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Sample records for alloy femoral stem

  1. In vivo testing of porous Ti-25Nb alloy serving as a femoral stem prosthesis in a rabbit model

    Science.gov (United States)

    Weng, Xiaojun; Yang, Hailin; Xu, Jian; Li, Xiaosheng; Liao, Qiande; Wang, Jing

    2016-01-01

    The aim of the present study was to observe the performance of Ti-25Nb alloys with various porosities as femoral stem prostheses in a rabbit model, thus providing basic experimental evidence for the development of porous prostheses. The porous Ti-25Nb alloy prostheses were designed according to the morphology of the medullary cavity. These prostheses were placed into the femoral medullary cavities in 36 New Zealand white rabbits. Postoperative X-ray films, scanning electron microscopy (SEM) of the implant interface, energy-dispersive spectroscopy (EDS) analysis of the implant surface, pulling-out test and general observations were conducted. The specimens showed good biocompatibility; there was no obvious bone absorption in porous Ti-25Nb specimens with different porosities at different time points observed using X-ray films. Under SEM examination, calcium deposits were observed inside the pores and in the interface between bone and prostheses. The EDS analysis demonstrated that calcium deposits were present on the surface of the prostheses at the eight-week point postoperatively. The pulling-out test showed good bonding strength between bone and implant; after pulling out, the surface and inside the pores of the prostheses all presented bone mass. Porous Ti-25Nb alloy implants presents good biocompatibility as well as providing a biological fixation between the bone and implant. A porosity of 70% is more advantageous to the newborn bone ingrowth, combined with achieving a more solid bone-implant interface. PMID:27602063

  2. Femoral component revision using extensively porous-coated cementless stem

    Institute of Scientific and Technical Information of China (English)

    WU Li-dong; XIONG Yan; YAN Shi-gui; YANG Quan-sen; DAI Xue-song

    2005-01-01

    Objective: To evaluate the clinical and radiographic results of extensively porous-coated femoral stem in revision of total hip arthroplasty (THA).Methods: From January 1999 to December 2003,fifteen hips of fifteen cases received revision of THA with extensively porous-coated femoral stem. There were six males and nine females. The average age was 66 years (ranging 58-82 years). The reason for the revision was aseptic loosening in 10 cases, septic loosening in 2, femoral shaft fracture around loose implant in 2, and femoral revision for malposition of the femoral component in 1. All the patients were clinically evaluated using Harris hip score and radiographically evaluated both preoperatively and postoperatively at regular follow-up intervals.Results: No patients were lost for follow-up. The average length of follow-up was 2.3 years (range, 1-5years). The average preoperative Harris hip score was 42points, which was improved to 89 points at latest follow-up.The latest follow-up showed that bone in-growth occurred in fourteen stems and solid fibrous fixation in one.Complications consisted of femoral shaft fracture in two cases (1 undisplaced distal femur fracture and 1 cortical perforation at the tip of the prosthesis), and postoperative dislocation in one. There was no mechanical failure of the stem in this study.Conclusions: Satisfactory results of short-term clinical and radiographic follow-up have been achieved in using extensively porous-coated femoral stem for revision of THA. It should be noticed that the straight, 203 mm stem should be used with caution in short people.

  3. Performance of CF/PA12 composite femoral stems.

    Science.gov (United States)

    Campbell, Melissa; Bureau, Martin N; Yahia, L'Hocine

    2008-02-01

    This study presents the microstructural and mechanical behavior of the CF/PA12 composite material developed as well as its biomechanical performance when used for the fabrication of femoral stems. The static tests were performed to evaluate the compressive and flexural modulus as well as the ultimate compressive and bending strength. It was found that CF/PA12 composite had bone-matching properties in the same order of magnitude as cortical bone in the femur. Density and void content measurements were also done to assess the consolidation quality. Dynamic fatigue testing was conducted on both CF/PA12 cylinders and femoral stems to evaluate the long term durability and mechanical reliability of the composite. Compression-compression cyclic loading was used at a frequency of 6 Hz with loads varying between 17 kN and 22 kN for the composite cylinders while a frequency of 10 Hz and load of 2300 N was employed for the femoral stems. Results indicate that the fatigue performance of CF/PA12 composite surpasses by far the required fatigue performance for total hip prosthesis (THP) stems. The overall performance of the CF/PA12 femoral stems confirms that this composite is an excellent candidate material for orthopedic applications such as THP stems. PMID:17619978

  4. Removal of well-fixed fixed femoral stems.

    Science.gov (United States)

    Laffosse, J-M

    2016-02-01

    The removal of a well-fixed prosthetic stem raises technical challenges. The objective is not only to remove the material, but also to prepare the implantation of a new prosthesis. Cemented stems are only very rarely unremovable; extraction of the cement mantle and plug raises the greatest difficulties. The main risk is cortex perforation, and a radiograph should be obtained at the slightest doubt. The removal of cementless stems carries a higher risk of fracture. Difficulties should be anticipated based on thorough familiarity with the implant design and on evaluations of implant fixation and bone stock. The intramedullary approach is usually sufficient to extract a cemented or cementless, well fixed, standard stem. Routine use of a transfemoral approach is warranted only in the following situations: revision surgery for infection, S-shaped stem, long stem, curvature or angulation of the femoral shaft, or unfeasible hip dislocation. However, the possibility that the intramedullary approach may need to be converted to a transfemoral approach should be anticipated. Thus, preoperative planning must include determination of the optimal length of a femoral osteotomy or femoral flap, should one be needed, and the surgeon must have access to all the revision implants and tools that might be needed for re-implantation. Experience with the various techniques is indispensable, as a well-performed extensive approach is associated with less morbidity than a fracture or trajectory error. There are three main techniques, which are described here: intramedullary extraction of a cementless stem, intramedullary extraction of a cemented stem, and transfemoral extraction through an extended trochanterotomy. The patients should receive detailed information on the difficulties of femoral stem removal and on the available solutions. PMID:26797009

  5. Bone ingrowth through porous titanium granulate around a femoral stem: histological assessment in a six-month canine hemiarthroplasty model.

    Science.gov (United States)

    Turner, Thomas M; Urban, Robert M; Hall, Deborah J; Andersson, Gunnar B J

    2007-01-01

    The procedure of using of porous titanium granules for cementless fixation of a hip replacement femoral stem was studied in a hemiarthroplasty model in 10 canines for 6 months. A vibrating instrument was used to facilitate both the delivery and distribution of the irregularly shaped porous titanium granules into the femoral canal as well as the subsequent insertion of a titanium alloy stem into the intramedullary bed of granules. Histological examination revealed lamellar bone formation through the mantle of porous titanium granules in continuity with the surrounding cortex resulting in the formation of an integrated mantle of bone and titanium granulate around the prosthesis. PMID:17578819

  6. Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty

    International Nuclear Information System (INIS)

    Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system (DePuy international Ltd). (author)

  7. Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty.

    LENUS (Irish Health Repository)

    Butt, Ahsan Javed

    2013-02-01

    Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system (DePuy international Ltd).

  8. Titanium Alloy Cage Implantation for the Treatment of Ischemic Necrosis of Femoral Head in Dogs

    Institute of Scientific and Technical Information of China (English)

    Ruiying WANG; Yan GAO; Shuhua YANG; Cao YANG

    2008-01-01

    To study the effect of titanium alloy cage on the treatment of the ischemic necrosis of femoral head in dog, the model of the ischemic necrosis of femoral head was made with the liquid nitrogon in 15 hybrid adult dogs. The titanium alloy cage made of a hollow cylinder was driven into the subchondral bone of necrotic femoral head via central channel. The dogs were divided into 3 groups, each group was sacrificed 3, 6, 12 weeks after the operation respectively. No collapse of femoral head was observed after the operation. The position of the cages was good on radiograph. Microscopically, the cancellous bone of necrotic femoral head rebuilt gradually and grew into cage. After 12 weeks of creeping substitution, the cancellous bone filled up the hollow cavity and holes of the cages. It is concluded that the titanium alloy cage can provide structural support for the subchondral bone and prevent collapse and can be used for the treatment of the ischemic necrosis of femoral head.

  9. Heterologous mesenchymal stem cells successfully treat femoral pseudarthrosis in rats

    OpenAIRE

    Ferreira Manoel; Silva Paulo; Alvarez Silva Lucas; Bonfim Danielle; Conilho Macedo Müller Lucas; Espósito Christiano; Schanaider Alberto

    2012-01-01

    Abstract Background This study evaluated the effectiveness of treating pseudarthrosis in rats by using bone marrow cell suspensions or cultures of bone marrow mesenchymal stromal cells Methods Thirty-eight specific pathogen-free (SPF) animals were randomly assigned to four groups: Group 1, Control, without surgical intervention; Group 2 (Placebo), experimental model of femoral pseudarthrosis treated only with saline solution; Group 3, experimental model of femoral pseudarthrosis treated with ...

  10. Impact of intraprosthetic drilling on the strength of the femoral stem in periprosthetic fractures: A finite element investigation.

    Science.gov (United States)

    Brand, Stephan; Bauer, Michael; Petri, Maximilian; Schrader, Julian; Maier, Hans J; Krettek, Christian; Hassel, Thomas

    2016-07-01

    Treatment of periprosthetic femur fractures after total hip arthroplasty remains a major challenge in orthopedic surgery. Recently, a novel surgical technique using intraprosthetic screw fixation has been suggested. The purpose of this study was to evaluate the influence of drilling the femoral hip stem on integrity and strength of the implant. The hypothesis was that intraprosthetic drilling and screw fixation would not cause the load limit of the prosthesis to be exceeded and that deformation would remain within the elastic limit. A sawbone model with a conventional straight hip stem was used and a Vancouver C periprosthetic fracture was created. The fracture was fixed with a nine-hole less invasive stabilization system plate with two screws drilled and inserted through the femoral hip stem. Three different finite element models were created using ANSYS software. The models increased in complexity including joint forces and stress risers from three different dimensions. A variation of drilling positions was analyzed. Due to the complexity of the physiological conditions in the human femur, the most complex finite element model provided the most realistic results. Overall, significant changes in the stresses to the prosthesis caused by the drilling procedure were observed. While the stresses at the site of the bore hole decreased, the load increased in the surrounding stem material. This effect is more pronounced and further the holes were apart, and it was found that increasing the number of holes could counteract this. The maximum load was still found to be in the area of the prosthesis neck. No stresses above the load limit of titanium alloy were detected. All deformations of the prosthesis stem remained in the elastic range. These results may indicate a potential role for intraprosthetic screw fixation in the future treatment of periprosthetic femur fractures. PMID:27272200

  11. Survivorship and Complications of Revision Total Hip Arthroplasty with a Mid-Modular Femoral Stem.

    Science.gov (United States)

    Riesgo, Aldo M; Hochfelder, Jason P; Adler, Edward M; Slover, James D; Specht, Lawrence M; Iorio, Richard

    2015-12-01

    We retrospectively reviewed 161 revision THAs with diaphyseal fitting, mid-modular femoral components performed by ten surgeons at two academic medical centers. The average follow-up was 6.1 years. At final follow-up, 4 patients required re-revision for failure of the femoral component; 3 (2%) for aseptic loosening and 1 for mechanical failure of stem in setting of periprosthetic fracture. There were a total of 24 (14.9%) revisions for any reason, with the most common reason being septic failure (10 of 24). To our knowledge, this is the largest reported series of mid-term survivorship and complications of revision THA with mid-modular femoral components. Our results show that these stems have a low rate of aseptic loosening, subsidence, and mechanical failure.

  12. Radiostereometric migration analysis of the Cerafit femoral stem: 28 patients followed for 2 years.

    Science.gov (United States)

    Tschunko, Franz; Wagner, Benedikt; Hong, Yutong; Söder, Stephan; Wölfel, Rainer; Müller, Lutz A; Forst, Raimund; Sesselmann, Stefan

    2016-06-01

    Radiostereometric analysis (RSA) is the gold standard evaluating micromovements after total hip arthroplasty. The aim of this study was to investigate the migratory pattern of an uncemented femoral stem during the first 2 years after surgery. We followed 28 patients with a mean age of 57 (SD 13) years for the first two postoperative years. Radiostereometric analysis was used to measure the translation and rotation of the femoral component. The Harris hip score (HHS) was determined to evaluate the clinical outcome. No stem had to be revised. The mean HHS advanced from 35 (SD 11) preoperative to 89 (SD 10) 1 year after surgery. At the end of the observation period, mean subsidence of the stem was 0.26 mm (SD 0.82). Maximum total point motion (MTPM) was 1.23 mm (SD 1.22). The main distal migration took place up to 6 weeks after surgery with nearly no further subsidence up to 2 years postoperatively. All the measured migrations of the hip stem were very small. Results of the HHS demonstrate good clinical outcome. Long-term RSA is necessary to assess possible late migration of the Cerafit standard femoral stem. PMID:25996482

  13. Effect of simulated early weight bearing on micromotion and pullout strength of uncemented distal femoral stems.

    Science.gov (United States)

    Barr, Jennifer S; White, Jedediah K; Punt, Stephanie E W; Conrad, Ernest U; Ching, Randal P

    2015-05-01

    The effect of simulated early weight bearing on both micromotion and pullout strength of uncemented distal femoral stems was evaluated in this study. The effect of stem endosteal contact and bone quality on implant pullout strength was also analyzed. A randomized matched-pair study was performed using 8 bilateral pairs of fresh human cadaveric femoral specimens. Each specimen pair was dual-energy x-ray absorptiometry scanned, uniformly implanted, fluoroscopically imaged, and randomly assigned to the cycled or uncycled group. The cycled group received 5000 cycles of axial compressive loading (to 700 N) and the contralateral side was not cycled. Micromotion was monitored during cycling and compared with a failure threshold (150 µm), and all implants underwent direct axial distraction (pullout) testing. During cycling, minimal micromotion was observed with an asymptotic decrease in differential motion between the first and last 50 cycles. Both cycled and uncycled groups demonstrated no statistical difference in average pullout force (4888±2124 N vs 4367±1154 N; P=.43). The percentage of cortical contact for each implant was determined from panoramic fluoroscopy images using digital image analysis software. Contact area for the distal third of the stem showed the highest correlation with pullout force and with predicting pullout force. Bone quality did not correlate with pullout force (r(2)=0.367) or stem contact area (r(2)=0.394). In sum, press-fit uncemented femoral stems did not loosen or demonstrate decreased pullout strength with early weight bearing simulated by cyclical axial compressive loading.

  14. Effects of Materials of Cementless Femoral Stem on the Functional Adaptation of Bone

    Institute of Scientific and Technical Information of China (English)

    He Gong; Wei Wu; Juan Fang; Xin Dong; Meisheng Zhao; Tongtong Guo

    2012-01-01

    The objective of this paper is to identify the effects of materials of cementless femoral stem on the functional adaptive behaviors of bone.The remodeling behaviors of a two-dimensional simplified model of cementless hip prosthesis with stiff stem,flexible 'iso-elastic' stem,one-dimensional Functionally Graded Material (FGM) stem and two-dimensional FGM stem for the period of four years after prosthesis replacement were quantified by incorporating the bone remodeling algorithm with finite element analysis.The distributions of bone density,von Mises stress,and interface shear stress were obtained.The results show that two-dimensional FGM stem may produce more mechanical stimuli and more uniform interface shear stress compared with the stems made of other materials,thus the host bone is well preserved.Accordingly,the two-dimensional FGM stem is an appropriate femoral implant from a biomechanical point of view.The numerical simulation in this paper can provide a quantitative computational paradigm for the changes of bone morphology caused by implants,which can help to improve the design of implant to reduce stress shielding and the risk of bone-prosthesis interface failure.

  15. Effect of morselized bones on binding of the canine hydroxyapatite-coated femoral stem

    Institute of Scientific and Technical Information of China (English)

    SONG Ke-guan; MA De-sheng; HOU Jian-wen; WANG Huan; YAN Jing-long; YU Zhan-ge; LIANG Zhi-zhong

    2010-01-01

    Background Non-cement femoral stems are recognized in clinical use, but there are still some problems. The aim of this research was to make non-cement femoral stems to be press-fit with the medullary cavity. Methods Twenty-four healthy adult mongrel dogs were randomly divided into experimental and control groups. In the right hip joint, an artificial femoral bone replacement surgery was conducted. For the experimental group, the replacement surgery of hydroxyapatite (HA)-coated femoral stems was done, while autogeneous morselized bone was implanted into the medullary cavity. For the control group, morselized bone was not implanted. At postoperative 1, 3, 6 months, a test for interfacial shear characteristics was conducted in the MTS810 Tester. The comparison between the two groups' bone-prostheses in shear strength for their interface from shearing destruction was made. A histological observation to check prosthesis-bone interface contact ratios and bone growth was carried out. Results For the experimental group, shear strength was 0.317 MPa in 1 month, 1.447 MPa in 3 months, and 1.621 MPa in 6 months. For the control group, shear strength was 0.195 MPa in 1 month, 1.023 MPa in 3 months, and 1.483 MPa in 6 months. The difference was statistically significant. Stereomicroscope-based observation showed that the number of trabecular bones in the experimental group was larger than that of the control group, and bone growth of the former group was better than that of the latter group. Inverted microscopic observation showed that the binding degree between the prosthesis and trabecular bone of the experimental group was higher than that of the control group. Comparatively, the experimental group's trabecular bone had more stromal cells. Conclusions The morselized bones can effectively improve the biological bonding strength and bone-contact ratios in the short term for the HA-coated femoral stem and accelerate the bonding process. The use of morselized autogenous bones

  16. Early migration characteristics of a hydroxyapatite-coated femoral stem: an RSA study.

    Science.gov (United States)

    Campbell, David; Mercer, Graham; Nilsson, Kjell G; Wells, Vanessa; Field, John R; Callary, Stuart A

    2011-04-01

    Measurement of early stem subsidence can be used to predict the likelihood of long-term femoral component loosening and clinical failure. Data that examines the early migration pattern of clinically proven stems will provide clinicians with useful baseline data with which to compare new stem designs. This study was performed to evaluate the early migration pattern of a hydroxyapatite-coated press-fit femoral component that has been in use for over ten years. We enrolled 30 patients who underwent THA for osteoarthritis. The median age was 70 years (range, 55-80 years). Patients were clinically assessed using the Harris hip score. Radiostereometric analysis was used to evaluate stem migration at three to four days, six months, one year and two years. We observed a mean subsidence of 0.73 mm at six months, 0.62 mm at one year and 0.58 mm at two years and a mean retroversion of 1.82° at six months, 1.90° at one year and 1.59° at two years. This data suggests that subsidence is confined to the first six months after which there was no further subsidence. The results from this study can be compared with those from novel cementless stem designs to help predict the long-term outcome one may expect from new cementless stem designs. PMID:20012862

  17. Adaptive Bone Remodeling of the Femoral Bone After Tumor Resection Arthroplasty With an Uncemented Proximally Hydroxyapatite-Coated Stem.

