The supraepitrochlear process of the humerus.

On the basis of five cases of supraepitrochlear process of the humerus the authors recall the most significant anatomical and clinical aspects of the disease. The presence of clinical symptoms, going under the name of Struthers syndrome, indicates surgical removal.

Diagnostic protocol in prosthetic loosening.

The authors report the results they obtained in 35 cases studied based on a protocol to identify prosthetic loosening and to preoperatively establish its possible septic etiology. After clinical and radiographic assessment, the protocol called for a total body bone scan with Tc 99 m which, in positive cases, were associated laboratory tests and further instrumental testing (CT, bone scan and needle aspiration). Thanks above all to bone scan with labelled granulocytes the protocol provided high accuracy (91.4%) in preoperatively identifying the causes of infection.

Radiographic evaluation of HDPE cemented and cementless Lord and An.C.A. screwed acetabular models.

A total of 187 alumina screwed porous-ceramic coated sockets (An.C.A.), 48 screwed smooth-surfaced Lord sockets, and 251 cemented polyethylene sockets were radiographically evaluated at an average follow-up of 30, 51 and 96 months respectively. After 6 years the Lord prostheses revealed a 38% incidence of loosening, similar to that observed for cemented sockets 10-12 years after surgery. The An.C.A. prostheses revealed radiographic loosening equal to 12% (6 cases) in the first 50 implants, and only 0.7% in the remaining 137 cases: overall, the An.C.A. acetabular prosthesis revealed an index of radiographic loosening equal to 3.3% (7/187). To guarantee "osteointegration" of the porous coating of An.C.A. sockets optimal stability must be obtained when the prosthesis is screwed in. Because the mid-term follow-up for this clinical experience is relatively short (30 months), an opinion on the reliability of the screwed "porous" sockets must await confirmation.