Catheter fragment embolism in a dog

Catheter fragment embolism is a potential complication of peripheral venous catheterisation. A three-year-old male dachshund was treated for a tibial fracture. The anaesthesia, orthopaedic procedure and hospitalisation recovery were uneventful. At the time of venous catheter removal, its breakage was noticed. A catheter tip embolisation was suspected and confirmed in the cephalic vein with radiography and ultrasound. A tourniquet was immediately applied proximally to the elbow. It prevented the catheter tip from further migration and central embolisation. A longitudinal venotomy of the cephalic vein allowed the removal of the fragment. Stitches were removed 10 days later and clinical examination was normal.

A Need for Functionally Graded Stiffness Femoral Stem for Reduction in Stress Shielding and Promoting Bone Growth: Computational Analysis

Total Hip Arthroplasty (THA) is an orthopaedic procedure that is available to reduce pain and restore the functionality of hip joints. THA has been successfully implemented for the last 40 years. However, after more than 40 years of design and implementation, premature loosening of the femoral stem still occurs due to the stress shielding. Stress shielding can be reduced by using implants with lower stiffness. This however, could increase the micromotion and interface debonding between the stem and femur bone. The aim of this study is to investigate stress and micromotion distribution across the length of the stem and to develop a bone in growth simulation model. To achieve this, a bone growth mechano-regulation algorithm based on deviatoric strain was applied to study the tissue differentiation process. The initial outcome of the study indicates that the stiffness of the implant should not be uniform rather graded from the distal to proximal and lateral to medial directions of the implant. With such graded stiffness, bone growth density was possible across the entire length of the stem, hence reducing aseptic loosening due to stress shielding.

The Need for Guidelines in Asplenic Patients Undergoing Total Joint Arthroplasty: A Case Report

There are currently no guidelines for splenectomy patient undergoing total joint arthroplasty. We present a case history of a 63-year-old man with a history of splenectomy that underwent a total knee arthroplasty with standard intravenous antibiotic prophylaxis. Two weeks postoperatively, he developed a prosthetic joint infection and followed the standard antimicrobial management with intravenous and oral antibiotics prior to having revision surgery. We propose that there are guidelines to properly manage these patients in the pre- and perioperative setting following an orthopaedic procedure.

Development of Methodology to Assess the Effect of Stem Surface Finish on Implant Loosening

Joint replacement surgery is a common orthopaedic procedure used for the treatment of diseased or damaged joints. The majority of these replacement systems incorporate a stemmed portion which is inserted into the bone canal, either with or without bone cement, to achieve fixation to the host bone. Although this procedure has proven effective, relative displacement at the bone-cement and/or cement-stem interfaces (i.e., implant loosening) is a common complication, leading to pain and the need for revision surgery.