A comparison of SanatMetal Sanat Swing and Zimmer NexGen® total knee implants: 10-year postoperative follow-up results.

Objectives: In this study, we present our 10-year postoperative follow-up results of Sanat Swing® and NexGen® total knee implants.

Patients And Methods: A total of 189 patients (93 males, 96 females; mean age: 68 years; range, 48 to 86 years) who underwent total knee replacement between January 2008 and September 2010 were retrospectively analyzed. A total of 105 patients (Group A) were implanted a cemented Sanat Swing knee prosthesis and 84 patients (Group B) were implanted a cemented NexGen knee prosthesis.

Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice.

This article describes a one-step operative technique for the treatment of circumscript cartilage defects of weight-bearing surfaces of the knee. Since 1992, a total of 227 patients were treated using this technique for full-thickness lesions resulting from chondropathy, traumatic chondral defects, and osteochondritis dissecans; the procedure was evaluated in 57 patients who had > 3 years of follow-up. Magnetic resonance imaging, computed tomography arthrographies, ultrasound, and arthroscopy were used to evaluate the technique.

Arthroscopic autogenous osteochondral mosaicplasty for the treatment of femoral condylar articular defects. A preliminary report.

An arthroscopic technique for the use of mosaicplasty osteochondral grafting in the treatment of femoral condylar articular defects is described. During the procedure, small cylindrical grafts are harvested from the nonweightbearing periphery of the patellofemoral joint and implanted in mosaiclike fashion into the focal cartilage defect of the weightbearing condylar surface. This report describes the arthroscopic technique using newly designed instruments and the early results of 44 patients treated by this method.

Comparison of results of different types of knee arthroplasties.

We summarise our experience gained with knee arthroplasties over 18 years. Between 1976 and 1994 1103 knee arthroplasties (1044 primary cases, 59 revisions) were performed at the Orthopaedic Department of the National Institute of Rheumatology and Physiotherapy in Budapest, Hungary. The diagnoses were osteoarthritis (OA) in 50.

Cost-effectiveness of a coronary care unit versus an intermediate care unit for emergency department patients with chest pain.

Background: Guidelines are not available for which patients with acute chest pain should be admitted to the coronary care unit and which patients can be reasonably triaged to monitored beds in lower levels of care.

Methods And Results: Clinical and resource utilization data from 12 139 emergency department patients with acute chest pain were used in a decision-analytic model to identify cost-effective guidelines for the admission to a coronary care unit versus an intermediate care unit for initially uncomplicated patients without other indications for intensive care. The probability of clinical complications and death were derived from data on age-specific subsets of the population.

[Orthopedic surgery in patients with rheumatoid arthritis].

Studying their subject the authors have been found that among the orthopedic surgical interventions the most frequently applied procedure were the alloarthroplasty and the synovectomy. Half of the operations are performed on the hand and the knee. Because of the polyarticular and multilocular characteristic of the disease very often more than one operations are necessary in case of rheumatoid patients.

Finding a lasting cure for U.S. health care.

In "Making Competition in Health Care Work" (July-August 1994), Elizabeth Olmsted Teisberg, Michael E. Porter, and Gregory B. Brown ask a question that has been absent from the national debate on health care reform: How can the United States achieve sustained cost reductions while at the same time maintaining quality of care? The authors argue that innovation driven by rigorous competition is the key to successful reform.

[Management of early avascular femur head necrosis by flexion osteotomy. 2-year follow up].

Authors report on the results of treatment in 19 patients, operated for avascular necrosis of the femoral head. The first operation was performed in October, 1989. The average follow-up was 28 (24-42) months, the minimal follow-up 2 years.

[Management of early avascular femur head necrosis by implantation of a muscle-bone graft].

Authors describe the results of 10 patients operated for avascular necrosis of the femoral head. The first operation was performed in October 1987. The follow-up was in average 41.

The effect of hospital financial characteristics on quality of care.

Objective: To assess the relationship among hospital financial characteristics, patient payer mix, and the incidence of negligent medical injuries.

Design: Retrospective medical record review linked to hospital financial reports.

Setting: Acute care hospitals in New York State in 1984.

Racial differences in the use of revascularization procedures after coronary angiography.

Objective: To assess whether rates of coronary revascularization procedures differ between blacks and whites after coronary angiography is performed and to assess the relationship of these rates to hospital characteristics.

Design: A retrospective cohort study using 1987 and 1988 data on hospital claims and characteristics from the Health Care Financing Administration.

Setting: One thousand four hundred twenty-nine acute care hospitals that provide coronary angiography in the United States.

