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Biomedical subjects

F C Ewald

Publications and source records attributed to F C Ewald.

9 recordsLinked to original sources
PubMed1978

Total hip replacement with and without osteotomy of the greater trochanter. Clinical and biomechanical comparisons in the same patients.

Twelve patients with bilateral hip replacement, one side performed with a trochanteric osteotomy and the other without osteotomy, were analyzed by review of the clinical records, the findings on physical examination, preoperative and postoperative Harris hip scores, each patient's evaluation, biomechanical analysis of the preoperative and postoperative roentgenograms of the hips and pelvis, and force-plate gait analysis. All operations yielded good results clinically but the majority of patients preferred the replacement done without osteotomy. Blood loss and trochanteric bursitis were greater problems in patients who had an osteotomy. There were no differences between the two groups in the postoperative Harris scores or in the biomechanical measurements made on the preoperative and postoperative roentgenograms except for the change in the abductor-muscle length. Changes in this parameter correlated well with the patients' symptoms and clinical findings.

Adult↗
PubMed1976

Complications of total hip-replacement arthorplasty in patients with rheumatoid arthritis.

During the period 1969 through 1974, 716 total hip-replacement arthorplasties were performed. The results of the surgery in 275 cases of rheumatoid arthritis as regards complications were compared with those in 382 procedures in cases of osteoarthritis. In contrast to the reports of others,the incidence of deep would infection in the two groups was found to be equal. Patients undergoing total hip-replacement arthroplasty as a revision of a previous operation had a substantially increased risk of infection. Patients with rheumatoid arthritis, however, were more subject to certain other complication (intraoperative fracture, difficulties with anesthesia, and malposition of prosthetic components), in addition to the complications that were predictable because of the involvement of multiple joints and the systemic disease process.

Adult↗
PubMedDate not supplied

Total knee arthroplasty experience at the Robert Breck Brigham Hospital.

Between 1973 and 1978, 1,474 metal-to-plastic knee arthroplasties were evaluated to determine the typical modes of failure and improved design concepts (Table 2). Although the concepts are still evolving, and longer follow-up is necessary, recent experience with nearly 1,000 semiconstrained devices allowing cruciate retention strongly suggests that duopatella and kinematic design concepts are correct. Soft tissue reconstruction is critical with these designs, since they rely heavily on soft tissue integrity and balance. If the concepts of soft tissue balance, prosthetic design, and physical rehabilitation are applied, total knee replacement is as reliable in relieving pain and restoring function as total hip replacement. The low incidence of radiolucency at the bone-cement interface (although the length of follow-up is relatively short), coupled with the results of in vitro bench testing, suggest that the longevity of this generation of knee implants should be adequate.

Biomechanical Phenomena↗
PubMedDate not supplied

Giant cell synovitis associated with failed polyethylene patellar replacements.

Destroyed patellar articular surfaces were replaced with a high molecular weight polyethylene prosthesis in two patients. The patellofemoral articulation of the femur consisted of eburnated bone in one case and degenerative cartilage in the other. Both operations failed within one year because of a giant cell synovitis caused by a high volume (0.2 cc) of fine polyethylene (1-100 mu) wear particles. Ultra high molecular weight polyethylene should not be used as a prosthetic bearing surface to articulate against cortical, cancellous or eburnated bone or against degenerative articular cartilage in a major joint.

Aged↗
PubMedDate not supplied

Comparison of preoperative, intraoperative and early postoperative total hip replacement with and without trochanteric osteotomy.

A series of 100 consecutive patients with total hip replacements in whom trochanteric osteotomy was performed was compared with 100 patients in whom the greater trochanter was left in place. The groups were comparable with respect to age and incidence of osteoarthritis and connective tissue disorders. Although no statistically significant difference was noted among trochanterectomy groups or disease subgroups in terms of preoperative impairment as indicated by preoperative Harris score, 16 patients presented exposure problems necessitating trochanteric osteotomy despite preoperative plans to leave the trochanter in place. Salvage operations after unsuccessful previous operations were performed in 18 patients in the osteotomy group and 11 in the nonosteotomy group. Mean operating time was 3 hours for patients in the osteotomy group and 2 hours for those in the nonosteotomy group. Considerably more intraoperative and postoperative blood replacement was required in the patients having osteotomy. Patients sat, stood, walked, and left the hospital sooner in the nonosteotomy group than in the osteotomy group. Trochanteric bursitis requiring treatment 3 or more months after operation occurred in 17 patients having osteotomy and in 3 patients not having osteotomy. Hematomas developed in 15 patients in the osteotomy group and in 4 in the nonosteotomy group. Ectopic bone formation was observed in 12 of the osteotomy group, 8 with limitation of function, and 5 of the nonosteotomy group; non had symptoms. Six osteotomized patients had troublesome abductor weakness secondary to wire breakage and proximal migration of the trochanter. The rates of infection and thrombophlebitis were low in both groups. When exposure was not difficult, leaving the trochanter intact had many advantages.

Collagen Diseases↗