The “Zemel technique” for scaphoid pseudarthrosis without major carpal collpse is a modification of the Matti-Russe procedure, using only cancelous bone graft and 2 Kirchner wires for fixation – these are introduced under direct vision after a large curetage of the pseudarthrosis, then partially withdrawn and reintroduced after tight local cancelous bone packing.

We used it in 51 cases, obtaining bone union in 48. In 9 patients bone, union was not certain after 12 weeks of plaster and K wires were replaced by a screw with no further immobilization, but we still had 3 nonunions.

This procedure, technically easy to perform and using current orthopaedic material, seems a good alternative to non-angulated pseudarthrosis of the scaphoid, except of its proximal pole.

Introduction: Treatment of hip joint disease with Total Hip Arthroplasty (THA) is in continuous evolution with new approaches, new size of components and type of bearing surfaces. Meanwhile, the analyses of proven implants continues to yeld results with a high survivor-ship and almost absent osteolysis, even with the greater wear found in the poliethylene (PE) insert of 10 to 15 year old implants. The results of these THA and the need to revise some implants not loosened but with wear of the PE, is the object of this study.

Methods: 330 non-cemented THA with the CLS expansion cup, performed by four surgeons over 15 years, are retrospectively analyzed. General anthropometric data of the studied population was obtained from medical records. Clinical elements are evaluated, among others the diagnosis, size and orientation of the components, time of partial/total weight bearing, period of crutch assisted walking, subjective patient satisfaction.

X-rays were measured for numerical assessment of the orientation of the cup, migration, radiolucent lines, osteolysis and indirect evaluation of the wear of the PE insert. Obtained data recorded over the life of the implant was computed for correlations. Other studied elements include survival rate, complication, occurrence and type of revisions.

Results: The encountered populations age was 62.7 +/− 10.9 years (Min 20, Max 86), the sex 43.1% male 56.9% female, the affected side 53.5% right 46.5% left. Charts of clinical elements, radiological measurements and correlation studies are presented. The wear of the PE insert correlates with the age of the implant and the inclination of the cup but not with radiolucent lines or osteolysis, which have a very low incidence. The complications and the survivorship analysis of the implants are presented and discussed. The encountered revision rate was 2.3% in the studied population. Without loosening, most revisions consisted on simple PE and head exchange.

Conclusions: In the authors’ opinion, the very high rate of long-term survivorship with the CLS expansion cup makes this an excellent implant for THA. Even in the 10 to 15 year old group of implants presenting greater wear of PE, there is very low presence of osteolysis and low rate of loosening, permitting to perform simple exchange of the insert and head, a simple revision procedure that will allow quick functional recovery, high patient satisfaction and a good cost/efficiency relationship.