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Arthroplasty after war injuries to major joints
1Department of Orthopedic Surgery, School of Medicine, University of Zagreb, Croatia.
Military Medicine
|May 20, 1999
Summary
Total joint replacement (arthroplasty) in soldiers with severe joint injuries showed good outcomes in most cases. However, two patients developed septic arthritis and required further surgery.
Area of Science:
- Orthopedic surgery
- Trauma surgery
- Reconstructive surgery
Background:
- Joint reconstruction in soldiers with severe injuries presents unique challenges.
- Arthroplasty is considered for severe joint damage, contractures, and pain.
- This study evaluates endoprosthetic joint replacement outcomes in a military cohort.
Observation:
- Ten soldiers underwent joint replacement (5 knees, 3 hips, 2 shoulders) between 1992-1995.
- Injuries included explosive (6) and gunshot (4) trauma, with replacement occurring 9-42 months post-injury.
- Indications for surgery were severe contractures and debilitating pain.
Findings:
- Eight out of ten patients achieved good results after 36-48 months follow-up.
- Two patients experienced early septic arthritis and endoprosthesis loosening, with Staphylococcus aureus identified.
- These two patients subsequently underwent knee arthrodesis with external fixation.
Implications:
- Arthroplasty can be effective for severe joint destruction in soldiers.
- Vigilance for infection is crucial, as complications can necessitate revision surgery.
- Arthrodesis remains a viable option for managing infected or failed joint replacements.