Letter To The Editor
I would like to make some observations concerning the paper by Drs. Newton C. McCollough and Raymond E. Gilmer, Jr., entitled "A Method of Determining Total Contact in Prostheses," which was published in the February 1967 issue of the Inter-Clinic Information Bulletin.
As you know, our clinic has been utilizing X-rays to check the fit of patellar-tendon-bearing prostheses since 1961. We published our initial report on this procedure in the April 1963 issue of the ICIB (Vol. II, No. 6). Therefore I agree that every effort should be made to determine the achievement of total contact between the stump and the socket. However, I take exception to the implication in the paper by Drs. McCollough and Gilmer that if one does not use an opaque substance between skin and socket, no information can be gained. This implication would leave the uninitiated reader with the idea that unless this material were available to him, it would be useless to X-ray the stump in the prosthesis under weight-bearing conditions. We have had no difficulties interpreting our X-rays and suggest that if difficulty is experienced, it may be related to the quality of the pictures taken.
I am sure that Dr. McCollough did not intend to mean that unless a radiopaque material is utilized, one will gain no information from the X-ray. However, I did wish to emphasize that considerable useful information can be obtained by routine views.
Richard E. King, M.D. Atlanta Orthopedic Clinic Atlanta, Georgia