Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
Neurohistological findings after experimental anterior cruciate ligament allograft transplantation.
A multiplicity of surgical operations have been developed in an attempt to achieve satisfactory function after anterior cruciate ligament (ACL) repair. None of these procedures have been able to duplicate the fiber organization, anatomy of the attachment site, vascularity, or function of the ACL. Eighteen foxhounds received a deep-frozen bone-ACL-bone allograft and a ligament augmentation device. ⋯ As in normal ACLs, both neuroreceptor types were mostly located near the surface of the allografts and at the two bony attachments. This study demonstrated the first histological evidence of viable mechanoreceptors and free nerve endings in transplanted ACL allografts, not previously reported in other ACL substitutes used for ACL reconstruction. Particularly importantly for postoperative rehabilitation, this technique may allow the reconstruction of the proprioceptive functions of normal ACLs.
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Arch Orthop Trauma Surg · Jan 1992
Moderate heat treatment of bone allografts. Experimental results of osteointegration.
The use of bone allografts is often essential in orthopedic surgery. Strict donor screening, including HIV testing 3 months postoperatively, is mandatory before a transplant may be used. Yet these measures do not definitely rule out the possibility of HIV transmission, as there is a window period before infection is revealed by blood testing. ⋯ Five zones of bone repair and osteointegration were distinguished. We conclude that thermal treatment of bone allografts has adverse effects on osteointegration in the rabbit femoral condyle. Thus, it may contribute to improving safety in human bone transplantation.
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The long deltopectoral approach promoted by Neer is the standard for performing a total shoulder arthroplasty. However, this exposure is inadequate for preparation and bone grafting of the glenoid cavity or repairing an associated large rotator cuff tear. ⋯ Afterwards we used this approach in 7 of 13 patients in whom a Biomet Bio-modular shoulder arthroplasty was planned. The study is prospective with a 1-year follow-up of 12 cases.
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Arch Orthop Trauma Surg · Jan 1992
Bone-cement removal with the excimer laser in revision arthroplasty.
The excimer laser was thought to be an appropriate tool for the removal of bone cement without damaging the bone. However, due to its low ablation rate, its clinical use in total hip revision arthroplasty proved to be impossible. This experimental study was designed to evaluate the maximal ablation rate by adjusting the laser's parameters. ⋯ The removal of 10 g bone cement takes about 1 h. Thus, complete cement removal by means of the excimer laser alone is not possible. However, selective application of the excimer laser in combination with other techniques could be discussed.
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Arch Orthop Trauma Surg · Jan 1992
Clinical results and radiologic findings after cementless implantation of PCA stems in total hip replacement.
The results of radiologic and clinical follow-up of 81 PCA (porous coated anatomie) hip joint prostheses implanted in our clinic between 1986 and 1988 are presented. One of the prostheses had to be explanted because of aseptic loosening after 2.5 years' implantation. Contrary to the fixation concept of the prosthesis, which requires both proximal osseointegration and free axial shifting of the distal part of the prosthesis, our follow-up radiographs showed proximal lysis of 2 mm and more as well as distal hypersclerosis of 3 mm and more in the form of endosteal bone formation in 70% of cases 3 years after implantation. On the basis of our data, the question whether these bone reactions will finally lead to aseptic loosening of the implant cannot be answered yet.