1,720,982 research outputs found
Lo stelo ad ancoraggio meta-diafisario
No full textCD relativo alla tecnica chirurgica della artroprotesi d'anc
Arthroplasty in Congenital Posterior iliac hip dislocation: personal experience and clinical review
No full text
Navigazione TC guidata nella protesizzazione dell’anca
No full textAim. With this study we describe our personal experience with computed tomography (CT)-guided navigation in hip replacement. Navigation is done with a computer system that orientates the surgeon during the operation by providing a continuous visual flow of three dimensional anatomic and numeric data. Methods. Since 2001, this technique has been employed in total hip replacement in 60 patients. All patients underwent postoperative CT; the real accuracy of the CT-guided technique versus the conventional procedure in positioning the cup prosthesis was compared (mean error, 3.9°, range, 0-8°). Controls were 95 total hip replacement patients evaluated by postoperative CT (mean error 6°, range, 0-23°). Results. CT-guided navigation improved the accuracy of cup prosthesis placement, as demonstrated by case-control studies conducted at our institution. Conclusion. Although the use of CT-guided navigation achieved greater accuracy in placement of the acetabular cup, whether or not the technique is clinically effective still needs to be corroborated by long-term data and in comparison with the optimum results surgical techniques can achieve without the auxiliary use of navigation
Protesi di superficie (resurfacing). Dall’esperienza del passato, il presente, le prospettive future
No full textSurface hip prostheses are not a novelty. The use of glass surface prostheses (Smith-Petersen) began in the 1940s; a new generation of surface prostheses was introduced in the 1970s. International experiences all shared a common rationale: to spar the proximal femoral epiphysis. However, the outcomes were less than promising because of failure due to the then employed materials and fabrication techniques. Past lessons, analysis of previous case series and new materials and techniques helped provide the needed improvement in the quality of the devices in the late 1990s. Last generation surface prostheses are hybrid devices (non cemented acetabular cup and cemented femoral lining), with a metal-to-metal coupling and optimal fabrication. Initial results from sufficiently large case series hold promise. Following the reasonable results our team achieved with the Wagner prosthesis during the 1980s, and considering the technical advances in last generation devices, we decided to reintroduce surface prostheses. To minimize impairment of circulation of the femoral head, we modified our standard surgical approach (lateral direct) by adding periacetabular capsulotomy. In this way, we combined the advantages of the Wagner approach (preservation of epiphysial circulation) and those of the lateral direct approach (less invasive technique and better functional recovery). Currently, surface prosthesis advocates are seriously working on such key issues as how to place the femoral component, what type of cement to use, which surgical approach and which indications to follow. A lively debate now surrounds the prospects for surface prostheses
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