RESUMO
Surgical exposure for total elbow replacement should provide complete visualization of the joint surfaces. The soft tissue reconstruction following replacement often requires protection and can lead to complications such as triceps tendon rupture. We describe a modification of the posterior approach to the elbow that provides optimal exposure and allows early mobilization.
RESUMO
PURPOSE: Total knee arthroplasty (TKA) is typically carried out either with retention (CR) of the posterior cruciate ligament (PCL) or with sacrifice of this ligament and implantation of a posterior stabilised (PS) prosthesis. This paper investigates a comparison of PCL function in knees treated for osteoarthritis with TKA where the PCL is preserved to those knees treated with TKA and posterior stabilisation. METHODS: One hundred and sixty-eight patients (232 knees) who had undergone TKA with either a PS or CR implant were included in the study. Clinical assessment included antero-posterior (AP) laxity and posterior sag assessment with an arthrometer. RESULTS: The mean AP laxity at 90° of flexion for CR TKAs was 6.5 mm (±3.1) and was the same [6.5 mm (±2.4)] as in the PS group. However, 56% of the PCL-preserved knees had a posterior sag of over 3 mm compared to 18% of the knees in the PS group. The American Knee Society Scores for either group showed that, although the mean function score was the same, the knee score was superior in the PS group (77 vs. 84). The range of motion was also superior in the PS group (111° vs. 105°). CONCLUSION: The use of the PS prosthesis for TKA provides a more predictable outcome with regard to posterior sag and a better maximum flexion than a CR implant.
Assuntos
Artroplastia do Joelho/métodos , Instabilidade Articular/fisiopatologia , Ligamento Cruzado Posterior/fisiopatologia , Ligamento Cruzado Posterior/cirurgia , Amplitude de Movimento Articular/fisiologia , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/efeitos adversos , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Instabilidade Articular/prevenção & controle , Prótese do Joelho , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Medição da Dor , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Valores de Referência , Medição de Risco , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
We present a case of a Smith-Petersen mould arthroplasty in a 77-year-old man. The implant was inserted by Sir John Charnley himself in 1948. The patient is pain-free and walks without aids. At 56 years, this case represents the longest surviving Smith-Petersen mould arthroplasty with a satisfactory result in the current literature.
Assuntos
Artroplastia de Quadril/métodos , Osteoartrite do Quadril/cirurgia , Idoso , Prótese de Quadril , Humanos , Masculino , Militares , Desenho de Prótese , Fatores de TempoRESUMO
We report a rare case of benign fibrous histiocytoma presenting as an intra-articular tumor in the knee joint causing pain and limitation of movements. This is the first case reported with no attachment to tendinous or ligamentous structures.
