Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 1990
Pathology of the bone-cement interface in loosening of total hip replacement.
The histopathology of the bone-cement interface in nine retrieved hip prostheses is reported. Three cases presented features similar to those observed by Charnley in highly successful implants, and they were classified as stable prostheses, although signs of periprosthetic bone resorption were already present. ⋯ The polymorphous features of this connective membrane probably resulted from instability and movement at the bone-cement and stem-cement interfaces. On the basis of the pathological changes observed in the study, the process of loosening must be far advanced before it is detected on radiographs; it is suggested that scintigraphy is the best noninvasive technique to demonstrate macrophage activation and increased bone remodeling around the cement in the early phases of loosening.
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Arch Orthop Trauma Surg · Jan 1989
ReviewIncisional hernia through iliac crest defects. A report of three cases with a review of the literature.
Although the iliac crest is the most common site from which autogenous bone grafts are obtained, complications are surprisingly rare. One of these is incisional hernia through the resulting bony defect. ⋯ Elective repair of such hernias is advisable in order to avoid such complications. Attention to primary closure of bony iliac defects when complete is mandatory to prevent the occurrence of incisional hernia.
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Arch Orthop Trauma Surg · Jan 1989
Case ReportsNeurofibromatosis with spinal paralysis due to arteriovenous fistula.
A case of neurofibromatosis with spinal paralysis due to arteriovenous fistula is reported. Preoperatively, the appropriate diagnosis was missed because angiography had not been performed. Postoperative angiography disclosed that an arteriovenous fistula formed a tumor-like mass, and that a part of the mass had invaded the spinal canal, compressing the spinal cord. It is concluded that the possibility of an arteriovenous fistula should be kept in mind in neurofibromatosis patients with spinal cord symptoms.
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Arch Orthop Trauma Surg · Jan 1989
Factors associated with heterotopic bone formation following total hip replacement.
In order to delineate groups of patients suitable for treatment to prevent heterotopic bone formation (HBF) following total hip replacement, 99 patients were examined to evaluate predisposing factors. One year after surgery, HBF was found in 73% of the patients. ⋯ Previous ipsilateral hip surgery did not increase the risk of HBF. Although not significant, all patients who developed heterotopic bone after previous ipsi- or contralateral hip surgery showed HBF of the same or even a higher grade after the present replacement.