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Biomedical subjects

Kwong-Yuen Chiu

Publications and source records attributed to Kwong-Yuen Chiu.

3 recordsLinked to original sources

Hip arthroplasty for failed internal fixation of intertrochanteric fractures.

Nineteen patients who had hip arthroplasties for complications of internal fixation of intertrochanteric fractures were reviewed. There were 6 males and 13 females. The mean age was 64.1 years (range, 21-87 years) at the time of the fracture. The average interval from fracture to arthroplasty was 40.3 months (range, 2-288 months). The prosthesis types included 16 total hip arthroplasties and 3 bipolar hip arthroplasties. A standard femoral stem was used in every patient, and although the stem length did not extend well beyond the most distal screw holes, there was no stress fracture. Complications such as intraoperative fracture of the greater trochanter and postoperative dislocation were common. The Harris Hip Score significantly improved from 38.4 points before the conversion to 79.8 points after an average follow-up of 7.4 years (range, 2-18 years). There was no revision for mechanical failure.

Arthroplasty, Replacement, Hip↗

Acetabular revision without cement.

We reviewed the clinical and radiologic results of 47 cementless acetabular revisions performed by a single surgeon. The mean follow-up period was 58 months. The American Academy of Orthopaedic Surgeons (AAOS) acetabular defect classification was type I in 4 hips, type II in 9 hips, and type III in 32 hips. All patients received AML (Depuy, Warsaw, IN) Duraloc cup implants. Morcellized allograft was used in 23 hips (49%), and screw augmentation in 22 hips (47%). The Harris Hip score improved from 72 to 90 points. No revisions were performed for aseptic loosening. Nonprogressive thin radiolucent lines were found in a single zone in 10 hips (21%) and in all 3 zones in 5 hips (11%). No migration was found in any cups with radiolucent lines, and the presence of a radiolucent line was considered clinically unimportant. Progressive loosening with migration of the cup was found in 1 hip (2%). Kaplan-Meier survivorship using revision for aseptic loosening or radiologic loosening as end points was 92% at 72 months. No statistically significant difference was found in the survival of the cups fixed with or without screws. These encouraging midterm results confirm the role of cementless acetabular revision.

Acetabulum↗

Patellar clunk syndrome after posterior stabilized total knee arthroplasty.

Two hundred thirty-six posterior stabilized total knee arthroplasties (TKAs) were performed consecutively. Twenty-seven patellar clunk syndromes were identified in 25 patients. Insall-Salvati ratio, position of joint line, postoperative patellar height, and anterior-posterior position of tibial tray were measured. It was found that postoperative low-lying patella (P<.001) and anterior placement of tibial tray (P=.011) was associated with patellar clunk syndrome. Thirteen patients had bilateral TKAs of the same prosthesis (5 bilateral AMK knees and 8 bilateral Insall Burstein knees) but unilateral patellar clunk syndrome. The nonclunk sides were used as control for comparison with the clunk sides. The congruency and tilting of the patellar button in the skyline view were documented. It was observed that the congruency of the patellar button was less satisfactory in the clunk side (P=.019).

Aged↗