An assessment of cost-effectiveness studies in joint replacement.
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Antibiotic Prophylaxis↗
Biomedical subjects
E Guerado
Publications and source records attributed to E Guerado.
[Bone regeneration, cell therapy and tissue engineering].
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Animals↗
Perthes' disease. A study of constitutional aspects in adulthood.
We studied 16 patients suffering from osteoarthritis of the hip who had had Perthes' disease during childhood. They were compared clinically and radiologically with a control group who had not had Perthes' disease, in order to assess whether a generalised, pre-existing constitutional disorder was present. Nine patients with a previous history of Perthes' disease had some other skeletal abnormality, but only three presented with clinical symptoms. Only one patient in the control group was found to have an abnormality but was symptom-free. Our findings provide further evidence that patients with Perthes' disease may have a generalised abnormality related to chondrogenesis which can produce other skeletal anomalies that persist into adult life.
Adult↗
Proximal rectus femoris lengthening.
There are two main problems with muscle tendon lengthening: thinness created by the technical procedure weakens the tendon, and in short tendons, lengthening may not provide enough length for the amount of joint motion required. In proximal rectus femoris lengthening, the distal ends of the reflected and straight heads are sutured together. Using this technique, the tendon will not be thinned, and a later second lengthening is possible.
Adolescent↗
Pneumoencephalomeningitis secondary to infected lumbar arthrodesis with a fistula: a case report.
Pneumocephalus associated with spinal problems is very rare. Association with encephalomeningitis secondary to a fistula after an infected elective lumbar spine fusion has not been previously reported. The authors report a case in which the clinical onset of pneumoencephalomeningitis occurred after an airplane flight. CT-scan and lumbar puncture were used to make diagnosis; the treatment was based on parenteral antibiotics. The symptoms and signs of infection and neurological deficit resolved but the fistula remained. Diagnosis in such cases must be based upon CT-scan and lumbar puncture. Treatment should consist of systemic antibiotic therapy. Surgical management of infection and fistula is desirable, should the status of the patient allow such a treatment. In any case, as airplane flights in such cases may predispose to pneumocephalus, patients with an infected CSF fistula should avoid airplane flights until the problem is solved.
Aircraft↗
Acute atraumatic compartment syndrome in the leg.
The compartment syndrome is well recognised as occurring after trauma, but atraumatic acute compartment syndrome is less widely known. We report 3 cases in whom an acute compartment syndrome developed without major injury. Early diagnosis and prompt treatment by decompressive fasciotomy is of vital importance if limb function is to be preserved and complications avoided.
Acute Disease↗
Median nerve neuropathy from an old lunate dislocation.
The case of an old volar dislocation of the lunate, associated with median nerve neuropathy, is described in a 37-year-old patient. The treatment took into account the age of the patient and the relative tolerance to the dislocation. We performed a simple excision of the lunate combined with a release of the transverse carpal ligament in order to free the median nerve, together with a tenosynovectomy of flexor digitorum profoundus. Two years after operation, wrist function was virtually complete and the patient was asymptomatic and had resumed his occupation.
Adult↗
CT-scan in the diagnosis of patellar malalignment.
Fifty-one knees with patellofemoral symptoms, but with normal conventional radiographs, were studied by CT-scan. All but five showed evidence of malalignment, and when operated on had an abnormality of the articular cartilage. The authors conclude that in many cases a CT-scan is the best diagnostic procedure for the evaluation of disorders of the patellofemoral joint.
Adolescent↗
Growth-plate modifications after drilling.
Thirty 5-week-old male rats were used to discern the local modifications of the growth plate after drilling. A 1-mm wide drill hole was made on the right femur from the intercondylar notch to the diaphysis crossing the growth plate, with the left femur acting as a sham-operated control. Animals were killed in four five-unit groups at 1, 2, 8, and 16 weeks, respectively, after the surgical procedure. Soft tissues were removed and bone length measured. Distal growth plates of both femora were histologically, histomorphometrically, and histochemically studied. There were no significant differences in length or growth-plate height between drilled bones and their controls. Drill holes were filled by bony trabeculi formed progressively from metaphyses and adjacent cartilage metaplasia. This bone bridge grew wider as time passed after the surgical procedure. These experimental findings suggest that caution should be taken when pinning fractures through the growth plate. Failed attempts can produce permanent epiphysiodesis bridges.
Animals↗