[Six to ten year results of use of the alloclassic hip prosthesis--a multicentre survival analysis]. / 6 - 10-Jahres-Ergebnisse des zementfreien Alloclassic-Hüftsystems--Eine multizentrische Survival-Studie.

AIM: This prospective study describes This retrospective multicenter study was undertaken to calculate mid- and long-term survival rates of the cementless Zweymüller/Alloclassic total hip prosthesis. MATERIAL AND METHODS: The rectangular titanium stem and threaded cup have been in use since 1986. The ball head is made of alumina ceramic, the inlay of UHMW polyethylene. Five hospitals in Austria, France and Germany cooperated in the follow-up of 848 patients operated between October 1986 and September 1990 (mean age 62.2 years, 62% women, 38% men, mean patient weight 73.8 kg, body mass index 26.8). 468 patients were followed clinically, 320 patients interviewed on the phone, 29 sent a letter. No information was available concerning the remaining 31 patients. Probabilities of implant survival were estimated with the Kaplan-Meier method. RESULTS: 98 patients (11.5%) had died at a median follow-up time of 81.1 months. The probability of survival at 81.1 months was 98.6% looking at stem and cup. There was no significant association of survival of the prosthesis and patient weight, gender or body mass index. CONCLUSION: Our results are in accordance with previously published data of smaller series using the Zweymüller/Alloclassic( total hip. The survival rate of this cementless rectangular titanium prosthesis for the reported follow-up time compares favorably with contemporary cemented hip prostheses.

Longterm analysis of Sheehan total knee arthroplasty.

Sheehan total knee arthroplasty was carried out in 405 knees at two centres. The patients were followed up from two to eleven years. The clinical results were assessed, the complications documented and the influence of specific factors on the result was evaluated. The principal complications arose from the patella and the femorotibial articulation. The low rate of loosening and the achievement of satisfactory alignment lead the authors to support the concept of a long stem.

[Basic studies on the pathogenesis and treatment of fat embolism. I. Fracture mechanism and fat embolism]. / Grundlagenuntersuchungen zur Pathogenese und Therapie der Fettembolie. I. Frakturmechanismus und Fettembolie.

We examined the amount of fat that can be forced into the circulation by compression of femora and of heads of the tibia in the very moment of injury. By fractures of diaphyses no considerable reduction of the intraosseous space was achieved and no fat was expelled through the foramina nutritia before the hard cortical bone was splintered. However, considerable amounts of fat were expelled into veins, when the epiphyses of the femora or when the head of the tibia was compressed from medially and from laterally. Even by a purely manual compression some fat was forced to leave the spongiosa by the foramina nutritia. This is explained by the higher elasticity of the spongious bone, permitting a marked space reduction by compression even before a fracture sets in. The mechanism resembles the procedure of opacification of veins by contrast media, injected into the bone cavity under pressure. The significance of these findings for the pathogenesis of clinical fat embolism is discussed.