Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2004
Comparative StudyUnstable versus stable uncemented femoral stems: a radiological study of periprosthetic bone changes in two types of uncemented stems with different concepts of fixation.
Uncemented stems in total hip arthroplasty (THA) are used increasingly often because they are believed to offer a reliable long-term fixation. However, periprosthetic bone remodelling has been a worrying issue. A proximal demineralization has been noted in femurs with well-fixed stems, and it has been explained as by-passing of mechanical forces along the fixed implant (stress-shielding). Aseptic loosening has been a major problem in several uncemented series with earlier designs. The objective for this study was to investigate how the host bone adapts to a loose stem compared with a well-fixed stem after a long time. ⋯ The assessment of periprosthetic bone remodelling after uncemented THA with long-term observation shows a different host-bone response in stable versus unstable femoral implants. Prior to a femoral revision, measurement of the BMD could be beneficial; it may guide the surgeon when deciding which surgical technique to use.
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Arch Orthop Trauma Surg · Jul 2004
Case ReportsTreatment of missed posterior dislocation of the shoulder by delayed open reduction and glenoid reconstruction with corticocancellous iliac bone autograft.
This is a report of a 2-year follow-up of a missed posterior shoulder dislocation treated with open reduction and glenoid reconstruction with corticocancellous iliac bone autograft. In such cases, this treatment option may be an alternative to hemiarthroplasty of the shoulder.