[10 years of cementless implantation of total hip endoprosthesis using Zweymüller's stem]. / 10 Jahre zementfreie Implantation von Hüfttotalendoprothesen unter Verwendung des Zweymüller-Schaftes.

A retrospective study of the first consecutive 111 cementless Zweymüller Stems has been performed. 56 cases have been followed clinically and radiologically with an interval of 10-11 years. The average harris hip score was 90.7 pts, the cumulative success rate of the stem was 97.96% after 10-11 years. The frequency of bony reactions around the stem and their changes during the course of time could be followed in 40 implants with a complete radiologic documentation at 5 and 10 years postoperative. Hypertrophic changes of the bone around the tip of the stem remained unchanged from the fifth to the tenth year but there was an increase of proximal lucencies (27% at 5 yrs, 35 at 10 yrs), widening of the calcar (20% at 5 yrs, 25% at 10 yrs) and stress shielding (30% at 5 yrs, 47% at 10 yrs).

High free and latent collagenase activity in psoriatic arthritis synovial fluids.

Collagenase activity has been studied intensively in SF from OA and RA patients. Less is known about collagenolytic activity in PsA SF. Therefore we examined collagenolytic activity in crude and trypsin treated SF as well as the alpha 1-antitrypsin and alpha 2-macroglobulin concentrations in 50 patients suffering from OA (n = 13), RA (n = 17), and PsA (n = 20). Free collagenolytic activity was low in the crude OA SF (1.80 +/- 1.35 micrograms released collagen/min/ml SF) and almost equally low in RA SF (2.35 +/- 1.80 micrograms released collagen/min/ml SF; P > 0.3). The PsA SF, however, exhibited a significantly higher free collagenolytic activity (5.63 +/- 5.69 micrograms released collagen/min/ml SF; P < 0.05 in comparison to OA and RA SF). The treatment of the SF with trypsin further activated collagenolytic activity in each group (OA 2.17 +/- 1.35 micrograms released collagen/min/ml SF; RA 6.48 +/- 6.73 micrograms released collagen/min/ml SF; PsA 11.24 +/- 5.02 micrograms released collagen/min/ml SF) and yielded significant differences between OA and RA, OA and PsA, and RA and PsA SF (P < 0.05). Concomitantly with the collagenolytic activity, the alpha 1-antitrypsin and alpha 2-macroglobulin concentrations of the SF were measured. In SF from patients with PsA (172.9 +/- 69.4 mg/100 ml) and RA (190.6 +/- 64.7 mg/100 ml) the alpha 1-antitrypsin was significantly higher than in those from OA SF (106.1 +/- 39.2 mg/100 ml).(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term results after implantation of McKee-Farrar total hip prostheses.

From 1973 to 1976, McKee-Farrar total hip arthroplasties were performed in the Orthopaedics Department at the Centre of Pulmology. In the present study, only patients with a complete record of radiological changes at the bone/implant or bone/cement interface were evaluated. A series of 81 patients with 100 total hip prostheses in situ according to the Mayo Clinic hip score and 36 patients who had undergone 36 revision operations were studied. The design of the metal cup with metal studs at the outer surface has a favourable effect on the stability of the implant/cement combination: loosening at the implant/cement interface did not occur in any of these cases and there were few cement fractures. In spite of the metal-to-metal combination, abrasion is slight and there is no danger of metallosis.