Between January 1999 and August 2008, ninety-six femoral revisions were performed with extensively porous-coated stems in Paprosky type III femoral defects (89 type IIIA and 7 type IIIB defects). Seven type IIIB defects with a mean canal of 16.5 mm were observed; 6 defects achieved stable bone ingrowth and 1 achieved stable fibrous condition. Average postoperative Harris Hip Score was 92.3±8 (r...

The removal of well-fixed bone cement from the femoral canal during revision of a total hip replacement (THR) can be difficult and risks the loss of excessive bone stock and perforation or fracture of the femoral shaft. Retaining the cement mantle is attractive, yet the technique of cement-in-cement revision is not widely practised. We have used this procedure at our hospital since 1989. The st...

We have implanted 76 biaxial total wrist prostheses as a primary procedure in patients with rheumatoid arthritis of the wrist. A total of 66 was reviewed at a mean follow-up time of 52 months. Pain was relieved in 67% of the surviving wrist replacements. On the basis of the Hospital for Special Surgery scoring system, 49 wrists (74%) were graded as fair to excellent. More than half of the 27 pa...

PURPOSE To report the long-term results of total hip arthroplasty (THA) using small size Exeter femoral stems. METHODS Eight men and 34 women aged 60 to 83 (mean, 70) years underwent 45 THAs using the Exeter small stem with offsets of 30 mm (n=3), 33 mm (n=15), and 35.5 mm (n=27). The Harris hip score was assessed pre- and post-operatively. Stem alignment and axial subsidence of the stem were...

PURPOSE To report mid-term results of total hip arthroplasty (THA) using the Opti-Fix Plus Hip System (Opti-Fix Hip), and to assess the correlations between peri-implant bone changes and the distal medullary occupancy rate. METHODS 11 men (13 hips) and 53 women (58 hips) aged 24 to 87 (mean, 61) years underwent THA using the Opti-Fix Hip, with a modular stem and a distal sleeve, and were foll...

BACKGROUND Nonunion is a challenging and not uncommon complication of distal humeral fractures. Our long-term experience with linked semiconstrained total elbow arthroplasty as a salvage procedure for patients with distal humeral nonunion not amenable to internal fixation was investigated. METHODS Ninety-one consecutive patients (ninety-two elbows) underwent total elbow arthroplasty for the t...

UNLABELLED Total hip arthroplasty in hypoplastic femurs is technically difficult and the incidence of complications and aseptic loosening is relatively high. Cemented, uncemented, off-the-shelf, and custom-made stems all have been advocated in these cases. From 1978 to 1997, we performed 86 total hip arthroplasties in 77 patients with a hypoplastic femur using a cemented, off-the-shelf, small, ...

PURPOSE To determine the survival and failures of cemented vs cementless endoprostheses. METHODS We retrospectively studied 232 patients treated with lower limb salvage surgery and reconstruction using cementless and cemented endoprostheses from 2002 to 2007. We compared survival and failures of the endoprostheses regarding age, gender, body mass index (BMI), diagnosis, site of reconstruction...

After total hip replacement, some cemented titanium stems show above-average early loosening rates. Increased release of wear particles and resulting reaction of the peri-prosthetic tissue were considered responsible. The objective was to develop a test method for analysing the abrasive wear behaviour of cemented stems and for generating wear particles at the interface with the bone cement. By ...