We have made a retrospective study of 1001 custom-made prostheses used as replacements after surgery for bone tumours. There were 493 distal femoral, 263 proximal femoral and 245 proximal tibial prostheses. Aseptic loosening was shown to be the principal mode of failure of the implants, and 71 patients had revision for aseptic loosening of a cemented intramedullary stem. The probability of a pa...

Bleeding from cancellous bone causes lamination within bone cement and at its prosthetic interfaces, and weakens the fixation of joint replacements. We examined the effects of anaesthesia and blood pressure on bleeding in human cancellous bone, and investigated the local response to freezing saline, 1:200,000 adrenaline and hydrogen peroxide. Spinal anaesthesia reduced cancellous bleeding by an...

Revision knee arthroplasty for infection poses a treatment challenge. The presence of massive osteolysis limits the treatment options in this cohort. Controversy exists in the management of these patients. Direct exchange arthroplasty has provided good results in the presence of infection, but whether this is appropriate in the presence of massive bone defects associated with the infection is u...

OBJECTIVES To investigate the cognitive effects of high-dose oral estrogen alone or in combination with oral methyltestosterone in postmenopausal women. METHODS Participants were tested with a randomized, double-blind design on the Identical Pictures, Cube Comparisons, Building Memory and Shape Memory tasks before and after 4 months of hormone treatment. RESULTS Women receiving estrogen and...

Limb salvage is now customary in the treatment of primary bone tumours. The proximal tibia is a frequent site for these neoplasms but reconstruction, especially in children, is a formidable challenge. We reviewed 20 children with extendible replacements of the proximal tibia, all with a minimum follow-up of five years. Five died from their disease and, of the remaining 15, four had above-knee a...

The aim of our study was to assess the effect of knee replacement with or without bone cement on periprosthetic bone density. Periprosthetic bone density in two comparable groups (30 each) of cemented and uncemented knee replacements was measured with DEXA scanner. Bone loss was more in the area posterior to the anterior femoral flange in the cemented subgroup, nearing statistical significance ...

The calculation of range motion (ROM) is a key factor during preoperative planning total hip replacements (THR), to reduce the risk impingement and dislocation artificial joint. To support assessment THR, magnetic resonance imaging (MRI)-based computational framework was generated; this enabled estimation patient-specific ROM type (bone-to-bone, implant-to-bone, implant-to-implant) postoperativ...