PURPOSE: To determine the clinical, functional, and radiographic long-term results of patients who underwent arthroscopic partial lateral meniscectomy in an otherwise normal knee. TYPE OF STUDY: This was a retrospective case-control study. METHODS: Between 1982 and 1991, 107 arthroscopic partial lateral meniscectomies were performed; 75 of these patients had an isolated lateral meniscal tear and their data were evaluated using the Lysholm score and a questionnaire recording patients' subjective satisfaction. Radiographic analysis was performed according to the Jäger-Wirth classification and Fairbank changes. RESULTS: All 75 patients were examined by questionnaire, 55 underwent physical examination, and 58 had radiographic analysis. The follow-up period ranged from 5 to 15 years. Excellent and good Lysholm score results decreased from 77% at maximal improvement to 66% at follow-up; 43% of patients maintained their level of maximal improvement, 78% showed one or more Fairbank changes at follow-up, and using the Jäger-Wirth score, 84% showed radiographic deterioration. CONCLUSIONS: Although deterioration of functional and especially radiographic results occurred after arthroscopic partial lateral meniscectomy, the number of good results, even with mean follow-up of 12.3 years, is remarkable. There was a high percentage of radiographic changes in our study, but there is no significant correlation between them and subjective symptoms or between them and functional outcome. We believe that careful meniscectomy provides good results for a long period of time but, the longer the follow-up, the more radiographic changes have to be expected; when meniscal refixation is possible, it should be performed.

Adult↗

PubMedDate not supplied

[Osseontegration of trial implants of carbon fiber reinforced plastics].

PROBLEM: To what extent are carbon fibre-reinforced plastics (CFRP) suitable as an osseous integration surface for implants? METHOD: CFRP test implants having a plexus-structured, rhombus-structured, and plexus-structured, hydroxyapatite surface were implanted in the femura of mini-plgs. Exposure time lasted 12 weeks. The implants were subjected to a macroradiological, a histological-histomorphometrical, and a fluorescence-microscopical evaluation. RESULTS: One half of the uncoated, plexus-structured implants were not osteointegrated, the other half displayed an osteointegration rate of 11.8% in the spongy area and 29.8% in the cortex layer. The HA-coated test implants showed an osteointegration of 29.5% in the spongiosa and 56.8% in the cortex layer. The rhombus-structured test implants had an osteointegration of 29.2% (spongiosa) and 46.2% (cortex layer). CONCLUSION: Compared to the osteointegration of metallic, especially titanium surfaces the CFRP surfaces tested by us fared worse, especially the uncoated, plexus-structured surfaces. For this reason we view very critically the use of carbon-fibre reinforced plastics together with the surfaces tested by us as osteointegrating surfaces.

Animals↗

PubMedDate not supplied

[Osseointegration of a laser-structured titanium hemispheric acetabulum in the animal experiment].

Eight hemispherical titanium-cups with a new laser structured surface had been implanted in sheeps. Duration of implantation was eight weeks and one year. Analysis and evaluation of the results were done by post-operative x-rays, x-rays of the specimen, macroradiography, microradiography, fluorescencemicroscopy and histology. A quantitative analysis of the bony ingrowth was performed with a computer-aided system. The 8 weeks-cups showed an osseointegration rate of 28.8%, the one year group of 52.1% of the available surface. Bony ingrowth of the laserstructured titanium surface is possible. The laserstructured titanium surface can be used for the cementless fixation of implants.

Acetabulum↗

PubMedDate not supplied

[Clinical and radiological isthmus reconstruction in lumbar spondylolysis and minimal spondylolisthesis].

Treatment of spondylolysis and minor form of spondylolisthesis in childhood is usually conservative and includes physical therapy, a temporary reduction in sport activities or the use of an orthosis. Persisting pain despite conservative therapy, neurological symptoms and progressive sliding on x-ray may indicate surgical treatment. We report about the results in 25 patients operated by direct repair of the isthmus between 1982 and 1990 in the Orthopaedic Hospital in Mannheim. In 75% of the cases the special hook-screw by Morscher was used. The other patients were operated according to the original method described by Buck or by the Scott procedure with wire fixation. The clinical and radiological results were available in all patients by a mean follow-up of 8.9 years (4-12 years). All juvenile patients had good or very good clinical results. Within the adult group half of the patients had fair or worse clinical results. Only in 3 out of 14 cases we found bony consolidation of both arches. In 6 cases the x-ray showed pseudoarthrosis on both sides. In 3 of these patients spondylodesis had to be performed. Because of the bad results of direct repair in adult patients, we looked for further criteria, which are necessary to achieve good clinical and radiological results. In addition of the age, the condition of the disc is important. In adolescent patients (more than 16 years old) we documented a degeneration of the disc by NMR or by intraoperative discography.

Adolescent↗

PubMedDate not supplied

[Gliding polyethylene-PMMA combination as "wear model"].

The situation, described in this casuistry, shows the fatal consequences of the huge amount of wear particles from the PE-PMMA-components of a total hip prosthesis. The prosthesis had been implanted in Russia. It was made of a PE-ball fixed to a titanium stem and a socket, which had been molded intraoperatively in situ. The combination of PMMA and PE in the bearing surface caused an extreme osteolysis in the proximal femur and the acetabulum and the loosening of the cup and the stem within only a few months.

Aged↗