Biomedical subjects

Charles H Crawford

Publications and source records attributed to Charles H Crawford.

5 recordsLinked to original sources

PubMed2006

Impaction grafting for femoral component revision using a non-polished bead-blasted chrome cobalt stem-average 8 1/2-year follow-up.

Impaction grafting for femoral component revision in patients with significant bone loss has been reported using a tapered polished femoral component that is meant to subside. This study reports our results of femoral component revision using impaction grafting with a bead-blasted chrome cobalt stem designed not to subside. Forty-eight femoral component revisions using impaction grafting were retrospectively reviewed with a minimum 6 1/2-year follow-up. There were 2 failures due to aseptic loosening of the femoral component (4%). There were 22 total complications, and the overall failure rate was 21%. Impaction grafting for femoral component revision using a bead-blasted chrome cobalt stem in patients with a large femoral canal diameter has shown good results with respect to aseptic loosening with minimal subsidence.

Adult↗

PubMed2006

The trochanteric nail versus the sliding hip screw for intertrochanteric hip fractures: a review of 93 cases.

BACKGROUND: The trochanteric nail, a redesigned short gamma nail, (Howmedica, Rutherford, NJ) was introduced in the United States during 1998 for the treatment of intertrochanteric fractures. METHODS: We retrospectively reviewed 93 patients who were treated for an intertrochanteric fracture with either a sliding hip screw (SHS) or the short trochanteric nail (TN). RESULTS: In all, 94% of the patients in the sliding hip screw group healed without complication. There was one case of femoral head necrosis, one lag screw cutout, and one hardware removal for pain. Eighty-nine percent of the patients in the trochanteric nail group healed without complication. There was one late fracture at the tip of the nail, three cases of lag screw cutout, and one nonunion. CONCLUSIONS: This study suggests that the trochanteric nail is a reasonable alternative to the sliding hip screw when used for intertrochanteric fractures, although it may be associated with higher complication rates.

Aged↗

PubMed2005

Histologic and mechanical evaluation of impaction grafting for femoral component revision in a goat model.

A goat model of revision hip arthroplasty was used to examine the histology and mechanical performance of impaction grafting using two femoral stems varying in stem surface finish. There were no significant mechanical or qualitative histologic differences between smooth, tapered, polished stems and step-cut, grit-blasted stems. Allograft distribution, bone incorporation, and cement mantle thickness were not uniform within the femoral canal. Efforts to improve the impaction grafting technique may be more important than stem design.

Animals↗

PubMed2004

Femoral component revision using an extensively hydroxyapatite-coated stem.

Femoral component revisions with extensively coated stems have shown promising clinical results, although concerns over stress shielding still exist. We retrospectively reviewed 59 patients undergoing femoral component revision with an extensively hydroxyapatite (HA)-coated stem. The average length of follow-up was 3.3 years (range, 2-5 years). The average preoperative Harris Hip Score was 43 points, which improved to 86 points at the latest follow-up (P < .01). The overall mechanical failure rate was 2%. No evidence of stress shielding was seen in 78% of patients. The clinical results of this series using an extensively HA-coated stem are similar to those using an extensively porous-coated stem. Long-term follow-up is required to determine if an extensively HA-coated implant will be superior to an extensively porous-coated implant with regard to stress shielding.

Aged↗

PubMed2002

Temporal progression of angiogenesis and basal lamina deposition after contusive spinal cord injury in the adult rat.

After spinal cord injury (SCI), the absence of an adequate blood supply to injured tissues has been hypothesized to contribute to the lack of regeneration. In this study, blood vessel changes were examined in 28 adult female Fischer 344 rats at 1, 3, 7, 14, 28, and 60 days after a 12.5 g x cm NYU impactor injury at the T9 vertebral level. Laminin, collagen IV, endothelial barrier antigen (SMI71), and rat endothelial cell antigen (RECA-1) immunoreactivities were used to quantify blood vessel per area densities and diameters in ventral gray matter (VGM), ventral white matter (VWM), and dorsal columns (DC) at levels ranging 15 mm rostral and caudal to the epicenter. This study demonstrates an angiogenic response, defined as SMI71/RECA-1-immunopositive endothelial cells that colocalize with a robust deposition of basal lamina and basal lamina streamers, 7 days after injury within epicenter VGM. This angiogenesis diminishes concurrent with cystic cavity formation. GAP43- and neurofilament- (68 kDa and 210 kDa) immunopositive fiber outgrowth was associated with these new blood vessels by day 14. Between 28 and 60 days after injury, increases in SMI71-immunopositive blood vessel densities were observed in the remaining VWM and DC with a corresponding increase in vessel diameters up to 15 mm rostral and caudal to the epicenter. This second angiogenesis within VWM and DC, unlike the acute response observed in VGM, did not correspond to any previously described changes in locomotor behaviors in this model. We propose that therapies targeting angiogenic processes be directed at the interval between 3 and 7 days after SCI.

Animals↗