The Experts below are selected from a list of 3279 Experts worldwide ranked by ideXlab platform
Hiroshi Tsumura - One of the best experts on this subject based on the ideXlab platform.
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Mechanical evaluation of hip Cement Spacer reinforCement with stainless steel Kirschner wires, titanium and carbon rods, and stainless steel mesh
European Journal of Orthopaedic Surgery & Traumatology, 2015Co-Authors: Nobuhiro Kaku, Tomonori Tabata, Hiroshi TsumuraAbstract:Introduction In two-stage treatments for infections after total hip arthroplasty, antibiotic-loaded Cement Spacers help treat the infection by antibiotic elution and prevent contraction. However, such Spacers are weak and may fracture while awaiting replaCement, impairing functionality. We evaluated whether a Kirschner wire (K-wire) mounted into the Spacer reinforced its strength along with the effects of the reinforcing material, position, and intensity. Methods Spacers without reinforcing materials constituted the control group. As reinforcing materials, stainless steel K-wires (diameters 3 and 6 mm), titanium alloy and carbon fibers (diameter 3.175 mm), and stainless steel meshes (inner and outer diameters, 6 and 9 mm, respectively) were inserted into the Spacer mold before filling with Cement. The Spacers complied with ISO 7206-4; a compressive load was applied using a testing machine with a velocity of 25.4 mm/min, and the maximum load was recorded. We used 1–3 K-wires positioned on the medial side, lateral side, neck only, and stem only and tested 3 specimens for each condition. Results The control group withstood the highest load. Stainless steel was the strongest material; 3-mm K-wires in the neck and lateral side withstood a higher load. The computed tomography (CT) imaging revealed a cavity between the K-wires and Cement. When K-wires were inserted along the whole length, despite Cement fractures, continuity was maintained because of the reinforcing materials. Conclusion It is difficult to improve the reinforcing strength of Spacers using K-wires; however, K-wires prevented dislocation of Cement Spacer fragments, which can help prevent contraction and facilitate Spacer removal during replaCement.
Henry A Finn - One of the best experts on this subject based on the ideXlab platform.
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intramedullary rod and Cement static Spacer construct in chronically infected total knee arthroplasty
Journal of Arthroplasty, 2012Co-Authors: Suhel Y Kotwal, Yasser R Farid, Suresh S Patil, Kris J Alden, Henry A FinnAbstract:Two-stage reimplantation, with interval antibiotic-impregnated Cement Spacer, is the preferred treatment of prosthetic knee joint infections. In medically compromised hosts with prior failed surgeries, the outcomes are poor. Articulating Spacers in such patients render the knee unstable; static Spacers have risks of dislocation and extensor mechanism injury. We examined 58 infected total knee arthroplasties with extensive bone and soft tissue loss, treated with resection arthroplasty and intramedullary tibiofemoral rod and antibiotic-laden Cement Spacer. Thirty-seven patients underwent delayed reimplantation. Most patients (83.8%) were free from recurrent infection at mean follow-up of 29.4 months. Reinfection occurred in 16.2%, which required debridement. Twenty-one patients with poor operative risks remained with the Spacer for 11.4 months. All patients, during Spacer phase, had brace-free ambulation with simulated tibiofemoral fusion, without bone loss or loss of limb length.
Nobuhiro Kaku - One of the best experts on this subject based on the ideXlab platform.
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Mechanical evaluation of hip Cement Spacer reinforCement with stainless steel Kirschner wires, titanium and carbon rods, and stainless steel mesh
European Journal of Orthopaedic Surgery & Traumatology, 2015Co-Authors: Nobuhiro Kaku, Tomonori Tabata, Hiroshi TsumuraAbstract:Introduction In two-stage treatments for infections after total hip arthroplasty, antibiotic-loaded Cement Spacers help treat the infection by antibiotic elution and prevent contraction. However, such Spacers are weak and may fracture while awaiting replaCement, impairing functionality. We evaluated whether a Kirschner wire (K-wire) mounted into the Spacer reinforced its strength along with the effects of the reinforcing material, position, and intensity. Methods Spacers without reinforcing materials constituted the control group. As reinforcing materials, stainless steel K-wires (diameters 3 and 6 mm), titanium alloy and carbon fibers (diameter 3.175 mm), and stainless steel meshes (inner and outer diameters, 6 and 9 mm, respectively) were inserted into the Spacer mold before filling with Cement. The Spacers complied with ISO 7206-4; a compressive load was applied using a testing machine with a velocity of 25.4 mm/min, and the maximum load was recorded. We used 1–3 K-wires positioned on the medial side, lateral side, neck only, and stem only and tested 3 specimens for each condition. Results The control group withstood the highest load. Stainless steel was the strongest material; 3-mm K-wires in the neck and lateral side withstood a higher load. The computed tomography (CT) imaging revealed a cavity between the K-wires and Cement. When K-wires were inserted along the whole length, despite Cement fractures, continuity was maintained because of the reinforcing materials. Conclusion It is difficult to improve the reinforcing strength of Spacers using K-wires; however, K-wires prevented dislocation of Cement Spacer fragments, which can help prevent contraction and facilitate Spacer removal during replaCement.
Suhel Y Kotwal - One of the best experts on this subject based on the ideXlab platform.
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intramedullary rod and Cement static Spacer construct in chronically infected total knee arthroplasty
Journal of Arthroplasty, 2012Co-Authors: Suhel Y Kotwal, Yasser R Farid, Suresh S Patil, Kris J Alden, Henry A FinnAbstract:Two-stage reimplantation, with interval antibiotic-impregnated Cement Spacer, is the preferred treatment of prosthetic knee joint infections. In medically compromised hosts with prior failed surgeries, the outcomes are poor. Articulating Spacers in such patients render the knee unstable; static Spacers have risks of dislocation and extensor mechanism injury. We examined 58 infected total knee arthroplasties with extensive bone and soft tissue loss, treated with resection arthroplasty and intramedullary tibiofemoral rod and antibiotic-laden Cement Spacer. Thirty-seven patients underwent delayed reimplantation. Most patients (83.8%) were free from recurrent infection at mean follow-up of 29.4 months. Reinfection occurred in 16.2%, which required debridement. Twenty-one patients with poor operative risks remained with the Spacer for 11.4 months. All patients, during Spacer phase, had brace-free ambulation with simulated tibiofemoral fusion, without bone loss or loss of limb length.
S V N George - One of the best experts on this subject based on the ideXlab platform.
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an intramedullary Cement Spacer in total hip arthroplasty
Journal of Arthroplasty, 1998Co-Authors: Rajiv G Deshmukh, K Thevarajan, C S Kok, N Sivapathasundaram, S V N GeorgeAbstract:Revision arthroplasty of the hip is often complicated by infection, bone loss, and perioperative fracture of the femur. A simple, inexpensive Spacer that keeps tissue planes intact and prevents soft tissue contracture during the interoperative period of a 2-stage revision is described. This can provide intramedullary support to a fractured or weak femur and enable local antibiotic delivery, as well as permit limited mobilization of the patient. It can be easily fabricated during surgery using universally available materials and can be tailored for specific requirements. Such a Spacer was used in 5 cases. The experience is presented, and the technique and pitfalls are discussed.