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At least 973 records · Page 54Linked to original sources
PubMed2005

Systemic delivery versus elution of drugs that enhance device performance.

Questions are being raised as to whether it is better to deliver a drug systemically or via a controlled-release mechanism in situations where it is intended that the drug would enhance medical device performance. The issues are addressed here in relation to cardiovascular devices and orthopaedics.

Anti-Bacterial Agents↗
PubMed1975

[Compression arthrodesis of the knee joint].

The results of 42 cases of compression arthrodesis of the knee joint during a 5.5 years period are reviewed. Main indications were degenerative, rheumatoid and posttraumatic arthrosis and tuberculosis of the knee joint. Other differential indications and the operative procedure following the Charnley-Müller method are described. The complications - pseudarthrosis, infection, false rotation - are discussed.

Adult↗
PubMed1991

Surgical treatment for temporomandibular joint problems.

Surgical intervention may be necessary for some patients with specific pathology or derangement of the temporomandibular joint as part of an overall management protocol. The current literature discusses the efficacy of arthroscopy, the treatment of the difficult problem of ankylosis, and the use of implants and autogenous and allogenic materials to replace the disk.

Ankylosis↗
PubMedDate not supplied

The Keller arthroplasty with use of the Dow Corning titanium hemi-implant.

Complications following the Keller arthroplasty, such as instability, shortening, and recurrence, are well known. Implants acting as a joint spacer may present some of these complications. Presently, silicone is the implant material most widely accepted and used, despite its unsuitability for long-term use and potential to produce bone and soft tissue pathology. Titanium is a more suitable material for long-term implantation and has been available since 1986 for use in the first metatarsophalangeal joint. Presented is a brief review of first metatarsophalangeal arthroplasty progressing to the development of the Titanium hemi-implant and a case report of its use with a 3-year followup.

Female↗
PubMedDate not supplied

Foreign body reaction in a Dacron-meshed hemi-implant.

With increased experience in the use of silicone elastomer great toe implants, there has been a commensurate increased incidence of foreign body reaction to these prostheses. In the mid- to late 1970s, the use of Dacron-meshed hemi-implants was abandoned due to the high incidence of such reactions. Although previously thought to be due to the Dacron mesh itself, the authors content that it was, rather, due to the inferior grade of silicone elastomer used in these products.

Female↗
PubMed1990

[Reconstructive surgery of malunited joint fractures of the hand].

Malunion of fractures, joint fractures and pseudoarthroses leads to therapy-resistant pain during function and loading, especially in the wrist, with a risk of early arthrosis. In spite of the extraordinary adaptability of the hand, malunion in the axis and rotation can lead, for example, to cross-finger malfunction. Because of the relatively thin layer of soft tissue, secondary operations to correct the axis, rotation and the length of the phalanx are possible. Each reoperation on the hand diminishes the blood flow, and the anatomical structures change with cicatrices. Thus, the risk of damaging blood vessels or nerves is increased. Operative correction of the position, arthroplasties, joint prostheses, arthrodeses, arthrolyses and denervation are all part of the operative repertoire. It is necessary to repair the joint surface as well as the capsule-ligament structures. Furthermore, we also express our opinion regarding the indications and contraindications of secondary operations. We discuss the risks and complications during operations and especially stress the aspect of having enough patient information. Finally, we describe the operative techniques in special cases. The necessity for reconstructive secondary operations is increasing as more and more replantations are being done and hand lesions in polytraumatized patients are being neglected. To date, not enough attention has been given to these problems in the scientific literature.

Arthrodesis↗
PubMed1989

[Preoperative autologous blood deposit and liquid storage for replacement arthroplasty].

Transfusion of homologous blood components is associated with immunological (incompatibility, alloimmunization, immunosuppression) and infectious risks (hepatitis, cytomegalovirus, HIV and other agents). Endoprosthetic surgery of the hip and knee frequently requires transfusion. Preoperative deposit of autologous blood can reduce homologous transfusion requirements. The simplest method is liquid storage of whole blood. In order to re-examine the efficiency of our present scheme of preoperative deposit, we studied patients scheduled for endoprosthetic surgery with respect to the amount of blood deposited, stimulation of erythropoiesis, and homologous blood requirements at the time of operation. PATIENTS AND METHODS. Sixty-seven consecutive patients (33 men, 34 women) scheduled for endoprosthetic replacement of hip or knee or for revision arthroplasty of the hip were studied. Patients with anemia, coagulopathies, coronary heart disease, severe obstructive or restrictive pulmonary disease, cerebral sclerosis, syncopes and seizures were excluded from preoperative deposit. Patients deposited 450 ml at weekly intervals, with occasionally slightly higher or lower volumes. A patient was temporarily deferred when the hemoglobin concentration prior to donation fell below 11 g/dl. Blood was collected in CPDA-1 buffer. The aim was a deposit of three units. In patients undergoing exchange reoperation of a total hip arthroplasty, intra- and postoperative autotransfusion with a cell separator was employed in addition to preoperative donation. RESULTS. The age of the patients ranged from 43 to 83 years (mean +/- SD: 61.2 +/- 9.1). The differences between men and women with respect to height (172.9 +/- 6.8 vs 160.6 +/- 7.4 cm; p less than or equal to 0.001), weight (75.7 +/- 11.2 vs 69.1 +/- 11.0 kg; p less than or equal to 0.05), calculated blood volume (p less than or equal to 0.001), and erythrocyte volume prior to donation (p less than or equal to 0.001) were significant. A total of 185 units was deposited. Men donated 1350 (450-1970) ml blood (median, range) and women 1260 (340-1450) ml (p less than or equal to 0.01). Hemoglobin concentrations decreased significantly from an average of 14.7 g/dl in men and 13.8 g/dl in women prior to donation to 13.4 g/dl and 12.3 g/dl preoperatively (p less than or equal to 0.0001 for both groups). The donation was not associated with serious complications. For 4 patients the scheduled operation was deferred for a longer term. Forty-six patients (23 men, 23 women) underwent total hip arthroplasty, 12 (4 men, 8 women) exchange of total hip arthroplasty, and 5 (3 men, 2 women) endoprosthetic knee surgery. In total hip arthroplasty men required 0 to 500 ml homologous packed red cells (median=0), women 0 to 1250 ml (median=0;p less than or equal to 0.05). Thirty-nine (69.6%) of the patients, 19 (82.6%) men and 13 (56.5%) women, did not require homologous transfusion.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