Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Jul 1998
[Evaluating the quality of life before and after implantation of a total hip endoprosthesis].
Quality of Life of patients with Total Hip Arthroplasty is analysed before and one year after surgery. The evaluation included the functional capacity of our patients in every day life comparing the preoperative situation with the result one year after surgery. Age and duration of symptoms were analysed with respect to their influence on the success of the procedure. Finally the question should be answered, if clinical examinations and questionnaires concerning Quality of Life result in comparable data. ⋯ The objective evaluation of results after implantation of a total hip joint-endoprosthesis should not be based only on clinical scores (f.e. Harris-Hip-Score). Subjective informations by the patients using questionnaires on Quality of Life (f.e. NHP, FFbH-R) have to be included into these evaluations. The different judgments of the outcome of surgery underline the necessity, not only to use clinical scores but also to include the patients' feeling into the interpretation of the clinical result.
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Z Orthop Ihre Grenzgeb · Mar 1998
[An in vitro model for producing femoral fractures and for the study of primary stability of cerclage].
Intraoperative femoral fracture is a well recognized intraoperative complication of cementless total hip arthroplasty (THA). This study was designed to establish an in-vitro model for initiation of fractures of the femur in cementless THA and to assess the effect of fracture fixation by cerclage wiring using steel wire (Protasul). ⋯ During insertion of a conical stem the orthopaedic surgeon should look for fractures of the medial cortex of the femur which is the most frequent location for fractures. This in-vitro model provides a reproductable method for the initiation and propagation of longitudinal femoral fractures in press-fit noncemented THA system and to assess the effect of fracture fixation in the form of cerclage wiring.
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Z Orthop Ihre Grenzgeb · Mar 1998
[Comparative periprosthetic bone density measurements of the proximal femur shaft using dual energy x-ray absorptiometry (DEXA) with experimental "Press Fit-gliding Stem Prosthesis"].
Periprosthetic bone atrophy caused by stress shielding is one of the problems of non-cemented femoral stems of hip arthroplasty. Stress shielding and thus the loss of bone mass and their dissemination in the proximal part of the femur of conventional non-cemented femoral stems depends on stiffness (E-modules of the material and the geometry) of the implant and on the bonding between implant and bone. All currently implanted non-cemented femoral stems lead to proximal bone loss which goes up to 40-50% of the original bone mineral content. The senior author (E. M.) developed a femoral stem (Press Fit-Gliding Stem PFGS) which shifts relative movements of force-transmission from the bone-implant interface into the interior of the prosthetic system (Inner Bearing-System) and which only transfers forces proximal into the femur. ⋯ The Press Fit-Gliding Stem is still in the clinical test-program.
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Z Orthop Ihre Grenzgeb · Mar 1998
[MRI-controlled outcome after core decompression of the femur head in aseptic osteonecrosis and transient bone marrow edema].
We evaluated the signal changes of avascular necrosis and transient bone marrow oedema before and after core decompression of the femoral head to deduce prognostic factors for this operative procedure. ⋯ In the case of transient bone marrow oedema, a restitutio ad integrum can be achieved with core decompression. In stage I and II of avascular necrosis, the successful outcome depends on the lesion size of the femoral head. Necrotic lesions less than 30% seem to have the best prognosis. In stage III and IV, core decompression cannot be recommended.
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Z Orthop Ihre Grenzgeb · Jan 1998
Comparative Study Clinical Trial[Extracorporeal shockwave therapy in epicondylitis humeri ulnaris or radialis--a prospective, controlled, comparative study].
Has extracorporal shockwave therapy in chronic golfer's elbow comparable results as in tennis elbow? ⋯ The indication for extracorporeal shock-wave therapy in medial epicondylitis must be questioned.