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PubMed1992

Cementless prosthesis of the hip joint with "spongy metal" surface. A prospective study.

Our investigations in human specimens and animal experiments show that prostheses with a spongy metal surface can become fixed by bony ingrowth to varying degrees. After consistent clinical and radiological follow-up over 12-65 months (mean 34 months) in a prospective study of 100 consecutive patients in whom 106 cementless total hip replacements had been carried out, we were able to show that after 1 year 82% of patients were pain-free with the prosthesis fixed by bony ingrowth, 8% were pain-free with the prosthesis fixed by dense fibrous tissue and 10% were not pain-free, but did not want revision surgery. Thigh pain decreased steadily from 53% 3 months postoperatively to 6.6% 15 months after operation. We believe that, when the implantation technique is exact, a high percentage of cementless spongy metal prostheses are fixed by bony ingrowth, and that a cementless prosthesis should be implanted only in patients under 60 years of age without osteoporosis.

Female↗
PubMed1986

Uncemented two-component femoral prosthesis for the hip joint. A 50-month follow-up study.

The Monk Duopleet femoral interlocking uncemented two-component endoprosthesis consists of a polyethylene cup covered by a metal cap and an Austin-Moore type stem. Seventy-two patients (average age, 71 years) were treated by this arthroplasty: 27 for subcapital femoral neck fracture, 36 for osteoarthritis, and nine as an exchange operation. Three patients died following operation. After a mean follow-up time of 50 months, 47 patients were reexamined clinically and radiographically. Because of loosening, four patients had the prosthesis removed. Twenty-six patients were classified as excellent, 12 as good, six as fair, and three as poor. There were no cases of acetabular intrusion. The Monk Duopleet prosthesis may solve the problem of the loosening that had been associated with femoral component alone. The long-term results are promising and appear to be better than the results of the standard Moore prosthesis. The Monk Duopleet prosthesis is an alternative to other two-component endoprostheses for the treatment of subcapital hip fractures and in the group of patients suffering from osteoarthritis, where an arthroplasty with a cemented prosthesis may be considered hazardous because of age or general disease.

Adult↗
PubMed1986

Silicone rubber implant arthroplasty of the metacarpophalangeal joint in rheumatoid arthritis: a follow-up study of 32 patients.

A retrospective analysis of silicone rubber implant arthroplasty of the metacarpophalangeal joint in 32 patients with rheumatoid arthritis is reported. One hundred seven implants were followed in 37 hands for an average of 44 1/2 (12 to 120) months. Active motion of the metacarpophalangeal joint averaged 34 degrees, with a mean extension deficit of 7 degrees and a mean flexion 41 degrees. Ulnar deviation recurred to more than 10 degrees in 33 of 107 fingers (31%). Fracture of the spacer was confirmed in four joints (4%). One fracture of the proximal phalanx and one of the metacarpal head had occurred. Bone resorption around the stem or a hinge and migration of the implant were found in 26 (24%) fingers. Patient satisfaction was high; 27 patients experienced significant pain relief, the functioning of 31 hands (84%) was improved, and 28 patients (32 hands) thought that the cosmetic appearance of the hand was improved.

Adult↗
PubMed1996

High implant fracture incidence with Sutter silicone metacarpophalangeal joint arthroplasty.

We performed a retrospective review of Sutter silicone metacarpophalangeal (MP) joint arthroplasties in 34 patients (42 hands, 168 implants) with rheumatoid arthritis. Patients were evaluated at an average of 27 months (minimum follow-up period, 12 months). Twenty percent of the implants were shown to be definitely fractured on final follow-up examination, and 45% followed for more than 3 years were definitely fractured. At the final follow-up examination, the average ulnar drift in intact implants was 11 degrees and in the fractured implants, 23 degrees. However, there was no correlation between implant fracture and patient satisfaction. Eighty percent of patients said they would undergo the procedure again. Because of a significantly higher implant fracture incidence at a relatively shorter follow-up period than that of most studies of silicone MP implants of the Swanson design, we have abandoned the use of the Sutter implant.

Arthritis, Rheumatoid↗
PubMed1990

Replacement of the first metatarsophalangeal joint with a silicone elastomer ball-shaped spacer.