    Science.gov (United States)

    Andersen, Mikkel R; Petersen, Michael M

    2016-01-01

    Loss of bone stock and stress shielding is a significant challenge in limb salvage surgery. This study investigates the adaptive bone remodeling of the femoral bone after implantation of a tumor prosthesis with an uncemented press fit stem. We performed a prospective 1 yr follow-up of 6 patients (mean age: 55 (26-78) yr, female/male=3/3) who underwent bone tumor resection surgery of the proximal femur (n=3) or distal femur (n=3). Reconstruction was done using a Global Modular Replacement System (Stryker® Orthopaedics, Mahwah, NJ) tumor prosthesis, and all patients received a straight-fluted 125-mm uncemented press-fit titanium alloy stem with hydroxyapatite coating of the proximal part of the stem. Measurements of bone mineral density (BMD; g/cm2) were done postoperatively and after 3, 6, and 12 mo in the part of the femur bone containing the Global Modular Replacement System stem using dual-energy X-ray absorptiometry. BMD was measured in 3 regions of interest (ROIs) in the femur bone. Nonparametric analysis of variance (Friedman test) for evaluation of changes in BMD over time. BMD decreased in all 3 ROIs with time. In ROI 1 (p=0.01), BMD decreased by 10% after 3 mo and ended with a total decrease of 14% after 1 yr. In ROI 2 (p=0.006), BMD was decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 9% below the postoperative value. In ROI 3 (p=0.009), BMD decreased by 6% after 3 and 6 mo; after 1 yr of follow-up, BMD was 8% below the postoperative value. A bone loss of 8%-9% during the first postoperative year was seen along the femoral stem, but in the bone containing the hydroxyapatite-coated part of the stem, the decrease in BMD was 14%, thus indicating that stress shielding of this part of the bone may play a role for the adaptive bone remodeling. PMID:25843447

  18. Primary Stability Recognition of the Newly Designed Cementless Femoral Stem Using Digital Signal Processing

    Science.gov (United States)

    Salleh, Sh-Hussain; Hamedi, Mahyar; Zulkifly, Ahmad Hafiz; Lee, Muhammad Hisyam; Mohd Noor, Alias; Harris, Arief Ruhullah A.; Abdul Majid, Norazman

    2014-01-01

    Stress shielding and micromotion are two major issues which determine the success of newly designed cementless femoral stems. The correlation of experimental validation with finite element analysis (FEA) is commonly used to evaluate the stress distribution and fixation stability of the stem within the femoral canal. This paper focused on the applications of feature extraction and pattern recognition using support vector machine (SVM) to determine the primary stability of the implant. We measured strain with triaxial rosette at the metaphyseal region and micromotion with linear variable direct transducer proximally and distally using composite femora. The root mean squares technique is used to feed the classifier which provides maximum likelihood estimation of amplitude, and radial basis function is used as the kernel parameter which mapped the datasets into separable hyperplanes. The results showed 100% pattern recognition accuracy using SVM for both strain and micromotion. This indicates that DSP could be applied in determining the femoral stem primary stability with high pattern recognition accuracy in biomechanical testing. PMID:24800230

  19. Primary stability recognition of the newly designed cementless femoral stem using digital signal processing.

    Science.gov (United States)

    Baharuddin, Mohd Yusof; Salleh, Sh-Hussain; Hamedi, Mahyar; Zulkifly, Ahmad Hafiz; Lee, Muhammad Hisyam; Mohd Noor, Alias; Harris, Arief Ruhullah A; Abdul Majid, Norazman

    2014-01-01

    Stress shielding and micromotion are two major issues which determine the success of newly designed cementless femoral stems. The correlation of experimental validation with finite element analysis (FEA) is commonly used to evaluate the stress distribution and fixation stability of the stem within the femoral canal. This paper focused on the applications of feature extraction and pattern recognition using support vector machine (SVM) to determine the primary stability of the implant. We measured strain with triaxial rosette at the metaphyseal region and micromotion with linear variable direct transducer proximally and distally using composite femora. The root mean squares technique is used to feed the classifier which provides maximum likelihood estimation of amplitude, and radial basis function is used as the kernel parameter which mapped the datasets into separable hyperplanes. The results showed 100% pattern recognition accuracy using SVM for both strain and micromotion. This indicates that DSP could be applied in determining the femoral stem primary stability with high pattern recognition accuracy in biomechanical testing. PMID:24800230

  20. Primary Stability Recognition of the Newly Designed Cementless Femoral Stem Using Digital Signal Processing

    Directory of Open Access Journals (Sweden)

    Mohd Yusof Baharuddin

    2014-01-01

    Full Text Available Stress shielding and micromotion are two major issues which determine the success of newly designed cementless femoral stems. The correlation of experimental validation with finite element analysis (FEA is commonly used to evaluate the stress distribution and fixation stability of the stem within the femoral canal. This paper focused on the applications of feature extraction and pattern recognition using support vector machine (SVM to determine the primary stability of the implant. We measured strain with triaxial rosette at the metaphyseal region and micromotion with linear variable direct transducer proximally and distally using composite femora. The root mean squares technique is used to feed the classifier which provides maximum likelihood estimation of amplitude, and radial basis function is used as the kernel parameter which mapped the datasets into separable hyperplanes. The results showed 100% pattern recognition accuracy using SVM for both strain and micromotion. This indicates that DSP could be applied in determining the femoral stem primary stability with high pattern recognition accuracy in biomechanical testing.

  1. Galvanically enhanced fretting-crevice corrosion of cemented femoral stems

    OpenAIRE

    Bryant, M.; Farrar, R; Freeman, R; Brummitt, K; J. Nolan; Neville, A

    2014-01-01

    The Ultima TPS MoM THR was designed and developed as a 2nd generation MoM THR specifically aimed at younger more active patients due to the anticipated low wear rates and increased longevity of MoM THRs. In 2010, published clinical data highlighted the early failure of the Ultima TPS MoM due to fretting-crevice corrosion at the stem-cement interface. Since 2010 similar observations have been reported by other clinical centres implicating competitor products as well as the Ultima TPS MoM THR. ...

  2. Application of an interface failure model to predict fatigue crack growth in an implanted metallic femoral stem.

    Science.gov (United States)

    Chen, J; Browne, M; Taylor, M; Gregson, P J

    2004-03-01

    A novel computational modelling technique has been developed for the prediction of crack growth in load bearing orthopaedic alloys subjected to fatigue loading. Elastic-plastic fracture mechanics has been used to define a three-dimensional fracture model, which explicitly models the opening, sliding and tearing process. This model consists of 3D nonlinear spring elements implemented in conjunction with a brittle material failure function, which is defined by the fracture energy for each nonlinear spring element. Thus, the fracture energy criterion is implicit in the brittle material failure function to search for crack initiation and crack development automatically. A degradation function is employed to reduce interfacial fracture properties corresponding to the number of cycles; thus fatigue lifetime can be predicted. Unlike other failure modelling methods, this model predicts the failure load, crack path and residual stiffness directly without assuming any pre-flaw condition. As an example, fatigue of a cobalt based alloy (CoCrMo) femoral stem is simulated. Experimental fatigue data was obtained from four point bending tests. The finite element model simulated a fully embedded implant with a constant point load. Comparison between the model and mechanical test results showed good agreement in fatigue crack growth rate.

  3. Study of bone remodeling of two models of femoral cementless stems by means of DEXA and finite elements

    Directory of Open Access Journals (Sweden)

    López-Prats Fernando

    2010-05-01

    Full Text Available Abstract Background A hip replacement with a cemented or cementless femoral stem produces an effect on the bone called adaptive remodelling, attributable to mechanical and biological factors. All of the cementless prostheses designs try to achieve an optimal load transfer in order to avoid stress-shielding, which produces an osteopenia. Long-term densitometric studies taken after implanting ABG-I and ABG-II stems confirm that the changes made to the design and alloy of the ABG-II stem help produce less proximal atrophy of the femur. The simulation with FE allowed us to study the biomechanical behaviour of two stems. The aim of this study was, if possible, to correlate the biological and mechanical findings. Methods Both models with prostheses ABG-I and II have been simulated in five different moments of time which coincide with the DEXA measurements: postoperative, 6 months, 1, 3 and 5 years, in addition to the healthy femur as the initial reference. For the complete comparative analysis of both stems, all of the possible combinations of bone mass (group I and group II of pacients in two controlled studies for ABG-I and II stems, respectively, prosthetic geometry (ABG-I and ABG-II and stem material (Wrought Titanium or TMZF were simulated. Results and Discussion In both groups of bone mass an increase of stress in the area of the cancellous bone is produced, which coincides with the end of the HA coating, as a consequence of the bottleneck effect which is produced in the transmission of loads, and corresponds to Gruen zones 2 and 6, where no osteopenia can be seen in contrast to zones 1 and 7. Conclusions In this study it is shown that the ABG-II stem is more effective than the ABG-I given that it generates higher tensional values on the bone, due to which proximal bone atrophy diminishes. This biomechanical behaviour with an improved transmission of loads confirmed by means of FE simulation corresponds to the biological findings obtained with

  4. Preparation of artificial canine femoral stem with HA-Ti ladder-type coating on plasma-sprayed pure Ti substrate and its performance evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zeng Xianlin, E-mail: zxlxhh@163.com [Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022 (China); Li Jingfeng; Yang Shuhua; Zheng Qixin; Zou Zhenwei [Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022 (China)

    2012-03-01

    An ideal, biological-type, artificial femoral stem prosthesis has good stability and improved bone-prosthesis bonding capacity. In the current study, pure hydroxyapatite (HA)-coated, cementless, artificial femoral stems were prepared by adopting different plasma spray powers and distances and were tested in terms of shear strength. The pure titanium (Ti) substrates, HA coatings, and composite Ti-HA ladder-type coatings prepared under vacuum and atmospheric conditions were examined to compare the shear strengths, microscopic constitutions, and structures of the coatings. The coating was fabricated and the bond strength was improved by adopting 35 kW of spray power and an 80 mm spray distance. The comparisons show that the shear strength of the Ti coating prepared under vacuum conditions was higher than that of the coating prepared under atmospheric conditions (P < 0.05). Moreover, the pressure-shear strength of the Ti + HAG + Ti + V group coating was statistically significantly different from those of the HA + Ti + V and HA + Ti + A groups (P < 0.05). The coatings were compared using scanning electron microscopy, X-ray diffraction, and infrared spectrum analysis. The composite HA-Ti ladder-type coating group, where pure Ti substrate was sprayed onto the Ti alloy under vacuum conditions, had a successive laminate structure. In addition, the intergranular bond in the HA surface layer on the gradient coating was compact and highly crystallized. Under vacuum conditions, the plasma-sprayed layer was characterized by higher tightness, moderate porosity, higher bonding strength to HA, and higher HA crystallinity. The proposed coating can be used in new, cementless, artificial femoral stems with improved bone-prosthesis bonding capacity and stability.

  5. The potential application of a Cobalt Chrome Molybdenum femoral stem with functionally graded orthotropic structures manufactured using Laser Melting technologies.

    Science.gov (United States)

    Hazlehurst, K B; Wang, C J; Stanford, M

    2013-12-01

    The cementless fixation of porous coated femoral stems is a common technique employed for Total Hip Arthroplasty (THA). With the rate of revision surgery appearing to rise and younger more active patients requiring primary surgery it can be thought that alternative methods for increasing implant longevity need to be considered. The stress shielding of periprosthetic bone still remains a contributing factor to implant loosening, caused through a mismatch in stiffness between the implant and the bone. However, the ability to achieve stiffness matching characteristics is being realised through the use of Additive Layer Manufacturing (ALM) technologies and Functionally Graded Materials (FGM). This paper proposes an alternative design methodology for a monoblock Cobalt Chrome Molybdenum (CoCrMo) femoral stem. It hypothesises that a femoral stem suitable for cementless fixation can be manufactured using Laser Melting (LM) technology offering orthotropic functionally graded porous structures with similar mechanical properties to human bone. The structure and mechanical properties of the natural femur have been used as a basis for the design criteria which hypothesises that through a combination of numerical analysis and physical testing, an optimal design can be proposed to provide a lightweight, customised femoral stem that can reduce the risk of implant loosening through stress shielding whilst maintaining bone-implant interface stability.

  6. Stable Fixation of a Cementless, Proximally Coated, Double Wedged, Double Tapered Femoral Stem in Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Rolfson, Ola; Rubash, Harry E;

    2016-01-01

    BACKGROUND: The objective of this 5-year prospective study of 51 hips was to assess migration of a cementless tapered femoral stem using radiostereometric analysis (RSA), plain radiographs (radiolucencies), and patient-reported outcome measures (PROMs). METHODS: Forty-seven patients (51 hips...

  7. The contribution of the nonporous distal stem to the stability of proximally porous-coated canine femoral components.

    Science.gov (United States)

    Jasty, M; Krushell, R; Zalenski, E; O'Connor, D; Sedlacek, R; Harris, W

    1993-02-01

    The contribution of the distal nonporous-coated stem to the stability of the uncemented femoral components, which were porous coated only proximally, was investigated under two conditions: (1) immediately after insertion and (2) at 6 months, 1 year, and 2 years after surgery in a canine model. The relative motion of the femoral components at the bone porous-coating interface under loads simulating the canine midstance was measured at these time periods using displacement transducers. The measurements were repeated after severing the connection between the porous-coated proximal body and the nonporous-coated distal stem through a small hole in the anterior cortex. The results showed that while the distal nonporous-coated stem enhanced the immediate stability of the proximally porous-coated uncemented femoral components, it contributed little to the long-term stability of the femoral components after bony ingrowth had occurred in vivo. The mean relative motion between the body of the prosthesis and the cortical bone increased from 12 microns (+/- 7 microns) to 31 microns (+/- 34 microns) in the posterior transverse direction when the stem was immediately severed after the surgery. However, at 6 months, 1 year, and 2 years after surgery, extensive bone ingrowth had occurred into the proximal porous-coated regions of the body and provided excellent stability to the femoral components. With bone ingrowth, the mean relative motion was less than 5 microns at any site. Under these conditions, severing the stem did not increase the relative motion of the prostheses significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8436987

  8. Intravenous transplantation of allogeneic bone marrow mesenchymal stem cells and its directional migration to the necrotic femoral head

    Directory of Open Access Journals (Sweden)

    Zhang-hua Li, Wen Liao, Xi-long Cui, Qiang Zhao, Ming Liu, You-hao Chen, Tian-shu Liu, Nong-le Liu, Fang Wang, Yang Yi, Ning-sheng Shao

    2011-01-01

    Full Text Available In this study, we investigated the feasibility and safety of intravenous transplantation of allogeneic bone marrow mesenchymal stem cells (MSCs for femoral head repair, and observed the migration and distribution of MSCs in hosts. MSCs were labeled with green fluorescent protein (GFP in vitro and injected into nude mice via vena caudalis, and the distribution of MSCs was dynamically monitored at 0, 6, 24, 48, 72 and 96 h after transplantation. Two weeks after the establishment of a rabbit model of femoral head necrosis, GFP labeled MSCs were injected into these rabbits via ear vein, immunological rejection and graft versus host disease were observed and necrotic and normal femoral heads, bone marrows, lungs, and livers were harvested at 2, 4 and 6 w after transplantation. The sections of these tissues were observed under fluorescent microscope. More than 70 % MSCs were successfully labeled with GFP at 72 h after labeling. MSCs were uniformly distributed in multiple organs and tissues including brain, lungs, heart, kidneys, intestine and bilateral hip joints of nude mice. In rabbits, at 6 w after intravenous transplantation, GFP labeled MSCs were noted in the lungs, liver, bone marrow and normal and necrotic femoral heads of rabbits, and the number of MSCs in bone marrow was higher than that in the, femoral head, liver and lungs. Furthermore, the number of MSCs peaked at 6 w after transplantation. Moreover, no immunological rejection and graft versus host disease were found after transplantation in rabbits. Our results revealed intravenously implanted MSCs could migrate into the femoral head of hosts, and especially migrate directionally and survive in the necrotic femoral heads. Thus, it is feasible and safe to treat femoral head necrosis by intravenous transplantation of allogeneic MSCs.

  9. Analysis of Femoral Components of Cemented Total Hip- Arthroplasty

    CERN Document Server

    Singh, Shantanu

    2014-01-01

    In cemented Total Hip Arthroplasty (THA), material chosen for femoral stem and cross section of stem itself, proved to be critical parameters for, stress distribution in the femoral components, interfacial stresses and micro movements. Titanium alloy (Ti6Al4V), when used as a material for femoral stem, recorded large displacement as compared to Chromium alloy (CoCrMo) stems. This large displacement in case of Ti6Al4V caused the stem to bend inside the cement mantle, thus destroying it. Thus, CoCrMo proved to be a better in cemented THA. Failure in THA may occur at cement-stem or cement-bone interface, thus interfacial stresses and micro movements were analysed in the present study. Comparison between trapezium and circular cross section showed that, femoral stem with trapezium cross section underwent lesser amount of sliding and debonding, at both interfaces, as compared to circular cross section. Moreover, trapezium cross section also generated lower peak stresses in femoral stem and cortical femur. The pres...

  10. The Effect of Hydroxyapatite Coating on Long-term Results of Total Hip Arthroplasty with Hydroxyapatite-coated Anatomic Femoral Stem

    Science.gov (United States)

    Im, Chae-Hyun; Kim, Dae-Hee; Heo, Ju-Yeong; Jang, Young-Jae

    2014-01-01

    Purpose To evaluate the clinical and radiological results, as well as the survival rate, associated with total hip arthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplasty with a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the time of surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). The Harris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. We observed osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoral stems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation for any reasons was defined as the end point. Results The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only around the HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around the distal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. A reactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations were performed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stem survival rate was 75% over the mean duration of follow-up. Conclusion Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rate of revision operations due to osteolysis around the femoral stem in this long term follow-up study.

  11. Bone marrow mesenchymal stem cell transplantation combined with core decompression and bone grafting in the repair of osteonecrosis of femoral head

    Institute of Scientific and Technical Information of China (English)

    Zhang Yang; Wang Nan; Yang Li-feng; Ma Ji; Li Zhi

    2015-01-01

    BACKGROUND: Core decompression alone for osteonecrosis of femoral head easily causes fovea of femoral head and colapse of inner microstructure. Therefore, autologous bone is needed for filing and supporting. Moreover, bone marrow stem cel transplantation can decrease the incidence of femoral head colapse. OBJECTIVE:To discuss the clinical effects of core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels for osteonecrosis of femoral head. METHODS: A total of 33 patients were treated by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels in the Fourth Department of Bone Surgery, Central Hospital Affiliated to Shenyang Medical Colege in China from December 2012 to May 2013. RESULTS AND CONCLUSION:After the treatment by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels, Harris hip function score increased and pain disappeared in patients with osteonecrosis of femoral head. They could do various labors. Radiographs or CT examination displayed normal femoral head in 30 hips, accounting for 79%. Pain significantly reduced. Normal or slight limp walking was found in 15 hips, accounting for 40%. There were 35 hips in patients, whose walking distance was extended, accounting for 92%. 24 hips dysfunction was improved markedly, accounting for 63%. Al results suggested that core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels improved the local blood supply of femoral head, and played a positive role in promoting the necrotic bone absorption and bone repairing.

