ABSTRACT
The Motec cementless modular metal-on-metal ball-and-socket wrist arthroplasty was implanted in 16 wrists with scaphoid nonunion advanced collapse (SNAC; grades 3 or 4) and 14 wrists with scapholunate advanced collapse (SLAC) in 30 patients (20 men) with severe (grades 3 or 4) post-traumatic osteoarthritis of the wrist. The mean age of the patients was 52 years (31 to 71). All prostheses integrated well radiologically. At a mean follow-up of 3.2 years (1.1 to 6.1) no luxation or implant breakage occurred. Two wrists were converted to an arthrodesis for persistent pain. Loosening occurred in one further wrist at five years post-operatively. The remainder demonstrated close bone-implant contact. The clinical results were good, with markedly decreased Disabilities of the Arm Shoulder and Hand (DASH) and pain scores, and increased movement and grip strength. No patient used analgesics and most had returned to work. Good short-term function was achieved using this wrist arthroplasty in a high-demand group of patients with post-traumatic osteoarthritis.
Subject(s)
Arthroplasty/methods , Osteoarthritis/etiology , Osteoarthritis/surgery , Wrist Injuries/complications , Wrist Joint/surgery , Adult , Aged , Arthroplasty/adverse effects , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pain Measurement , Range of Motion, Articular , Treatment Outcome , Wrist Joint/pathologyABSTRACT
BACKGROUND AND PURPOSE: Range of motion (ROM) measurements have been included in several hip scores evaluating the results after hip surgery. The clinical procedures of performing these measurements vary and disagreement exists about the accuracy of visual estimatess compared to goniometer measurements. The purpose of this study was to study the reliability of goniometric measurements and visual estimates of hip ROM in patients with osteoarthrosis. METHOD: Hip ROM measurements (abduction, adduction, extension, flexion and internal/external rotation) were recorded by four different teams on the same day and were repeated one week later. Teams 1, 2 and 3 consisted of physiotherapists using standardized goniometric measurements. Team 4 involved an experienced orthopaedic surgeon making the assessments from visual estimates only. Twenty-five patients (6 M, 19 F; mean age 68.5 years, range 46-76 years) with osteoarthrosis of the hip, verified both clinically and radiologically, participated in the study. RESULTS: With the exception of abduction (p = 0.03), there were no significant differences between the measurements recorded on the first and the second occasions for the same teams. The coefficient of variance was 5.5% for flexion (lowest) and 26.1% for extension (highest). Reproducibility was best for flexion. There was also high reliability when all the arcs of motion were summed up (abuction + adduction + extension + flexion + internal/external rotation). With the exception of internal rotation, there were highly significant differences between the teams when two people performed the measurements compared to the values measured by a single individual. Concordance, expressed as the standardized agreement index, between visual estimates made by one individual (the orthopaedic surgeon) and goniometric measurements made by two experienced physiotherapists, were 0.77-0.83 which indicates good agreement. CONCLUSION: The reproducibility of hip ROM measurements was highest for flexion. There was also high reliability when all the six arcs of motion were summed up. Concordance between visual estimates and goniometric measurements indicates good agreement.
Subject(s)
Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/rehabilitation , Physical Therapy Modalities/methods , Range of Motion, Articular/physiology , Aged , Analysis of Variance , Female , Hip Joint/physiology , Humans , Male , Middle Aged , Observer Variation , Physical Examination/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Recombination-defective female meiotic mutants representing 7 loci in Drosophila melanogaster have been examined for effects on gonial recombination in males. These loci were chosen for study because they represent a broad range of the known types of defects in processes necessary for meiotic recombination and somatic chromosome stability. Alleles at 6 of the loci studied did not increase the frequency of gonial recombination in males, whereas a mutant at one locus was associated with an increase (about 10-fold) in gonial recombination. These results suggest that the defects in chromosomal metabolism caused by these recombination, and in some cases repair, defective mutants are distinct from those of the male-recombination promoting elements (Mr) recently isolated from many natural populations. Analysis of the spontaneous events detected in this study showed that a third to a half of the events detected are actually of mutational rather than recombinational origin.
