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At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

[Early results of implantation of an unconstrained metatarsophalangeal joint prosthesis of the first toe].

PURPOSE: Does the ReFlexion Implant System provide an alternative in operative treatment of hallux rigidus? METHODS: We have been using the non-constrained prosthesis since April 1997. 26 implants were reviewed 13-41 months after insertion, analysing radiological and clinical data. A questionnaire was answered by the patients. RESULTS: Surgery was either performed cementless (8 cases), as a hybrid, i.e., only phalangeal part cemented (14 cases), or cemented in both components (4 cases). So far, 3 joint replacements had to be removed for pain. Radiological signs of loosening around the cemented phalangeal components were evident in 11 cases. There was no correlation between radiological loosening and discomfort. CONCLUSIONS: The implant can reduce pain distinctly. Patients satisfaction with the treatment is relatively high. The range of movement in the first MTP is still limited. In our opinion the ReFlexion Prosthesis can be quoted as an acceptable alternative for surgical treatment in advanced cases of hallux rigidus. In case of failure a conversion to the distraction-arthrodesis is possible.

Aged↗
PubMed1996

[Septic infection of hip joint prosthesis with Listeria monocytogenes].

A case of Listeria monocytogenes septicaemia and infection of a prosthetic hip joint is presented in a patient with non-insulin-dependent diabetes mellitus. The patient developed the infection five and a half years after primary alloplastic operation. The prosthesis was removed and a temporary prosthesis with gentamicin was placed ("spacer"). The antibiotic treatment included ampicillin, pivampicillin and sulfamethoxazole-trimetroprim. Six weeks after removal of the prosthesis an un-cemented prosthesis was placed, and the patient had a full functional recovery.

Aged↗
PubMedDate not supplied

[Radiologic changes of the bones following cement-free implantation of hip joint prosthesis in inflammatory rheumatic diseases].

The postoperative x-rays of 34 patients with rheumatoid arthritis or spondylitis who had received a cement-free fixed total hip endoprosthesis were examined. The postoperative period ranged from 3 months to four years. In the region of the acetabular component an increasing rate of osseous integration in relation to the postoperative time was observed. Adaptive modeling changes in the area of the femoral stem were found as radiolucent lines parallel to the implant. Also a densification of cancellous bone and cortical hypertrophy as well as cortical rarefaction was noticeable. The bone in rheumatoid arthritis or spondylitis reacts to the implantation of a cementless fixed total hip prosthesis similar as the bone in osteoarthritis.

Adult↗
PubMed1992

[Injury of the inguinal blood vessels in implantation of hip joint prosthesis].

Vascular injuries during or after total hip replacements have often been reported. In 2257 artificial hip joint replacements, we observed 8 cases of vascular injuries requiring reconstruction (3 cases), suturing (2 cases), end-to-end anastomosis (1 case), or ligature (2 cases) performed by a vascular surgeon. A separate skin incision for vascular repair was necessary in all patients. Most of the injuries occurred as a result of technical errors through lack of caution when using bone hooks or rough handling, resulting in dislocation of the hip joint. The latter occurs mainly in revision procedures. Six patients recovered fully, but two died, one of hemorrhagic shock and the other of cardiac decompensation.

Aged↗
PubMedDate not supplied

[Is the implantation of hinged knee joint prostheses still justifiable today? 15 years' experience using the Blauth knee joint prosthesis].

In objection to knee hinge prostheses there is often mentioned a higher complication rate. An increased load impact on the bone-cement interface results from the close connection of tibial and femoral components. This is assumed to cause bad results, as reported from early artificial knee joint replacements, characterised by weight bearing axes and direct contact metal to metal. These are contrasted to long term results of the Blauth hinge prosthesis. The Blauth prosthesis is constructed according to the low friction principle without a weightbearing axis. A prospective multicentric long term follow-up study reports on 556 prostheses. 463 (83%) were controlled between 1 and 15 years after operation (average: 43 months). Aseptic loosenings had to be confirmed in 1.3% of the patients, deep infections in 2.6%. The survival analysis did not show an erratic deterioration in dependence of the observation period. After 10 years there is still a probability of 89% that a prosthesis does not show a deep infection or loosening. The efficiency of artificial knee joint replacement by hinge joints should therefore not be judged on the results of the first generation of these models.

