• Title/Summary/Keyword: orthopaedic implants

Search Result 38, Processing Time 0.025 seconds

Cervical Open-Door Laminoplasty by Hydroxyapatite Implant Insertion Without Suturing

  • Kawanabe, Yoshifumi;Fujimoto, Motoaki;Sato, Tsukasa
    • Neurospine
    • /
    • v.15 no.4
    • /
    • pp.362-367
    • /
    • 2018
  • Objective: To assess the efficacy of cervical open-door laminoplasty by hydroxyapatite implant insertion between the lamina and the lateral mass without suturing. Methods: All patients who underwent cervical open-door laminoplasty with C2/C7 undermining and insertion of hydroxyapatite implants from C3 to C6 were retrospectively evaluated for surgical time and neurological outcomes according to the Japanese Orthopaedic Association (JOA) score. To assess the alignment of the cervical spine and postoperative cervical pain, the C2-7 angle and a visual analogue scale score were used, respectively. Results: The population consisted of 102 women and 222 men ranging in age from 32 to 90 years. The average surgical time was 86 minutes. Fourteen of 1,296 hydroxyapatite implants were kept in place with sutures due to a weak restoration force of the hinge during surgery. No hydroxyapatite implant dislocation was detected on cervical computed tomography at 1 year after surgery. The average JOA score was $10.2{\pm}2.5$ before surgery and $14.6{\pm}2.8$ at 1 year after surgery. The average recovery rate was 61.8%. The average C2-7 angle at the neutral position was $7.1^{\circ}{\pm}6.2^{\circ}$ before surgery and $6.5^{\circ}{\pm}6.3^{\circ}$ at 1 year after surgery. Conclusion: This method enabled us to achieve minimal exposure of the lateral mass, prevention of lateral mass injury and dural injury, and a shorter surgical time while maintaining acceptable surgical outcomes. The idea that firm suture fixation is needed to prevent spacer deviation during cervical open-door laminoplasty may need to be revisited.

Coronoid view: A New Radiograph for the Evaluation of the Coronoid Fractures (Coronoid view: 구상돌기 골절을 평가하는 새로운 방사선 촬영법)

  • Song, Joo-Hyoun;Lee, Joo-Yup;Yang, Sung-Cheol;Lee, Han-Yong;Kim, Jong-Ik
    • Clinics in Shoulder and Elbow
    • /
    • v.10 no.2
    • /
    • pp.199-203
    • /
    • 2007
  • Purpose: It is very important to evaluate and fix coronoid process fractures because they are a critical element for a stable, effective elbow function. The lateral view of the elbow joint is used for a radiographic evaluation of the coronoid but an understanding of the fracture pattern is often difficult because of overlap of the radial head and obliquity of the fracture line. We developed the coronoid view, which is a new radiograph for an evaluation of the coronoid process fracture, and discuss its advantages for a postoperative follow-up. Materials and Methods: The coronoid view was designed for an evaluation of the anteromedial fragment of the coronoid process. After the patient sat on his side, the shoulder was abducted $45^{\circ}$ and the elbow was flexed $90^{\circ}$. The X-ray beam was shot perpendicular to the table. Since shoulder was abducted $45^{\circ}$ the fracture line of the coronoid process can be parallel to the X-ray beam, and the radial head can be cleared. Conclusion: The coronoid view can be a good alternative radiograph for an evaluation of a coronoid process fracture because the beam is parallel to the fracture line. The coronoid view can be particularly useful in postoperative patient follow-up where computed tomography is impractical due to metal implants and cost.

Effect of Surface Modification by Heat Treatment of Co-Cr Alloy (Co-Cr alloy의 열처리에 따른 표면개질의 영향)

  • Park, J.M.;Kim, W.C.
    • Journal of the Korean Society for Heat Treatment
    • /
    • v.23 no.3
    • /
    • pp.137-141
    • /
    • 2010
  • The Co-Cr alloys have clinical histories in dental and orthopaedic implants, and recently in cardiovascular stent applications because the alloys exhibit a high elastic modulus and radiopacity. In order to improve mechanical property of the Co-Cr alloys, electropolishing is employed as the final process. Electropolishing, an anodic dissolution process in the transpassive state, is sensitively affected by process conditions such as current density, machining time, electrode gap. In this study, the effect of heat treatment conditions on surface roughness and inclusion analysis is investigated in Co-Cr alloy (L605). The most smooth surface of Co-Cr alloy is obtained when electropolishing is performed at 15-20 V for 15-30 sec with a electrode gap of 3.5 mm.

