Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialErythropoietin for autologous blood donation in total hip arthroplasty patients.
Forty patients who were scheduled for a total hip arthroplasty were enrolled in a prospective study and were randomly divided into two groups. Group 1 received recombinant human erythropoietin (300 U/kg twice a week), and group 2 received placebo. The medication was started 2 weeks before the operation, and only one dose of medication was given after the operation. ⋯ The study showed that short-term and low-dose erythropoietin usage strongly stimulates the bone marrow. Erythropoietin administration and preoperative autologous blood donation diminished the total units of allogenic blood required during the intraoperative or postoperative period. Autologous blood administration without concurrent erythropoietin did not stimulate the bone marrow adequately.
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Arch Orthop Trauma Surg · Jan 2001
Comparative StudyThe Kapandji technique for fixation of distal radius fractures--a biomechanical comparison of primary stability.
The goal of this study was to compare Kapandji-K-wiring and established K-wiring techniques of the distal radius fracture for primary stability in a biomechanical model: dorsal K-wiring according to Kapandji using different angles of the K-wire, parallel and diagonal alignment of the K-wires. A new testing system which uses a synthetic material enabled us to carry out the cantilever bending test. ⋯ A higher reaction force of the other techniques, especially of the parallel wiring, are only observable under high-grade bending stress. Application of the Kapandji procedure with K-wires at a smaller angle to the axis of the radius results in the highest primary stability of the procedures investigated in the essential range of initial deformation.
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Arch Orthop Trauma Surg · Jan 2001
The GSB total knee arthroplasty. A medium- and long-term follow-up and survival analysis.
From 1981 to 1987, 77 GSB-II total knee arthroplasties were implanted in 65 patients. There were 23 men and 42 women aged on average 60 years old (range 30-85 years). The diagnosis was osteoarthritis (OA) in 21 knees, rheumatoid arthritis (RA) in 44 knees, and other in 12 knees. ⋯ For the worst-case scenario, the 6- and 15-year survival rates were 95% (CI 89%-100%) and 56% (CI 0%-100%), respectively. The medium- and long-term results of the GSB-II total knee arthroplasty were good, and a decline in the knee score did not occur beyond the mid-term follow-up. Patella complications were abundant, and a marked decrease in implant survival was noted when moderate or severe pain and lost to follow-up were included as endpoints.
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Arch Orthop Trauma Surg · Jan 2001
A model for assessing the rotational stability of uncemented femoral implants.
Permanent secondary stability of the uncemented femoral stem of hip prostheses can only be achieved once primary rotational and axial stability has been ensured. Rotational stability means that the stem is resistant to the articular forces that induce rotation around the implant's longitudinal axis. The 10-year survival rates of two uncemented conical shaped stems with decisively different proximal shapes were significantly different (Schenker SK 63.9%, Zweymüller SL 97.0%). ⋯ A reduction in the mediolateral height of the metaphyseal part by one-third led to a 20% smaller angle of ascent (P < 0.01), which indicated lower resistance. The proximally broader (mediolateral) prosthesis therefore proved to have better rotational stability. The study confirms that aseptic stem loosening is attributable to the design of the proximal part of the prosthesis.
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Arch Orthop Trauma Surg · Jan 2001
Case ReportsTotal knee arthroplasty in a patient with chronic occlusion of the superficial femoral artery.
In a 67-year-old patient with severe valgus gonarthrosis and chronic occlusion of the superficial femoral artery on the same side, total knee replacement was performed without preceding angioplasty because the collateral circulation was intact. No tourniquet was used. To leave the peripatellar arterial ring intact on one side in this case of lateral patellar maltracking, a lateral approach was used. ⋯ To achieve gentle eversion of the patella, the tibial tubercle was osteotomized. One year postoperatively, the patient was satisfied with the outcome and showed no clinical signs of any vascular deterioration. It is concluded that total knee replacement may be possible in the presence of chronic occlusion of the superficial femoral artery provided that the collateral circulation is intact.