The effects of patellar resurfacing in total knee arthroplasty on position sense: a prospective randomized study.

To find out the improvement of joint position sense after total knee arthroplasty with patellar resurfacing compared to total knee arthoplasty without patellar resurfacing, the study was carried out as a randomised parallel trial in patients who had stage III and IV primary osteoarthrosis of only 1 side of the knee with a 2 year follow-up. Twenty-one patients underwent patellar resurfacing and 26 patients had no patellar resurfacing. Joint position sense was evaluated by the average absolute different angle of the operated knees from the non operated knees which was the asymptomatic knee and acted as the reference knee. Position sense was improved significantly in both groups. However, the patients without patellar resurfacing had better improvement. The patients with patellar resurfacing had better results in terms of anterior knee pain and tenderness. Patellar resurfacing should be used in severe articular cartilage damage, not as a routine operation.

Immediate stabilization of unstable pelvic fractures versus delayed stabilization.

To compare the immediate and long term outcome of immediate stabilization of the unstable pelvic fractures to delayed stabilization with simple external fixation, the study was carried out as a paralell trial with 2 year follow-up. There were 112 patients with 69 males and 43 females who had unstable pelvic fractures. They were allocated randomly into 2 groups. In group 1, 40 patients, conventional management was performed while in group 2, 72 patients, reduction and anterior stabilization of pelvic fractures with a simple external fixator were carried out immediately just after the unstable fractures were detected. Blood transfusion, post operative pain, need of reconstructive surgery of the pelvic fractures and late deformities were less in the group 2. Immediate anterior reduction and stabilization of the unstable pelvic fractures gave encouraging results.

The reconstruction twisted wire-screws for internal fixation of two- and three-part fractures of the proximal humerus.

Using the implants for internal fixation of the proximal humeral fractures has several problems which lead to complications and poor results of the fracture treatment. Because there is no suitable implant for internal fixation of the fracture. Therefore, the reconstruction twisted wire was developed in 1990 to improve the results of the fracture treatment. Between 1990 and 1994, the reconstruction twisted wire was used in 31 patients whose ages ranged from 18 to 90 years. Sixteen patients had displaced two-part surgical neck fractures. Fifteen patients had displaced three-part fractures. Postoperative follow-up ranged from two and a half years to five years and one month. All fractures healed. No avascular necrosis of the humeral head was observed at the follow-up. There was temporary subluxation of the shoulder joint in three patients and loosening of the screws in two patients with marked osteoporosis. One had a rupture of wire between the greater tuberosity and the shaft and loosening of the screw at the greater tuberosity and united with 10 degrees varus deformity. According to the functional scale proposed by Hawkins, 28 of the 31 patients achieved a "good" result and 3 patients had a "fair" result.