Search results for "treatment."
showing 10 items of 17500 documents
Optimal positioning of the humeral component in the reverse shoulder prosthesis.
2014
Total reverse shoulder arthroplasty is becoming more and more the standard therapeutic practice for glenohumeral arthropathy with massive lesions of the rotator cuff. The biomechanical principle of this prosthesis is represented by the reversion of the normal anatomy of the shoulder joint. This non-anatomical prosthesis leads to a medialization of the rotation centre of the glenohumeral joint and also to a distalization of the humeral head. All that causes a deltoid tension increasing so allowing a larger abduction of the arm. Main complications of the reverse shoulder prosthesis are due to the joint instability, the scapular notching and the wear of the polyethylene insert. The main goal o…
Treatment of distal intraarticular tibial fractures: A biomechanical evaluation of intramedullary nailing vs. angle-stable plate osteosynthesis
2015
In factures of the distal tibia with simple articular extension, the optimal surgical treatment remains debatable. In clinical practice, minimally invasive plate osteosynthesis and intramedullary nailing are both routinely performed. Comparative biomechanical studies of different types of osteosynthesis of intraarticular distal tibial fractures are missing due to the lack of an established model. The goal of this study was first to establish a biomechanical model and second to investigate, which are the biomechanical advantages of angle-stable plate osteosynthesis and intramedullary nailing of distal intraarticular tibial fractures. Seven 4(th) generation biomechanical composite tibiae feat…
The influence of the decompressive operation on the intracranial pressure and the pressure-volume relation in patients with severe head injuries.
1978
Measurements of intracranial pressure by ventricular catheter were performed in 47 patients with severe head injuries. Thirty-three patients with decompressive operations such as osteoclastic craniotomy and dilatation by means of duraplastic have been compared with 14 patients with closed heads with regard to volume pressure response (intracranial elasticity). This was determined either by intraventricular injection of 2 ml saline or by drainage of cerebrospinal fluid. The examination clearly shows that patients with closed heads have a much higher intracranial elasticity than patients who have decompressive operations, so that in the first group minor differences of the intracranial volume…
Two different posterior-stabilized mobile-bearing TKA designs: navigator evaluation of intraoperative kinematic differences
2020
Purpose: The purpose of this study was to compare two types of posterior-stabilized (PS) mobile-bearing (MB) total knee arthroplasties (TKAs). The hypothesis was that no major differences were going to be found among the two TKA designs. Methods: Two cohorts of patients who were divided according to implant design (Cohort A, new design gradually reducing radius PS MB TKA; Cohort B, traditional dual-radius PS MB TKA) were analyzed by means of intraoperative navigation. All operations were guided by a non-image-based navigation system that recorded relative femoral and tibial positions in native and implanted knees during the following kinematic tests: passive range of motion (PROM), varus–va…
Patient Specific Instrumentation for Total Knee Arthroplasty: a Literature Review
2014
During the past decade, total knee arthroplasty (TKA) has been markedly increased. Recently, patient-specific custom cutting guides have been commercially introduced in order to achieve an accurate component alignment during TKA. In fact, these cutting blocks are specific to a patient’s knee anatomy and should help the surgeons to perform bone cuts, reducing the complexity of conventional alignment and sizing tools. Nevertheless, there are critical arguments against patient-specific cutting guides for routine use, such as poor evidence and higher costs. Additionally, there are still no mild and long-term results available that describe the clinical outcomes following patient-specific instru…
Kinematics of the patellofemoral joint. Investigations on a computer model with reference to patellar fractures.
1990
Patellofemoral kinematics were studied on a computer model. The articulating point of the patella moves from distal to proximal during flexion, until the quadriceps tendon starts to turn around the femur tendo-femoral gliding. The pattern of patellofemoral movement consists of a gliding and rolling component, the latter at its maximum at the beginning of flexion. The pathway of the instant centers of motion moves from dorsal to ventral during flexion. Stress analysis shows that the contact area is at all times the area of maximum bending stress. The distal part of the patella is the part with mechanical stress at all angles of flexion. The conclusions to be drawn for treatment are that frac…
Molekulare Signalwege der aseptischen Endoprothesenlockerung (Molecular pathways in aseptic loosening of orthopaedic endoprosthesis)
2008
Operative joint replacement to treat disabling joint conditions secondary to degenerative and inflammatory arthritides has become one of the most efficacious and cost-effective procedures to relieve pain and restore joint function. However, prosthetic implants are not built to last forever and osteolysis and aseptic loosening has been associated with prosthetic arthroplasties since their introduction. The functional life of a synthetic joint is influenced by many factors including the material of the implant, operation procedures and the surgeon involved, as well as patient-related factors. Although promising developments have been achieved in this field, more than 10% of all implants still…
Primäre Ellenbogenprothese bei distalen Humerustrümmerfrakturen
2004
The use of hip- and shoulder arthroplasty in elderly patients for grossly displaced intraarticular fractures is being more and more accepted. Total elbow replacement (TER) has not been considered as an option for the treatment of extensively comminuted fractures of the distal humerus because surgeons feel the outcome is not predictable after TER generally. On the basis of a Medline literature research of this issue and the documented results based on the improvement of the designs of the implants, operative technique and the selection of patients, TER has a definite role in the treatment of some fractures of the distal humerus. We retrospectively reviewed forty-nine acute distal humeral fra…
Correlative histologic and arthroscopic evaluation in rheumatoid knee joints.
1992
The correlation between arthroscopic observations and histologic changes in rheumatoid arthritis is still controversial. Synovial samples of 21 knee joints in rheumatoid arthritis patients were comparatively investigated by endoscopy and histology. Biopsies were scored by an endoscopist and subsequently dissected. Different histochemical and immunocytochemical staining techniques were used to define inflammatory activity. Arthroscopic and histological values were compared by rating scales and variance analysis. Our study indicates that synovial biopsy is of diagnostic value in rheumatoid arthritis. However, its usefulness depends on the histochemical methods used. The results revealed highl…
Reconstruction of vertebral body in thoracolumbar AO type A post-traumatic fractures by balloon kyphoplasty: a series of 85 patients with a long foll…
2019
Background Traumatic fractures of the thoracolumbar spine are common injuries, accounting for approximately 90% of all spinal traumas. Optimal management of these fractures still gives rises to much debate in the literature. Currently, one of the treatment options in young patients with stable traumatic vertebral fractures is conservative treatment using braces. Kyphoplasty as a minimally invasive procedure has been shown to be effective in stabilizing vertebral body fractures, resulting in immediate pain relief and improved physical function with early return to work activity. The aim of the study is to report VAS, ODI scores, and kyphosis correction following treatment. Methods This is a …