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1.  Fixation of the fully hydroxyapatite-coated Corail stem implanted due to femoral neck fracture 
Acta Orthopaedica  2012;83(2):153-158.
Background
Today, dislocated femoral neck fractures are commonly treated with a cemented hip arthroplasty. However, cementing of the femoral component may lead to adverse effects and even death. Uncemented stems may lower these risks and hydroxyapatite (HA) coating may enhance integration, but prosthetic stability and clinical outcome in patients with osteoporotic bone have not been fully explored. We therefore studied fixation and clinical outcome in patients who had had a femoral neck fracture and who had received a fully HA-coated stem prosthesis.
Patients and methods
50 patients with a dislocated femoral neck fracture were operated with the fully HA-coated Corail total or hemiarthroplasty. 38 patients, mean age 81 (70–96) years, were followed for 24 months with conventional radiographs, RSA, DEXA, and for clinical outcome.
Results
31 of the 38 implants moved statistically significantly up to 3 months, mainly distally, mean 2.7 mm (max. 20 mm (SD 4.3)), and rotated into retroversion mean 3.3º (–1.8 to 17) (SD 4.3) and then appeared to stabilize. Distal stem migration was more pronounced if the stem was deemed to be too small. There was no correlation between BMD and stem migration. The migration did not result in any clinically adverse effects.
Interpretation
The fully hydroxyapatite-coated Corail stem migrates during the first 3 months, but clinical outcome appears to be good, without any adverse events.
doi:10.3109/17453674.2011.641107
PMCID: PMC3339529  PMID: 22112154
2.  The Elite-Plus stem migrates more than the flanged Charnley stem 
Acta Orthopaedica  2010;81(3):280-285.
Background and purpose
The Charnley Elite-Plus stem was introduced in 1993 as a presumed improvement of the flanged Charnley stem. We started this study in 1996 to investigate the migratory pattern of the Elite-Plus stem.
Patients and methods
We followed 114 patients with osteoarthritis and a primary total hip replacement with the Elite-Plus stem. Mean age at the time of operation was 64 (50–76) years. The mean follow-up time was 6.5 (2–7) years. Radiographs were evaluated with respect to cementing technique, migration, and wear measured by radiostereometry (RSA).
Results
The stem survival was 98% (CI: 96–100) at 7 years and 92% (CI: 86–97) at 10 years. Mean migration of the femoral head was 0.35 mm (SD 0.3) medially, 0.51 mm (SD 0.6) distally, and 1.1 mm (SD 1.8) in the dorsal direction. Mean total point motion was 1.7 mm (SD 1.7). The migration of the stems stabilized after 5 years in the medial and dorsal directions, but continued to subside slightly. Migration along any of the axes was higher if the cementing technique was inferior.
Interpretation
Patients with a Charnley Elite-Plus stem and defects in the cement mantle or other signs of inferior implantation technique should be carefully monitored.
doi:10.3109/17453674.2010.480937
PMCID: PMC2876827  PMID: 20367422
3.  Comminuted fractures of the radial head 
Acta Orthopaedica  2010;81(2):224-227.
Background There have been few reports on the long-term outcome of comminuted radial head fractures in adults.
Method 10 women and 9 men with a mean age of 45 (21–65) years when they sustained a comminuted fracture of the radial head were re-evaluated after 15–25 years. 6 patients had been nonoperatively (NO) treated while 13 had had a radial head excision. The uninjured elbow served as a control.
Results At follow-up, 11 patients (4 NO patients) rated their fractured elbow as being without deficits, 7 (1 NO) as being slightly impaired, and 1 (NO) as being severely impaired. Range of motion and elbow strength were not impaired, and even though there were more degenerative changes such as cysts, osteophytes, and sclerosis in the injured elbows by radiography, the prevalence of joint space reduction was not higher.
Interpretation Most patients with an isolated comminuted fracture of the radial head treated nonoperatively or with a radial head excision report no or only minor long-term complaints.
doi:10.3109/17453671003717815
PMCID: PMC2895342  PMID: 20367419
4.  Long-term outcome of displaced radial neck fractures in adulthood 
Acta Orthopaedica  2009;80(3):368-370.
Background There have been no reports on the long-term outcome of radial neck Mason type IIIb fractures in adults.
Methods 3 women and 2 men, aged 46 (22–69) years when they sustained a radial neck Mason type IIIb fracture, were evaluated after an average of 18 (16–21) years. All had been treated with radial head excision.
Results 3 individuals had no subjective elbow complaints while 2 reported occasional weakness. None had severe elbow complaints. The maximum elbow-to-elbow difference in range of motion was a deficit of mean 10° in extension in the injured elbow. Mean deficits in elbow flexion, forearm pronation, and forearm supination were below 5° and the mean difference in cubitus valgus angle was only 2° . There was no instability and no recurrent elbow dislocations. Radiographically, there were cysts, sclerosis, and osteophytes in all formerly injured elbows but none in the uninjured elbows. We found reduced joint space in 1 elbow that had been formerly injured.
Interpretation Mason type IIIb fracture in adults, treated with radial head excision, appears to have a favorable long-term outcome.
doi:10.3109/17453670902967307
PMCID: PMC2823199  PMID: 19421911

Results 1-4 (4)