Treatment of late-onset temporomandibular joint prosthesis infection by prosthesis revision: a case report

Late-onset infection of an inserted temporomandibular joint prosthesis is a difficult complication to treat. Most treatment protocols for late prosthetic infections include device replacement. A 40-year-old female patient with an infected and exposed temporomandibular joint prosthesis presented 3 years after implant placement. The patient was treated with prosthesis revision including fistula coverage with a temporalis muscle flap and prolonged antibiotic therapy for 10 weeks. Since completion of treatment, the patient has been infection-free.

One-stage versus two-stage prosthesis replacement for prosthetic knee infections

INTRODUCTION

Periprosthetic knee infection is a severe complication. Confirmed criteria are lacking to choose between one-stage or two-stage prosthesis replacement to treat the infection. The one-stage replacement could lead to a satisfactory control of the infection and to better functional results.

METHOD

Retrospective study conducted between January 1, 2009 and December 31, 2014. The objectives of this study were to compare the infection outcome and functional results between the one-stage and two-stage replacement procedures. Functional results were evaluated using the IKS score, KOOS score, and SF-12 quality of life score.

RESULTS

Forty-one patients underwent a two-stage replacement procedure and 21 patients a one-stage replacement. The average follow-up was 22 months after surgery. The infection was cured in 78% of patients who underwent a two-stage replacement and 90% of patients who underwent a one-stage replacement (P=0.3). The flexion range of motion was significantly better in the one-stage group than in the two-stage group (P=0.04). Results of the IKS score and of the KOOS score were better in the one-stage group. No difference was observed for the SF-12 score.

CONCLUSION

The one-stage replacement procedure for periprosthetic knee infection was associated with a similar healing frequency as the two-stage replacement procedure, and with better knee function.

Prosthesis replacement in Mason III radial head fractures: A meta-analysis

INTRODUCTION

This present study was to evaluate the clinical efficacy of prosthesis replacement (PR) for patients with Mason III radial head fractures (RHF) compared with open reduction and internal fixation (ORIF).

METHODS

We retrieved the relevant trials up to September 2013 from several public databases, mainly including PubMed, Embase, Springer, Elsevier Science Direct, Cochrane Library, Google scholar, CNKI and Wanfang database. Weighted mean difference (WMD) or odds ratio (OR) and their 95% confidence intervals (CI) were calculated to compare the clinical outcomes between PR and ORIF.

RESULTS

A total of 9 studies including 365 patients with Mason III RHF (169 patients treated with PR and 196 patients treated with ORIF) were reanalyzed in the meta-analysis. The results showed that the patients with Mason III RHF receiving PR, compared with the ORIF ones, had a significantly higher percentage of postoperative excellent and good rate (OR=3.48, 95% CI=1.98 to 6.11, P<0.0001), better Broberg and Morrey elbow scores (WMD=9.79, 95% CI=4.22 to 15.36, P=0.0006) and significantly lower postoperative complications (OR=0.33, 95% CI=0.16 to 0.69, P=0.003).

CONCLUSIONS

Although the results of this study supported the use of PR in the treatment of Mason III RHF in Chinese population with short-term outcomes, the evidences are of low quality and further studies were required for confirming these results in the longer term on other populations.

LEVEL OF EVIDENCE

Level III. Low power meta-analysis.