A stature-specific concept for uncemented, primary total hip arthroplasty.

Background And Purpose: Variations in hip anatomy limit the femoral canal fit of standard uncemented hip stems. In addition, there are still issues with leg length discrepancy and offset reconstruction, potentially resulting in impingement, dislocation, and wear. Modular stems with different shapes for femoral canal fit and multiple neck options may improve the outcome and reduce complications.

Custom stems for femoral deformity in patients less than 40 years of age: 70 hips followed for an average of 14 years.

Background And Purpose: Femoral deformity associated with osteoarthritis is a challenge for both the surgeon and the implant. Many of the patients with these deformities are young. Standard implants can be difficult to fit into these femurs.

The value of bedside cardiac multibiomarker assay in rapid and accurate diagnosis of acute coronary syndromes.

For emergency department physicians, timely triage and risk stratification of chest pain patients remains a challenge. Faced with an aging population and the growing prevalence of heart disease, clinicians are seeking more effective ways to diagnose acute coronary syndromes rapidly and accurately. Emergency department physicians must make critical and time-sensitive decisions based on patient history, physical examination, and 12-lead electrocardiogram as justification for diagnosis of acute coronary syndromes.

Prehospital management of rapid atrial fibrillation: recommendations for treatment protocols.

The present study was completed to establish an epidemiological database defining prehospital rapid atrial fibrillation (RAF) and interventions given such patients in the hope of developing recommendations for further treatment protocols. On review of 4,749 paramedic run reports from a low-volume urban emergency medical services (EMS) system, 33 persons (0.69%) presented with RAF.

[Virtual simulation for optimizing the range of motion in hip alloarthroplasty using an adapted thrust-plate prosthesis model].

The purpose of the present study was to increase the free range of motion in conventional trust-plate prosthesis design and to optimize the trust-plate contact as well as the osteointegration area below the trust-plate. For the first part of the study, the two-dimensional geometry of the osteotomy plane was demonstrated in 25 CT-reconstructed femora after performing a virtual cut at a CCD angle of 135 degrees. In the second part, we constructed a prototype of an anatomic adapted trust-plate prosthesis (A-TPP) with an optimized trust-plate and corpus geometry based on the three-dimensional data of three human cadaveric femurs (age 67-75 years).

[Design features of an individual thrust plate prosthesis].

The purpose of the present study was to document the osteotomy plane for the thrust plate prosthesis, and to evaluate the question whether the geometry of the thrust plate itself correlates with the range of motion after implantation and whether the osteointegration area can be optimised. For the first part of the study, the two-dimensional geometry of the osteotomy was demonstrated in 12 computer-reconstructed femurs after performing a virtual cut at a CCD angle of 135 degrees. In the second part we constructed a prototype of an I-TPP with an optimised thrust plate and corpus geometry.

[Fundamental aspects of osteoinductive activity of bone tissue and potential clinical application].

Osteoinductive polypeptide factors such as the various isoforms of Bone Morphogenetic Protein described are of increasing scientific and clinical interest because of the great progress in this field of skeletal biology recently achieved. In a review some fundamental chemical and biological aspects of bone and its endogenous osteoinductive activity including isolation and assay of osteoinductive factors are described. Through combination of osteoinductive factors with appropriate carrier materials it seems possible to create osteoinductive implant materials and the results of such investigations and some basic aspects of carrier materials are summarized.

[3D-based production of hip joints: the Aldinger system].

Total hip replacement is regarded as one of the most successful surgical procedures. However, aseptic loosening of the foreign material still remains a great problem with endoprostheses. Bone cement, a material for filling and fitting, allows a solution to the problem in old people, but for younger people surgeons have looked for alternatives without cement.

Bone morphogenetic protein: a review.

The osteogenic potential of bone and bone matrix has been characterised only by its biological effects and the parameters influencing it. Recently, the osteoinductive ability of bone matrix had been defined chemically by the description of a bone morphogenetic protein (BMP), and the parameters of osteogenic factors from different species have now been recognised. The current state of isolation, purification and characterisation of these factors is summarised in this review.

