Acta orthopaedica
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Randomized Controlled Trial Comparative Study
Different loss of BMD using uncemented press-fit and whole polyethylene cups fixed with cement: repeated DXA studies in 96 hips randomized to 3 types of fixation.
In cemented THA, aseptic loosening of the cup is more common than loosening of the stem, while periprosthetic osteolysis of the socket resulting in difficult reconstruction problems has emerged as the most significant problem with cementless cup fixation. ⋯ Contrary to previous studies of cemented stems, the use of fluoride cement did not influence the periprosthetic BMD 2 years after the examination. Increased loss of BMD with use of uncemented press-fit cups in the region in which osteolytic lesions are commonly found suggests that stress shielding may initiate the development of this complication. Longer follow-up will, however, be necessary to substantiate this hypothesis.
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Treatment of fractures of the humeral head remains controversial. We reviewed the outcome of our treatment of 2- and 3-part fractures of the proximal humerus using external fixation as a way of preventing damage to the vascularity of the humeral head and of reducing the risk of infection associated with open techniques. ⋯ This procedure provides satisfactory early functional results, simplifies rehabilitation by limiting postoperative motion to a lesser degree than other techniques, is less aggressive than open reduction techniques and osteosynthesis, and leads to few complications.