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PubMed1991

Anti-inflammatory and combined anti-inflammatory/analgesic medication in the early management of iliotibial band friction syndrome. A clinical trial.

Forty-three athletes presenting with unilateral iliotibial band friction syndrome (ITBFS) were randomly divided into three groups for the first 7 days of treatment (placebo-controlled, double-blind): 1--placebo (N = 13); 2--anti-inflammatory medication (N = 14) (Voltaren; Geigy); and 3--analgesic/anti-inflammatory combined medication (N = 16) (Myprodol; Rio Ethicals). All subjects rested from day 0 to day 7 and all groups received the same physiotherapy outpatient treatment programme from day 3 to day 7. On days 0, 3 and 7 the subjects performed a functional treadmill running test (maximum 30 minutes) during which they reported pain (scale 0-10; 0 = no pain, 10 = unbearable pain) each minute. Total running distance, total running time and the area under the pain v. time curve was calculated. Daily 24-hour recall pain scores were also recorded. The 24-hour recall pain scores decreased significantly for all the groups over the treatment period. This method of assessing efficacy of treatment therefore failed to show differences between groups. In contrast, during the running test only group 3 improved their total running time and distance from day 0 to day 7, whereas in all the groups the area under the pain v. time curve decreased from day 0 to day 7. All the other groups improved total running time and running distance from day 3 to day 7. All three treatment modalities are effective in the early treatment of ITBFS but physiotherapy in combination with analgesic/anti-inflammatory medication is superior.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetaminophen↗
PubMed1989

[Quantification of friction-induced corrosion of non-precious metal dental alloys].

In six commercially cast non-precious metal alloy samples friction-induced corrosion products were quantified by means of an electrochemical method. For a prosthodontic tooth restauration a model calculation arrives at uncritical ion concentrations, if measurement criteria are the daily nutritional element uptake or element concentrations considered toxic for the tissue. In case of multiple restaurations for some alloys nutritional element levels may be reached or exceeded.

Corrosion↗
PubMed1989

Fifteen years' experience with Charnley low-friction arthroplasty.

In the years from 1973 to 1986, 359 low-friction hip arthroplasties were performed by the precise Charnley technique in 310 patients. Three hundred seventeen hips were reexamined both clinically and roentgenologically. Clinical evaluation was performed according to follow-up time, separating the total number of hips into three groups. In Group A, 78.49% of the reevaluated hips remained asymptomatic ten to 14 years postoperatively, a percentage that has risen to 92.02% in Group B (studied five to nine years postoperatively) and 98.38% in Group C (studied one to four years postoperatively). The infection rate was 9.6% in Group A hips, 4.7% in Group B hips, and inconsequential in Group C hips. The roentgenographic study included 96 asymptomatic hips with a follow-up period of six to 11 years (mean, 8.3%). A radiolucent line was present in the acetabulum in 40.6% of cases; cortical hypertrophy at the tip of the stem was present in 48.8% of cases. Cup wear of more than 1 mm was measured in 41.3% of hips and was correlated with longer follow-up times and younger patient age. The results are encouraging for the continuation of arthroplasty by this method.

Adult↗
PubMed1978

A statistical review of 100 consecutive "U.C.I." low friction knee arthroplasties with analysis of results.

In 100 U.C.I. low friction knee arthroplasties, the primary goal of relief from pain was accomplished in most patients. However, the precise evaluation of the result of a knee arthroplasty can be difficult. Many of the patients who rated good or better within an average follow up time of one year had patellofemoral complaints to some extent. Cold flow deformation and prosthetic loosening is a definite concern about the tibial component. A longer follow-up study is needed to better evaluate the significance of the 1-2 mm radiolucent line at the bone cement interface of the tibial component. Although most patients in this series were greatly relieved of their pain, even better results are possible if the arthroplasty would include the patellofemoral joint and tibial component more substantially bonded to cancellous bone.

Aged↗
PubMed1988

Wear and loosening of the socket in the Charnley low-friction arthroplasty.

In the Charnley low-friction arthroplasty, wear of the HDP socket and the dimensional changes resulting from it are more important than the tissue response to wear debris. Study of wear and the related mechanical factors is likely to be more rewarding than the search for alternative methods of fixation.

Acetabulum↗
PubMed1988

Long-term results of Charnley low-friction arthroplasty of the hip.

