Ramon B. Gustilo

CHEMODECTOMA (CAROTID-BODY TUMOR) METASTASIZING TO BONE; CASE REPORT.

A case of carotid-body tumor with two isolated metastases to the left ilium is presented. The first metastatic lytic lesion to the left ilium appeared thirty-five years after the mass was first noted and thirteen years after excision of the primary tumor. Two biopsies—done four years apart—revealed metastatic carotid-body tumor. X-ray and cobalt irradiation followed each biopsy with no demonstrable effect on the size or structure of the tumor. At the time of writing, the patient is still alive with minimum discomfort in the left hip, despite a pathological fracture of the acetabulum and increase in the size of the iliac lesions.

Can rotational congruity be achieved in both flexion and extension when the femoral component is externally rotated in total knee arthroplasty

Abstract Commercially available total knee implants were cemented onto a custom made jig which provided an axis of rotation perpendicular to the mechanical axis. The femoral component was fixed in 3° of external rotation and articulated with a tibial component implanted in either 3° of external rotation or neutral rotation. A modified femoral component having a thicker posterior lateral than posterior medial condyle was implanted in neutral rotation to articulate with a neutrally rotated tibial component. Fuji film placed in both the medial and lateral compartments was used to determine the centroids of the medial and lateral tibiofemoral contact areas and rotational congruity between the femoral and tibial components. When the femoral component was externally rotated, rotational incongruity of 3.53° occurred in extension if the tibial component was not externally rotated, and rotational incongruity of 3.23° occurred in flexion if the tibial component was externally rotated. With the modified femoral component the angle of rotational congruity remained relatively constant at approximately 0.15° throughout the flexion range and did not exceed 0.20°.