Adult↗
PubMed2001

Investigation of hip joint prosthesis damage.

Following total hip arthroplasty the durability of a prosthetic implant depends on many factors but is generally limited by two types of damage: wearing of frictional surfaces of the acetabular and femoral component as well as the loosening and migration of the "rosthesis-cement-bone" system. Since it is possible to establish a cause-and-effect relationship between these two damage types, the aim of this research is to investigate the phenomena related to the contact surface and their influence on the prosthesis-bone relationship in general for various sizes and conditions of loading of the hip joint. The experimental study was conducted using a Timken testing device modified in such a way that simulation of relative movements of the joint elements was achieved using a mechanism that produces conditions similar to those in the human hip joint. The analysis of obtained measurements showed that actual radii of friction of the hip prosthesis did not correspond to the theoretical ones and that only a small portion of the total friction surface is realized. Variations of the radius of friction for the examined prosthesis type were very large, which changes the hypotheses on the ability of the prosthetic head and the "prosthesis-cement-bone" system to bear a certain amount of load. The construction and design of prosthetic implant components has a significant influence on both the amount of wear at the site of contact and the loosening of prosthesis.

Arthroplasty, Replacement, Hip↗
PubMed1992

Fibrosarcoma in association with a total knee joint prosthesis.

A case of fibrosarcoma of the proximal tibia, arising at the site of a cemented Richards total knee joint replacement with cobalt chrome alloy is reported. The patient, an 80-year-old man, received the endoprosthesis because of osteoarthritis of the knee 4 years ago. The literature on malignant tumours occurring in association with endoprostheses is summarized and briefly discussed.

Aged↗
PubMed1998

Hip joint prosthesis design: effect of stem introducers.

The stress levels in the femoral component of a total hip prosthesis (Corin Taper Fit, Corin Medical Ltd, Cirencester, Gloucestershire, UK) were calculated by finite element (FE) analysis. This prosthesis has two holes drilled in the shoulder to engage a stem introducer. There were no unacceptable stress levels around these holes. Instead the maximum stresses were around the periphery of the shaft of the stem, as has been observed for FE analyses of conventional designs. Three prostheses were also subjected to cyclic mechanical testing (peak load 2.3 kN) according to the appropriate British Standard. The holes were examined for cracks, before and after testing, by stereomicroscopy. All three specimens were able to withstand 5 million loading cycles with no evidence of damage. Thus it is possible to design a femoral component with holes in the shoulder, to accommodate a stem introducer, without creating unacceptable stress concentrations.

Computer Simulation↗
PubMed2006

Low sensitivity of histology to predict the presence of microorganisms in suspected aseptic loosening of a joint prosthesis.

Intraoperative histology has a high specificity and sensitivity when a septic prosthesis loosening is suspected. However, its usefulness to predict the presence of microorganisms when aseptic loosening is suspected is not well defined. Intraoperative histology and cultures from periprosthetic tissue of 61 revision arthroplasties performed owing to suspected aseptic loosening were retrospectively reviewed. Frozen sections were evaluated following Mirra's criteria (adapted by Feldman). Culture was considered positive when the same microorganism was isolated in at least two samples. The cultures were positive in 12 cases and coagulase-negative staphylococci were the most common microorganisms (11 cases). In six out of 12 cases (50%), the histology revealed more than five polymorphonuclear leukocytes per high-power field. The sensitivity, specificity, positive and negative predictive value of histology to detect the presence of microorganisms was 50, 81, 40 and 86%, respectively. In conclusion, intraoperative histology using Mirra's criteria had a low sensitivity to predict the presence of microorganisms in samples from suspected aseptic prosthetic loosening.

