Elusive Differential of a Painful Unstable Total Knee Arthroplasty – Metal on Cement Disease

Painful metal-on-metal total hip arthroplasty.

Two patients were evaluated for the possibility of hypersensitivity to a Metasul articulation (Centerpulse, Austin, Tex) coupled with total hip arthroplasty. Serum was tested with a lymphocyte proliferation assay, and the capsular tissues from the hip were examined for perivascular lymphocytes. The diagnosis of hypersensitivity to Metasul could not be confirmed in these patients, and ultimately...

Total Knee Arthroplasty in Severe Unstable Knee: Case-Report and Literature Review

  Multiplanar or global laxity in arthritic knee is rare , most of this patients have neuromuscular disorder (post poliomyelitis , spinal dystrophy) or history of knee trauma. Ligament insufficiency and severe bone loss is significant in this patient. The estimated prevalence for the concurrence of charcot marie-tooth (CMT) with myasthenia gravis (MG) suggests an extremely rare event. We have p...

Systematic Analysis of Painful Total Knee Prosthesis, a Diagnostic Algorithm

Magnetic resonance imaging evaluation of the painful total knee arthroplasty.

Optimization of metal artifact reduction pulse sequences over the past decade has rendered MRI valuable in knee arthroplasty assessment. MRI can reliably predict the presence and extent of infection, component loosening and polyethylene wear, and component malrotation, and it can evaluate the integrity of surrounding soft tissue structures. Using dynamic contrast-enhanced angiographic technique...

Use of antibiotic-loaded cement in total knee arthroplasty.

Bone cement has the capacity to release antibiotic molecules if any antibiotic is included in it, and these elution properties are improved as cement porosity is increased. In vitro studies have shown high local antibiotic concentration for many hours or few days after its use. Antibiotic loaded bone cement (ALBC) is helpful when treating an infection in total knee arthroplasty (TKA) revision s...