The personalized hip prosthesis.

The authors discuss the general concept, method of use and first clinical results obtained with a "personalized" femoral component of a hip arthroprosthesis based on the computer-graphic processing of measurements obtained from radiography and CT scan. This prosthesis is considered to be innovative as compared to traditional cementless prostheses.

[Progress in endoprosthesis via computed tomography?].

A new procedure for the manufacture of endoprostheses with the aid of computer tomography is described. This modern radiological technique has not only revolutionised many diagnostic problems, but will also affect treatment intimately.

[Computer assisted production of individual anatomic endoprostheses].

Long-term anchorage of foreign material in vital bone has proven to be the main problem in endoprosthetics. In the authors opinion, modelling of an individual anatomic anchorange component is, at present, the best way to transmit stresses harmoniously in order to utilize functional adaptation of bone and to attain long-term function. The production of a true-to-scale joint model is possible with computer-assisted-tomography.

[Experience with Baycast plastic bandages and their possibilities].

A new method of manufacturing temporary orthoses is described. Immobilization--as much as necessary and as little as possible--is attainable with these orthoses, which reduce damage by immobilization and simplify rehabilitation. Recommendation to the manufacture regarding the characteristics of the material and accessory aids are presented.

[The Freeman-Sheldon Syndrome].

Freeman-Sheldon syndrome (FSS) or craniocarpotarsal dysplasia is characterized by a triad of symptoms: 1. Masklike, whistling facial expression (whistling face syndrome), 2. Ulnar deviation of digits II to V and adduction contracture of the thumb and 3.

[Alternative to plaster cast bandage of the thigh].

Immobilization by means of a femoral plaster-cast box cannot always cope with the wide variety and severity of the injuries and diseases in the knee-joint region. To achieve best possible rehabilitation, several alternative and subsequent methods of surgical bandaging are described, including indications, technique and pros and cons.

Rare fracture of a total hip replacement.

Material fractures in the femoral part of total hip replacements, a late complication, are usually observed in the shaft. In our case, a fatigue fracture of the ball-neck weld occurred 8 1/2 years after implantation of the prosthesis because of insufficient weld depth. Additional negative factors proved to be varus implantation and overloading of the prosthesis due to obesity.

Computer-aided manufacture of individual endoprostheses. Preliminary communication.

Long-term anchorage of foreign material in vital bone has proven to be the main problem in endoprosthetics. In the authors' opinion, modelling an endoprosthetic anchorage component to the individual anatomic needs is, at present, the best way to transmit stresses harmoniously from the prosthesis to the sensitive bone, in order to utilize functional adaptation, and to guarantee long-term function. The production of a true-to-scale joint model is possible with computer-assisted tomography.

Aseptic loosening of cement-anchored total hip replacements.

The special conditions contributing to the loosening of 61 hip prostheses were studied and compared with 325 clinical and roentgenologically intact total hip replacements. The loosening rate rose sharply after the 6th postoperative year. One third of the artificial joints examined showed signs of loosening after the 9th year.

[Medium-term results of osteotomy near the knee joint in the treatment of gonarthrosis (author's transl)].

271 osteotomies near the knee joint were performed between 1968 and 1977 at the Orthopedic Clinic of Tübingen University. The article reports on the results obtained in 69 patients who had been osteotomized because of gonarthrosis, out of a total of 135 patients, the results being evaluated after an average period of 4.9 years following the operation.

Psychiatric sequelae of phencyclidine abuse.

Phencyclidine use has been noted to produce a psychosis of several week's duration in a small fraction of users. Descriptions of the premorbid personalities of those who became psychotic resemble descriptions of LSD and marijuana users who experienced prolonged psychiatric difficulty. In addition, the psychosis produced can often be recognized as a "hallucinogen" psychosis.