When drilling an oil well, the well is lined by sinking a steel casing, or liner, into the drilling mud (see Figure 1). The inside of the liner forms a central pipe, and leaves an annular gap between the outside of the liner and the surrounding rock. The inside and outside of the liner are initially filled with drilling mud, which is displaced by pumping a sequence of fluids down inside the lin...

Reconstruction for concurrent infection of an ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) is a challenge. We report a 2-stage reconstruction of a THA for chronic infection of both the THA and TKA with severe femoral bone loss secondary to interprosthetic fractures. The reconstruction involved using a custom-made, temporary, antibiotic-impregnated PROSTALAC spacer ...

Antibiotic-impregnated hip cement spacers of various types and materials have been used in the treatment of periprosthetic hip infections. We developed a handmade spacer by using polymethylmethacrylate (PMMA) and/or α -tricalcium phosphate ( α -TCP). In this study, we retrospectively reviewed the surgical outcomes in 36 consecutive patients treated with 2-stage revision total hip arthroplasty b...

Segmental long bone defects resulting from injury or surgical intervention are difficult problems to manage. Amputation, external fixators, vascularized fibular grafts, acute limb shortening, and various quantities of allograft and autograft have historically been the mainstays of treatment. Recently, the use of osteoinductive substances such as recombinant bone morphogenic proteins, and osteoc...

INTRODUCTION Infected periprosthetic femoral fractures are among the most complex and significant complications of total hip arthroplasty (THA). We report the novel use of a temporary THA-like spacer for treating an infected periprosthetic femoral fracture after revision surgery using a long stem. CASE PRESENTATION We present a 72-year-old woman sustained a left infected periprosthetic femora...

PURPOSE To evaluate the curative effect of Ilizarov bone transport combined with antibiotic cement spacer for infected tibial nonunion with bone defect. METHODS We retrospectively reviewed the outcomes of 58 patients with infected tibial nonunion from January 2008 to March 2011 at our institution. Patients were treated with complete debridement, radical sequestrectomy, antibiotic cement space...

INTRODUCTION Two-stage revision arthroplasty is today considered as the gold standard for control of chronic deep prosthetic infection. Although the revision arthroplasty should only be considered when infection is eliminated, the diagnosis of residual infection prior to the revision remains a challenging problem. MATERIALS AND METHODS We evaluated triple-phase bone scintigraphy as a useful d...

Masquelet technique, which is the use of a temporary cement spacer followed by staged bone grafting, is a recent treatment strategy to manage a posttraumatic bone defect. This paper describes a series of 9 patients treated with this technique of staged bone grafting following placement of an antibiotic spacer to successfully manage osseous long bone defects. The injured limbs were stabilized an...

©2015 by The Orthopaedic Journal at Harvard Medical School BACKGROUND Shoulder arthroplasty procedures have generally excellent clinical outcomes, but infection following shoulder arthroplasty continues to be a difficult problem both diagnostically and therapeutically. Two-stage reimplantation with use of a temporary Prosthesis of Antibiotic-Loaded Acrylic Cement (PROSTALAC) (DePuy, Warsaw, Ind...