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Biomedical subjects

B L Penenberg

Publications and source records attributed to B L Penenberg.

3 recordsLinked to original sources

The bipolar endoprosthesis and bone graft in the management of aseptic acetabular component loosening.

Ten patients with large acetabular defects underwent hip arthroplasty revision with the use of allografts in conjunction with a bipolar prosthesis. Six patients had solid femoral head allografts and the others, morselized allografts. Radiographs at 2-year follow up showed an average of 8 mm of superior migration and 4 mm of medial migration. Our experience has shown that bipolar revision arthroplasties tend to migrate against the allograft. We recommend that bipolar revisions be limited to small acetabular defects that give the bipolar prosthesis full rim contact.

Adult↗

Further follow-up on socket fixation using a metal-backed acetabular component for total hip replacement. A minimum ten-year follow-up study.

In 1982, Harris and White reported the data after a minimum five-year follow-up of fifty-three total hip replacements in forty-seven patients in whom a cemented metal-backed acetabular component had been used. There actually had been fifty-four total hip replacements in fifty-three hips, as in one hip a revision was done for a traumatic disruption of the initial acetabular component that occurred two months after the first insertion. Six of the fifty-four operations did not qualify for inclusion in this ten-year follow-up study, including four operations in three patients who had died before that time. The remaining forty-eight hips have been followed for ten to 13.5 years (mean, 11.3 years). With one exception, the ages of the patients at the time of the index operation ranged from seventeen to fifty years (mean, forty-one years). Six (12.5 per cent) of the forty-eight hips required revision because of symptomatic aseptic loosening of the acetabular component. In addition, two acetabular components, although they were not loose, were revised concomitantly with revision of the femoral component because of the presence of radiolucent lines at the cement-bone interface of the acetabular implant. One other acetabular component that was not loose was revised because of unexplained pain, one was removed because of sepsis, and for one only the polyethylene liner was exchanged because of damage to the polyethylene when the weld holding the femoral head to the femoral neck failed. Nine additional hips (19 per cent), although they were not revised, showed radiographic evidence of migration, and one (2 per cent) showed radiographic evidence of impending failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗

Computer-aided simulation, analysis, and design in orthopedic surgery.

Three-dimensional computer reconstructions of bony anatomy based on computed tomographic images and radiographs may be used to analyze, simulate, and design certain orthopedic procedures. In osteotomy surgery, the computer-reconstructed models may be used to measure critical angles, surface area, and congruity of the joint surfaces. Computer reconstructions may be used in total joint replacement surgery to simulate the effect of surgical reamers and rasps, to select the geometrically optimum standard implant, or to design a custom implant. In allograft reconstructive surgery, computer reconstructions may be used to measure bony defects and to identify the appropriate allografts for the reconstruction. Plastic models may be sterilized and used as templates to sculpt the allografts immediately preoperatively. In all three applications in orthopedic surgery, three-dimensional, computer-aided reconstructions have the potential to improve results and reduce morbidity.

Bone Transplantation↗