Blood chemistry and lipid profiles of elite distance runners.

In summary, we conclude that the analysis of the blood profiles of elite runners offers no explanation for their superior fitness of physical ability when compared to the good runners. Selected enzymes related to cellular or tissue damage may be elevated in distance runners and could be classified as abnormal on routine clinical evaluation if unaware of their physical lifestyles. It is also important to note that certain blood profile parameters, especially the hematocrit, could be classified as abnormally low. Finally, the high degree of daily physical activity performed by the elite runners and good runners appears to be associated with a lipoprotein profile consistent with a low risk for development of coronary artery disease manifestations. These profiles persist despite increasing age in active running males.

Comparison of preoperative and postoperative diflunisal for suppression of postoperative pain.

Despite the demonstrated therapeutic advantage of preoperatively administered nonsteroidal anti-inflammatory agents (NSAIAs) in suppressing postoperative pain, clinicians are reluctant to administer these drugs orally before surgical procedures performed using sedation or general anesthesia. Using a within-subject, crossover experimental design, this study compared the analgesic efficacies of an NSAIA, diflunisal 1,000 mg, administered either 30 minutes preoperatively or 30 minutes postoperatively to 20 patients undergoing the removal of impacted third molars. Pain intensity was assessed preoperatively and postoperatively for eight hours using category-rating and visual analog scales. Treatment with diflunisal 30 minutes after completion of surgery proved to be just as effective in suppressing postsurgical pain as presurgical administration. Administration of an NSAID in the immediate postoperative period may be indicated for optimum postoperative analgesia for patients in whom preoperative oral intake is contraindicated.

Total hip replacements using the ceramic Mittelmeier prosthesis.

One hundred twelve consecutive primary total hip replacements were performed for osteoarthritis or osteonecrosis by a single surgeon using the Mittelmeier ceramic prosthesis without cement between January 1983 and July 1984. Ninety-three of these hips were followed prospectively to a minimum of 60 months and a median of 108 months. Five (5.4%) hips have been revised for loosening. Of the remaining hips, 77 (87.5%) were rated clinically satisfactory. Cumulative survival probability using revision as endpoint was estimated to be 92.7% at 5 years and 87.9% at 10 years. However, overall mechanical failure rates were 21.5% for the cup and 22.6% for the stem. There was no case of either femoral or acetabular osteolysis observed.

Total hip arthroplasty using the Zweymuller stem implanted without cement. A prospective study of consecutive patients with minimum 3-year follow-up period.

A prospective study was undertaken over a 2-year period to evaluate the clinical efficacy of using the Zweymuller femoral component (Allopro, Berne, Switzerland) in cementless total hip arthroplasty. Forty consecutive patients (46 hips) were included for final evaluation. Ninety-four percent of the femurs were classified as Dorr class B or C before surgery. The mean follow-up period was 50 months (median, 48 months). Ninety-eight percent of the hips were rated good or excellent clinically. No stem was classified as definitely loose. No hip has required any reoperation. There was no incidence of femoral or acetabular osteolysis up to 6 years.

Unsatisfactory results of a first-generation modular femoral stem implanted without cement. A 4- to 9-year follow-up study.

Eighty primary total hip arthroplasties were performed using a first-generation modular femoral stem inserted without cement. Modular distal sleeves made of methacrylate were used in 33% of the hips. Dorr type B or C femoral geometry was present in 80% of the cases. The mean follow-up period was 81 months with a minimum of 48 months. Satisfactory clinical results were observed in 74% of the hips at the final follow-up visit. Revision of the stem had been performed in 14% of the hips, all for aseptic loosening. The overall mechanical failure rate was 48%. Canal fill by the stem was not any better with the sleeves than without. The incidence of failure, however, was less in those hips in which sleeves were used. Femoral osteolysis was present in 19% of the hips. The experience with this particular stem design has been disappointing.