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M I Gusso

Publications and source records attributed to M I Gusso.

22 records · Page 2Linked to original sources

Indications and limits of hybrid hip prostheses (cementless acetabulum and cemented stem).

The authors report the indications and short-term results obtained in a series of 99 total hip prostheses with a screwed acetabulum and cemented stem. The principles which inspired their choice and the criteria used to select patients are discussed. The results obtained, evaluated both clinically and radiographically, are satisfactory, particularly with regards to percentage of pain symptoms in the femur.

Acetabulum↗

Ganz reinforcement rings in acetabular revision: indications and medium-term results.

Metal reinforcement rings, systems used widely in the past for prosthetic revision surgery, are still effective, in that they allow us to restore the correct hip rotation center and protect the bone grafts used to increase acetabular bone stock. To provide a better definition of the current indications for use of reinforcement rings in acetabular revisions we conducted a retrospective study in a group of 25 patients in whom a Ganz reinforcement ring was used in association with autoclaved cancellous bone grafts. The Ganz ring is made of titanium and it has a lower hook that contributes to the mechanical stability of the implant. Mean age of patients was 72.5 years. Pre-revision acetabular bone defects were divided according to the Paprosky classification system: type 2A: 2 cases; type 2B: 6 cases; type 2C: 6 cases; type 3: 6 cases; type 3B: 5 cases. Clinical and radiographic results were evaluated after a mean follow-up of 4.6 years. Score based on the Harris evaluation form went from a mean preoperative value of 45 points to 92 points after revision. Overall, clinical results were excellent in 9 cases (36%), good in 12 cases (48%), fair in 3 cases (12%), poor in 1 case (4%). Radiographically, we observed a significant reduction (62%) in mean vertical distance of the hip rotation center after revision, that contributed to reduction in hypometria of the limb submitted to surgery, ranging from a mean preoperative value of 2.2 cm to 0.72 cm after surgery. Stability of the implant in time was evaluated based on the Gill criteria. None of the cases required further revision surgery; in 3 cases (12%) with type 3 preoperative defects, the implant was judged to be probably or possibly loosened because of the presence of radiolucent lines.

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The screwed acetabulum in acetabular reimplantations: long-term results.

The authors report the method used and long-term results for 61 acetabular reimplantations involving screwed truncated-conical acetabula and bone grafts. Mean follow-up was 6.3 years. From a clinical point of view the cases classified as excellent were 14 (24.1%), good 26 (44.8%), fair 12 (20.7%), and poor 6 (10.4%). As for radiographic evaluation, the acetabulum appeared to be stable in 37 cases (63.8%), there was fibrous stability in 13 cases (22.4%), the radiographic findings had shown uncertain stability in 5 cases (8.6%), and the acetabulum was unstable in 3 cases (5.2%). Long-term results show that the biological stabilization and, in particular, the implantation of screwed acetabula, when technically correct, may constitute a valid solution in revision surgery for the acetabular component.

Acetabulum↗

The spacer block technique in revision of total knee arthroplasty with septic loosening.

Five cases of septic loosening of total knee arthroplasty were treated by two-stage revision using a cement mixed with antibiotic. The spacer block was responsible for greater mechanical stability of the joint in the interval between the two stages of the operation, and the association of the antibiotic favored resolution of septic complications, allowing at the same time for systemic antibiotic treatment at doses lower than usual. In all of the cases treated reimplantation was performed in conditions of apparent sterility. The minimum amount of time between the first operation and reimplantation was 3 months, maximum was 5 months. Four to 18 months after reimplantation there was no recurrence of infection. Despite the short follow-up, the technique used appears to constitute a valid solution for septic complications in total knee arthroplasty.

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