More complications in uncemented compared to cemented hemiarthroplasty for displaced femoral neck fractures: a randomized controlled trial of 201 patients, with one year follow-up.

Background: It is unclear whether cemented or uncemented hemiarthroplasty is the best treatment option in elderly patients with displaced femoral neck fractures. Previous randomized trials comparing cemented and uncemented hemiarthroplasty have conflicting results. We conducted a randomized controlled trial to compare cemented and uncemented hemiarthroplasty.

Metal ion levels and functional results after either resurfacing hip arthroplasty or conventional metal-on-metal hip arthroplasty.

Background: Modern metal-on-metal hip resurfacing was introduced as a bone-preserving method of joint reconstruction for young and active patients; however, the large diameter of the bearing surfaces is of concern for potentially increased metal ion release.

Patients And Methods: 71 patients (< 65 years old) were randomly assigned to receive either a resurfacing (R) hip arthroplasty (n = 38) or a conventional metal-on-metal (C) hip arthroplasty (n = 33). Functional outcomes were assessed preoperatively and at 6, 12, and 24 months.

[A boy with a painless swelling of the wrist].

A 3-year-old boy presented with a painless swelling of his right wrist, which was diagnosed as dysplasia epiphysealis hemimelica.

Correction accuracy and collateral laxity in open versus closed wedge high tibial osteotomy. A one-year randomised controlled study.

In a randomised clinical trial in 50 patients with symptomatic osteoarthritis of the medial compartment of the knee, the clinical results of high tibial osteotomy (HTO) according to the open wedge osteotomy (OWO) and closed wedge osteotomy (CWO) were compared. In both groups locked plate fixation was used. Clinical and radiological assessments were performed preoperatively and after one year.

Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty.

As cytokines are involved in wound healing and other inflammatory processes, it could be valuable to measure their levels at the operative site. This study was conducted to investigate whether different cytokines are measurable in drainage fluid and, when measurable, whether we can find a difference in cytokine levels between one and six hours postoperatively. Samples from the drainage system in 30 consecutive patients undergoing primary total hip replacement were collected at one and six hours after closure of the wound.

Cemented versus non-cemented hemiarthroplasty of the hip as a treatment for a displaced femoral neck fracture: design of a randomised controlled trial.

Background: A discussion is ongoing whether displaced femoral neck fractures in elderly patients should be treated with a non-cemented or a cemented hemiarthroplasty. A recent Cochrane analysis stresses the importance of further research into the relative merits of these techniques. We hypothesise that non-cemented hemiarthroplasty will result in at least the same technical-functional outcome and complication rate, with a shorter operation time.

Lengthener loosening in a reversed shoulder prosthesis: a case report.

The reverse shoulder prosthesis is designed for the treatment of glenohumeral arthritis with irreparable cuff arthropathy. Although it has given good short term results the prosthesis is not free of complications. In this case report we describe an implant-related complication.

Patients poorly estimate the overall costs of a total knee arthroplasty and strongly overestimate the surgeon's fee.

In an attempt to reduce health care expenses, regulated competition between health care providers has been introduced in The Netherlands. As for total hip and knee arthroplasties, health care providers have to publish their prices to make them available for the insurance companies and the public. Eventually, competition between health care providers should result in optimal care for lower prices.

Similar effects of rofecoxib and indomethacin on the incidence of heterotopic ossification after hip arthroplasty.

Background: Although indomethacin is effective in preventing heterotopic ossification (HO) after primary total hip arthroplasty, side effects are frequently observed. In the last decade a new class of drugs--the COX-2 selective nonsteroidal anti-inflammatory drugs--has been developed. To investigate the effect of these COX-2 selective NSAIDs on heterotopic ossification (HO) after primary total hip arthroplasty (THA), we conducted a randomized controlled trial using either indomethacin or rofecoxib for 7 days.

No local recurrence of enchondroma after curettage and plaster filling.

Introduction: The most common treatment of enchondromas is curettage (with or without adjuvant therapy) followed by cancellous bone grafting. To avoid donor-site morbidity of the iliac crest, we applied plaster of Paris as a bone defect filler after curettage of enchondromas.

Materials And Methods: We treated 19 enchondromas of the hand and foot in 19 patients (mean age 40 years, range 21-79 years) with curettage and filling of the cavity with sterile plaster of Paris (calcium sulphate/phosphate) tablets.

Accuracy and initial stability of open- and closed-wedge high tibial osteotomy: a cadaveric RSA study.

We analyzed the difference in angle-correction accuracy and initial stability between open-wedge (OWO) and closed-wedge tibial valgus osteotomy (CWO). Five fresh-frozen pairs of human cadaver lower limbs were used; their bone mineral density (BMD) was measured with DEXA and a planned 7 degrees valgus osteotomy was performed, either with an open (right knees) or closed (left knees) technique. All knees for osteotomy were fixed with a rigid locked plate.

Biaxial total wrist arthroplasty in rheumatoid arthritis. Satisfactory functional results.

We reviewed 16 uncemented biaxial total wrist arthroplasties (TWA) in 14 patients with rheumatoid or juvenile arthritis. The mean follow-up was 25 months (range 5-60). According to the Hospital for Special Surgery scoring system (HSS), good-to-excellent results were accomplished in 69%, moderate in 19%, and poor in 12%.

Limited posterior approach for internal fixation of a glenoid fracture.

We present the case of a patient who was treated by open reduction and internal fixation for a displaced glenoid fracture using a limited posterior approach.

Patient versus surgeon satisfaction after total hip arthroplasty.

We compared patient satisfaction with surgeon satisfaction after total hip arthroplasty (THA) in a group of 193 patients (200 THAs, mean follow-up six years) using a visual analogue scale (VAS), and two objective and two subjective scoring systems. We also determined the survival rate with different endpoints. For the 121 hips available for clinical follow-up, we did not find a significant difference in satisfaction between patient and surgeon.

Central grafting for persistent nonunion of the tibia. A lateral approach to the tibia, creating a central compartment.

We report the operative technique and results of a new method of central grafting for persistent nonunion of the tibial shaft. The operation is performed through a lateral approach, anterior to the fibula. Fresh autogenous bone from the iliac crest is used to form a central bridge between the tibia and fibula above, below and at the level of the nonunion.

Rupture of the pectoralis major muscle in body-builders.

Rupture of the pectoralis major muscle is rarely encountered. However, among body-builders this lesion, commonly called the "pec-tear", is well known. The bench-press exercise is a common cause.

[Urination problems following total hip arthroplasty: insertion or not of an indwelling catheter?].

Objective: To assess the frequency of urine retention and of urinary tract infection after total hip replacement in order to: to minimize morbidity due to urine retention and urinary tract infection after total hip replacement; to limit the discomfort to the patient; to decrease the work load of the nursing staff, if possible.

Setting: University Hospital Rotterdam.

Design: Prospective, randomized.

Reconstruction of the tibia by dual grafting. 3 cases of tumor resection.

Large defects of the tibia can be bridged with autologous cancellous grafts between the remaining fibula and a contralateral tibial cortical graft. The long-term results of this technique in 3 cases after resection of a malignant tumor were either excellent or fair. It is concluded that this technique is an effective limb-saving surgical procedure.