INTRODUCTION

Cementless femoral component designs supplemented with hydroxyapatite (HA) coating have been hypothesised to enhance osseointegration, thereby improving stability and clinical outcomes. We herein offer interim results at 5 years from a prospective, multi-centre study of a femoral stem (SL-PLUS™ Hip Stem Prosthesis), forged from titanium alloy (Ti6Al7Nb) and consisting of a titanium plasma sprayed coating (0.3mm) with an additional 0.05mm layer of HA.

Aims: To evaluate the inßuence of simultaneous local anesthesia (LA) on the clinical outcome after repetitive low-energy extracorporeal shock wave application (ESWT) for chronic plantar fasciitis. Methods: A prospective randomized observer-blinded pilot trial was performed in 48 painful heels (40 patients), having been resistant to various conservative treatment procedures for more than 6 months. 24 heels (20 patients) received 3 applications of 1500 impulses of 0.4 mJ/mm2 without LA (Group I)on 3 consecutive days with a conventional ultrasound-guided orthopaedic shock wave device (Sonocur plus, Siemens AG, Erlangen, Germany). 24 heels (20 patients) received 3 applications of 1500 impulses of 0.04 mJ/mm2 with LA on 3 consecutive days (Group II). Main outcome measure was the number of good or excellent outcomes needing no further therapy at three month follow-up. Secondary outcome measure was pain after weightbearing assessed on a visual analog scale (VAS; range, 0–10). Both groups did not differ signiþcantly before the start of the trial. Results: In Group I 16 of 24 (67%) heels reached a good or excellent result, in Group II 7 of 24 heels (29%) at three-month follow-up (p= 0.0199 for difference between groups; difference= 0.38; 95%CI= 0.09 to 0.66). Pain after weightbearing was 2.2±2.6 on a VAS in Group I, and 3.8±2.5 on a VAS in Group II (p= 0.0318 for difference between groups; mean difference= 0.16; 95%CI= 0.01 to 0.30). Conclusions: The simultaneous use of local anesthesia has a negative inßuence on repetitive low-energy shock wave therapy for chronic plantar fasciitis. Further prospective studies should be performed to evaluate more exactly the extent of this negative inßuence.

We reviewed 80 patients (87 hips) who were older than 80 years of age at the time of cementless total hip arthroplasty. An Alloclassic SL stem had been implanted in all patients. A variety of cementless acetabular components was used. After a mean follow-up of 69.3 months (39.2 to 94.1) 48 hips in 43 patients were analysed clinically and radiologically. One patient had sustained a traumatic periprosthetic fracture of the femur with subsequent exchange of the stem 73 months after operation. Thirty-two patients (34 hips) had died and five patients (five hips) were unavailable for follow-up because of health reasons (four patients) or lack of co-operation (one patient). If the endpoint is defined as removal of the prosthesis because of aseptic loosening, the survival rate was 100% for the cup and stem after 78 months. The mean Harris hip score was 81.9 points. Radiolucent lines and osteolysis were seldom found.