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Abstract
This invaluable proceedings contains contributions from leading scientists in astrophysics, cosmology and related fields such as gravitation and elementary particles physics. It provides a general review of the status and the prospects of research in these fields for an audience of astrophysicists and physicists. The book includes both in depth reviews of various fields of relativistic astrophysics and shorter contributions on the latest results and developments in more specific areas. Some of the topics discussed are: physics of the early universe, cosmological parameters, formation of galaxies, black holes and compact objects, gravitational waves, cosmic rays, high energy radiation, dark matter, cosmic background, active galactic nuclei, supernovae and gravitational lensing.The proceedings have been selected for coverage in:• Index to Scientific & Technical Proceedings (ISTP CDROM version / ISI Proceedings)
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Contents | vii | ||
| Upper Extremity Arthroplasty, Genval (Belgium), April 1995 | 1 | ||
| Upper Extremity Arthroplasty | 1 | ||
| Brussels International Upper Extremity Symposium | 1 | ||
| General Outline of the Book | 3 | ||
| References | 5 | ||
| Part I General Concepts | 7 | ||
| Small Joint Arthroplasty of the Hand: A Short History | 9 | ||
| Friction, Wear and Biological Response | 12 | ||
| Abstract | 12 | ||
| Friction | 12 | ||
| Wear | 13 | ||
| Biological Consequences of Wear | 15 | ||
| Discussion | 17 | ||
| References | 17 | ||
| European Legislation for Medical Devices | 19 | ||
| Abstract | 19 | ||
| Introduction | 19 | ||
| European Union Directives | 20 | ||
| European Normalization Policy | 20 | ||
| The Medical Devices Directives | 21 | ||
| The Conformity Assessment Procedures | 22 | ||
| An Overview of me Medical Device Approval Process in the United States, with Emphasis on Upper Extremity Devices | 23 | ||
| Abstract | 23 | ||
| Description of U.S. Device Regulations | 24 | ||
| Background and definition | 24 | ||
| Device classifications | 24 | ||
| Establishment registration and medical device listing | 25 | ||
| Implantable devices specifications | 26 | ||
| Premarket Notification- 510(k) | 26 | ||
| Definition | 26 | ||
| Substantial equivalence | 26 | ||
| Comparison testing | 27 | ||
| Summary or statement of safety and effectiveness | 27 | ||
| Implant/upper extremity specifications | 27 | ||
| Premarket Approval (PMA) | 28 | ||
| Definition | 28 | ||
| Valid scientific evidence | 28 | ||
| Premarket approval review process | 28 | ||
| Investigational Device Exemption | 29 | ||
| Definition | 29 | ||
| Risk categories | 29 | ||
| Requirements | 29 | ||
| Cost recovery | 30 | ||
| General Considerations | 30 | ||
| Refuse to file procedures | 30 | ||
| Medical device reporting | 30 | ||
| Facilities inspections | 31 | ||
| Import detentions and refusals | 31 | ||
| Reality-Based Examples | 32 | ||
| Class II device- 510(k) | 32 | ||
| Class III device - premarket approval (PMA) | 33 | ||
| Acknowledgments | 37 | ||
| Reference | 37 | ||
| Upper Extremity Arthroplasty : Indications, Contraindications, Patient Selection | 38 | ||
| Abstract | 38 | ||
| Introduction | 38 | ||
| Decision Factors | 39 | ||
| Symptomalogy | 39 | ||
| Age of the patient | 39 | ||
| Affected joint(s) | 42 | ||
| Cause of the joint degeneration | 45 | ||
| Importance of the soft tissues | 46 | ||
