Acta orthopaedica Scandinavica最新文献

{"title":"Articular cartilage degeneration after acute subchondral bone damage: an experimental study in dogs with histopathological grading.","authors":"Andreas Lahm,&nbsp;Markus Uhl,&nbsp;Christoph Erggelet,&nbsp;Jörg Haberstroh,&nbsp;Eike Mrosek","doi":"10.1080/00016470410004166","DOIUrl":"https://doi.org/10.1080/00016470410004166","url":null,"abstract":"<p><strong>Background: </strong>Subchondral fracture patterns and bone bruises have been described and some clinical studies have shown alterations in the initially healthy cartilage after such lesions.</p><p><strong>Methods and results: </strong>After having performed cadaver studies, we created an animal model to produce pure subchondral damage without affecting the articular cartilage, under MRI control. We used 12 beagle dogs. For quantification of different degrees of staining, we used a grading of the sections by means of the HHGS (Histological-Histochemical Grading System) or Mankin score.</p><p><strong>Results: </strong>In all cases, FLASH 3D sequences revealed intact cartilage in MRI after impact. The best detection of subchondral fractures was achieved in fat-suppressed TIRM sequences. Image analysis based on the HHGS showed changes in 10 of 12 samples, with a high degree of significance 6 months after the initial trauma. Correlation analysis showed loss of the physiological distribution of proteoglycans and glycoproteins in the different zones of articular cartilage. Subcategories \"Structure\", \"Cells\" and \"Safranin-O Staining\" also showed high significance, and the category \"Tidemark Integrity\" showed a tendency.</p><p><strong>Interpretation: </strong>Our findings indicate that acute subchondral fractures are a predictor of degenerative changes within 6 months. Modifications and supplements to rehabilitation might be needed in cases with accompanying subchondral lesions, e.g. in ACL tears.</p>","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"762-7"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why does outer joint motion predominate in bipolar hip prosthesis? Experimental and clinical studies.","authors":"Sung Man Rowe,&nbsp;Jae Yoon Chung,&nbsp;Eun Sun Moon,&nbsp;Taek Rim Yoon,&nbsp;Hyoung Yeon Seo,&nbsp;Jae Joon Lee","doi":"10.1080/00016470410004067","DOIUrl":"https://doi.org/10.1080/00016470410004067","url":null,"abstract":"<p><strong>Background: </strong>Theoretically, the motion of a bipolar hip prosthesis is most likely to occur at the inner joint if the frictional coefficients are equal at both surfaces. However, many studies have suggested that most motion occurs at the outer joint.</p><p><strong>Material and methods: </strong>We performed an analysis of motion in a cadaveric bone model and in 50 patients during fluoroscopic examination, to determine how the motion is distributed between the two joints and what factors contribute to this distribution.</p><p><strong>Results: </strong>The motion distributions varied widely between the patients. However, there was a relative pre-ponderance (63-90%) of outer motion in all directions of leg movement in addition to a persistent coexistence of motion at both joints in 44 of 50 patients. This preponderance of outer motion was the result of an early impingement of the acetabular cup and structural differences between the two joints.</p><p><strong>Interpretation: </strong>An adjustment of the positive eccentricity and a decrease in the frictional torque of the inner joint as a result of better lubrication and smoothness can be expected to improve the motion distribution, thus reducing the amount of acetabular erosion.</p>","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"701-7"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25002335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of radiographic and radiostereometric wear measurement of different hip prostheses: an experimental study.","authors":"T. von Schewelov, L. Sanzén, N. Börlin, Patrik Markusson, I. Onsten","doi":"10.1080/759369229","DOIUrl":"https://doi.org/10.1080/759369229","url":null,"abstract":"BACKGROUND\u0000In vivo measurement of wear in the ball and socket articulation of total hip arthroplasties is of interest in the evaluation of both existing and new implants. Controversy reigns regarding the accuracy of different radiological measurement techniques and in particular how accuracy has been assessed.\u0000\u0000\u0000MATERIAL AND METHODS\u0000We assessed the accuracy of 2 radiostereometric (RSA) techniques for wear measurement and 3 standard radiographic techniques, namely Imagika (image analyzing software), Imagika corrected for head center displacement, and the Charnley Duo method. 5 custom-made adjustable phantoms with different prosthetic components were used.