Search

Radboud Universiteit Nijmegen, 27 mei 2011, Promotores : Verdonschot, N.J.J., Buma, P. Co-promotores : Schreuder, H.W.B., Waal Malefijt, M.C. de, Contains fulltext : 87168.pdf (publisher's version ) (Open Access)

Contains fulltext : 89732.pdf (publisher's version ) (Closed access)

1 januari 2010, Contains fulltext : 87743.pdf (publisher's version ) (Closed access), Large segmental diaphyseal bone defects can be reconstructed with massive structural allografts, but this technique is associated with high complication rates. Tantalum tabecular metal implants have been successfully used to restore bone defects associated with revision total knee or hip arthroplasties. The aim of this study was to investigate if tantalum cylinders could be used to reconstruct large load bearing segmental diaphyseal bone defects in the presence or absence of a periosteum coverage. Segmental bone defects were reconstructed with tantalum cylinders with or without preservation of the periosteum and stabilized by an intramedullary nail. Radiological analysis was performed postop and at 26 weeks follow-up. New bone was labeled with fluorochromes at 13 and 26 weeks follow-up. Reconstructions were tested mechanically and subsequently investigated histologically. Contra-lateral femurs were used as controls. Clinically all goats returned to normal functional loading after 2 weeks allowing unlimited weight bearing. Radiologically, all tantalum cylinders with periosteum coverage united with the host bone. Reconstructions with cylinders without periosteum coverage lead to radiological nonunion in five out of six cases. The strengths of the reconstruction with and without periosteum preservation were respectively 102.1% and 24.5% compared to controls. In the periosteum covered implants, bone contact was found at all levels of the tantalum cylinder and more and deeper bone ingrowth was found in this group. Tantalum cylinders seem a safe and reliable alternative for a massive cortical graft to reconstruct large diaphyseal bone defects in a goat model if healthy periosteum is present.

Contains fulltext : 81182.pdf (publisher's version ) (Closed access)

Contains fulltext : 80079.pdf (publisher's version ) (Closed access)

Contains fulltext : 81425.pdf (publisher's version ) (Closed access)

Contains fulltext : 49230.pdf (publisher's version ) (Closed access), Thirty-three symptomatic scaphoid non-unions were treated by a simple, minimally invasive procedure using a percutaneous autologous corticocancellous bone graft. After an average follow-up of 3.5 years, union was observed in 29 cases. These patients had no, or mild, pain at work and an almost normal range of motion and grip strength. No progression to osteoarthritis was observed.

Item does not contain fulltext, We used a visual analog scale (VAS) to assess the satisfaction after total knee arthroplasty (TKA) in a group of 108 patients (126 TKAs) with short-term to medium-term follow-up. We also used the Knee Society scoring system, Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC), pain VAS, and survival analysis. A comparison between the subjective and objective outcome systems revealed only poor correlations. This comparison suggests that the concerns and priorities of patients and surgeons differ. The outcome assessed with the satisfaction VAS revealed a significantly better subjective outcome in rheumatoid arthritis patients compared with osteoarthritis patients, whereas Knee Society scores were not different. The satisfaction VAS provides additional information about subjective outcome after TKA.