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plastic limit of UHMWPe. Changes in the femoral condylar shape after TKA were small basedon alignment analysis of the medial and lateral condyles. Kinematic analysis revealed anaverage 16.9 degrees tibial internal rotation with flexion to 90 degrees. Condylar translationsexhibited a medial pivot pattern from 0 to 90 degrees of flexion, with an average of 0.9 mmanterior translation of the medial condyle and 9.0 mm posterior translation of the lateralcondyle. As a result, tibial internal rotation with medial pivot pattern was accepted.Conclusions: The novel TKA design based on restoration of articular surface orientation andbony geometry exhibits in vivo kinematics and alignment, contact mechanics that arecompatible with excellent functional performance and implant longevity for Asian.Friday, October 8, 2010, 14:00-14:50Session A14: Complication ManagementAggressive Early Debridement Can Be Successful for Infected Total HipArthroplasty*Mohamed Sukeik - University College London Hospital - London, United KingdomF S Haddad - University College London Hospital - London, United KingdomIntroduction*Email: msukeik@hotmail.comUp to 2% of total hip arthroplasties (THA) are still complicated by infection. This leads todissatisfied patients with poor function, and has far-reaching social and economicconsequences. The challenge in these cases is the eradication of infection, the restoration of fullfunction and the prevention of recurrence. We report the outcome of early aggressivedebridement in the acutely infected THA.MethodsWe studied 28 consecutive patients referred with acutely infected THA (18 primaries, 10revisions) which occurred within 6 weeks of the index operation or of haematogenous spreadbetween 1999 and 2006. Microbiology confirmed bacterial colonisation in all cases with 20early post-operative infections and 8 cases of acute haematogenous spread. Patients with acemented THA underwent aggressive open debridement, a thorough synovectomy and exchangeof all mobile parts. Uncemented THA were treated as a single stage revision with removal of allimplants, aggressive debridement and re-implantation of new prosthesis. Antibiotics werecontinued in all cases until inflammatory markers and the plasma albumin concentrationreturned to within normal limits.ResultsTen patients required multiple washouts. 7 patients needed a two stage revision. 21 patientsreturned to their expected functional level without removal of the implants and with noradiographic evidence of prosthetic failure. At a minimum 2 years follow-up, we had a 75%infection control rate. The outcome was significantly better in patients treated in the first 120file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]