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At least 721 records · Page 40Linked to original sources

Radiographic evaluation of the Zurich cementless total hip acetabular component.

OBJECTIVE: To radiographically evaluate the Zurich cementless total hip (ZCTH) cup and correlate lucency with clinical signs of implant instability, time since surgery, and implant generation, using zonal analysis. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 53). METHODS: Radiographs of dogs that had ZCTH arthroplasty (>1 year) were evaluated using zonal analysis, for lucency surrounding the cup-bone interface (number of zones, length, area). Dogs were examined for clinical signs of implant instability (lameness, hip pain). Lucency was correlated with lameness, time after surgery, and implant generation. RESULTS: Radiographs of 68 implants (18 generation I, 50 generation II) were evaluated. Eight dogs were lame (11.8%). Dogs with lameness were more likely to have lucency in > or =2 zones of analysis (per view), have >2 times the average curvilinear length of lucency, and have >4 times the average area of lucency surrounding the implant compared with non-lame dogs. A weak relationship was observed between time after surgery and implant generation; however, there was no relationship between time after surgery and lucency. CONCLUSIONS: Dogs with lameness after ZCTH arthroplasty were more likely to have lucency at the cup-bone interface. Lucency was better evaluated by radiographic projection than zonal analysis. Temporal progression of lucency was weakly correlated with implant generation. CLINICAL RELEVANCE: Dogs with lucency in > or =2 zones of analysis should be evaluated more frequently for clinical signs of implant loosening. Further investigation of serial radiographs after ZCTH arthroplasty is warranted.

Acetabulum↗

Wide-track polycentric total knee arthroplasty: one year follow-up study.

The use of a peritoneal catheter enhances diagnosis using arthroscopy by affording a clear visibility of the knee joint. The accuracy in diagnosis is significantly enhanced using this method of irrigation. No better method of irrigation is available for cases of acute knee joint injuries.

Adult↗

Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty.

OBJECTIVE: To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty (TKA) the microorganism-specific cumulative probability of treatment failure after prosthesis removal and delayed reimplantation arthroplasty. PATIENTS AND METHODS: All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester between 1980 and 1991 were identified. The study group comprised patients who were free of infection at the time of reimplantation arthroplasty. This cohort was followed up until treatment failure, infection with another organism, prosthesis removal, death, or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate the cumulative probability of treatment failure. RESULTS: Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period, 38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure occurred in 1 (2.6%) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5-year cumulative probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%). CONCLUSIONS: These data suggest that prosthesis removal and delayed reimplantation arthroplasty is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time of reimplantation arthroplasty.

Adult↗

[Treatment of malignant fractures of the femur with total hip-femur-knee joint alloplastics (author's transl)].

This is to report as an example of 2 such cases, the indications and operative procedures of total hip-femur-knee joint alloplastics for malignant fractures of the femur. This is an alternative to the exarticulation of the femur in the case of impossibility to fix the osteosynthesis material on the remaining femur. The higher radicality of this method in comparison to the common femur-saving way might lead to a wider usage.

Adenocarcinoma↗

The planning of orthopaedic reconstructive surgery using computer-aided simulation and design.

Three-dimensional reconstructions from computed tomographic (CT) images are currently being used clinically in a wide variety of orthopaedic surgical applications. The computer may be used to select the optimum standard artificial joint replacement or to design a custom artificial joint replacement for a particular patient. Where large bony defects exist, the computer may be used to design bone allografts for joint reconstruction and to manufacture models of the bones for use in planning the surgery. In cases where osteotomies are performed to improve the mechanics of the joint, each proposed osteotomy may be simulated on the computer to identify the surgical plan that will optimally normalize the diseased joint.

Adolescent↗

Osseointegration and mechanical stability of pyrocarbon and titanium hand implants in a load-bearing in vivo model for small joint arthroplasty.

PURPOSE: To test the mechanical stability and histologic osseointegration under load-bearing conditions of 2 different materials, pyrocarbon (Py) and titanium (Ti), in a rabbit model. METHODS: Proximal interphalangeal implants (9 Ti, 8 Py) were placed into rabbit knees and the animals were killed after 3 months. Subsidence was assessed by monthly x-rays. Mechanical stability was measured with a nondestructive pullout test. Implant osseointegration was evaluated by an analysis of the relative implant-calcified bone contact surface on microradiographs and by a histomorphometric analysis of the percentage of bone and connective tissue contact with the implant surface. Histologic examination included assessment of bone apposition on the basis of fluorochromes. RESULTS: Subsidence was found in all 8 Py implants but in none of the Ti group. All 9 Ti implants were mechanically stable; all 8 Py implants were loose. A significantly higher implant-bone contact was found for the Ti group compared with the Py group. Bone apposition increased with time and was highest for the Ti implants 6 weeks after implantation. CONCLUSIONS: In the rabbit model osseointegration of implants was highly dependent on the material. A reliable osseointegration was found for Ti implants. For Py implants no osseointegration or implant stability was achieved. For use of small joints of the hand we therefore recommend Ti-based implants.

Animals↗

Arthroplasty of the knee.

Arthrodesis of the knee is a simple and safe operation that ensures stability and freedom from pain. But it is achieved at the expense of movement and occasionally of social acceptability. If arthroplasty is to be recommended, the advantages of arthrodesis must be retained, with the added bonus of a functional arc of movement.

Aged↗

Clinical experience with two-component first metatarsal phalangeal joint implants.

The development of the two-component implant systems has generated considerable interest over the past 5 years. It is important to critically document and record the clinical experiences with these devices as they occur. The authors present an objective evaluation of their early findings and comment on possible recommendations for the future.

Contraindications↗