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P Opdecam

Publications and source records attributed to P Opdecam.

At least 37 records · Page 2Linked to original sources
PubMed1993

Total hip arthroplasty with the porous-coated anatomic (PCA) prosthesis: the femoral component.

This paper reviews the clinical and roentgenographic results of 228 primary non-cemented porous-coated (PCA) total hip replacements after a follow-up time of at least 2 years. The overall clinical results in the current series were satisfactory with at least 84% excellent and good clinical results at 2 years as well as 5 years postoperatively. Although functional results showed no deterioration with time we remain concerned about the high rate of persisting midthigh pain, the progressive loss of bone in the proximal part of the femur and the further loosening of beads from the femoral component's porous coating.

Adult↗
PubMed1993

Total hip arthroplasty with the porous-coated anatomic (PCA) prosthesis: the acetabular component.

Two hundred and twenty-eight uncemented total hip arthroplasties using the porous coated anatomic (PCA) one-piece acetabular component were implanted between June 1984 and July 1987 at two hospitals. The PCA total hip was one of the first hip implants to offer uncemented fixation by bone ingrowth. It was used in the younger patients with adequate bone stock. While most arthroplasties were performed for osteoarthritis, it was also used in rheumatoid arthritis, osteonecrosis and dysplastic hips. Revisions were excluded in this series. Bone grafts (autograft) were used to reconstruct the acetabulum in segmental and contained defects. All components were inserted without cement. In all cases a 32 mm femoral head was used. In cases of protrusion often the deep socket design was inserted for reestablishment of the anatomic hip rotation center. Initial cup stability was aimed for by line to line reaming while rotatory stability was augmented by the presence of two peripheral pegs. A maximum contact with the acetabular rim was always aimed for. A variation of the straight lateral approach was used in all cases. In a prospective study the clinical scores were evaluated. X rays were evaluated on AP and lateral views taken immediately after the operation, at two years and at latest follow-up. Cup migration was recorded when there was a change in cup angle, vertical migration of more than two millimeters. Polyethylene (PE) wear was recorded in case of eccentric localisation of the femoral head in the cup. The relationship between PE wear and cup size was also recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetabulum↗
PubMed1993

Massive resection and prosthetic replacement for the treatment of metastases of the trochanteric and subtrochanteric femoral region bipolar arthroplasty versus total hip arthroplasty.

Twenty-eight metastases of the proximal femur were treated by resection and by prosthetic replacement using a large femoral component with diaphyseal support (megaprosthesis). When metastatic involvement of the acetabulum was not evident a mobile self-centering cup was used (bipolar hip arthroplasty: 17 cases). When metastatic destruction of the acetabulum was evident acetabular reconstruction was performed (total hip arthroplasty: 11 cases). Postoperative pain relief according to Habermann was excellent in 81.5% and good in 14.8% of the patients. The functional results according to Merle d'Aubigné were rated as excellent in 19%, very good in 22%, and good in 22% of the hips. The rate of postoperative dislocation was significantly lower (p < 0.05) in the bipolar arthroplasty group when compared to the total hip arthroplasty group. Our experience indicates that, when bone disease of the acetabulum is not evident, a bipolar arthroplasty rather than a total hip arthroplasty should be recommended. In the current series pain relief as well as postoperative walking ability were comparable in both groups but the dislocation rate was significantly lower with bipolar arthroplasty.

Acetabulum↗
PubMed1993

Evaluation of impending fractures and indications for prophylactic fixation of metastases in long bones. Review of the literature.

This paper reviews the current literature on metastatic lesions most likely to result in a pathologic fracture of a long bone. Prophylactic surgery is recommended in the following situations: Persisting or increasing local pain despite the completion of radiation therapy; permeative involvement; a solitary well-defined lytic lesion greater than 2.5 cm; a solitary well-defined lytic lesion circumferentially involving more than 50% of the cortex; metastatic involvement of the proximal femur associated with a fracture of the lesser trochanter.

Bone Neoplasms↗
PubMed1993

Cemented acetabular reconstruction with the Müller support ring. A minimum five-year clinical and roentgenographic follow-up study.

In a previous study, the results of cemented acetabular reconstruction with a Müller support ring were reported after a mean follow-up period of 40 months. The current report concerns a minimum five-year follow-up study of the same 43 patients. Two early failures at four months and at 17 months were related to poor surgical technique. The latest overall functional results, according to the Merle d'Aubigné rating scale, were excellent, very good, or good in 81.82% of the hips: a drop from 86.67% since the previous report. Sequential roentgenographic analysis demonstrated a high incidence of nonprogressive radiolucencies at the cement-bone interface. These nonprogressive radiolucencies did not correlate with the overall functional results. The progression of a radiolucency at the cement-bone interface, however, or the appearance of radiolucencies around the screw threads, always resulted in clinical failure.

Acetabulum↗
PubMed1992

Surgical treatment of acute type V acromioclavicular injuries. A prospective study.

In a prospective study, 28 consecutive patients with an acute Type V acromioclavicular sprain were treated with a coraco-clavicular repair using a double velour Dacron graft. All patients were reviewed after a mean follow-up period of 5.1 years (range: 1 to 9 years). At follow-up, 20 patients (71.4%) showed good or excellent results, according to the Imatani evaluation system, and 8 patients (28.6%) demonstrated a fair or poor result according to the same system. Loss of reduction was encountered in 11 shoulders (40%), despite an initial anatomical reduction. No correlation was seen between the overall scores at follow-up and the degree of residual dislocation, between the overall scores and the presence of coraco-clavicular calcifications or ossifications, between the overall scores and the development of posttraumatic arthritic changes, or between the overall scores and the presence of osteolysis of the distal clavicle.

