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Biomedical subjects

I Gualtieri

Publications and source records attributed to I Gualtieri.

At least 19 recordsLinked to original sources

Comparison of cemented ceramic and metal-polyethylene coupling hip prostheses in ankylosing spondylitis.

Two groups of patients suffering from ankylosing spondylitis were treated by total hip arthroplasty. Twenty-one patients (37 hips) were treated with cemented metal-polyethylene prosthesis, whereas 18 patients (36 hips) had cemented ceramic coupling implants. The two groups had similar preoperative clinical data. The average follow-up period was seven to eight years for both. Each patient was graded clinically (pain, function, range of motion, deformities) and roentgenographically (radiolucent lines, etc.). Patients with metal-polyethylene implants showed important modifications of the bone around the implant. Clinical and roentgenographic results were relatively good in patients with ceramic implants. The results underline the importance of the friction coupling of the implant.

Adult↗

Arthroprosthetic reimplantation with bioceramics.

The study analyzes the results obtained in 50 cases of arthroprosthetic substitution surgery performed as a result of "aseptic detachment of the implant"; it involves a consecutive series of operations performed between 1979 and 1983. In all of the cases ceramic-ceramic cemented prostheses were implanted. The results, which were generally satisfactory, confirmed the excellent properties of alumina (low wear, elevated tolerance).

Adult↗

Metal ions in body fluids after arthroplasty.

We measured levels of metal ions in urine and plasma of 17 patients 7-15 years after they had a Co-Cr-Mo alloy total hip replacement. They had higher levels of cobalt and chromium than controls. No case of skin sensitivity to the investigated metals was observed. The values of cobalt and chromium in plasma and urine were considerably lower than in professionally exposed groups and do not represent a toxic hazard for the patients.

Aged↗

The treatment of acetabular fractures.

The results are reported of 52 acetabular fractures treated surgically and followed up for 6 to 16 years. The cases were sufficiently comparable for statistically significant analysis. Satisfactory results were obtained in 34 cases (65%), and poor in 18 (35%). The poor results were due to: epiphyseal necrosis (8%), secondary arthritis (17%), periarticular ossification (9%). The treatment of these poor results is discussed, including the indications for intertrochanteric osteotomy and, in particular, total hip replacement.

Acetabulum↗

Derotation varising osteotomy (in children between 5 and 10 years of age).

The results obtained with derotation varising osteotomy in 108 patients between the ages of five and ten years affected by the sequelae of congenital dislocation of the hip are reported. Fifty-one of these were followed up for periods between three and ten years. In fifteen cases the operation was performed bilaterally. The result was excellent in twenty-four cases, good in thirty, fair in nine and poor in three.

Age Factors↗

A new device ("G3 - IOR") for external fixation.

External fixation is nowadays an essential part of orthopaedic and traumatological surgery, since it offers a method of firm fixation, which can be applied at some distance from the fracture. It is easy to apply and to remove and, most important, there is no direct contact with the fracture site. THe writers present an apparatus of their own design which should eliminate all the disadvantages of the apparatus at present in use, while at the same time being simpler to apply and more effective in action.

Animals↗

Ilizarov external fixation in the treatment of comminuted leg fractures.

Fifty consecutive comminuted leg fractures were treated by Ilizarov external fixation. Eleven were closed fractures, 37 were Grade II, and 2 were Grade III open fractures. Forty-five fractures healed within 6 months. In 5 fractures the Ilizarov device was removed and healing occurred by intramedullary nailing (2 cases) and decortication (3 cases). The causes of failure were: rapid peroneal union or bone fragment necrosis. Subjective tolerance and fracture stability are limited by septic loosening of the wires requiring frame removal after 6 to 8 months. Excellent results may be obtained (no leg length discrepancy, no angulation, no rotation, no joint stiffness), but the time required for union is long and additional surgery is required.

Adolescent↗

Preliminary results in 167 bioceramic cemented arthroplasties with five-year follow-up in patients aged 60 years or over.

A total of 167 ceramic-ceramic cemented arthroplasties with a mean follow-up of 62.5 months were evaluated. There were no signs of loosening in the femoral components. Loosening of the acetabulum was observed in 5 patients. A statistical study conducted on the two groups (the first aged under 70 years, the second aged 70 or over) did not reveal any relationship between failure of the acetabular component and the age of the patient. An evaluation of bone density based on the DXA system in 5 cases of loosening revealed its diminution in relation to follow-up parameters. Based on our experience, implantation of the ceramic-ceramic cemented prosthesis is a reliable choice in patients with good bone trophism, in those where there is a significant reduction in bone density; it is best to use polyethylene-ceramic implants.

Age Factors↗