An 11- to 15-year clinical outcome study of the Advance Medial Pivot total knee arthroplasty: pivot knee arthroplasty.

Aims: The Advance Medial-Pivot total knee arthroplasty (TKA) was designed to reflect contemporary data regarding the kinematics of the knee. We wished to examine the long-term results obtained with this prosthesis by extending a previous evaluation.

Patients And Methods: We retrospectively evaluated prospectively collected data from 225 consecutive patients (41 men and 184 women; mean age at surgery 71 years, 52 to 84) who underwent 284 TKAs with a mean follow-up of 13.

Acetabular reconstruction in patients with low and high dislocation: 20- to 32-year survival of an impaction grafting technique (named cotyloplasty).

We report the results at a mean of 24.3 years (20 to 32) of 61 previously reported consecutive total hip replacements carried out on 44 patients with severe congenital hip disease, performed with reconstruction of the acetabulum with an impaction grafting technique known as cotyloplasty. The mean age of the patients at operation was 46.

Expression patterns of endothelin-1 and its receptors in colorectal cancer.

Background And Objectives: Endothelin-1 (ET-1), a potent vasoconstricting peptide, plays an important role in carcinogenesis. Previous in vitro studies have shown that colorectal cancer cells produce ET-1.

Methods: ET-1 and its receptors ET-A (ET(A) R) and ET-B (ET(B) R) were analyzed in colorectal cancer cell lines and tumors by Western blot and immunohistochemistry.

The effect of radial osteotomy on the position of the posterior interosseous nerve.

The purpose of this study was to determine whether a radial shaft fracture would decrease the protection provided to the posterior interosseous nerve by the pronation maneuver during posterolateral exploration. The position of the nerve in 14 cadaveric elbows, before and after a radial osteotomy, was determined using CT scans in full supination and full pronation after injection of the nerve with radio-opaque dye. The angle formed by the olecranon, radial head and posterior interosseous nerve, and the distance between the nerve and the most lateral aspect of the radial head were measured.

The influence of the acromioclavicular joint degeneration on supraspinatus outlet impingement and the acromion shape.

Purpose: To assess the anatomic association of acromioclavicular joint degeneration to supraspinatus outlet impingement and the acromion shape.

Methods: Sagittal oblique magnetic resonance images of 49 shoulders in 49 patients were reviewed. 29 of them (mean age, 59 years) underwent surgery for impingement with or without rotator cuff tear (group 1), whereas the 20 controls (mean age, 27 years) were treated for shoulder instability without rotator cuff disease or acromioclavicular joint derangement (group 2).

Epidural bleeding after ACL reconstruction under regional anaesthesia: a case report.

Introduction: Epidural bleeding as a complication of catheterization or epidural catheter removal is often associated with perioperative thromboprophylaxis especially in adult reconstructive surgery.

Case Presentation: We report on a case of a 19 years old male athlete that underwent anterior cruciate ligament reconstruction, receiving low molecular weight heparin for thromboprophylaxis and developed an epidural hematoma and subsequent cauda equina syndrome two days after removal of the epidural catheter. An urgent magnetic resonance imaging scan revealed an epidural hematoma from the level of L3 to L4.

A mid-term clinical outcome study of the Advance Medial Pivot knee arthroplasty.

The Advance Medial Pivot Total Knee Arthroplasty (Wright Medical Technology, Arlington, Tennessee, USA) has been designed to reproduce modern ideas of knee kinematics. We report a prospective clinical outcome study of 284 arthroplasties in 225 consecutive patients with a mean follow-up of 6.7 years (range 4 to 9 years).

Use of a mini-external fixator for the treatment of hand fractures.

Purpose: To evaluate the outcome of hand fractures managed with mini-external fixators (MEFs) in order to assess their usefulness in different fracture types and to make recommendations regarding potential applications.

Methods: Fifty-one patients with 59 metacarpal and phalangeal fractures were treated with MEFs. Fixators were used to reduce the fracture or to achieve volar plate arthroplasty when anatomical joint reconstruction was impossible.

Protrusio of a ceramic femoral head through the acetabular metallic shell, extensive metallosis and 'bubble sign'.

A 24-year-old patient with a history of juvenile rheumatoid arthritis underwent a primary cementless left total hip arthroplasty (THA). The original THA consisted of an Optifix 54 cup with a 3-mm thick polyethylene liner, an Optifix size 4 stem (Smith & Nephew Richards, Memphis, Tennessee) and a Biolox aluminum 32-mm femoral head. Fourteen years later, radiographs demonstrated extensive wear of the polyethylene liner resulting in direct articulation and abrasion wear of the ceramic femoral head on the cup and a bubble sign.

Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomised clinical and radiological trial.

We report the clinical and radiological results of a two- to three-year prospective randomised study which was designed to compare a minimally-invasive technique with a standard technique in total knee replacement and was undertaken between January 2004 and May 2007. The mini-midvastus approach was used on 50 patients (group A) and a standard approach on 50 patients (group B). The mean follow-up in both groups was 23 months (24 to 35).

Computed tomography study of radial head morphology.

Computed tomography scans of 22 cadaveric adult elbows were obtained in 3 forearm positions: full supination, neutral, and full pronation. The radial head dimensions, the radiocapitellar joints, and the proximal radioulnar joints were measured. Multivariate analysis of variance was used to determine which portions of each articulation were the most congruent.

