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At least 811 records · Page 45Linked to original sources
PubMed1988

[Rheumatoid arthritis: surgery of the metacarpophalangeal joints of the long fingers].

The author reviews the pathophysiological mechanisms of rheumatoid deformations of the long fingers' MP joint. He considers the different possibilities of surgical treatments; then focusing on arthroplasty, he compares and comments on technical points (incision, resection of the MP head, section of intrinsic muscles, size of the implant, joint capsule and ligament reconstruction, dressing, postoperative care) and results (mobility, implant fracture, ulnar deviation and palmar dislocation) achieved by various authors. He concludes that the Swanson implant remains at present the best therapeutic treatment of rheumatoid arthritis of the long fingers' MP joint. However, in order to improve the results obtained, and to avoid long term complications, research should be pushed until we can avail ourselves of a true prosthetic arthroplasty based on other principles and new materials.

Arthritis, Rheumatoid↗
PubMed1995

Intraarticular carcinogenesis bioassays of CoCrMo and TiAlV alloys in rats.

Wear-debris powders of cobalt-chromium-molybdenum (CoCrMo) and titanium-aluminum-vanadium (TiAlV) alloys, which are widely used for orthopedic implants (eg, hip and knee prostheses), were tested for carcinogenic activity following intraarticular administration (20 mg/rat) to groups of 44 male Fischer-344 rats (Charles River Breeding Laboratories, North Wilmington, MA). Control groups received similar intraarticular injections of either a noncarcinogen (manganese powder, negative control rats) or a potent carcinogen (nickel subsulfide powder, positive control rats). The experimental groups of 8-12 rats were observed for 24 months after injection. No local tumors developed at the injection site in the negative control rats or in rats that received the CoCrMo or TiAlV powders; poorly differentiated or pleomorphic sarcomas developed at the injection site in 10 of the 12 positive control rats that were treated with nickel subsulfide. Incidences of primary tumors distant from the injection site did not differ significantly among the experimental groups. This study shows that, under experimental conditions, any carcinogenic activity of CoCrMo or TiAlV wear-debris powders is weak in comparison to nickel subsulfide. Based on this study and observations in other laboratories, intraarticular administration of test materials to rats provides a practical, reliable, and biologically relevant method for carcinogenesis testing of biomaterials used for orthopedic implants.

Alloys↗
PubMed2004

Techniques of digital arthrodesis: revisiting the old and discovering the new.

Digital surgery is commonplace for foot and ankle surgeons. The techniques of arthrodesis are more exacting and complex than techniques of arthroplasty. They are generally performed in cases of more severe deformity or underlying biomechanical abnormalities, which strongly influence the development and propagation of the deformity. When performed properly in a patient with good compliance, the results are consistently good and rewarding to patients and surgeons. Attention to detail cannot be overemphasized in managing digital deformities. Failure to do so is likely to result in a less than satisfactory outcome for physician and patient. Traditional techniques are proven effective approaches. Meticulous attention to detail and precise execution of the procedure will minimize complications. The exact role of newer implants for fusion is yet to be determined. Further short-term and long-term experience will determine their role in foot surgery.

Arthrodesis↗
PubMed1992

A randomized trial on the efficacy of an autologous blood drainage and transfusion device in patients undergoing elective knee arthroplasty.

The purpose of the study reported here was the determination of the efficacy of a postoperative autologous blood drainage and transfusion device in reducing allogeneic red cell requirements in patients undergoing elective knee arthroplasty. The study was a randomized controlled trial with adult patients undergoing unilateral elective arthroplastic knee surgery. Patients underwent suction drainage, attached to an autologous blood drainage and transfusion device, or standard suction drainage. Allogeneic red cells were given according to strict transfusion guidelines based on blood loss and postoperative hemoglobin values. Outcome measures included the mean number of allogeneic red cell concentrates required and the number of patients in each group who required no transfusion. Patients assigned to standard suction drainage had a mean allogeneic red cell utilization of 1.2 units (SD 1.0), as compared to a mean of 0.4 units (SD 0.8) in the group undergoing drainage with the autologous blood drainage and transfusion device (p = 0.0007). The percentage of patients not requiring allogeneic red cells was significantly higher in the latter group (74.3% vs. 32.5%; p = 0.002). The postoperative drainage and transfusion device was efficacious in reducing the amount of allogeneic red cells required by patients undergoing knee arthroplasty, and its use resulted in a 42 percent reduction in the number of patients requiring allogeneic transfusion.

Blood Transfusion, Autologous↗
PubMed2006

Sonography of joint replacements.

Sonography is ideally suited for the evaluation of joint effusion, synovial thickening, and the ligaments and tendons surrounding a joint replacement because it is not hampered by the dephasing artifact of magnetic resonance imaging or the beam-hardening streak artifact of computed tomographic scanning. Although it is unable to visualize deep within the joint or into the bone surrounding an arthroplasty component, its dynamic capability allows evaluation of joint kinematics and its real-time capability can guide interventional procedures. This article reviews the sonographic appearances of complications of arthroplasty of the shoulder, hip, and knee.

Hip Joint↗
PubMed2006

Magnetic resonance imaging of joint replacements.

An increasing number of joint replacements are being performed annually. Complications of joint arthroplasty are diverse and may involve the hardware as well as osseous and soft tissue components. Although modalities such as conventional radiography and scintigraphy remain the mainstay of radiological investigation, in some cases these traditional methods of imaging may be negative or underestimate the extent of disease. Magnetic resonance imaging (MRI) has been considered of limited benefit following arthroplasty because of severe image degradation caused by metallic components. However, with modification of pulse sequences, artifact reduction and improved visualization of periprosthetic tissues are achievable, enabling a comprehensive assessment of articular and nonarticular pathologies. The common artifacts in the presence of orthopedic hardware, optimization of pulse sequences to minimize metal-related artifacts, and the clinical uses of MRI following joint replacement, particularly with regard to total hip arthroplasty, total knee arthroplasty, and shoulder arthroplasty, are reviewed.

Arthroplasty, Replacement↗
PubMedDate not supplied

[Endoprosthetic replacement of the metatarsophalangeal joint of the big toe].

The article reports on 20 cases of cup-plasties of the first metatarsophalangeal joint. 13 cups were done without, 7 with bone cement. The early results in both groups were promising. One third of all cases showed failure 2 years postoperatively. Fixation with bone cement leads to markedly better results. In cases of failure it is always possible to bring about a result comparable to resection arthroplasty (Brandes' operation) by removal of loose components. The reaction of cancellous bone under the metal cup can be compared with that of the double cup arthroplasty of the hip.

Adult↗
PubMed1981

[Electron spectroscopy for chemical analysis. (ESCA). Examinations on formation and re-formation of the passive layer on vitallium (author's transl)].

The passive layer of a metal implant is responsible for its tolerance in a biological environment. A report is given on ESCA-investigations on the passive layer on Vitallium implants which consists largely of Cr-oxide and is only approx. 3-5 micrometer thick. This passive layer can easily be damaged with OP-instruments. The oxide layers rebuilt on exposure to air or on sterilization in boiling water were also investigated by ESCA. Oxide layers normally formed are very similar to the original passive layer. Accumulations of Co- and Mo-oxides are also observed, however. Some short implantation experiments show that the thin Cr-oxide layer is indeed effective as a passive layer. The analytical findings indicate that the formation or re-formation of the passive layer is due to a selective dissolution process. This accords with results obtained by the neutron activation analysis of the serum.

Chromium Alloys↗
PubMed1975

Osteoarthritis.

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Exercise Therapy↗