Cases reported "Osteoarthritis"

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1/44. Rapid tibial polyethylene failure in porous-coated anatomic total knees as a cause of clinical failure.

    Among 52 patients with porous-coated anatomic total knee arthroplasties, three (6%) underwent revision surgery because of failure of the tibial polyethylene at two years and three months, four years and three months, and four years and nine months after surgery. Thinning of the tibial polyethylene may have contributed to the failure in one patient. Heat pressing fabrication and the articular geometry possibly played a role in the development of failure in all three patients. Surgical latitude of the prosthetic design was considered to be too narrow to be applied to knee joints with severe deformity, for which knee prostheses with more intrinsic stability might be appropriate.
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2/44. Incomplete nondisplaced tibial osteotomy for treatment of osteoarthritic knee pain.

    Intraosseous venous hypertension is considered a significant factor in the production of knee pain secondary to degenerative arthrosis, thus vascular decompression by means of tibial osteotomy is a rational option for treatment of selected patients. A preliminary report is presented of six patients with symptoms of primary or secondary degenerative arthrosis who were treated by incomplete nondisplaced proximal tibial osteotomy with good or excellent results. These patients were refractory to nonoperative treatment and were not deemed suitable candidates for angulated osteotomy, arthroscopic surgery alone, or total knee arthroplasty. patients ranged in age from 36 to 61 years (mean age: 47 years). Follow-up ranged from .8 to 6.7 years (mean: 3.1 years). The subjects were studied postoperatively by interview, physical examination, radiographs, and bone scans. Results were assessed using the knee rating system of The Hospital for Special Surgery.
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3/44. Early experience with total knee replacement.

    This paper presents a review of two years' experience with the geometric total knee replacement. The results of 23 arthroplasties in 22 patients are discussed. Relief of pain was consistent and dramatic, movement was increased postoperatively in only three patients, but imporvement in overall function occurred in 20 of the 22 patients. There was one failure requiring arthrodesis. In this patient, six months after surgery the medial tibial condyle collapsed and the polyethylene tibial component fractured. This complication has not been reported before. Early results are encouraging. Total knee joint replacement is a useful procedure in advanced arthritis when arthrodesis is the only alternative.
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keywords = tibia
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4/44. Total knee replacement in an amputee patient: a case report.

    osteoarthritis is the most prevalent and more disabling of the rheumatic diseases. One of the most effective forms of treatment of severe osteoarthritis is total joint arthroplasty. Although studies suggest that the incidence of osteoarthritis is higher in prosthetic users, research supporting total joint arthroplasty as an option for treating amputee patients with advanced osteoarthritis is lacking. We report the case of a 76-year-old man with right transtibial amputation who had an excellent outcome after undergoing bilateral total knee replacements for advanced osteoarthritis.
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keywords = tibia
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5/44. Unusual complication associated with femoral intramedullary alignment guide in total knee arthroplasty.

    The few reported complications related to the use of a femoral intramedullary alignment guide in total knee arthroplasty include increase in perioperative bleeding and fat embolism. We report 3 patients suffering from an unusual complication, concerning trapping of the tibial locking pin inside the intramedullary canal of the femur secondary to the use of an intramedullary alignment guide. methods of retrieving the locking pin from the medullary canal are discussed.
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keywords = tibia
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6/44. Tibial plafond fractures. How do these ankles function over time?

