[Medium-term results of the uncemented threaded SCL prosthesis. International experience apropos of 5,341 cases since 1982. Groupe International d'Etude].
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Biomedical subjects
Publications and source records attributed to C Callea.
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In this second paper on total prostheses of the hip without cement, we analyse the results of twenty four cases (one of them bilateral) in which Mittelmeier's prosthesis without cement was used. The results are considered encouraging. The indications are discussed and the advantages and disadvantages of this type of arthroprosthesis are assessed.
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The authors report the results obtained with arthroprostheses without cement. In this preliminary report they examine sixteen cases treated with Sbarbaro's arthroprosthesis from 1972 to 1976, at the Orthopaedic Division of the Specialized Regional Hospital, Udine. They stress the efficacy of this kind of arthroprosthesis, which can be used in subjects under the age of sixty years who have severe bilateral lesions, especially of the femoral head. The operation is contraindicated when there is severe dysplasia of osteoporosis of the acetabulum. Weight bearing must be avoided for six months, the time required for the noncemented arthroprosthesis to become stabilized. The two poor results were attributable to local metabolic changes in one case, and general changes in another, rather than to the arthroprosthesis itself.
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After reviewing the literature the authors discuss the aetiology and pathogenesis of gluteal fibrosis. We believe that the condition occurs more frequently than is thought. If this is borne in mind when dealing with children from four to six years old, presenting with abnormal gaits, an early diagnosis can be made. As regards treatment, we agree with those authors who maintain that if diagnosed early the lesion can be treated successfully by physiotherapy alone. In more advanced cases, Z lengthening of the tendon is indicated.
The "painful prosthesis" is a difficult problem. Removal is often the best solution. Out of 566 McKee-Farrar prostheses, twenty six (4.2 per cent) were removed. The causes that made removal advisable are analysed. The methods used and the results obtained are described.
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