The effect of providing health coverage to poor uninsured pregnant women in Massachusetts.

Objectives: There has been substantial policy interest in whether the provision of health coverage to poor uninsured pregnant women affects access to prenatal care and birth outcomes. We therefore examined whether the statewide provision of health coverage to uninsured low-income pregnant women affects access to prenatal care and infant birth outcomes.

Design: Natural experiment.

[Low contact stress knee prosthesis system. Results and complications].

This paper reports on the global results of the low contact stress knee prosthesis system with mobile weight bearing surfaces. The follow-up result of 918 cemented and 963 cementless knee prostheses was in more than 90 per cent excellent and good 2-8 years after the operation. The ratio of complications connected with the construction decreased to 2.

[Knee arthroplasty with total condylar endoprosthesis].

Authors report on experiences gained with the Total Condylar knee prosthesis, representing the third generation in the development of the knee endoprosthesis. Based on results of 17 operations it is stressed that after the implantation in the severely degenerated or destroyed knee joint they succeeded to reach a significant decrease of pain and increase of the range of movement. After the implantation of the prosthesis adequate stability can be gained in knee joints without cruciate ligaments.

[A newly developed cementless elbow joint prosthesis].

Authors describe briefly the history of the development of elbow arthroplasty. They report on their experiences with the silicone, cementless, unconstrained elbow prosthesis developed by them and implanted in 23 cases during 3 years. The prosthesis is described, the operative indication and the problems of the operative technique are reviewed.

Acute myocardial infarction in the Medicare population. Process of care and clinical outcomes.

Objective: To describe the process of care and clinical outcomes associated with acute myocardial infarction (AMI) in the Medicare population, and to examine differences in process of care and outcome of care as a function of patient age, gender, and race.

Design: Retrospective cohort study using a longitudinal database created from Medicare utilization and administrative files. PATIENT POPULATIONS: A cohort of AMI patients covered by Medicare in 1987 and a random sample of Medicare patients without AMI.

Cost-effectiveness and cost-benefit analyses in the medical literature. Are the methods being used correctly?

Objective: To determine whether published cost-effectiveness and cost-benefit analyses have adhered to basic analytic principles.

Design: Structured methodologic review of published articles.

Study Sample: Seventy-seven articles published either from 1978 to 1980 or from 1985 to 1987 in general medical, general surgical, and medical subspecialty journals.

Determinants of resource utilization for patients admitted for evaluation of acute chest pain.

Objective: To identify determinants of resource utilization among patients with suspected acute myocardial infarction.

Design: Prospective cohort study, with prospective collection of detailed clinical data and retrospective collection of nonclinical data and resource utilization data.

Setting: Urban, tertiary-care, teaching hospital.

Comparison of the quality of ambulatory care for fee-for-service and prepaid patients.

Objective: To determine whether the quality of care for common ambulatory conditions is adversely affected when physicians are provided with incentives to limit the use of health services.

Design: Retrospective cohort study over a 2-year period.

Setting: Four group practices that cared for both fee-for-service patients and prepaid patients within a network model health maintenance organization (HMO).

Arthroplasty using acetabular implants in secondary protrusioned hips.

From 1979 to 1987, 102 operations were performed at the author's institution. The technique is simple and does not use any heterogenic material. There were no complications, except for one suppuration.

[Transplantation of a bone with muscle pedicle in a case of pathological fracture of the femur neck].

Authors performed an operation for danger of fracture in case of extensive cystic fibrous dysplasia, localized in the femoral neck. The cyst was filled after refreshing its walls, with cancellous bone. To increase ossification a cortico-spongious bone cube, gained from the trochanter major and with retained connection with the insertion of the anterior third of the medial gluteus muscle was inserted in the area filled.

[Use of a tumor prosthesis in the management of complications from a Guepar-type knee prosthesis].

In the operative treatment of the knee diseases Guepar prosthesis was used formerly more frequently, presently however only rarely. The frequence of complications and their treatment are many times serious problems. Authors describe one case in which the postoperative supracondylaer fracture necessitated the insertion of a special knee prosthesis.

Teaching status and resource use for patients with acute myocardial infarction: a new look at the indirect costs of graduate medical education.

To investigate whether the process of graduate medical education increases costs in teaching hospitals by causing longer lengths of stay and greater resource use, we compared lengths of stay, hospital charges, and the use of cardiovascular procedures for patients with acute myocardial infarction admitted to the teaching and nonteaching services of a university-affiliated community hospital. After adjusting for severity of illness and demographic characteristics, patients on the teaching services had a mean length of stay that was shorter by 0.6 days (p = 0.