Archives of orthopaedic and trauma surgery
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In this study the function of the knee measured at a medium-follow-up of 5-6 years was correlated with influencing factors concerning the implant of total condylar knee prosthesis in 90 patients. The only variable affecting postoperative extension was the preoperative range of extension whereas postoperative flexion was influenced by the preoperative flexion, valgus deviation of the preoperative AP tibial-femoral angle, position of the patella, and thickness of the resection of the distal femur cut.
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Arch Orthop Trauma Surg · Jan 1992
A simpler surgical technique to treat aseptic nonunion-associated femoral length discrepancy.
In a prospective study from December 1986 to August 1989, 17 consecutive patients with femoral shortening due to aseptic nonunion of femoral shaft fractures were treated with limitedly open Gross-Kempf locking nailing with a lengthening procedure. Patients were followed up for at least 1 year (average 25 months). There was a 88.2% union rate with an average union period of 5.2 months. ⋯ Complications (11.8%) were 5.9% implant failure and 5.9% nonunion which were not difficult to manage. No neurovascular complications were noted. We conclude that for 5 cm shortening or less in femoral aseptic nonunion, this treatment constitutes the simplest technique and can achieve a very satisfactory result.
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Arch Orthop Trauma Surg · Jan 1992
Inflammatory reactions in primary osteoarthritis of the hip and total hip prosthesis loosening.
In 14 patients [9 with loosened total hip arthroplasty (THA), 5 with primary osteoarthritis], the inflammatory cell infiltrate was characterized in cryostat tissue sections using antibodies against subsets of macrophages and lymphocytes. In all patients the abundance of a mature type macrophage (25F9+) was observed, whereas 27E10+ macrophages, characteristic of acute inflammatory reactions, were not seen in primary osteoarthritis but were found in 4 out of 9 patients with THA loosening. The RM3/1 + macrophage phenotype was seen in some of both sets of patients (osteoarthritis 4/5; THA loosening 4/9). ⋯ The data reveal remarkable differences between the two groups of patients. While the inflammatory infiltrate in patients with osteoarthritis lacks the characteristics of acute inflammation, in patients THA loosening the inflammatory process seems to be determined by periods of acute reactions. The occasional presence particularly of T-helper cells suggests that the inflammatory process is less T-cell but rather macrophage-driven.
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Arch Orthop Trauma Surg · Jan 1992
Comparative StudyEffect of animal species and age on plate-induced vascular damage in cortical bone.
Plates used for fracture fixation produce vascular injury to the underlying cortical bone. During the recovery of the blood supply, temporary osteoporosis is observed as a result of Haversian remodeling of the necrotic bone. This process temporarily reduces the strength of the bone. ⋯ Using implants scaled to the size of the bone, we found comparable cortical vascular damage in the sheep and in the dog, and in the tibia and femur of each animal. We observed a significant reduction in cortical vascular damage using plates that had a smaller contact area with the underlying bone. No significant difference in cortical vascular damage was noted in animals of different ages.
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Arch Orthop Trauma Surg · Jan 1992
Ciprofloxacin-impregnated poly-L-lactic acid drug carrier. New aspects of a resorbable drug delivery system in local antimicrobial treatment of bone infections.
Resorbable poly-L-lactic acid (PLLA) cylinders (3.5 mm diameter, 5 mm in length) carrying 6% of weight ciprofloxacin (Ciprobay, Bayer AG, Leverkusen, FRG) were investigated in vitro to explore their properties as a slow-release antibiotic deposit. Forty bioactive cylinders stored in test tubes were covered with phosphate buffer (pH 7.4 at 37 degrees C) and 40 with fresh human blood plasma and tested under various conditions. For comparison a gentamicin-polymethylmethacrylate (PMMA) chain (Septopal, E. ⋯ Complete degradation of the PLLA-cylinders was not seen in the observed period of 92 days. The mean loss of mass was 8.4%. The recovery of incorporated ciprofloxacin was 6.5% on average.