69 research outputs found
Graves’ orbitopathy as a rare disease in Europe: a European Group on Graves’ Orbitopathy (EUGOGO) position statement
Human synovial mast cells. II. Heterogeneity of the pharmacologic effects of antiinflammatory and immunosuppressive drugs.
Problematiche medico-legali nella valutazione risarcitoria/indennitaria del danno alla persona da artroprotesi di ginocchio
Fatta una preliminare sintetica prospettazione dei maggiori fattori di ordine clinico e biomeccanico che informano la protesizzazione di ginocchio, si procede ad un’analisi comparativa dei più autorevoli ed aggiornati barèmes nazionali ed internazionali al fine di estrarne criteriologie e tassi di invalidità che possono valere alla formulazione di una rinnovata proposta valutativa. Da tale analisi emerge da un lato una discreta diversità di impostazione di metodi e parametri considerati, con variabilità del numero e della tipologia di criteri guida su cui è strutturata la stima del danno da artroprotesi di ginocchio e dall’altro una prospettazione di ranges percentuali di danno tra loro solo parzialmente sovrapponibili. Da ciò è parso utile proporre prime riflessioni in tema di elementi minimi da considerare per la valutazione della resa funzionale del dispositivo artroprotesico di ginocchio e, quindi, il tasso di ridotta efficienza fisica della persona, nonché dei tempi medi di recupero negli interventi primari e di revisione
Complete polyethylene wear-through and secondary breakage of the expansion cup in a ceramic-polyethylene total hip arthroplasty
INTRODUCTION: Catastrophic polyethylene failure is an uncommon complication of ceramic-on-polyethylene total hip arthroplasty (THA) because of the favourable tribological characteristics of these implants. We present a case of a 50-year-old woman who formerly underwent bilateral ceramic-on-polyethylene THA with expansion acetabular cups and eleven years later presented with unilateral THA dislocation, secondary to catastrophic polyethylene failure and metal shell fracture. CASE PRESENTATION: The patient came to our hospital for worsening pain in her left hip and an acute incapacity to bear weight on her left lower limb. Twelve and eleven years earlier she had undergone bilateral ceramic-on-polyethylene THA with acetabular expansion components of identical size on both sides. Radiographically, the left femoral head appeared superiorly dislocated and severe polyethylene wear was detected. The inclination angles of the left and right cups were 60 degrees and 44 degrees , respectively. The patient underwent left acetabular revision, and complete polyethylene wear-through with fracture of a cranial lobe of the expansion metal shell was noted at surgery. One large osteolytic lesion in the roof of the acetabulum and diffuse periarticular metallosis were also present. These findings required the use of a Burch-Schneider reinforcement cage. Two years later the patient is functioning well and has full autonomy in her activities of daily living. CONCLUSION: The correct inclination of the acetabular component is necessary to prevent accelerated polyethylene wear in THA, even though favourable articular bearing surfaces have been used (e.g., ceramic-on-polyethylene coupling). Should the cup appear well fixed and fairly oriented on follow-up radiographies, the early detection of severe polyethylene wear may permit a revision of only the femoral head and acetabular liner
[Giant cell tumor of the knee treated with autoplastic graft of the patella. Our experience]
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