Total replacement of the elbow with (St.-Georg) prothesis.
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This is a report of a total elbow low friction arthroplasty consisting of a vitallium humeral component and a high density polyethylene ulnar component equipped with a special snap-lock fit joint. The immediate results in 16 patients are most encouraging.
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The author presents an original conceptual scheme of the complex medical rehabilitation of patients with RA on the basis of the conservative and surgical treatment of RA (3,000 cases). Successful results were attained in 70% of cases (follow-up of 5 years).
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Explore the source record for details and available documents.
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After clinical and radiological examination, the elbows of 74 patients with rheumatoid arthritis were examined by ultrasound. Clinical examination gives a good impression of the inflammatory changes of the elbow joint. Sonography was very useful in detecting synovitis and joint effusion and their distribution in the different parts of the joint. It is a good method to document the therapeutic effects; therefore, beside the clinical and radiological findings ultrasound may be helpful in planning further therapeutic measures for the patient.
An in vitro study was conducted to assess the efficacy of advanced cementing techniques in the fixation of the humeral stem in elbow arthroplasty. Sixteen fresh frozen cadaveric distal humeri were prepared to accept an acrylic sham humeral stem. Conventional cementing technique using doughy cement manually inserted and packed was performed in 8 specimens. The advanced cementing technique, consisting of canal irrigation, brushing and drying with gauze, canal plugging, and low viscosity cement pressurization with a delivery system was performed in the other specimens. All humeri subsequently were sectioned into 10 mm thick sections, photographed, and digitized to quantify the perimeter and area of the stem, cement mantle, corticocancellous junction, and cement voids. The degree of cement filling, determined from the area fraction of cement to the total available area within the corticocancellous junction, was significantly greater in the advanced group compared with the conventional group. Mechanical assessment of the specimens consisted of a push out load to failure test of the cement mantle from bone. For all locations in the distal humerus, the failure load and failure stress in the advanced group was significantly greater than the conventional group. It is concluded that development of an effective cement restrictor and application of advanced cement techniques in vivo should improve the initial fixation of the humeral component and may decrease the incidence of aseptic loosening associated with elbow arthroplasty.
Indications for radial head endoprosthetic replacement (Link) and early results in 2 patients 52 and 20 years of age are presented. Excellent results were achieved according to Mayo Elbow Performance Index criteria. The authors introduce own dismantable endoprosthesis with moving head.
In 1972 the authors began working on a limb amputation method using custom endoprostheses. Because of the biomechanical characteristics of these prostheses, good long-term results have been achieved. The current study presents the analysis of 27 cases, including 11 total femoral replacements, with a followup between 10 to 24 years (median, 14.4 years), with an overall score of 75% using the International Symposium On Limb Salvage evaluation system. Analyzing this surviving group, the authors realize that proximal humerus and proximal femur prosthesis with total or partial joint replacement have better scores of prosthetic survival, limb function, and patient acceptance and the lowest rates of mechanical complications. However, the replacement involving the knee had more complications and worse scores. The authors conclude that the simplest prosthetic design implanted had the fewest intrinsic prosthetic complications. Reducing the stiffness of a prosthesis and increasing the range of movement of the joint involved decreasing the stress forces between the prosthesis and the bone. This may have contributed to the favorable outcomes reported in the series.