Function after tibial osteotomy for medial gonarthrosis below aged 50 years.

Twenty-seven patients (28 knees), with a median age of 42 (27-50) years treated with a high tibial osteotomy for early medial gonarthrosis (Ahlbäck's Stage I) were examined after 11 (7-18) years. Twenty-four were men; 18 knees had had previous meniscus and ligament lesions. At follow-up, 22 knees were satisfactory and 9 patients managed high-activity sports or heavy work. In 25/28 knees, the arthrotic process had not progressed radiographically.

Revision of the uncemented hip prosthesis.

In a series of 213 consecutive total hip replacements a.m. Lubinus, the clinical course after 72 revisions and 141 primary procedures was compared after 5 years. The revised THRs were uncemented Ring prostheses. Dislocation and peroperative fracture were more common in the revision group. Two failures because of aseptic loosening occurred in the revision group and 3 in the control group. No excisional arthroplasty was required, and no infections occurred. Radiographic evaluation of prosthetic positioning, component loosening, calcar resorption, and paraarticular ossification disclosed only slightly inferior results in the revision group. Clinically, the revised cases were not inferior to the primary ones. Revision of the uncemented hip seems less difficult than of the cemented hip.

Hip replacement in obese patients.

In a 5-year follow-up study of 125 hip replacements a. m. Lubinus, 41 obese and 84 nonobese patients were compared. Peroperative blood loss was greater in the obese patients. There was, however, no difference in the operation or hospitalization times between the compared groups. There was no infection, wound dehiscence, or delay in wound healing. No deaths occurred during the immediate postoperative period. The obese patients had a lower preoperative walking-ability score. At follow-up, this difference was eliminated. Radiographic signs of loosening were equally common in the compared groups. Three patients, two of whom were in the nonobese group, had been reoperated on because of prosthetic loosening. Our results indicate that obesity does not increase the risk of surgical complication or prosthetic loosening in hip replacement.

Total hip replacement ad modum Lubinus: five- to seven-year follow-up.

A study of 141 total hip replacements with the Lubinus prosthesis is presented. The complications in the total patient group and the results in 129 hips with follow-up times from 5 to 7 years are described. Three prostheses (2.1%) have been reoperated because of loosening. There were radiographic signs of definitive loosening in 2.3%. Varus positioning was associated with an increased loosening rate. No infections have been encountered, and none of the hips have undergone excision arthroplasty. Ninety-two percent of the hips were free from significant pain and 78% had a total range of motion exceeding 160 degrees. THR was performed, without subsequent infections, in a conventional operating room using prophylactic penicillin and gentamicin cement. We propose that the surgical technique of exposure and the cement injection technique with a partial vacuum in the medullary canal may be responsible for the low incidence of femoral prosthesis loosening (0.7%).

The Catterall classification of Perthes' disease: an assessment of reliability.

The reliability of the Catterall grouping of Perthes' disease was examined by determining the agreement between pairs of observers using weighted kappa statistics. Anteroposterior and lateral radiographs of 100 hip joints were grouped independently by four experienced observers. There was a low, and in our opinion, unacceptable degree of inter-observer agreement even when Groups 2 and 3 were combined.