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Biomedical subjects

R S Ling

Publications and source records attributed to R S Ling.

At least 19 recordsLinked to original sources
PubMed1993

Impacted cancellous allografts and cement for revision total hip arthroplasty.

We report the results of using impacted cancellous allografts and cement for fixation of the femoral component when revision arthroplasty is required in the face of lost bone stock. In 56 hips reviewed after 18 to 49 months there were few complications and a majority of satisfactory results with evidence of incorporation of the graft. Further study and review are necessary, but the use of the method appears to be justified.

Aged↗
PubMed1993

Histology of cancellous impaction grafting in the femur. A case report.

We report the histology of a femur retrieved 3.5 years after a cemented revision of a hip replacement in which impaction allografting had been used to fill two large cortical defects. The allograft chips had largely been replaced by viable cortical bone, and the interface between cement and tissue resembled that seen after primary cemented arthroplasty.

Bone Regeneration↗
PubMed1992

The Exeter bipolar prosthesis in the active elderly patient: the results at 7 years.

Seventy one Exeter bipolar hemiarthroplasties were reviewed after a mean follow up of 3.2 years (range 1-7 years). Patients with displaced subcapital fractures were selected for operation on the basis of good mobility before the fracture. The operation was well tolerated and the mortality at 1 month and 6 months was 3.7% and 6.5% respectively. Using a newly devised hip scoring system 89% had a good or excellent result and 94% had no or only occasional pain. There was no radiological evidence of acetabular erosion.

Aged↗
PubMed1992

A venous foot pump reduces thrombosis after total hip replacement.

In a prospective, randomised controlled trial, the efficacy of the A-V Impulse System in the prevention of deep-vein thrombosis was investigated in 84 patients who had undergone total hip replacement. The incidence of venographically proven, and clinically significant postoperative deep-vein thrombosis was 40% in the control group and 5% in the treatment group (p less than 0.001). No adverse reactions were recorded.

Assisted Circulation↗
PubMed1992

The use of a collar and precoating on cemented femoral stems is unnecessary and detrimental.

Evidence is presented, largely from clinical sources, that a large collar is not necessary for the transfer of load to the proximal femur in cemented total hip arthroplasty. In fact, the use of a collar may have a number of deleterious side effects that cannot be predicted from theoretical analyses. Concern is also raised over the use of precoated femoral stems.

Arthroplasty↗
PubMed1990

Reduction of post-traumatic swelling and compartment pressure by impulse compression of the foot.

Following the discovery of a powerful venous pump in the foot that is activated by weight-bearing independently of muscular action, a pneumatic impulse device was developed to actuate this pump artificially. In a multicentre international trial the device was shown to reduce post-traumatic and postoperative swelling; pain also was alleviated. Evidence is also presented that dangerously high compartment pressures may be reduced to acceptable levels and fasciotomy avoided. We present an explanation of the clinical effects of activation of the venous footpump, based on recent improved understanding of the physiology of the microcirculation. The hyperaemic response that follows the liberation of endothelial-derived relaxing factor (EDRF) by sudden changes of pressure after weight-bearing or impulse compression is particularly important.

Adolescent↗
PubMed1990

Localised endosteal bone lysis in relation to the femoral components of cemented total hip arthroplasties.

Four cases are described of localised endosteal bone lysis in the femur occurring in association with cemented femoral components that were not obviously 'loose' radiologically. In each, the area of lysis was shown at operation to be related directly to a region in which there was a local defect in the cement mantle surrounding the stem. Via the space between the stem and cement, such defects provide a route through which the contents of the joint cavity may reach the endosteal surface of the femur, subsequently leading to localised bone lysis, and later to frank loosening.

Aged↗
PubMed1988

Experience with the Exeter total hip replacement since 1970.

The satisfactory long-term radiographic appearances with the use of the collarless, smooth, polished, tapered stem encourage its continued use. With the same stem geometry shortly to become available with interchangeable heads, the capacity for the surgeon to change the bearings when polythene wear starts to become marked should address what certainly will emerge as one of the major long-term problems of total hip arthroplasty.

Adult↗
PubMed1987

Cementing technique and the effects of bleeding.

We report the results of simple laboratory experiments which showed that bleeding pressures known to occur at the bone surface during total hip arthroplasty may compromise the integrity of the bone-cement interface and the cement itself. Such undesirable effects can be prevented by maintaining adequate pressure on the cement until its increased viscosity can resist displacement caused by the bleeding pressure.

Blood Pressure↗
PubMed1986

Observations on the fixation of implants to the bony skeleton.

This paper summarizes the now considerable evidence to support the suggestion that the structure of the junctional tissues that separate any skeletal implant from the bone is substantially dependent on mechanical factors, given that the implant itself if basically nonreactive.

Animals↗
PubMed1985

Acetabular bone destruction related to non-steroidal anti-inflammatory drugs.

In a retrospective investigation of the relation between use of non-steroidal anti-inflammatory drugs (NSAIDs) and acetabular destruction in primary osteoarthritis of the hip, 70 hips were studied in 64 patients. Cranial acetabular migration, a measure of acetabular destruction, was present in 37 hips and absent in 33. Migrators and non-migrators did not differ in age, sex, hip pain score, walking ability score, femoral neck-shaft angle, or distribution of atrophic and hypertrophic types of osteoarthritis. Regular intake of NSAIDs was noted for 31 of the 37 migrating hips and irregular intake for a further 3. Among the 33 non-migrating hips, the corresponding numbers were 7 and 5, respectively. This highly significant association between NSAID use and acetabular destruction gives cause for concern, not least because of the difficulty in achieving satisfactory hip replacements in patients with severely damaged acetabula.

Acetabulum↗