Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
ReviewSystemic effects of implanted prostheses made of cobalt-chromium alloys.
Systemic effects of Co-Cr alloy/polyethylene hip joint prostheses were investigated using instrumental neutron activation to determine the concentrations of up to 16 elements. First, in a prospective study whole blood and serum taken from 10 patients from 1 day before to 90 days after implantation were analyzed. Secondly, in a retrospective study whole blood and serum from 23 patients who had had prostheses in place for up to 18 years were analyzed. ⋯ The analyses of tissues from the vicinity of the implants in the two deceased implant patients showed strong local effects of Co, Cr, Zr, and Hf, the latter two elements originating from the X-ray contrast media in the bone cement. The analyses of organs revealed significant Co and Cr enrichment in several tissues and organs. Consequently, it can be seen that implant corrosion is not an occurrence of merely local significance, but one that affects the trace element status of the entire organism.
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Arch Orthop Trauma Surg · Jan 1991
Lateral band release for post-traumatic extension contracture of the proximal interphalangeal joint.
In the patient with scarring of just the central band and lateral bands, there is a loss of active and passive flexion of the proximal interphalangeal (PIP) joint because the lateral bands have lost their normal volar shift. Surgical freeing of the lateral bands from the central band using parallel incisions may be required to allow full flexion of the PIP joint. ⋯ All operations were successful, with an average gain in range of motion of 47.5 degrees. This technique is simple, quick, and can be performed effectively on an out-patient basis.
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Arch Orthop Trauma Surg · Jan 1991
Comparative StudyUncoated polyethylene RM acetabular component versus Müller cemented acetabular component. A 4- to 8-year follow-up study.
Comparable patient populations with 160 uncoated RM acetabular cups and 263 cemented Müller standard acetabular cups were submitted to survival-time analysis in a retrospective study with a mean follow-up of 5.3 years for the RM cup and 6.1 years for the Müller cup. After 7-8 years 12% of the RM cups and 4% of the Müller cups had been exchanged, 40% and 15% respectively were loose. The poor performance of the RM cups is ascribed to additional external polyethylene wear, which leads to the formation of granulomas and destroys the weight-bearing osseous structures. Similar granulomas also develop on the proximal stem and thus endanger the same.
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Arch Orthop Trauma Surg · Jan 1991
Comparative StudyAseptic loosening of straight- and curved-stem Müller femoral prostheses.
Out of 1099 Müller total hip prostheses with straight and curved stems consecutively implanted between 1980 and 1984, those performed in as homogeneous a group as possible of patients under the age of 70 years were selected for the present retrospective study. There were 158 straight femoral stems with cementless RM acetabular cups, 105 straight stems with cemented Müller acetabular cups, and 158 curved stems with cemented Müller acetabular cups, and their results over a mean follow-up period of 5.8 +/- 1.24 years were compared. ⋯ Survival curves show a worse result for straight stems after 6 years; within a follow-up period of 6-8 years there was significantly more radiological loosening in straight stems than in curved. Loosening in straight stems is assumed to develop mainly as a physiological reaction to the presence of bone cement particles.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsClinicoradiological diagnosis of benign osteoblastoma of the spine in children.
Three cases of benign osteoblastoma of the spine in children are reported, diagnosed on the basis of clinicoradiological findings and confirmed at surgery and by histopathology. The authors feel that in all cases of painful scoliosis and painful torticollis, a careful search should be made for any suspicious area of sclerosis, especially in the posterior elements of the vertebrae, and all the positive or suspected cases should undergo nuclear bone scanning. All patients whose bone scan is positive should be subjected to computed tomography for differential diagnosis between osteoid osteoma and benign osteoblastoma.