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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 104 (1985), S. 251-261 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Acetabular replacement without cement using three types of pegged polyethylene prostheses was begun as a prospective trial by Morscher (August 1977), Ring (June 1979), and Freeman (January 1980); 1878 hips have been replaced using this technique and are reviewed. Follow-up averaged 2 years (range: 6 months-6 years). Successful pain relief and satisfactory walking ability were present in 97% and adequate flexion in 90%. Radiographic review showed the consistent development of a stable, uniform sclerotic line adjacent to the prosthesis. No component migration could be documented. Ten hips have been revised for obvious femoral loosening, and two acetabula showed slight motion during revision for femoral failure and were revised. Deep infection (0.37%) occurred only in patients not receiving perioperative antibiotics and not operated upon in unidirectional filtered air-flow enclosures. Postmortem histological evaluation of eight hips showed a thin fibrous membrane separating the prosthesis from viable bone. These results are preliminary, but nevertheless at least as good as those in any large series of cemented acetabula with the same follow-up. The advantages of this technique are its reproducible results, low complication rate, limited invasion of the skeleton, and easy revision should failure occur.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 101 (1983), S. 225-229 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Eine zementfreie PolyaethylenProthesenpfanne wurde entwickelt, die außen eine konische Konfiguration aufweist and mit einem Freeman-Zapfen verankert wird. Diese Prothesenpfanne steht in 4 Größen zur Verfügung und wird gewöhnlich in Kombination mit einer zementfreien Kopfprothese verwendet. Während der letzten 3 Jahre wurden 875 Implantate dieser Art eingesetzt. Die Ergebnisse bei diesen Patienten, bei denen die Operation jetzt 1-3 Jahre zurückliegt, wurden mit 236 Fallen verglichen, bei denen Implantate einer ähnlichen Konfiguration mit Zement verankert wurden. Die beiden Gruppen waren bezüglich Diagnose, Lebensalter and Geschlecht miteinander vergleichbar. Die Ergebnisse der zementierten and zementfreien Kunstgelenke sind im wesentlichen identisch, mit der Ausnahme, daß 30% der zementierten Pfan nen einen Resorptionssaum aufwiesen, während nur eine einzige zementfreie Pfanne solche r6ntgenologischen Veränderungen aufwies. Die Auswertung der Rbntgenbefunde weist darauf hin, daß der Knochen im Azetabulum günstig auf die einwirkenden Kräfte reagiert, unter der Voraussetzung, daß der Drehpunkt des Kunstgelenkes an anatomischer Stelle liegt. Unter diesen Umständen wird sich Knochensubstanz zur Befestigung der Prothesenpfanne auch in einem dysplastischen Azetabulum oder bei einer Protrusion entwickeln.
    Notes: Summary An uncemented Polyethylene acetabular component has been developed using a cup of conical outer configuration locked in position with the Freeman osseous peg. This cup is available in four sizes and is normally used with an uncemented femoral component. During the last 3 years 875 implants of this sort have been inserted and the results in these patients who are between 1 and 3 years post-operatively have been compared with the results in 236 replacements of a similar configuration but secured with bone cement in the usual way. The two groups have been demonstrated to be comparable in pre-operative diagnosis, age and sex. The results using the uncemented articulation are broadly the same as those using the cemented joint during the period of study but the acetabular component in 30% of the cemented joints showed a zone of demarcation between cement and bone whereas only one of the uncemented acetabular components showed similar radiological changes. The examination of the radiographs of the uncemented group suggests that the pelvic bone responds favourably to the stresses which are imposed upon it provided that the centre of the joint movement is relocated in the anatomical position, under these circumstances bone will usually build up to support the cup in a dysplastic acetabulum and in the floor of a central protrusion.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 107 (1988), S. 309-315 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A prospective study of the Ring Total Knee Replacement is presented. The senior author (P. A. Ring) designed this prosthesis and began to apply it clinically in 1974. The Ring prosthesis is a resurfacing, unconstrained type of knee prosthesis and is designed for use without cement. It comprises two components, femoral and tibial, both made of titanium. A polyethylene liner is attached to the tibial component. The method was used for treatment of osteoarthritis and rheumatoid arthritis of the knee on 149 patients (178 knees) in the period from 1974 to 1985. Seventeen patients were lost to follow-up, leaving 132 patients (161 knees) for review. During the last review, 75.2% of the knees were pain free and 72% had full correction of the deformity. The average follow-up period was 5.1 years and the survival rate of the prosthesis during the same period was 94.4%. To evaluate the method we used computer analysis of preoperative and postoperative assessment cards with 153 observations. The result was excellent in 92 (57.2%) knees, good in 38 (23.6%) knees, and poor in 31 (19.2%) knees. Loosening of the components occurred in 3.7% knees, and the total revision rate was 5%. One knee was arthrodesed.
    Type of Medium: Electronic Resource
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