Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2001
ReviewNine-year results of Müller cemented titanium Straight Stems in total hip replacement.
At the Orthopaedic Department of the University of Basel, a total of 540 cemented Müller titanium alloy (Ti6Al7Nb) Straight Stems were inserted between 1989 and 1993. A cohort of 120 consecutive patients (66 women, 54 men) with 126 prostheses operated on between March and December 1989 were followed clinically and radiologically in a prospective manner for a mean observation time of 9.1 years. In all cases, the Müller titanium alloy Straight Stem was combined with the senior author's (E. ⋯ Our results do not confirm the high rate of osteolysis and revisions with the Müller titanium alloy Straight Stem presented by some other institutions. The verdict on a specific endoprosthetic implant must be made by combined assessment of the design, the implant surface condition, the material, the cement, the cementing procedure and the operative technique. The statement made in earlier publications that cemented titanium alloy should not be used as a femoral stem prosthesis should be reconsidered.
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Arch Orthop Trauma Surg · Jul 2001
Effect of chemotherapeutic agents on distraction osteogenesis. An experimental investigation in rabbits.
Limb-salvage operations such as vascularised or non-vascularised osseous grafts and allograft and callus distraction methods have replaced amputations because of the increase in the life expectancy of patients with malignant tumours. In this study we aimed to evaluate the effects of chemotherapeutic agents on distraction osteogenesis. For this purpose, 23 rabbits randomly divided into two groups were included in the study. ⋯ No difference between the two groups was observed in radiological, scintigraphical and histopathological studies carried out before the distraction period and following the end of the distraction period. In this study, it was shown that the use of antineoplastic drugs has no significant negative effect on distraction osteogenesis applied for reconstruction in rabbits. We think that it can be an alternative treatment method in humans as well.
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Arch Orthop Trauma Surg · Jul 2001
Extracorporeal shock-wave therapy for chronic lateral tennis elbow--prediction of outcome by imaging.
Today the clinical use of extracorporeal shockwave application (ESWA) for the treatment of lateral tennis elbow is hampered by the lack of results from randomized controlled trials and of predictive parameters of clinical outcome. The present prospective study aimed to provide the latter by means of magnetic resonance imaging (MRI). Twenty-three female and 19 male patients with unilateral chronic tennis elbow of the dominant site were clinically examined before and after repetitive low-energy ESWA. ⋯ For female patients, MRI scans could be applied for predicting a positive clinical outcome of ESWA. This study reports the first indication of predictability of positive clinical outcome of the treatment of chronic lateral tennis elbow by ESWA using imaging prior to treatment. This may serve as an important step towards overcoming the therapeutic nihilism with respect to the non-operative management of this condition recently in the literature.
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Arch Orthop Trauma Surg · Jul 2001
Intracellular measurement of polyethylene particles. A histomorphometric study.
A histological and histomorphometric study was carried out on pseudo-capsules retrieved from patients during revision surgery of cementless total hip replacement. Polyethylene loading and areal polyethylene particle size in different cells of the reticuloendothelial cell line were determined within the tissue by histomorphometry. In the reticuloendothelial cell line, foreign-body giant cells are considered to be the result of confluence of mononuclear macrophages caused by large particles or other unknown stimuli. ⋯ This difference was statistically significant between macrophages and large foreign-body giant cells (t-test, P < 0.05). The findings of this light-optical study show that the mean intracellular polyethylene particle size is greater in foreign-body giant cells. In addition, absolute polyethylene loading tends to be higher in foreign-body giant cells than in mononuclear macrophages.
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Conservative treatment was performed for 60 trigger thumbs (19 right, 17 left, 12 bilateral) in 48 children (19 boys, 29 girls); the age at initial diagnosis ranged from 0 to 48 months old (mean 26 months). In this approach, only passive exercise of the affected thumb was performed by the mother. As a result, two patients (two thumbs) dropped out of treatment. ⋯ Sixteen thumbs (in stage 2) and eight thumbs (in stage 3) showed completely recovery. Four thumbs (in stage 3) have not yet improved. In conclusion, we suggest that conservative treatment is effective for trigger thumbs in stage 2, while surgical therapy was thought to be indicated for stage 3 before the age of 3 years to avoid flexion deformity.