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Biomedical subjects

R P Veth

Publications and source records attributed to R P Veth.

At least 91 records · Page 5Linked to original sources
PubMed1989

Megaprostheses in the treatment of primary malignant and metastatic tumors in the hip region.

Twenty patients with malignant bone tumors of the hip region were treated surgically by resection and reconstruction with an endoprosthesis. Histologic types included five primary bone tumors and 15 metastatic lesions. At review four primary bone tumor patients are still alive without evidence of disease. The length of the observation period varied from 26 to 104 months. Eleven patients with metastatic bone disease died. The average postsurgical survival time was 23 months. All patients were able to walk with or without a cane. Failure of an endoprosthesis occurred in one case. According to the Enneking Evaluation System 11 patients had a good and 9 a fair result.

Adolescent↗
PubMed1989

Bilateral total hip and knee replacement in rheumatoid arthritis patients.

Between 1978 and 1983, 14 patients suffering from rheumatoid arthritis were treated by bilateral total hip and knee replacement. At the time of this follow-up study (32-92 months postoperatively) one patient had died of concomitant disease and was excluded. The postoperative results regarding pain relief, improvement in performing daily activities, and function were studied in the remaining 13 patients. A 200-point rating scale was used, which compared the pre- and postoperative findings at follow-up. All patients showed marked relief from pain, good function and a good functional score. Although walking ability did not always improve, all patients were enthusiastic.

Activities of Daily Living↗
PubMed1989

Design of a load cell for the Wagner distractor.

A leg length inequality can be treated by using a Wagner distractor. With this apparatus, it is possible to extend the upper or lower leg slowly. By analysing the measurements of the axial force acting on the femur or tibia the treatment can be optimized and soft tissue damage prevented. To measure the axial force, a load cell has been designed and constructed. This load cell is built into a Wagner distractor and connected with a specially designed measuring amplifier. The load cell and amplifier do not interfere with the lengthening procedure. They are safe for the patient and have an acceptable error of 7 per cent. So far, some test measurements were performed on two patients in the Rummelsberg Hospital in West Germany. The load cell proved to function in a clinical situation.

Adolescent↗
PubMed1989

Design of a lengthening element for a modular femur endoprosthetic system.

A malignant tumour may develop around the knee joint of a child. In the majority of cases it will then be necessary to resect the involved bone with adjacent tissue. A joint team of Groningen University Hospital and University of Twente is currently working on the project of developing a modular endoprosthetic system to bridge the defect resulting from the resection. Since the other, normal, leg continues to grow, the endoprosthetic system will have to include an element the length of which can be adjusted non-invasively. The main conditions to be met by the lengthening element are non-invasive continuous adjustability and a maximum total lengthening of 114 mm. This was achieved by using an external magnetic field. Animal experiments showed that the lengthening element worked well, although moisture infiltrated the telescopic tubes and the lengthening element was covered by proliferating bone at an early stage. Also, the necessary magnetic field proved to be larger than calculated. In a revised design, these problems are resolved. In vitro tests show that the new lengthening element meets all requirements.

Animals↗
PubMed1989

Magnetic resonance imaging (MRI) in evaluating in vivo response to neoadjuvant chemotherapy for osteosarcomas of the extremities.

Limb-saving procedures for patients with osteosarcomas of the extremities are based on the anatomical localization and extent of the tumor. The effectiveness of neoadjuvant chemotherapy, high-dose methotrexate (HD MTX), was prospectively analyzed in patients using magnetic resonance imaging (MRI) and histologic evaluation of bone biopsies. Evaluation of in vivo response to neoadjuvant chemotherapy for osteosarcomas with MRI is a method which seems promising in predicting the histologic tumor reaction.

Adolescent↗
PubMed1986

Eriksson-Ellison reconstructions. The results of a combined intra- and extra-articular procedure for anterolateral instability and a lesion of the anterior cruciate ligament.

A rupture of the anterior cruciate ligament will give rise to the signs and symptoms of anterolateral instability after secondary insufficiency of the lateral capsule and the iliotibial tract have developed. Untreated knee instability predispose to meniscal lesions, chondromalacia, and osteoarthritis of the knee. Other reasons for reconstruction are the patient's wish to return the knee to near-normal function and rejection of life-long utilization of a brace. A combination of an intra-articular Eriksson-Drez procedure and an extra-articular Ellison procedure was carried out in 27 patients with anterolateral instability. Follow-up evaluations were performed, with an average follow-up of 4 years and 5 months. The subjective and objective results are encouraging and similar to those obtained with other combined techniques.

Adult↗
PubMed1986

Experimental meniscal lesions reconstructed with a carbon fiber-polyurethane-poly(L-lactide) graft.

