Biomedical subjects

David F Dalury

Publications and source records attributed to David F Dalury.

7 recordsLinked to original sources

PubMed2005

Total knee replacement for patellofemoral disease.

This study evaluates the technical results and outcomes of total knee replacement (TKR) in a group of patients with isolated patellofemoral disease based on the amount of bone loss and patella subluxation seen at the time of surgery. Thirty-three TKRs in 25 patients comprised the study group. All patients had radiographic evidence of isolated end-stage disease in the patellofemoral joint and had cemented tri-compartmental knee replacements. All patellae could be resurfaced. Average follow-up was 5.2 years (range: 3.8-8.4 years). Average Knee Society Scores was 62 preoperatively and 96 at final follow-up. There was no correlation in outcomes related to either the amount of patellar wear, size of the patella, or amount of subluxation of the patella. Total knee replacement is an effective means of managing end-stage arthritis of the patellofemoral joint.

Aged↗

PubMed2005

Mini-incision total knee arthroplasty can increase risk of component malalignment.

UNLABELLED: Interest in minimal-incision total knee arthroplasty has increased in recent years. We compared a group of 30 patients who had total knee arthroplasty with a mini-incision to a similar group of 30 patients who had total knee arthroplasty with a standard length incision. The minimal-incision group had some minor early advantages (less pain medication use, earlier improvement in range of motion), but these advantages dissipated by 3 months followup. Radiographic evaluations showed that four of the 30 patients with minimal incisions had tibial component varus malalignment (< 87 degrees ), whereas no patients with the standard length incision had malalignment. Although total knee arthroplasty performed using a minimal incision may provide some early advantages, minimal incisions can impede a surgeon's vision and may influence component alignment and possibly compromise long-term outcome. LEVEL OF EVIDENCE: Therapeutic study, Level III-1 (retrospective comparative study). See the Guidelines for Authors for a complete description of levels of evidence.

Aged↗

PubMed2005

The technique of cemented total hip replacement.

Cement fixation has a 30-year history in total hip arthroplasty. Cement fixation is a durable and reproducible means of fixation in a variety of hips. A key determinant to a cement mantle's longevity is the technique of cementing. This article reviews what has been learned in the past and outlines the state of the art in cement technique today.

Acetabulum↗

PubMed2004

The incidence of heterotopic ossification after total knee arthroplasty.

Five hundred consecutive patients undergoing primary cemented knee arthroplasties were prospectively followed up and evaluated for the presence of heterotopic ossification. Of the patients studied, 95% had osteoarthritis and 5% had inflammation. A radiographic grading system was devised based on the size and location of the heterotopic bone. The overall incidence of heterotopic ossification in this group was 15%. The patients who developed HO tended to be heavier than the average and were more likely to be men. This is the most comprehensive prospective study of the incidence of HO in primary cemented knee arthroplasty. Other than a small subset of the patients (4 of 500), HO does not appear to have a major influence on the outcome of knee arthroplasty.

Aged↗

PubMed2003

Extensor mechanism problems following total knee replacement.

Despite advances in TKR, a number of complications related to the extensor mechanism still exist. The vast majority of these are preventable with good surgical technique and attention to detail. Proper component positioning, adequate soft-tissue balancing and dissection, and gentle retraction are imperative. Proper resection and resurfacing of the patella, central tracking of the implant, maintenance of the patella vascularity, and use of an implant with a well designed patellofemoral joint help minimize complications of TKR.

Arthroplasty, Replacement, Knee↗

PubMed2003

The long-term outcome of total knee patients with moderate loss of motion.

This study determined the outcome of total knee replacement (TKR) patients with moderate loss of motion who received no particular treatment. Twenty patients with an average arc of motion of 8 degrees-91 degrees of flexion 3 months postoperatively underwent 3-year follow-up. No formal treatment was given. All patients' range of motion and Knee Society scores improved over time. Most of the improvement occurred by 2 years. Patients with moderately stiff TKRs continue to improve over time without vigorous, prolonged physical therapy, manipulation, or bracing.

Aged↗

PubMed2002

Intraoperative measurements of male and female distal femurs during primary total knee arthroplasty.

The anteroposterior (AP) and medial-lateral (ML) dimensions of 200 consecutive osteoarthritic knees (100 males and 100 females) undergoing unilateral primary total knee arthroplasty were compared. For all patients, the mean AP dimension was 57.3 mm (range: 49-66 mm) and the dimension was 10.5% taller in height in men than women. The mean ML dimension was 71.6 mm (range: 56-85 mm), and the dimension was 13.7% wider in men than women. The mean AP/ML ratio was 0.8 for all patients, 0.82 (range: 0.73-0.93) for females and 0.79 (range: 0.70-0.89) for males (P<.001). The data suggest that for any given AP femoral dimension, women tend to have a narrower ML dimension than men, independent of AP height, and an AP/ML ratio of 0.80 most closely approximates a standard-sized distal femur across gender. This report documents important gender differences that may serve as a reference for femoral implant designers and knee surgeons.

Adult↗