Anchorage of Wrist Joint Prostheses to Bone Using the Osseointegration Principle

1997 ◽  
Vol 22 (1) ◽  
pp. 84-89 ◽  
Author(s):  
G. LUNDBORG ◽  
P. I. BRÅNEMARK
Keyword(s):  
Wrist Joint ◽  
Clinical Results ◽  
Joint Arthroplasty ◽  
Artificial Joint ◽  
Range Of Movement ◽  
Titanium Screws ◽  
Joint Mechanism ◽  
Joint Prostheses ◽  
Observation Period

Five patients with rheumatoid arthritis (age 28–60 years) underwent wrist joint arthroplasty with individually designed artificial joint mechanisms, anchored to bone using the osseointegration principle. We report on the result from a 4 to 6.5 year follow-up with special emphasis on the fixation of the prosthesis to bone. There was no bone resorption or loosening of screws. Osseointegration of the titanium screws occurred in all cases and persisted throughout the observation period, although scattered lytic zones could sometimes be seen around the screws. The clinical results were satisfactory with pain relief and maintenance of a functional range of movement. The principle has prospects for fixation of a wrist joint mechanism to bone, although the presently used joint mechanism requires further refinement.

Wrist Joint Arthroplasty in Rheumatoid Arthritis: A Comparison between the Meuli and Swanson Prostheses

1984 ◽  
Vol 9 (2) ◽  
pp. 171-176 ◽  
Author(s):  
BRUCE SUMMERS ◽  
MICHAEL J. S. HUBBARD
Keyword(s):  
Rheumatoid Arthritis ◽  
Wrist Joint ◽  
Joint Arthroplasty ◽  
Range Of Movement ◽  
Ulnar Head ◽  
Plastic Metal ◽  
Carpal Joint ◽  
Metal Design ◽  
Ulnar Head Prosthesis ◽  
Wrist Arthroplasty

A personal series of twelve wrist arthroplasties performed on ten patients with rheumatoid arthritis of the radio-carpal joint were reviewed in retrospect. Six arthroplasties were of the Meuli metal/plastic/metal design and six were of the Swanson silastic type with an additional silastic ulnar head prosthesis. Both prostheses were successful in giving a pain free stable joint with some degree of useful movement. The Meuli appeared to give a greater range of movement than the more constrained Swanson prosthesis. Although complications were encountered it is concluded that wrist arthroplasty does have a place in the management of patients with rheumatoid arthritis of the radio-carpal joint. Our present policy is to continue with the use of the Swanson design because of the advantages of a cement free prosthesis.

Results of 115 Rubis II reverse thumb carpometacarpal joint prostheses with a mean follow-up of 10 years

2017 ◽  
Vol 42 (6) ◽  
pp. 592-598 ◽  
Author(s):  
M. Dehl ◽  
M. Chelli ◽  
S. Lippmann ◽  
S. Benaissa ◽  
V. Rotari ◽  
...  
Keyword(s):  
Clinical Results ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Thumb Carpometacarpal Joint ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Joint Prostheses ◽  
Clinical And Radiological Results

The aim of this study was to assess the clinical and radiological results of the Rubis II thumb carpometacarpal joint reverse prosthesis, at a mean follow-up of 10 years. Between 1997 and 2008, 253 prostheses were implanted in 199 patients; 115 were reviewed. The survival after a mean of 10 years was 89%. At the last follow-up, 70% of prostheses were painless; the others reported moderate or intermittent pain. The satisfaction rate was 98%. The mean opposition was 9 on the Kapandji scale; the mean QuickDASH score was 30. Wrist, key and tip pinch strengths were comparable with the non-operated side. Of the 115 implants, one was radiologically loose (1%) and 15 had suffered dislocations (13%), 12 of which were caused by an injury. Eleven thumbs had revision surgery. This study confirms that the good clinical results of the Rubis II prosthesis are maintained in the medium and long term, and represents a useful alternative to trapeziectomy for selected patients. Level of evidence: IV

Use of a revision cup for treatment of Zurich cementless acetabular cup loosening

2013 ◽  
Vol 26 (05) ◽  
pp. 408-415 ◽  
Author(s):  
L. Vezzoni ◽  
V. Montinaro ◽  
A. Vezzoni
Keyword(s):  
Postoperative Complications ◽  
Clinical Results ◽  
Variable Number ◽  
Outer Shell ◽  
Acetabular Cup ◽  
Press Fit ◽  
Titanium Screws ◽  
Successful Clinical Outcome ◽  
Hip Luxation

SummaryLoosening of the acetabular cup is one of the most common complications following total hip replacement and has an incidence rate of 1.8% to 36.8%. The objective of this study was to describe the surgical technique for the application of a cementless acetabular component specifically designed for treatment of cup loosening and preliminary clinical experience. The Kyon revision cup is composed of two components; the first is a perforated titanium outer shell with holes for 2.4 mm titanium screws, which is impacted into the acetabulum after removal of the loose cup and reaming of the acetabulum. It is secured with a variable number of screws. The second component is an inner plain titanium cup with an ultra-high-molecular-weight polyethylene insert, which is impacted into the outer shell to obtain press-fit stability. This revision cup was used in 31 dogs with cup loosening and a minimum follow-up period of six months. There were four intra-operative complications and two postoperative complications. The main intra-operative complication was difficulty inserting the inner cup into the outer shell. Postoperative complications included craniodorsal hip luxation in one dog, which was successfully managed, and cup loosening in another dog, which required explantation of the prosthesis. The main advantage of the revision cup appears to be increased implant stability afforded by screw fixation. Our initial clinical results in 31 dogs were promising; all but one dog had a successful clinical outcome.

