Five-year experience of cementless Oxford unicompartmental knee replacement.

PURPOSE: Cementless unicompartmental knee replacement (UKR) was introduced to address some of the problems that can occur following cemented UKR. The aim of this study was to report the 5-year experience of the first 512 medial cementless Oxford UKR implanted by two surgeons for the recommended indications. METHODS: The first consecutive 512 cementless Phase 3 Oxford UKRs implanted by two surgeons for the recommended indications between June 2004 and October 2013 were prospectively identified and followed up independently. All the procedures were carried out through a minimally invasive approach without eversion or dislocation of the patella. Patients were assessed clinically pre-operatively and at 1, 2, 5, 7 and 10 years after surgery with functional outcome scores and radiographs. RESULTS: There were eight reoperations of which six were revisions giving a 5-year survival of 98 % (95 % CI 94-100 %). At a mean follow-up of 3.4 years (1.0-10.2), the mean OKS was 43 (SD 7), AKSS (objective) was 81 (SD 13), and AKSS (functional) was 86 (SD 17). The first 120 cases had a minimum follow-up of 5 years (mean 5.9; range 5-10.2). In these patients, the mean OKS was 41 (SD 8), AKSS (objective) was 81 (SD 14), and AKSS (functional) was 82 (SD 18). There were no femoral radiolucencies and no complete tibial radiolucencies. 11 % of tibial components had partial radiolucent lines; the remaining 89 % had no radiolucencies. CONCLUSION: The clinical results are as good as or better than those previously reported for cemented fixation. The radiographic results are better with secure bony attachment to the implants in every case. LEVEL OF EVIDENCE: IV.

[Argon-green laser photocoagulation in the treatment of cystoid macular edema secondary to branch vein occlusion]. / Traitement de l'oedème maculaire cystoïde secondaire à une occlusion de branche veineuse par photocoagulation au laser monochromatique vert.

The present study evaluates the use of argon-green photocoagulation in the absorption rate of macular oedema and the visual recovery of patients suffering of branch venous occlusion of non-diabetic aetiology. Twenty patients suffering from branch venous occlusion and angiographically proven cystoid macular oedema were entered in this prospective study; they were randomly divided in two equal groups and were treated with photocoagulation 1-4 months after the onset of the disease. Patients in the first group were treated according to the clinical regime with focal and scattered photocoagulation which was applied over the affected area. Patients in the second group were photocoagulated so as to reduce the blood flow of the afferent arteriole to a volume that can be drained away by the diseased efferent venule. All patients were carefully followed-up for 6-24 months, particularly for the degree of macular oedema and their visual status. We discuss the clinical observations and present our results.

[Primary malignant melanoma of the cornea (author's transl)]. / Mélanome primitif malin de la cornée.

In this communication, we present a case of malignant melanoma of the cornea, in an 80-year old female. The tumor, covering 3/4 of the cornea, had a lobulated appearance, pinkish colour with vascularization and pigment granules, in a few places. The limbal area was free of tumor. Histologic examination indicated that the melanoma was primary, of the epithelioid type, with a few areas of spindle type cells.

Corneal thickness after cataract surgery.

An increase in corneal thickness occurs so regularly after cataract surgery as to be considered to be the rule. It reflects the state of endothelial activity and is therefore affected both by the preoperative condition of the endothelium and the degree of surgical manipulation. The question how quickly the endothelium can be expected to recover with consequent disappearance of corneal swelling is still open to discussion. The central corneal thickness of 55 eyes with normal slit-lamp endothelial appearance undergoing cataract surgery was measured preoperatively and on the 3rd, 7th, 14th, 21st, 28th, and 42nd postoperative days. The initial corneal thickness was 0.56 mm. The greatest corneal swelling, found on the third postoperative day, was 16%. Corneal thickness returned to preoperative values in four eyes within 7 days, in 19 eyes within 14 days, in 39 eyes within 21 days, in 50 eyes within 28 days, and in all 55 eyes within 42 days. Corneal swelling, as measured on the third postoperative day, was greatest (19%) when chromic catgut was used, less (13-16%) when black silk 7/0 was used, and least (9%) when virgin silk 8/0 was used.

360-degree buckling as the procedure of choice in cases of retinal detachment with poor prognosis.

A 360-degree scleral buckling procedure was used 82 cases of retinal detachment with poor prognosis. This procedure was successful in 58.6% of the cases after one operation and 76.8% after two operations. Because the complications observed were partially attributed to the extensiveness of the operation, it is proposed that this procedure be reserved for certain cases of retinal detachment with poor prognosis.