Archives of orthopaedic and trauma surgery
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The long deltopectoral approach promoted by Neer is the standard for performing a total shoulder arthroplasty. However, this exposure is inadequate for preparation and bone grafting of the glenoid cavity or repairing an associated large rotator cuff tear. ⋯ Afterwards we used this approach in 7 of 13 patients in whom a Biomet Bio-modular shoulder arthroplasty was planned. The study is prospective with a 1-year follow-up of 12 cases.
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Arch Orthop Trauma Surg · Jan 1992
Clinical results and radiologic findings after cementless implantation of PCA stems in total hip replacement.
The results of radiologic and clinical follow-up of 81 PCA (porous coated anatomie) hip joint prostheses implanted in our clinic between 1986 and 1988 are presented. One of the prostheses had to be explanted because of aseptic loosening after 2.5 years' implantation. Contrary to the fixation concept of the prosthesis, which requires both proximal osseointegration and free axial shifting of the distal part of the prosthesis, our follow-up radiographs showed proximal lysis of 2 mm and more as well as distal hypersclerosis of 3 mm and more in the form of endosteal bone formation in 70% of cases 3 years after implantation. On the basis of our data, the question whether these bone reactions will finally lead to aseptic loosening of the implant cannot be answered yet.
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Arch Orthop Trauma Surg · Jan 1992
Bone-cement removal with the excimer laser in revision arthroplasty.
The excimer laser was thought to be an appropriate tool for the removal of bone cement without damaging the bone. However, due to its low ablation rate, its clinical use in total hip revision arthroplasty proved to be impossible. This experimental study was designed to evaluate the maximal ablation rate by adjusting the laser's parameters. ⋯ The removal of 10 g bone cement takes about 1 h. Thus, complete cement removal by means of the excimer laser alone is not possible. However, selective application of the excimer laser in combination with other techniques could be discussed.
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Arch Orthop Trauma Surg · Jan 1992
Epiphyseal chondroblastoma of bone. Long-term effects on skeletal growth and articular function in 15 cases treated surgically.
The authors describe the long-term sequelae of chondroblastoma in 15 patients with open growth plates, whose age at operation ranged from 8 to 15 years. At follow-up, the youngest patient was 21 and the oldest 48 years old. Upper limb length discrepancy ranging from 2 cm to 10 cm was present in the four patients who had a proximal humeral epiphyseal location; in three of them, the range of motion of the shoulder was also limited and X-rays showed marked irregularities of the humeral head. ⋯ One patient with proximal tibial epiphyseal involvement also had mild genu valgum. Radiographic osteoarthritis was present only in the trapeziometacarpal joint of a patient in whom the first metacarpal bone affected by the tumor was replaced by a free fibular graft. The abnormalities observed did not cause important functional loss in either the everyday or the working activities of any of our patients.
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In the pelvic region three major compartments (gluteus medius-minimus compartment, gluteus maximus compartment, and iliopsoas compartment) can be distinguished from the smaller compartment of the tensor fasciae latae muscle. Pelvic compartment syndromes are rare. A clear history of trauma is often lacking. ⋯ The mean follow-up of the four other patients was 29 months (7-48 months). Three of these four patients revealed a decrease of gluteal muscle volume. Ergometric tests showed a decrease in gluteal muscle force in all patients.