| Contraindications | 46 | ||
| References | 47 | ||
| Part II Finger Joint Replacement | 49 | ||
| Finger Joint Replacement : A Challenge for the Next Century | 51 | ||
| Abstract | 51 | ||
| Introduction | 51 | ||
| Axes of Motion and Mechanics of the Joints | 52 | ||
| Joint Stability and Motion | 52 | ||
| Behavior of Materials | 53 | ||
| Behavior of Bone Tissue | 54 | ||
| Conclusions | 55 | ||
| References | 57 | ||
| Stress Analysis of the Finger Bones in Contact with Artificial Implants | 58 | ||
| Abstract | 58 | ||
| Introduction | 59 | ||
| Physiology and Kinematics of a Finger | 59 | ||
| Distribution of Forces in a Finger Structure | 61 | ||
| Stress Analysis in a Normal Proximal Phalanx Bone. | 64 | ||
| Stress Analysis in the Phalanx Bone with Implant | 66 | ||
| Results and Discussion | 67 | ||
| Conclusion | 69 | ||
| References | 70 | ||
| Metacarpal and Proximal Interphalangeal Joint Replacement: History and Perspectives | 71 | ||
| Abstract | 71 | ||
| The Past | 72 | ||
| First generation | 72 | ||
| Second generation | 72 | ||
| Third generation | 72 | ||
| Common Problems of Finger Joint Prostheses | 72 | ||
| Our Series | 73 | ||
| Semiconstrained | 73 | ||
| Multicentric | 73 | ||
| Proximal component | 73 | ||
| Surgical technique | 73 | ||
| Indications | 74 | ||
| Postoperative management | 74 | ||
| Materials | 74 | ||
| Conclusion | 74 | ||
| References | 75 | ||
| DJOA Arthroplasty Ten Years of Experience, and Introducing the DJOA 3 | 76 | ||
| Abstract | 76 | ||
| Introduction | 76 | ||
| Analysis and Comments About the First Generation of DJOA Arthroplasty | 78 | ||
| Materials | 78 | ||
| Methods | 78 | ||
| Results | 79 | ||
| Discussion | 79 | ||
| Conclusions | 80 | ||
| DJOA 3 Arthroplasty | 80 | ||
| Materials and Methods | 82 | ||
| Operative technique | 82 | ||
| Complications | 83 | ||
| Clinical results | 83 | ||
| Radiological results | 85 | ||
| Overall assessment | 86 | ||
| Discussion | 87 | ||
| Surgical Approach | 87 | ||
| Stem Prothesis Fization | 88 | ||
| Conclusion | 89 | ||
| References | 89 | ||
| Proximal Interphalangeal Joint Replacement with Swanson Implant or DJOA Prosthesis: A Comparative Study | 91 | ||
| Abstract | 91 | ||
| Introduction | 91 | ||
| Materials and Methods | 92 | ||
| Operative technique | 92 | ||
| Clinical study | 93 | ||
| Results | 94 | ||
| Conclusion | 97 | ||
| References | 97 | ||
| The Palmar Approach in Flexmle Implant Resection Arthroplasty of the Proximal Interphalangeal Joint | 99 | ||
| Abstract | 99 | ||
| Introduction | 99 | ||
| Material and Methods | 100 | ||
| Surgical approach | 100 | ||
| Patients synopsis | 101 | ||
| Discussion | 103 | ||
| References | 103 | ||
| Technique and Results of Flexible Proximal Interphalangeal Arthroplasty Following Long-Term Arthrodesis | 105 | ||
| Abstract | 105 | ||
| Introduction | 105 | ||
| Patients | 105 | ||
| Technique | 106 | ||
| Results | 106 | ||
| Conclusion | 106 | ||
| References | 108 | ||
| Development of a Surface Replacement Arthroplasty for the Proximal Interphalangeal Joint | 109 | ||
| Abstract | 109 | ||
| Introduction | 109 | ||
| Materials and Methods | 110 | ||
| Clinical material | 110 | ||
| Surgical technique | 112 | ||
| Results | 114 | ||
| Complications | 115 | ||
| Discussion | 116 | ||
| References | 118 | ||
| Design of a Surface Replacement Metacarpophalangeal Prosthesis | 120 | ||
| Abstract | 120 | ||
| Introduction | 120 | ||