We report the use of a silicone elastomer ball-shaped spacer for the treatment of hallux valgus and hallux rigidus. One hundred and eleven operations were performed in 77 patients over a 5-year period. The best results were obtained in patients with hallux rigidus. Good results were obtained in hallux valgus, but it was found that in patients with severe preoperative deformity the correction obtained was inadequate, and an additional procedure would be required for full correction. There were no cases of silicone synovitis.

Adult↗
PubMed2004

Seventeen-year survivorship analysis of silastic metacarpophalangeal joint replacement .

We reviewed the records and radiographs of 381 patients with rheumatoid arthritis who had undergone silastic metacarpophalangeal joint replacement during the past 17 years. The number of implants was 1336 in the course of 404 operations. Implant failure was defined as either revision or fracture of the implant as seen on radiography. At 17 years, the survivorship was 63%, although on radiographs two-thirds of the implants were seen to be broken. Factors which improved survival included soft-tissue balancing, crossed intrinsic transfer and realignment of the wrist. Surgery to the thumb and proximal interphalangeal joint had a deleterious effect and the use of grommets did not protect the implant from fracture.

Adult↗
PubMedDate not supplied

Modification of the total first metatarsophalangeal joint implant arthroplasty.

The Swanson Silastic HP 100 Flexible Hinge Toe Implant (Dow Corning Wright, Arlington Tennessee) displays superior tensile, elongation and tear propagation strength in comparison to other silicone implant materials. It is, however, subject to many factors which may shorten its life-span. One reason for such failure has been attributed to the irregular contour of bone ends created after metatarsophalangeal joint arthroplasty, resulting in abrasion shards and shearing fractures of the implant stems and hinge. Titanium grommets were developed to alleviate this factor. This case report demonstrates a complication subsequent to total first metatarsophalangeal joint implant arthroplasty and the effectiveness of the Swanson Flexible Hinge Toe Joint Grommet. (Dow Corning Wright, Arlington, Tennessee).

Consumer Behavior↗
PubMed1988

[Long-term results of finger joint endoprostheses of the "St. Georg" model].

Long-term results of 100 cemented finger joint replacements (endoprosthesis) of the "St. Georg" design are presented. Good reduction in pain and swelling was noted. There was only a little improvement in motion of the replaced metacarpophalangeal joint, but more in the proximal interphalangeal joint; the latter decreasing from radial to ulnar. Approximately one half of the preoperative ulnar deviation was corrected. Mechanical failures occurred in approximately 30% of the implants. Without changing the design, this demanding technique cannot be recommended routinely.

Adult↗
PubMed1979

[Comments on the lateral load capacity of the phalangeal joints (author's transl)].

The article compares the load capacity of the collateral ligaments of the metacarpo-phalangeal and interphalangeal joints exposed to a laterally applied force. The tests were performed in vivo with 50 each female and male volunteers. It was found that the average load capacity of the metacarpo-phalangeal and interphalangeal joints in women was 5.8 kp and in men 12.3 kp. Furthermore, the bones of the long fingers with the preserved joint capsules and collateral ligaments of ten corpses were also examined, and the collateral ligaments exposed to a load which was increased to the point of their destruction. The average values found in this manner were 26.5 kp for the metacarpo-phalangeal collateral ligaments and 15.4 kp for the interphalangeal collateral ligaments. This means that the pain threshold is usually below the destruction limit, so that generally there will be no spontaneous overloading. It is important for the construction of endoprostheses that their stability level should always be above that of the pain threshold and should attain at least the values of the tear tests, since otherwise these endoprotheses will not function properly. These basic prerequisites enable a comparative study of endoprostheses, the results of which will be presented at a later date.

Adult↗
PubMed1980

[Last result of the first humerus prosthesis out of isoelastics (author's transl)].

The present knowledge about alloarthroplastic is given in a short summary, pointing out the special importance of the isoelastic prosthesis. The importance of a long term observation is pronounced and demonstrated by the first isoelastic shoulder prosthesis implanted 10 1/2 years ago, after resection of a semimalignant caput humerus tumor. During this time no pain, incompatibility, stress protection or loosening of the prosthesis could be observed. The bone reaction during the time of fixation is described. Within 10 1/2 years the mobility of the prosthesis as part of the shoulder joint has decreased, which is probably explained by a shrinking of the shoulder joint capsule.

Female↗