Acromioclavicular Joint↗
PubMed1991

External fixation for comminuted intra-articular wrist fractures.

We treated 101 consecutive patients with Frykman type III, IV, VII and VIII fractures of the distal radius and ulna with the small Hoffman external fixator between 1986 and 1989. All patients were reviewed after a mean follow-up period of 22 months (range: 12 to 45 months). At follow-up, 88 wrists (87%) were rated good or excellent, according to the demerit point system, and 13 wrists (13%) were rated fair or poor according to the same system. A highly significant correlation (p less than 0.01) was found between the overall scores at follow-up and the grade of postoperative articular incongruity, between the overall scores and the grade of osteoarthritis at follow-up, between the grade of postoperative articular incongruity and the grade of osteoarthritis at the follow-up, as well as between the overall scores and the grip strength at follow-up. A significant correlation (p less than 0.05) was found between the length of follow-up and the grade of osteoarthritis at follow-up. Although the complication rate was rather high (40%), most of these problems were minor, transient and pin-related.

Adolescent↗
PubMed1991

Meniscal bearing dislocation in the Oxford knee.

The Oxford knee is a unicompartmental knee prosthesis with a polyethylene meniscal bearing. Anterior dislocation or medial subluxation has been described in lateral compartment arthroplasties. The authors present the case of a medial dislocation of the lateral meniscal bearing and a review of the literature concerning meniscal bearing instability in the Oxford Knee.

Female↗
PubMed1991

Osteosarcoma appearing as a pathologic fracture.

Osteosarcoma is the most frequent primary malignant bone tumor. It usually occurs in the second decade of life. Pathologic fracture as the primary manifestation of an osteosarcoma is rather unusual, especially under the age of 10. The authors present the case of a 9-year-old boy with a diaphyso-metaphyseal femoral fracture, in whom the radiological features of an osteosarcoma were not recognized at the time of the fracture as they were not clearly visible, and at follow-up initially were considered as proliferative callus formation.

Child↗
PubMed1989

Malignant schwannoma. A case report and review of the literature.

A rare case of a malignant schwannoma presenting as a central fracture-dislocation of the acetabulum is reported. Histological examination showed a high-grade sarcoma. A pleural metastasis was present. A local reconstructive procedure consisting of local tumor excision with an acetabular prosthetic replacement and adjunctive radiation therapy was elected for the patient, who had a short-term prognosis.

Acetabulum↗
PubMed1989

An unexpected cause of pathologic hip fracture. Malignant fibrous histiocytoma.

We describe a case of a 68-year-old patient presenting with pathological hip fracture and multiple pulmonary metastases, who has been operated without a prior histological diagnosis. The hip lesion was thought to be a metastasis of an unknown primary tumor. The proximal part of the femur was resected and replaced by a Müller mega-prosthesis. Histological analysis of the resected bone revealed a malignant fibrous histiocytoma, a rare but very aggressive bone tumor. The patient died three weeks after operation of widespread metastases. By presenting this case report, we want to stress the importance of pretreatment histological diagnosis of osteolytic bone lesions in older patients with metastases.

Aged↗
PubMed1989

CT arthrography and MRI of the patella.

The importance of CT scanning in the diagnosis of patello-femoral disorders is reviewed and illustrated. CT double-contrast technique is compared to Magnetic Resonance Imaging (MRI) using both clinical examples and a cadaver study. The authors demonstrate the superiority of MRI to CT in detecting retropatellar cartilage lesions.

Adult↗
PubMed1989

Dome osteotomy of the tibia for osteoarthritis of the knee.

Dome osteotomy of the tibia was performed for osteoarthritis of the medial knee compartment in 54 knees (48 patients). All patients were reviewed after a mean follow-up period of 5-7 years (range: 2 to 10 years). At follow-up, 42 knees (78 per cent) were rated good or excellent, according to the Hospital for Special Surgery Knee Service Rating System (H.S.S.). Twelve knees (22 per cent) were rated fair or poor, according to the H.S.S. score. A highly significant correlation (p less than 0.01) was found between the H.S.S. score and the preoperative grade of osteoarthritis, as well as between the H.S.S. score and the grade of preoperative laxity. Immediate postoperative complications occurred in 19 knees (35 per cent), although without significant influence on the final clinical outcome. Revision surgery had to be performed in 6 knees.

Adult↗
PubMed1989

Osteoblastoma of the patella. Case report and review of the literature.

Benign osteoblastoma is a rare tumor; the majority of lesions occur in the spine, femur, and tibia. Osteoblastoma in the patella is so rare that it seems not to have been reported previously in more than one case. A 29-year-old man with a sports injury, who failed to respond to conservative treatment over a prolonged period of time, was later found to have an osteoblastoma of the patella.

Adult↗
PubMed1989

Treatment of unstable intertrochanteric and subtrochanteric fractures in elderly patients. Primary bipolar arthroplasty compared with internal fixation.

Thirty-seven consecutive patients who were more than seventy-five years old and had an unstable intertrochanteric or subtrochanteric fracture were treated by primary bipolar arthroplasty from 1983 through 1986. The functional results, according to the rating scale of Merle d'Aubigné, were rated as good or excellent in 75 per cent of the patients and remained almost unchanged with time. Roentgenographic follow-up showed early bone formation around the extramedullary part of the femoral component. The results in this prospective group of patients were compared with those in a similar but retrospective control group of forty-two patients who were treated by internal fixation from 1979 through 1982 and in whom early full weight-bearing was not possible. In the bipolar arthroplasty group, rehabilitation was easier and faster, and the incidences of pressure sores, pulmonary infection, and atelectasis were significantly lower (p less than 0.05). The early walking with full weight-bearing that the bipolar arthroplasty made possible is considered to be a major contributing factor to these results.

Aged↗