\u0000\u0000\u0000RESULTS\u0000In 20 measurements of all 5 phantoms at 3 levels of simulated wear (0.2 mm, 1.0 mm and 1.5 mm), the mean measurement error of the digital RSA examinations was 0.010 mm (accuracy 0.42). The corresponding error values for the three radiographic techniques were 0.19 (accuracy 1.3) for Charnley Duo, 0.13 (accuracy 1.3) for Imagika corrected, and 1.021 (accuracy 2.99) for Imagika. Measurement error decreased from 0.011 mm with ordinary RSA to 0.004 with RSA digital measurement. Head size, direction of wear in relation to the cup or type of prosthetic component did not influence the measurement error. The results of Charnley Duo and Imagika corrected were similar but the latter had an inexplicable systematic error in measuring one of the phantoms. Imagika had the worst results due to its inability to compensate for the out-of-head center effect. Alumina heads were difficult to analyze with all methods.\u0000\u0000\u0000INTERPRETATION\u0000By using the ISO standard for assessing accuracy, RSA can be expected to measure wear with an accuracy of about 0.4 mm irrespective of prosthetic component studied or direction of wear, whereas the best technique, in our study, based on standard radiographs can be accurate to about 1.3 mm.","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"4 1","pages":"691-700"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60614785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mennen clamp-on plate fixation of periprosthetic fractures of the humerus after shoulder arthroplasty--a report on 3 patients.","authors":"Helmut Lill,&nbsp;Pierre Hepp,&nbsp;Tim Rose,&nbsp;Jan Korner,&nbsp;Christoph Josten","doi":"10.1080/00016470410004184","DOIUrl":"https://doi.org/10.1080/00016470410004184","url":null,"abstract":"Copyright © Taylor & Francis 2004. ISSN 0001–6470. Printed in Sweden – all rights reserved. DOI 10.1080/00016470410004184 The clamp-on plate described by Mennen (1989) was originally developed only for shaft fractures of the forearm. The therapeutic spectrum has subsequently been expanded to include treatment of periprosthetic fractures of the femur (Liu et al. 1995, Otremski et al. 1998, Kamineni and Ware 1999, Kligman and Roffman 1999). Jähnich et al. (2000) described the use of the Mennen plate for humeral shaft nonunions. Kamineni and Ware (1999) treated 2 periprosthetic humeral head fractures after previous shoulder arthroplasty. We describe our experience of 3 such cases. Case 1 An 81-year-old woman suffered a periprosthetic humeral fracture after a fall, 3 years after a cementless shoulder arthroplasty with a bi-rotational head system for a proximal humerus 4-part fracture (Neer IV). The humeral shaft was unstable and radiographs showed a periprosthetic fracture with a nonunion near the tip of the stem, and cranial migration of the prosthesis in the gleno-humeral joint (Figure 1). We used an anterior approach for fixation with two wire cerclages. For further stabilization, a medium-sized Mennen plate was applied to the humeral shaft. Cancellous bone grafts were applied. At 20 months, radiographs showed a complete bony union and there was no pain (Figure 2). The Constant score was 38 points.","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"772-4"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-assisted fluoroscopic navigation of pedicle screw insertion: an in vivo feasibility study.","authors":"T. Fu, L. Chen, Chak-Bor Wong, P. Lai, Tsung-Ting Tsai, C. Niu, Wen‐Jer Chen","doi":"10.1080/759369234","DOIUrl":"https://doi.org/10.1080/759369234","url":null,"abstract":"BACKGROUND\u0000Accurate placement of pedicle screws is difficult.\u0000\u0000\u0000PATIENTS AND METHODS\u0000We evaluated the feasibility and accuracy of pedicle screw insertion assisted by a real-time, 2-dimensional (2D) image-guided navigation system in 12 patients who underwent thoraco-lumbar and/or lumbar stabilization. 66 pedicle screws were inserted either by senior spine surgeons or residents. The accuracy of positioning of the screws was evaluated using postoperative plain radiographs and thin-cut CT.\u0000\u0000\u0000RESULTS\u000061 of the 66 screws were inserted successfully. 5 screw insertions showed structural violations: 4 on the medial and 1 on the lateral pedicle wall. The accuracy was higher in the sagittal plane than in the axial plain. There was no difference between the surgical error rates caused by the senior surgeons and the residents.