This prospective study reports the clinical and radiological results of a single-surgeon series using the Mayo conservative hip stem in a district hospital. 30 total hip arthroplasties were performed in 26 physically active patients. There were 18 women and 8 men, with a mean age of 57.4 years (range 36-79). 4 cases were bilateral. The operation was performed for severe primary or secondary osteoarthritis of the hip .Duration of follow-up ranged from 67-87 months (mean 81 months). There were no early complications relating to the surgical procedure. There was one case of traumatic fracture of the femur during rehabilitation,while late complications included two cases of late infection (4 months and 16 months after surgery)both revised in two-stage procedures. There was considerable improvement in Merle d'Aubignescore following surgery. There were no revisions for aseptic loosening, but we identified 2 implants with significant radiolucent lines and subsidence six years after the index operation. Neither patient experienced pain in the hip or restriction of activity. Therefore, the aseptic loosening survival rate was 100%(end point = revision operation). Taking radiological loosening as the end point survivorship was 93.3%.The use of the Mayo short stem component in active patients may preserve bone and enable subsequent revision operations to proceed using primary implants. Our results suggest that conservative designs of this type may be of benefit in selected individuals.
The Columbus knee system is designed as a standard knee implant to allow high flexion without additional bone resection. Between August, 2004 and March, 2010 we performed 109 total knee arthroplasties of the Columbus knee system in 101 consecutive patients suffering from primary arthrosis of the knee. Mean age was 72.4 years in women and 70.3 years in men. Mean followup was 47.3 months. The 4-year results of a group of patients who received the NexGen Full Flex implant operated by the same surgeon were used for comparison. Mean total knee score was Columbus: 175.6 and NexGen Flex: 183.4; P = 0.037. Mean operation time was 53 min for Columbus and 66 min for NexGen Flex; P < 0.001. With new streamlined instruments operative time became 60 min for the Columbus; P > 0.05. Radiological assessment showed no signs of loosening for both groups. Therefore, the Columbus knee system can be recommended for flexion angles up to 140°.
In the sport of golf, there is no standard teaching method or swing technique even though golf is known for overuse injuries. This prospective study was to analyze classic swing kinematics in comparison with the Free-Release ® method and to define a physiological golf swing. Two hundred eighty-three players, age 50–59 years, were included in the study. For both swing techniques, examination addressed swing visualization, center of pressure (COP), center of mass (COM), as well as pelvic movement in relationship to different standing widths. The position of the spine was evaluated in the frontal and lateral planes. Using the classic technique, no golfer was able to describe his swing parameters, which would be necessary for visualization and to tolerate physiological range of movement, whereas players using the Free-Release method ® were able to provide such a description. COP and COM showed pathological swing mechanics for the classic technique, whereas for the Free-Release method mechanics were physiological. We conclude that to prevent lumbar spine injury, the classic swinging technique, which is characterized by lateral shear forces, static and dynamic pelvic side bending while rotating with high force against the spine, and an unbalanced COM and COP, should be substituted by the Free-Release technique as a new physiological guideline.
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