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Biomedical subjects

F W Reckling

Publications and source records attributed to F W Reckling.

14 recordsLinked to original sources
PubMed1992

Titanium-induced arthropathy associated with polyethylene-metal separation after total joint replacement.

Complications of total joint replacements are not infrequent. The authors describe five patients with displacement of the polyethylene component in two knee (metal-backed patellar component) and three hip joint replacements. Clinical, radiographic, surgical, and pathologic findings were reviewed in all cases. Conventional radiographs revealed abnormal position of the metal components in all patients and opaque curvilinear periarticular deposits in four. Arthropathy caused by deposition of small titanium particles from metal friction (in the absence of interposed polyethylene) was pathologically proved to correspond to the periarticular opacity. The subtle radiolucent polyethylene component was identified in all patients; adequate visualization in some cases may necessitate imaging with additional methods such as magnification, phosphor plate, and soft-tissue radiographic techniques; conventional tomography; and arthrography. Early recognition of these abnormalities in patients with painful joint replacements may allow less extensive surgical revision and prevent development of titanium-induced arthropathy.

Aged↗
PubMed1991

Somatosensory-evoked potential monitored during total hip arthroplasty.

One hundred consecutive patients were monitored using somatosensory-evoked potential (SEP) monitoring to detect intraoperative sciatic nerve compromise during total hip arthroplasty. The peroneal nerve was stimulated using the contralateral extremity to rule out systemic influences on the SEP tracings. Loss of amplitude or an increase in latency of greater than 10% was considered significant. Of the 18 patients who exhibited changes that met these criteria, 16 were female. Two patients had loss of amplitude of the tracings at the time of closure, and both of these patients exhibited postoperative sciatic nerve palsies. There were no false negatives. Femoral reaming and reduction are the surgical events most commonly associated with nerve reactions. Patients who have had prior hip procedures appear to be at higher risk. There was no correlation with intraoperative SEP changes and age, weight, surgical approach, or leg lengthening. Compared with unmonitored patients, there was no reduction in the incidence of sciatic palsy.

Evoked Potentials, Somatosensory↗
PubMed1977

Osteoid osteoma and osteoblastoma. Similar histologic lesions with different natural histories.

A study of 9 new cases of osteoid osteoma and 3 new cases of osteoblastoma demonstrated very similar histologic findings. Both lesions were extremely vascular and frequently showed areas with histologic features of an aneurysmal bone cyst. Differentiation between the 2 lesions often depended on their clinical features and radiographic appearances. A review of 851 osteoid osteomas and 181 osteoblastomas from the literature supported a difference, however, in the natural history of the 2 lesions with osteoid osteomas tending toward regression, and osteoblastomas tending toward progression and possible late malignant transformation. Osteoid osteomas were found to have a 4.5% recurrence rate compared with a 9.8% recurrence rate for osteoblastomas (p less than 0.01). No recurrence has ever been reported after complete en-bloc resection of either lesion and this must be considered the surgical treatment of choice for both lesions where possible. Despite apparent incomplete excisions, cures are achieved in many cases among both lesions.

Adolescent↗
PubMed1977

The bone-cement interface temperature during total joint replacement.

Sets of thermoprobe measurements of the temperature of the bone-cement interface were made during twenty total joint-replacement procedures. Although the range of rise in temperature was wide, from 3 to 17 degrees centigrade, the highest temperature obtained was 48 degrees centigrade, which is well below the denaturation point (56 degrees centigrade) of proteins. Several factors, such as the presence of blood and moisture at the interface and the large surface area and poor heat conductivity of methylmethacrylate, prevent the interface from experiencing the high rise in temperature that occurs at the center of the polymerizing cement mass.

Bone Cements↗
PubMed1977

A longitudinal study of the radiolucent line at the bone-cement interface following total joint-replacement procedures.