\u0000\u0000\u0000INTERPRETATION\u0000Using computer-assisted 2D fluoroscopic image navigation, it is possible to achieve reliable and accurate pedicle screw insertion during low thoracic and lumbar spinal surgery.","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6 1","pages":"730-5"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60614985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life after hip revision with impaction bone grafting on a par with that 4 years after primary cemented arthroplasty.","authors":"Isam Atroshi,&nbsp;Ewald Ornstein,&nbsp;Herbert Franzén,&nbsp;Ragnar Johnsson,&nbsp;Anna Stefánsdóttir,&nbsp;Martin Sundberg","doi":"10.1080/00016470410004030","DOIUrl":"https://doi.org/10.1080/00016470410004030","url":null,"abstract":"<p><strong>Background: </strong>There have been few studies evaluating patient-reported quality of life outcomes after hip revision with impaction bone grafting.</p><p><strong>Patients and methods: </strong>The inclusion criteria were aseptic loosening after primary arthroplasty performed for osteoarthrosis, and first-time revision with impacted morselized allograft bone and cemented Exeter stem. During a 4-year period, 35 patients were eligible and all were included. The Nottingham Health Profile (NHP) was completed by the patients and the Charnley hip scores recorded by the examining surgeon preoperatively, after 6 months and yearly up to 4 years (28 patients) postoperatively. For comparison, 35 osteoarthrotic patients completed the NHP 4 years after cemented Exeter primary arthroplasty.</p><p><strong>Results: </strong>At 4 years, the NHP scores for the revision patients did not differ significantly from those recorded in the primary arthroplasty group. Among the revision patients, mixed model analysis showed improvement in NHP pain (p < 0.001) and physical mobility scores (p = 0.002). The effect size at 4 years was large for pain (1.2) and moderate for physical mobility (0.6). The major improvement was recorded at 6 months, with no further substantial change observed. The correlations between the NHP and Charnley scores were weak or moderate (r, -0.15 to -0.67).</p><p><strong>Interpretation: </strong>Hip revision with impaction bone grafting leads to substantially improved quality of life, similar to that 4 years after primary arthroplasty.</p>","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"677-83"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position of the humeral head and rotator cuff tear: an anatomical observation in cadavers.","authors":"Nirav N Shah,&nbsp;Panos Diamantopoulos","doi":"10.1080/00016470410004139","DOIUrl":"https://doi.org/10.1080/00016470410004139","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the humeral head position and rotator cuff tears is not well described.</p><p><strong>Material and methods: </strong>We performed an anatomical study of 22 cadaveric shoulders to find out the relationship between the normal anatomical position of the humeral head and tears of the rotator cuff. After dissection, the rotator cuff pathology was documented. The position of the humeral head was noted in relation to the acromion. The humeral head with intact acromion and articulated shoulder joint was photographed from the superior aspect of the joint and the area of the humeral head outside the acromion was measured, i.e. the part of the humeral head lateral to the lateral border of the acromion process. The relationship between rotator cuff pathology and uncovering of the humeral head was determined.</p><p><strong>Results: </strong>9 specimens had a partial cuff tear, while 4 had a complete tear. Those specimens with a rotator cuff tear had a mean area of 83% of the humeral head under the acromion. The specimens that did not show a rotator cuff tear had a mean area of 61% of the humeral head under the acromion.</p><p><strong>Interpretation: </strong>We suggest that there is individual variation in anatomical position of the humeral head in relation to the acromion and that this position correlates with the occurrence of rotator cuff pathology.</p>","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"746-9"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture of fully hydroxyapatite-coated titanium femoral stem of a total hip replacement--a report of 3 cases.","authors":"Dinesh K Sharma,&nbsp;Stuart Brooks,&nbsp;Stuart Creasey,&nbsp;Brian Lewis","doi":"10.1080/00016470410004175","DOIUrl":"https://doi.org/10.1080/00016470410004175","url":null,"abstract":"Copyright © Taylor & Francis 2004. ISSN 0001–6470. Printed in Sweden – all rights reserved. DOI 10.1080/00016470410004175 Fracture of the femoral stem of a total hip replacement has become an unusual but well recognised complication when using cement. Fracture of the femoral stem in an uncemented total hip replacement is rare, however. We report 3 cases of fracture of the femoral stem (2 of which were done in our hospital and 1 that was referred from outside) with a hydroxyapatite-coated prosthesis where the metal was fully covered by the hydroxyapatite coating. The femoral prosthesis used was the JRI (Joint Replacement