Biomedical subjects
Publications and source records attributed to H Baldursson.
This is the first report of septic arthritis of the knee caused by Chryseobacterium meningosepticum. The infection was associated with a penetrating injury to the joint. The patient was cured by flushing of the joint and antibiotic treatment.
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UNLABELLED: In order to evaluate the feasibility of a roentgen stereophotogrammetric method for the analysis of the migration pattern of joint prostheses, tantalum balls were implanted into the acetabular socket and the pelvic bone during total hip replacement in four patients with rheumatoid arthritis. During the postoperative period, the migration of the acetabular socket was determined. The observation period varied from 5-24 months. No clinical or radiographic signs of mechanical loosening or infection were noted. All the investigated patients showed a gradual migration of the acetabular socket. The cranial migration measured up to 1.8 mm in 2 years. The migration along the transverse and sagittal axes was less but not constantly directed. The rotatory movements about the three axes varied and measured up to 5.5 degrees in 2 years. The translation and rotation were greatest during the first few months. The results indicate a gradual migration of the acetabular socket in hip arthroplasty in the osteopenic skeleton in rheumatoid arthritis. IN CONCLUSION: roentgen stereophotogrammetry may prove to be a valuable means of analysing the migration of implanted prostheses and detecting prosthetic loosening, thereby increasing the possibility of early and correct diagnosis and therapy.
A follow-up investigation was made of 74 patients suffering from rheumatoid arthritis (RA) who underwent total hip replacement (THR) according to McKee-Farrar during the years 1969-1975. There were 27 bilateral cases. The mean observation time was 47 months (range 9-85 months). The results were graded according to the method of d'Aubigné & Postel. As regards pain relief and increase in hip mobility after THR the results were good, but walking ability was not greatly improved, partly because many other factors besides the state of the hips influence walking ability. In addition to the THRs, 332 other orthopaedic operations were performed on the 78 patients. No correlation was shown between the results and RA serology, age at THR, preoperative classification of hip radiographs, or observation times. A high frequency of migration of the prosthetic components was found.
There is often a need for multiple orthopaedic operations and other interventions in rheumatoid arthritis. A material of 78 patients with rheumatoid arthritis, all of whom have had one or two total hip replacements (THR) is presented. At the last follow-up examination it was found that these patients had undergone 5.6 orthopaedic operations on the average because of their rheumatoid arthritis. About 60% of the patients wore specially fitted shoes, and about 50% of the patients had received financial help to improve their homes or to find other accommodation more suited to their disability.
A roentgen stereophotogrammetric analysis of hip prostheses was made in four patients with rheumatoid arthritis during a postoperative period of 2 years. Implanted tantalum balls, prosthetic femoral head, and ends of the wire in the acetabular socket were used as measurement points. The migration of the prosthetic head and the acetabular socket in relation to the pelvic bone was determined. The difference between the cranial migration of the head and the socket is a measure of the postoperative instability of the hip joint and deformation of the prosthetic components. This deformation occurs in the plastic acetabular socket and is mainly due to wear. The roentgen stereophotogrammetric method can be applied to standard hip orostheses with a metal femoral head and a plastic or metal acetabular socket to study migration or loosening of the prosthesis in relation to the supporting bone, prosthesis instability, and deformation of the prosthetic components.
Fifty-three patients with rheumatoid arthritis were interviewed by questionnaire. All the patients had undergone total hip replacement and were married at the time of operation. They were asked if they had had sexual difficulties because of hip pain or stiffness and if the hip operation had in any way alleviated these problems. Forty-four of the 53 patients answered the questionnaire. Twenty-eight patients had had sexual problems which they attributed to hip symptoms. Following total hip replacement the hips of 27 patients were no longer considered to be the cause of sexual difficulties, but in 10 of those patients other problems still rendered sexual life difficult.
Young patients with rheumatoid arthritis and other chronic diseases of the skeleton are increasingly being operated on with replacement of major joints. The great number of associated X-ray examinations performed on these patients has caused some anxiety amongst orthopaedic surgeons. Two patients with juvenile rheumatoid arthritis have been studied. An attempt was made to calculate the total radiation dose to bone marrow and gonads. For lack of recommendations for the maximum permissible radiation dose to patients, the dose calculated has been compared with the maximum permissible dose of radiation workers, and with the dose limit for non-occupational irradiation of individuals. The yearly absorbed dose in these two patients is much lower than the maximum permissible dose of radiation workers and only slightly higher than the dose limit for non-occupational exposure of individuals.
Eighteen total hip replacements were performed in 10 patients with ankylosing spondylitis. The mean observation time was 3.8 years. Seven hips had been operated on before total hip replacement (THR); 6 Were ankylotic before THR. The results as regards pain relief and increased walking distance were good. All hips improved in mobility after THR and this improvement was maintained during the observation time. Six of the 10 patients went back to full-time work. The differences between patients with ankylosing spondylitis and rheumatoid arthritis, as regards indications for and rehabilitation after THR, are discussed.
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