After 100 consecutive total hip arthroplasties, a radiolucent line at the bone-cement interface as seen on serial roentgenograms was on the acetabular side in fifty-nine hips and on the femoral side, in three. Similarly, after seventy-five consecutive non-hinged knee-replacement arthroplasties, a radiolucent line was found at the bone-cement interface beneath the polyethylene component more frequently in knees in which the more constrained geometric implant was used (forty-two of fity-nine) than in knees in which the less constrained polycentric and modular prostheses were used (three of sixteen). The presence of a lucent line at the bone-cement interface in these joints did not signify looseness or failure of the arthroplasty.

Bone Cements↗
PubMed1976

Changing concepts in the management of pathological and impending pathological fractures.

The benefits in the management of pathological fractures by internal fixation are well recognized. However, failures in bone or metal can occur where there is a large amount of bone destruction. Seven of 69 pathological fractures in our series were treated by internal fixation with adjunctive use of methylmethacrylate without failure. This allowed for secure fixation in fractures with large amounts of bone destruction, thus decreasing the patient's pain and allowing earlier mobilization. Neither the effects of radiotherapy on bone involved with neoplasm nor methylmethacrylate are altered when radiotherapy is used after internal fixation and adjunctive use of methylmethacrylate. We believe that an aggressive program of stabilization of these fractures or fixation before actual fracture provides significant patient benefits including reduction of pain, decreased length of hospital stay, reduction of financial expense, and return to as near normal function as possible.

Adolescent↗
PubMed1975

Performance analysis of an ex vivo geometric total knee prosthesis.

Studies were made of a well functioning geometric total knee prosthesis, removed at autopsy from a sixty-one-year-old man, which had been used for eight months. The components were firmly embedded in bone with no evidence of loosening. There was significant deformation of the polyethylene tibial component, but no significant wear on the metallic component. Thin layers of fibrous tissue were found in some areas of the bone-cement interfaces.

Acrylates↗
PubMedDate not supplied

Intracortical and subperiosteal lesion of unknown etiology.

A painful intracortical and subperiosteal lesion of the fibula with a 14 year follow-up is reported to regress to a painfree state. Infection is favored in the differential diagnosis. Biopsy with histological and radiographical correlation are essential for exclusion of: osteoid osteoma, osteoblastoma, periostitis, glomus tumor, eosinophilic granuloma, enostosis, hemangioma of bone, giant cell tumor, simple cyst, aneurysmal bone cyst, non-ossifying fibroma, polyostotic fibrous dysplasia, hyperparathyroidism, Paget's disease, localized area of avascular necrosis, stress fracture and even metastatic disease.

Bone Diseases↗
PubMedDate not supplied

Limb length discrepancy and related problems following total hip joint replacement.

Limb lengthening is not uncommon after total hip replacement and may cause subjective problems for patients. We have studied 150 total hip replacements to investigate the operative change in limb length. A radiologic evaluation is used and is shown to be accurate. One hundred forty-four limbs were lengthened an average of 15.9 mm. Slightly less lengthening was observed if the greater trochanter was removed as part of the operative procedure. For subjective complaints 40 (27%) patients required heel lifts on the unoperated side to gain a satisfactory gait pattern. Partial sciatic nerve palsies also occurred in this series (3.3%) subsequent to total hip replacements. These palsies did not correlate with sex, lengthening of the extremity, or operative procedure, but did correlate with repeat surgeries and in all instances the condition resolved or improved.

Aged↗
PubMedDate not supplied

Normal pregnancy and delivery following total hip joint replacement.

Total joint replacement procedures should be restricted to older individuals or persons with limited physical activities or life expectancy. However, on occasion a total joint replacement may be the only means to avoid serious disability in a young, otherwise healthy individual. This report of a 19-year-old woman who underwent a total hip joint replacement following unsuccessful treatment of a severely comminuted intracapsular hip fracture. Subsequent to the total hip joint replacement the patient experienced a normal pregnancy and delivery.

Adolescent↗