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At least 1,405 records · Page 78Linked to original sources
PubMed2001

Guidance by ultrasound of intra-articular injections in the knee and hip joints.

OBJECTIVE: To develop and assess a stable method for ascertaining the placement of intraarticular injections for osteoarthritis (OA) in the hip and knee. METHODS: Injections into the hip or knee joint with e.g. hyaluronan or cortisone were performed under the guidance of ultrasound. For this purpose an Acuson Sequoia apparatus and a 8-15 MHz transducer were used. After perforation of the capsule with a 21 G needle, 0.5-1 ml of atmospheric air and 1 ml lidocain 1% was injected with simultaneous recording of the ultrasound signals. This procedure was undertaken before the injection of the medication through the in situ needle. RESULTS: In the hip joint the injected air could readily ascertain the placement of the injection with a sharp echoic contrast forming on the ultrasound picture respecting the joint cavity. In the knee joint the procedure gave the best results in joints which have a small amount of fluid in either the suprapatellar bursa or in a pouch regularly observed over the lateral joint margin. However, also in some so-called 'dry' knee joints the air could be traced in the bursa by ultrasound. CONCLUSION: By the injection of air, it is possible to test the placement of intraarticular injections in both hip and knee joints. This procedure will give a supplementary documentation of the injection as compared to a mere ultrasonographic demonstration of the position of the needle in the joint. The method is proposed as a tool for both learning purposes and quality assurance in daily therapy.

Adjuvants, Immunologic↗
PubMed1984

Trace element burdening of human tissues due to the corrosion of hip-joint prostheses made of cobalt-chromium alloys.

Using instrumental neutron activation analysis, the concentrations of 18 elements were studied in human articular capsule and fascia lata before and after application of total endoprostheses of the hip joint made of cobalt-chromium alloys. Tissues from the vicinity of the implant showed extreme burdening by corrosion products (Co, Cr, Ni), as well as by Zr, Hf, and Ba from the bone cements. Tissues more distant from the implants exhibited lower, but still significant burdening. Moreover, some essential trace elements not contained in the implant materials were changed in the tissues after implantation. In order to clarify the dissolution of alloy constituents in biological media, the passivation of cobalt-chromium alloy was investigated by tracer techniques using Ringer's solution as a simple model of the body fluids. The passivation process lasted for more than 1 month and was accompanied by a selective dissolution of the alloys constituents in the order Ni greater than Co approximately Fe greater than Mo greater than Cr. A comparison of the tissue analyses with the corrosion experiments demonstrates that the distribution patterns of the corrosion products in the tissues are influenced by both the corrosion process and the biochemical properties of the corrosion products.

Adult↗
PubMed1992

[The effect of blood conservation techniques on the plasma concentration and elimination of midazolam in patients undergoing hip joint surgery].

OBJECTIVE: The question was to evaluate whether haemodilution or intraoperative autotransfusion have an influence on plasma levels and clearance of midazolam. DESIGN: The study was designed as a prospective evaluation of patients with total hip joint replacement. The patients received neuroleptanalgesia supplemented with enflurane. After induction of anaesthesia with midazolam (0.1 mg/kg body weight) haemodilution procedure was started. During surgery a cell saver was used for blood salvage. In the recovery room drainage blood was also being processed by a cell saver. PATIENTS: The study includes 10 patients belonging to ASA-group II with an average weight of 79.4 kg (53-100 kg), at an average age of 57.9 years (44-68 years). MEASUREMENTS AND MAIN RESULTS: Midazolam was measured in patient blood and in autologous blood units by gas chromatography. 151 micrograms of midazolam, i.e. 1.8% of the initial dose was retransfused in hemodilution blood. By processing of blood in the cell saver, 99.5% of the amount of midazolam found in the sample unit was eliminated. The maximum quantity was 5.5 micrograms in the washed autologous red cell concentrate. CONCLUSION: Considering the analytic limit of 2 micrograms/l of midazolam in plasma, retransfusion of autologous blood cannot influence the plasma concentration of midazolam. Therefore, there is no risk of re-sedation in retransfusing autologous blood postoperatively.

Aged↗
PubMed1988

Shaft fissures due to implantation of cementless total endoprostheses of the hip joint. An experimental study.

Since 1982, at the Orthopedic Department of the Pulmologic Center of the City of Vienna we have used the Zweymüller shaft system and the pyramidal threaded socket by Schwägerl when implanting cementless hip endoprostheses. Some patients repeatedly complained about pains in the shaft region within the first postoperative months, though these complaints could not be explained clinically or radiographically. On 15 human cadavers we implanted a total of 20 Zweymüller shafts and examined the femurs for ruptures of the shaft. Our special interest was the course of the fracture lines, their localization, and their display on roentgenograms. It appeared that fissures of the shaft are easily caused by the forced driving-in of the prosthesis. In about half of all cases the fissure cannot be seen on roentgenograms because of the site is covered by the implant itself. The fracture lines do not always begin intertrochanterally or from the calcar femoris; therefore, they cannot be recognized during surgery. This problem should be considered during implantation as well as during postoperative remobilization.

Aged↗