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PubMed1979

New knees now.

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Arthroplasty↗
PubMed1979

Total joint arthroplasty. The knee.

Total knee replacement has become an established form of treatment for gonarthrosis and usually results in excellent relief of pain and approximately 90 degrees of joint motion with satisfactory joint stability. The anatomic stability that cannot be restored at surgery must be provided for by additional prosthetic stability. Fixation of prosthetic devices, particularly in the tibia, is marginal and results in an increased incidence of loosening when the quality of bone is weak, as in osteoporosis, or when shear stress is increased because of malalignment or prosthetic constraint. Resurfacing techniques provide the greatest options if surgical revision is necessary. Surgical goals should be realistically assessed so as to maintain the best potential for future treatment options.

Arthroplasty↗
PubMed1995

The axes of rotation of the thumb interphalangeal and metacarpophalangeal joints.

The axes of rotation of the thumb interphalangeal and metacarpophalangeal joints were located using a mechanical method. The interphalangeal joint axis is parallel to the flexion crease of the joint and is not perpendicular to the phalanx. This offset of the axis with respect to the phalanx explains the ulnar deviation and pronation that occurs with flexion of the interphalangeal joint. The metacarpophalangeal joint has 2 fixed axes: a fixed flexion-extension axis just distal and volar to the epicondyles, and an abduction-adduction axis related to the proximal phalanx passing between the sesamoids. Neither axis is perpendicular to the phalanges. All physiologic motion for these joints occurs about the axes. These are the mechanical axes of the joints through which the muscles and external forces act. Knowledge of their location should help in constructing prosthetic joints and in planning reconstructive surgery such as tendon transfers.

Finger Joint↗
PubMed1994

[Tendon interposition arthroplasty vs Kessler silicone prosthesis for basal joint arthritis of the thumb].

Of 86 patients with osteoarthrosis of the trapeziometacarpal or pantrapezial joint operated on during 1978-1988, 52 cases (14 males, 38 females) were reviewed. 32 had undergone interposition of the flexor carpi radialis tendon and 18 Kessler's silicone prosthesis technique. 2 had silicone prosthesis replacement in 1 hand and tendon interposition in the other. The average age of all patients was 65.5 years (range 56-74). Average follow-up was 7.0 years for the 32 after the interposition procedure (range 8-14), and 10.5 years (range 8-14) after prosthesis implantation. A greater proportion of those after tendon interposition reported alleviation of pain. There was no statistically significant difference between the groups with regard to patient satisfaction, need for job change, range of abduction and opposition, grip and pinch power, thumb length and ability in activities of daily living. Tendon interposition arthroplasty is simple and relatively inexpensive compared to silicone prosthesis insertion, which has inherent complications, such as breakage of the prosthesis and synovitis. Tendon interposition has therefore been our standard procedure since 1988.

Aged↗