Biomedical subjects
L Spotorno
Publications and source records attributed to L Spotorno.
The CLS system. Theoretical concept and results.
The CLS femoral prosthesis is a titanium stem designed as a 3-dimensional taper for press-fit implantation. The distal part of the prosthesis is intentionally made small so that it will not fill the intramedullary canal in the proximal diaphysis. The surface is bead blasted and has no bone ingrowth surface. Ribs in the proximal part of the prosthesis are designed to minimize rotational migration. The CLS acetabular component is a 6-sided expanding cup intended for implant with press-fit stabilization. This article emphasizes indications for use of the CLS, and it includes a brief report on clinical and radiographical results. Data from a review of the first 300 CLS stems implanted from 1983 to 1985 with an 82-month average follow-up suggested that neither bone ingrowth nor distal fit and fill are necessary for stable secondary fixation of an uncemented stem.
[Personal experiences with uncemented prostheses].
Experience with different types of non-cemented total hip endoprostheses is critically discussed. Three radiological criteria of a good result indicated: the presence of radiolucent lines, cancellous transformation, and a particular appearance and thickness of the cortex. The radiological changes and clinical results make it possible to draw a 'survival curve' for each type of implant. This series shows that unsatisfactory results have been due mostly to primary diaphyseal, distal fixation of the prosthetic stem. The CLS prosthesis, with mainly metaphyseal primary anchorage, is presented. Discussion of the radiologically and histologically established response of bone.
[Bone scintigraphy in choosing the therapy for the postoperative hip prosthesis patient with persistent pain].
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[On a case of hyperparathyroidism due to an adenoma with initial skeletal manifestations].
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First implant acetabular components: historical aspects, a comparison of models and a review of the literature.
The article describes the features of the most commonly-used acetabular components in first implants in light of development in construction as regards intrinsic features, materials used, biological behavior, and design. The following versions are examined: screwable cone-shaped trunk, cemented polyethylene, cemented metal-back, HA-coated press-fit, expansion, dysplastic hip, and anti-dislocating components. The screwable cone-shaped trunk acetabular component takes hold in the acetabular bone through torsion and compression, and threading provides greater stability as compared to equivalent models that have wings or screws. Cemented polyethylene acetabular components are characterized by low costs and good results, on the condition that some specific parameters are respected (the presence of a dry bone bed, pressurization of the cement, use in elderly patients who do very little physical activity). Cemented metal-back acetabular components have features similar to polyethylene components, from which they differ because of the possibility of being able to substitute the internal polyethylene component without having to revision the entire acetabulum. HA-coated press-fit components have solved the problems encountered in cemented versions, such as loosening and the generation of polyethylene particulate, at the same time obtaining excellent osteo-integration. The expansion cup self-stabilizes thanks to a memory effect due to the contraction-relaxation mechanism with which it is lodged, adapting to the micro-movements of the acetabulum. Components used in the dysplastic hip are particular versions with a reduced diameter that have specific hooks that provide stabilization, capable of settling in the pathologic bone with minimum reaming of the same. Anti-dislocation cups are special models that have bipolar inserts or a ring (plastic or metal) that blocks the head in the prosthetic acetabulum, obstructing its dislocation.