Stuttgart Mühlhausen, Germany
Stuttgart Mühlhausen, Germany

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Horstmann T.,Medical Park Bad Wiessee St. Hubertus | Horstmann T.,TU Munich | Listringhaus R.,St Anna Hospital | Haase G.-B.,Center for Orthopedics and Traumatology | And 4 more authors.
Clinical Biomechanics | Year: 2013

Background Appropriate gait function is an important determinant of the outcome of total hip arthroplasty and relies on appropriate joint motion and muscle activity. The purpose of this study was to test the hypothesis that 6-month postoperative dynamic joint range of motion, time-distance measures and muscle activity in the operated limb in patients undergoing total hip arthroplasty differ from preoperative levels and are more similar to those observed postoperatively in the contralateral limb and in healthy subjects. Methods Basic time-distance gait measurements, knee and hip kinematics and electromyographic activity from eight hip muscles were obtained preoperatively and 6 months postoperatively in 52 patients undergoing total hip arthroplasty and in 24 age-matched healthy subjects during treadmill walking. Findings Postoperative dynamic hip range of motion for the operated limb (confidence interval differences [- 3.9; - 2.3 ]) and postoperative knee range of motion for both limbs (operated: [- 8.4; - 5.6 ]; contralateral: [- 8.1; - 5.3 ]) in patients with total hip arthroplasty were significantly lower than values for the control subjects (P < 0.001). Postoperative gait in patients with total hip arthroplasty was more symmetric than preoperative gait. Preoperative and postoperative electromyographic intensities were higher in patients with total hip arthroplasty than values for the control subjects (P < 0.001), and patients had different EMG patterns compared to the control group. Interpretation Pre- and postoperative differences not only in hip but also in knee kinematics emphasize the importance of evaluating the dynamic outcome of total hip arthroplasty by assessing joint motion of all lower extremity joints in both legs. © 2013 Elsevier Ltd.

Ferraris S.,Polytechnic University of Turin | Miola M.,Polytechnic University of Turin | Bistolfi A.,University of Turin | Fucale G.,Center for Orthopedics and Traumatology | And 3 more authors.
Journal of Applied Biomaterials and Biomechanics | Year: 2010

Purpose: The purpose of this study is the evaluation of the differences and, eventually, of the advantages or disadvantages of manual formulations with respect to industrial ones. Methods: Medical-grade bone cements (Palacos R® and Palacos LV®), based on poly-methyl methacrylate (PMMA) and used clinically in several cemented prosthetic devices were manually enriched with gentamicin sulphate during preparation and then compared with a commercially-available, antibiotic-loaded cement (Palacos R+G®) by means of an in vitro antibacterial test (inhibition zone evaluation). The purpose of this study was to evaluate the differences and advantages or disadvantages, if any, of manual formulations compared to commercial ones. The use of a different antibiotic (vancomycin) alone or in addition to gentamicin-containing bone cements was also considered. Results and conclusion: The commercial formulation produces an inhibition zone that is a bit larger and more regular than the manually mixed preparation. The vancomycin halo is smaller but clearer than the gentamicin halo. The addition of vancomycin to gentamicin-containing bone cements does not significantly increase the halo dimensions but could be an interesting strategy in the prevention of multiple and resistant infections. © 2010 © Società Italiana Biomateriali.

PubMed | Center for Orthopedics and Traumatology
Type: Journal Article | Journal: Journal of spinal disorders & techniques | Year: 2010

An innovative function preserving technique for the treatment of odontoid nonunion via ventral cancellous bone augmentation of the dens is described. A retrospective clinical study of 17 patients, thus treated by this technique is reported.Assessment of a new method, which preserves the rotational mobility of the C1/C2 joint.Nonunion after odontoid fractures are usually treated by posterior fusion of C1/C2. Although there are reports of good clinical results, restriction of rotational mobility is inevitable.Seventeen patients with dens pseudarthrosis or delayed healing were operated on between the year 1991 and 2005. A hole was drilled in the dens and packed with autologous bone graft. Temporary Instrumentation C1/C2 (anteriorly or posteriorly) was performed for 3 to 4 months. Patients were evaluated clinically and radiographically, rotation computed tomography or magnetic resonance imaging studies were conducted.Fifteen patients were available for follow-up. Nine patients demonstrated healing of the pseudarthrosis with preservation of C1/C2 joint mobility (confirmed by rotation-computed tomgraphy or rotation -magnetic resonance imaging in 7 cases, average segmental rotation 37.3 degrees). Four patients showed persistent pseudarthrosis (2 were fused by posterior C1/C2 fixation) and 2 patients demonstrated spontaneous C1-C2 fusion.Ventral cancellous bone augmentation of the dens and temporary instrumentation C1/C2 is a function-preserving option in the treatment of dens pseudarthrosis.

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