  12. Clinical significance of uncemented long femoral stem prosthesis in the treatment of Vancouver type B perprosthetic femoral fractures%非骨水泥长柄股骨假体治疗Vancouver B型股骨假体周围骨折

    Institute of Scientific and Technical Information of China (English)

    杨二平; 彭昊; 杜远立; 梁杰

    2016-01-01

    Objective To evaluate the clinical results of femoral revision using an uncemented long femoral stems with wire or memory titanium alloy embracing fixator in the treatment of Vancouver type B2 and B3 periprosthetic femoral fractures. Methods We retrospectively reviewed 17 cases of periprosthetic femoral fracture treated with the un-cemented long femoral stem prosthesis. Of these, eight cases were Vancouver type B2 periprosthetic femoral fractures, and nine cases were Vancouver type B3 periprosthetic femoral fractures. The clinical outcomes were assessed with Harris hip score. Radiological evaluations were conducted using Beals and Tower'criteria, and any complication during the fol-low-up period was recorded. Results The average follow-up period was 41.7 months. The average Harris hip score was 68.2 at the final follow-up. All fractures were united. There was femoral stem subsidence less than 10 mm in 4 cases with-out an evidence of loosening both radiologically and clinically. The radiological results using Beals and Towers' criteria were excellent in eight cases, good in five and poor in four. Conclusion An uncemented long femoral stem prosthesis with wire or memory titanium alloy embracing fixator provides a good fracture stability that promotes fracture healing and offers a successful solution for the management of Vancouver type B2 and B3 periprosthetic femoral fractures.%目的 探讨非骨水泥长柄股骨假体治疗人工髋关节置换术后VancouverB型股骨假体周围骨折的临床疗效.方法 回顾性分析宜昌市第一人民医院骨科2008年5月至2014年9月应用非骨水泥长柄股骨假体行股骨侧翻修结合钢丝或记忆合金环抱器固定治疗的Vancouver B2和B3型股骨假体周围骨折患者的临床资料,其中B2型8例,B3型9例.末次随访时采用Harris评分行髋关节功能评估,采用Beals和Tower标准行影像学评估,并记载随访时不良反应.结果 所有患者均获随访,平均随访41.7个月,末

  13. Analysis of Femoral Components of Cemented Total Hip Arthroplasty

    Science.gov (United States)

    Singh, Shantanu; Harsha, A. P.

    2015-10-01

    There have been continuous on-going revisions in design of prosthesis in Total Hip Arthroplasty (THA) to improve the endurance of hip replacement. In the present work, Finite Element Analysis was performed on cemented THA with CoCrMo trapezoidal, CoCrMo circular, Ti6Al4V trapezoidal and Ti6Al4V circular stem. It was observed that cross section and material of femoral stem proved to be critical parameters for stress distribution in femoral components, distribution of interfacial stress and micro movements. In the first part of analysis, designs were investigated for micro movements and stress developed, for different stem materials. Later part of the analysis focused on investigations with respect to different stem cross sections. Femoral stem made of Titanium alloy (Ti6Al4V) resulted in larger debonding of stem at cement-stem interface and increased stress within the cement mantle in contrast to chromium alloy (CoCrMo) stem. Thus, CoCrMo proved to be a better choice for cemented THA. Comparison between CoCrMo femoral stem of trapezium and circular cross section showed that trapezoidal stem experiences lesser sliding and debonding at interfaces than circular cross section stem. Also, trapezium cross section generated lower peak stress in femoral stem and cortical femur. In present study, femur head with diameter of 36 mm was considered for the analysis in order to avoid dislocation of the stem. Also, metallic femur head was coupled with cross linked polyethylene liner as it experiences negligible wear compared to conventional polyethylene liner and unlike metallic liner it is non carcinogenic.

  14. Minimal stress shielding with a Mallory-Head titanium femoral stem with proximal porous coating in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Lombardi Adolph V

    2009-12-01

    Full Text Available Abstract Background As longevity of cementless femoral components enters the third decade, concerns arise with long-term effects of fixation mode on femoral bone morphology. We examined the long-term consequences on femoral remodeling following total hip arthroplasty with a porous plasma-sprayed tapered titanium stem. Methods Clinical data and radiographs were reviewed from a single center for 97 randomly selected cases implanted with the Mallory-Head Porous femoral component during primary total hip arthroplasty. Measurements were taken from preoperative and long-term follow-up radiographs averaging 14 years postoperative. Average changes in the proximal, middle and diaphyseal zones were determined. Results On anteroposterior radiographs, the proximal cortical thickness was unchanged medially and the lateral zone increased 1.3%. Middle cortical thickness increased 4.3% medially and 1.2% laterally. Distal cortical thickness increased 9.6% medially and 1.9% laterally. Using the anteroposterior radiographs, canal fill at 100 mm did not correlate with bony changes at any level (Spearman's rank correlation coefficient of -0.18, 0.05, and 0.00; p value = 0.09, 0.67, 0.97. On lateral radiographs, the proximal cortical thickness increased 1.5% medially and 0.98% laterally. Middle cortical thickness increased 2.4% medially and 1.3% laterally. Distal cortical thickness increased 3.5% medially and 2.1% laterally. From lateral radiographs, canal fill at 100 mm correlated with bony hypertrophy at the proximal, mid-level, and distal femur (Spearman's rank correlation coefficient of 0.85, 0.33, and 0.28, respectively; p value = 0.001, 0.016, and 0.01, respectively. Conclusion Stress shielding is minimized with the Mallory-Head titanium tapered femoral stem with circumferential proximal plasma-sprayed coating in well-fixed and well-functioning total hip arthroplasty. Additionally, the majority of femora demonstrated increased cortical thickness in all zones

  15. External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration

    Directory of Open Access Journals (Sweden)

    Terasa Foo

    2013-01-01

    Full Text Available An appropriate animal model is critical for the research of stem/progenitor cell therapy and tissue engineering for bone regeneration in vivo. This study reports the design of an external fixator and its application to critical-sized femoral defects in athymic rats. The external fixator consists of clamps and screws that are readily available from hardware stores as well as Kirschner wires. A total of 35 rats underwent application of the external fixator with creation of a 6-mm bone defect in one femur of each animal. This model had been used in several separate studies, including implantation of collagen gel, umbilical cord blood mesenchymal stem cells, endothelial progenitor cells, or bone morphogenetic protein-2. One rat developed fracture at the proximal pin site and two rats developed deep tissue infection. Pin loosening was found in nine rats, but it only led to the failure of external fixation in two animals. In 8 to 10 weeks, various degrees of bone growth in the femoral defects were observed in different study groups, from full repair of the bone defect with bone morphogenetic protein-2 implantation to fibrous nonunion with collagen gel implantation. The external fixator used in these studies provided sufficient mechanical stability to the bone defects and had a comparable complication rate in athymic rats as in immunocompetent rats. The external fixator does not interfere with the natural environment of a bone defect. This model is particularly valuable for investigation of osteogenesis of human stem/progenitor cells in vivo.

  16. The influence of cement mantle thickness and stem geometry on fatigue damage in two different cemented hip femoral prostheses.

    Science.gov (United States)

    Ramos, A; Simões, J A

    2009-11-13

    Experimental models can be used for pre-clinical testing of cemented and other type of hip replacements. Total hip replacement (THR) failure scenarios include, among others, cement damage accumulation and the assessment of accurate stress and strain magnitudes at the cement mantle interfaces (stem-cement and cement-bone) can be used to predict mechanical failure. The aseptic loosening scenario in cemented hip replacements is currently not fully understood, and methods of evaluating medical devices must be developed to improve clinical performance. Different results and conclusions concerning the cement micro-cracking mechanism have been reported. The aim of this study was to verify the in vitro behavior of two cemented femoral stems with respect to fatigue crack formation. Fatigue crack damage was assessed at the medial, lateral, anterior and posterior sides of the Lubinus SPII and Charnley stems. All stems were loaded and tested in stair climbing fatigue loading during one million cycles at 2 Hz. After the experiments each implanted synthetic femur was sectioned and analyzed. We observed more damage (cracks per area) for the Lubinus SPII stem, mainly on the proximal part of the cement mantle. The micro-cracking formation initiated in the stem-cement interface and grew towards the direction of cortical bone of the femur. Overall, the cement-bone interface seems to be crucial for the success of the hip replacement. The Charnley stem provoked more damage on the cement-bone interface. A failure index (maximum length of crack/maximum thickness of cement) considered was higher for the cement-stem interface of the Lubinus SPII stem. For a cement mantle thickness higher than 5 mm, cracking initiated at the cement-bone interface and depended on the opening canal process (reaming procedure and instrumentation). The analysis also showed that fatigue-induced damage on the cement mantle, increasing proximally, and depended on the axial position of the stem. The cement

  17. Preparation of artificial canine femoral stem with HA-Ti ladder-type coating on plasma-sprayed pure Ti substrate and its performance evaluation

    Science.gov (United States)

    Zeng, Xianlin; Li, Jingfeng; Yang, Shuhua; Zheng, Qixin; Zou, Zhenwei

    2012-03-01

    An ideal, biological-type, artificial femoral stem prosthesis has good stability and improved bone-prosthesis bonding capacity. In the current study, pure hydroxyapatite (HA)-coated, cementless, artificial femoral stems were prepared by adopting different plasma spray powers and distances and were tested in terms of shear strength. The pure titanium (Ti) substrates, HA coatings, and composite Ti-HA ladder-type coatings prepared under vacuum and atmospheric conditions were examined to compare the shear strengths, microscopic constitutions, and structures of the coatings. The coating was fabricated and the bond strength was improved by adopting 35 kW of spray power and an 80 mm spray distance. The comparisons show that the shear strength of the Ti coating prepared under vacuum conditions was higher than that of the coating prepared under atmospheric conditions (P prosthesis bonding capacity and stability.

  18. Skeletal muscle perfusion and stem cell delivery in muscle disorders using intra-femoral artery canulation in mice.

    Science.gov (United States)

    Matthias, Nadine; Hunt, Samuel D; Wu, Jianbo; Darabi, Radbod

    2015-11-15

    Muscular dystrophies are among major inherited muscle disorders characterized by progressive muscle damage and fibrosis with no definitive cure. Recently, gene or cell based therapies have been developed to restore the missing gene expression or replace the damaged tissues. In order to test the efficiency of these therapies in mice models of muscular dystrophies, the arterial route of delivery is very advantageous as it provides uniform muscle exposure to the therapeutic agents or cells. Although there are few reports of arterial delivery of the therapeutic agents or cells in mice, there is no in-depth description and evaluation of its efficacy in perfusion of downstream muscles. This study is aimed to develop a practical method for intra-femoral artery perfusion in mice and to evaluate perfusion efficiency using near-infrared-fluorescence (NIRF) imaging as well as histology following stem cell delivery. Our results provide a practical guide to perform this delicate method in mice. By using a sensitive fluorescent dye, different muscle groups of the hindlimb have been evaluated for proper perfusion. As the final step, we have validated the efficiency of arterial cell delivery into muscles using human iPS-derived myogenic cells in an immunodeficient mouse model for Duchenne muscular dystrophy (NSG-mdx(4cv)).

  19. Skeletal muscle perfusion and stem cell delivery in muscle disorders using intra-femoral artery canulation in mice.

    Science.gov (United States)

    Matthias, Nadine; Hunt, Samuel D; Wu, Jianbo; Darabi, Radbod

    2015-11-15

    Muscular dystrophies are among major inherited muscle disorders characterized by progressive muscle damage and fibrosis with no definitive cure. Recently, gene or cell based therapies have been developed to restore the missing gene expression or replace the damaged tissues. In order to test the efficiency of these therapies in mice models of muscular dystrophies, the arterial route of delivery is very advantageous as it provides uniform muscle exposure to the therapeutic agents or cells. Although there are few reports of arterial delivery of the therapeutic agents or cells in mice, there is no in-depth description and evaluation of its efficacy in perfusion of downstream muscles. This study is aimed to develop a practical method for intra-femoral artery perfusion in mice and to evaluate perfusion efficiency using near-infrared-fluorescence (NIRF) imaging as well as histology following stem cell delivery. Our results provide a practical guide to perform this delicate method in mice. By using a sensitive fluorescent dye, different muscle groups of the hindlimb have been evaluated for proper perfusion. As the final step, we have validated the efficiency of arterial cell delivery into muscles using human iPS-derived myogenic cells in an immunodeficient mouse model for Duchenne muscular dystrophy (NSG-mdx(4cv)). PMID:26341268

  20. Treatment with embryonic stem-like cells into osteochondral defects in sheep femoral condyles

    OpenAIRE

    Pilichi, Susanna; Rocca, Stefano; Pool, Roy R.; Dattena, Maria; Masala, Gerolamo; Mara, Laura; Sanna, Daniela; Casu, Sara; Manunta, Maria L.; Manunta, Andrea; Sanna Passino, Eraldo

    2014-01-01

    Background Articular cartilage has poor intrinsic capacity for regeneration because of its avascularity and very slow cellular turnover. Defects deriving from trauma or joint disease tend to be repaired with fibrocartilage rather than hyaline cartilage. Consequent degenerative processes are related to the width and depth of the defect. Since mesenchymal stem cells (MSCs) deriving from patients affected by osteoarthritis have a lower proliferative and chondrogenic activity, the systemic or loc...

  1. Contact damage failure analyses of fretting wear behavior of the metal stem titanium alloy-bone cement interface.

    Science.gov (United States)

    Zhang, Lanfeng; Ge, Shirong; Liu, Hongtao; Wang, Qingliang; Wang, Liping; Xian, Cory J

    2015-11-01

    Although cemented titanium alloy is not favored currently in the Western world for its poor clinical and radiography outcomes, its lower modulus of elasticity and good biocompatibility are instrumental for its ability supporting and transforming physical load, and it is more suitable for usage in Chinese and Japanese populations due to their lower body weights and unique femoral characteristics. Through various friction tests of different cycles, loads and conditions and by examining fretting hysteresis loops, fatigue process curves and wear surfaces, the current study investigated fretting wear characteristics and wear mechanism of titanium alloy stem-bone cement interface. It was found that the combination of loads and displacement affected the wear quantity. Friction coefficient, which was in an inverse relationship to load under the same amplitude, was proportional to amplitudes under the same load. Additionally, calf serum was found to both lubricate and erode the wear interface. Moreover, cement fatigue contact areas appeared black/oxidative in dry and gruel in 25% calf serum. Fatigue scratches were detected within contact areas, and wear scars were found on cement and titanium surfaces, which were concave-shaped and ring concave/ convex-shaped, respectively. The coupling of thermoplastic effect and minimal torque damage has been proposed to be the major reason of contact damage. These data will be important for further studies analyzing metal-cement interface failure performance and solving interface friction and wear debris production issues. PMID:26241891

  2. Effects of femoral component material properties on cementless fixation in total hip arthroplasty. A comparison study between carbon composite, titanium alloy, and stainless steel.

    Science.gov (United States)

    Otani, T; Whiteside, L A; White, S E; McCarthy, D S

    1993-02-01

    Carbon-fiber-reinforced-carbon composite material is an attractive implant material because its modulus of elasticity can be made similar to that of cortical bone. This study investigated the effect of femoral prosthesis elastic modulus on cementless implant fixation. Distal, as well as proximal, relative micromovements between implant and bone were measured in two testing protocols (axial-load and torsional-load), comparing identically shaped carbon composite (modulus of elasticity = 18.6 GPa), Ti6Al4V (100 GPa), and 630 stainless steel (200 GPa) prostheses. In the axial-load test, proximal mediolateral micromotions were significantly larger in the flexible composite stem than in the two metals. In the torsional-load test, rotational micromotions and "slop" displacements in the flexible stem were significantly larger proximally and significantly smaller distally than in the two metals. While these results suggest that proximal stress transfer may be improved by a flexible stem, they raise the possibility of increased proximal micromotion, and suggest that improved proximal fixation may be necessary to achieve clinical success with flexible composite femoral components.

  3. Clinical outcomes of osteonecrosis of the femoral head after autologous bone marrow stem cell implantation: a meta-analysis of seven case-control studies

    Directory of Open Access Journals (Sweden)

    Heng-feng Yuan

    2016-02-01

    Full Text Available The purpose of this study was to evaluate the clinical outcomes of osteonecrosis of the femoral head after autologous bone marrow stem cell implantation. We searched the PubMed, Embase and Web of Science databases and included all case-control trials that reported on the clinical outcomes of osteonecrosis progression, incidence of total hip arthroplasty and improvement in Harris hip scores. Overall, seven case-control trials were included. Compared with the controls, patients treated with the bone marrow stem cells implantation treatment showed improved clinical outcomes with delayed osteonecrosis progression (odds ratio = 0.17, 95% CI: 0.09 - 0.32; p<0.001, a lower total hip arthroplasty incidence (odds ratio = 0.30, 95% CI: 0.12 - 0.72; p<0.01 and increased Harris hip scores (mean difference = 4.76, 95% CI: 1.24 - 8.28; p<0.01. The heterogeneity, publication bias, and sensitivity analyses showed no statistical difference significant differences between studies. Thus, our study suggests that autologous bone marrow stem cells implantation has a good therapeutic effect on osteonecrosis of the femoral, resulting in beneficial clinical outcomes. However, trials with larger sample sizes are needed to confirm these findings.

  4. Clinical outcomes of osteonecrosis of the femoral head after autologous bone marrow stem cell implantation: a meta-analysis of seven case-control studies.

    Science.gov (United States)

    Yuan, Heng-Feng; Zhang, Jing; Guo, Chang-An; Yan, Zuo-Qin

    2016-02-01

    The purpose of this study was to evaluate the clinical outcomes of osteonecrosis of the femoral head after autologous bone marrow stem cell implantation. We searched the PubMed, Embase and Web of Science databases and included all case-control trials that reported on the clinical outcomes of osteonecrosis progression, incidence of total hip arthroplasty and improvement in Harris hip scores. Overall, seven case-control trials were included. Compared with the controls, patients treated with the bone marrow stem cells implantation treatment showed improved clinical outcomes with delayed osteonecrosis progression (odds ratio = 0.17, 95% CI: 0.09 - 0.32; p <0.001), a lower total hip arthroplasty incidence (odds ratio = 0.30, 95% CI: 0.12 - 0.72; p <0.01) and increased Harris hip scores (mean difference = 4.76, 95% CI: 1.24 - 8.28; p<0.01). The heterogeneity, publication bias, and sensitivity analyses showed no statistical difference significant differences between studies. Thus, our study suggests that autologous bone marrow stem cells implantation has a good therapeutic effect on osteonecrosis of the femoral, resulting in beneficial clinical outcomes. However, trials with larger sample sizes are needed to confirm these findings. PMID:26934241

  5. Clinical Effects of Novel Nanoscaled Core Decompression Rods Combined with Umbilical Cord Mesenchymal Stem Cells on the Treatment of Early Osteonecrosis of the Femoral Head

    Directory of Open Access Journals (Sweden)

    Hongyang Gao

    2015-01-01

    Full Text Available Osteonecrosis of the femoral head (ONFH is one of the most common diseases in orthopedics. In this study, we investigated the clinical effects of novel nanoscaled core decompression rods combined with mesenchymal stem cells on the treatment of the ONFH. 12 adult patients with early ONFH (at the stage of Ficat II received the treatment using the implantation of novel nanoscaled core decompression rods combined with umbilical cord mesenchymal stem cells. The grade of the patients’ hip was scored by Harris marking system before and after the surgery, and then paired t-test was done. We assessed the curative efficiency based on the change of the patients before and after the surgery. In particular, the survival rate of femoral head was assessed at 12 months after the surgery. The results demonstrated that according to the standard of Harris Scoring, the average grade of hip joint before the surgery was 54.16 ± 4.23 points while average grade of hip joint at 12 months after the surgery was 85.28 ± 3.65 points. So, the implantation of the novel nanoscaled core decompression rods combined with mesenchymal stem cells had satisfactory clinical effects, suggesting that this implantation should be effective to treat early ONFH.

