A simulation trainer for complex articular fracture surgery.

Background: The purposes of this study were (1) to develop a physical model to improve articular fracture reduction skills, (2) to develop objective assessment methods to evaluate these skills, and (3) to assess the construct validity of the simulation.

Methods: A surgical simulation was staged utilizing surrogate tibial plafond fractures. Multiple three-segment radio-opacified polyurethane foam fracture models were produced from the same mold, ensuring uniform surgical complexity between trials.

Radiographic structural abnormalities associated with premature, natural hip-joint failure.

Background: Significant controversy exists regarding the causes of premature, natural hip-joint failure. Identification of these causes may guide future investigations targeting prevention of this disorder. The aims of this study were to: (1) determine and characterize structural abnormalities associated with premature, natural hip-joint failure, and (2) analyze disease progression in the contralateral hips of patients with femoroacetabular impingement deformities.

Cemented total hip replacement cable debris and acetabular construct durability.

Background: Third-body wear can adversely affect the outcome of total hip arthroplasty by causing increased polyethylene wear, osteolysis, and component loosening. We hypothesized that there would be greater generation and migration of metal debris to the bearing surfaces in hips in which cobalt-chromium cables were used to reattach the osteotomized greater trochanter when compared with hips in which stainless steel wires were used.

Methods: Between June 1981 and December 1983, 196 consecutive total hip arthroplasties were performed with use of an Iowa stem and a titanium-backed cemented acetabular component, with cobalt-chromium cable trochanteric reattachment.

Total hip arthroplasty with cement and use of a collared matte-finish femoral component: nineteen to twenty-year follow-up.

Background: In the mid- to late 1970s, on the basis of laboratory and finite element data, many surgeons in the United States began using collared matte-finish femoral components and metal-backed acetabular components in their total hip arthroplasties. The purpose of this study was to evaluate the long-term results of the use of one such construct in arthroplasties performed by a single surgeon in a consecutive nonselected patient cohort.

Methods: Between January 1984 and December 1985, 273 patients underwent a total of 304 consecutive nonselected total hip arthroplasties with cement and use of the Iowa femoral component (which is collared, has a proximal cobra shape, and has a matte finish) and a metal-backed TiBac acetabular component performed by a single surgeon.

Variances in sagittal femoral shaft bowing in patients undergoing TKA.

We asked, "What are the quantitative variances in sagittal femoral bowing in patients who were indicated for total knee arthroplasty?" We retrospectively evaluated 145 consecutive patients who underwent 166 primary total knee arthroplasties with adequate preoperative nonrotated sagittal plane full-leg lateral radiographs. Digital radiographs were processed such that each femoral shaft was divided into three segments. A purpose-written program determined the flexion/extension of the femoral component using the Knee Society method of focusing on the distal femur and a second method using the whole femur.