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At least 145 records · Page 8Linked to original sources
PubMed2005

[The WEKO finger joint prosthesis].

The WEKO prosthesis was developed between 1989 and 1993 in order to restore stability and function of destroyed metacarpophalangeal joints in rheumatoid arthritis. The prosthesis is a hinged one and is fixed to the bone cementlessly by special osseointegrated sleeves in which the stem of the implant is fastened by a cone. Forty-eight patients with 74 prosthesis have been operated on in 1993. In a follow-up study in 2003, 43 of them (89.5 %) with 65 prostheses (87.8 %) could be re-examined clinically and radiographically. In seven patients (16.2 %) implant arthroplasty failed comprising loosening of the prosthesis within their sleeves, loosening of the sleeves in the bone and implant breakage. Twelve implants (16.2 %) had to be removed. The range of motion at follow-up was 0/10/70 degrees in comparison to 0/0/90 degrees postoperatively. Patients satisfaction over the first three to four years was higher than later due to deterioration of the rheumatoid disease. Thus, classical handscores to assess the outcome could not be applied. A second generation of the WEKO prosthesis was developed to improve rotational stability and osseointegration paying attention to reports concerning failures which were seen also by other authors. The stem of the implant was changed to a cylindrical one with star shaped cross-section which allows some pistoning in order to reduce the stressload of the sleeves.

Arthritis, Rheumatoid↗
PubMed2001

[Biomechanical considerations on shoulder joint prosthesis implantation].

The biomechanical goals of prosthetic reconstruction of the shoulder are to restore the normal anatomy and range of motion, and to recreate the normal soft tissue balance of the static and dynamic stabilizers of the glenohumeral joint. An unconstrained prosthesis design best reproduces the physiological articulation and original anatomy of the shoulder. Humeral head components have been recently developed, which are adaptable to the variable anatomy of the proximal humerus (third generation design). A precise reconstruction of the three dimensional structure of the proximal humerus may lead to an improved functional outcome. However, there is still a lack of biomechanical data to support this concept. The optimal design of the glenoid component remains a challenge for future research. Specific issues including the choice of biomaterials, the optimum shape, radius of curvature, surface area of the articulation, component height and stem design remain under investigation. Although the prosthetic design represents an important factor in the success of glenohumeral arthroplasty, the surgical reconstruction of the soft tissues to recreate the normal soft tissue balance as well as postoperative rehabilitation determine the functional outcome.

Biomechanical Phenomena↗
PubMed1981

A clinical evaluation of the total first metatarsophalangeal joint prosthesis: the use of footprints in assessing foot contact.

The use of footprints in evaluating surgical results is most significant to the physician. This clinical investigation consisted of patients whose surgical correction of severe hallux valgus included the use of the Swanson-total great toe hinged prosthesis. The resulting failure of weightbearing by the great toe pulp postoperatively were found to be associated with excessive weightbearing by the lesser metatarsal heads, evidenced by discrete keratomas, a relative lesser metatarsalgia, and footprinting analysis. In conclusion, we believe that there is a definite relationship between the lack of weightbearing under the first ray and the instability of the first metatarsophalangeal musculoligamentous structures. This was found to be influenced by metatarsal protusion and first metatarsophalangeal joint range of motion. The possibility also exists that the intrinsic property of silicone played a role in failure of great toe weight-bearing. It is our belief that the Swanson-total is truly and mainly a joint spacer that relieves pain associated with first metatarsophalangeal joint arthrosis. The possibility exists that when using the Swanson-total with a short first metatarsal protrusion it may be necessary to perform shortening osteotomies on the appropriate lesser metatarsals. This redesigning of the metatarsal parabola could restore a normal forefoot weight-bearing pattern and minimize postoperative complications. Further research on this matter is in the planning stages.

Adult↗