| Hinged prostheses | 121 | ||
| Flexible prostheses | 122 | ||
| Third generation prostheses | 122 | ||
| Concept of the New Design | 124 | ||
| Design of the Bearing Surfaces | 124 | ||
| Sizes | 124 | ||
| Shape | 125 | ||
| Centre of rotation | 126 | ||
| Contact pressure | 126 | ||
| Lubrication | 129 | ||
| Material choice | 132 | ||
| Intramedullary Stems | 134 | ||
| Position and shape | 134 | ||
| Fixation | 135 | ||
| Modular or solid design | 137 | ||
| Discussion | 138 | ||
| Acknowledgements | 139 | ||
| References | 139 | ||
| On the Possibility of Using a Regnauld Spacer for Posttraumatic osteoarthritis of the Metacarpophalangeal Joint in Adolescents | 143 | ||
| Abstract | 143 | ||
| Introduction | 143 | ||
| The Regnauld Technique in the Case of Hallux Rigidus | 143 | ||
| Case Report in the Hand | 144 | ||
| Discussion | 146 | ||
| Interphalangeal and Metacarpophalangeal Joint Reconstruction Using Vascularized Tissue Transfer | 147 | ||
| Abstract | 147 | ||
| Introduction | 147 | ||
| History | 147 | ||
| Indications | 148 | ||
| Vascularized Joint Transfers | 148 | ||
| From a Finger | 148 | ||
| From a Toe | 150 | ||
| Complications and Technical Difficulties | 152 | ||
| The microsurgical problem | 152 | ||
| The bone problem | 153 | ||
| The tendon problem | 153 | ||
| Discussion | 153 | ||
| References | 154 | ||
| Part III Trapeziometacarpal Joint Replacement | 157 | ||
| A Three-Dimensional Biomechanical Study of the Carpometacarpal Joint Using Medical Imaging | 159 | ||
| Abstract | 159 | ||
| Introduction | 159 | ||
| Materials and Methods | 160 | ||
| Acquisition of the mechanical model | 160 | ||
| Image analysis | 161 | ||
| Mechanical analysis | 162 | ||
| Results | 163 | ||
| Carpometacarpal constraint force | 163 | ||
| Geometrical models | 163 | ||
| Discussion and Conclusion | 163 | ||
| Acknowledgements | 165 | ||
| References | 165 | ||
| Guepar Total Trapeziometacarpal Arthroplasty | 166 | ||
| Abstract | 166 | ||
| Introduction | 166 | ||
| Indications and Contraindications | 167 | ||
| Guepar Total Trapeziometacarpal Arthroplasty | 167 | ||
| Surgical Technique | 167 | ||
| Postoperative Rehabilitation | 168 | ||
| Results | 169 | ||
| Discussion | 170 | ||
| Conclusion | 171 | ||
| References | 172 | ||
| Failure of Uncemented Trapeziometacarpal Total Prosthesis. A Multicenter Study | 174 | ||
| Abstract | 174 | ||
| Materials and Methods | 174 | ||
| Presentation of the series | 174 | ||
| Orthopaedics surgeons | 175 | ||
| Review of the Failures | 175 | ||
| Intraoperative incidents | 175 | ||
| Postoperative pain | 175 | ||
| Postoperative radiological assessment | 176 | ||
| Surgical reoperation | 178 | ||
| Conclusion | 178 | ||
| Acknowledgements | 179 | ||
| References | 179 | ||
| Tripodal Noncemented Prosthesis for Trapeziometacarpal Joint Osteoarthritis | 180 | ||
| Abstract | 180 | ||
| Introduction | 180 | ||
| Materials and Methods | 181 | ||
| Results | 184 | ||
| Conclusion | 187 | ||
| References | 188 | ||
| Twenty Years' Experience in the Two-Axis Flexible Prosthesis of the Trapeziometacarpal Joint | 190 | ||
| Abstract | 190 | ||
| Introduction | 191 | ||
| The Two-Axis Prosthesis | 191 | ||
| Surgical Procedure | 191 | ||
| Results | 196 | ||
| Associated surgical procedures | 197 | ||
| Complications | 197 | ||
| Revisions | 197 | ||
| Early postoperative results | 198 | ||
| Final results | 198 | ||
| Discussion | 199 | ||
| Indications | 199 | ||
