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[Indications for surgery of the knee joints in chronic rheumatoid arthritis (author's transl)].
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Synovectomy or total replacement of the knee in hemophilia.
Eighteen major operations on the knee joint were performed in sixteen patients with hemophilia, eight operations being synovectomy and ten being total knee replacement. Synovectomy was performed for recurrent bleeding associated with synovitis. The average age at operation for patients who underwent synovectomy was 16.4 years, and the average follow-up was thirty-one months. No patient had a recurrent hemorrhage following synovectomy. The patients who had total knee arthroplasty for disabling pain had an average age at surgery of 35.7 years and an average follow-up of twenty-three months. The pain was markedly reduced in all eight patients and all achieved full unprotected weight-bearing. Loss of some motion was observed in twelve patients, but the functional gain outweighed the loss of knee mobility. Seven major complications occurred in the sixteen patients, but none of them affected the outcome.
Autologous transfusions in elderly total joint replacement patients. A review of blood replacement methods.
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Total knee arthroplasty. A prospective study of 180 cases.
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[Orthopedic surgery in patients with rheumatoid arthritis].
Studying their subject the authors have been found that among the orthopedic surgical interventions the most frequently applied procedure were the alloarthroplasty and the synovectomy. Half of the operations are performed on the hand and the knee. Because of the polyarticular and multilocular characteristic of the disease very often more than one operations are necessary in case of rheumatoid patients. In case of sequence operations attention is called constant communication with rheumatologist and individual assessment of each case.
[The sheep: an animal model for ligament prostheses?].
Ruptures of the anterior cruciform ligament is difficult to repair. Ligament prostheses are sometimes useful. We tested a ligament prosthesis which had the original property of combining a polyester braid with a matrix favouring collagen ingrowth. We implanted this prosthesis in the knee joint of 10 sheep after sectioning the anterior cruciform ligament at it origin. The ligaments were recovered after 6 months. We studied the functional and radiographic results. Tolerance was studied in samples of the articular fluid and synovial tissue. We evaluated bone attachment and fibrous growth using micro-radiography and specific coloration techniques. Samples were examined under electron microscope. No rupture was encountered. We observed a satisfactory functional and radiographic result. No intolerance was observed. The neoligament had a bony or mixed attachment in 60% of the cases and was comprised of oriented tissue in 90% of the cases. Vascular invasion was important. These findings are promising and suggest that long-term studies should be undertaken.
Interposition of Vitallium plates in arthroplasties of the knee: Preliminary report.
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The evolution of total knee arthroplasty.
The current status of knee replacement surgery suggests that high density polyethylene and chrome cobalt alloy or stainless steel are acceptable materials for use in the intra-articular environment of the knee; that prosthetic components of knee units can be firmly fixed in bone with methylmethacrylate; and that a wide range of prosthetic units are available which will provide acceptable clinical results if used within the limits for which they have been designed. The indications for total knee arthroplasty have been designed. The indications for total knee arthroplasty have become reasonably simple and straightforward. Contraindications for the use of the various units available are relatively obscure and very seldom stressed. Each unit available will fail, however, if used under conditions of bone loss, deformity, and ligamentous instability for which it was not designed. The importance of the surgeon understanding and respecting the limitations of the total knee unit he chooses, and skillfully adapting it to the pathologic anatomy and pathophysiology of the patient's knee cannot be overemphasized.
[Synovectomy and prosthetic substitution of rheumatic knee joints (author's transl)].
Synovectomy and alloarthroplasty are the prinicpal forms of surgical treatment of rheumatoid arthritis (RA) of the knee joint. The aim of both procedures is the reduction or elimination of the painful condition, the quantitative reduction of analgesics and hormone preparations, and improvement of function. Synovectomy removes the principal pathogenetic area of RA. The indications, contra-indications, valve technique of the two methods are gone into. The problems of rehabilitation are referred to.
Pennsylvania dentist. Hospital not liable for defective prosthesis.
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The bone-cement interface temperature during total joint replacement.
Sets of thermoprobe measurements of the temperature of the bone-cement interface were made during twenty total joint-replacement procedures. Although the range of rise in temperature was wide, from 3 to 17 degrees centigrade, the highest temperature obtained was 48 degrees centigrade, which is well below the denaturation point (56 degrees centigrade) of proteins. Several factors, such as the presence of blood and moisture at the interface and the large surface area and poor heat conductivity of methylmethacrylate, prevent the interface from experiencing the high rise in temperature that occurs at the center of the polymerizing cement mass.
Hallux limitus/rigidus deformity: a new great toe implant.
The authors present a new alternative to the problem of hallux limitus/rigidus deformity. The new Bioaction great toe implant (Orthopaedic Biosystems, LTD, Scottsdale, Arizona) appears to be superior to the popular hinged implant, since it is comprised of two separate components and therefore appears to be more resilient to implant breakage/failure. This manuscript will examine the etiologic factors contributing to this deformity, a brief retrospective review of traditional surgical treatment and a case presentation utilizing the Bioaction great toe implant.
Results of single compartment arthroplasty with acrylic cement fixation. A minimum follow-up of two years.
Single compartment modular knee replacements produced good or excellent three-year follow-up results in a success rate of 92 per cent. Contracture, thrombophlebitis, infections and other complications are infrequent.
[Indication and first results of 110 partial- and total knee joint replacements (author's transl)].
First experiences in allo-arthroplastics of the knee with 82 Guepar- and 28 sledge protheses are reported. The primary indication was painful osteoarthritis. The most important complication was the recurrent dislocation of the patella with following osteoarthritis, secondary vascular and infected tissue lesions.
Hemophilic arthropathy. Current concepts of pathogenesis and management.
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Ipsilateral hip and knee replacements as a single surgical procedure.
A total of thirteen surgical procedures were performed on eight patients, all of whom had a history of rheumatoid arthritis. Five patients had bilateral hip and knee replacements and three patients had ipsilateral hip and knee replacements for a total of twenty-six joint replacements. Ambulatory status for all patients was significantly improved and all patients subjectively reported a great reduction in pain postoperatively. Complications included two transient peroneal-nerve palsies in the same patient from which she recovered spontaneously, and one questionable pulmonary embolus which resolved with heparin therapy. The relative advantages of this type of procedure and the indications for and against surgery are discussed.
A longitudinal study of the radiolucent line at the bone-cement interface following total joint-replacement procedures.
After 100 consecutive total hip arthroplasties, a radiolucent line at the bone-cement interface as seen on serial roentgenograms was on the acetabular side in fifty-nine hips and on the femoral side, in three. Similarly, after seventy-five consecutive non-hinged knee-replacement arthroplasties, a radiolucent line was found at the bone-cement interface beneath the polyethylene component more frequently in knees in which the more constrained geometric implant was used (forty-two of fity-nine) than in knees in which the less constrained polycentric and modular prostheses were used (three of sixteen). The presence of a lucent line at the bone-cement interface in these joints did not signify looseness or failure of the arthroplasty.