The influence of radiation therapy on the Harris hip score in cementless total hip arthroplasty.

Heterotopic ossification may adversely influence the outcome of total hip arthroplasty, causing discomfort or limiting the range of motion and function of the hip. In this prospective study we examined the influence of prophylactic radiation therapy on the postoperative Harris Hip Score in cementless total hip arthroplasty, with a follow-up from 2 to 5 years. Radiation therapy lowered the incidence of unsatisfactory results and increased the Harris Hip Score in hips with a poor preoperative range of motion.

Postoperative dropfoot after cementless total hip arthroplasty.

From 1989 through 1993, postoperative dropfoot occurred in seven patients after noncemented total hip replacement. After analysis of the records and a review of the literature the authors assume that cementless components may be a contributory factor to sciatic nerve palsy in total hip replacement, especially in combination with Low Molecular Weight Heparin.

Radiation therapy to prevent heterotopic ossification in cementless total hip arthroplasty.

Heterotopic ossification is the most frequent complication in total hip arthroplasty. In this prospective trial the influence of radiation therapy on heterotopic ossification in cementless total hip arthroplasty was investigated. Radiation therapy reduces the incidence and the degree of heterotopic ossification, especially in hips with a poor preoperative range of motion.

Radiological aspects in preoperative planning and postoperative assessment of cementless total hip arthroplasty.

Some radiographic aspects in the preoperative measurement of prosthetic component size in cementless total hip arthroplasty were evaluated, primarily the magnification factor of the x rays. The influence of femoral rotation on the assessment of the pre- and postoperative AP x rays was investigated.

Osteosynthesis of pathologic fractures and prophylactic internal fixation of metastases in long bones.

Osteosynthesis was performed in 36 pathologic fractures, and in 21 metastases prophylactic internal fixation was carried out. The principles of the operative technique consist of a rigid osteosynthesis with removal of metastatic tissue and filling up of the bone defect with allograft or methylmethacrylate. The indications and benefits of prophylactic internal fixation are discussed.

Synovectomy of the elbow in rheumatoid arthritis.

The results of 39 synovectomies of the elbow performed during the period 1976-1980 were evaluated, and the factors which may have influenced the success of synovectomy analysed. Synovectomy results were satisfactory in 27 of the cases. Success of synovectomy seems to be related to the operative approach used and not to the radiographic grade of destruction of the elbow or to the duration of the follow-up.

The GSB knee prosthesis.

In the three years' period 1976-1978, 53 GSB knee prostheses were inserted in 46 patients. The use of this type of prosthesis was mainly indicated for the relief of pain in the presence of severe deformity or ligamentous insufficiency. There were two subsequent arthrodeses, one for infection and one for persistent pain. A follow-up study of 39 prostheses (excluding the two arthrodeses) revealed relief or reduction of pain to an acceptable level in 35 of the 39 knees (90%). The patients, however, were enthusiastic or satisfied with 37 of the 39 knee prostheses available for follow-up (05%). Good alignment and movement were obtained in all knees except one, in which flexion was less than 60 degrees. The most frequent problem was mild to moderate patello-femoral pain in 12 (31%) of the 39 knee-arthroplasties. This can largely be avoided if taken into account when planning the operation.

Case report: the accessory soleus muscle: symptomatic soft tissue tumour or accidental finding.

Two cases of the infrequently reported accessory soleus muscle are described. In the first case the muscle was responsible for an intermittently painful swelling behind the medial malleolus and in the second case the muscle was an accidental asymptomatic finding during removal of the plantaris tendon for an ankle ligament reconstruction. The possibility of an accessory soleus muscle should be considered in the differential diagnosis of soft tissue swellings behind the medial malleolus. The CT-scan and EMG can be valuable diagnostic investigations.

Protection from stress in bone and its effects. Experiments with stainless steel and plastic plates in dogs.

In a preliminary experiment the paired radii and femora of dogs were tested for bone mineral mass and mechanical properties including the load at break, the ultimate bending strength and the modulus of elasticity; symmetry was observed for most of the parameters determined. The influence of the elasticity of materials used for the internal splintage of bone and its relationship to bone remodeling were then investigated for stainless steel and plastic plates applied to the femora of dogs. A significant decrease in bone mineral mass per centimetre length of bone and in mechanical properties was demonstrated for the femora plated with steel, and microradiography showed that this was due to massive endosteal resorption. A model for determining the influence of protection from stress in bone is presented.