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Biomedical subjects

L H Riley

Publications and source records attributed to L H Riley.

63 records · Page 4Linked to original sources

Nerve injuries in total hip arthroplasty.

Nerve injury occurs in 1% to 2% of patients who undergo total hip arthroplasty and is more frequent in patients who need acetabular reconstruction for dysplasia and those undergoing revision arthroplasty. Injury to the peroneal division of the sciatic nerve is most common, but the superior gluteal, obturator, and femoral nerves can also be injured. Nerve injury can be classified as neurapraxia, axonotmesis, or neurotmesis. The worst prognosis is seen in patients with complete motor and sensory deficits and in patients with causalgic pain. Prevention is of overriding importance, but use of ankle-foot orthoses and prompt management of pain syndromes can be useful in the treatment of patients with nerve injury. Electrodiagnostic studies hold promise in complex cases; however, their intraoperative role requires objective, prospective, controlled scientific study before routine use can be recommended.

Arthroplasty, Replacement, Hip↗

Total knee arthroplasty.

Eighty-six nonhinged total knee arthroplasties performed between 1971 and 1981 have been reviewed. Fifty-one were of the geometric type and 35 of the anametric type. The use of both units resulted in a statistically and clinically significant improvement in preoperative pain and an increase in functional activities. Three of 51 geometric units developed loose components that required revision. None of the 35 anametric units has required revision for loosening. Partial radiolucent lines at the tibial bone-cement interface were noted in 43% of the group. Data analysis of age, weight, and sex demonstrated no statistically significant characteristic of this group when compared with the group without radiolucent lines. However, radiolucent lines were more common in those patients with osteoarthritis than in the group with rheumatoid arthritis. In addition, radiolucent lines were noted in 90% of knees in which a metal-backed tibial tray with a central post was used, compared with 36% of knees without metal-backed tibial components. Relief of pain and correction of instability and deformity can be achieved for most patients following nonhinged total knee arthroplasty.

Arthritis, Rheumatoid↗

Anametric total knee arthroplasty.

The early experience with the anametric knee prosthesis shows it to be effective in achieving the aims desired in total knee arthroplasty. Decreased pain and improved function have been noted in most patients, with relatively few complications. In osteoarthritics, patellar replacement increases the level of improvement. This prosthetic system has been improved by the addition of further sizes and additional tibial fixation options. Detailed long-term follow-up evaluation of these patients will be necessary to judge the effectiveness of the newly introduced design modifications.

Adult↗