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At least 1,549 records · Page 86Linked to original sources
PubMed2003

Spatial component position in total hip arthroplasty. Accuracy and repeatability with a new CT method.

PURPOSE: 3D detection of centerpoints of prosthetic cup and head after total hip arthroplasty (THA) using CT. MATERIAL AND METHODS: Two CT examinations, 10 min apart, were obtained from each of 10 patients after THA. Two independent examiners placed landmarks in images of the prosthetic cup and head. All landmarking was repeated after 1 week. Centerpoints were calculated and compared. RESULTS: Within volumes, all measurements of centerpoints of cup and head fell, with a 95% confidence, within one CT-voxel of any other measurement of the same object. Across two volumes, the mean error of distance between center of cup and prosthetic head was 1.4 mm (SD 0.73). Intra- and interobserver 95% accuracy limit was below 2 mm within and below 3 mm across volumes. No difference between intra- and interobserver measurements occurred. A formula for converting finite sets of point landmarks in the radiolucent tread of the cup to a centerpoint was stable. The percent difference of the landmark distances from a calculated spherical surface was within one CT-voxel. This data was normally distributed and not dependent on observer or trial. CONCLUSION: The true 3D position of the centers of cup and prosthetic head can be detected using CT. Spatial relationship between the components can be analyzed visually and numerically.

Arthroplasty, Replacement, Hip↗
PubMed2003

[Cochlear implants in adults: indications and realizations. Part I: Diagnosis, operation techniques and results].

From the technical point of view, cochlear implant (CI) surgery in adults is a well established procedure. Pre- and postoperative evaluation, surgical approach and rehabilitation programs are standardized, presenting CI as a low risk procedure with rare complications similar to those of middle ear surgery. Modern advanced CI devices offer technical reliability and multiple speech encoding strategies and recently, even small processors which are worn behind the ear. Further technical advances are continuously available, even for implanted patients. Upgrading is usually easy because the outer parts of the implant are exchangeable and software upgrades can be transmitted transcutaneously to the implant. Assuming that medical and rehabilitation requirements are available, there are only very few indications against CI in adults. Candidate patients should therefore be transferred to CI-centres where a decision can be taken depending on presurgical evaluation results.

Adult↗
PubMed2003

Small-vessel stents for intracranial angioplasty: in vitro comparison of different stent designs and sizes by using CT angiography.

BACKGROUND AND PURPOSE: Our purpose was to evaluate whether CT angiography is a suitable alternative to conventional angiography in the evaluation of small-vessel stents for intracranial angioplasty. METHODS: CT angiographic appearances of 23 stents of different designs and sizes (2.0, 3.0, and 4.0 mm) were investigated after they were filled with a solution of 0.9% NaCl or diluted contrast medium. For each stent, artificial lumen narrowing (ALN) was measured, and the difference in the number of pixels with a Hounsfield value below 200 HU between the two filling states, DIFF(HU<200), was calculated to provide an objective indicator of the size of the evaluable stent diameter. RESULTS: With a window width of 1500 HU at a window level of 400 HU, ALN ranged from 66.8% to 97.7% in the group of 2.0-mm stents and from 38.6% to 66.8% in the groups of 3.0- and 4.0-mm stents. For the 2.0-mm stents, DIFF(HU<200) was zero. In the groups of 3.0- and 4.0-mm stents, DIFF(HU<200) ranged from 0.3 to 6.7, corresponding to a diameter of 0.13-3.0 mm, when the pixel size was presupposed to be 0.449 mm. CONCLUSION: CT angiographic evaluation of small-vessel patency after stent placement is considerably impaired by ALN. Stent manufacturers should be aware of potential artifacts caused by their stents during noninvasive diagnostic studies such as CT angiography.

Angioplasty, Balloon↗
PubMed2003

Petrous bone fractures in children: risk of meningitis, and indication for early Cochlear implant?

The case of a 5 year old boy who had a right petrous bone fracture with right CSF otorrhea and deafness is reported. This child presented, three years after the trauma, a right side otitis media, complicated by meningitis and pneumococcal sepsis, which might have as consequence a left side deafness. The bilateral deafness and the early possibility for cochlear ossification made us decide rapidly on a cochlear implant. Benjamin was then operated for a left side cochlear implant 40 days after contracting meningitis. Two months later, this boy was able to understand a speech without lip reading. Current concepts in the management of petrous bone fractures with CSF otorrhea are reviewed in this report. We also discussed prophylactic attitudes to adopt to reduce the risk of post temporal bone fracture meningitis.

Accidental Falls↗
PubMedDate not supplied

Postoperative dressing and management strategies for transtibial amputations: a critical review.

Postamputation management is an important determinant of recovery from amputation. However, consensus on the most effective postoperative management strategies for individuals undergoing transtibial amputation (TTA) is lacking. Dressings can include simple soft gauze dressings, thigh-high rigid cast dressings, shorter removable rigid dressings, and prefabricated pneumatic dressings. Postoperative prosthetic attachments can be added to all but simple soft dressings. These dressings address the need to cleanly cover a fresh surgical wound, but not all postoperative dressings are designed to facilitate the strategic goals of preventing knee contractures, reducing edema, protecting from external trauma, or facilitating early weight bearing. The type of dressing and management strategy often overlap and are certainly interrelated. Current protocols and decisions are based on local practice, skill, and intuition. The current available literature is challenging, and difficulties include variations in healing potential, in comorbidity, in surgical-level selection, in techniques and skill, in experience with postoperative strategies, and with poorly defined outcome criteria. This paper reviews the published literature and compares measures of safety, efficacy, and clinical outcomes of the various techniques. Analysis of 10 controlled studies supported only 4 of the 14 claims cited in uncontrolled, descriptive studies.

Amputation, Surgical↗