摘要:

A technique is standardized from which the funnel shape of the intramedullary canal and quality of cortical bone of the proximal femur can be measured on prcopenuive radiographs. The same points of measurement are used to calculate the percentage fill of noncemented femoral components. A cadaveric study was undertaken to test the validity of this radiographic techniqueBone stock was qualitatively assessed from 100 radiographs as type A, B, or C and quantitatively by calculating the cortical index, which is the determination of the relative thickness of cortical bone. Type A bone had an average calcar-to-canal isthmus (CC) ratio of .56 with a cortical index of .59 on the anteroposterior (AP) and .53 on the lateral radiographs. Type B bone had an average CC ratio of .39 with a cortical index of .51 on the AP and .4-1 on the lateral radiographs. Type C bone had a CC ratio of .65 with a cortical index of A1 on the AP and .29 on the lateral radiographs. The lateral radiograph may yield information critical to the clinician in preopcrative planning. The stem-bone ratio statistically correlated with bone type and was .-13 on the AP and AI on the lateral for type A bone, .-19 on the AP and A4 on the lateral for type B bone, and .53 on the AP and AS on the lateral radiographs for type C bone.By using a simple standardized technique, the surgeon will be able to predict the outcome of noncemented femoral components and provide a common ground for comparing the results of noncemented hip arthroplasties.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Multifilamenc cables made of stainless steel or cobalt-chromium alloys arc stronger than monofilament wires. Fastening the cables with crimping sleeves is mechanically superior to knotting or twisting wires. This article describes cable techniques that have been developed for reconstruction of the proximal femur with bone stock lass or fractures, useful in revision total hip arthroplasty.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The orthopaedic community has extensive experience with the use of cement for bonding a prosthesis to bone in the human body — dating back over 20 years. Although alternative methods of bonding an implant to bone have been developed, none has yet been shown to be as good as of better than cement for either short- or long-term fixation of total hip arthroplasty (THA) prostheses. This article reviews current indications for the use of cemented fixation and outlines the essential features of modem cement technique as they apply to total hip replacement arthroplasty.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The success of cemented total hip arthroplasty is dependent on the quality of cement techniques. The techniques can be divided into three groups: bone preparation, cement application, and prosthesis insertion. Modern cement techniques have improved the results of total hip arthroplasty. Careful adherence to each of the steps throughout the procedure remains of critial importance and will maximize the opportunity for successful long-term results.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The theoretical basts for and the practical application of a technique for using cement in the femur in total hip arthroplasty are described.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The APR hip system was originally designed to allow cementless fixation of hip arthroplasty after the poor results of cemented arthroplasty were noted in younger, more active patients. The APR II system is the next generation in this line of proximally porous-coated titanium implants. The anatomic proximal bow and numerous size options maximizes fit of the prosthesis to the cortical bone of the proximal femur, which, along with the porous-coated medial collar, allows for excellent proximal fixation of the prosthesis to bone. Several distal sleeve options allow for excellent fill of the femoral diaphysis to maintain proper alignment and reduce toggle. A proximally grit-blasted stem, specifically designed for cemented fixation, allows for symmetrical cement columns via proximal methacrylate spacers and a distal centralizer.The technique used by the designing surgeon of the APR system (LDD) to produce accurate and reproducible cemented and cementless hip arthroplasty is described in a step by step fashion. The radiographic evaluation of cementless arthroplasty and specific recommendations for when to use cement fixation are also included.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

This article describes the recent changes in preoperative planning, component design, and implementation technique of the AML prosthesis. Improvements in the acetabular component include changes in the bearing surface and design and improved polyethylene locking mechanisms. Although the design of the AML femoral component has not changed, the introduction of modular ceramic heads, new instrumentation, and a new technique of reaming the intramedullary canal 0.5 mm undersized to the diameter of the porous-surfaced portion of the prosthesis have improved the author's results. The templating technique described many seem elaborate, but experience has shown that this degree of attention to derail increases the success rate.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

Cementless total hip replacement is a technically demanding procedure and the results are technique dependent. Long-term success depends upon the surgeon's ability to achieve initial stability of the implant in bone. Since its introduction in 1983, the porous coated anatomic (PCA) total hip system has offered a proximally porous coated bowed femoral stem and a fully porous coated hemispheric acetabular component intended for use without cement. The authors offer their preferred technique for primary PCA total hip replacement with particular attention to preoperative templating, surgical exposure, bone preparation, and component selection.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

摘要:

The CLS femoral prosthesis is a titanium stem designed to be a three-dimensional taper for press-Be implantation. The distal part of the prosthesis is intentionally made small so that it will not fill the intramedullary canal in the proximal diaphysis. The surface is bead blasted and has no bone ingrowth surface. Ribs in the proximal part of the prosthesis are designed to minimize rotational migration. The CLS acetabular component is a six-sided expanding cup implant with press-fit stabilization.The operative technique for implantation of the CLS system is detailed in this article. Emphasis is placed on indications for use of the CLS and on the necessity for careful preoperative planning. Postoperative care is also described.

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID

ISSN:0885-9698    

出版商:OVID    

年代:1991

数据来源: OVID