagnosis of prosthesis infection in patients with total hip or knee arthroplasty. The results from 19 patients with suspected total joint arthroplasty infection who had undergone a three-phase bone scan and a subsequent examination with 99mTc-sulesomab during a 1-year period were reviewed. Twelve patients were shown to have prosthesis infection on culture of aspirated synovial fluid or intra-operative samples. The overall sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for 99mTc-sulesomab were 75%, 86%, 90%, 66% and 79%, respectively, compared with 54%, 83%, 88%, 45% and 63%, respectively, for the three-phase bone scan. This study showed that 99mTc-sulesomab had good diagnostic value for the detection of prosthesis infection. The combination of 99mTc-sulesomab with other laboratory or imaging examinations may improve diagnostic performance in prosthesis infection and should be investigated further. </jats:p

Minimum ten year results of total hip arthroplasty with the acetabular reinforcement ring in avascular osteonecrosis

Total hip arthroplasty (THA) still carries a higher failure rate in patients with avascular necrosis of the femoral head (AVN) than in a similar patient population with THA for other reasons. This is particularly true for the acetabular component. One of the major factors accounting for this is the compromised acetabular bone quality with structural defects subsequent to collapsing of the femoral head in high-grade AVN. In this study we implanted an acetabular reinforcement ring with hook (ARRH), which had been used successfully for other indications with acetabular bone stock deficiency, in 32 consecutive THA’s in 29 patients with AVN. Five patients died during the observation period of causes unrelated to the surgery, one patient was lost to follow-up and one patient could not be followed up due to chronic illness, leaving 25 hips (23 patients) with a minimum follow-up of ten years (mean: 11.8; range: 10–15). The mean Merle d’Aubigne score increased significantly from 7.7 preoperatively to 16.6 postoperatively (p < 0.001). One revision was performed for aseptic stem loosening. Of the unrevised hips, one acetabular component was classified as definitively loose. The cumulative 12-year survivorship for THA with ARRH in AVN was 95.2% (confidence interval: 86.1–100%) for both components, 100% for the cup and 95.2% for the stem (86.1–100%)

Osteogenic abilities of bone marrow stromal cells are not defective in patients with osteonecrosis

We investigated whether the proliferation activities and osteogenic capacities of bone marrow stromal cells (BMSCs) are depressed in patients with osteonecrosis of the femoral head (ONFH). BMSCs were isolated from fresh bone marrow of the iliac crests of 54 donors and were differentiated into osteogenic lineage in vitro. The results of 27 consecutive patients with ONFH (16 idiopathic and 11 alcohol-induced) were compared with those of 27 patients with a nonnecrotic hip disorder. The proliferative activities of BMSCs in patients with ONFH were not found to be reduced and their osteogenic capacities (alkaline phosphatase activity and calcium deposition amount) were unaltered during in vitro differentiation. Results from patients with idiopathic or alcohol-induced ONFH were similar to those of matched patients with nonnecrotic disorder. These findings suggest that the osteogenic potentials of BMSCs are not defective in patients with ONFH