    BACKGROUND: The intermediate outcome of fractures of the tibial plafond treated with current techniques has not been reported, to our knowledge. The purpose of this study, performed at a minimum of five years after injury, was to determine the effect of these fractures on ankle function, pain, and general health status and to determine which factors predict favorable and unfavorable outcomes. methods: Fifty-six ankles (fifty-two patients) with a tibial plafond fracture were treated with a uniform technique consisting of application of a monolateral hinged transarticular external fixator coupled with screw fixation of the articular surface. Thirty-one patients with thirty-five involved ankles returned between five and twelve years after the injury for a physical examination, assessment of ankle pain and function with the iowa ankle Score and ankle osteoarthritis Scale, assessment of general health status with the Short Form-36 (SF-36), and radiographic examination of the ankle. RESULTS: arthrodesis had been performed on five of the forty ankles for which the outcome was known at a minimum of five years after the injury. Other than removal of prominent screws (two patients), no other surgical procedure had been performed on any patient. The average iowa ankle Score was 78 points (range, 28 to 96 points). The scores on the SF-36 and ankle osteoarthritis Scale demonstrated a long-term negative effect of the injury on general health and on ankle pain and function when compared with those parameters in age-matched controls. The degree of osteoarthrosis was grade 0 in three ankles, grade 1 in six, grade 2 in twenty, and grade 3 in six. The majority of patients had some limitation with regard to recreational activities, with an inability to run being the most common complaint (twenty-seven of the thirty-one patients). Fourteen patients changed jobs because of the ankle injury. Fifteen ankles were rated by the patient as excellent; ten, as good; seven, as fair; and one, as poor. Nine patients with previously recorded ankle scores had better scores after the longer follow-up interval. The patients perceived that their condition had improved for an average of 2.4 years after the injury. CONCLUSIONS: Although tibial plafond fractures have an intermediate-term negative effect on ankle function and pain and on general health, few patients require secondary reconstructive procedures and symptoms tend to decrease for a long time after healing.
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keywords = tibia
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7/44. Posterior tibial subluxation and short-term arthritis resulting from failed posterior cruciate ligament reconstruction.

    Posterior tibial subluxations because of combined or isolated posterior cruciate ligament (PCL) injuries require detailed evaluation. PCL reconstructions are difficult procedures because of the low rate of such injuries and the complex anatomy of the ligament. We report on 2 cases of failed PCL reconstruction because of malpositioned femoral tunnels. These 2 cases support the existing biomechanical evidence that the correct placement of the tunnels, especially in the femur, is a major factor in defining the outcome. It seems that the drilling of the tunnels, especially in the femur, during PCL reconstruction must be performed with accuracy and always be evaluated in cases of graft failure. In addition, failed PCL reconstructions are usually accompanied by a short-term excessive arthritis that results in poor functional outcome.
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keywords = tibia
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8/44. The use of an external tibial fixator in the treatment of genu varum.

    This paper reports 72 cases of genu varum treated by a U-shaped osteotomy of the tibia and an oblique osteotomy of the fibula in combination with immobilization effected by a specially designed external tibial fixator. Owing to this modified approach, the patients were able to stand up and move about much earlier than usual. Our trial yielded 80.7% excellent, 16.6% good and 2.7% fair results. The treatment course was shortened to two thirds of the time required when using previously described techniques.
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keywords = tibia
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9/44. polyethylene delamination in the PCA total knee. Material analysis in two failed cases.

    Two patients had severe polyethylene-wear synovitis after total knee arthroplasty for arthrosis. Full-leg length weight-bearing radiographs were diagnostic. The polyethylene of the tibial components showed excessive delamination. The morphology and crystallinity of the polyethylene showed that surface treatment of the material could well be held responsible for the massive wear.
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ranking = 0.16666666666667
keywords = tibia
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10/44. Localised mastocytosis at the bone and porous coated interface of a knee prosthesis.

    A porous coated tibial plateau component, which was not loose, was removed 6 weeks after operation. An absence of bony ingrowth was demonstrated by histological and microradiographic examination. The radiolucent space was filled by young connective tissue and inflammation was indicated by the presence of a few macrophages or foreign body giant cells; there was also an increased number of mast cells near the metallic beads. Such inflammatory cells have not previously been reported around a firmly fixed joint prosthesis, but they have been associated with metallic particles. Since accumulations of mast cells can interfere with the process of bony ingrowth, further studies of removed porous coated prostheses should be made with adequate histological techniques so that the clinical significance of these cells can be better understood.
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keywords = tibia
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