ABSTRACT
Aseptic loosening is the most common chronic complication of total joint arthroplasty,which significantly shortens the life span of prosthesis and leads to mental stress and heavy economic burden of patients.Hence,how to overcome aseptic loosening is a focus in the research of joint arthroplasty.A series of mechanisms participates the pathogenesis of aseptic loosening,including oste-olysis induced by wear particles,micromotion,stress shielding,high fluid pressure,endotoxin and genetic factors.Osteolysis induced by wear particles is the most recognized mechanism.The latest study suggested that autophagy,epigenetic regulation and immunologic derangement all participate the development of osteolysis induced by wear particles.However,the prevention,treatment and even the concept of aseptic loosening is still controverial.We hope that the future study will provide a definite mechanism for aseptic loosening and provide new theoretic evidence for the prevention and treatment of aseptic loosening.
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<p><b>OBJECTIVE</b>To evaluate the short-term clinical results of a new approach of lumbar-pelvic fixation for lumbosacral reconstruction after resection of sacral tumors.</p><p><b>METHODS</b>Fifteen patients with sacral tumors underwent lumbar-pelvic fixation using TSRH-3D, CDH-M8 or ISOLA with iliac screws. The lumbosacral stability was evaluated according to the X-ray result to assess the feasibility and therapeutic effect of this approach.</p><p><b>RESULTS</b>X-ray showed that high lumbosacral stability was achieved in all the 15 cases after the operation, and satisfactory therapeutic effect was obtained.</p><p><b>CONCLUSION</b>Lumbar-pelvic fixation with iliac screw is feasible for lumbosacral reconstruction after resection of the sacral tumors, which provides strong internal fixation and produce good clinical outcomes.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Lumbar Vertebrae , General Surgery , Pelvis , General Surgery , Sacrum , Spinal Neoplasms , General Surgery , Treatment OutcomeABSTRACT
Objective To evaluate the outcome of unconstrained shoulder arthroplasty in treatment of se- vere damages of shoulder and proximal humerus.Methods Eleven cases of unconstrained shoulder arthroplasty were carried out in our department from 1999 to 2004.The average age of the 11 patients was 65 years.Nine cases underwent hemi-arthroplasty for their complex fractures of proximal humerus with unstrained protheses and two cases received total shoulder arthroplasty for their shoulder osteoarthritis.Cemented prostheses were used in all the cases. Results Follow-ups averaged 2.3 years.Two cases of four-part fractures reported slight pain and limited external rotation of the shoulder after operation,while there was no pain or loosening of prosthesis in all the other cases who recovered full range of motion.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe tech- nique for severe damages of proximal humerus.
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Objective To evaluate the outcome of unconstrained shoulder arthroplasty for severe injury of proximal part of the humerus.Methods Twelve eases were all treated with unconstrained shoul- der arthroplasty.Six patients with complex fractures of proximal humerus and four with bone tumor in the proximal part of the humerus used hemiarthroplasty and two patients with osteoarthritis were managed with total shoulder arthroplasty.Cemented prostheses were used in all the cases.Results The average age was 65 years and the follow-up was 2.3 years.Two cases of complex fractures had light pain with limited external rotation of the shoulder.No pain or prosthetic stems loosening were found,and the range of motion and the function of the shoulder were satisfactory in other cases.Conclusion Unconstrained shoulder arthroplasty is a satisfactory and safe technique for severe injury of proximal humerus.
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Objective To compare the effect of allograft and autograft of bone-patellar tendon- bone (B-PT-B) under arthroscopy in reconstruction of anterior cruciate ligament (ACL).Methods The injured ACL was reconstructed under arthroscopy by using autograft of B-PT-B in 30 cases and al- lograft of B-PT-B in 28 cases from January 2000 to August 2003.After over twelve months follow up,a comparison was done on rehabilitation of quadriceps femoris,knee stability,the Lysholm's score of knee and the enlargement of tunnel in both groups.Results Both groups obtained marked improvement of knee stability and symptoms after operation.But in the early time,the rehabilitation of quadriceps femoris in the ailograft group is faster than that in the autograft group.The rehabilitation of quadriceps femoris, knee stability and the Lysholm's score of knee were similar at 12th month (P＞0.05).There could be seen enlargement of tunnel in both groups,with more in the allograft group (P＞0.05).Conclusion For arthroscopic reconstruction of anterior crucial ligament (ACL),allograft of B-PT-B is good substitute, for it is characterized by effectiveness,convenience and minor side effect.