PubMed · 1139545
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S Robb. 1975. Bunion surgery.. https://pubmed.ncbi.nlm.nih.gov/1139545/
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OBJECTIVE: To evaluate the effect of surgical treatment of the impingement syndrome of the shoulder on the fitness for work. DESIGN: Retrospective. SETTING: Academic Hospital Groningen, department of Orthopaedics, the Netherlands. PATIENTS AND METHODS: A group of 31 patients who had undergone an anterior shoulder decompression between 1 January 1984 and 31 December 1993 because of shoulder symptoms due to impingement lasting more than one year, were subjected in January 1996 to a study of the effect of the treatment on the pain, fitness for work and participation in the labour process. The results were measured using an objectivated score list for pain and function and with a comparison of the labour situations before and after the operation as described by the patients. RESULTS: End results as measured with the score list were fair to good in 97 patients (74%). The numbers of those completely fit for work before operation and at follow-up were identical, viz. 45 out of 131 (34%). Thirty-four patients (26%) had other jobs or adjusted activities and 37 (28%) were completely unfit for work (together 71 patients: 54%); 15 patients (11%) had stopped working for reasons of age. The probability to be definitely rejected for work after the operation was increased significantly by a job causing shoulder overstrain and by having been on sick leave with pay prior to the operation. CONCLUSION: Although the objective results were reasonably good, the percentage of those completely fit for work was not changed appreciably by the surgical treatment.
Laser ablation of acrylic bone cement is an alternative method of cement removal that can be used during revision arthroplasty of cemented implants. This study investigated the feasibility of using a continuous-wave Argon ion laser (wavelength = 514 nm) with the addition of methylene blue or red dye no. 13 to enhance the ablation of two types of bone cements: polymethylmethacrylate and polybutylmethylmethacrylate. Six cement/dye combinations were studied while power (0.5, 0.75, and 1.0 W) and exposure times (30, 45, 60, and 90 seconds) were varied. The Argon laser was unable to ablate undyed polymethylmethacrylate or polybutylmethylmethacrylate. However, ablation was shown for both cements with either dye. The red dye had a stronger absorption peak at 514 nm than did the blue dye. Statistically larger ablation areas were seen for red polymethylmethacrylate than for blue polymethylmethacrylate (p < 0.013) at all levels tested. Ablation areas were larger in red than in blue polybutylmethylmethacrylate cement. Blue polybutylmethylmethacrylate cement produced larger ablation areas than did blue polymethylmethacrylate cements at all energy levels tested, with smaller surrounding damage areas. Red polybutylmethylmethacrylate cement also produced larger ablation areas than did red polymethylmethacrylate cement (at 0.75 and 1.0 W), again with smaller damage areas. Damage zones were smallest in red polybutylmethylmethacrylate cements at all test levels. These results suggest that, by using dyes to selectively alter the absorption characteristics of bone cement, laser ablation can be an effective method for cement removal. Changes in the chemical structure of the cement can also influence the response to laser treatment. Furthermore, the absorption spectra of the bone cement can be altered to maximize energy absorption at a wavelength that is not absorbed by bone tissue; this potentially minimizes damage to bone during revision surgery.
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