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At least 307 records · Page 17Linked to original sources
PubMed1998

[Intestinal anastomosis with a biofragmentable rind (BAR). Results in comparison with mechanical and manual anastomosis].

METHODS: The use of the biofragmentable anastomosis ring (Valtrac-BAR) was attempted in 25 selected patients (group I) undergoing elective colonic resection for primary colon cancer, at the General and Cardiovascular Institute of the University of Milan. The results were compared with those of 30 selected patients who underwent elective colonic resection for the same pathology during the same period, and had their bowel anastomosis stapled (group II) or hand-sutured (group III). RESULTS: In group I there were 2 complications requiring reoperation: a little tear of the bowel near the BAR, and a postoperative ileus, compared with none in group II, that developed only 3 cases of abdominal wall infections. In group III, 2 patients developed a leakage of the anastomosis, one of them required reoperation. In the perioperative course there were 2 deaths (3.6%), in group II and III due to cardiovascular diseases. The results obtained showed no significant difference in the clinical course of the patients, or time of return of bowel function, and hospital stay. CONCLUSIONS: The conclusions is drawn that Valtrac-BAR device is a safe and reliable alternative to conventional suture anastomosis in all areas of the intestinal tract, except the low rectum.

Adult↗
PubMed1998

[Augmented anterior cruciate ligament replacement with the Kennedy-LAD (ligament augmentation device)--long term outcome].

The ligament augmentation device (Kennedy-LAD) is used to protect tendon grafts during the posttransplantation decrease in strength in anterior cruciate ligament (acl) reconstructions. The augmentation with the LAD is based on the concept of load sharing. Since 1983 we used the LAD in acl-reconstructions in 856 patients. In 63 cases we had to treat complications like infection (8), recurrent effusions (21), arthrofibrosis (34). The overall results are good with respect to stability, regain of strength and sports activity. In 73 cases resurgery was necessary because of synovitis (7), LAD-rupture due to re-injury (9), fatigue-rupture of the LAD (22), meniscal tears (35), 2.7 +/- 2.3 years (range: 2 months to 10 years) after LAD implantation. Modern techniques in acl reconstruction lead to comparable results without synthetic augmentation. Therefore, we now recommend the use of a LAD only in cases of repeated acl replacement with week tendon grafts, to avoid an allograft.

Adult↗
PubMed2002

Implant complications and failures: the fixed prosthesis.

The implant-retained fixed prosthesis has been advocated as an effective restoration offering significant benefits over conventional prosthetics. The success of treatment depends on careful pre-surgical planning and prosthesis design. This paper outlines some common complications encountered during the planning, fabrication and maintenance of both large and small fixed prostheses and suggests how these complications can be minimized.

Bite Force↗
PubMed2002

Rotationplasty after failure of a knee prosthesis for a malignant tumour of the distal femur.

Failure of massive knee endoprostheses implanted for malignant tumours of the distal femur in children presents a difficult problem. We present the results of rotationplasty undertaken under these circumstances in four boys. They had been treated initially at a mean age of 9.5 years for a stage-IIB malignant tumour of the distal femur by resection and implantation of a massive knee endoprosthesis. After a mean period of eight years and a mean of four operative procedures, there was failure of the endoprosthesis because of aseptic loosening in two and infection in two. Function was poor with a mean Musculoskeletal Tumor Society score of 7.5/30, and considerable associated psychological problems. At a mean follow-up of 4.5 years after rotationplasty there was excellent function with a mean score of 27.5/30 and resolution of the psychological problems.

Adolescent↗
PubMed2002

Early failure of a press-fit carbon fiber hip prosthesis with a smooth surface.

We investigated a press-fit anatomically shaped hip stem made of carbon fiber-reinforced composite material in a prospective clinical study. The intention of the design was that a surface of interlaced carbon fibers in the proximal part would achieve metaphyseal fixation. A total of 51 carbon stems were implanted in 48 patients (30 women and 22 men). Mean age at operation was 59 years. The patients were followed clinically, radiologically, and with computed tomography. At 6-year follow-up, aseptic loosening was observed in 47 hips (92%). Forty stems were revised on average 30 months (range, 9-58 months) postoperatively. All revised carbon stems showed fibrous fixation without any bony on-growth. No osteolysis was seen. Histologically, no carbon wear or inflammatory reactions were observed. Only 4 cases had a good clinical result with bony fixation on computed tomography scan. The carbon fiber prosthesis without effective ingrowth or on-growth irregularities showed a high rate of early loosening.

Arthroplasty, Replacement, Hip↗
PubMed1994

The use of muscle flaps for salvage of failed total knee arthroplasty.

