BACKGROUND Total ossicular replacement prostheses (TORP) are often used to re-establish ossicular coupling of sound in an ear lacking a stapes supra-structure. The use of TORPs, however, is associated with a 2/3 five year failure rate due to their anatomic instability over time in the middle ear. The use of autologous fat to try and stabilize TORPs may improve long-term results with this challe...

An Alvarez disc valve prosthesis had been implanted in the mitral and tricuspid positions in 15 patients between 1964 and 1967 in this hospital. Of these 15 patients, only three survived longer than 10 years, all three dying unexpectedly between 16 and 18 years postoperatively. Two deaths were a direct result of disruption of the Alvarez prosthesis. The third patient was not examined at necrops...

INTRODUCTION Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. CASE PRESE...

Periprosthetic fracture of the femur is an uncommon complication after total hip replacement, but appears to be increasing. We undertook a nationwide observational study to determine the risk factors for failure after treatment of these fractures, examining patient- and implant-related factors, the classification of the fractures and the outcome. Between 1979 and 2000, 1049 periprosthetic fract...

The survivorship method of analysis has been used to compare the failure rate and overall success of 1,430 cemented primary total knee arthroplasties performed at The Hospital for Special Surgery over a 15-year period. There were 224 total condylar prostheses with a polyethylene tibia, 289 of the posterior stabilised type with an all polyethylene tibia, and 917 posterior stabilised with a metal...

PURPOSE There is much controversy about the minimum number of implants and maximum cantilever length in mandible prosthetic restoration. Finite elements analysis of three and four implant-supported prostheses was performed to determine the stresses in the superstructure, implants and cortical bone and, therefore, the failure prediction for each restoration. METHODS An edentulous mandible was ...

Dr. Byrne is an associate professor, Department of Adult Restorative Dentistry, College of Dentistry, University of Nebraska, 40th and Holdrege, Room 128, Box 830740, Lincoln, Neb. 68583-0740, e-mail “[email protected]”. He also is an evidence reviewer for the American Dental Association. Address reprint requests to Dr. Byrne. Clinical question. Are there any differences in outcomes between onest...

Statement of the problem Many partially edentulous situations are present whereby the choice between a removable and a fixed partial denture lies within the delicate balance of a single standing abutment. This abutment is called as a pier abutment. If and when a fixed fixed prosthesis is given in such a case, the retainer over the pier abutment acts as a fulcrum and invariably leads to cement f...

Although leakage through a tracheoesophageal shunt prosthesis is the main cause of prosthesis failure in a laryngectomy patient, this has never been the subject of in vitro evaluation. The aim of this study was to compare three commercially available voice prostheses by comparison of their in vitro leakage patterns, in absence or presence of a biofilm. To compare in vitro leakage patterns, a mo...

Loosening of the prosthesis, an important cause of clinical failure following total joint replacement, may be due to faulty implantation of the prosthesis, to trauma, or to infection in the tissues adjacent to the implant. Cases of loosening exist, however, in which the technique of implantation appears to have been satisfactory, in which there is no history of injury and in which there is no e...