Effect of Electropolishing Process on Corrosion Resistance of Co-Cr Alloy (Co-Cr alloy의 전해연마에 따른 부식의 영향)

  • Park, Je-Min;Kim, Wan-Cheol
    • Journal of the Korean institute of surface engineering
    • /
    • v.43 no.4
    • /
    • pp.199-204
    • /
    • 2010
  • The Co-Cr alloys have clinical histories as dental and orthopaedic implants, and recently as cardiovascular stent applications because they exhibit a high elastic modulus and radiopacity. In order to improve their mechanical and corrosion resistance, electropolishing is employed as the final process. Electropolishing, an anodic dissolution process in the transpassive state, is sensitively affected by process conditions such as current density, machining time, and electrode gap. In this study, the effect of the electropolishing conditions on surface roughness and corrosion resistance is investigated for Co-Cr alloys (L605). The most smooth surface is obtained when electropolishing is performed at 15-20 V for 15-30 sec with a electrode gap of 3.5 mm. It is found out that electropolishing reduces corrosion rate about one-tenth as much.

Treatment of Malunion (부정유합의 치료)

  • Kim, Joon-Woo;Park, Kyeong-Hyeon;Oh, Chang-Wug
    • Journal of the Korean Orthopaedic Association
    • /
    • v.56 no.2
    • /
    • pp.117-124
    • /
    • 2021
  • Although current surgical techniques have reduced the incidence of malunion, it is still observed because of the complexity of the fracture or associated injuries. Osteotomy is needed when the amount of malunion is expected to result in an overload of cartilage and instability of the joint. Preoperative planning is essential when performing an osteotomy for malunion. Inadequate planning can result in serious complications, such as iatrogenic malalignment, intraoperative fracture, postoperative recurrence of deformity, or soft tissue injuries. In addition, a poor functional result can occur secondary to poor patient selection. This review article includes the surgical indications and planning to correct malunion. Various methods of corrective osteotomy are described according to the kinds of plane and fixation implants.

Biomechanics of Hip and Hip Replacement Arthroplasty (고관절 및 인공 고관절의 생역학)

  • Lee, Young-Kyun;Choi, Ji Hye;Won, Heejae;Koo, Kyung-Hoi
    • Journal of the Korean Orthopaedic Association
    • /
    • v.54 no.5
    • /
    • pp.377-383
    • /
    • 2019
  • The biomechanics study of the hip is aims to understand and explore the dynamic principles of weight transfer through the hip joint. This basic science knowledge can be applied in a variety of areas, including degenerative joint diseases and hip replacement arthroplasty. In particular, understanding of the biomechanics of the hip has led to the development of materials, design and fixation of implants, and it can be applied in various areas, such as the selection of surgical methods and the location of the implant. Moreover, it is essential to have good knowledge of the biomechanics of the hip to achieve better clinical results for patients. Therefore, this paper introduces the basic knowledge and biomechanical characteristics of a normal hip and hip replacement arthroplasty, which are needed to approach the biomechanics of the hip.

A modified trans-anconeus approach to facilitate fixation of a posterior radial head fracture: a cadaveric feasibility study

  • Ahmed Mohamed Desouky;Ahmed Naeem Atiyya;Mohamed Elbishbishi;Marwa Mohamed El Sawy
    • Anatomy and Cell Biology
    • /
    • v.56 no.1
    • /
    • pp.39-45
    • /
    • 2023
  • Fixation of radial head fracture with minimally invasive posterior approach remains a significant challenge. The aim of this study was to determine the feasibility of trans-anconeus posterior elbow approach and to observe lateral ulnar collateral ligament (LUCL) in extended elbows. This cadaveric study was performed in twenty upper limbs of fresh fixed adult male cadavers. An oblique incision was made in the middle segment of anconeus until the lateral ligament complex and the joint capsule had been revealed. A deep dissection was explored to observe the anatomical relationship of the LUCL to the anconeus. Measurements of the LUCL were recorded while the elbow was fully extended. The mean distance between the edge of the radial head and the proximal insertion of the LUCL was 13.3 mm (11.5-16.2 mm); the mean distance between the edge of the radial head and the distal insertion of the LUCL was 20.9 mm (19.2-23.4 mm); the distance between the edge of the radial head and the distal edge of the annular ligament was 11.2 mm (8.22-11.7 mm). By estimate correlation of the previous measurements, the direct and accessible way to expose the posterolateral articular capsule of the elbow joint was through a window in medial 2/3 of the middle segment of anconeus muscle. These trans-anconeus approach is useful. It provides good visualization, facilitates applying the implants, and lessens the risk of radial nerve injury. Awareness of the anatomy is mandatory to avoid injury of LUCL.

Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.8 no.1
    • /
    • pp.1-11
    • /
    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

  • PDF

Study of Bio-absorbability and Bio-compatibility of Poly-L-lactic-acid Implant in Dogs (개에서 Poly-L-lactic-acid 이식물의 생분해성과 생체적합성에 관한 연구)

  • Park, Po-Young;Kim, Young-Ki;Bahk, Jong-Yoon;Park, Joung-Man;Koh, Phil-Ok;Chang, Hong-Hee;Lee, Hee-Chun;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
    • /
    • v.24 no.2
    • /
    • pp.182-191
    • /
    • 2007
  • Bioabsorbable devices have been utilized and experimented in many aspects of orthopaedic surgery. Depending upon their constituent polymers, these materials can be tailored to provide sufficient rigidity to allow bone healing, retain mechanical strength for certain period of time, and then eventually begin to undergo degradation. The objective of this study was to estimate extent in which Poly-L-latic acid (PLLA) implants had bioabsorbability and biocompatibility with bone and soft tissue in dogs and also to develop bioabsorbable, biocompatible materials with the appropriate strength and degradation characteristics to allow for regular clinical use for treating orthopedic problems in humans as well as animals. Eighteen dogs were used as experimental animals and were inserted two types of PLLA implants. PLLA rods were inserted into subcutaneous tissue of back or the abdomen wall. And the rods were tested for material properties including viscosity, molecular weight, melting point, melting temperature, crystallinity, flexural strength, and flexural modulus over time. PLLA screws were inserted through cortical bone into bone marrow in the femur of the dogs and stainless steel screw was inserted in the same femur. Radiographs were taken after surgery to observe locations of screw. Histological variations including cortical bone response, muscular response, bone marrow response were analyzed over the time for 62weeks. The physical properties of PLLA rods had delicate balances between mechanical, thermal and viscoelastic factors. PLLA screws did not induce any harmful effects and clinical complications on bone and soft tissue for degradation period. These results suggest that PLLA implants could be suitable for clinical use.

Functional and Radiological Results of Intermediate-term Follow Up in $MUTARS^{(R)}$ Tumor Endoprostheses ($MUTARS^{(R)}$ 종양 대치물을 이용한 사지 구제술의 기능적 및 방사선학적 중기 추시 결과)

  • Kang, Dong-Joon;Kim, Jeung-Il;Oh, Jong-Seok;Moon, Tae-Yong;Lee, In-Sook
    • The Journal of the Korean bone and joint tumor society
    • /
    • v.17 no.1
    • /
    • pp.36-43
    • /
    • 2011
  • Purpose: This study was designed to verify intermediate-term functional and radiological results of limb salvage operation using endoprosthetic replacement system ($MUTARS^{(R)}$) used in patients with a malignant bone tumor. Materials and Methods: Thirty one cases which used $MUTARS^{(R)}$ tumor prosthesis were reviewed. The mean age of the patients was 49.2 years and the mean follow up was 39.8 months. We retrospectively reviewed complications, and evaluated functionally and radiologically by Enneking functional score, ISOLS radiological implants evaluation system at last follow-up. Results: 3 patients had died of disease, distant metastasis was seen in 4 patients and local recurrence was seen in 1 patients. Complications were developed in 12 patients. (infection 6, leg length discrepancy 2, aseptic loosening 2, periprosthetic femoral fracture 1, screw loosening 1) Mean value of total functional scores were 81.2% in proximal femur, 77.4% in distal femur, 78.1% in proximal tibia, and 80.2% in proximal humerus. The overall radiological result was relatively satisfactory. Conclusion: Our results suggest limb salvage with the $MUTARS^{(R)}$ endoprosthesis is successful with good functional and radiological results. But we should be careful with complications such as infection.