  6. Femoral hernia

    International Nuclear Information System (INIS)

    A retrospective study of 18 patients with femoral hernia assessed by herniography is presented. Although a palpable lump was present in 11 patients (61%), the diagnosis of a femoral hernia was not made before herniography. Surgical exploration was performed in 12 patients and a femoral hernia was found and repaired with beneficial outcome in 9 of them. In conclusion: herniography is of value for the diagnosis of a femoral hernia in patients with obscure groin pain. (author). 14 refs.; 2 figs

  7. Combining Concentrated Autologous Bone Marrow Stem Cells Injection With Core Decompression Improves Outcome for Patients with Early-Stage Osteonecrosis of the Femoral Head: A Comparative Study.

    Science.gov (United States)

    Tabatabaee, Reza Mostafavi; Saberi, Sadegh; Parvizi, Javad; Mortazavi, Seyed Mohammad Javad; Farzan, Mahmoud

    2015-09-01

    The management of early-stage osteonecrosis of the femoral head (ONFH) remains challenging. This study aimed to evaluate the effects of core decompression and concentrated bone marrow implantation on ONFH. The study recruited 28 hips with early ONFH randomly assigned into two groups of core decompression with (group A) and without (group B) bone marrow injection. Patients were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, Visual Analogue Scale (VAS) pain index, and MRI. The mean WOMAC and VAS scores in all patients improved significantly (PBone marrow stem cell injection with core decompression can be effective in early ONFH. PMID:26143238

  8. Exosomes from Human Synovial-Derived Mesenchymal Stem Cells Prevent Glucocorticoid-Induced Osteonecrosis of the Femoral Head in the Rat

    Science.gov (United States)

    Guo, Shang-Chun; Tao, Shi-Cong; Yin, Wen-Jing; Qi, Xin; Sheng, Jia-Gen; Zhang, Chang-Qing

    2016-01-01

    Osteonecrosis of the femoral head (ONFH) represents a debilitating complication following glucocorticoid (GC)-based therapy. Synovial-derived mesenchymal stem cells (SMSCs) can exert protective effect in the animal model of GC-induced ONFH by inducing cell proliferation and preventing cell apoptosis. Recent studies indicate the transplanted cells exert therapeutic effects primarily via a paracrine mechanism and exosomes are an important paracrine factor that can be directly used as therapeutic agents for tissue engineering. Herein, we provided the first demonstration that the early treatment of exosomes secreted by human synovial-derived mesenchymal stem cells (SMSC-Exos) could prevent GC-induced ONFH in the rat model. Using a series of in vitro functional assays, we found that SMSC-Exos could be internalized into bone marrow derived stromal cells (BMSCs) and enhance their proliferation and have anti-apoptotic abilities. Finally, SMSC-Exos may be promising for preventing GC-induced ONFH.

  9. Measurement of bone mineral density by dual-energy x-ray absorptiometry in patients with the Wisconsin hip, an uncemented femoral stem.

    Science.gov (United States)

    Kiratli, B J; Checovich, M M; McBeath, A A; Wilson, M A; Heiner, J P

    1996-02-01

    Although qualitative evidence of femoral bone remodeling, secondary to total hip arthroplasty (THA), is apparent on radiographs, quantification of change in bone mass from radiographs is limited. Dual-energy x-ray absorptiometry overcomes many of the limitations and yields accurate and precise bone mineral density (BMD) data. In this study, regional changes in femoral BMD were examined in 89 THA patients with a 2-year follow-up period. Thirty-two patients were evaluated initially before surgery and followed through the first 2 postoperative years. A second group was comprised of 57 patients whose surgery had been performed 1 to 6 years prior to entry into the study; they were also followed for 2 years hence. Thus, both immediate and later bone responses were evaluated prospectively. Maximal bone remodeling was seen in the first 6 months after THA and with a near plateau by the end of the first year. A slow yearly decline in BMD appeared to occur as long as 8 years after THA, thus demonstrating the long-term effects of the introduction of a femoral stem. Variance in preoperative BMD was explained by disease only; no other factors (age, weight, sex) showed significant associations, and body weight was the only variable that affected rate of remodeling after THA (not age, weight, sex, prosthesis size, nor disease). All patients were healthy, relatively young individuals who were good candidates for uncemented implantation, and none showed evidence of clinical complications or surgical failure. It is therefore suggested that the patterns and results reported here be viewed as normative data, that is, the typical skeletal adaptation to THA. In future application, observation of disparate BMD results as compared with these "normal" data may be predictive of abnormal response to surgery and potential for later problems.

  10. Is instillation of bone marrow stem cells at the time of core decompression useful for osteonecrosis of the femoral head?

    Directory of Open Access Journals (Sweden)

    Jorge Cabrolier

    2016-03-01

    Full Text Available La osteonecrosis de cabeza femoral lleva a degeneración de la cabeza y finalmente al desarrollo de artrosis de cadera. La descompresión constituye el tratamiento más utilizado, sin embargo su eficacia es limitada. Se ha planteado que la instilación de células madre en conjunto con la descompresión tendría mejores resultados. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen dos estudios controlados aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que instilar células madre de médula ósea al momento de la descompresión ósea en la osteonecrosis de cabeza femoral probablemente disminuye la progresión a artrosis de cadera y podría disminuir la necesidad de cirugías posteriores. No está claro si tiene algún efecto sobre la funcionalidad porque la certeza de la evidencia es muy baja.

  11. Fixation strength of taper connection at head-neck junction in retrieved carbon fiber-reinforced PEEK hip stems.

    Science.gov (United States)

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Sugano, Nobuhiko

    2014-12-01

    Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) hip prostheses possess numerous advantages over metal prostheses; however, the security of the taper connection between the CFR-PEEK stem and the modular femoral head in vivo has not been verified. Therefore, we mechanically examined the taper connection of retrieved in vivo loaded CFR-PEEK stems in comparison with in vivo loaded titanium alloy stems. CFR-PEEK and titanium alloy femoral stems with a 12/14 taper trunnion were implanted in ovine hips. A 22-mm ceramic head was intraoperatively impacted to the stem. Retrieved specimens were obtained following weight-bearing conditions for up to 39 postoperative weeks and taper junction pull-off tests were conducted. Postoperative retrieved CFR-PEEK stem pull-off strength was significantly greater than that at time zero. Postoperative retrieved CFR-PEEK stem pull-off strength was also significantly higher than that of postoperative retrieved titanium alloy stem. Microscopic findings of the taper surface revealed no obvious damage in the retrieved CFR-PEEK stems, whereas fretting and corrosion were observed in the retrieved titanium alloy stems. The present findings suggest that the taper connection between the ceramic head and the 12/14 CFR-PEEK stem trunnion is more secure than that between the ceramic head and the titanium alloy trunnion. PMID:25190272

  12. Mid-term study of bone remodeling after femoral cemented stem implantation: comparison between DXA and finite element simulation.

    Science.gov (United States)

    Herrera, Antonio; Rebollo, Sarai; Ibarz, Elena; Mateo, Jesús; Gabarre, Sergio; Gracia, Luis

    2014-01-01

    This five-year prospective study was designed to investigate periprosthetic bone remodeling associated with two cemented stem models, ABG-II (Stryker) and VerSys (Zimmer), randomly implanted in patients older than 75 years. The sample consisted of 64 cases (32, ABG-II; 32, VerSys). Inclusion criterion was diagnosis of osteoarthritis recommended for cemented total hip arthroplasty. Besides clinical study, Finite Element (FE) simulation was used to analyze biomechanical changes caused by hip arthroplasty. Bone Mineral Density (BMD) measurements showed a progressive increase in bone mass throughout the entire follow-up period for both stems, well correlated with FE results except in Gruen zones 4, 5, 6 for ABG-II and in zones 4, 5 for VerSys, denoting that remodeling in those zones does not depend on mechanical factors but rather on biological or physiological ones. PMID:23725926

  13. Autologous Bone Marrow Mesenchymal Stem Cells Associated with Tantalum Rod Implantation and Vascularized Iliac Grafting for the Treatment of End-Stage Osteonecrosis of the Femoral Head

    Directory of Open Access Journals (Sweden)

    Dewei Zhao

    2015-01-01

    Full Text Available Tantalum rod implantation with vascularized iliac grafting has been reported to be an effective method for the treatment of young patients with osteonecrosis of the femoral head (ONFH to avert the need for total hip arthroplasty (THA. However, there have been unsatisfactory success rates for end-stage ONFH. The authors describe a modified technique using bone marrow mesenchymal stem cells (BMMSCs associated with porous tantalum rod implantation combined with vascularized iliac grafting for the treatment of end-stage ONFH. A total of 24 patients (31 hips with end-stage ONFH were treated with surgery; ARCO IIIc stage was observed in 19 hips and ARCO IV stage was observed in 12 hips. All patients were followed for a mean time of 64.35 ± 13.03 months (range 26–78. Operations on only five hips were converted to THA. The joint-preserving success rate of the entire group was 89.47% for ARCO stage IIIc and 75% for ARCO stage IV. The mean Harris hip score of the 31 hips improved significantly from 38.74 ± 5.88 points (range 22–50 to 77.23 ± 14.75 points (range 33–95. This intervention was safe and effective in delaying or avoiding total hip replacement for end-stage ONFH.

  14. Comparison of Different Materials and Proximal Coatings Used for Femoral Components in One-Stage Bilateral Total Hip Arthroplasty.

    Science.gov (United States)

    Miyatake, Kazumasa; Jinno, Tetsuya; Koga, Daisuke; Yamauchi, Yuki; Muneta, Takeshi; Okawa, Atsushi

    2015-12-01

    To evaluate the mid-term effects of different materials and coatings used for femoral components, we prospectively performed 21 one-stage bilateral total hip arthroplasties using 2 anatomical stems which have identical geometries, randomized to side. One stem was made of Ti6Al4V alloy and had a hydroxyapatite coating on grit-blasted surface proximally, and the other was made of TMZF™ alloy and had a proximal coating of hydroxyapatite in addition to an arc-deposited titanium surface coating. Although we found extensions of radiopaque lines to the surface of coatings of seven grit-blasted stems whereas we found none in the case of the arc-deposited titanium stems, all hips showed excellent clinical and radiological outcomes as shown by radiographs and bone mineral density at the final follow-up, average 5.5 years postoperatively. PMID:26190568

  15. Cytotoxicity assessment of adipose-derived mesenchymal stem cells on synthesized biodegradable Mg-Zn-Ca alloys.

    Science.gov (United States)

    Fazel Anvari-Yazdi, Abbas; Tahermanesh, Kobra; Hadavi, Seyed Mohammad Mehdi; Talaei-Khozani, Tahereh; Razmkhah, Mahboobeh; Abed, Seyedeh Mehr; Mohtasebi, Maryam Sadat

    2016-12-01

    Magnesium (Mg)-based alloys have been extensively considered as biodegradable implant materials for orthopedic surgery. Mg and its alloys are metallic biomaterials that can degrade in the body and promote new bone formation. In this study, the corrosion behavior and cytotoxicity of Mg-Zn-Ca alloys are evaluated with adipose-derived mesenchymal stem cells (ASCs). Mg-2Zn and Mg-2Zn-xCa (x=1, 2 and 3wt.%) alloys were designated. Mg alloys were analyzed with scanning electron microscopy and potentiodynamic polarization. To understand the in-vitro biocompatibility and cytotoxicity of Mg-2Zn and Mg-2Zn-xCa alloys, ASCs were cultured for 24 and 72h in contact with 10%, 50% and 100% extraction of all alloys prepared in DMEM. Cell cytotoxicity and viability of ASCs were examined by MTT assay. Alloying elements including Zn and Ca improved the corrosion resistance of alloys were compared with pure Mg. The cytotoxicity results showed that all alloys had no significant adverse effects on cell viability in 24h. After 72h, cell viability and proliferation increased in the cells exposed to pure Mg and Mg-2Zn-1Ca extracts. The release of Mg, Zn and Ca ions in culture media had no toxic impacts on ASCs viability and proliferation. Mg-2Zn-1Ca alloy can be suggested as a good candidate to be used in biomedical applications.

  16. Embracing fixator for treating periprosthetic femoral fractures

    Institute of Scientific and Technical Information of China (English)

    张先龙; 章玮; 眭述平; 将垚; 曾炳芳

    2001-01-01

    @@Femoral fractures in the presence of other intramedullary implants are uncommon. These fractures are difficult to manage and the presence of other intramedullary implants creates a complex problem. The rate of these fractures has increased due to an increase in the number of patients having total hip arthroplasty (THA) and the use of various new techniques for femoral fractures.1-5 Literature on the treatment of femoral fractures with other intramedullary implants is rare.2,3 From 1995 to 1998, we reduced these fractures openly and fixed them with a shape memory alloy sawtooth-arm embracing fixator (EF), and the outcomes were satisfactory.

  17. Uncemented fully porous-coated long femoral stem prosthesis for management of Vancouver type B2 periprosthetic femoral fracture%生物型全涂层股骨长柄假体治疗Vancouver B2型股骨假体周围骨折

    Institute of Scientific and Technical Information of China (English)

    都斌; 王勇; 蒋建农; 张盘军; 焦杰君

    2015-01-01

    Objective To evaluate the clinical results of uncemented fully porous-coated long femoral stems in treating Vancouver type B2 periprosthetic femoral fracture following hip arthroplasty.Methods A retrospective analysis was made on 12 patients (12 hips) with Vancouver type B2 periprosthetic femoral fracture treated using the uncemented fully porous-coated long femoral stem prosthesis combined with cerclage fixation with steal-wire or titanium cable devices from February 2006 to January 2013.There were 5 males and 7 females,aged average 69.8 years (range,62 to 79 years).The status of primary arthroplasty was uncemented bipolar hemiarthroplasty in 2 patients and total hip arthroplasty in 10 patients (2 cement and 8 cementless femoral stems).At the final follow-up,Harris hip score for clinical evaluation,Beals and Tower's criteria for radiological evaluation,and complications were recorded.Results There were no intra-operative complications such as femoral perforation and femoral fracture.All patients were followed up for mean 38 months (range,24-72 months).At the last followup,mean Harris hip score was 87.2 points (range,50 to 100 points).All fractures healed at average 16 weeks (range,12-28 weeks).All the 12 hips showed prosthesis stability despite there was one femoral stem subsidence of 3 mm.One patient slipped and sustained another periprosthetic fracture (Vancouver type B1) at postoperative 4 months and was treated successfully with locking plate and cables.According to the Beals and Tower's criteria,there were 10 excellent,1 good and 1 poor results.Final follow-up revealed no complications of deep vein thrombosis,dislocation and prosthesis loosening.Conclusion Uncemented fully porous-coated long femoral stems provide good primary stability that promotes fracture healing and offers a reasonable treatment of Vancouver B2 femoral periprosthetic fracture.%目的 探讨应用生物型全涂层股骨长柄假体治疗人工髋关节置换术后VancouverB2型股骨假

  18. 经动脉骨髓干细胞移植治疗股骨头坏死61例%The artery transplantation of bone marrow stem cells to treat 61 cases of femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    高泽锋; 王娜; 许楠; 崔庆明; 曹晓芙

    2015-01-01

    目的:研究分析经动脉骨髓干细胞移植治疗股骨头坏死的临床效果。方法选取该院骨科2012年9月—2013年9月收治的61例股骨头坏死的患者,给予所有患者经动脉骨髓干细胞移植治疗,观察患者的临床治疗效果。结果所有患者通过治疗后,53例髋关节疼痛具有不同程度的缓解,占86.9%。其中行走间距延长的患者有33例,占54.1%;关节功能有所改善的患者有20例,占32.8%。患者的生活质量得到较好的提高,其总有效率为86.9%。结论针对股骨头坏死的患者,采取经动脉骨髓干细胞移植治疗,其操作方法简便、安全有效,在治疗的时候没有不良反应,其是治疗股骨头坏死的理想方式。%Objective Research and analysis the artery of the bone marrow stem cell transplantation for treatment of femoral head necrosis. Methods Select our hospital between September 2012 and September 2012 were 61 cases of patients with femoral head necrosis, giving all the artery in patients with bone marrow stem cell transplantation therapy, observe the clinical therapeutic effect of patients. Results With patients after treatment, 53 cases of the hip joint with different degree of pain relief, and accounted for 86.9%. 33 cases of patients with walking distance to extend, accounted for 54.1%; Joint function improvement in 20 cases of pa-tients, accounting for 32.8%. The patientˊs quality of life for the better, the total effective rate was 86.9%. Conclusion Via artery approaches for the patients with femoral head necrosis, bone marrow stem cell transplant treatment, its operation method is simple, safe and effective, and in the treatment of no adverse reaction, it is an ideal way to treat femoral head necrosis.

