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Biomedical subjects

F R Convery

Publications and source records attributed to F R Convery.

At least 37 records · Page 2Linked to original sources

Cement composite delivery system.

Several new and innovative techniques have recently been introduced that purport to increase the strength of polymethyl methacrylate bone cement. One of these concepts is the use of carbon and polymer fibers to form a cement composite. Bone cement composites usually 1% fiber, are very difficult to use clinically. The composite is very sticky and viscous, which precludes effective hand packing or the use of conventional delivery systems. A new delivery system for very viscous materials is presented and examples of in vitro application are shown.

Animals↗

The erythrocyte sedimentation rate in orthopaedic patients.

The ESR, a sensitive measure of the inflammatory response, is elevated in 90% of patients who have serious orthopedic infections, e.g., discitis, septic arthritis, and hematogenous osteomyelitis. In most cases, it is sufficient to distinguish these entities from the less serious disease states, i.e., transient synovitis. After major surgical operations or extensive trauma, the ESR often increases to high levels and, if sepsis does not supervene, it returns to normal within six months. Outpatient determination of the ESR, although useless in the early detection of malignancy, is valuable in detecting inflammatory arthridities and major sepsis.

Arthritis, Infectious↗

The spherocentric knee: a re-evaluation and modification.

The purpose of this study was to assess prospectively the initial results of total knee replacement with the standard spherocentric component and to identify retrospectively the pathogenesis of any unsatisfactory results. As a consequence of this study, the femoral component was modified. Thirty-six knees were reviewed twenty-two to fifty-two months after a standard spherocentric total knee replacement, with a mean follow-up of thirty-five months. Twenty-five (70 per cent) of the knees had significant relief of pain and improved function. Eleven knees were not improved because of confirmed loosening in five, supracondylar fracture in two, infection in one, and suspected loosening in three. Ten of these eleven complications became manifest within the first postoperative year. Alignment in the coronal plane was not consistently precise and hyperextension was a recurrent problem in twelve of the thirty-six knees. A modification in the femoral component was made: the stem was lengthened to 10.0 centimeters and the body was reoriented so that there was 5 degrees of valgus and 15 more degrees of posterior rotation than the original design. This modified prosthesis was used in twenty-five additional knees, with definite improvement in alignment, but the follow-up was insufficient to ascertain the effect of the modification on lossening and fracture.

Adult↗

Fracture-dislocation of the dorsal-lumbar spine. Acute operative stabilization by Harrington instrumentation.

Twenty-four patients (of whom 17 were paraplegic) with acute fracture dislocations of the dorsal-lumbar spine underwent stabilization with Harrington instrumentation and were followed for an average of 16 months. Immediate postoperative ambulation was achieved in 16 patients. There was little difference between compression and distraction with respect to reduction and maintenance of correction. Compression rods resulted in solid union in 15 of 16 patients, while distraction rods were successful in 6 of 8 instances. In contrast to reported series in which operative intervention has been avoided, at least a 50% reduction in total hospitalization stay and costs has been achieved. Functional results were comparable to or exceeded the results of other series, and complication rates were similar with the exception of postoperative pain in 2 patients.

Adolescent↗

Polyarticular disability: a functional assessment.

The purpose of this study was to design and evaluate a system for the functional evaluation of patients with polyarticular disease. A single assessment can be done in approximately 15 minutes. Extensive prior preparation is not required. The evaluation is reproducible and the numerical characterization agrees well with a physician's overall assessment of functional impairment. The subscores can be used independently of the total score to focus on specific areas of disability. Use of the evaluation in other institutions has produced a high degree of reliability. Statistical evaluation has demonstrated areas of weakness that have been eliminated or modified to increase reliability of the system.

Activities of Daily Living↗

The relative safety of polymethylmethacrylate. A controlled clinical study of randomly selected patients treated with Charnley and ring total hip replacements.

Forty patients from a group of seventy elected to participate in a prospective randomized clinical study designed to evaluate the systemic effects of polymethylmethacrylate implanted with a Charnley total hip replacement, utilizing patients treated with a Ring total hip prosthesis ad controls. Intraoperative alterations in cardiovascular function were related to use of methylmethacrylate, but postoperative changes in pulmonary function, erythrocyte sedimentation rate, serum lactic acid dehydrogenase, serum glutamicoxalacetic transaminase, and alkaline phosphatase were not. Charnley total hip replacements were associated with more ectopic-bone formation twelve months postoperatively. The two "latent" infections recognized during the thirty-four months of the study were in hips without acrylic fixation.

Alkaline Phosphatase↗

The rheumatoid knee.

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Anti-Inflammatory Agents↗

Connective tissue response to immobility. Correlative study of biomechanical and biochemical measurements of normal and immobilized rabbit knees.

The biomechanical changes in rabbit knee contractures were measured after 9 weeks of immobilization. These results were correlated with the biochemical composition of periarticular connective knee tissue of the same knees. The loss of total hexosamine correlates significantly with joint stiffness on an animal-to-animal basis. Total hexosamine also correlates with the energy required cyclicly to flex and to extend the experimental joints. Of the individual glycosaminoglycan fractions, only hyaluronic acid showed significant correlation with the biomechanical data. The possible mechanism of contracture formation was postulated based on these results.

Animals↗

Experimental hemarthrosis in the knee of the mature canine.

The knee joints of 14 skeletally mature mongrel dogs were subjected to a continuous hemarthrosis. Minimal morphologic changes of the articular cartilage did not occur until after 16 weeks. As early as 4 weeks, biochemical analyses showed a significant decrease in glycosaminoglycans (GAG) that became progressively more severe with time, whereas total collagen was not significantly altered until after 12 and 16 weeks. Bioengineering measurements of the experimental cartilage surfaces showed that the tissue becomes more deformable as well as less resistive to shear than the control at 8 weeks. These differences increased as the duration of hemarthrosis increased.

Animals↗