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At least 1,099 records · Page 61Linked to original sources
PubMed1984

The pronated index finger deformity in the rheumatoid hand.

Rotatory deformities of the digits have received little attention in either the anatomical or surgical literature. In developing the flexible hinge silicone arthroplasty method for the metacarpophalangeal joint, we found rotation deformity was a problem that interfered with obtaining an ideal functional result. The study reported here was the result of our interest in improving this arthroplasty method for the rheumatoid patient.

Arthritis, Rheumatoid↗
PubMed1983

The use of the Papineau bone-grafting technique in salvage of the infected total joint implant.

The development of osteomyelitis after first metatarsophalangeal total implant-arthroplasty can be a complication encountered by any foot surgeon. The postoperative course is often long with a guarded to poor prognosis. The authors present a salvage procedure for this surgical complication utilizing aggressive surgical debridement followed by an autogenous bone graft. The technique, as described by Papineau, was developed to shorten hospitalization time and reduce deformity. A case presentation is given to illustrate the successful use of this procedure in the treatment of postoperative osteomyelitis of the foot without systemic antibiotics.

Adult↗
PubMed1978

[Amputation of the knee joint in vascular diseases].

Reported are 97 extensive amputations in 87 patients from 1975 to 1977. Postoperative early mortality was 47% and depended on the disease and the various factors that made amputation necessary. Amputations in chronic occlusive vascular disease without septicemia had a far lower mortality, 10%. Amputations in patients with septicemia resulted in a mortality of 90%. According to Burgess, amputations of the lower leg, exarticulation in the knee joint, and myeloplastic and open amputation of the thigh should be considered in that order. Exarticulation in the knee joint is only feasible in the presence of an open, deep, femoral artery.

Acute Disease↗
PubMed1984

Foot abnormalities in rheumatoid arthritis.

By anticipating the deformities that can occur in the rheumatoid foot and by carefully and compulsively looking for them, we can more effectively deal with the pathologic conditions. Although we usually equate conservative care with nonoperative treatment, and shoe corrections are certainly important, early operative intervention may be essential. Procedures we must use early if indicated are as follows: decompression of the posterior tibialis tendon and other medical structures in the tarsal tunnel, excision of intermetatarsal bursae, and talonavicular arthrodesis. Furthermore, relating forefoot to hindfoot deformities is important. A valgus hindfoot should be corrected before laterally dislocated MTP joints. A great deal can now be accomplished in treating the remaining weight-bearing joints of the lower extremity. The possibility of combining some of these procedures while hips or knees are undergoing surgery also exists. For example, it may certainly be reasonable when performing a knee arthroplasty to consider a hindfoot arthrodesis or a forefoot arthroplasty on the opposite side.

Ankle Joint↗
PubMed1978

Simultaneous and staged bilateral total knee arthroplasty.

Bilateral total knee arthroplasties were performed in twenty-six patients with severe rheumatoid arthritis and osteoarthritis. Twelve had simultaneous operations bilaterally and fourteen had separate, staged procedures. The improvement in the two groups of patients was statistically comparable to the relief of pain and the over-all restoration of function. There were no intraoperative complications. The postoperative morbidity was minimum and was not predominant in either group. Costs were greatly increased with the staged procedure.

Arthritis, Rheumatoid↗
PubMed1984

Osteonecrosis in the transplant recipient.

From 1969 to 31 March 1982, 1,769 organ transplants were performed by the University of Minnesota Transplant Service. Fifty-one patients had severe osteonecrosis develop requiring 83 total joint arthroplasties. Patients with diabetes were underrepresented in the arthroplasty population; this may be due to neuropathy masking some disease. All of the patients received dramatic relief from pain and experienced improved function. Only one surgical mortality occurred--a patient with sepsis. To minimize complications, prophylactic antibiotics were used, and most patients did not undergo prophylactic anticoagulation. The most common complication was dislocation of the hip, at five to eight times the rate of those in the nontransplant arthroplasty population. These can be minimized by avoiding the posterior lateral surgical approach and by meticulous capsular repair. Despite the youth and activity of these patients, component wear was not a problem. However, because of the multicentric nature of this disease, components and surgical approach should be chosen carefully. Incidence of severe osteonecrosis was highest among cadaver kidney recipients. No HLA identical kidney recipient had severe osteonecrosis develop. Consequently, we concur with previous authors that osteonecrosis may be caused by the higher dosages of immunosuppressive agents required to prevent rejection of HLA nonidentical organs.

Adolescent↗
PubMed1984

A synopsis of surgery for rheumatoid arthritis (excluding the hand).

Over the years, orthopedic surgery has become more involved in the care of the rheumatoid patient. A more active and aggressive attitude by orthopedic surgeons has thrown new light on the handling of the rheumatoid patient. Currently, the surgical treatment of rheumatoid arthritis is evaluated not only by the outcome of a procedure on a single skeletal part but also by the generalized effects of the disease on the activity of the patient and the function of neighboring joints. Soft-tissue procedures, such as synovectomy and release operations, have been beneficial. Prosthetic surgery yields satisfactory results, and every effort should be made to give the rheumatoid patient as long a period as possible with relief of pain and increased mobility.

Arthritis, Rheumatoid↗
PubMed1984

Biomechanics of implanted joints of the foot.

Joint implants in the foot have contributed much to reducing deformity and pain. They can act as spacers to improve cosmetic appearance; they can increase or decrease motion in joints, while adding stability; and they can replace arthritic or diseased joints and reduce their associated symptoms. They cannot produce normal function of the foot. There is a great need to know more about the long-range effects of implanted joints on foot function and the associated compensations that invariably occur. This knowledge will lead to improved criteria for the existing implants and new designs and materials for the implants yet to come.

Biomechanical Phenomena↗