| Conclusion | 200 | ||
| References | 200 | ||
| Part IV Total Wrist Replacement | 203 | ||
| Aanatomy and Knematics of the Wrist | 205 | ||
| Abstract | 205 | ||
| Introduction | 205 | ||
| Biologic Materials: Function and Vulnerability | 206 | ||
| Anatomy and Kinematics | 207 | ||
| Mechanics | 209 | ||
| References | 211 | ||
| Biomechanics of the Wrist. Multidisciplinary Approach | 213 | ||
| Abstract | 213 | ||
| Introduction | 213 | ||
| Vectorial Analysis | 215 | ||
| Analysis Based on Finite Elements | 217 | ||
| Wrist Loading Apparatus | 219 | ||
| Results | 220 | ||
| Discussion | 221 | ||
| Conclusion | 221 | ||
| References | 221 | ||
| Total Wrist Arthroplasty A 25 Year Experience | 223 | ||
| Abstract | 223 | ||
| Introduction | 223 | ||
| Indications and Contraindications | 224 | ||
| Design and Development of Total Wrist Prostheses | 224 | ||
| Results and Discussion | 226 | ||
| Conclusion | 227 | ||
| References | 227 | ||
| Guepar Wrist Prosthesis in Rheumatoid Arthritis | 229 | ||
| Abstract | 229 | ||
| Introduction | 229 | ||
| The Guepar Wrist Prosthesis | 230 | ||
| Surgical Technique | 231 | ||
| Clinical Results | 231 | ||
| Discussion | 233 | ||
| References | 234 | ||
| The Reconstruction of Seriously Destroyed Wrist Joints through the Implantation of a Total Wrist Joint with Reconstruction of the Tensor and Flexor Tendon Apparatus Under Local Hypothermia | 237 | ||
| Abstract | 237 | ||
| Introduction | 237 | ||
| Technique of Hypothermia | 238 | ||
| Use of hypothermia in bilateral band surgery | 239 | ||
| Applications During Wrist Armroplasty | 240 | ||
| Conclusion | 240 | ||
| References | 242 | ||
| Arthrodesis of the Wirst: Back to the Future? | 243 | ||
| Abstract | 243 | ||
| Introduction | 243 | ||
| Clinical Material | 244 | ||
| Degenerative conditions | 245 | ||
| Rheumatoid arthritis | 246 | ||
| Neurological indications | 248 | ||
| Other indications | 249 | ||
| Discussion | 249 | ||
| References | 253 | ||
| Part V Elbow Replacement | 255 | ||
| Loose-Hinge Total Elbow Arthroplasty: Biomechanics and Clinical Experience | 257 | ||
| Abstract | 257 | ||
| Introduction | 257 | ||
| Biomechanical Study of the Coonrad-Morrey Total Elbow Arthroplasty | 258 | ||
| Materials and methods | 258 | ||
| Results | 259 | ||
| Clinical Experience in Belgium | 260 | ||
| Discussion | 261 | ||
| Replication of normal motion | 261 | ||
| Kinematic pattern | 263 | ||
| Muscle moment arms | 263 | ||
| Conclusion | 263 | ||
| References | 263 | ||
| Guepar Elbow Prosmesis in Rheumatoid Arthritis | 266 | ||
| Abstract | 266 | ||
| Introduction | 266 | ||
| The Guepar Total Elbow Arthroplasty | 266 | ||
| Surgical Procedure and Rehabilitation | 268 | ||
| Results | 268 | ||
| Discussion | 271 | ||
| References | 272 | ||
| Silastic Replacements for Comminuted Radialhead Fracfures: A Long-Term Follow-up | 276 | ||
| Abstract | 276 | ||
| Introduction | 276 | ||
| Patients and Methods | 277 | ||
| Results | 278 | ||
| Discussion | 279 | ||
| Conclusion | 281 | ||
| References | 281 | ||
| Part VI Shoulder Arthroplasty | 283 | ||
| Shoulder Involvement in Rheumatoid Arthritis | 285 | ||
| Abstract | 285 | ||
| Introduction | 285 | ||
| Patients and Methods | 286 | ||
| Results | 286 | ||
| Restrospective study | 286 | ||
| Description of the Lesions | 289 | ||
| Soft tissues | 289 | ||
| Osteoporosis and cysts | 289 | ||
| Erosion | 290 | ||
| Glenohumeral chondrolysis | 291 | ||
| Cranial subluxation | 291 | ||
