We studied the changes in serum C-reactive protein levels (CRP) and erythrocyte sedimentation rates (ESR) in patients with primary osteoarthritis, who underwent uncomplicated arthroplasty. Of the 28 patients studied, 12 had cementless total hip replacement (THR), and 16 underwent cemented total knee replacement (TKR) with a tourniquet. In both groups serum CRP levels increased rapidly after surgery, peaking on day 2 (THR 23.17 mg/dl, TKR 26.02 mg/dl), and dropping gradually to pre-operative values on day 21 in THR patients and at the end of the second month in TKR patients. ESR peaked on day 5 after operation (THR 100.5 mm/h, TKR 101.3 mm/h), dropping close to pre-operative values at the end of the third month in THR patients and at the end of the ninth month in TKR patients, although, even after a year, ESRs were slightly above their pre-operative values. Serum CRP levels changed more rapidly than ESRs and returned to normal more rapidly. CRP and ESR values tended to be higher in TKR than in THR patients.
Fifteen of 18 cases who underwent conversion total hip prosthesis due to painful hemiarthroplasty, between 1992 and 1997, were investigated retrospectively. The 13 (86.6%) women and two (13.4%) men (mean age, 59 years) were followed up for an average of 32 months. Pre-operative and post-operative Harris hip scores were 36.4 (28 -42) and 85.9 (69 -98), respectively. In all cases the femoral component had more than 2 mm radiolucency in Gruen zones I, IV and VII, and five cases had acetabular protrusion; other cases had cartilage erosion. In the last follow-up of conversion total hip prosthesis, there was no radiolucency in either femoral or acetabular components. Comparing our results of conversion total hip prosthesis with primary total hip prosthesis results for femoral neck fractures in the literature we conclude that, in elderly patients with femoral neck fractures, primary total hip prosthesis has better results.
This study aimed to evaluate the clinical and radiological results of closed wedge osteotomy (11 knees) and focal dome osteotomy (14 knees) in cases of high tibial osteotomy undertaken for varus knee with medial compartment osteoarthritis. Clinical evaluation was performed using the Knee Society Score and no significant difference was seen between the two groups at final follow-up. Radiological evaluation was made on the basis of the pre-and postoperative mechanical axis, postoperative movement of the tibial axis, loss of correction at final follow-up and patellar height measured using the Insall-Salvati index. Statistically significant differences were seen with focal dome osteotomy compared with closed wedge osteotomy in the InsallSalvati index at final follow-up, the amount of correction loss and the change in tibial axis location. It is concluded that, in the treatment of medial compartment osteoarthritis by high tibial osteotomy, focal dome osteotomy is more beneficial than closed wedge osteotomy in not creating any additional deformity.
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