Treatment of pelvic osteolysis associated with a stable acetabular component inserted without cement as part of a total hip replacement.

Thirty-five patients who had had a primary total hip replacement with a porous-coated acetabular component inserted without cement had a revision procedure to treat pelvic osteolysis. The mean age at the time of the revision operation was forty-nine years (range, twenty-nine to eighty-five years). Forty-six distinct pelvic osteolytic lesions were noted radiographically around the thirty-five cups.

Treatment of major defects of bone with bulk allografts and stemmed components during total knee arthroplasty.

We reviewed the results an average of fifty months (range, twenty-four to 120 months) after the use of thirty-five allografts in thirty patients during primary or revision total knee replacement. Twenty-nine femoral-head allografts, five distal femoral allografts, and one proximal tibial allograft were used in conjunction with a long-stemmed implant to reconstruct large osseous defects. The patients were evaluated clinically, radiographically, and subjectively (with use of a questionnaire).

Thigh pain and total hip arthroplasty: scintigraphy with 2.5-year followup.

From January 1988 to May 1990, 60 patients underwent 68 total hip arthroplasties at the Eisenhower Army Medical Center. The authors excluded 11 patients (11 hips) in whom infection developed, who were lost to followup, or who had incomplete records, leaving 49 patients (57 hips) as the study population. The 35 uncemented and 22 cemented femoral stems were evaluated with technetium bone scans at 1 week, 6 months, 1 year, and 2.

Fractures through cystic lesions of the greater trochanter. A cause of late pain after cementless total hip arthroplasty.

Four patients who presented with sudden onset of hip pain 7 to 11 years after successful porous-coated cementless hip arthroplasty are described. These four patients were all diagnosed to have fractures through osteolytic cysts in the greater trochanter. One patient was seen initially with a displaced fracture of the greater trochanter.

The diagnostic accuracy of history, physical examination, and radiographs in the evaluation of traumatic knee disorders.

We prospectively looked at the diagnostic accuracy of clinical examination of the knee in patients with arthroscopically documented knee injuries. The study included 156 patients with 156 knee injuries (72 acute and 84 chronic) who were seen during 1 year at Martin Army Hospital at Fort Benning Georgia. All patients were given a primary diagnosis based on their history, physical examination, and routine radiographs.

Prophylactic cerclage: a method of preventing femur fracture in uncemented total hip arthroplasty.

The incidence of femur fracture in non-cemented hip arthroplasty has been reported to be between 4.1% and 27.8%.

Arthroscintography for detection of femoral component loosening.

Arthroscintography is a simple and effective means of detecting femoral component loosening. Fourteen patients with painful total hip arthroplasties were evaluated using arthroscintography for the detection of femoral component loosening. Using this method, a sensitivity of 100% and a specificity of 75% were achieved.

False-positive radionuclide arthroscintigraphy with a porous-coated total hip prosthesis.

The evaluation of a painful hip prosthesis for suspected loosening frequently requires a multi-modality approach. Radionuclide arthroscintigraphy is a valuable adjunct to contrast arthrography, demonstrating greater sensitivity than contrast arthrography in detecting loosening of the femoral component of the prosthesis. Despite its reliability in the evaluation of cemented hip prostheses, the value of arthroscintigraphy in patients with uncemented or porous-coated prostheses is undetermined.