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Biomedical subjects

S C Kozinn

Publications and source records attributed to S C Kozinn.

6 recordsLinked to original sources
PubMed1989

Unicompartmental knee arthroplasty. A 4.5-6-year follow-up study with a metal-backed tibial component.

The results in the first 50 patients to receive an improved-design unicompartmental knee prosthesis were reviewed after an average follow-up period of 5.5 years. The prosthesis is composed of a metal-backed polyethylene tibial component and a wide femoral surface replacement that are fixed to bone with acrylic cement. Forty-five patients with 55 unicompartmental knee arthroplasties were available for clinical study. Ninety-two percent of the knees were rated as having a good or excellent result, and 94% had lasting relief of pain. There have been no failures requiring revision. A radiographic review demonstrated that no tibial component was bordered by a complete radiolucent line. There was no subsidence or loosening of either the tibial or femoral components, and there was no instance of local osteolysis. These results, coupled with a 14-year follow-up experience with the original-design unicondylar prosthesis, encourages the authors to remain advocates of this procedure in selected patients with unicompartmental osteoarthritis.

Aged↗
PubMed1989

Simplified extraction of broken femoral stems. A brief technical note.

A simple and inexpensive technique for extracting the retained distal portion of broken femoral stems is described. After removing the loose prosthetic head fragment and surrounding cement, needle-nosed pliers are used to grab the edges of the exposed distal stem. A vise-grip locking wrench is then applied tightly to the pliers to allow axial extraction with mallet blows.

Hip Prosthesis↗
PubMed1988

Surgical treatment of unicompartmental degenerative arthritis of the knee.

The number of patients with unicompartmental osteoarthritis is increasing with the average age of our population. Good surgical techniques are available to improve pain and increase motion in the knee with degenerative disease. It is important to make early accurate diagnoses in arthritic patients so that the least surgically ablative procedure can be performed that will maximally benefit each patient. Total knee replacement is an extremely effective operation for relieving pain, but its major drawback is the large amount of bone stock that must be sacrificed during the procedure. Unicondylar knee replacement has proven itself to be an excellent alternative to total knee replacement in more limited arthritic disease. High tibial osteotomy still plays a major role as treatment for unicompartmental arthritis in younger and more active patients. McKeever interpositional hemiarthroplasty is an alternative in young patients when osteotomy is contraindicated. Arthroscopy is playing an increasing role in both diagnosis and treatment of unicompartmental osteoarthritis. The decision to perform unicompartmental arthroplasty, osteotomy, or total knee replacement is made on an individual basis. The extent of cartilage degeneration in the knee as well as the age, weight, and activity demands of the patient help to guide that decision.

Arthroscopy↗
PubMed1986

The biologic interface between bone and cementless femoral endoprostheses.

Femoral canal membrane tissue from patients who had revision of an uncemented endoprosthesis to a total hip replacement was analyzed and interlocking bone specimens were retrieved from implant fenestrations to compare membrane histology with microscopic bony remodelling. Radiographs of each hip were evaluated for bony adaptations and correlated with implant stability and interface histology. Uncemented canal membranes are composed mostly of mildly cellular dense connective tissue. Significant inflammation is rare, even in the presence of moderate metallic debris. A fibrocartilage interface often occurs above interlocking bone in areas subject to direct compressive loads. A thin membrane helps to distribute loads evenly from the rigid implant to more compliant bone. Dense lines of bone around the implant stem may be a biologic response indicating a steady-state, load-sharing equilibrium; they are not a reliable sign of implant instability. Retrieved interface membranes allow a direct view of the prosthetic-bone junction of human joint implants. In the absence of polyethylene and methacrylate wear debris, the membrane contains quiescent fibrous tissue with little inflammation. Membrane formation appears to be a mechanical adaptation to improve load distribution in the proximal femur. Presence and function of the membrane must be considered in the design and application of future press-fit implants.

Adaptation, Physiological↗