Implants and Allografts

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1.  Your breast implant patient heard on Oprah that silicone causes cancer in rats – does it?  What is solid state carcinogenesis?

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2.  Your arthritic patient arrives with her lawyer to hear about your proposal to put a silicone joint prosthesis in her.  What risks and benefits will you tell her about?

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3.  Your patient wants collagen injected into her lip and glabellar lines.  Should you use Zyderm or Zyplast?  How do you do it technically?  How much does it cost?  What are the risks?  Does it cause immune problems?

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4.  You are placing Medpor cheek implants, a Medpor dorsal nasal graft, and a chin implant.  What is Medpor made of?  How long does it last?  What are the side effects?

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5.  Tell us about methylmethacrylate.  Read the package insert.  Is a methylmethacrylate cranioplasty better than a bone graft cranioplasty?  Why choose one or the other?

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6.  Do methylmethacrylate beads impregnated  with antibiotics work for osteomyelitis?  How do you make them?

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7.  What are the facial fracture plates that we use made of?  What are the advantages of each kind of metal?  What happens to these plates and screws with time?  (PRS 1992; 90:568)

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8.  A patient sues you because he claims that he got AIDS from allograft that you placed on his wound.  How is allograft prepared?  Is this possible?

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9.  Do breast implants cause autoimmune disease?

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10.  Tell us about osseotintegrated dental and facial prosthesis implants.

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11.  You are putting in mesh after a TRAM.  Should you use Marlex, Prolene, or Goretex?  What are each made of?  What are the disadvantages and advantages of each?

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12.  Tell us about hydroxyapatite.  Tell us about BoneSource.  (PRS 1991; 88:1076)

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13.  You want to bone graft a nose.  Should you use endochondral or membranous bone.  Should you fix it?  Strip the periosteum?  How should you orient it?

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14.  Tell us about bone morphogenic protein.

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15.  How do bone grafts get incorporated?

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16.  What is the theory behind texturing implants?  Is there any proof of the claim that textured implants are softer than regular implants?  (PRS 1992; 90:77)

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17.  Tell us about Biobrane and Alloderm.

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18.  Tell us about the degradation products of the polyurethane (meme) implant.  If a patient had a meme implant placed seven years ago and is not having difficulty, should she have it removed?

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19.  Is Goretex approved for facial implants?  What is it made of?

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20.  What happens to a cartilage autograft?  Can you use allograft cartilage?

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