Osteosynthesis of Postosteomyelitic Forearm Defects in Children Using a Modified Bone Grafting Technique: The Fibular Intramedullary Bridging Bone and Additional Grafting (FIBBAG)

2020 ◽  
Vol 25 (01) ◽  
pp. 13-19
Author(s):  
Anil Agarwal ◽  
Rahul Yogendra Raj ◽  
Shobhit Gupta ◽  
Mukesh Shanker
Keyword(s):  
Bone Grafting ◽  
Wrist Joint ◽  
Clinical Results ◽  
Radiological Evaluation ◽  
Grafting Technique ◽  
Procedural Complication ◽  
Average Patient ◽  
Forearm Bones ◽  
Fibular Strut

Background: There are many options to treat post osteomyelitic gaps in forearm bones. We report a pediatric series with postosteomyelitic forearm segmental defects reconstructed with fibular only graft: the non vascular fibular intramedullary bridging bone and additional grafting (FIBBAG) and the results thereof. Methods: Outcomes in 8 patients treated with fibular strut and overlay matchstick grafts were retrospectively assessed. The clinical results were expressed as forearm shortening, range of motion at elbow and wrist joint. The radiological evaluation included time to union, presence of fractures and recurrence of infection, if any. Results: The average patient age was 6 years (range, 3–12 years). The radius was involved in 6 and ulna in 2. Union occurred in all patients. The average intraoperative gap to be spanned was 5.86 cm (range, 3–14 cm). The average time for union was 6.63 months (range, 2–14 months). Two patients required additional bone grafting procedures. No graft fatigues/fractures were noted in available follow up. There was no recurrence of infection in any case. A positive ulnar variance was seen in 3 patients at follow up. Forearm shortening was a major cosmetic limitation following the procedure. Conclusions: Fibular strut and additional bone grafting (FIBBAG) is one of the viable options for reconstruction of post osteomyelitic forearm defects in children with low procedural complication rate.

TREATMENT OF EXTRA-ARTICULAR DISTAL RADIAL MALUNION WITH PERCUTANEOUS OSTEOTOMY AND AN INTRAMEDULLARY IMPLANT

Hand Surgery ◽  
2014 ◽  
Vol 19 (02) ◽  
pp. 217-222 ◽  
Author(s):  
Mitsuhiko Takahashi ◽  
Ichiro Tonogai ◽  
Koichi Sairyo
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Wrist Joint ◽  
Clinical Results ◽  
Radius Fracture ◽  
Disability Score ◽  
Intramedullary Implant ◽  
Distal Radius Malunion ◽  
Radius Malunion

Purpose: Distal radius malunion is often seen after distal radius fracture. We performed a less invasive but secure corrective surgery using an intramedullary implant combined with percutaneous osteotomy. The purpose of this study was to evaluate the results of this surgical technique. Patients and methods: Three patients with malunion of a distal radius fracture were included. We assessed the wrist joint disability scores pre-operatively and at the final follow-up an average of 21 months after surgery. We also performed radiological assessments of volar tilt, radial inclination, and ulnar variance. Results: All three patients achieved excellent clinical results with an average joint disability score of 93.3 at the final follow-up. The radiological parameters improved without any post-operative correction loss. Discussion: Intramedullary implant combined with percutaneous osteotomy provides sufficient stability after correction of distal radius malunion and avoids the complications associated with the use of a volar plate.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

HRA Model for Hypercholesterolemia Based on a Longitudinal Health Database

1998 ◽  
Vol 37 (02) ◽  
pp. 130-133
Author(s):  
T. Kishimoto ◽  
Y. Iida ◽  
K. Yoshida ◽  
M. Miyakawa ◽  
H. Sugimori ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Model Analysis ◽  
Serum Total Cholesterol ◽  
Hazards Model ◽  
The Mean ◽  
Health Database ◽  
Observation Period