Deep infections occur in 1-5% of all patients undergoing total knee arthroplasty, and may result in failure of the prosthesis and subsequent arthrodesis. Two-stage reimplantation is often successful, but depends upon the presence of good soft tissue coverage. We have treated 9 patients in whom chronic infection developed which required removal of the prosthesis, debridement, and implantation of antibiotic impregnated spacers for control. These patients all had poor quality soft tissue cover precluding prosthesis reimplantation. The use of muscle flaps resulted in 7 of the 9 patients having successful reimplantation of a prosthesis and remaining free of infection in a follow-up ranging from 1-5 years.

Adult↗
PubMed1998

Metal-backed patellar component failure in total knee arthroplasty: a possible risk for late infection.

Between 1985 and 1987, 1837 primary total knee arthroplasty (TKA) prostheses were implanted in 1503 patients. Group I included 843 knee with metal-backed patellar components (MBPC), and group II included 994 knees with all polyethylene patellar components (APPC). Follow-up averaged 5.7 years (range, 2 to 11 years). Twenty-four MBPC (2.9%) and 16 APPC TKA cases (1.6%) developed deep infection. In the time interval between arthroplasty and 2-year follow-up, eight MBPC and 11 APPC knees developed deep periprosthetic infection. The difference in the cumulative probability of infection between the two groups during this time interval was not significant (relative risk, 0.9; 95% confidence interval [CI], 0.3-2.1; P = 0.73). However, after the 2-year follow-up, 16 MBPC and 5 APPC knees developed late infection, and the difference in the cumulative probability of infection between the MBPC and APPC knees during this time interval was significant (relative risk, 3.1; 95% CI, 1.1-8.5; P = 0.02). Although the mechanism for this increased risk of these late infections is not well understood, the attendant synovitis, effusion, and relative hyperemia of these knees in the presence of the particulate metal and polyethylene debris may increase the potential of bacterial seeding to these prostheses. Particulate metal debris has been previously shown to suppress bacterial phagocytosis and may play a role in the pathogenesis of these infections. We propose that the presence of metal-backed patellar failure represents a "prosthesis at risk" for the development of late prosthetic infection.

Adolescent↗
PubMed2006

Risk of infection with an antibiotic coated penile prosthesis at device replacement for mechanical failure.

PURPOSE: The inflatable penile prosthesis is well established as an effective treatment for select patients with organic erectile dysfunction. The risk of prosthetic infection at primary implantation is approximately 2%. However, for revision or replacement procedures the risk of infection has been reported to be as high as 13.3%. To minimize the overall risk of prosthetic infection an antibiotic coated inflatable penile prosthesis (InhibiZone) has been developed. To assess the impact on infection rates we reviewed our experience with the use of this device at prosthesis replacement for mechanical failure. MATERIALS AND METHODS: We retrospectively reviewed the records of all patients undergoing inflatable penile prosthesis replacement for mechanical failure with an antibiotic coated prosthesis between May 2001 and November 2004. Salvage procedures for clinically infected prostheses were excluded from analysis. Chart review was performed with examination of operative notes, all postoperative contacts and microbiological data. RESULTS: A total of 55 patients underwent replacement of an inflatable penile prosthesis for mechanical failure using a device coated with rifampin and minocycline HCL (InhibiZone). In all patients before reimplantation component spaces were irrigated in standard fashion. With a median followup of 32 months (range 12 to 54) postoperative device infection requiring explantation developed in 1 patient (1.8%). Intraoperative cultures from the pump site grew coagulase negative staphylococcus. CONCLUSIONS: Our data suggest that an antibiotic coated inflatable penile prosthesis may lead to decreased infection rates in patients undergoing penile prosthesis replacement for mechanical failure.

Adult↗
PubMed1988

Success and failure in penile prosthesis surgery: two cases highlighting the importance of psychosocial factors.

Two cases, carefully selected from a longitudinal, prospective investigation of the relationship between psychosocial variables and postsurgical adjustment to a penile prosthesis implantation, were studied intensively. In both cases, the patient and sexual partner were assessed, presurgically, on a number of psychological, marital, and sexual functioning variables; their subsequent satisfaction with the prosthesis, and their psychological, marital, and sexual adjustment were measured at 6 and 12 months postsurgery. Despite many similarities in medical aspects of the surgery, for one couple a successful outcome was evidenced, whereas the other couple demonstrated a therapeutic failure despite the technical success of the surgery. Psychosocial differences between the couples were identified as they may relate to the discordant outcomes observed. Clinical implications of these results are discussed, as are the strengths and weaknesses of our methodological approach.

Adaptation, Psychological↗