The infected implant

 

[The infected implant.]

Orthopade. 2008 Mar 8;

Authors: Wodtke J, Löhr JF

The periprosthetic infection is a permanent risk and a severe complication in joint arthroplasty. Raising numbers of cases, unsatisfactory results of treatment and high cost urge to sufficient prophylactic behaviour in primary surgery and research for new treatment strategies. In the future antibiotic coating of the implants and influence on biofilm could possibly be established. Disciplined early diagnostic measures and rational actions following the established concepts are able to create better results and reduce the extreme high costs.

PMID: 18324389 [PubMed - as supplied by publisher]

March 10, 2008 | Filed Under Surgey | Leave a Comment 

Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography.

Abnormal course of the vertebral artery at the craniovertebral junction in patients with Down syndrome visualized by three-dimensional CT angiography.

Neuroradiology. 2008 Mar 7;

Authors: Yamazaki M, Okawa A, Hashimoto M, Aiba A, Someya Y, Koda M

INTRODUCTION: We determined the incidence of vertebral artery (VA) anomalies at the craniovertebral junction (CVJ) in patients with Down syndrome, and characterized the VA anomalies. METHODS: The course of the VA in 46 consecutive patients who were due to undergo posterior arthrodesis surgery at the CVJ were evaluated by three-dimensional CT angiography (3DCTA). Included were five patients with Down syndrome who suffered from myelopathy due to atlantoaxial subluxation. All five patients with Down syndrome also had a simultaneous congenital skeletal anomaly, either os odontoideum or ossiculum terminale. RESULTS: Of the five patients with Down syndrome, three had VA anomalies at the CVJ, two had fenestration and one had a persistent first intersegmental artery. Of the other 41 patients without Down syndrome, five had VA anomalies at the CVJ. The incidence of VA anomalies at the CVJ was much higher in patients with Down syndrome than in those without Down syndrome. CONCLUSION: In planning surgery in patients with Down syndrome with symptomatic atlantoaxial subluxation and a congenital skeletal anomaly at the CVJ, we should consider the possible presence of VA anomalies. Preoperative 3DCTA allows us to precisely identify an anomalous VA and evaluate the possible risk of intraoperative VA injury in advance.

PMID: 18324393 [PubMed - as supplied by publisher]

March 10, 2008 | Filed Under Surgey | Leave a Comment 

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