Aim

To provide proof of concept in an in vivo animal model for the prevention of prosthetic joint infection prevention using electric fields along with conventional antibiotic prophylaxis.

Corresponding Author: Marti Bernaus

Introduction: Anterior cruciate ligament (ACL) surgery is ever more frequent and commonly has a satisfactory outcome.

Purpose: To assess whether platelet-enriched gel has positive effects on immediate postoperative evolution and on the final clinical result.

Materials and methods: We carried out a prospective, randomized study by alternatively selecting 50 patients. The control group (without gel) comprised 25 patients and the Gel group (with platelet gel) also contained 25 patients; both groups were homogeneous in terms of age and sex. The same anesthesia, surgery and analgesia protocol was used in all cases and hospital discharge was 24–48 hours postoperatively. Pain assessment was carried out by detection of inflammation (pre and post patellar perimeter) and PCR (at 24 hours and 7 days). Clinical results were assessed by means of IKDC; radiological studies were performed using plain x-rays and MRI.

Results: No statistically significant differences were found (p< 0.05) in all the data analyzed, although there is a trend towards less inflammation in the group treated with gel, both clinically and analytically. There were no significant differences in the functional results of surgery and the MRI showed an increased intensity of signal and greater homogeneity in T2 in the gel group plasties.

Conclusions: The use of platelet gel in ACL surgery could have a beneficial effect on inflammatory and analytical parameters, but not on clinical results.

Purpose: The purpose of this review is to present our experience in prosthetic reconstruction after resection arthroplasty, its outcome and possible complications.

Materials and methods: We carried out a retrospective study of 23 hips reconstructed after an average of 2.2 years. Inclusion criteria were: having had a resection arthroplasty, a reconstruction with joint prosthesis and a minimum follow-up of one year. For evaluation we used the Merle d’Aubigne score for pain, walking and range of motion.

Results: The operated limb was lengthened 2.9 cm (1.2–4.8). The average for pain was 4.6, for range of motion 4.3 and walking 5.2. The overall outcome, 14.1 points, was considered acceptable. 47% had good or very good outcomes. All the patients improved their ability to walk. Four patients presented dislocation of the prosthesis after reconstruction and only one patient had a reinfection.

Conclusions: Prosthetic reconstruction after resection arthroplasty is technically difficult. This is due mainly to wear in the soft tissues and changes in the amount and quality of bone stock as a result of prior surgery. The biggest gain is seen in the ability to walk while there is less improvement in pain and range of motion. Candidates for reconstruction must be carefully selected to prevent complications and/or false expectations of always achieving excellent results.