  19. 解剖型生物固定股骨柄假体的设计特征与临床应用效果%Design features and clinical results of anatomic femoral stem in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    蒋涛; 孙俊英; 查国春; 游镇君; 王涛

    2014-01-01

    BACKGROUND:Ribbed anatomic femoral stem meets the biomechanical features of the femur, and has achieved satisfactory clinical efficacy with good initial stability, rapid bone growth and low stress shielding. OBJECTIVE:To evaluate the design features and clinical results of the cementless anatomic Ribbed femoral stem (Ribbed stem) in total hip arthroplasty. METHODWe retrospectively analyzed 52 patients (52 hips) with hip joint disease who were treated with Ribbed stem in total hip arthroplasty between March 2010 and March 2012. There were 20 males and 32 females. The mean age was 59 years (range 22-78 years). The mean fol ow-up was 3.1 years (range 2-4 years). The preoperative and postoperative Harris hip scores, the rate of postoperative thigh pain, the incidence of intraoperative femoral fracture, wound healing, dislocation and revision were recorded. Radiographic evaluation was used to evaluate the rate of stem fil , subsidence of femoral stem, periprosthetic radiolucent line, bone ingrowth, stress shielding, and osteolysis. RESULTS AND CONCLUSION:The incidence of intraoperative femoral fracture was 6%. Al incisions were healed. There were no cases of hip dislocation and revision;the rate of thigh pain was 6%, no patient had thigh pain after 1 year postoperatively. The mean preoperative Harris hip score was 48 points, which improved to a mean of 96 points at the final fol ow-up. Postoperative X-ray showed that al patients had a satisfactory femoral fil in both planes and al of the femoral stems were wel-fixed at the final fol ow-up. The average fil ing rate was 91%, 88%and 86%by normotopia imaging, while 88%, 85%and 81%by lateral imaging, at the metaphysic, middle and distal ends respectively. At the final fol ow-up, 49 hips (92%) showed stable bone ingrowth, 3 hips showed stable fiber ingrowth. No osteolysis around the components at the femur or acetabulum was observed. 5 (10%) hips appeared the subsidence of femoral stems, which were  目的:探

  20. Tratamento da Osteonecrose da Cabeça Femoral com celulas progenitoras autólogas em anemia falciforme Femoral Head Necrosis treatment with autologous stem cells in sickle cell disease

    Directory of Open Access Journals (Sweden)

    Gildásio Cerqueira Daltro

    2008-01-01

    Full Text Available OBJETIVO: Avaliação da segurança e eficácia do uso de células progenitoras autólogas da medula óssea (CMMO no tratamento da Osteonecrose da Cabeça Femoral (OCF de pacientes portadores de anemia falciforme. MÉTODOS: Foram estudados 8 pacientes portadores de anemia falciforme, com OCF nos estágios I e II (classificação de Ficat e Arlet. As CMMO retiradas da crista ilíaca posterior foram concentradas e reinfundidas na área central da osteonecrose. Os principais parâmetros avaliados foram segurança, sintomas clínicos e progressão da doença, através da avaliação clínica (Harris Hip Score e radiológica. RESULTADOS: A maior parte dos pacientes (7 em 8 referiu melhora dos sintomas após o tratamento. Não houve complicações durante o procedimento anestésico e cirúrgico. A medida do escore (Harris Hip Score no pré-operatório foi 78,5 +/- 6,2 pontos, com aumento significativo destes valores no pós-operatório (98,3 +/- 2,5 pontos (pPURPOSE: To assess the efficacy and safety of autologous bone-marrow mononuclear cells (BMMC implantation in necrotic lesions of the femoral head in patients with sickle cell disease. METHODS: We studied eight patients with stage-I or -II femoral head osteonecrosis according to the system by Ficat and Arlet. BMMCs were harvested and re-infused into the necrotic zone. The primary endpoints studied were safety, clinical symptoms and disease progression, these being assessed according to the Harris hip score (HHS and to X-ray studies. RESULTS: After eight months, seven of the eight patients reported improvement from symptoms. There were no complications during anesthetic and surgery procedures. There was a significant postoperative increase in the HHS (98.3 +/- 2.5 points compared to preoperative HHS (78.5 +/- 6.2 points (p< 0.001. X-ray evaluation and cell parameters were found to be favorable. CONCLUSION: The autologous bone-marrow mononuclear cells implantation seems to be a safe and effective

  1. 骨髓间充质干细胞在治疗股骨头坏死方面的临床研究%Clinical study on the treatment of femoral head necrosis with Bone marrow mesenchymal stem cells

    Institute of Scientific and Technical Information of China (English)

    于德军; 刘丽晶; 吕艳欣; 田少华

    2015-01-01

    Objective To study the curative effect of bone marrow stem cell transplantation in the treatment of the femoral head necrosis.Methods Selecting 60 cases of patients in orthopedic department in the third hospital affiliated to Qiqihar medical college as study subjects, all the patients were at 1 or 2 stage according to ARCO stage standard.Among the patients 30 cases received the treatment of dead bone curettage plus bone transplantation plus marrow mesenchymal stem cell transplantation technology, however, the other 30 cases adopted the traditional treatment including dead bone curettage and bone transplantation.The change of the bone and the postoperative VAS pain score and Harris hip score were compared between the two groups, the rate of good curative effect of two kinds of treatment method using χ2 test.Results The differences of hospitalized time and cure efficacy between the two groups were statistically significant.Conclusions Treating femoral head necrosis with bone marrow mesenchymal stem cell transplantation can effectively restore the hip joint function, reduce hip pain symptoms, improve the blood supply of femoral head necrosis area, preventing the collapse of the femoral head, achieve femoral head protection and delay the time of hip replacement surgery.%目的:探讨骨髓间充质干细胞移植技术在治疗股骨头坏死的疗效。方法选用齐齐哈尔医学院附属第三医院骨科股骨头坏死患者60例,按ARCO分期均为1~2期,其中采用死骨刮除+植骨+骨髓间质干细胞移植技术治疗股骨头坏死患者30例,采用传统死骨刮除+植骨治疗股骨头坏死患者30例,通过放射线检查术后骨质变化情况和VAS疼痛评分及Harris 髋关节功能评分进行对比,对两种治疗方法疗效优良率采用χ2检验。结果两组患者住院时间及治疗效果比较差异显著,有统计学意义。结论骨髓间充质干细胞移植治疗股骨头坏死,能够有效恢复髋关

  2. Fracture of femoral total hip replacement components

    International Nuclear Information System (INIS)

    The biomechanical factors responsible for fatigue fracture of femoral total hip component stems were studied by laboratory loading simulations using implants which were instrumented with strain gauges. Stress levels were low when the prosthesis was rigidly fixed in acrylic along its entire length. Significantly higher stresses were recorded in stems which were loose in the acrylic or which were fixed in their distal portion only

  3. Tuning Mesenchymal Stem Cell Response onto Titanium-Niobium-Hafnium Alloy by Recombinant Fibronectin Fragments.

    Science.gov (United States)

    Herranz-Diez, C; Mas-Moruno, C; Neubauer, S; Kessler, H; Gil, F J; Pegueroles, M; Manero, J M; Guillem-Marti, J

    2016-02-01

    Since metallic biomaterials used for bone replacement possess low bioactivity, the use of cell adhesive moieties is a common strategy to improve cellular response onto these surfaces. In recent years, the use of recombinant proteins has emerged as an alternative to native proteins and short peptides owing to the fact that they retain the biological potency of native proteins, while improving their stability. In the present study, we investigated the biological effect of two different recombinant fragments of fibronectin, spanning the 8-10th and 12-14th type III repeats, covalently attached to a new TiNbHf alloy using APTES silanization. The fragments were studied separately and mixed at different concentrations and compared to a linear RGD, a cyclic RGD and the full-length fibronectin protein. Cell culture studies using rat mesenchymal stem cells demonstrated that low to medium concentrations (30% and 50%) of type III 8-10th fragment mixed with type III 12-14th fragment stimulated cell spreading and proliferation compared to RGD peptides and the fragments separately. On the other hand, type III 12-14th fragment alone or mixed at low volume percentages ≤50% with type III 8-10th fragment increased alkaline phosphatase levels compared to the other molecules. These results are significant for the understanding of the role of fibronectin recombinant fragments in cell responses and thus to design bioactive coatings for biomedical applications. PMID:26735900

  4. Femoral hernia repair

    Science.gov (United States)

    Femorocele repair; Herniorrhaphy; Hernioplasty - femoral ... During surgery to repair the hernia, the bulging tissue is pushed back in. The weakened area is sewn closed or strengthened. This repair ...

  5. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis...

  6. 21 CFR 888.3570 - Knee joint femoral (hemi-knee) metallic uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3570 Section 888.3570 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-knee) metallic uncemented prosthesis. (a) Identification. A knee joint femoral (hemi-knee) metallic uncemented prosthesis is a device made of alloys, such as cobalt-chromium-molybdenum, intended...

  7. 自体干细胞治疗股骨头坏死的手术室围术期护理研究%STUDY ON THE PERIOPERATIVE NURSING IN THE TREATMENT OF FEMORAL HEAD NECROSIS BY ;AUTOLOGOUS STEM CELLS

    Institute of Scientific and Technical Information of China (English)

    刘瑜; 陈芳

    2016-01-01

    Objective To study the process of perioperative nursing in the treatment of the femoral head necrosis,and to have a more cooperate on operation,and to ensure the operative process smoothly.Methods Taking a control study method,this research selected 45 cases of autologous stem cell transplantation with femoral head necrosis surgery from Jan.2014 to Dec.2014,treated in the hospital implementation,as the observation group,while the 42 cases of the patients with the same disease were selected as the control group in Jan.2013 and Dec.2013.Control group in accordance with the previous nursing routine nursing, observation group according to the nursing process of surgical nursing staff were targeted training,improve surgical nursing care standard and proficiency with,the nursing of the two groups were compared with the results of the difference.Results The operation start time,stem cell implantation time and the average op-eration time of the observation group were 15.3 +4.2(min),51.8+9.3(min)and 73.2 +7.5(min),re-spectively,significantly low than the control group [21.7 + 5.6 (min),58.0 + 8.6 (min),78.6 + 8.5 (min)],the difference was statistically significant (P 0.05).The Harris score of the observation group was 71.11%,higher than that of the control group,but the difference was not statistically significant(P >0.05).Conclusion For autolo-gous stem cell transplantation in the treatment of avascular necrosis of the femoral head surgery peri opera-tion period nursing process of nursing staff training is conducive to shorten the operation time and improve the doctor of surgical nursing staff with satisfaction.%目的:针对性的对自体干细胞移植治疗股骨头坏死手术室围术期护理流程进行研究,更好的配合手术操作,保障手术过程顺利完成。方法本研究采取对照研究方法,以2014年1—12月收治的在该院实施自体干细胞移植治疗股骨头坏死手术的45例患者作为观察组,2013年1—12月在该院实施自

  8. Femoral shaft fractures

    International Nuclear Information System (INIS)

    The femur is the longest, largest, and strongest bone in the body. Because of its length, width, and role as primary weight-bearing bone, it must tolerate the extremes of axial loading and angulatory stresses. Massive musculature envelopes the femur. This masculature provides abundant blood supply to the bone, which also allows great potential for healing. Thus, the most significant problem relating to femoral shaft fractures is not healing, but restoration of bone length and alignment so that the femoral shaft will tolerate the functional stresses demanded of it

  9. Interaction between mesenchymal stem cells and Ti-30Ta alloy after surface treatment.

    Science.gov (United States)

    Capellato, Patricia; Escada, Ana L A; Popat, Ketul C; Claro, Ana P R Alves

    2014-07-01

    In this study, in vitro cytocompatibility was investigated in the Ti-30Ta alloy after two kinds of surfaces treatments: alkaline and biomimetic treatment. Each condition was evaluated by scanning electron microscopy/energy-dispersive X-ray spectroscopy. Cellular adhesion, viability, protein expression, morphology, and differentiation were evaluated with Bone marrow stromal cells (MSCs) to investigate the short and long-term cellular response by fluorescence microscope imaging and colorimetric assays techniques. Two treatments exhibited similar results with respect to total protein content and enzyme activity as compared with alloy without treatment. However, it was observed improved of the biomineralization, bone matrix formation, enzyme activity, and MSCs functionality after biomimetic treatment. These results indicate that the biomimetic surface treatment has a high potential for enhanced osseointegration.

  10. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  11. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    Energy Technology Data Exchange (ETDEWEB)

    Citak, Musa; Jagodzinski, Michael; Krettek, Christian; Huefner, Tobias [Hannover Medical School, Trauma Department, Hannover (Germany); Citak, Mustafa [BG-University Hospital Bergmannsheil, Department of Surgery, Bochum (Germany); Kendoff, Daniel; O' Loughlin, Padhraig F. [Hospital for Special Surgery, Orthopaedic Department, New York, NY (United States); Tavassol, Frank [Hannover Medical School, Department of Oral and Maxillofacial Surgery, Hannover (Germany)

    2009-12-15

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  12. Estimation of pretraumatic femoral antetorsion in bilateral femoral shaft fractures

    International Nuclear Information System (INIS)

    To describe a system for measurement of the pretraumatic femoral antetorsion angle post-bilateral femoral shaft fracture with the use of new imaging software which allows segmentation and three dimensional (3D) reconstruction of DICOM (digital imaging and communications in medicine) images. This case involved a 20-year-old patient with bilateral femoral shaft fractures. Following initial clinical examination, CT scans of both femurs were performed. Subsequently, the DICOM datasets were uploaded to the new software tool. Following segmentation and 3D reconstruction, pretraumatic femoral antetorsion angles were determined. Femoral antetorsion was described and assessed in two ways by referring to the intersection of the posterior condylar plane and (1) a line drawn between the center of the femoral head and femoral neck, (2) a line drawn between the centers of the femoral head and greater trochanter. Using these definitions, values for femoral antetorsion were found to be, respectively, 20 at the right fracture site and 19 on the left site, and 33 bilaterally. The investigators describe in this current technical report the use of new imaging software which enables the calculation of femoral AV following reduction of virtual fracture fragments which are created from standard DICOM images. We believe that this 3D reconstruction method of measuring the antetorsion angle can be integrated into a regular treatment algorithm and may potentially optimize clinical outcomes. (orig.)

  13. Acute femoral neck fracture

    International Nuclear Information System (INIS)

    Ten patients with traumatic femoral neck fracture were studied with MR imaging (0.5 T, Magnetom, Siemens): unenhanced (multiecho, TR/TE = 1,600/30--240 [repetition time/echo time, msec]; gradient echo, TR/TE = 315/14, θ = 90 degrees) and Gd-DTPA enhanced (0.1 mM/kg body weight, Magnevist, Schering; gradient echo, TR/TE = 315/14, θ = 90 degrees). MR images were compared with clinical-radiographic findings. Digital subtraction angiography of the femoral head (FH) in five patients showed complete interruption of blood supply to the FH in three patients (signal intensity of FH did not increase on postcontrast images) and intact FH arteries in two patients (FH signal increased on postcontrast images, as did the healthy-side signal)

  14. Proximal Focal Femoral Deficiency

    Directory of Open Access Journals (Sweden)

    Vishal Kalia, Vibhuti

    2008-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a developmental disorder of the proximal segment of thefemur and of acetabulum resulting in shortening of the affected limb and impairment of the function. It isa spectrum of congenital osseous anomalies characterized by a deficiency in the structure of the proximalfemur. The diagnosis is often made by radiological evaluation which includes identification and descriptionof PFFD and evaluation of associated limb anomalies by plain radiographs. Contrast arthrography orMagnetic Resonance Imaging is indicated when radiological features are questionable and to disclose thepresence and location of the femoral head and any cartilagenous anlage. The disorder is more commonlyunilateral and is apparent at birth. However, bilateral involvement is rarely seen. Therapy of the disorder isdirected towards satisfactory ambulation and specific treatment depending on the severity of dysplasia.

  15. Prospective evaluation of femoral head viability following femoral neck fracture

    International Nuclear Information System (INIS)

    The bone scans of 33 patients (pts) with recent subcapital fractures (fx) of the femur were evaluated prospectively to determine their value in predicting femoral head visability. Each of the 33 pts (ll men, 22 women, age range 30-92) had a pre-operative bone scan within 72 hrs of the fx (23 pts within 24 hrs). Anterior and posterior planar views of both hips and pinhole views (50% of pts) were obtained 2 hrs after administration of Tc-99m HDP. The femoral head was classified as perfused if it showed the same activity as the opposite normal side or if it showed only slightly decreased activity. Femoral heads showing absent activity were classified as nonperfused. Overall, 20 of the 33 pts showed a photopenic femoral head on the side of the fx. Only 2 pts showed increased activity at hte site of the fx. Internal fixation of the fx was performed in 23 pts, 12 of whom had one or more follow-up scans. Five of these 12 pts showed absent femoral head activity on their initial scan, but 2 showed later reperfusion. The other 7 pts showed good perfusion initially, with only 1 later showing decreased femoral head activity. The other 10 pts (7 of whom had absent femoral head activity) had immediate resection of the femoral head and insertion of a Cathcart prosthesis. The results suggest that femoral head activity seen on a bone scan in the immediate post-fx period is not always a reliable indicator of femoral head viability. Decreased femoral head activity may reflect, in part, compromised perfusion secondary to post-traumatic edema, with or without anatomic disruption of the blood supply

  16. In vitro mesenchymal stem cell responses on laser-welded NiTi alloy.

    Science.gov (United States)

    Chan, C W; Hussain, I; Waugh, D G; Lawrence, J; Man, H C

    2013-04-01

    The biocompatibility of NiTi after laser welding was studied by examining the in vitro (mesenchymal stem cell) MSC responses at different sets of time varying from early (4 to 12h) to intermediate phases (1 and 4 days) of cell culture. The effects of physical (surface roughness and topography) and chemical (surface Ti/Ni ratio) changes as a consequence of laser welding in different regions (WZ, HAZ, and BM) on the cell morphology and cell coverage were studied. The results in this research indicated that the morphology of MSCs was affected primarily by the topographical factors in the WZ: the well-defined and directional dendritic pattern and the presence of deeper grooves. The morphology of MSCs was not significantly modulated by surface roughness. Despite the possible initial Ni release in the medium during the cell culture, no toxic effect seemed to cause to MSCs as evidenced by the success of adhesion and spreading of the cells onto different regions in the laser weldment. The good biocompatibility of the NiTi laser weldment has been firstly reported in this study. PMID:23827581

  17. Tribological characterization of surface-treated commercially pure titanium for femoral heads in total hip replacement: a feasibility study.

    Science.gov (United States)

    Cotogno, G; Holzwarth, U; Franchi, M; Rivetti, S; Chiesa, R

    2006-12-01

    Most noncemented total hip replacements combine a titanium alloy stem, a CoCrMo femoral head and an ultra-high molecular weight polyethylene (UHMWPE) acetabular cup. In spite of its nickel content of up to 1% and the resulting biocompatibility issues in some clinical situations, the higher cost and some difficulties in machining, CoCrMo alloy is preferred to titanium alloys thanks to its outstanding tribological properties, higher hardness and elastic modulus. Nowadays most of the heads of hip prostheses use CoCrMo as bearing material. The present study investigates the effect of various surface treatments and combinations of treatments, such as electrochemical oxidation (anodization), laser surface melting and barrel polishing, on the tribological properties of commercially pure grade 2 titanium. The aim of the study was to characterize surface treatments capable of improving the tribological properties of titanium surface to the same extent as CoCrMo. The tribological properties were characterized by multidirectional pin-on-flat screening wear tests, using UHMWPE pins as bearing surface. The experiments showed the possibility of improving the wear resistance of titanium to the degree of CoCrMo. Although further efforts will be required to optimize the treatments studied, the results are encouraging enough to warrant pursuing this direction of investigation.

