Zeitschrift für Orthopädie und Unfallchirurgie
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Periprosthetic fractures in cases without prior loosening of the stem can be treated with open reduction and internal fixation, but cases with preexisting loosening and/or bone defects present specific challenges to the surgeon. The keys to the success of intramedullary stabilization of femoral fractures--reconstruction of length, axis and rotation rather than meticulous reduction of the fragments and minimal impact on fragment vascularization by the surgical approach--can be transferred to the treatment of periprosthetic fractures. ⋯ In conclusion, combined application of the principles of intramedullary nailing and of uncemented total hip replacement by use of the distally interlocked Bicontact revision stem enables successful treatment of periprosthetic femoral fractures.
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In a retrospective study, all patients with bilateral cementless Bicontact-Plasmacup total hip arthroplasty in the period May 1993 to June 2000 were followed up clinically and radiologically. ⋯ The results of this study have confirmed the biomechanical concept of the implant system employed. In contrast to the stem design, the cup design and slide bearing options have been supplemented in the meantime. The ceramic bearing was only available from 1997 and was used less often in this group of patients than would be indicated today for patients of the same age and degree of activity.
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The aim of the study was the evaluation of the medium- to long-term results of the cementless Bicontact SD hip arthroplasty, which was designed specially for narrow femoral medullary cavities. ⋯ The clinical and radiological results confirmed the proximal fixation concept in dysplastic femurs and narrow medullary cavities.