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PubMed1982

Surgical rehabilitation.

There is hardly any other disorder where the possibility of replacing destroyed joints by artificial ones has transformed the functional outcome so decisively as in rheumatoid arthritis. The advances achieved in surgery may even be regarded as the most important result of any research on rheumatoid arthritis as published in recent years. Arthroplastics account for almost half of all interventions in our own statistics which cover almost 6000 operations on patients with this disease. Surgical synovectomies account for more than 40 per cent, and various other techniques are used in only 10 per cent of operations. Indications and contra-indications are discussed first in a more general way, and the need for close collaboration of family doctor, rheumatologist, orthopaedic surgeon and highly qualified therapeutic staff is emphasized. In the following sections the most rewarding methods used for rehabilitation of the upper limbs are described, including pre- and post-surgical management as well as the results to be expected. Subsequently our standard programme for the surgical rehabilitation of the affected joints of the lower limbs is presented. Special reference is made to a new technique for the fixation of the arthroplasty in cases of rheumatoid acetabular protrusion.

Adult↗
PubMed1991

Souter-Strathclyde arthroplasty of the rheumatoid elbow. 23 cases followed for 3 years.

Twenty-three elbows in 17 rheumatoid arthritis patients have undergone unconstrained Souter-Strathclyde elbow replacements since March 1984. One patient developed a deep-wound infection, and 4 others had a temporary ulnar nerve paresis. At follow-up 3 (0.5-6) years postoperatively, there was a moderate improvement in the arc of movements: 25 degrees in extension-flexion and 45 degrees in forearm rotation. Pain relief was achieved in 20 cases. Three elbows required revision, two following recurrent dislocation and the other after a humeral fracture and component loosening.

Adult↗
PubMed1993

Radiographic assessment of component orientation in elbow arthroplasty. A technical description.

We describe an alternative method of taking standardized radiographs of the elbow in patients with rheumatoid arthritis, taking into account fixed deformities. The technique enables assessment of the orientation of joint replacement components, including their axial rotational alignment. The accuracy of the method for calculating axial rotational alignment has been evaluated using a skeleton model. Within the 20 degrees limits of arm position the accuracy was found to be on average 1.4 degrees for the humerus and 2.2 degrees for the ulna.

Arthritis, Rheumatoid↗
PubMed2003

[Total elbow arthroplasty].

The authors describe indications and contraindications for total elbow arthroplasty. The brief characteristic of total elbow replacement is done. The authors describe its own case of clinical use of the Coonrad-Morrey implant.

Arthroplasty, Replacement↗
PubMed1989

Surgical management of advanced hemophilic arthropathy. An overview of 20 years' experience.

Advanced hemophilic arthropathy often causes moderate to severe pain and significant incapacity by the third or fourth decade of life. Most of these patients can be managed conservatively with clotting factor replacement on demand, therapeutic exercises, antiinflammatory drugs, orthoses, and activity restriction. Some patients, however, have such severe pain and disability and frequent need for clotting factor replacement that reconstructive surgery is required. Over the last 20 years at the present authors' institution, 168 such procedures have been performed. Of these, 141 were primary procedures and 27 were reoperations for persisting or recurring symptoms, failed prostheses, and infection. End-result analysis at the latest follow-up examination indicates that all patients are improved in terms of recurrent hemarthroses and pain, and all but two are improved in terms of function. Results are analyzed and compared with existing reports in the world literature in order to determine appropriate indications for surgery and which procedures are most successful.

Adult↗
PubMed1985

Surgical treatment of juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis is rare and only affects a small number of children but can lead to severe crippling of adolescents or adults unless they are treated early. In this review the problems encountered in the surgical treatment, particularly those caused by skeletal stunting are discussed. The results of synovectomy of the knee and elbow are valuable procedures in suitably selected patients. Stapling of the knee in young children with genu valgum gave good correction in the majority. Soft tissue operation on the hip and knee in young children with severe deformities have given encouraging results. Complications and the results of reconstructive surgery for the hip and knee are discussed, and it was found that total joint replacement in these young patients with badly damaged hips is fully justified before they become chairbound.

Adolescent↗
PubMed1985

Motion pattern analysis for evaluation and design of a prosthetic hook.

This study was designed to evaluate motion patterns of individuals with upper extremity amputations while performing a manual task. The objectives were to analyze performance time of repeatable motion elements that constituted the locomotion of upper extremity amputees, and to develop the performance profile which could be used as an evaluation method of hand prostheses. The findings identified a significant difference in performance ability for motion element grasp, as compared to motion elements reach, move, position, and release. Performance profile of amputee patients was introduced. The profile displayed the contribution of the various motion elements to the overall performance time. The performance profile was used to evaluate the standard prosthetic hook, and served as a criterion for the design of a new functional hook.

Activities of Daily Living↗