  18. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P;

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  19. Scintigraphical observation of femoral head in femoral neck fractures

    International Nuclear Information System (INIS)

    In IO cases of femoral neck fracture treated with prosthetic replacement, the preopera tive sup(99m)Tc-MDP scintigraphs were investigated and then compared with each histological findings of the extracted femoral head. The appearances of the scintigraphs were classified into following 3 patterns; increased activity pattern of sup(99m)Tc-MDP uptake in the overall femoral head (type I) in 4 cases, deficient activity pattern at the lateral side correspond to weight-bearing area (type II) in 2 cases and considerably deficient activity pattern in the whole femoral head (type III) in remaining 4 cases. Histological examination of the extracted femoral heads revealed the narrow part of ischemic necrosis in type I. However type II showed extensive necrosis in the portion of deficient activity by scintigraphs and in type III, the femoral heads except articular cartilage were entirely necrotic. This classification of sup(99m)Tc-MDP scintigraphy is correlated with the degree of femoral head necrosis and it can be emphasized that the preoperative scintigraphy is a useful method to select osteosynthesis or prosthetic replacement treatment, etc. (author)

  20. 中央柄设计对髋关节表面置换术后股骨颈骨折风险影响的有限元分析%The influence of prosthesis stem design on femoral neck fracture by using finite element analysis

    Institute of Scientific and Technical Information of China (English)

    高宗炎; 高雁卿; 郑稼; 金毅; 唐超; 杨卫兵

    2015-01-01

    Objective To investigate the influence of prosthesis metaphyseal stem design on femoral neck fracture with a range of implant orientations.Methods A finite element model of the hip resurfacing arthroplasty was reconstructed on the basis of data of a normal femur (from a 63-year-old male) and a 50 mm birmingham hip resurfacing (BHR) prosthesis.And this modeling was used to indicate the effects of prosthesis metaphyseal stem design on femoral neck fracture with a given load of 0-6 kN,with a range of varus-valgus implant orientations.Results The analysis suggested that the intact femoral neck strength could be maintained across a wider range of varus-valgus orientations for short-stemmed and stemless prostheses.The model predicted that the damage initiation load would be decreased by approximately 20% with varus implant orientation and 10% in neutral orientation.Compared with the stemmed,traditional-design prosthesis,the short-stemmed and stemless designs had less weakening effect upon the femoral neck.For the stemless design in all orientations,the femoral neck strength was predicted to be within 5% of that for the intact bone,and the strength with the short-stemmed design was within 3% of the intact case.Conclusion The study suggests that a short-stemmed resurfacing head offers improved tolerance to misalignment over traditional designs.While femoral neck fractures are multifactorial,biomechanical factors are of clear importance to the clinical outcome,so this may reduce the risk for patients at the edge of the indications for hip resurfacing.%目的 观察表面置换股骨假体中央柄不同设计对置换术后股骨颈骨折风险的影响.方法 CT扫描1名63岁健康男性股骨近端,构建股骨近端有限元模型,以直径50 mm的Birmingham hip resurfacing(简称BHR)假体为模板,建立传统假体、短中央柄假体、无中央柄假体的模型,分别于中立位、外翻10°、内翻10°放置假体并骨水泥固定,模拟下肢单腿

  1. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  2. 髓心减压并自体骨髓干细胞移植治疗创伤性股骨头坏死%Treatment of avascular necrosis of femoral head by medullary core decompression and autograft bone marrow stem cells

    Institute of Scientific and Technical Information of China (English)

    王兵; 兴华; 王稼祥

    2009-01-01

    Objective To investigate the curative effects of medullary core decompression and autologous bone marrow stem cells transplantation in treatment of avascular necrosis of femoral head (ANFH). Methods Nine patients of avascular necrosis of femoral head were mobilized by rhG - CSF to get bone marrow stem cells. Bone marrow were collected on the nest day, then medullary core decompression, and the stem cells suspension was injected. After transplantation ,all the patients were followed up to observe the degree, property and duration of coxa joint pain. After 5 months arteriography of femora] head was carried out. Results Totally 9 patients were involved in the result analysis. Follow - up was performed for 10 months. The coxa joint pain were rcmissioned and the quality of life was improved. After 5 months,9 patients had arteriography of femoral head. The caliber of the arteria circumflexa femoris medialis, laterlis and arteria obturateria were thickening,new vessels grew more and blood flow rate became faster. Conclusions The operative treatment of avascular necrosis of femoral head under medullary core decompression and sutologous bone marrow stem cell transplantation has the advantages of light damage, simplicity and effectiveness.%目的 观察髓心减压并自体骨髓干细胞移植治疗股骨头坏死的临床效果.方法 9例股骨头坏死患者经骨髓干细胞动员后,第2天进行骨髓干细胞采集,经髓心减压后,将干细胞悬液缓慢匀速注入.干细胞移植后随访观察患者髋关节疼痛程度、性质及持续时间变化,5个月后行股骨头供血动脉造影术观察股骨头血供情况.结果 9例患者随访10个月,髋关节疼痛有不同程度缓解,关节功能改善.干细胞移植5个月后,9例患者股骨头供血动脉数字减影血管造影严查,均显示旋股内动脉及闭孔动脉管径增粗,新生血管增多,血流速度增快,股骨头血液供应明显改善.治疗中均为发生严重的并

  3. APPLICATION PROGRESS OF SIVASH-RANGE OF MOTION FEMORAL MODULAR STEM PROSTHESIS IN DEVELOPMENTAL DYSPLASIA OF HIP AND HIP REVISION%组配式S-ROM假体在髋关节发育不良及髋关节翻修术中的应用进展

    Institute of Scientific and Technical Information of China (English)

    赵众首; 孙俊英

    2012-01-01

    Objective To summarize the design and the biomechanical characteristics of Sivash-range of motion femoral modular stem (S-ROM) prosthesis and mainly to introduce its clinical use in developmental dysplasia of hip (DDH) and hip revision. Methods Literature concerning S-ROM prosthesis was extensively reviewed and analyzed. Results The S-ROM prosthesis based on the modularity feature can reach press-fit in metaphysis and diaphysis of femur concurrently. Additionaly, S-ROM prosthesis can fit for anatomic differences of the DDH femur and is capable of use in correction osteotomy and hip revision. Conclusion Modular junctions of S-ROM prosthesis increase the potentials of implant fracture and metallic debris production, so further follow-up study is needed to verify the long-term effectiveness.%目的 总结S-ROM (Sivash-range of motion femoral modular stem)假体设计及生物力学特点,以及在髋关节发育不良(developmental dysplasia of hip,DDH)的关节置换及髋关节翻修术中的应用进展. 方法 广泛查阅近年S-ROM假体的相关文献,并进行综合分析. 结果 S-ROM假体利用其组配性可以在股骨近端与远端同时达到紧密压配,适用于存在股骨解剖差异以及需行股骨截骨矫形的DDH人工全髋关节置换,以及伴骨缺损的髋关节翻修. 结论 S-ROM假体组配结合部增大了假体折断及产生金属磨屑的可能,其远期疗效需进一步随访明确.

  4. Calcar Preservation Arthroplasty for Unstable Intertrochanteric Femoral Fractures in Elderly

    OpenAIRE

    Celiktas, Mustafa; Togrul, Emre; Kose, Ozkan

    2015-01-01

    Background The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. Methods Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study. All patients were tr...

  5. 钽棒植入联合自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死%Early Clinical Results of Implantation of Tantalum Rod Combined Transplantation of Autologous Bone Marrow Mesenchy-mal Stem Cells for Early Stage of Avascular Necrosis of Femoral Head

    Institute of Scientific and Technical Information of China (English)

    梁红锁; 黄克; 李林; 张波; 韦程寿

    2014-01-01

    Objective:To study the effects of implantation of tantalum rod and transplantation of autologous bone mar-row mesenchymal stem cells for early stage of avascular necrosis of femoral head .Methods:27 patients with avascular necrosis of femoral head in the early stage were treated with implantation of tantalum rod and transplantation of autolo-gous bone marrow mesenchymal stem cells .Results:The average period of follow-up was thirteen months (7 ~ 24 months) .Pain of all patients disappeared .The movement range of the hip joint was normal or approximate to normal . Except two cases evolved to stage of ARCOⅢ ,X-ray showed that cystic degeneration disappeared .The Harris score was 54 .2 ± 7 .1 before operation and it increased significantly to 83 .9 ± 8 .6 after operation .Conclusion:It has the ad-vantage to minimal damage of implantation of tantalum rod and transplantation of autologous bone marrow mesenchy-mal stem cells for early stage of avascular necrosis of femoral head .It is an effective way for the treatment of femoral head necrosis .The short-term efficacy is good .%目的:观察钽棒植入联合自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死的临床疗效。方法:对27例ARCOⅠ、Ⅱ期的ANFH患者采用股骨头髓芯减压后植入钽棒并联合自体骨髓间充质干细胞移植。结果:所有患者经过7~24个月(平均13个月)的随访,关节疼痛基本消失,活动范围接近或恢复正常,除2例患者进展为ARCOⅢ期外,其余股骨头均无塌陷,影像学检查结果示股骨头囊性变消失,Harris评分由术前的(54.2±7.1)分提高到术后(83.9±8.6)分。结论:钽棒植入联合自体骨髓间充质干细胞移植治疗早期股骨头缺血性坏死,具有创伤小、疗效确切等优点,近期临床疗效良好。

  6. 体外冲击波疗法联合自体骨髓干细胞移植治疗股骨头坏死%Extracorporeal shock wave therapy combined with autologous bone marrow stem cells transplantation for osteonecrosis treatment of femoral head

    Institute of Scientific and Technical Information of China (English)

    邢更彦; 张鹏礼; 姜川; 刘水涛

    2011-01-01

    Objective To evaluate the therapeutic effects of extracorporeal shock wave therapy ( ESWT ) combined with autologous bone marrow stem cells transplantation for osteonecrosis of the femoral head (ONFH ), and to explore new treatment of saving the head. Methods 120 patients ( 180 hips ) with ONFH were inrolled in General Hospital of Chinese Armed Police Force from January 2006 to June 2009. All patients were divided into four groups: blank control group, ESWT group, stem cell transplantation group and combining group. Harris score was used to evaluate hip function during follow-up by telephone and mail. The collapse of femoral head was summarized. and the collapse rates in the third year were compared among the four groups. Results Harris score of extracorporeal shock wave therapy combined with autologous bone marrow stem cell transplantation group was significantly better than ESWT group ( P < 0. 05 ) and stem cell transplantation group. The head collapse rate of the combining group in the third year was lower than the other groups. Conclusions Based on these results, it is concluded that with the features such as effective, minimally invasive and easily accepted by patients. the therapy is an ideal method of saving the femoral head with osteonecrosis.%目的 应用体外冲击波疗法(ESWT)联合自体骨髓干细胞移植治疗股骨头坏死(ONFH),分析其治疗效果,探索该病新的保髋治疗方法.方法 收集2006年1月至2009年6月在武警总医院收治的股骨头缺血性坏死患者120例180髋,分为空白对照组,单纯ESWT组,单纯干细胞移植组以及联合治疗组,采用髋关节功能评分标准(Harris评分)对患者进行电话随访以及书信随访,对治疗前后髋关节功能进行评价;统计所收集患者的股骨头塌陷情况,比较随访3年时各组股骨头塌陷率.结果 ESWT联合自体骨髓干细胞移植治疗ONFH在harris评分明显优于单纯ESWT组(P<0.05),以及单纯骨髓干细胞移植术(P<0.05),

  7. Pseudopathologic fracture of the femoral neck

    International Nuclear Information System (INIS)

    We have seen two cases of traumatic subcapital fractures of the femoral neck which resembled pathologic fractures on plain radiography. We have named this entity pseudopathologic fracture of the femoral neck and offer suggestions for why it occurs. (orig.)

  8. Femoral neck shortening after internal fixation

    OpenAIRE

    LIU, YUE; AI, Zi Sheng; Shao, Jin; Yang, Tieyi

    2014-01-01

    Objective: The aim of this study was to assess the factors affecting femoral neck shortening after internal fixation of femoral neck fractures. Methods: Eighty-six patients with femoral neck fractures were treated using three parallel cannulated screws between May 2004 and January 2011. The shortening of the femoral neck in the horizontal (X), vertical (Y), and along the resultant along the (Z) vector (XÆ, YÆ, ZÆ) was measured on anteroposterior radiographs corrected by screw diameter and ...

  9. Mechanical implications of interfacial defects between femoral hip implants and cement: a finite element analysis of interfacial gaps and interfacial porosity.

    NARCIS (Netherlands)

    Scheerlinck, T.; Broos, J.; Janssen, D.; Verdonschot, N.J.J.

    2008-01-01

    Two types of defect between femoral hip implants and cement have been identified. Interfacial porosity arises from cement shrinkage during curing and presents as pores randomly located along the stem. Interfacial gaps are much larger stem-cement separations caused by air introduced during stem inser

  10. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  11. Preliminary study of influence of bone tissue from osteonecrosis of femoral head on the proliferation and differentiation of canine bone marrow mesenchymal stem cells%股骨头坏死骨组织对骨髓间充质干细胞增殖分化的影响

    Institute of Scientific and Technical Information of China (English)

    王萌; 廖琦; 周斌; 仇志强; 程立明

    2013-01-01

    Objective To examine the effects of bone tissue from osteonecrosis of femoral head on the proliferation and differentiation of canine bone marrow mesenchymal stem cells in vitro culture.Methods A canine model of femoral head osteonecrosis was induced by liquid nitrogen freezing.BMSC were isolated from dog ilium bone marrow by a combination of gradient centrifugation and adherent wall culture.Different bone tissues and BMSC were cultivated indirectly in vitro by co-cultured in Transwell plate.According to the culture media,3 groups were established:blank group (10% FBS/DMEM),control group (10% FBS/DMEM + bone tissue from natural femoral head) and experimental group(10% FBS/DMEM + bone tissue from osteonecrosis of femoral head).Cell proliferation was measured by methylthiazol tetrazolium (MTT)method.Cell differentiation was examined by alkaline phosphatase (ALP) staining and its concentration examined.Alizarin red staining method was used to study the calcification effects and Oil red O staining method was used to detect if there was fat emergence.Results As compared with the blank group,the proliferation in the control and experiment groups were significantly promoted after culturing for Days 1,3 and 5 (P < 0.05).The proliferation of the experiment group was higher than the control group at Day 5 and 7 day (P < 0.05).After a 7-day co-culturing,ALP staining was positive in the control and experiment groups.At Day 7 and 9,the ALP activity in culture fluid was in this order:control group > experiment group >blank group(P <0.05).Alizarin red staining show control group had the most calcium nodules(12.17 ±2.48,P < 0.05) and the number of calcium nodules in the experiment group was more than the blank group (P <0.05).Oil red O staining show there was no fat emergence after 21 days in every group.Conclusion Both natural and osteonecrotic bone tissue of femoral head could promoted the proliferation of canine BMSC and induces them osteogenic

  12. Successful transplant of mesenchymal stem cells in induced osteonecrosis of the ovine femoral head: preliminary results Sucesso no transplante de células tronco mesenquimais em ovinos com osteonecrose induzida da cabeça do fêmur: resultados preliminares

    Directory of Open Access Journals (Sweden)

    Matheus Levi Tajra Feitosa

    2010-10-01

    Full Text Available PURPOSE: Evaluate the bone tissue recovery following transplantation of ovine mesenchymal stem cells (MSC from bone marrow and human immature dental-pulp stem cells (hIDPSC in ovine model of induced osteonecrosis of femoral head (ONFH. METHODS: Eight sheep were divided in three experimental groups. First group was composed by four animals with ONFH induced by ethanol through central decompression (CD, for control group without any treatment. The second and third group were compose by two animals, six weeks after ONFH induction received transplantation of heterologous ovine MSC (CD + oMSC, and hIDPSC (CD + hIDPSC, respectively. In both experiments the cells were transplanted without application of any type of immunosupression protocol. RESULTS: Our data indicate that both cell types used in experiments were able to proliferate within injured site providing bone tissue recovery. The histological results obtained from CD+hIDPSC suggested that the bone regeneration in such animals was better than that observed in CD animals. CONCLUSION: Mesenchymal stem cell transplant in induced ovine osteonecrosis of femoral head by central decompression technique is safe, and apparently favors bone regeneration of damaged tissues.OBJETIVO: Verificar os efeitos das células-tronco mesenquimais da medula óssea de ovinos e da polpa dentária imatura humana em ovinos com osteonecrose induzida, da cabeça do fêmur. MÉTODOS: Oito ovelhas foram distribuídas em três grupos experimentais. O primeiro grupo foi composto por quatro animais com osteonecrose da cabeça do fêmur induzida por etanol através da descompressão central, que não receberam nenhum tratamento. O segundo e o terceiro grupo, cada um composto por dois animais, receberam transplante heterólogo de células tronco mesenquimais de ovinos e polpa dentária imatura humana seis semanas após a indução da osteonecrose da cabeça do fêmur, respectivamente. Em ambos os grupos experimentais as c

  13. Superselective intra-arterial DSA in patients with femoral head necrosis and femoral neck fracture

    International Nuclear Information System (INIS)

    The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.)

  14. Unusual Contents of the Femoral Hernia

    OpenAIRE

    Ahmed Alzaraa

    2011-01-01

    Different contents in the femoral hernia have been reported in the literature, but herniation of the fallopian tube in a femoral hernia is very rare due to its normal anatomical position. Case Presentation. A female patient was admitted to the surgical ward for a lump in the right groin. Clinical examination confirmed a right femoral hernia. The patient underwent surgery to repair the hernia. Intraoperatively, the right uterine tube was found in the hernia. The tube was reduced back into the ...

  15. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    International Nuclear Information System (INIS)

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  16. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right...

  17. Method for Characterization of Material Loss from Modular Head-Stem Taper Surfaces of Hip Replacement Devices

    OpenAIRE

    Racasan, Radu; Bills, Paul J.; Blunt, Liam; Hart, Alister; Skinner, John

    2015-01-01

    Assessment of the head-stem taper junction requires the estimation of material loss from the taper surfaces of both femoral head and stem. This paper describes a method for the measurement and analysis of material loss from the modular taper junction of hip replacements, in particular femoral stem tapers where generally the entire taper surface has been engaged. In such cases no direct unworn datum is readily identifiable to assess material loss. The highly anisotropic topology of some stem d...

  18. Self-assembled monolayers of alendronate on Ti6Al4V alloy surfaces enhance osteogenesis in mesenchymal stem cells

    Science.gov (United States)

    Rojo, Luis; Gharibi, Borzo; McLister, Robert; Meenan, Brian J.; Deb, Sanjukta

    2016-07-01

    Phosphonates have emerged as an alternative for functionalization of titanium surfaces by the formation of homogeneous self-assembled monolayers (SAMs) via Ti-O-P linkages. This study presents results from an investigation of the modification of Ti6Al4V alloy by chemisorption of osseoinductive alendronate using a simple, effective and clean methodology. The modified surfaces showed a tailored topography and surface chemistry as determined by SEM microscopy and RAMAN spectroscopy. X-ray photoelectron spectroscopy revealed that an effective mode of bonding is created between the metal oxide surface and the phosphate residue of alendronate, leading to formation of homogenous drug distribution along the surface. In-vitro studies showed that alendronate SAMs induce differentiation of hMSC to a bone cell phenotype and promote bone formation on modified surfaces. Here we show that this novel method for the preparation of functional coatings on titanium-based medical devices provides osseoinductive bioactive molecules to promote enhanced integration at the site of implantation.

