Archives of orthopaedic and trauma surgery
-
Although various operative procedures have been applied for advanced or terminal osteoarthritis of the hip joints in relatively young patients, the long-term results are controversial. Since 1974, we have performed the triple-cup arthroplasty developed by Aoki in 110 patients who were comparatively young. The triple-cup assembly is composed of stainless-steel outer and inner cups between which a high density polyethylene cup is incorporated, so that there are basically four mobile surfaces, but the major movement is actually taking place between the outer cup and the plastic cup [8]. ⋯ The femoral head in the cup was often covered with a layer of fibrous tissue. We could utilize the femoral head as a bone graft, even though the residual volume of bone varied in each case. The result of revision surgeries after the triple-cup arthroplasty was good clinically and radiographically at last follow-up.
-
Arch Orthop Trauma Surg · Jan 1999
Comparative Study Clinical TrialEndoscopy of the femoral canal in revision arthroplasty of the hip.A new method for improving the operative technique and analysis of implant failure.
Femoral endoscopy using a special endoscope was performed in 28 revision arthroplasties with the aim of improving the operative technique and to analyze implant failure. Before clinical application, the method was used to analyze the implant bed in clinically and radiographically well-fixed prostheses in autopsy cases without implant failure. Initially, it was performed on 4 experimental implantations of newly designed revision devices into cadaver femurs to obtain additional information concerning the design rationale of implants and instruments for revision surgery. ⋯ Further, it was possible to directly visualize the shape and condition of the primary implant bed after removal of the implant. Femoral endoscopy improved the surgical technique in revision arthroplasty. In addition, it is a very useful tool for the analysis of the implant bed in clinical and autopsy cases as well as in experimental implantations.
-
Arch Orthop Trauma Surg · Jan 1999
Case ReportsReactions and complications after the implantation of Endobon including morphological examination of explants.
In the study described here, the integration of hydroxyapatite (HA) ceramic implants (Endobon) was investigated. These implants have an interconnecting system of pores and are free from foreign protein. The material is not toxic, genotoxic, nor zytotoxic, and it is biocompatible. ⋯ If the implant is not sufficiently protected from mechanical stress, bony integation will not take place, and the implant may fracture. HA ceramic, with a porosity between 30% and 80%, is not comparable to cortical bone but only to spongy bone. This factor must be taken into account when deciding whether a HA ceramic implant is indicated.
-
Arch Orthop Trauma Surg · Jan 1999
Structural properties of the fibular band in congenital total absence of the fibula.
Nine children with unilateral total congenital absence of the fibula were examined by magnetic resonance imaging (MRI), and histological study of the fibular band was performed in four of them. Both examinations revealed two types of fibular band. ⋯ In type II, the band directly attached to the calcaneus without any evidence of hyaline cartilage, and the feet could be corrected only by total excision. We suggest partial excision of the band in type I and total excision in type II as the initial treatment of congenital total absence of the fibula.
-
Arch Orthop Trauma Surg · Jan 1999
Case ReportsIsolated posterolateral dislocation of the radial head in a boy.
Isolated dislocation of the radial head in children is a rare injury. We report an isolated posterolateral dislocation of the radial head in a boy after a fall on the outstretched arm. Immediate closed reduction and early active motion achieved satisfactory results.