The "MRP-TITANIUM modular revision prostheses" has proved to be reliable in cases of revision surgery with extensive bony defects. The failure rate was 2.1 % for 48 prospectively examined prostheses.
With a subtly differentiated interpretation (categories I - V) of the qualitative glucose metabolism safe statements can be made regarding septic/aseptic endoprostheses loosening. This was impressively confirmed by the agreement of the FDG results with the histological results.
The pathogenesis is still unknown. Diagnosis often is obtained much too late due to missing specific symptoms. PVNS occurs in local forms as well as in a diffuse growth pattern. Recurrence rates of up to 78% are very high. Besides arthroscopic and open synovectomy, the treatment with radiosynoviorthesis must be considered. Depending on the growth pattern, the tumour masses, and the affected joint, the therapy has to be chosen very carefully and sometimes different forms have to be combined if a recurrence--free result is to be achieved.
Titanium is justified as a cementable material in total hip arthroplasty. By respecting specific implant characteristics, very good failure rates can be achieved. The high failure rates, published in several studies, are based upon implant characteristics which are not suitable for cementing techniques and not upon the implant material titanium itself.
As the removal offemoral bone cement is one ofthe most challenging tasks in cemented Total Hip Revision, a lot of different technical devices have been developed to aid the surgeon. All oftheirpros and cons are partly consequences of the specific system-design but mainly arisefrom the basic physical principles used. Tlie known methods and devices äs well äs their datahandling have therefore been analysed, reduced to their principles according to the criteria ofsystematic engineering design and systematised in order to provide a better comparability and starting point for the development of ne\v devices.
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