  19. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  20. 羟基磷灰石涂层股骨柄初次全髋关节置换随机对照试验的meta分析%Comparing hydroxyapatite coated versus non hydroxyapatite coated femoral stems in primary total hip arthroplasty: a meta analysis of randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    李书振; 林宗汉; 陈跃平; 高辉; 崔伟; 范锲

    2013-01-01

    Objective To evaluate the difference of clinical outcomes and radiological outcomes through meta-analysis on the total hip arthroplasty (THA) between hydroxyapatite (HA) coating and non-HA coating femoral stems.Methods We searched the MEDLINE,Embase,Cochrane library and CBM for published randomized controlled trial (RCT) comparing HA coating and non-HA coating femoral stems in primary THA clinical outcomes with Harris hip score and incidence postoperative thigh pain,radiological outcomes with presence of endosteal condensation and radioactive line on the prothesis,heterotopic ossification.Data analysis were performed using RevMan 5.0 (the Cochrane Collaboration).Results Ten studies and 917 hips into our analysis,with 464 hips in HA groups and 453 hips in non-HA groups.The combined results of the meta-analysis indicated there was no statistical differences between the two groups on postoperative Harris hip score (WMD =3.04,95% CI:-4.47-10.54,P =0.43),there was statistical difference on incidence postoperative thigh pain (RR =0.56,95 % CI:0.33-0.94,P =0.03).There were no significant differences between the two groups on presence of endosteal condensation(RR =1.01,95% CI:0.91-1.11,P =0.91),presence of radioactive line (RR =0.99,95% CI:0.88-1.11,P =0.83) and incidence of heterotopic ossification(RR =0.97,95% CI:0.77-1.21,P =0.77).Conclusions There are no clinical and radiological benefits in the use of HA coating femoral stems in Primary THA,there is not enough evidence prove the HA can reduce the incidence postoperative thigh pain.%目的 评价羟基磷灰石涂层与非羟基磷灰石涂层股骨柄初次全髋关节置换术的临床和放射学结果差异.方法 计算机检索MEDLINE、Embase、Cochrane图书馆、中国生物医学文献数据库,搜集比较羟基磷灰石涂层与非羟基磷灰石涂层股骨柄初次全髋关节置换术的随机对照试验,临床结果评价指标包括Harris评分、大腿疼痛发生率,放射学结果评价

  1. The femoral sulcus in total knee arthroplasty.

    Science.gov (United States)

    Lingaraj, Krishna; Bartlett, John

    2009-05-01

    The position of the femoral sulcus relative to the midline of the distal femoral resection in total knee arthroplasty (TKA) was studied to determine if centralized placement of the femoral component on the distal femur was justified in terms of aligning the prosthetic sulcus with the native femoral sulcus. The location of the femoral sulcus was studied in 112 consecutive patients undergoing TKA. The mean sulcus position was 0.7 mm lateral to the midline of the distal femoral resection (SD 1.4, 95% CI, 0.5-1.0 mm). However, the variation in sulcus positions ranged from 4 mm medial to 4 mm lateral to the midline. The mean sulcus position in valgus knees was 1.0 mm lateral to the midline (SD 1.8), and that in varus knees was 0.7 mm lateral to the midline (SD 1.2) (P = 0.501). It appears prudent to centre the femoral component on the native sulcus rather than the midline of the distal femoral resection, so as to ensure accurate alignment of the prosthetic sulcus with the native sulcus and to encourage normal patella tracking.

  2. Effect of laser treatment on the attachment and viability of mesenchymal stem cell responses on shape memory NiTi alloy

    Energy Technology Data Exchange (ETDEWEB)

    Chan, C.W., E-mail: c.w.chan@qub.ac.uk [School of Mechanical and Aerospace Engineering, Queen' s University, Belfast, Northern Ireland (United Kingdom); Hussain, I. [School of Life Sciences, University of Lincoln, Brayford Pool, Lincoln, Lincolnshire LN6 7TU (United Kingdom); Waugh, D.G.; Lawrence, J. [Laser Engineering and Manufacturing Research Group, Faculty of Science and Engineering, University of Chester, Parkgate Road, Chester, CH1 4BJ (United Kingdom); Man, H.C. [Department of Industrial and Systems Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong (China)

    2014-09-01

    The objectives of this study were to investigate the effect of laser-induced surface features on the morphology, attachment and viability of mesenchymal stem cells (MSCs) at different periods of time, and to evaluate the biocompatibility of different zones: laser-melted zone (MZ), heat-affected zone (HAZ) and base metal (BM) in laser-treated NiTi alloy. The surface morphology and composition were studied by scanning electron microscope (SEM) and X-ray photoemission spectroscopy (XPS), respectively. The cell morphology was examined by SEM while the cell counting and viability measurements were done by hemocytometer and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) colorimetric assay. The results indicated that the laser-induced surface features, such as surface roughening, presence of anisotropic dendritic pattern and complete surface Ni oxidation were beneficial to improve the biocompatibility of NiTi as evidenced by the highest cell attachment (4 days of culture) and viability (7 days of culture) found in the MZ. The biocompatibility of the MZ was the best, followed by the BM with the HAZ being the worst. The defective and porous oxide layer as well as the coarse grained structure might attribute to the inferior cell attachment (4 days of culture) and viability (7 days of culture) on the HAZ compared with the BM which has similar surface morphology. - Highlights: • Laser-treated surface induces a more spreading cell morphology than the non-treated. • Laser-treated surface shows higher cell attachment and viability than the non-treated. • Laser surface treatment is a feasible method to improve the responses of MSCs. • The improvement is attributed to the surface features induced by laser treatment.

  3. Computer navigation experience in hip resurfacing improves femoral component alignment using a conventional jig

    Directory of Open Access Journals (Sweden)

    Zachary Morison

    2013-01-01

    Full Text Available Background:The use of computer navigation has been shown to improve the accuracy of femoral component placement compared to conventional instrumentation in hip resurfacing. Whether exposure to computer navigation improves accuracy when the procedure is subsequently performed with conventional instrumentation without navigation has not been explored. We examined whether femoral component alignment utilizing a conventional jig improves following experience with the use of imageless computer navigation for hip resurfacing. Materials and Methods:Between December 2004 and December 2008, 213 consecutive hip resurfacings were performed by a single surgeon. The first 17 (Cohort 1 and the last 9 (Cohort 2 hip resurfacings were performed using a conventional guidewire alignment jig. In 187 cases, the femoral component was implanted using the imageless computer navigation. Cohorts 1 and 2 were compared for femoral component alignment accuracy. Results:All components in Cohort 2 achieved the position determined by the preoperative plan. The mean deviation of the stem-shaft angle (SSA from the preoperatively planned target position was 2.2° in Cohort 2 and 5.6° in Cohort 1 ( P = 0.01. Four implants in Cohort 1 were positioned at least 10° varus compared to the target SSA position and another four were retroverted. Conclusions: Femoral component placement utilizing conventional instrumentation may be more accurate following experience using imageless computer navigation.

  4. Fixation of non-cemented total hip arthroplasty femoral components in a simulated proximal bone defect model.

    Science.gov (United States)

    Sangiorgio, Sophia N; Ebramzadeh, Edward; Knutsen, Ashleen R; Borkowski, Sean L; Kalma, Jeremy J; Bengs, Benjamin C

    2013-10-01

    An accelerated sequential proximal femoral bone loss model was used to measure the initial stability of three noncemented femoral stem designs: fully porous-coated, proximally porous-coated, and dual-tapered, diaphyseal press-fit (N=18). Only dual-tapered, diaphyseal press-fit stems remained stable with as much as 105 mm of bone loss, with average cyclic micromotion remaining below 25 μm in ML and below 10 μm in AP planes. In contrast, with proximally coated and fully coated stem designs with circular or oval cross-sections, 60mm of bone loss, resulting in lower than 10 cm of diaphyseal bone contact length, led to gross instability, increasing average cyclic micromotions to greater than 100 μm prior to failure. Therefore, the results provide support for using a dual-tapered stem in revision cases with proximal bone loss. PMID:23523487

  5. Subchondral insufficiency fractures of the femoral head

    International Nuclear Information System (INIS)

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  6. Tension free femoral hernia repair with plug

    Institute of Scientific and Technical Information of China (English)

    Milivoje Vukovi; Neboja Moljevi; Sinia Crnogorac

    2013-01-01

    Objective: To investigate the conventional technique involves treatment of femoral hernia an approximation inguinal ligament to pectineal ligament. In technique which uses mesh closure for femoral canal without tissue tension. Method: A prospective study from January 01. 2007-May 30. 2009. We analyzed 1 042 patients with inguinal hernia, of which there were 83 patients with 86 femoral hernia. Result: Femoral hernias were present in 7.96% of cases. Males were 13 (15.66%) and 70 women (84.34%). The gender distribution of men: women is 1:5.38. Urgent underwent 69 (83%), and the 14 election (17%) patients. Average age was 63 years, the youngest patient was a 24 and the oldest 86 years. Ratio of right: left hernias was 3.4:1. With bilateral femoral hernias was 3.61% of cases. In 7 patients (8.43%) underwent femoral hernia repair with 9 Prolene plug. Conclusions: The technique of closing the femoral canal with plug a simple. The plug is made from monofilament material and is easily formed. This technique allows the reduction of recurrence and can be used safely, quickly and easily in elective and emergency situations.

  7. Lateral femoral cutaneous neuralgia: an anatomical insight.

    Science.gov (United States)

    Dias Filho, L C; Valença, M M; Guimarães Filho, F A V; Medeiros, R C; Silva, R A M; Morais, M G V; Valente, F P; França, S M L

    2003-07-01

    A detailed anatomic study was carried out on the lateral femoral cutaneous nerve to better understand the etiology and treatment of lateral femoral cutaneous neuralgia. As it passed from the pelvis into the thigh, the lateral femoral cutaneous nerve ran through an "aponeuroticofascial tunnel," beginning at the iliopubic tract and ending at the inguinal ligament; as it passed through the tunnel, an enlargement in its side-to-side diameter was observed, suggesting that the fascial structures proximal to the inguinal ligament may be implicated in the genesis of lateral femoral cutaneous neuralgia. The finding of pseudoneuromas at this location, distant from the inguinal ligament, supports this hypothesis. The anterior superior iliac spine is located approximately 0.7 cm from the lateral femoral cutaneous nerve and serves as the bony landmark for nerve localization. Within the first 3 cm of leaving the pelvis, the lateral femoral cutaneous nerve was observed deep to the fascia lata; therefore, surgical dissection within the subcutaneous fascia may be conducted with relative impunity near the anterior superior iliac spine just inferior to the inguinal ligament. In 36% of cases there was no posterior branch of the nerve, which is correlated to lateral femoral cutaneous neuralgia symptoms often being limited to the anterior branch region. An accessory nerve was found in 30% of cases. PMID:12794914

  8. Variations of femoral condyle shape.

    Science.gov (United States)

    Biscević, Mirza; Hebibović, Mujo; Smrke, Dragica

    2005-12-01

    The aim of this study is to mathematically approximate the shape of the femoral articulating line and compare radiuses of condylar curves within and between males and females. Ten male and ten female participants were included in the study. Radiuses of medial and lateral condylar curves were calculated from the side view knee X-ray by original mathematical equation. Average radiuses of condylar curves were between 4.5 and 1.7 cm medially, and between 3.2 and 1.8 cm laterally, for 0 degrees and 90 degrees flexion contact point respectively. Males had longer curve radiuses of both condyles (p knee geometry, and other ellipsoidal structures in human body, like wrist, scull segments, dental arches, etc.

  9. [Change of the shape of the proximal metaepiphysis of the femoral bone after corrective osteotomy

    OpenAIRE

    Olijnik O.E.

    2015-01-01

    Background. The changes of the shape of the proximal part of the femur due to the pathological process and consequences of osteotomy have the significant influence on the steps of surgical intervention and on the choice of the construction of endoprosthesis stem. Objective. To determine the shape of the proximal part of femoral channel after the correcting osteotomy from the viewpoint of the following hip joint replacement. Methods. Criteria of evaluation of changes of the shape of the proxim...

  10. Treatment of a femoral shaft fracture in a patient with congenital hip disease: a case report

    OpenAIRE

    Koutsostathis Stefanos D; Tsakotos George A; Macheras George A

    2010-01-01

    Abstract Introduction We present a rare case of two concomitant morbidities treated in one operation. To our knowledge, this is the first report of its kind in the literature. Case presentation A 57-year-old Greek woman was admitted to the emergency department having sustained a spiral mid-shaft femoral fracture. She also suffered from an ipsilateral hip congenital dysplasia with ankylosed hip joint due to severe arthritis. She was treated with a total hip arthroplasty using a long stem perfo...

  11. The mechanical effect of the existing cement mantle on the in-cement femoral revision.

    LENUS (Irish Health Repository)

    Keeling, Parnell

    2012-08-01

    Cement-in-cement revision hip arthroplasty is an increasingly popular technique to replace a loose femoral stem which retains much of the original cement mantle. However, some concern exists regarding the retention of the existing fatigued and aged cement in such cement-in-cement revisions. This study investigates whether leaving an existing fatigued and aged cement mantle degrades the mechanical performance of a cement-in-cement revision construct.

  12. Femoral anteversion measured by ultrasonography and radiography

    International Nuclear Information System (INIS)

    Radiographic and real-time ultrasound measurements of femoral anteversion were compared in an anatomic study of 20 dried adult femurs. The real anteversion (AV) angle was determined by biplanar radiography. In four ultrasound measurements, the linear transducer was kept either horizontal or tilted. The measuring lines were either the anterior tangent of the femoral head-greater trochanter or the anterior tangent of the femoral neck. With the tilted transducer, the correlation between the head-trochanter AV angle and the real AV angle was high (r=0.9452), and slightly less when the anterior neck AV angle was used (r=0.9142). The clinical relevance is that the tilted transducer technique with the head-trochanter tangent is recommended for AV screening in patients with clinical signs of increased femoral anteversion. In adults 8.50 has to be subtracted in order to obtain an approximation of the real AV angle. (orig.)

  13. Limited Quadricepsplasty for Contracture during Femoral Lengthening

    OpenAIRE

    Khakharia, Saurabh; Fragomen, Austin T.; Rozbruch, S. Robert

    2009-01-01

    Extension contracture of the knee is a common complication of femoral lengthening. Knee flexion exercises to stretch the contracture with physical therapy can be effective but take a prolonged amount of time to work and place increased stress across the patellofemoral joint. We developed a minimal-incision limited quadricepsplasty surgical technique to treat knee extension contracture secondary to femoral lengthening and retrospectively reviewed 16 patients treated with this procedure. The me...

  14. Laparoscopic repair of an incarcerated femoral hernia

    OpenAIRE

    Yagan Pillay

    2015-01-01

    Introduction: A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case: We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair...

  15. Mini-mesh repair for femoral hernia

    OpenAIRE

    Hakan Kulacoglu

    2014-01-01

    INTRODUCTION: Femoral hernia consists only 4% of all primary groin hernias. It is described as “the Bête Noire of Hernias” because of its nature and anatomy which is difficult to understand for the surgeons and tendency to recurrence. Although there is some large series of femoral hernia in the literature, few studies prospectively comparing repair techniques especially for this type of hernia has been published. A new technique named mini-mesh repair is described here. PRESENTATION OF CAS...

  16. Hygroma following endovascular femoral aneurysm exclusion

    DEFF Research Database (Denmark)

    Wad, Morten; Pedersen, Brian Lindegaard; Lönn, Lars;

    2013-01-01

    Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory.......Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory....

  17. Clinical experience of ioxaglate in femoral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, S.; Mine, H.; Iwai, T. (Tokyo Medical and Dental Univ. (Japan). School of Medicine)

    1982-01-01

    Painless femoral angiography could be performed in patients under slight analgesic premedication by using ioxaglate (320 mg I/ml). Slower flow of ioxaglate resulted in longer segments of the arteries being filled by the contrast column than by using iothalamate, which was confirmed by serial whole-limb angiography. The dynamic characteristics of ioxaglate, in addition to marked reduction of pain, fulfilled the requirements for its use as a contrast medium in femoral or peripheral angiography.

  18. Femoral Bone Plug in Total Knee Replacement.

    Science.gov (United States)

    Vulcano, Ettore; Regazzola, Gianmarco M V; Murena, Luigi; Ronga, Mario; Cherubino, Paolo; Surace, Michele F

    2015-10-01

    The intramedullary alignment guides used in total knee replacement disrupt the intramedullary vessels, resulting in greater postoperative blood loss. The use of an autologous bone plug to seal the intramedullary femoral canal has been shown to be effective in reducing postoperative bleeding. The authors present a simple technique to create a bone plug from the anterior chamfer femoral cut to perfectly seal the intramedullary canal of the femur. PMID:26488774

  19. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

  20. Calcar Preservation Arthroplasty for Unstable Intertrochanteric Femoral Fractures in Elderly

    Science.gov (United States)

    Togrul, Emre; Kose, Ozkan

    2015-01-01

    Background The treatment of unstable intertrochanteric fractures in elderly is still controversial. The purpose of this study is to present treatment strategies for unstable intertrochanteric fractures with hemiarthroplasty using standard uncemented collared femoral stems and at the same time preserving the fractured calcar fragment. Methods Fifty-four patients aged 75 years or older with unstable intertrochanteric fractures were included in this prospective cohort study. All patients were treated with calcar preserving hemiarthroplasty using cementless collored femoral stems. Fractured calcar fragment was stabilized either by compaction between the implant and femur or fixed with cable grip system. Follow-up evaluations were performed at least 24 months and later. Palmer and Parker mobility score and visual analogue scale (VAS) pain score were assessed. We also analyzed radiographs of the operated hip at each follow-up visit. Results The patients were 15 males and 39 females with a mean age of 81.3 years (range, 75 to 93 years). The average operative time was 86.6 minutes. The mean transfused blood units were 1.2 units. The average duration of hospital stay was 5.3 days. The preoperative mean mobility score was 6.20. This score was found to be 4.96 on postoperative third day and 5.90 at 24 months postoperatively. The results of the statistical analysis revealed significant increase in the mobility scores at each follow-up after three days. Radiological interpretation revealed no loosening in the cable-grip systems, and no significant subsidence (> 5 mm) of prosthesis was observed. Conclusions Calcar preservation arthroplasty is a good option for elderly patients with severe osteoporosis, frail constitution and the patients who are at higher risk for second operation due to unstable intertrochanteric fractures. PMID:26640625

  1. Early diagnosis for segmental collapse of the femoral head after femoral neck fracture by scintigraphy

    International Nuclear Information System (INIS)

    In order to obtain an early prediction for segmental collapse of the femoral head after femoral neck fracture, we have studied in 53 cases of the femoral neck fracture using 99mTC-MDP scintimetry. According to the radionuclide uptake ratio of the femoral heads, we can estimate the gravity of the avascular necrosis of the femoral head after fracture and recognize the repair process in the necrotic head. Fifty-three cases of fresh fracture were examined by sequential scintigraphy before operation and during follow up examinations after operation. The radionuclide uptake were all increased in 3 to 4 months after operation as comparing with that done before operation. The uptake ratios in 37 cases decreased gradually and approached 1 in 12 months after operation. All of them have an excellent result during follow up examination 36 months after surgery. The uptake ratios in 19 cases were also increased after operation, but still maintained at a high level in 6 to 12 months. They all showed radiographical signs of segmental collapse 18 to 24 months after operation. These results showed that uptake ratio of the radionuclide bone imaging is able to predict the occurrence of segmental collapse of the femoral head after femoral neck fracture. The time of the diagnosis by scintigraphy for segmental collapse of the femoral head is earlier than that by radiography. (authors). 5 refs., 1 tab

