Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2000
Review Case ReportsMonostotic fibrous dysplasia of the spine: report of a case involving the lumbar transverse process and review of the literature.
Monostotic fibrous dysplasia of the spine is rare. We report its clinical, radiologic and histologic features affecting a 47-year-old housewife. She presented with low-back pain of 1-year's duration, and radiographs showed a diffuse expansile lesion in the left transverse process of the fourth lumbar vertebra. ⋯ It most commonly involves the body and adjacent pedicle, although no part of the vertebra is spared. It is worth noting that a propensity for progressive enlargement, even to the extent of causing graft destruction, exists if the lesion is left untreated or incompletely treated. Complete removal of all involved bone, together with stabilization, should therefore be the treatment of choice for this condition.
-
Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Clinical TrialTransesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty. A randomized study in patients with a femoral neck fracture.
Forty patients suffering from a medial femoral neck fracture participated in a prospective, randomized study. In 20 patients, the femoral component was cemented using a contemporary technique. In the patient group operated on with the bone vacuum technique, the medullary cavity was drained during the insertion of the stem. ⋯ These distinct hemodynamic changes were not observed in the bone vacuum group. This study was able to show a clearly reduced risk of pulmonary emboli using the bone vacuum cementing technique. The presence of pre-existing disease greatly magnified the clinical relevance of fat embolism.
-
Arch Orthop Trauma Surg · Jan 2000
Case ReportsExpression of keratan sulfate at the arthroplasty surface after cup arthroplasty.
Fibrous tissue which regenerated on the acetabular arthroplasty surface was obtained from a 52-year-old woman who underwent total hip replacement after cup arthroplasty. The histological features of this newly formed fibrous tissue and expression of keratan sulfate, which is a characteristic matrix component of articular cartilage, were studied. ⋯ Immunostaining for keratan sulfate revealed clear positive staining around the cells of the nodular structures communicating with the bone marrow, while only weakly positive staining was observed in the superficial layer of the loose fibrous tissue. The present study revealed marked formation of articular cartilaginous tissue in areas having good communication with the bone marrow, which indicates that maintenance of this communication may be necessary to improve the outcome of cup arthroplasty.
-
We report here three fully documented cases of periosteal chondroma diagnosed and treated in our hospital. There have been few references since Lichtenstein first described this condition as a separate tumour, and none of them concerned children under 10 years old. deSantos accurately describes the radiological features of the tumour. ⋯ The study included a previous histological examination in two cases and a follow-up in all of them. From this study we learned that invasive diagnosis procedures are unnecessary as we could follow the behaviour and evolution of this cartilaginous benign tumour for a long period of time.
-
Arch Orthop Trauma Surg · Jan 2000
Total hip arthroplasty using an uncemented femoral component with taper design: outcome at 10-year follow-up.
The aim of this study was to assess the clinical and radiological outcome of the cementless-system (CLS) femoral component designed by Spotorno with a taper design. Ninety-four patients (107 hips) were operated on from January 1987 to December 1988. The female/male ratio was 2/1, the mean age was 51 years (range 20-77 years). ⋯ In all of these hips, the Mecron cup had been used. At a mean follow-up of 10 years, the results of the CLS femoral component are comparable with those of modern techniques of cementing in primary total hip arthroplasty and with the long-term outcomes of other uncemented stems with tapered design. The long-term fixation of the cup remains an unsolved problem.