Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyBigger size and defatting of bone chips will increase cup stability.
Morcellised bone allograft in an in vitro model was used to test the tendency towards cup rotation using small or larger fragment sizes of an impacted graft bed and different fat contents. A cup cemented on an impacted graft bed of larger sized bone chips from the Howex bone mill containing natural marrow fat was loaded eccentrically until the cup rotated. ⋯ The smaller sized bone chips from the Tracer bone mill defatted in a similar manner required only 1950 N for cup rotation. The conclusion was that larger sized chips, partly defatted, prevent rotation of a cup cemented on a graft bed.
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Arch Orthop Trauma Surg · Jan 2000
Extracorporal shock wave therapy in patients with tennis elbow and painful heel.
The aim of this study was to evaluate the effect of extracorporal shock wave therapy (ESWT) in tennis elbow and painful heel. Nineteen patients with tennis elbow and 44 patients with painful heel in which conservative treatment had failed underwent ESWT. ⋯ The success rate (excellent and good results) was 63% in tennis elbows and 70% in painful heels. ESWT seems to be a useful conservative alternative in the treatment of both conditions.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyHistological and microbiological findings in non-infected and infected revision arthroplasty tissues. The OSIRIS Collaborative Study Group. Oxford Skeletal Infection Research and Intervention Service.
An assessment of clinical and laboratory findings is generally required to distinguish between septic and aseptic loosening of a hip implant. In order to evaluate the diagnostic utility of histological and microbiological investigative techniques to differentiate between these two conditions, we analysed their results in 617 patients with hip implant loosening. Histology and microbiology study confirmed the clinical diagnosis of septic loosening in approximately 98% and 89%. respectively. ⋯ In all but 2 of 81 cases of septic loosening, in which an organism was isolated on microbiological culture, the histological diagnosis of septic loosening was made on the basis of the degree of the acute inflammatory infiltrate (i.e. the presence of 1 or more neutrophil polymorphs per high power field (x 400) on average after examination of at least 10 high power fields) in periprosthetic tissues. In 10 patients for whom there was a strong clinical suspicion of septic loosening but no organisms were isolated on microbiological culture, the histological findings, using the above criteria, were in keeping with the clinical diagnosis of septic loosening. As almost 11% of cases of septic loosening would not have been diagnosed by microbiological investigation alone, our findings indicate that histological examination of periprosthetic tissues should form part of the investigative protocol to distinguish between aseptic and septic loosening.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyBipolar versus total hip endoprosthesis: functional results.
Some functional parameters of the hip-joint 3.3 years on average (range 2-8.6 years) after hip arthroplasty are compared with regard to two types of hip endoprostheses: the total (TEP) and the bipolar (BPEP). Flexion, extension, abduction, adduction, and internal and external rotation were measured for 75 patients with BPEP type Self-Locking, for 11 patients with BPEP type Vario-Cup, and for 43 with TEP type Lubinus. ⋯ It was found that flexion, abduction and adduction were significantly higher in the BPEP endoprosthesis (P < 0.05). The results obtained are favourable for the bipolar hip endoprosthesis, and they can be related to the biomechanical differences between both types of hip endoprosthesis.
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Arch Orthop Trauma Surg · Jan 2000
Comparative StudyEffects of single-dose versus fractionated irradiation on the suppression of heterotopic bone formation--an animal model-based follow-up study in rats.
The histological and enzymatic effects of single-dose irradiation of 7 Gray (Gy) versus fractionated irradiation of 5 x 2 Gy on the suppression of heterotopic ossification were examined over a period of 60 days in adult male Wistar rats (n = 57). The standardized osteogenesis model system in rats 19, 10, 11, 16, 19] was used for this purpose. The course of developing ossifications was documented quantitatively and qualitatively by means of quantitative computed tomography/osteodensitometry and digital luminescence radiography. ⋯ Therefore, it may be concluded that the smaller degree of heterotopic ossification in the irradiated groups was due to damage of and a decrease in the number of mesenchymal stem cells at the implant site. Our results stress the necessity of instituting postoperative irradiation therapy as early as possible to prevent heterotopic ossification. In view of experimentally proven better effects, fractionated irradiation has to be preferred to a dose-equivalent single-dose radiation, especially considering the fewer side-effects noted with fractionated irradiation.