Reconstructive procedures were investigated in meniscal lesions in 14 dogs. Large wedge-shaped lesions were repaired with a graft containing carbon fibers and an organic polymer, prepared from physical mixtures of poly(L-lactide) and a segmented polyurethane. Four and eight weeks postoperation, arthroscopy was performed and the implants were excised. In ten dogs, the reconstructed area appeared to be invaded almost completely by fibrous tissue and, occasionally, by repair-simulating hyaline cartilage. There were no signs of infection.

Animals↗
PubMed1985

The treatment of primary tumors of the femur with chemotherapy (if indicated), resection and reconstruction with an endoprosthesis.

The treatment protocol of 15 patients with a primary tumor of the femur, including osteosarcoma, malignant fibrous histiocytoma and chondrosarcoma is presented. All patients had been selected for resection and reconstruction with an endoprosthesis. An endoprosthesis was implanted in 12 patients. The results of this type of treatment appear to be satisfactory. In eight osteosarcoma cases resection and reconstruction with an endoprosthesis combined with preoperative and postoperative chemotherapy, according to Rosen, were performed. Follow-up in all 15 patients, varying from 1.4 to 6.0 years, showed no evidence of disease in 12 patients. Three patients had died. Function of the involved leg was satisfactory in most cases. The advantage and disadvantages of the use of an endoprosthesis are discussed as well as complications in this series of patients.

Adolescent↗
PubMed1985

Van Buchem's disease and aneurysmal bone cyst. A case history.

A patient suffering from Van Buchem's disease combined with an aneurysmal bone cyst in the para-acetabular region is described. The extreme rarity of both the primary disease and its combination with an aneurysmal bone cyst is discussed with respect to the clinical, radiological, and laboratory features.

Acetabulum↗
PubMed1985

Clinical significance of knee joint changes after meniscectomy.

The incidence of Fairbank's radiologic knee joint changes after unilateral meniscectomy was investigated in 180 patients. All patients who had a fracture, cartilage disorders, and/or ligamentous instability at the time of operation or suffered from identical lesions during the follow-up period were excluded. The degree of Fairbank's changes, squaring and sclerosis of the tibial and femoral chondylar articular surfaces, was compared with the postoperative results. The assessment of the results was based on the patient's history. An unsatisfactory postoperative result appeared to coincide more often with Fairbank's changes, but no relation could be demonstrated between the degree of Fairbank's changes and the postoperative result. Fairbank's changes were observed in 77 (42.8%) of the patients. No relation could be demonstrated between the length of the follow-up period and the degree of Fairbank's changes.

Adolescent↗
PubMed1984

Epiphyseal fractures in children treated for osteosarcoma of the femur with chemotherapy, tumourresection, and endoprosthesis: report of four fractures in two children.

This paper reports on two patients, who both were under treatment for osteosarcoma of the femur. Treatment consisted of chemotherapy, resection of the tumour, and reconstruction with an endoprosthesis . Both patients sustained an epiphyseal fracture on two occasions after a minor trauma. Careful observations of the x-rays, including tomography, reveals that a metaphyseal anomaly could be the cause of these fractures. It is suggested that these metaphyseal changes are caused by chemotherapeutic agents. All fractures healed well after a conservative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Dislocation of an artificial knee component due to extraordinary function.

A rare complication, namely dislocation of a knee component without fracture of the prosthesis and not caused by a trauma, is described in a patient who was treated for osteosarcoma of the femur. Probably the dislocation, which occurred 2 years postoperatively, was caused by an extraordinary function of this prosthesis. A partial revision of the prosthesis was performed. The newly designed knee component, which prevents dislocation, is described.

Child↗
PubMed1984

A pertrochanteric fracture in an adolescent treated for an osteogenic sarcoma of the shaft of the femur with chemotherapy, tumour resection and endoprosthesis.

Osteosarcomas of the femur are treated nowadays, if possible, by chemotherapy, resection of the tumor and reconstruction with an endoprosthesis. There is not only a risk of epiphyseal fractures in the long bones due to chemotherapy but also of a fracture in the remnant of the treated femur. These fractures should be treated conservatively because of the risk of infection and non-union if treated operatively.

Adolescent↗
PubMed1984

The abnormal proximal tibiofibular joint.

Abnormalities of the proximal tibiofibular joint are infrequently encountered. Mostly instability occurs as a result of trauma. Four types of instability are distinguished: subluxation, anterolateral, posteromedial and superior dislocation. Four radiological methods designed to visualize abnormalities of the proximal tibiofibular joint are discussed. Special notice is given to the clinical relevance of a new method. Instability was demonstrated in 19 patients; 16 of these were treated by an operation. History, data obtained by physical examination and ways of treatment are discussed.

Female↗