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Prosthetic AND Fracture

Silvio Mario Meloni, Edoardo Baldoni, Marco Duvina, Milena Pisano, Giacomo De Riu, Marco Tallarico
PURPOSE: To compare outcomes of immediate non-occlusal loading with delayed implant loading in the bilateral replacement of mandibular first molars. MATERIALS AND METHODS: This study was designed as a split-mouth, randomised controlled trial. Twenty patients with bilaterally missing mandibular first molars randomly received immediately or conventionally loaded single implants. One molar was restored with a non-occlusal temporary crown within 24 hours after implant placement (immediate loading group, IL) while the contralateral molar was restored with a definitive crown 4 to 5 months later (delayed loading group, DL)...
2018: European Journal of Oral Implantology
Andrew J Grazette, Vikki Wylde, Samantha Dixon, Sarah L Whitehouse, Ashley W Blom, Michael R Whitehouse
BACKGROUND: There is a paucity of long-term data concerning the pre- and postoperative patient reported function of total knee replacement. The aim of this study was to determine the mortality, implant survivorship, patient reported function and satisfaction in a cohort of 114 patients, from a single centre, who received a Kinemax total knee replacement more than 15 years ago. METHODS: Patients completed a questionnaire incorporating validated disease- and joint-specific scores, patient satisfaction and overall health preoperatively, at three months, one year, two years and a minimum of 15 years following surgery...
October 25, 2018: Knee
Greg Aj Robertson, Alexander M Wood
This editorial reviews and summarises the current evidence (meta-analyses and Cochrane reviews) relating to the use of hip hemi-arthroplasty for neck of femur fractures. Regarding the optimal surgical approach, two recent meta-analyses have found that posterior approaches are associated with: higher rates of dislocation compared to lateral and anterior approaches; and higher rates of re-operation compared to lateral approaches. Posterior approaches should therefore be avoided when performing hip hemi-arthroplasty procedures...
November 18, 2018: World Journal of Orthopedics
Benjamin K Wilke, Matthew T Houdek, Peter S Rose, Franklin H Sim
BACKGROUND: Large bone deficiencies are a challenging problem, historically treated with an allograft-prosthetic composite (APC) or megaprosthesis. There were several advantages of the APC compared with early megaprostheses, including the theoretical benefit of restoring bone stock. To our knowledge, there are no studies that have evaluated this claim. Our purpose was to review our institution's experience with APCs of the proximal femur that underwent revision for an aseptic cause and determine if the allograft bone was retained or removed during the revision procedure...
October 24, 2018: Journal of Arthroplasty
Sam Nahas, Akash Patel, Nicola Blucher, Vikas Vedi
BACKGROUND: Longer term outcome data are now becoming available for short-tapered femoral stems for cementless total hip arthroplasty. The shorter stem has a metaphyseal fit, loading the bone in this area, leading to physiological bone remodelling. It is also bone preserving, as it is 35 mm shorter. It may be easier to insert through a smaller incision and potentially reduce complication rates. We present a retrospective single surgeon case series of 196 patients (>53% follow-up over 5 years)...
May 2018: Journal of Orthopaedic Surgery
Mujahid Jamil Khattak, Umair Ashraf, Zohaib Nawaz, Shahryar Noordin, Masood Umer
Metastatic bony lesions involving proximal femur and hip joint pose a challenge to orthopedic surgeons. Lesions in this important weight-bearing zone of the femur weaken its ability to sustain load causing pain and impending pathologic fracture. These Patients warrant multidisciplinary approach including orthopedic surgeons, oncologist and medical specialties. Management of these lesions has evolved over the last 60 years from benign neglect to internal fixation and recently to prosthetic reconstruction for optimum function...
