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1.
HSS J ; 9(2): 113-7, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24426855

RESUMO

BACKGROUND: Cam-type femoral impingement is caused by structural abnormalities of the hip and is recognized as a cause of degenerative hip arthritis. Identifiable etiologies of this structural abnormality include congenital malformation, pediatric hip disease, and malunion of femoral neck fractures after internal fixation. PURPOSE: The purpose of this study was to determine the prevalence of radiographic impingement in healed Orthopaedic Trauma Association (OTA) type 31B fractures treated with reduction and internal fixation. METHODS: Seventy OTA 31B hip fractures treated with internal fixation were identified from our institutional trauma database and radiographs were retrospectively reviewed for signs of impingement. Mean follow-up was 53 months after fracture. Alpha angle, Mose templates, and femoral head retroversion were the measurements used to determine impingement. RESULTS: The overall prevalence of any sign of radiographic impingement was 75%. Alpha angle was elevated in 32 hips (46%), asphericity was present in 46 femoral heads (65%), and femoral head retroversion was present in 26 hips (37%). The rates were highest in displaced subcapital fractures (OTA 31B-3) with a 63% (13/19) prevalence of elevated alpha angle, 68% (14/19) prevalence of asphericity, and 47% (10/19) prevalence of retroversion. CONCLUSIONS: Prevalence of radiographic signs of impingement in this population is higher than expected based on population-based controls. Surgeons must be vigilant about reduction and fixation of femoral neck fractures. Malunion should be recognized as early intervention may be beneficial in improving long-term outcomes.

2.
J Arthroplasty ; 22(8): 1112-5, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18078878

RESUMO

Hybrid total knee arthroplasty in which the femoral component is cementless and the tibial component is cemented remains controversial. We report on the long-term results of 65 total knee arthroplasties followed for an average of 15 years. There were 18 revisions (27%); of these, 11 were femoral component revisions. The overall implant survival with revision as the end point was estimated as 64% at 15 years. The femoral component survivorship at 15 years was 72%. Because of the high failure rate, hybrid fixation on the femoral side with this design has been abandoned at our institution; but hybrid fixation with a trabecular metal tibia is currently under investigation.


Assuntos
Artroplastia do Joelho/métodos , Falha de Prótese , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação , Fatores de Tempo
3.
J Arthroplasty ; 22(6 Suppl 2): 67-70, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17823019

RESUMO

Fifty-two consecutive cemented total knee arthroplasties were performed using the Press-Fit Condylar (DePuy, Warsaw, Ind) knee system on patients aged 55 years or younger at Mayo Clinic Rochester from 1988 to 1994. Patients were followed for a minimum of 10 years, with an average follow-up of 12 years (range, 10-15 years). There were 8 total revisions (15%), including 2 revisions before 10 years, one for sepsis at 1 year, and one for instability at 8 years. Six revisions occurred between 10 and 15 years, all associated with polyethylene wear and osteolysis. Implant survival rate was estimated to be 96% at 10 years and 85% at 15 years of follow-up.


Assuntos
Artroplastia do Joelho/instrumentação , Prótese do Joelho , Osteoartrite/cirurgia , Adulto , Fatores Etários , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Reoperação
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