A high incidence of acetabular loosening following total hip arthroplasty is emerging as long term follow-up studies become available. The Müller and Burch-Schneider acetabular supports are indicated for acetabular deficiencies which are frequently present during revision hip arthroplasty. The Burch-Schneider support is indicated where the deficiencies are of such magnitude that the Müller ring does not have stable seating prior to screw fixation. These devices bring the resultant of forces across the hip joint under the acetabular roof and provide metal backing for the acetabular cup. They have the additional advantage of screw fixation which in the Müller ring is in line with the resultant of forces across the hip joint. In a one to three year follow-up of twenty-five hip replacements in twenty-four patients, the Müller support ring was used in twenty hips and the Burch-Schneider in five hips. The results were satisfactory and indicate that these supports are valuable in the treatment of patients with acetabular deficiencies.
Nonunion is an uncommon complication of high tibial osteotorny. Reported techniques of treating such a complication include resection of the pseudarthrosis and cast immobilization with risk of joint stiffness and loss of alignment. The special AO/ ASIF threaded external fixator with double clamps was used to treat three patients with nonunions following high tibial osteotomy for medial compartment osteaarthritis. The pseudarthrosis was not resected in any instance. All were allowed full unrestricted joint motion postoperation. Rapid healing of the osteotomy ensued. The external fixator achieved excellent stability and rapid union while maintaining joint motion.Valgus high tibial osteotomy is a widely accepted method of treatment of a vans knee with medial compartment osteoarthritis. Gariepy's technique4 of a closing wedge osteotomy performed above the tibial tubercle places the osteotomy through cancellous bone. In addition to the high healing potential, the cut flat surfaces of cancellous bone enhance stability and the contractile action of the quadriceps and hamstring muscles on the distal fragment causes the osteotomy to be com-
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