ABSTRACT
We studied retrospectively the outcome of patellofemoral arthroplasty (PFA) using the Richards prosthesis in 51 patients (56 knees). Their mean age was 50 years (30 to 77). In 43 patients (45 knees), the American Knee Society score and the patients' subjective judgement were assessed. Excellent or good results were obtained in 86% of cases at a mean follow-up of 17 years (15 to 21). Because of ongoing tibiofemoral osteoarthritis, two patients required a high tibial osteotomy and ten PFAs were converted to a total knee arthroplasty after a mean of 15.6 years (10 to 21). The PFAs were stable during follow-up with a loosening rate of only 2%. We conclude that a patellofemoral prosthesis is a good treatment option with successful long-term results in middle-aged patients with radiologically documented, isolated, patellofemoral osteoarthritis.
Subject(s)
Arthroplasty, Replacement, Knee/methods , Knee Prosthesis , Osteoarthritis, Knee/surgery , Adult , Aged , Arthroplasty, Replacement, Knee/instrumentation , Female , Femur/diagnostic imaging , Follow-Up Studies , Humans , Knee Joint/diagnostic imaging , Male , Middle Aged , Patella/diagnostic imaging , Postoperative Complications/etiology , Radiography , Reoperation , Retrospective Studies , Time Factors , Treatment OutcomeSubject(s)
Alkaptonuria/complications , Joint Diseases/etiology , Pigmentation Disorders/etiology , Scleral Diseases/etiology , Aged , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/surgery , Calcinosis/diagnostic imaging , Cartilage, Articular , Female , Humans , Joint Diseases/pathology , Ligaments, Articular , Radiography , Scleral Diseases/pathology , Spinal Diseases/diagnostic imaging , Synovial MembraneABSTRACT
OBJECTIVE: To inventory the current state of the art regarding the effectiveness of conservative treatment of chronic low back pain. DESIGN: Systematic reviews. METHOD: The relevant literature from the period January 1966-September 1999 was retrieved via Medline, Embase, PsychLit and the Cochrane Library and via reference lists in the articles found. The methodological quality of the studies was assessed using criteria for internal validity. On the basis of the number of examinations, their quality and the consistency of the findings, conclusions were subdivided into four levels of strength of scientific evidence. RESULTS: There was strong evidence that exercise therapy and multidisciplinary treatment programmes were effective in chronic low back pain, and moderate evidence that non-steroidal anti-inflammatory drugs (NSAIDs), back schools and behavioural therapy were effective in chronic low back pain. There was also strong evidence that traction was not effective in chronic low back pain. Strong evidence for effectiveness of many other commonly used interventions was lacking.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Behavior Therapy , Exercise Therapy , Low Back Pain/therapy , Traction , Behavior Therapy/methods , Chronic Disease , Combined Modality Therapy , Contraindications , Humans , Low Back Pain/drug therapy , Physical Therapy Modalities , Randomized Controlled Trials as TopicABSTRACT
Severe hip dysplasia in children with hereditary motor and sensory neuropathy (HMSN) is not necessarily congenital. We describe three patients with late symptoms, two of them with proven normal hips until early adolescence. A careful follow-up of all children with HMSN for hip dysplasia should be carried out.
Subject(s)
Hereditary Sensory and Motor Neuropathy/complications , Hip Dislocation/etiology , Adult , Child , Child, Preschool , Hereditary Sensory and Motor Neuropathy/diagnostic imaging , Hip Dislocation/diagnostic imaging , Humans , Male , Pedigree , RadiographyABSTRACT
The physical workload of ambulance assistants was assessed by means of the Ovako Working posture Analysis System (OWAS) observation method and a Work and Health Questionnaire (WHQ) for measuring perceived workload. In addition, a biomechanical model was applied to several specifically strenuous conditions that were simulated in a laboratory situation. Bad postures were identified for a number of activities: 16% to 29% of a work shift was spent in harmful positions. Strenuous situations occur particularly during rides in emergency situations. The results of observed and perceived workload are generally in agreement. A number of practical recommendations are made. They concern, for example, the equipment in ambulance cars, training of ambulance assistants and adaptations in working procedures.
Subject(s)
Emergency Medical Technicians , Physical Exertion/physiology , Workload , Ambulances , Automobile Driving , Biomechanical Phenomena , Emergency Nursing , Humans , Lifting , Male , Netherlands , Observer Variation , Posture/physiology , Surveys and QuestionnairesABSTRACT
A case report of a coracoid fracture of the scapula with acromioclavicular separation is presented. The treatment consisted of surgical reduction and fixation of the acriomioclavicular separation and of the coracoid fracture. After healing of the acromioclavicular separation and the coracoid fracture the left shoulder was asymptomatic with a full range of motion.
Subject(s)
Acromioclavicular Joint/injuries , Fractures, Bone/diagnostic imaging , Joint Dislocations/diagnostic imaging , Scapula/injuries , Acromioclavicular Joint/diagnostic imaging , Acromioclavicular Joint/surgery , Adult , Fractures, Bone/complications , Fractures, Bone/surgery , Humans , Joint Dislocations/surgery , Male , Radiography , Scapula/diagnostic imagingABSTRACT
Digital subtraction arthrography (DSA) was performed in 14 patients in the evaluation of painful hip prostheses. Information about component loosening seems to be as reliable as with conventional arthrography. The examination time is very short, and results are immediately available. Electronic image manipulation allows the examiner to produce optimal picture quality.
Subject(s)
Arthrography/methods , Hip Prosthesis , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prosthesis Failure , Subtraction TechniqueABSTRACT
After a short introduction dealing with the orthopaedic problems of Paget's disease, six patients are reported with pathological fractures due to this disease, which is rare in The Netherlands. Rigid fixation with osteosynthesis is the treatment of choice. In cases in which substantial bowing of the bone exists, a corrective osteotomy is advisable.