The long-term results of 73 Charnley low-friction arthroplasties with follow-up of 10-14 years are presented. Eight hips required revision for socket migration resulting from excessive medialisation of the cup (2, 2.7%); breakage of the femoral stem (5, 6.8%); and loosening (1). A further 5 hips had radiological changes suggesting that they would require revision in the foreseeable future. Sixty hips (82.2%) remained clinically excellent with minimal radiological changes.

Adult↗
PubMed1988

The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties.

In a series of 200 Charnley low friction arthroplasties revised for various reasons, the preoperative anteroposterior roentgenograms were categorized in terms of demarcation at the bone-cement interface of the socket and compared with the operative findings of movement at the bone-cement junction. All sockets showing no demarcation were found to be fixed soundly. Seven percent of the sockets showing demarcation of the outer one-third only were loose, and when two-thirds of the sockets were demarcated, 71% were loose. Ninety-four percent of the sockets with complete demarcation and all sockets that had migrated were found to be loose at revision. There is a definite correlation between roentgenographic demarcation and socket loosening. The more extensive the demarcation, the more likely it is that the socket is loose. Radiographic demarcation of the cemented socket is a prognostic sign for eventual failure.

Adult↗
PubMed1988

A fifteen-year follow-up study of one hundred Charnley low-friction arthroplasties.

This two-part study concerns the fate of 100 Charnley low-friction arthroplasties performed in 92 patients at The Hospital for Special Surgery. The first part of the study is a clinical and radiographic evaluation of the 40 hips that were available for follow-up at an average of 15.3 years after surgery. The second part is a survival analysis of the arthroplasty, the individual components, and the patients, using data from all 100 arthroplasties. The authors conclude that the vast majority of older patients who undergo cemented total hip arthroplasty will not require a subsequent arthroplasty, and will have satisfactory pain relief for the remainder of their lives.

Activities of Daily Living↗
PubMed1988

Charnley low-friction arthroplasty. A fifteen- to seventeen-year follow-up study.

One hundred Charnley low-friction arthroplasties have been reviewed at 15 to 17 years. Thirty-five of the patients have died. A revision rate of 16 per cent has been recorded. Only two cases demonstrated cavitation and cortical destruction of the femur, and these cases were revised successfully. One of the major causes for revision was fracture of the femoral component. With modern alloys, this should not be a long-term problem. Our data would suggest that the cemented arthroplasty can be used with confidence in patients 65 and older. It is our hope that modern cement technology and component design will increase the longevity of the cemented arthroplasty.

Adult↗
PubMed1986

Single-hand tying of the surgeon's or friction knot.

Described is a new method for single-hand tying of the Surgeon's or Friction Knot, which is essentially a modification of the basic knot-tying technique, involving the formation of an inside loop. It is recommended for obtaining secure knots with synthetic suture materials.

Humans↗
PubMed1986

Trochanteric osteotomy in Charnley low-friction arthroplasty of the hip.

The use of trochanteric osteotomy in lateral approach to the hip joint is a fundamental part of Charnley's low-friction arthroplasty. Its use allows adequate exposure and easy orientation of the hip. Reattachment using a single transverse and double vertical wires was evaluated in 500 consecutive hip arthroplasties. Of 500 patients, 466 (93.2%) showed complete bony union of their trochanteric osteotomy at three months. A further 20 (4%) patients united by 12 months, giving a union rate of 97.2%; 34 (6.8%) patients who showed incomplete or defective union at three months. There were five dislocations. Only one patient required removal of the wires, for bursitis. The patients with defective bony union had a relatively high rate of wire breakage at three months. Despite a 1.8% complete detachment and 1% fibrous union, the transtrochanteric approach allows easy access without fear of shaft fracture in very difficult cases, with surprisingly little ill effect or loss of function even in those failing to reunite.

Aged↗
PubMed1986

Femoral prosthetic subsidence after low-friction arthroplasty.