Aged↗
PubMed1990

[Traumatic indications for total hip joint prosthesis].

In the years 1978-1986 the authors implanted 207 total prostheses in patients with the fracture of the femoral neck or after the fractures in the area of the hip joint. 50 patients were operated on for an acute fracture of the neck. The surgical technique in these indications does not differ on principle from the surgical technique of coxarthrosis. They point out a higher number of some peroperative complications. They checked 141 patients with and average follow-up of 47 months. In 4.2 per cent of late complications they reported roentgenological symptoms of loosening. Reoperation because of the loosening of the acetabular component was inevitable in 2.9 per cent of patients. All these cases fall into the group of patients in which the total hip arthroplasty was performed after the fractures of the acetabulum. In no patient it was necessary to reoperate the femoral component. Within the check up the patients underwent roentgenological examination and the result was assessed by the method according to Harris. In total, excellent result was reported in 43.2 per cent of patients, good result in 29.8 per cent, fair result in 14.2 per cent and poor result in 12.8 per cent of patients. With regard to a low number of complications and very good results of the evaluation according to Harris the authors consider total hip arthroplasty in the treatment of post-traumatic conditions for fully indicated. Total hip arthroplasty is indicated also in acute fractures of the femoral neck in which it brings in a short time interval good functional results with minimum complications. A group at risk is represented by patients operated on after the fractures of acetabulum.

Aged↗
PubMed1987

[Biocorundum--a new/type of poreless ceramic material of aluminum oxide for the manufacture of the elements of hip joint prosthesis. Biological and technological studies].

The Institute of Refractories Materials in Gliwice undertook researches in the field of technology of a new ceramic material of aluminium oxide for production of coxal joint endoprostheses. A poreless ceramic material of high chemical purity and density and required microstructure and good resistance to fracture, was achieved. The new ceramic material was called Biocorundum. By means of a similar technology also series of samples were produced for testing the biocompatibility of the material. Biological studies were carried out in the Department of Experimental Surgery and Biomaterials Research, Chair of Traumatologic Surgery, Medical Academy of Wroclaw. The studies comprised: 1. laboratory and toxicological tests in vitro of water extracts, 2. pathomorphological studies after intramuscular, peritoneal and intra-bone implantation of samples of the material in rats and piglets, 3. ultrastructural scanning studies of the implantation in rats and pigs and after 3- and 6-months long keeping in the Ringer solution. Preliminary studies and biological studies in vitro have shown a complete conformity of the material with the requirements. Tissue reactivity was studied on 36 Wistar rats. By pathomorphological studies a systematic macroscopic and microscopic estimation was possible. They have shown only minimal tissue reactivity to biocorundum implantation. In experimental studies on 14 piglets the biocorundum grafts were implanted into the tibia epiphysis for 3- and 6-months. Clinical, pathomorphological and X-ray studies were carried out. In all cases the Biocorundum grafts healed without any complications. On the basis of pathomorphological studies, the tissue reactivity around the grafts were estimated as minimal. This shows a high biocompatibility of the ceramic material. In X-ray studies were observed around the grafts small osteosclerotic changes and periosteum stratification. These changes resulted after surgical interventions in quickly growing piglets. Complementary studies of the surface of the material by scanning microscopy after 3 months long implantation and after 3 months long contact with the Ringer solution did not show any changes in comparison with the surface of the initial samples. After 6 months long implantation in individual samples rounding of the ceramic material grain edges were found, which could result from biological corrosive power. This agree with the findings of other studies on other ceramic aluminium oxide materials. The achieved results of complex studies of biocompatibility of the new poreless material developed in Poland--Biocorundum--have shown its complete biological suitability for production of elements of osteoarticul

Aluminum↗