AbstractTo evaluate the risk factors for hypercholesterolemia, we examined 4,371 subjects (3,207 males and 1,164 females) who received medical checkups more than twice at an AMHTS in Tokyo during the period from 1976 through 1991; and whose serum total cholesterol was under 250 mg/dl. The mean follow-up duration was 6.6 years. A self-registering questionnaire was administered at the time of the health checkup. The endpoint of this study was the onset of hypercholesterolemia when the level of serum total cholesterol was 250 mg/dl and over. We compared two prognosis groups (normal and hypercholesterol) in terms of age, examination findings and lifestyle. After assessing each variable, we employed Cox's proportional hazards model analysis to determine the factors related to the occurrence of hypercholesterolemia. According to proportional hazards model analysis, total cholesterol, triglyceride and smoking at the beginning, and hypertension during the observation period were selected in males; and total cholesterol at the beginning and age were selected in females to determine the factors related to the occurrence of hypercholesterolemia.

scholarly journals Evaluation of the Accero Stent for Stent-Assisted Coiling of Unruptured Wide-Necked Intracranial Aneurysm Treatment with Short-Term Follow-Up

2020 ◽  
Vol 9 (9) ◽  
pp. 2808
Author(s):  
Wojciech Poncyljusz ◽  
Kinga Kubiak ◽  
Leszek Sagan ◽  
Bartosz Limanówka ◽  
Katarzyna Kołaczyk
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysms ◽  
Clinical Results ◽  
Class I ◽  
Unruptured Aneurysms ◽  
Patient Demographics ◽  
Stent Deformation ◽  
Unruptured Intracranial Aneurysms ◽  
Occlusion Rate

Background: Stent-assisted coiling is an effective method of treating intracranial aneurysms. The aim of the study was to assess the safety and efficacy of the new Accero stent for the treatment of intracranial aneurysms. Materials and Methods: It was a retrospective, single-center study. Eighteen unruptured intracranial aneurysms were treated using the stent-assisted coiling method with the Accero stent. Patient demographics, aneurysm characteristics, procedural parameters, grade of occlusion, complications, and clinical results were analyzed. Follow-up magnetic resonance (MR) was performed 6 months after intervention. Results: Seventeen patients with 18 incidental unruptured aneurysms were electively treated with coiling and the Accero stent. The aneurysms were located on internal carotid artery (ICA), middle cerebral artery (MCA) and basilar artery (BA). All stents were deployed successfully. Immediate complete occlusion rate Raymond-Roy occlusion classification (RROC) class I was achieved in 13 cases and class II in 4 cases. Complications occurred in 2/17 treatments and included guidewire stent perforation with subarachnoid hemorrhage (SAH) and stent deformation. Vascular spasm in the subarachnoid hemorrhage (SAH) patient subsided before discharge. Ninety days after intervention, the modified Rankin Scale (mRS) value was 0. RROC class I was observed in 88.23% of cases in follow-up. Conclusion: The Accero stent provides excellent support for coil mass. It constitutes an efficacious device with good initial occlusion rate for treating wide-necked unruptured intracranial aneurysms.

scholarly journals Adenosine-induced Asystole during AVM Embolization

2021 ◽  
Author(s):  
V. Hellstern ◽  
P. Bhogal ◽  
M. Aguilar Pérez ◽  
M. Alfter ◽  
A. Kemmling ◽  
...  
Keyword(s):  
Demographic Data ◽  
Clinical Results ◽  
Endovascular Embolization ◽  
Neurological Deficits ◽  
Residual Shunt ◽  
Grade 5 ◽  
Martin Grade ◽  
Grade 3 ◽  
Brain Avms

Abstract Background Adenosine induced cardiac standstill has been used intraoperatively for both aneurysm and arteriovenous malformation (AVM) surgery and embolization. We sought to report the results of adenosine induced cardiac standstill as an adjunct to endovascular embolization of brain AVMs. Material and Methods We retrospectively identified patients in our prospectively maintained database to identify all patients since January 2007 in whom adenosine was used to induce cardiac standstill during the embolization of a brain AVM. We recorded demographic data, clinical presentation, Spetzler Martin grade, rupture status, therapeutic intervention and number of embolization sessions, angiographic and clinical results, clinical and radiological outcomes and follow-up information. Results We identified 47 patients (22 female, 47%) with average age 42 ± 17 years (range 6–77 years) who had undergone AVM embolization procedures using adjunctive circulatory standstill with adenosine. In total there were 4 Spetzler Martin grade 1 (9%), 9 grade 2 (18%), 15 grade 3 (32%), 8 grade 4 (18%), and 11 grade 5 (23%) lesions. Of the AVMs six were ruptured or had previously ruptured. The average number of embolization procedures per patient was 5.7 ± 7.6 (range 1–37) with an average of 2.6 ± 2.2 (range 1–14) embolization procedures using adenosine. Overall morbidity was 17% (n = 8/47) and mortality 2.1% (n = 1/47), with permanent morbidity seen in 10.6% (n = 5/47) postembolization. Angiographic follow-up was available for 32 patients with no residual shunt seen in 26 (81%) and residual shunts seen in 6 patients (19%). The angiographic follow-up is still pending in 14 patients. At last follow-up 93.5% of patients were mRS ≤2 (n = 43/46). Conclusion Adenosine induced cardiac standstill represents a viable treatment strategy in high flow AVMs or AV shunts that carries a low risk of mortality and permanent neurological deficits.

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