December 2018: Annals of Medicine and Surgery
Gabriela Fernandes da Fonseca, Guilherme Schmitt de Andrade, Amanda Maria de Oliveira Dal Piva, João Paulo Mendes Tribst, Alexandre Luiz Souto Borges
Background: Carious lesions and dental fractures cause weakening in the dental structure. In these situations, endodontic treatment and prosthetic rehabilitation using an intraradicular post are indicated. However, the postspace preparation of the root canal further weakens the dental remnant, especially if there is no ferrule present. This study aimed to evaluate the stress distribution in endodontically treated upper premolars treated with different rehabilitation approaches. Materials and Methods: An endodontically treated first upper premolar was modeled for finite element analysis...
October 2018: Journal of Indian Prosthodontic Society
Olivier Guyen
The optimal treatment of recent femoral neck fractures remains debated. The available options are internal fixation, hemiarthroplasty (HA) and total hip arthroplasty (THA). There is a consensus in favour of internal fixation in younger patients. In elderly individuals who are institutionalised and have limited physical activity, HA is usually performed when the joint line is intact. Whether HA or THA deserves preference in patients aged 60 years or over is unclear. In addition, there are two types of HA, unipolar and bipolar, and two types of THA, conventional and dual-mobility...
November 15, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Filippo Casella, Fabio Favetti, Gabriele Panegrossi, Matteo Papalia, Francesco Falez
INTRODUCTION: In last three decades, total hip replacement in young patients became an habitual procedure. Principles of bone preservation are pushing many surgeons to implant conservative femoral components in patient younger than 65 years. Despite an overall good survivorship and clinical outcomes of conservative implants, failed cases are reported and the need to revise a conservative femoral component became an occasional procedure (with high prevalence of failed resurfacing implants)...
November 15, 2018: International Orthopaedics
P Jordá-Gómez, I Escribá-Urios, J Castro-Gil, J Aracil Silvestre
INTRODUCTION: Acetabular fractures in elderly patients present a therapeutic challenge, since their osteosynthesis may be hindered by comminution and poor bone quality. In certain cases, a good solution is acute total hip arthroplasty (THA) by direct anterior approach with or without minimal associated osteosynthesis. The objective of this study was to establish the indications and evaluate the clinical/functional, radiological results and complications, in the short and medium term, of acute THA using an anterior approach after acetabular fractures...
November 11, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Alessandro Marinelli, Marco Cavallo, Enrico Guerra, Alice Ritali, Graziano Bettelli, Roberto Rotini
INTRODUCTION: Only few case series of capitellar and trochlear fractures have been reported. Some of them assume that the presence of a posterior comminution (type B according to Dubberley classification) can represent a negative risk factor for treatment and prognosis respect to the type A cases (without posterior comminution). Nevertheless, how this parameter impacts the treatment and the prognosis has never been quantified before. MATERIALS AND METHODS: All the capitellar and trochlear fractures treated from 2007 to 2015 have been retrospectively reviewed...
November 2018: Injury
R Pascarella, P Sangiovanni, S Cerbasi, R Fantasia, O Consonni, V Zottola, A Panella, B Moretti
INTRODUCTION: Acetabulum periprosthetic fractures are rare, but are increasing, due to increase in high-energy trauma and a decrease in mortality index. Reconstruction of an acetabular fracture, in the presence of hip arthroplasty can be very complex and represents a real challenge for orthopedic surgeon. Aim of this multicentric study is to classify periprosthetic acetabulum fractures and to propose a treatment algorithm. MATERIALS AND METHODS: 24 cases of acetabular periprosthetic fracture were treated surgically from 01...
November 2018: Injury
Carlos D Novoa, Mustafa Citak, Akos Zahar, Roxana E López, Thorsten Gehrke, José L Rodrigo
BACKGROUND: Modular hip arthroplasty is widely recognized in hip surgery; nevertheless, despite advances in prosthetic design, the incidence of hip revision surgery is increasing. In these procedures, a modular adapter that engages the femoral stem and the modular femoral head could be useful in order to protect the neck-head junction and restore preoperative biomechanics and soft tissue tension when the femoral or acetabular component should be retained. The Merete™ BioBall™ system (Merete Medical, Berlin, Germany) could fill this need...
December 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Sang-Yun Kim, Yong-Hoon Choi, Young-Kyun Kim
Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included...
