Biomedical subjects

P Langan

Publications and source records attributed to P Langan.

25 records · Page 2Linked to original sources

PubMed1977

Changes in the calcar femoris in relation to cement technology in total hip replacement.

Radiological changes in the calcar femoris after total hip replacement, in 97 hips where an extreme valgus position of the prosthesis had been achieved, were compared with 119 hips where the alignment of the prosthesis ranged from varus to only a moderate degree of valgus. In the series with extreme valgus there was a minimum of 1 cm of cement between the calcar femoris and the prosthesis, whereas in the other series the thickness of cement averaged 4.5 mm. In the series with thick cement destructive changes in the calcar were reduced by a factor of 10 and there were no examples of incipient subsidence of the femoral prosthesis. This comparison was based on a follow-up of only 2 years.

Acrylic Resins↗

PubMedDate not supplied

Magnetic imaging in the assessment of the lumbar disk.

NMR is becoming an established diagnostic modality in many of the medical specialties. Seventy-four patients who underwent lumbar spine scans in this series were positive for herniated disk. Of that group, 35 underwent either traditional laminectomy with disk excision (19) or chemonucleolysis (16). All of the positive studies were confirmed at the time of the therapeutic procedure. Among the negative studies (78), three patients persisted in their complaints of pain and underwent subsequent myelogram enhanced CAT scans of the lumbar spine. All of these were negative. There are no known ill-effects of magnetic resonance imaging.

Humans↗

PubMedDate not supplied

The role of epidural cortisone injection in the treatment of diskogenic low back pain.

Primary treatment by epidural injection of cortisone in patients suffering from characteristic diskogenic disease was helpful in 82% of patients. However, when given after three months of back pain, after previous laminectomies, and in patients actually suffering from an unstable spine which required fusion, epidural injections were of little value. No complications resulted from the injection and there was no compelling evidence to indicate that the placement of the needle by radiologic means is necessary. Because of these benefits and the fact that all of the patients were candidates for laminectomy, the use of this injection prior to surgery should be considered. The number of injections that may reasonably be given, the degree to which the patient should become asymptomatic, and the period of time during which relief continues remain to be clarified by a larger and more sustained study.

Adolescent↗

PubMedDate not supplied

Femoral stem failure and ectopic bone formation in total hip arthropalsty: four case reports.

In 4 cases of fracture of the femoral stem in total hip arthroplasty (THA), 3 were preceded by clinical and radiographic evidence of loosening and the last was not. Each developed a significant amount of ectopic bone. Stem failure in THA is a continuum progressing in some cases from ectopic bone formation and calcar resorption to stem loosening. An association between ectopic ossification and stem loosening is determined by grading the quantity of new bone not only by the amount but also by its spatial relationship with the implant. Observation on a large number of cases by the method of DeLee, Ferrari, and Charnley is required to prove or disprove the effect of ectopic bone on stem failure. In any case, patients who develop ectopic bone should be restricted in their activities.

Aged↗

PubMedDate not supplied

Hip rating scales: a clinical analysis.

Thirty patients were graded both before and after total hip replacement according to several hip-rating scales and the results compared. This comparison shows that a scale which keeps the various parameters of pain, motion and function, separating rather than integrating them, is more useful to the surgeon. Subgrading the patients into A, B and C is essential for functional comparisons.

Arthritis, Rheumatoid↗

PubMedDate not supplied

Subluxation of the tibialis posterior, a complication of tarsal tunnel decompression: a case report.

In a 16-year-old girl, anterior subluxation of the posterior tibial tendon repeatedly occurred after release of the flexor retinaculum for tarsal tunnel syndrome. The symptoms resulting from this subluxation were more disabling than the original complaint. A reconstructive procedure eliminated the subluxation but did not cause recurrence of the tarsal tunnel syndrome. Though this complication is rare, it suggests that opening of the retinaculum for decompression of the tarsal tunnel should be done as far posteriorly as possible, so that the remaining retinaculum can act as a flap to prevent subsequent anterior subluxation of the tendon(s).

Adolescent↗

PubMedDate not supplied

Stability of the Giliberty bipolar hip: report of three cases.

The Giliberty Bipolar Hip Prosthesis consists of an unbonded acetabular cup which snap-fits over the head of the femoral prosthesis. Because of the free movement permitted at the cup-pelvic junction as well as at the snap-fit interface, there has been a great deal of concern over the potential for dislocation. Three patients in whom this unit was implanted sustained significant skeletal trauma subsequent to surgery. None of them dislocated. In each case the prosthetic head was known to be in a relatively vertical orientation with respect to the transverse axis of the pelvis prior to the injury. In 2 of the 3 cases radiographically identifiable movement of the cup was present before and after the injury. These observations suggest that the persistently mobile, vertically positioned unbonded cup remain stable despite the stress of significant trauma. It is probable that the potential for cup movement, even where on the X-ray it appears to have stopped, acts as a safety valve in absorbing force that might otherwise dislocate the hip or cause fractures of the femur or the pelvis.

Aged↗