PubMed · 5393246
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S Iino. 1969. [Hip prosthesis].. https://pubmed.ncbi.nlm.nih.gov/5393246/
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The development of malignant lesions in the acetabulum can lead to painful and disabling bone destruction. In carefully selected patients where the cortical still provides a sufficient barrier protecting the joint, percutaneous injection of ciment (10-15 cc) can be a successful mean of countering both pain and functional impairment. This easy-to-perform technique requires only local anaesthesia and can be highly cost-effective. The antalgic effect is rapid. Most patients are able to walk again within 1 to 5 days (an effect which is particularly spectacular in bedridden subjects) probably due to the reduced pain and to better distribution of the mechanical forces. Hospitalization is usually shortened. In our experience with 18 patients, clinical improvement has been maintained for up to 18 months (mean follow-up 7 months) if the osteolytic process remains under control. Secondary effects are not rare but usually temporary. Recurrent pain, fever and/or inflammatory processes have been observed and usually resolve within 1 to 4 days. Intra-articular leakage can be avoided by careful patient selection. In association with radiotherapy, percutaneous injection of ciment appears to be an useful alternative to surgery for patients with destructive malignant lesions of the acetabulum, particularly in those with a poor clinical status and a short life expectancy. This technique has already been shown to be effective in lesions of the vertebral bodies. Several teams have made further attempts in other localizations.
OBJECTIVE: To investigate incorporation of the grafted bone used for acetabular reconstruction. DESIGN: Single photon emission computed tomography (SPECT) was carried out at the 1st, 6th, and 12th month after the operation and the uptakes on serial SPECT scintigrams were normalized. The horizontal histogram of scintigraphic activity at the level of the central grafted bone in the coronal image was designated the profile curve. PATIENTS: Seven patients who had undergone bipolar hip arthroplasty for osteoarthritis of the hip were randomly selected. RESULTS AND CONCLUSION: Five of seven profile curves obtained at the 1st month demonstrated a single peak at the host-graft junction. The profile curve obtained at the 6th month showed two peaks at the host-graft junction and the periphery of the grafted bone in all patients. The profile curve at the 12th month showed slightly increased activity in the center of the grafted bone. This preliminary study demonstrates that comparison of the serial profile curves on SPECT is valuable in evaluating the progress of incorporation of the grafted bone in hip arthroplasty.
Massive hemorrhage from the deep femoral artery is an uncommon entity in the setting of blunt extremity trauma without femur fracture. A case of deep femoral artery injury causing massive hemorrhage treated by angiographic embolization is reported. In this patient, persistent unexplained hypotension warranted angiographic analysis of a pelvic fracture. Because of a swollen right thigh, the negative pelvic angiogram was extended to include the lower extremity, confirming the diagnosis of a ruptured branch of the deep femoral artery. Bleeding was controlled with embolization that promptly resolved the patient's hemodynamic instability. The salient feature in common with previous reported cases of deep femoral artery injury was hemodynamic instability beyond accountable blood loss. We recommend angiographic analysis with radiological and surgical intervention in the setting of thigh swelling without femur fracture and unexplained hypotension. This management strategy was well tolerated, and the patient received minimal transfusions.