[Round-table discussion on the surgical treatment of arthropathies].
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The authors present propositions of definitions and repartition of biomedical materials and products. After a historical review particular groups of biomedical materials were discussed, with special regard to implants.
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76 operated metastatic tumors of bone are reviewed. In the past 10 years modern methods (such as endoprothesis and the use of acrylic cement in the replacement of excised bone or for stabilisation of the spine) gave new possibilities to palliative surgery. Operative indication so that toleration of material are discussed.
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Kinesiologic measurements were made in patients with severe arthritis before and after geometric total knee replacements to evaluate the nature, rate and extent of change in their functional ability. Preoperatively, patients with rheumatoid arthritis functioned at lower levels than patients with osteoarthritis. Most patients with rheumatoid arthritis improved steadily after surgery, while progress of those with osteoarthritis was often irregular. The group with rheumatoid arthritis improved more than those with osteoarthritis, but they did not generally reach the functional level attained by the patients with osteoarthritis, and neither group reached the lower limits of normal variability 1 year postoperatively. On the average, both groups gained knee extensions, lost knee flexion, and gained isometric knee flexor muscle strength postoperatively. Every patient with osteoarthritis lost extensor muscle strength 1 year after surgery, while most with rheumatoid arthritis gained. During quiet standing, most patients had straighter knees postoperatively and bore a greater percent of body weight on the operated limb. Patients with rheumatoid arthritis improved more than patients with osteoarthritis in the type and amount of force applied to canes and crutches. Most patients walked faster postoperatively, took longer and more rapid steps, improved the pattern of knee motion used, and had smoother forward, lateral and vertical head motion.
Internal derangement of the knee joint following uni-compartmental total knee arthroplasty was caused by a loose fragment of methylmethacrylate lodging in the normal compartment of the knee joint.