Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1991
Comparative StudyUncoated polyethylene RM acetabular component versus Müller cemented acetabular component. A 4- to 8-year follow-up study.
Comparable patient populations with 160 uncoated RM acetabular cups and 263 cemented Müller standard acetabular cups were submitted to survival-time analysis in a retrospective study with a mean follow-up of 5.3 years for the RM cup and 6.1 years for the Müller cup. After 7-8 years 12% of the RM cups and 4% of the Müller cups had been exchanged, 40% and 15% respectively were loose. The poor performance of the RM cups is ascribed to additional external polyethylene wear, which leads to the formation of granulomas and destroys the weight-bearing osseous structures. Similar granulomas also develop on the proximal stem and thus endanger the same.
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Arch Orthop Trauma Surg · Jan 1991
Comparative StudyAseptic loosening of straight- and curved-stem Müller femoral prostheses.
Out of 1099 Müller total hip prostheses with straight and curved stems consecutively implanted between 1980 and 1984, those performed in as homogeneous a group as possible of patients under the age of 70 years were selected for the present retrospective study. There were 158 straight femoral stems with cementless RM acetabular cups, 105 straight stems with cemented Müller acetabular cups, and 158 curved stems with cemented Müller acetabular cups, and their results over a mean follow-up period of 5.8 +/- 1.24 years were compared. ⋯ Survival curves show a worse result for straight stems after 6 years; within a follow-up period of 6-8 years there was significantly more radiological loosening in straight stems than in curved. Loosening in straight stems is assumed to develop mainly as a physiological reaction to the presence of bone cement particles.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsClinicoradiological diagnosis of benign osteoblastoma of the spine in children.
Three cases of benign osteoblastoma of the spine in children are reported, diagnosed on the basis of clinicoradiological findings and confirmed at surgery and by histopathology. The authors feel that in all cases of painful scoliosis and painful torticollis, a careful search should be made for any suspicious area of sclerosis, especially in the posterior elements of the vertebrae, and all the positive or suspected cases should undergo nuclear bone scanning. All patients whose bone scan is positive should be subjected to computed tomography for differential diagnosis between osteoid osteoma and benign osteoblastoma.
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Arch Orthop Trauma Surg · Jan 1991
Case ReportsPseudoarthrosis of the ulna in neurofibromatosis. A report of four cases.
Four children suffering from neurofibromatosis with ulnar pseudarthrosis and progressive reabsorption of the middle and distal thirds of the ulna are reported. None had any pain or sensory loss, but all had progressive deformity of the forearm. ⋯ Non-operative management was decided on in the patient with slow ulna reabsorption. The creation of a one-bone forearm is more likely to produce sound union, thus avoiding the need for further operations, while conservative management should be reserved for patients with a slowly progressive condition.
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Arch Orthop Trauma Surg · Jan 1991
Juvenile and idiopathic kyphosis. Long-term follow-up of 20 cases.
Twelve patients with juvenile kyphosis and eight patients with idiopathic kyphosis were reviewed at an average follow-up of 19 years. The average age of the patients at follow-up was 33 years (range 26-45 years). ⋯ At follow-up, however, all the patients had lost the correction obtained and the curves had become worse than originally, those in idiopathic kyphosis more so than those in juvenile kyphosis. Despite the increase in their angular deformity, all the patients managed fairly well and only two complained of distressing back pain.