Instrumentation Ltd. or Furlong THR, London, UK), made of wrought titanium alloy with the surface completely covered with vacuum plasma sprayed hydroxyapatite coating. This coating is of 96% purity, has a thickness of 150 microns and a bond strength of 60 Mpa. It is attached to a 50-micron thick porous titanium undercoating. The stem has 3 parts. The rectangular proximal third with a small fin to counteract rotation is placed in the trochanter area. Further distally, there is a cone section to create mechanical stability. The distal portion is cylindrical. The design allows the distal femur to be over-reamed by 2 mm.","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"768-71"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibular autograft and silicone implant arthroplasty after resection of giant cell tumor of the metacarpal--a case report with 9-year follow-up.","authors":"Marco Manfrini,&nbsp;Cesare Stagni,&nbsp;Massimo Ceruso,&nbsp;Mario Mercuri","doi":"10.1080/00016470410004201","DOIUrl":"https://doi.org/10.1080/00016470410004201","url":null,"abstract":"Copyright © Taylor & Francis 2004. ISSN 0001–6470. Printed in Sweden – all rights reserved. DOI 10.1080/00016470410004201 A 32-year-old man had been treated by curettage and filling with tricalcium phosphate because of a giant cell tumor of the fourth metacarpal bone of the right hand. The tumor recurred almost immediately and the patient was referred to us (Figure 1). Radiographs showed a pathological fracture of the metacarpal bone. CT and MRI revealed a swollen osteolytic lesion extending into the diaphysis. Total body scintigraphy showed pathological uptake of contrast medium only at the lesion. The lesion was exposed by a dorsal longitudinal incision, which included the previous surgical scar. The metacarpophalangeal joint was then dislocated, preserving the capsule and the collateral ligaments, and the metacarpal was resected at its proximal fourth. The resected segment was 4.5 cm long.","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"779-81"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25001794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of radiographic and radiostereometric wear measurement of different hip prostheses: an experimental study.","authors":"Thord von Schewelov,&nbsp;Lennart Sanzén,&nbsp;Niclas Börlin,&nbsp;Patrik Markusson,&nbsp;Ingemar Onsten","doi":"10.1080/00016470410004058","DOIUrl":"https://doi.org/10.1080/00016470410004058","url":null,"abstract":"<p><strong>Background: </strong>In vivo measurement of wear in the ball and socket articulation of total hip arthroplasties is of interest in the evaluation of both existing and new implants. Controversy reigns regarding the accuracy of different radiological measurement techniques and in particular how accuracy has been assessed.</p><p><strong>Material and methods: </strong>We assessed the accuracy of 2 radiostereometric (RSA) techniques for wear measurement and 3 standard radiographic techniques, namely Imagika (image analyzing software), Imagika corrected for head center displacement, and the Charnley Duo method. 5 custom-made adjustable phantoms with different prosthetic components were used.</p><p><strong>Results: </strong>In 20 measurements of all 5 phantoms at 3 levels of simulated wear (0.2 mm, 1.0 mm and 1.5 mm), the mean measurement error of the digital RSA examinations was 0.010 mm (accuracy 0.42). The corresponding error values for the three radiographic techniques were 0.19 (accuracy 1.3) for Charnley Duo, 0.13 (accuracy 1.3) for Imagika corrected, and 1.021 (accuracy 2.99) for Imagika. Measurement error decreased from 0.011 mm with ordinary RSA to 0.004 with RSA digital measurement. Head size, direction of wear in relation to the cup or type of prosthetic component did not influence the measurement error. The results of Charnley Duo and Imagika corrected were similar but the latter had an inexplicable systematic error in measuring one of the phantoms. Imagika had the worst results due to its inability to compensate for the out-of-head center effect. Alumina heads were difficult to analyze with all methods.</p><p><strong>Interpretation: </strong>By using the ISO standard for assessing accuracy, RSA can be expected to measure wear with an accuracy of about 0.4 mm irrespective of prosthetic component studied or direction of wear, whereas the best technique, in our study, based on standard radiographs can be accurate to about 1.3 mm.</p>","PeriodicalId":75403,"journal":{"name":"Acta orthopaedica Scandinavica","volume":"75 6","pages":"691-700"},"PeriodicalIF":0.0,"publicationDate":"2004-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00016470410004058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25002334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}