RESUMO
Cerebral embolism in patients undergoing total joint arthroplasty has an incidence rate of 0.5%. In those cases where cerebral emboli were confirmed, a venous-to-arterial circulation shunt, most commonly a patent foramen ovale, was identified. We report a case of severe cerebral fat emboli during cementless total hip arthroplasty in the absence of an intracardiac defect.
Assuntos
Artroplastia de Quadril/efeitos adversos , Embolia Intracraniana/etiologia , Adulto , Evolução Fatal , Fraturas do Colo Femoral/cirurgia , Humanos , Embolia Intracraniana/diagnóstico , Imageamento por Ressonância Magnética , Masculino , ReoperaçãoRESUMO
A goat model of revision hip arthroplasty was used to examine the histology and mechanical performance of impaction grafting using two femoral stems varying in stem surface finish. There were no significant mechanical or qualitative histologic differences between smooth, tapered, polished stems and step-cut, grit-blasted stems. Allograft distribution, bone incorporation, and cement mantle thickness were not uniform within the femoral canal. Efforts to improve the impaction grafting technique may be more important than stem design.
Assuntos
Artroplastia de Quadril/métodos , Transplante Ósseo/métodos , Prótese de Quadril , Animais , Transplante Ósseo/patologia , Feminino , Cabras , Teste de Materiais , Reoperação/métodos , Estresse Mecânico , Transplante HomólogoRESUMO
Pathologic fractures from metastatic cancer pose formidable challenges to the orthopaedic surgeon technically and in terms of surgical decision making with regards to patient quality of life. We present the case of a 47-year-old woman with simultaneous bilateral pathologic femoral neck and acetabulum fractures and severe pulmonary shunt, who was treated successfully with cementless femoral and acetabular implants.
Assuntos
Acetábulo/lesões , Acetábulo/cirurgia , Artroplastia de Quadril , Fraturas do Colo Femoral/cirurgia , Fraturas Espontâneas/cirurgia , Prótese de Quadril , Cimentação , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Varus placement of the femoral component in total hip arthroplasty has been associated with poor outcomes. The purpose of this study was to examine results of total hip arthroplasty with varus alignment of a tapered titanium femoral prosthesis (Alloclassic; Sulzer, Zurich, Switzerland) at a minimum 5-year follow-up. Of a consecutive series of 585 patients, 23 met the inclusion criteria. Harris hip scores averaged 97, and all implants were clinically and radiographically stable at the most recent follow-up. In this series of patients, varus alignment of the prosthesis did not have an adverse effect on outcome. Although malalignment of the femoral prosthesis may compromise the results of some designs, the Alloclassic prosthesis has proved to be reliable and forgiving despite varus malalignment at 5 to 11 years' follow-up.