Distal ulnar implant arthroplasty as a definitive treatment of a recurrent giant-cell tumor.

Giant-cell tumors of the distal ulna are frequently recurrent and difficult to treat. A Darrach-type resection can lead to functional impairments of the wrist and hand. A case of a 42-year-old man, who underwent a distal ulna arthroplasty for recurrent giant-cell tumor of the distal ulna, is presented.

The role of MR imaging in staging femoral head osteonecrosis.

Reliability, accuracy and prognostic value of any classification system are important in evaluation and treatment of femoral head osteonecrosis. The purpose of the present study was to correlate the plain radiographs with MRI in femoral head osteonecrosis. Between 2000 and 2005, 115 hips (72 patients) were evaluated and classified according to the ARCO classification criteria with the use of plain radiographs and additional application of MRI.

Incision stretching in primary TKA: what is the real length of our approach?

This article examines the extent of anterior knee soft-tissue stretching that occurs in patients undergoing primary total knee arthroplasty for 331 consecutive patients. At the time of surgery, an anterior knee incision was drawn on the knee. Measurements were taken of the length of the incision with the knee in maximum extension and 90 degrees degrees of flexion.

Tumor-like meniscal cyst.

A 50-year-old woman presented with a 5-year history of mild pain in her right knee, which had increased over the last 2 years. A palpable mass over the anterolateral aspect of the knee was obvious and the last 3 months she was experiencing locking episodes with consequent knee effusion. The differential diagnosis was driven between meniscal cyst, pigmented villonodular synovitis, synovial sarcoma, synovial chondromatosis, and aneurysm.

Rotator cuff interval reconstruction.

Five pairs of cadaveric shoulders underwent posterior and anterior drawer and inferior sulcus tests in five progressive conditions: intact, vented, following opening of the rotator cuff interval, reconstruction of the interval, and transfer of the coracoacromial ligament. The surgical treatments--vented, open rotator cuff interval, reconstruction, and coracoacromial ligament transfer--had an effect compared to the intact shoulders on the inferior stiffness (P = .00002) and on the anteroposterior stiffness (P = .

Radial head fractures: MRI evaluation of associated injuries.

The purpose of this study was to evaluate the incidence of combined osteochondral and ligamentous injuries by magnetic resonance imaging (MRI) in 24 patients with an acute radial head fracture (Mason type II and III) without documented dislocation or tenderness at the distal radioulnar joint. Elbow radiographs (anteroposterior and lateral views) were obtained on all patients as well as magnetic resonance images in the sagittal, coronal, axial, axial oblique, and coronal oblique planes with the injured elbow in a splint. The incidence of associated injuries revealed by MRI was medial collateral ligament not intact in 13 of 24 (54.

MR imaging findings in early osteoarthritis of the knee.

Purpose: To carry out a modern diagnostic survey among patients with a clinical and radiological diagnosis of early osteoarthritis of the knee.

Materials And Methods: A magnetic resonance imaging survey was performed on 70 patients (82 knees) with a mean age of 59 years. (range, 40-71 years) who had chronic knee pain, clinical diagnosis of early osteoarthritis of the knee and conventional knee radiographs classified as 1 and 2 on the Kellgren-Lawrence scale.

The effects of calcitonin on acute bone loss after pertrochanteric fractures. A prospective, randomised trial.

We investigated the effect of calcitonin in the prevention of acute bone loss after a pertrochanteric fracture and its ability to reduce the incidence of further fractures in the same patient. Fifty women aged between 70 and 80 years who had a pertrochanteric fracture of the hip were randomly allocated to group A (200 IU of nasal salmon calcitonin daily for three months) or group B (placebo). Patients in group A showed a significantly higher level of total alkaline phosphatase and osteocalcin on the 15th day after injury and a significantly higher level of bone alkaline phosphatase on the 90th day after surgery.

Structural properties of the axis studied in cadaveric specimens.

Peripheral quantitative computed tomography scans of the axis in 20 fresh cadaveric specimens obtained at autopsy were studied to investigate the internal structural properties of the axis. In all specimens, serial scans were done in three planes. The area of the dens consisted of dense cortical and trabecular bone (Region 1, above the base of the dens) and showed statistically significantly greater peripheral quantitative computed tomography values when compared with the anterior part of the body of the axis (Region 2, below the base of the dens).

A radiographic study of proximal radius anatomy with implications in radial head replacement.

Anteroposterior (AP) and lateral radiographs of 20 healthy volunteers' forearms were taken in three views (full supination, neutral rotation, and full pronation). Radial head maximum diameter and angular measurements between the axis of forearm rotation (AFR) and the radial neck axis (RNA) were made with digital calipers. Repeated-measures analysis of variance revealed a statistically significant difference between the three AP groups, with supination having the smallest values (P <.

Position of the distal fibular fragment in pronation and supination ankle fractures: a CT evaluation.

Background: Although classically the fibula has been reported to be in external rotation after supination-external rotation (SER) or pronation-external rotation (PER) ankle fractures, a previous CT study demonstrated that what had traditionally been interpreted as external rotation of the distal fibular fracture fragment is actually internal rotation of the proximal fibular fragment. The purpose of this study was to evaluate a series of CT scans in patients who have suffered type IV SER or PER ankle fractures to assess the rotational deformity of the fibular fragment.

Materials And Methods: CT scans of the injured and uninjured extremities were performed on 30 extremities which had sustained either SER (21) or PER (9) injuries.