occlusal rest (Fig. 5, B), and guiding planes (Fig. 5, C). If there are voids or irregularities, they are filled with monomer and powder with a paint brush. 9. Try-in the removable partial denture (Fig. 6) to ensure a proper adaptation of the resin coping (Fig. 7). The die spacer can be removed from the tooth with a cotton pellet soaked in die spacer thinner. Rinse the tooth several times befor...

The PROSTALAC functional spacer is made of antibiotic-loaded acrylic cement but has a small metal-on-polythene articular surface. We have used it as an interim spacer in two-stage exchange arthroplasty for infected total knee replacement. PROSTALAC allows continuous rehabilitation between stages as it maintains good alignment and stability of the knee and a reasonable range of movement. It also...

BACKGROUND To treat total knee arthroplasty, 2-stage revision, including removal and reimplantation, remains the standard treatment for the infected arthroplasty. Articulating cement spacer has been shown to provide better functional results after reimplantation. However, its cost as a manufactured product is not always easily affordable and the choice of antibiotics is not flexible either. The...

Pyogenic knee arthritis in a patient with advanced osteoarthritis is a serious medical problem. We have performed arthroscopic debridement in 136 patients with pyogenic knee arthritis from January 1999 to December 2001. Five of these patients were diabetic, they did not respond to the standard treatment protocol and they continued to have infection. For these patients, we performed open arthrot...

Infections are a devastating complication of titanium alloy orthopedic implants. Current therapies include antibiotic-impregnated bone cement and antibiotic-containing coatings. Daptomycin (DAP) (1) is a novel peptide antibiotic that penetrates the cell membranes of Gram-positive bacteria. Few DAP-resistant strains have appeared so far. We hypothesized that when DAP covalently bonded via a flex...

Arthroscopic revision of rotator cuff lesions is an increasingly popular procedure with a relatively safe profile. However, associated deep articular infection has been described, with potentially destructive joint sequelae. When occurring, it poses the double challenge of eradicating the infectious agent while preserving the articulation and its function. Experience remains scarce and is mostl...

Femorotibial alignment is an important factor affecting patient outcome after total knee arthroplasty (TKA). It was the aim of this study to report our first results using a CT-based navigation system in two-stage revision surgery for infected TKA. Two patients with chronic deep infection after primary TKA underwent two-stage revision arthroplasty with temporary articulating cement spacers foll...

Shoulder arthroplasty is considered the most effective surgical procedure for endstage shoulder pain from different causes including osteoarthritis, cuff-tear arthropathy, trauma, and tumors. Although uncommon and less frequent than knee or hip periprosthetic infection, periprosthetic shoulder infection represents a devastating complication and, despite treatment, is associated with unsatisfact...

Tibial bone defect is a critical problem for revision knee arthroplasty. Instead of using metallic spacer or cement, biodegradable scaffolds could be an alternative solution. A numerical model of a revision knee arthroplasty was thus developed to estimate the mechanical resistance of the scaffold in this demanding situation. The tibia, scaffold, and prosthesis were represented by simplified par...

This investigation evaluated the effect of resin composite inlay/onlay thickness on the hardness of a group of eight dual-cure resin-based cements. Fourteen disc specimens measuring 6 mm in diameter and 2.5 mm thick were prepared from each of eight dual-cure cements: Adherence, Choice, Duolink, Enforce, Lute-It, Nexus, Resinomer and Variolink. Two specimens from each material were directly ligh...