December 2018: Maxillofacial Plastic and Reconstructive Surgery
Tarek Q Qasim, Billal M El-Masoud, Ahmed M Abu Laban
Objective: Prosthetic molar crowns in service are subjected to chewing loads, which cause a shift or dislodgment. The objective of this study is to investigate whether the addition of resistance grooves to the proximal surfaces of the abutment teeth would enhance the fracture resistance of the zirconia crowns and to compare between the patterns of cracks development on the zirconia crowns after the application of mono loading versus cyclic loading forces. Materials and Methods: Thirty-six all-ceramic zirconia cored crowns were prepared on the same abutment...
October 2018: European Journal of Dentistry
C D Novoa-Parra, J M Pelayo-de Tomás, S Gómez-Aparicio, R E López-Trabucco, M Morales-Suárez-Varela, J L Rodrigo-Pérez
OBJECTIVE: To evaluate the clinical results and survival of primary hip prosthesis with ceramic delta bearings (C-C) with a minimum follow-up of 5years. MATERIAL AND METHOD: A total of 205 primary hip arthroplasties performed between 2008 and 2012 were studied. The clinical results, pre-surgical and at 5years of follow-up were evaluated using the Harris Hip Score (HHS), the Short Form-36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the visual analogue scale (VAS)...
October 19, 2018: Revista Española de Cirugía Ortopédica y Traumatología
L Rony, R Lancigu, L Hubert
Metal implants are biomaterials widely used in orthopedics. They are both used in osteosynthesis and arthroplasty. Their mechanical properties, biocompatibility and resistance to corrosion make them a widely used option in orthopedics. Alloys are the most commonly used metals in orthopedics. As far as physical traumas are concerned, implants such as screws, plates and/or nails are used for osteosynthesis as they ensure the stability of the fractured area and contribute to bone healing. Prostheses are used in arthroplasty to restore joint function for as long as possible...
October 19, 2018: Morphologie: Bulletin de L'Association des Anatomistes
H Bezstarosti, E M M Van Lieshout, L W Voskamp, K Kortram, W Obremskey, M A McNally, W J Metsemakers, M H J Verhofstad
INTRODUCTION: Standardized guidelines for treatment of fracture-related infection (FRI) are lacking. Worldwide many treatment protocols are used with variable success rates. Awareness on the need of standardized, evidence-based guidelines has increased in recent years. This systematic literature review gives an overview of available diagnostic criteria, classifications, treatment protocols, and related outcome measurements for surgically treated FRI patients. METHODS: A comprehensive search was performed in all scientific literature since 1990...
October 20, 2018: Archives of Orthopaedic and Trauma Surgery
Jens Nestorson, Hans Rahme, Lars Adolfsson
BACKGROUND: Primary prosthetic replacement has become an accepted method for the treatment of complex distal humeral fractures. The present study investigated implant survival and adverse events related to this procedure based on available Swedish registries and examined the completeness of the Swedish Elbow Arthroplasty register. MATERIALS AND METHODS: Patients treated in Sweden with a primary elbow replacement due to a distal humeral fracture between 1999 and 2014 were identified through 3 different registries: The Swedish Elbow Arthroplasty Register, National Board of Health and Welfare inpatient register, and local registries of all orthopedic departments...
October 17, 2018: Journal of Shoulder and Elbow Surgery
Vesna Jurukovska-Shotarovska, Biljana Kapusevska, Biljana Evrosimovska
BACKGROUND: Prefabricated zirconium upgrading systems were examined to satisfy aesthetic needs in endodontically treated teeth. Endodontically treated teeth, together with non-metallic posts and superstructure, are substructures that enable the production of prosthetic structures that will allow aesthetics, resulting from normal light transmission. To investigate and analyse the retention of zirconium post systems cemented with RelyX Unicem 2 Automix (RLX) cement with Pull-out test. AIM: To examine the retention of zirconium post systems, cemented with Multi-Link Automix (MLA) cement and RelyX Unicem 2 Automix (RLX) cement with Pull-out test...
September 25, 2018: Open Access Macedonian Journal of Medical Sciences
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