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We followed up 10-14 years postoperatively the 106 ceramic cups type 'Lindenhof' that were implanted in the years 1978-1982. In that time, only 7 (6.6%) cups had to be changed due to aseptic loosening. Examination of 73 (68.9%) cups showed that only 4% of the patients were dissatisfied. Using the score of Merle d'Aubigne, we found 89% good and very good results. The high number of cup migrations reported by other authors could not be verified: we saw 35% in all. Most of them appeared in the early postoperative period, stabilized themselves and were not accompanied by pain. Our 10-year survival rate for this ceramic cup is 92%, including the septic changing of arthroplasties.

In our clinical the GSB-prosthesis has proved to be a good therapeutic concept. In 1988 we controlled 230 patients who had got GSB-prostheses in the years 1979-1987. The average age of our patients was 75 years. Most times surgery had been done because of idiopathic osteoarthrosis, rarely because of post-traumatic or rheumatoid arthritis. Indications for surgery were usually severe pain, limited range of movement and deformities of the knee joint. In the beginning of the studied period we had implanted GSB-type I-prostheses, later we had implanted GSB-type II-prostheses with or without femoropatellar surface. We achieved good results in pain reduction and in range of movement. However the major complications were caused by the patella. These patients had problems at climbing stairs, pain at the beginning of movements and at getting up from chairs. They presented with increased pain sensitivity at the tip of the patella and to friction of the patella. Regular radiological findings were severe destructions or fractures of the upper patellar pole. These problems led in 40 cases (17% of our cases) to reoperations until 1988 (At all we reoperated 50 times because some patients needed additional reoperations). According to our studies results there will be a need for reoperations in about 50 other cases. We discuss the following reasons for this high rate of severe patellar complications demanding re-surgery: 1. Localisation of the patella: according to our studies the patella is frequently dranged cranially, seldom laterally. 2. Often we found an internal rotation of the tibia against the femur.(ABSTRACT TRUNCATED AT 250 WORDS)

Background Negative pressure wound therapy (NPWT) is an alternative to the standard gauze dressings for wound treatment. Due to limited health resources, poor electrical supply, and high costs, NPWT in resource‐constrained settings is inaccessible. In conflict‐affected settings, civilian injuries typically involve traumatic wounds or chronic wound infections that affect the extremities. Methods PragmaVAC® is a manually operated NPWT device designed to increase accessibility to NPWT without the need of electrical power. We aimed to determine the clinical efficacy of PragmaVAC through a controlled, non‐blinded open‐label clinical trial in a resource‐constrained locality. The endpoint was formation of granulation tissue sufficient for wound closure. Results Fifty‐nine patients qualified for analysis (19 Gauze; 40 PragmaVAC). The mean age of participants was 49.25 years, 55.9% were male, and 42.4% were diabetic. Forty three wounds (72.9%) were acute, 44 wounds (74.6%) were clean‐contaminated, and 34 wounds (57.6%) were localized to the lower limb. The average duration of treatment was 15.3 days in PragmaVAC vs 36.5 days in control, p = 0.013. Similarly, PragmaVAC required fewer number of dressing changes 2.7 vs 23.2 times, p < 0.0001, at a lower frequency of dressings 0.22/day vs 0.73/day, in the control group, p < 0.0001. Conclusions PragmaVAC is associated with accelerated healing and less frequent requirement of dressing changes. The introduction of a manually operated, low‐cost device in resource‐constrained settings presents an opportunity to improve wound care outcomes, decrease interventions, and optimize usage of material and human resources.

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