A modified direct lateral approach for neck-preserving total hip arthroplasty: tips and technical notes.

Tissue-sparing surgery for hip replacement aims to minimize muscle damage and conserve the femoral neck through the use of mini-prostheses. We propose a modification of the classical direct lateral access procedure that preserves the gluteus medius. Further advantages during the surgical phase include limited blood loss, visualization of the entire acetabulum, and sparing of the transverse ligament.

Linezolid in the treatment of Gram-positive prosthetic joint infections.

Objectives: To investigate the clinical efficacy and safety of linezolid in the treatment of Gram-positive prosthetic hip and knee infections.

Materials And Methods: A retrospective evaluation of patients hospitalized in the Department of Infectious Diseases of San Martino Hospital in Genoa with the diagnosis of Gram-positive prosthetic joint infection and treated with intravenous and/or oral linezolid. Primary end points were the patient clinical outcome at the end of treatment and at long-term follow-up (up to 12 months after the end of treatment).

The TACK knee prosthesis. Analysis of a uniform case series.

We implanted the total arthroplasty knee or TACK prosthesis in 40 patients with degenerative osteoarthritis. We used the same surgical technique in all patients. Full extension and flexion more than 90 degrees were achieved in all 40 knees.

Biomechanical validation of a new nail-plate for the repair of stable proximal femoral fractures.

The mechanical performance and the stress shielding effects of the Howmedica Spherolock MKII implant were evaluated. Three types of stable proximal femoral fractures were created in composite femurs and fixed with the nail-plate. The femurs were loaded to failure, and the yield strength, stiffness, and failure modes were noted.

The technique of reimplantation as it relates to bone defect.

Bone loss is the principal problem in hip prosthesis revision surgery; repair of this loss may identify the method itself of reimplantation. In light of thirteen years of hip reimplantation surgery the authors propose a classification of bone loss that correlates pathologic anatomy with surgical strategy. Thus, three types of acetabular bone loss and four types of femoral bone loss are distinguished, to which correspond just as many surgical strategies, aimed at an attempt to obtain stability of the revision implant and its longer duration in time.

Femoral neck preservation in total hip replacement.

Preservation of the femoral neck in hip arthroplasty creates a particular biomechanical situation which is clearly different from what is found even after partial neck removal. The femoral neck consists in fact of a "cylinder of cortical bone" that can be used as the "base" for anchoring the stem to the femur, in contrast to the press-fit procedure or other solutions. The mechanical and biological advantages are as follows: 1) Primary triplanar stem stability, in particular rotational stability.

Bacteriological and histological study of 40 loose cemented hip prostheses.

The causes of the loosening of a hip prosthesis may be inflammatory, mechanical, immunitary or due to detritus. A bacteriological and histological study, in cases where further surgery was needed, may clearly contribute to the aetiopathogenesis of failure. Loose hip prostheses removed at operation were studied from a bacteriological and, in particular, histological point of view.

The Cathcart elliptical orthocentric endoprosthesis. A long-term clinical and radiographic study.

In 1971 Cathcart proposed the use of an elliptical head for the femoral endoprosthesis, based on his anatomical studies which had proved that the normal femoral head is elliptical and not spherical. Important biomechanical studies have also shown that the periacetabular trajectory system also assumes an elliptical gothic arch shape during stress loading (Fischer and Olivier, 1979). The authors therefore decided to use an elliptical head because it improves lubrication and therefore nourishment of the acetabular cartilage, and because it better distributes the load.

Experience with thymopentin in the treatment of periarthritis humeroscapularis, tendinitis, and gonarthrosis by local infiltration.

A total of 122 patients with periarthritis humeroscapularis, tendinitis, and gonarthrosis were accepted into a controlled, randomized double-blind study; of these patients, 61 subjects were administered local infiltrations of thymopentin (Timunox) 1 ml (50 mg) plus lidocaine 1 ml (2%), once a week for a period of 5 weeks. 61 subjects were during the same time treated with methylprednisolone depot 1 ml (40 mg) plus lidocaine 1 ml (2%). Demographic and clinical parameters were comparable in both groups.

Biodynamic total hip prosthesis.

The biodynamic total hip prosthesis which was devised in 1977-78 and implanted in 1979 was derived from a series of experimental studies and a lengthy clinical experience, both dating back to 1968. This prosthesis introduced two new and original concepts into the field of prosthetic hip surgery: 1) the biequatorial design of the cup; 2) the preservation of the femoral neck. This prosthetic system is based on maximum preservation of the bone stock as well as hip function.

Arthroprosthesis of the hip at 12 to 16 year follow-up. A clinical and radiographic study of 17 cases.

A clinical and radiographic study of prosthetic replacement of the hip with a very long follow-up permitted us to evaluate the various factors influencing the long-term stability of this arthroprosthesis. Seventeen patients who underwent this operation during the 15 year period from 1969 to 1973 were reviewed clinically (using a points system adopted in our Clinic), and radiographically after periods ranging from 12 to 16 years. There was a reassuringly high proportion (72%) of excellent or good results.

Effect of temperature changes in acrylic cement on prosthetic implant surgery. An investigation into the relationship between quantity and temperature changes at different levels on loosening of the implant.

Loosening of the prosthetic stem is one of the most frequent problems in arthroprosthetic replacement. Fixation at the bone/cement interface is therefore of crucial importance. This can be affected by several factors, one of which is the heat generated in the acrylic cement, which may exceed the level at which tissue viability is affected.

["Double-blind" clinical study of a non-steroid anti-inflammatory drug: glucametacine].

A double blind clinical study has been carried out with two non-steroid anti-inflammatory drugs, glucametacine and phenylbutazone in 40 patients suffering from inflammatory and degenerative type arthrorheumopathies, selected and randomised into two groups. Examination of results shows the greater effectiveness of glucametacine (78%)over phenylbutazone (60%). Glucametacine was also statistically (p < 0,05) better from the tolerance point of view.

Reduction, capsuloplasty and pelvic osteotomy in surgical treatment of inveterate congenital hip dislocation.

A new surgical technique is described for the treatment of inveterate congenital dislocation of the hip in patients aged between 6 and 26 years, i.e., when it is too late for simple surgical reduction of the dislocation and far too early for a total hip replacement.

Gluteal fibrosis.

The authors report a histological study of gluteal fibrosis, a disease which in the last few years has become a clinical entity in its own right. This condition is of more frequent occurance than the earlier reports seem to indicate. The salient point emerging from this investigationis that teno-fascial changes exist as well as changes in the striated muscle.