A quantitative method has been used to measure femoral prosthetic subsidence after insertion. Increased amounts of subsidence are associated with the development of radiologic signs by one year after surgery. The most marked effect occurs with fractures of the cement tip. Follow-up examination up to five years shows that the rate of subsidence usually stabilizes, or stops at about 5 mm. Less commonly, subsidence is progressive, averaging up to 2 cm at five years. Demonstrable subsidence is also associated with prostheses that subsequently go on to break. The implications are that the nonflanged femoral prostheses are end bearing, with eccentric loading of the distal cement column, which leads to radiologic signs around the cement tip, demarcation, and, eventually, fracture of the cement tip. There may also be resorptive changes in the proximal femur, characteristically demonstrated in the medial femoral neck. It is suggested that the recent improvements in cement technique and the addition of the prosthetic dorsal flange may increase the success of low-friction arthroplasty.

Bone Cements↗
PubMed1986

Conversion of hip fusion to Charnley low-friction arthroplasty.

Spontaneous fusion of the hip following infection or surgical procedures can result in deformity that causes degenerative change in the associated joints. Loss of function can cause pain in adjacent joints. Conversion of hips fused in a deformed position to low-friction arthroplasty reduces shearing strain and improves walking function. Conversion of the fused hips constitutes a technically difficult procedure; adequate exposure with trochanteric osteotomy with the patient in the supine position is strongly advocated.

Adolescent↗
PubMed1986

Low-friction arthroplasty of the hip. A 10-12-year follow-up study.

The data from a series of patients operated upon by Charnley and reviewed after ten to 12 years shows that low-frictional torque arthroplasty remains a sound concept of design. If done with precision, it is still the best operation for patients with discomfort and disability from coxarthrosis. The development of a sound interface is controlled not only by the initial strength of the interlock achieved by the surgeon, but also by the loads applied to it by the patients. The total hip arthroplasty may be a miracle of modern medicine, but it can never be superior to normal articulation; this should encourage the surgeon to steer the patient away from unreasonable expectations. In this review, 217 arthroplasties were performed in 184 patients; 58 died, leaving 153 arthroplasties in 126 patients. Eighty-eight percent were more than satisfactory; 6% required revision. This was due to aseptic loosening in only two percent.

Adult↗
PubMed1986

Long-term results of low-friction arthroplasty in patients 30 years of age or younger.

The long-term results of 49 Charnley low-friction arthroplasties performed in patients 30 years of age or younger at the time of surgery was reviewed, with special emphasis placed on the radiologic evaluation of the acetabular and femoral components with average follow-up period of nearly ten years and the longest follow-up period of 15.5 years. Fifty-three percent of the sockets had no cement-bone demarcation and 28.6% had only a small line in the upper outer quadrant of the socket. Of the seven sockets that failed (14.3%), six had very deficient bone stock at operation. There were only two cases of femoral loosening. The rate of wear was 1.7 mm at ten years, which is not much greater than in older patients. Most of these cases were patients with conditions causing built-in restraints against over activity.

Adolescent↗
PubMed1986

Long-term results of low-friction arthroplasty performed in a community hospital, including a radiologic review.

This report is a prospective review of 450 low-friction arthroplasties (LFAs) performed by a single surgeon from 1972 to 1983 in a community hospital. The clinical results show sustained quality of the result over a maximum follow-up period of 11 years. The radiologic review shows a slight increase in the number and size of radiolucent lines with time. Bacteriologic studies confirm that clean-air technology reduces the bacteriologic contamination of the operating room and the wound. Deep infections occurred in 1.6% of cases. The most notable complication was failure to obtain bony union of the osteotomized trochanter in 14% of cases. The revision rate for aseptic loosening of the cup was 0.7% and of the femoral prosthesis 0.0%.

Adult↗
PubMed1986

Failures and reoperations following low-friction arthroplasty of the hip. A five- to fifteen-year follow-up study.

One thousand nine Charnley low-friction arthroplasties performed by one surgeon were investigated for occurrence of failure from five to 15 years after operation. Six hundred ninety-six of the arthroplasties, 499 operations for primary and 197 for secondary surgery, qualified for study. Eleven hips of the 499 primary arthroplasties (2.2%) and five hips of 197 secondary surgery (2.5%) required reoperation. Six hips (of five patients) in primary and four hips in secondary surgery were identified as "pending failure," for which further surgical correction may be imminent. There were six deep infections (1%), one in primary and five in secondary surgery. Five patients (0.7%) required reoperations other than revision of arthroplasty. Combining the actual and pending failures resulting from mechanical failures and deep infection, there were 31 failures in 696 arthroplasties (4.5%).

Adult↗