Biomedical subjects

W J Petersilge

Publications and source records attributed to W J Petersilge.

5 recordsLinked to original sources

PubMed1999

Late deep venous thrombosis and delayed weightbearing after total hip arthroplasty.

One hundred ninety-nine patients who underwent primary total hip arthroplasty and used in hospital pneumatic compression stockings and aspirin as thromboembolic prophylaxis were screened for deep venous thrombosis using duplex ultrasonography on the fourth postoperative day. Of the initial 98 patients, 21 underwent noncemented arthroplasty, maintained touchdown weightbearing for 6 weeks after surgery, and then began progressive partial weightbearing. Of the subsequent 101 patients, 28 underwent noncemented arthroplasty and began progressive weightbearing immediately after surgery. All other patients underwent hybrid arthroplasty and began weightbearing to tolerance immediately after surgery. After duplex screening examination, patients with proximal deep venous thrombosis were given anticoagulation therapy, and patients with negative study results were observed clinically. The relative risk of proximal deep venous thrombosis after noncemented arthroplasty using delayed weightbearing was compared with that after noncemented arthroplasty using immediate progressive weightbearing. Of patients with noncemented arthroplasty, the prevalence of proximal deep venous thrombosis was significantly lower in those using progressive weightbearing immediately after surgery (none) than in those using delayed weightbearing rehabilitation (19%). This study showed that patients undergoing noncemented total hip arthroplasty with delayed weightbearing rehabilitation risk greater potential for deep venous thrombosis after hospital discharge. This study suggests consideration for continued thromboembolic prophylaxis or routine deep venous thrombosis surveillance, or both measures, after hospital discharge, unless more rapid progression of weightbearing is allowed.

Anticoagulants↗

PubMed1998

100 cemented versus 100 noncemented stems with comparison of 25 matched pairs.

Two series of 100 consecutive primary total hip arthroplasties, each using a single design of noncemented or cemented femoral component (all 28 mm heads), were compared. One cemented and two noncemented stems underwent revision for aseptic loosening. Of unrevised hips, outcome data statistically favored cemented, rather than noncemented, stems. The data for cemented and noncemented stems, respectively, were: An excellent to good result in 97% versus 88%; thigh pain in 3% versus 40%; subsidence in 0% versus 22%; and endosteal cavitation in 6% versus 12%. For patients with 25 unrevised matched pairs, selected by gender, age, diagnosis, and weight, outcome data also statistically favored cemented over noncemented stems, respectively: an excellent or good result in 25 versus 20 hips; thigh pain in two versus eight hips; and subsidence in none versus six hips. Midterm followup data for these concurrent total hip arthroplasty series of a mid 1980s design revealed prevalence of mechanical failure of 1% for cemented stems and 4% for noncemented stems. Corroborating matched pair comparison neutralized selection bias as a causative factor for these differences. These data indicate contemporary cemented femoral stem fixation is superior to second generation noncemented femoral stem fixation. Controlled comparative studies at midterm to long term followup, such as in this report, are needed to define outcome and indications for current third generation noncemented stem fixation.

Adult↗

PubMed1997

Prospective study of 100 consecutive Harris-Galante porous total hip arthroplasties. 4- to 8-year follow-up study.

This prospective study evaluates 100 consecutive Harris-Galante Porous (Zimmer, Warsaw, IN) noncemented femoral prostheses 4 to 8 years after surgery. Two femoral components were revised for aseptic loosening. The mean Harris hip score was 56 before surgery and 92 at final follow-up evaluation, with moderate thigh pain seen in 6%. Ingrowth was classified as bony (89%), stable fibrous (8%), and unstable (3%). A pedestal formed in 18%, measurable subsidence occurred in 22%, and endosteal erosion occurred in 12%. Patients with pedestal formation had a higher incidence of unstable growth pattern (P < .05). Patients with bony ingrowth had a lower mean subsidence (0.38 mm) than those with fibrous stable ingrowth (3 mm) and unstable ingrowth (7.5 mm) (P < .05). Thigh pain correlated with the type of ingrowth, and endosteal erosion with the linear polyethylene wear. Survival analysis was 97.5% at 8 years.

Adult↗

PubMed1996

Acetabular labral tears: evaluation with MR arthrography.

PURPOSE: To determine the usefulness of magnetic resonance (MR) arthrography in the diagnosis of acetabular labral tears. MATERIALS AND METHODS: MR arthrography of the hip was performed in 10 patients who underwent subsequent surgical evaluation. Eight arthrograms were obtained with intraarticular administration of gadolinium solution and two with intraarticular administration of normal saline. T1-weighted spin-echo (intraarticular gadolinium) or T2-weighted gradient-echo (intraarticular normal saline) images were obtained in the axial, sagittal, and coronal planes with use of a surface coil. Criteria for labral tears included labral blunting, absence, displacement, intrasubstance contrast material, and contrast material at the acetabular-labral junction. Labra with enlargement, intrasubstance intermediate signal intensity, or irregular margins were interpreted as degenerative. RESULTS: Labral tears were diagnosed in eight hips. Tears included six labra with contrast material that tracked at the acetabular-labral junction, one of which had associated intrasubstance extension. One tear was confined to the labral substance. The other tear exhibited absent labral tissue and an irregular remnant. One degenerative labrum and one normal labrum were identified. All MR arthrographic findings were confirmed at surgery. Extension of one anterosuperior tear into the posterosuperior labrum was not prospectively appreciated. CONCLUSION: In this preliminary study, MR arthrography appears to be a promising imaging modality for accurate diagnosis of acetabular labral tears.

Acetabulum↗

PubMed1994

The effect of trochlear design on patellofemoral shear and compressive forces in total knee arthroplasty.

Biomechanical testing was performed on 5 cadaveric knees to evaluate the effect of patellofemoral design on shear and compressive force at the patellar component-bone interface. Three patellofemoral designs with identical tibiofemoral articular surfaces were tested. The knees were tested under dynamic loading conditions from 0 degree to 100 degrees flexion. A transducer that measured 3 orthogonal force components was mounted between the patellar component and the patella. The combination of an oval dome patella with a 2-mm deeper trochlear groove and associated increased femoral resection was compared with a biconcave patella with standard trochlea and normal femoral resection. Alignment of the trochlear groove in 7 degrees valgus (anatomic) decreased medial-lateral shear by 10% to symmetric trochlear groove alignment.

Biomechanical Phenomena↗