Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1992
The influence of metal backing in unicompartmental tibial component fixation. An in vivo roentgen stereophotogrammetric analysis of micromotion.
The fixation of the tibial component in 36 patients with conventionally cemented unicompartmental knee arthroplasties for femorotibial gonarthrosis was studied using roentgen stereophotogrammetric analysis (RSA). Twenty-four tibial components were all-polyethylene while 12 were metal-backed. The follow-up was for 6 years. ⋯ A strong correlation was found between the extension of the radiolucent line and the migration. Otherwise, neither demographic, clinical, nor radiographic data correlated with the RSA results. In this study metal backing did not have any influence on prosthetic fixation as measured by RSA.
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We treated 66 consecutive type IV comminuted femoral shaft fractures with static Grosse-Kempf interlocking nails and followed them up for at least 1 year (median 27 months). Although the effect of weight bearing was completely lost, 60 fractures healed primarily without dynamization. We conclude that weight bearing contributes only an auxiliary role in promoting fracture healing, and that the most decisive role is adequate mechanical stability with sufficient nutrition.
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In an in vitro study we collected data relating to three-dimensional kinematics and stability patterns in 40 knee joint specimens. The specimens were tested in an apparatus: the femur was flexed on a fixed transverse axis, while a freely mobile tibial assembly allowed measurement of all passive translational and rotational movements. ⋯ This study compares the kinematics of a knee with mobile meniscal bearings (low contact stress, LCS) with the data relating to a more constrained system (Tricon M). The LCS knee showed the better kinematic behavior compared to the natural knee.
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The transgluteal approach to the hip, first described by Bauer et al. in 1979, has since become a recognized routine method. Its longitudinal incision of the fibers of the gluteus medius and minimus and the vastus lateralis muscles takes advantage of the tendinous junction of these muscles over the greater trochanter. This paper describes the modifications of the transgluteal approach described in the literature and compares them to the original procedure. ⋯ In 59.6% of all specimens there proved to be a united tendinous junction of all the muscles referred to above, while in 40.4% autonomous insertions of the gluteus medius and/or gluteus minimus were seen. In accordance with the anatomical results, the form of incision described by the original authors can be considered the most favourable. In roughly one-third of all hip operations, autonomous insertions of gluteus medius and minimus must be taken into account, since otherwise total or partial upward displacement of the autonomous muscle insertions could occur.
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Arch Orthop Trauma Surg · Jan 1992
Case ReportsAseptic osteonecrosis of acetabulum following prosthetic replacement of the femoral head. A case report.
Acetabular osteonecrosis is a rare condition. Only five cases with histological analysis have been reported in the literature, and these patients had previously received radiotherapy. ⋯ The necrosis was found during surgery to go so deeply into each bone composing the acetabulum that the hip joint could not be revised, and we had to perform a Girdlestone resection arthroplasty. The radiographic and histological findings resembled those reported in cases of aseptic osteonecrosis of the acetabulum after radiotherapy.