During a seven-year period, 63 total hip replacements were performed in osteoarthritis patients; Seven dislocations occurred. Three hips had one dislocation, while the remaining 4 dislocated more than once. Six dislocations were posterior and one, anterior. Open reduction was done in one, revision was required in 4.The angle and the height of the acetabular component of the roentgenograms were not significant between the control group and the dislocated group. The leg length (mean) in the surgery of the dislocated group was 9.5mm longer than that of the control group (p<0.01).
We performed rotational acetabular ostetomy (RAO) on 14 patients. All subjects were women, their ages at surgery ranged from 25 to 52 years, and the follow-up period averaged 4 years. We compared the CE angle and AC angle before and after surgery.All patients showed improvement of both the CE angle and AC angle. The mean CE angle improved from 4.4 degrees to 24.6 degrees (p<0.01), and the mean AC angle from 23.8 degrees to 8.3 degrees (p<0.01). The range of motion (flexion and abduction) did not decrease alter surgery. 1 patient showed progression of the degenerative change by the necrosis of the rotated bone.The clinical results for RAO were not significant compared to early stage OA (11 hips) and advanced OA (4 hips).
The purpose of this study was to evaluate outcome of bilateral total knee arthroplasties (TKA's) in two groups of patients: Group A had simultaneous arthroplasty of both knees, and Group B had staged bilateral arthroplasty.Bilateral (TKA's) were performed in fifteen patients with severe rheumatoid arthritis (4 cases) and osteoarthritis (11 cases). Group A (8 patients) had both knees replaced simultaneously in one operation. Group B (7 patients) had two operation in a staged procedure. The postoperative mobility was analyzed in the two groups of patients who were similar with respect to age, type of arthritis, preoperative range of motion, and postoperative management.In this small series of cases there was a significantly shorter hospitalization period, and cheaper costs in Group A.
For the treatment of calcaneal fractures, evaluation of the posterior articular facet is very important. Intra-articular fracture of the calcaneus can be divided into three groups based on Crosby's classification using CAT. We treated type II and III fractures by open reduction through the lateral approach, and we evaluated clinical results and post-operative congruity of the posterior articular facet of the calcaneus using CAT.There were 11 type II fractures operated on, and no type III fractures. Five patients achieved an excellent result and 6 patients a very good result with minor complaints. The posterior articular facet was reduced anatomically in 9 patients. Two fractures retained their pre-operative congruity.Crosby reported that patients with type II or type III fractures were not satisfied with the results by conservative treatment. We recommend that displacement of the posterior articular facet of the calcaneus be evaluated using CAT and type II fractures be treated surgically, rather than conservatively.
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