| Osteoarthritis of the shoulder joint | 291 | ||
| Lesions of the acromioclavicular joint | 292 | ||
| Classification | 293 | ||
| Conclusions | 295 | ||
| References | 296 | ||
| Neer Shoulder Prosthesis: Results Related to the Etiology | 297 | ||
| Abstract | 297 | ||
| Material and Methods | 298 | ||
| Preoperative Status | 298 | ||
| Pathology | 299 | ||
| Surgical Procedure | 300 | ||
| Rehabilitation | 301 | ||
| Assessment of the Results | 302 | ||
| Results | 303 | ||
| Overall outcome | 303 | ||
| Subjective outcome | 304 | ||
| Pain | 305 | ||
| Active motion | 305 | ||
| Activities of daily living | 305 | ||
| Arm flexion strength | 305 | ||
| Complications and Revisions | 306 | ||
| Discussion | 307 | ||
| Influence of diagnosis on outcome | 307 | ||
| Complications | 308 | ||
| How can we improve the results? | 309 | ||
| Conclusion | 310 | ||
| References | 311 | ||
| Adaptability and Modularity in Shoulder Prosthesis | 313 | ||
| Abstract | 313 | ||
| Introduction | 313 | ||
| Morphological Study of the Proximal End of the Humerus | 314 | ||
| Sphericity of the Humeral Head | 315 | ||
| Dimensional Variations of the Humeral Articular Surface | 316 | ||
| Modularity: The Consequences of Dimensional Variation | 316 | ||
| Variations in the Orientation of the Humeral Articular Surface | 317 | ||
| Variation of Posmon in Space of the Humeral Articularsurface | 317 | ||
| Adaptability: The Result of Variations in the Orientation and Position in Space of the Articular Surface | 319 | ||
| Inclination | 320 | ||
| Retroversion | 320 | ||
| Medial offset | 321 | ||
| Posterior offset | 323 | ||
| The aequalis prosthesis prosthesis: a modular and adaptable prosthesis | 325 | ||
| Conclusion | 326 | ||
| References | 327 | ||
| Rehabilitation Following Total Shoulder Arthroplasty | 329 | ||
| Abstract | 329 | ||
| Introduction | 329 | ||
| Postoperative Rehabilitation Program | 330 | ||
| From the first till the 21st postoperative day | 330 | ||
| From the 21st postoperative day | 331 | ||
| Conclusion | 332 | ||
| References | 332 | ||
| Isokinetic and Isometric Evaluation of the Shoulder Strength After Arthroplasty | 334 | ||
| Abstract | 334 | ||
| Introduction | 334 | ||
| Materials and Methods | 335 | ||
| External and internal rotation strength | 335 | ||
| Abduction and adduction strength | 335 | ||
| Results | 336 | ||
| External and internal rotation strength | 336 | ||
| Abduction and adduction strength | 336 | ||
| Discussion | 337 | ||
| Conclusion | 340 | ||
| Acknowledgements | 340 | ||
| References | 340 | ||
| An Alternative Reconstructive Procedure for Displaced Four-Part Proximal Humeral Fractures | 342 | ||
| Abstract | 342 | ||
| Introduction | 342 | ||
| Patients | 343 | ||
| Classification and Treatment of the Fractures | 343 | ||
| Results | 344 | ||
| Discussion | 344 | ||
| References | 345 | ||
| The Use of Osteochondral Allografts in the Upper Limb | 346 | ||
| Abstract | 346 | ||
| Introduction | 346 | ||
| Patients and Methods | 346 | ||
| Results | 347 | ||
| Discussion | 347 | ||
| References | 348 | ||
| An Alternative to Shoulder Arthroplasty: Shoulder Arthrodesis Using Combined Internal and External Fixations | 349 | ||
| Abstract | 349 | ||
| Introduction | 349 | ||
| Surgical Technique | 349 | ||
| Patients and Methods | 350 | ||
| Results | 351 | ||
| Discussion | 351 | ||
| Conclusion | 352 | ||
| References | 353 | ||
| Contributors | 355 | ||
| Index | 359 |