PURPOSE: A hollow cementless femoral stem has been developed to reduce intramedullary pressure and fat embolism during implantation. METHODS: In a prospective randomized clinical study, cementless hip stems (ALPHA-FIT) were implanted in 42 patients (24 women, 18 men, mean age: 65.9 years). In Group I (n=21) a solid standard stem was used. In Group II (n=21) a modified hollow stem was implanted with vertical and longitudinal communicating drill holes opening at the implant surface. During surgery the intramedullary pressure was measured by a cannula fixed distally. RESULTS: During stem insertion the mean pressure was 82 mmHg (minimum-maximum, 12-259 mmHg) for Group I and 27 mmHg (minimum-maximum, 0-48 mmHg) for Group II. This difference was statistically significant (t-test, p < 0.00076). The pressure measured in Group II was similar to the base pressure before opening of the intramedullary canal (mean 35 mmHg; minimum-maximum, 4-72 mmHg). In both groups higher pressures were found for opening of the canal, drilling with the smallest drill size and rasping. CONCLUSION: Using the hollow prosthesis, the intramedullary pressure could be reduced significantly. The higher pressures during preparation of the femoral canal need further research.

Adult↗

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[Assurance and proof of satisfactory and complete information].

To prevent unjustified blame and claims enforced by patients, is necessary to prove evidence of an indisputable and complete preoperative information. With the help of our developed software it takes little effort to satisfy the given demands.

Female↗

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[Surgical treatment possibilities in aseptic and septic loosening of endoprostheses of the hip].

There is a permanent increase of replacement of endoprosthesis of the hip. The improvement of operation procedure and the application of spongious bone make it possible to reconstruct extreme defects of bone tissue of acetabulum and femur. The bacterial infection of the supporting tissue is the most serious complication in endoprosthesis. Even in early diagnosis and consequent therapy the infection often is not curable until endoprosthesis is removed. The resulting condition, which is similar to that seen after Girdlestone's operation, will mostly ensure an improved functional capacity of the hip joint.

Acetabulum↗

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[Peculiarities of physical therapy treatment of the aged].

Physiotherapy in aged patients has to take into consideration the reduction of stress tolerance, of adaptability and of the willingness to performance. But also in aged peoples kinesiotherapy makes a better coordination of movement, makes the energy requirement less and makes the movement economical.

Aged↗

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[Spondylitis in the aged].

The spondylitis of the old patient is often late recognizable because of superposition with senile degeneration. The treatment is conform to the classical rules of musculoskeletal infections, after securing the diagnosis. The high risk of immobilisation in the age can be reduced by the operative therapy, but on the other hand must be an acceptance of the operative risk. Last named is very small, if the team is good acquainted with his work, accordingly short length of operation-time and without big histological lesions.

Aged↗

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[Periarthropathia humeroscapularis].

Degeneration of the rotator cuff causes the painful periarthritis humeroscapularis. Especially the supraspinatus tendon is afflicted. 90-95% of patients with acute affection of supraspinatus tendon get free from symptoms with conservative treatment. Impingement syndrome of the rotator cuff will also get free from symptoms with conservative treatment. When the symptoms persist in spite of treatment, the operative enlargement of the acromiocoracoidal passage is indicated. Periarticular soft tissue calcification often becomes painful during spontaneous absorption of calcium deposits. Conservative treatment is in the foreground.

Aged↗

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[Rupture of the rotator cuff in the elderly].

Rupture of rotator cuff in the elderly people is mostly degenerative. Due to the rupture, function of the arm may be disturbed up to pseudo-paralysis. Apart from the functional disturbances the patient is suffering from tormenting nightly pain. The therapy for the elderly people will almost always be a conservative one. Apart from symptomatic measures, physical therapy to prevent a frozen shoulder is essential. With old age operational indication should be particularly restrictive and only where conservative treatment has failed so far.

Aged↗

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[Special aspects of myopathies in children].

Explore the source record for details and available documents.

Adolescent↗