PROTEZA TOTALA DE SOLD NECIMENTATA ME/ME INDICATII SI REZULTATE PRELIMINARE

P.Botez., PD.Sarbu, R.Asaftei ,Aurora Cretu, Adriana Nitescu Neagu,C.Barbarosie,M.Barbuselu, Clinica de Ortopedie Spitalul Clinic de Recuperare ,Spitalul de Urgente Sf.Ioan Keywords: artroplastie totala sold ,endoproteza metal-metal Studiul priveste un numar de 19 artroplastii totale necimentate de old utilizand un cuplu de frictiune metal-metal (Metasul, ASR), realizate la pacienti cu varste intre 28-55 de ani, in perioada 2007-2010, in doua servicii de ortopedie. Rezultatele au fost comparate cu cele dupa artroplastia totala de sold cu proteze necimentate, cu alte cupluri de frictiune (ceramicceramic si metalpolietilena), utilizand scoruri functionale consacrate (Harris, Devane). La un recul de doi ani si peste, scorul Harris pentru lotul studiat a fost de 95, un scor foarte bun in comparatie cu celelalte tipuri de artroplastie. Concret, pentru acelasi interval de timp de urmarire postoperatorie, rezultatele functionale (mobilitate, stabilitate) au fost semnificativ mai bune in cazul protezelor metal/metal iar recuperarea postoperatorie a fost rapida si durabila. Tinand cont de limitele indicatiilor si datele recente din literatura privind riscurile si esecurile unor tipuri de implanturi ME/ME, recomandam acest tip de proteza pentru adultii tineri, de sex masculin si feminin(in afara perioadei fertile) cu un nivel de activitate crescut. O urmarire atenta a cazuisticii si un recul mai mare sunt necesare pentru a confirma/infirma datele contradictorii din literatura recenta privind indicatiile/contraindicatiile acestui tip de proteza.

LARGE HEAD METAL-ON-METAL CEMENTLESS TOTAL HIP ARTHROPLASTY INDICATIONS AND PRELIMINARY RESULTS.
P.Botez., PD.Sarbu, R.Asaftei ,Aurora Cretu, Adriana Nitescu Neagu, C.Barbarosie,M.Barbuselu, Clinica de Ortopedie Spitalul Clinic de Recuperare ,Spitalul de Urgente Sf.Ioan Keywords: total hip arthroplasty, metal-on-metal endoprosthesis The study concerns a total of 19 uncemented total hip arthroplasty using a metal-metal friction couple (Metasul, ASR), conducted in patients with ages between 28-55 years during 2007-2010, at two orthopedic departments. The results were compared with those after total hip arthroplasty with uncemented prostheses, with other friction couples (ceramic-ceramic and metalpolyethylene), using established functional scores (Harris Devane). In a setback for two years and over ,the Harris score for the study group was 95, a very good score compared to other types of arthroplasty. Specifically, for the same period of postoperative follow-up, functional outcome (mobility, stability) was significantly better for metal / metal prosthesis and and was obtained a rapid and sustainable postoperative recovery. Given the limits and indications of recent literature regarding the risks and failures of some types of ME / ME implants, we recommend this type of prosthesis for young adults, male and female (outside the fertile period) with an increased activity level. A better follow up of the cases and a greater setback is required to confirm / refute the contradictory data from recent literature regarding indications / contraindications of this type of prosthesis.