INTRODUCTION: The operative treatment of arthritis in congenital dysplastic hips (CDH) with an autologous femoral head graft is a well established technique in total joint arthroplasty. This prospective study introduces a new operative technique in which the fixation of the autologous bone graft is achieved through the threaded Zweymueller cup solely. Early results are presented. METHOD: 34 patients, (average age of 53.2 years, 24 to 74 years) with CDH had a total joint arthroplasty in combination with a femoral head autograft between 1995 and 1997 (32 patients in study). The fixation of the bone graft was achieved with screws or with a press-fit technique through the threaded cup. The results are described with an average of 2 years. RESULTS: The patients were followed prospectively for an average of 2 years. The Harris hip score increased from 32 preoperatively (range 14-61) to 82 (range 54 to 91) postoperatively. 30 hips had excellent and good results, one satisfactory and one had an unsatisfactory result. Radiographic evaluation demonstrated no osteolysis, one radiolucency was seen in Zone III of the acetabulum and heterotopic bone formation was observed in 11 of 31 radiographically evaluated hips (Brooker type I: 7, type II: 3 and type III: 1). All bone grafts achieved union, all grafts survived, and all acetabular components survived, but one. There were no complications such as dislocation, infection, nerve palsy, or a thrombo-embolic event observed. CONCLUSION: Fixation of the femoral head autograft in CDH with a threaded cup solely showed no disadvantages over the established fixation technique with screws over a short-term follow-up. A solid stable fixation of the graft with a threaded Zweymueller cup was achieved and resulted in full graft integration without the use of screws.

Acetabulum↗

PubMedDate not supplied

[Six to ten year results of use of the alloclassic hip prosthesis--a multicentre survival analysis].

AIM: This prospective study describes This retrospective multicenter study was undertaken to calculate mid- and long-term survival rates of the cementless Zweymüller/Alloclassic total hip prosthesis. MATERIAL AND METHODS: The rectangular titanium stem and threaded cup have been in use since 1986. The ball head is made of alumina ceramic, the inlay of UHMW polyethylene. Five hospitals in Austria, France and Germany cooperated in the follow-up of 848 patients operated between October 1986 and September 1990 (mean age 62.2 years, 62% women, 38% men, mean patient weight 73.8 kg, body mass index 26.8). 468 patients were followed clinically, 320 patients interviewed on the phone, 29 sent a letter. No information was available concerning the remaining 31 patients. Probabilities of implant survival were estimated with the Kaplan-Meier method. RESULTS: 98 patients (11.5%) had died at a median follow-up time of 81.1 months. The probability of survival at 81.1 months was 98.6% looking at stem and cup. There was no significant association of survival of the prosthesis and patient weight, gender or body mass index. CONCLUSION: Our results are in accordance with previously published data of smaller series using the Zweymüller/Alloclassic( total hip. The survival rate of this cementless rectangular titanium prosthesis for the reported follow-up time compares favorably with contemporary cemented hip prostheses.

Adult↗

PubMedDate not supplied

[Highly malignant telangiectatic osteosarcoma. Long-term follow-up].

The teleangiectatic osteosarcoma is an extremely malignant tumor of the bone with rapid progression and short time of survival. In a 57 y.o. male such a tumor in the right proximal femur was diagnosed. Previously for 13 years a cystic bony lesion was known and followed in consequent intervals radiologically and clinically. There was no change in appearance till all at once malignant change developed. Systemic bone disease as ethiopathogenetic factor (e.g. ostitis deformans Paget) could be excluded. This case demonstrates an uncommon development of a teleangiectatic osteosarcoma out of a radiologically benign bony cyst, consequently followed for 13 years.

Adult↗