  2. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  3. Solution广泛多孔钛涂层长柄假体结合钢丝环扎固定治疗股骨头置换术后Vancouver B2型假体周围骨折的中期随访%Midterm follow-up of long handle prosthesis-Solution extensively titanium porous coated stem with wire cerclage in revision of Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty

    Institute of Scientific and Technical Information of China (English)

    李海; 周宗科; 裴福兴; 沈彬; 杨静; 康鹏德

    2014-01-01

    Background: Patients with Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty often are elder with much more co-morbidities and poor bone condition. The perioperative management and surgical technique are very diffi-cult, and the incidence of complications is very high. Objective:The aim of the study is to evaluate the intermediate-term curative effect of long handle prosthesis-Solution exten-sively titanium porous coated stem with wire cerclage in revision of Vancouver type-B2 periprosthetic femoral fractures af-ter hemiarthroplasty. Methods:Clinical data of 14 patients with Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty treated between January 2008 and December 2012 in our hospital were retrospectively analyzed. There were 6 males and 8 females, with a mean age 70.3 years (range from 66 to 80 years). All of them received open reduction, internal fixation, and revision with Solution stem. Hip Harris score was assessed at the last follow-up after surgery. Radiographs were taken before sur-gery, 3, 6, 12 months after surgery and the last follow-up to assess the fracture restoration and healing, prosthesis initial fixa-tion and intermediate-term survival condition. Results:Sixteen patients, 1 case died of lung cancer 3 years after surgery, 1 case loss of follow-up, 14 cases were followed up 3-5 years, mean 4.2 years. Preoperative hip Harris score was not obtained because of fracture, and the mean Harris score was 88.7 at the last follow-up. Radiographs showed reduction of fracture was successfully achieved, the fixed length of the stem surpassing fracture line were more than 5 cm, and the femur was well pressed-fit well. The average healing time of fracture was (3.8±1.3) months (range, 3-6 months). There were no loosening, subsidence of Solution stem at the last follow-up. No infection, deep vein thrombosis and pulmonary embolism occurred. Conclusions: The mid-term curative effect of the long handle prosthesis

  4. Laparoscopic repair of an incarcerated femoral hernia

    Science.gov (United States)

    Pillay, Yagan

    2015-01-01

    Introduction A femoral hernia is a rare, acquired condition, which has been reported in less than 5% of all abdominal wall hernias, with a female to male ratio of 4:1. Presentation of case We report a case in a female patient who had a previous open inguinal herniorrhaphy three years previously. She presented with right sided groin pain of one month duration. Ultrasound gave a differential diagnosis of a recurrent inguinal hernia or a femoral hernia. A transabdominal preperitoneal repair was performed and the patient made an uneventful recovery. Discussion Laparoscopic repair of a femoral hernia is still in its infancy and even though the outcomes are superior to an open repair, open surgery remains the standard of care. The decision to perform a laparoscopic trans abdominal preperitoneal (TAPP) repair was facilitated by the patient having previous open hernia surgery. The learning curve for laparoscopic femoral hernia repair is steep and requires great commitment from the surgeon. Once the learning curve has been breached this is a feasible method of surgical repair. This is demonstrated by the fact that this case report is from a rural hospital in Canada. Conclusion Laparoscopic femoral hernia repair involves more time and specialized laparoscopic skills. The advantages are a lower recurrence rate and lower incidence of inguinodynia. PMID:26581083

  5. Femoral head vitality after intracapsular hip fracture

    International Nuclear Information System (INIS)

    Femoral head vitality before, during and at various intervals from the operation was determined by tetracycline labeling and/or 99 sp (m)Tc-MDP scintimetry. In a three-year follow-up, healing prognosis could be determined by scintimetry 3 weeks from operation; deficient femoral head vitality predicting healing complications and retained vitality predicting uncomplicated healing. A comparison between pre- and postoperative scintimetry indicated that further impairment of the femoral head vitality could be caused by the operative procedure, and as tetracycline labeling prior to and after fracture reduction in 370 fractures proved equivalent, it was concluded that the procedure of osteosynthesis probably was responsible for capsular vessel injury, using a four-flanged nail. The four-flanged nail was compared with a low-traumatic method of osteosynthesis, two hook-pins, in a prospective randomized 14 month study, and the postoperative femoral head vitality was significantly better in the hook-pin group. This was also clearly demonstrated in a one-year follow-up for the fractures included in the study. Parallel to these investigations, the reliability of the methods of vitality determination was found satisfactory in methodologic studies. For clinical purpose, primary atraumatic osteosynthesis, postoperative prognostic scintimetry and early secondary arthroplasty when indicated, was concluded to be the appropriate approach to femoral neck fracture treatment. (Author)

  6. A STUDY ON THE PATTERNS OF CIRCUMFLEX FEMORAL ARTERIES

    Directory of Open Access Journals (Sweden)

    R. Chitra

    2015-09-01

    Full Text Available Context: Many different patterns have been described to classify the origins of circumflex femoral arteries by many authors since from 1860.The aim of the present study was to classify the circumflex femoral arteries in 100 lower limbs of adult cadavers of both sexes following the recent classification and to compare with the previous studies. Materials and Methods: A total of 100 lower limbs of 50 embalmed human adult cadavers (Male: 37, Female: 13 were dissected and observed for the origins of circumflex femoral arteries in femoral triangle in routine educational dissection in the period of 2005-2009 Results: The medial and lateral circumflex femoral arteries have been classified into three different patterns based on the levels of their origin. Pattern I: Both arteries arose from the profunda femoris artery (56%. Type Ia, medial circumflex femoral artery origin was proximal to the lateral circumflex femoral artery origin (69%; Type Ib, lateral circumflex femoral artery origin was proximal to medial circumflex femoral artery origin (16 %; Type Ic, both arteries arose from a common trunk or at same level (14%. Pattern II: One of the arteries arose from the femoral artery and the other from the profunda femoris artery (36%. Type IIa, the medial circumflex femoral artery arose from the femoral artery (75% and Type IIb, the lateral circumflex femoral artery arose from the femoral artery (25%.Pattern III: Both arteries arose from the femoral artery (7%. The medial circumflex femoral artery was absent in a female cadaver on right side. Conclusion: In every pattern or type, there was significantly unilateral higher occurrence than bilateral occurrence. A precise knowledge of the circumflex femoral arteries in relation to the profunda femoris artery is important in surgical interventions of the hip region

  7. 99mTc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

    International Nuclear Information System (INIS)

    Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head

  8. Emergency intravenous access through the femoral vein.

    Science.gov (United States)

    Swanson, R S; Uhlig, P N; Gross, P L; McCabe, C J

    1984-04-01

    A study was undertaken to assess the efficacy and safety of femoral venous catheterization for resuscitation of critically ill patients in the emergency department setting. From May 1982 to April 1983, 100 attempts were made at percutaneous insertion of a large-bore catheter into the femoral veins of patients presenting to our emergency department in cardiac arrest or requiring rapid fluid resuscitation. Eighty-nine attempts were successful. Insertion was generally considered easy, and flow rates were excellent. The only noted complications were four arterial punctures and one minor groin hematoma. This study suggests that short-term percutaneous catheterization of the femoral vein provides rapid, safe, and effective intravenous access. PMID:6703430

  9. Participation of osteoporosis in femoral neck fracture

    International Nuclear Information System (INIS)

    Quantitative computed tomography (QCT) was used to measure bone mineral contents of the proximal femur. First, 62 specimens of cancellous bones of the proximal femur obtained at operation were burnt for mineral determination after preoperative QCT measurement to evaluate the relationship between QCT values and ash weight. The findings indicated that QCT measurement of proximal femur was as useful as that of the lumbar spine. Next, 10 groups of 50 men and 50 women ranging in age from the 5th to the 9th decade were tested to define the control mean and range of QCT mineral content of proximal femur, to compare with 32 cases of femoral neck fracture. In women with femoral neck fracture, QCT values of the femoral neck were less than those of the same normal age group except for cases of medial fracture in the 9th decade. This measurement might provide an index for fracture risk. (author)

  10. Selective arteriography in femoral head fractures

    International Nuclear Information System (INIS)

    The choice between conservative and radical operation in case of femoral neck fractures is very important because it is the determining factor for a successfull therapy. In case of epiphysial necrosis, an endoprosthesis as well as an osteosynthesis will be carried out. Selective arteriography of the medical circumflex artery represents the most reliable study to establish, immediately after the fractures, the possible presence of a post-traumatic ischemic necrosis. Angiography, as a reliable diagnostic tool, has to be carried out in the most selective way and needs the image subtraction technique. The authors report their preliminary results on the reliability of angiography in the femoral epiphyseal ischemic necrosis diagnosed by comparing the results of angiography with the wood light test carried out on the surgically removed femoral head

  11. Optimizing Stability in Femoral Neck Fracture Fixation.

    Science.gov (United States)

    Ye, Ye; Hao, Jiandong; Mauffrey, Cyril; Hammerberg, E Mark; Stahel, Philip F; Hak, David J

    2015-10-01

    Optimizing stability of femoral neck fracture fixation is important in obtaining a successful outcome. The mechanical problems and strategies for achieving optimal stability differ depending on patients' age and degree of osteoporosis. Femoral neck fractures in younger adults usually result from high-energy trauma and have a vertical fracture pattern. Strategies for optimizing fixation stability in this group include placing additional screws at right angles to the fracture plane and medial buttress plate augmentation. In elderly patients, screw position relative to the intact cortical femoral neck bone is of critical importance. Additional strategies for optimizing fixation stability in this group include the concept of length stable fixation, use of adjunctive calcium phosphate cement, and use of novel fixed angle fixation implants. PMID:26488776

  12. Micromotion of cemented and uncemented femoral components.

    Science.gov (United States)

    Burke, D W; O'Connor, D O; Zalenski, E B; Jasty, M; Harris, W H

    1991-01-01

    We evaluated the initial stability of cemented and uncemented femoral components within the femoral canals of cadaver femurs during simulated single limb stance and stair climbing. Both types were very stable in simulated single limb stance (maximum micromotion of 42 microns for cemented and 30 microns for uncemented components). However, in simulated stair climbing, the cemented components were much more stable than the uncemented components (76 microns as against 280 microns). There was also greater variation in the stability of uncemented components in simulated stair climbing, with two of the seven components moving 200 microns or more. Future implant designs should aim to improve the initial stability of cementless femoral components under torsional loads; this should improve the chances of bony ingrowth. PMID:1991771

  13. Osteochondritis dissecans in bilateral lateral femoral condyle in knees

    Directory of Open Access Journals (Sweden)

    Ari Zekcer

    2013-12-01

    Full Text Available The osteochondritis dissecans (OCD is a disease of unknown cause that classically affects the knee lateral border of the medial femoral condyle. We present a rare case of OCD in bilateral lateral femoral condyle.

  14. Femoral lipectomy increases postprandial lipemia in women.

    Science.gov (United States)

    Hernandez, Teri L; Bessesen, Daniel H; Cox-York, Kimberly A; Erickson, Christopher B; Law, Christopher K; Anderson, Molly K; Wang, Hong; Jackman, Matthew R; Van Pelt, Rachael E

    2015-07-01

    Femoral subcutaneous adipose tissue (SAT) appears to be cardioprotective compared with abdominal SAT, possibly through better triglyceride (TG) sequestration. We hypothesized that removal of femoral SAT would increase postprandial TG through a reduction in dietary fatty acid (FA) storage. Normal-weight (means ± SD; BMI 23.9 ± 2.6 kg/m(2)) women (n = 29; age 45 ± 6 yr) were randomized to femoral lipectomy (LIPO) or control (CON) and followed for 1 yr. Regional adiposity was measured by DEXA and CT. A liquid meal labeled with [(14)C]oleic acid was used to trace the appearance of dietary FA in plasma (6-h postprandial TG), breath (24-h oxidation), and SAT (24-h [(14)C]TG storage). Fasting LPL activity was measured in abdominal and femoral SAT. DEXA leg fat mass was reduced after LIPO vs. CON (Δ-1.4 ± 0.7 vs. 0.1 ± 0.5 kg, P fat area (-39.6 ± 36.6 vs. 4.7 ± 14.6 cm(2), P fat mass and CT visceral fat area were unchanged. Postprandial TG increased (5.9 ± 7.7 vs. -0.6 ± 5.3 × 10(3) mg/dl, P fat remained reduced 1 yr following lipectomy and was accompanied by increased postprandial TG and reduced femoral SAT LPL activity. There were no changes in storage of meal-derived FA or visceral fat. Our data support a protective role for femoral adiposity on circulating TG independent of dietary FA storage and visceral adiposity. PMID:25968576

  15. Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991-1995)

    International Nuclear Information System (INIS)

    Objective-To determine clinical signs, radiographic findings, results of surgical management, and potential causes of aseptic loosening of the femoral implant (ALFI) in dogs that have undergone cemented total hip arthroplasty (THA). Design-Retrospective study. Animals-11 cases of ALFI in 10 dogs. Procedure-Medical records of all dogs undergoing THA revision surgery were reviewed. Only dogs with ALFI were included. The prosthesis and cement were removed by creating a longitudinal osteotomy of the cranial femoral cortex. Postoperative radiographs of all dogs that underwent THA during the study period were reviewed. Results-The most common clinical sign was intermittent, subtle. or non-weight-bearing lameness. On radiographs obtained after THA, contact of the distal stem tip with cortical endosteum was evident in all dogs. Radiographic changes at the time of diagnosis of ALFI included asymmetric periosteal reaction along the femoral diaphysis, radiolucent lines between the prosthesis and cement, altered implant position, and femoral fracture. Surgical revision yielded good or excellent results in 9 cases. In 1 dog. the implant became infected; in another, aseptic loosening recurred. Aseptic loosening was significantly more common in dogs in which there was contact between the distal stem tip and cortical endosteum than in dogs in which there was no contact. Clinical Implications-ALFI is an uncommon, but important, complication of THA, and radiography is warranted in dogs with clinical signs of ALFI. Initial centering of the prosthetic stem within the femoral shaft may reduce the incidence of ALFI

  16. Tribological behavior of Ti-6Al-4V and Ti-6Al-7Nb Alloys for Total Hip Prosthesis

    Directory of Open Access Journals (Sweden)

    Mamoun Fellah

    2014-01-01

    Full Text Available The aim of the study is to evaluate the friction and wear behavior of high-strength alloys Ti-6Al-7Nb used in femoral stem and compare it with a Ti-6Al-4V alloy cylindrical bar corresponding to ISO 5832-3 part 3/01-07-199 standard. The tribological behavior was investigated by wear tests, using ball-on-disc and pin-on-disc tribometers. These tests consisted of measuring the weight loss and the friction coefficient of samples. The oscillating friction and wear tests have been carried out in ambient with oscillating tribotester in accordance with standards ISO 7148, ASTM G99-95a, and ASTM G133-95 under different conditions of normal loads (3, 6, and 10 N and sliding speeds (1, 15, and 25 mm·s−1. As counter pairs, a 100Cr6 steel ball with 10 mm in diameter was used. Results show that the two alloys had similar friction and wear performance, although their grain structures and compositions are different. Occurrence of large frictional occurred, is probably caused by formation and periodic, localized fracture of a transfer layer. Higher friction with larger fluctuation and higher wear rate was observed at the higher siding speed. The Ti-6Al-4V wear mechanism transforms from ploughing and peeling off wear at low sliding speed to plastic deformation and adhesive wear.

  17. A correlation between femoral neck shaft angle to femoral neck length

    OpenAIRE

    gujar, subhash moolchand; Vikani, Sanjay; Parmar, Jigna; Bondre, K V

    2013-01-01

    Knowledge of the anatomy of proximal end of femur is a prerequisite for a complete understanding of the mechanics of the hip joint and serves as a basis for the treatment of pathological condition of the hip and femur. A total of 250 adult femora were used to  measure femoral neck shaft angle, femoral neck length & femoral total length at S.B.K.S Medical institute, Vadodara. The neck shaft angle range from 116o to 150o with means of 136.3o & no significant side difference. The neck le...

  18. Femoral component loosening after hip resurfacing arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Zustin, Jozef; Sauter, Guido [University Medical Centre Hamburg-Eppendorf, Institute of Pathology, Hamburg (Germany); Hahn, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); Morlock, Michael M. [TUHH Hamburg University of Technology, Biomechanics Section, Hamburg (Germany); Ruether, Wolfgang [University Medical Centre Hamburg-Eppendorf, Department of Orthopaedics, Hamburg (Germany); Amling, Michael [University Medical Centre Hamburg-Eppendorf, Center for Biomechanics and Skeletal Biology, Hamburg (Germany); University Medical Centre Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany)

    2010-08-15

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  19. External fixation of complex femoral shaft fractures

    OpenAIRE

    Zlowodzki, M; Prakash, J. S.; Aggarwal, N. K.

    2006-01-01

    Conversion of temporary external fixation to an intramedullary nail within the first 2 weeks after a femoral shaft fracture is standard practice. However, due to financial constraints, in large parts of the world external fixation of femoral shaft fractures is often the definitive treatment. Out of 60 fractures, 47 were followed-up for a minimum period of 39 weeks. The average follow-up time was 75 weeks. Fourteen fractures were closed, and 33 open. Forty-four fractures united at an average o...

  20. Occult, massive hematomas following antegrade femoral angioplasty

    International Nuclear Information System (INIS)

    Small groin hematomas are not uncommon after percuatenous antegrade femoral angioplasty (PAFA) and are usually apparent clinically. The authors describe three patients of 235 who underwent PAFA, in whom occult, massive hemorrhage was detected after the procedure. All patients underwent fluoroscopically guided antegrade punctures, with adequate hemostasis achieved after the procedure. CT revealed extraperitoneal hematomas in two patients. One patient required surgical intervention with ligation of the inferior epigastric artery. The authors postulate that these hematomas arose due to inadvertent injury to a branch of the common femoral artery during the puncture. The radiologist should be aware of the chance occurrence of this occult, potentially life-threatening complication

  1. In vitro and in vivo studies on biodegradable magnesium alloy

    Institute of Scientific and Technical Information of China (English)

    Lida Hou; Zhen Li; Yu Pan; Li Du; Xinlin Li; Yufeng Zheng; Li Li

    2014-01-01

    The microstructure, mechanical property, electrochemical behavior and biocompatibility of magnesium alloy (BioDe MSM™) were studied in the present work. The experimental results demonstrated that grain refining induced by extrusion improves the alloy strength significantly from 162 MPa for the as-cast alloy to 241 MPa for the as-extruded one. The anticorrosion properties of the as-extruded alloy also increased. Furthermore, the hemolysis ratio was decreased from 4.7%for the as-cast alloy to 2.9%for the as-extruded one, both below 5%. BioDe MSM™alloy shows good biocompatibility after being implanted into the dorsal muscle and the femoral shaft of the New Zealand rabbit, respectively, and there are no abnormalities after short-term implantation. In vivo observation indicated that the corrosion rate of this alloy varies with different implantation positions, with higher degradation rate in the femur than in the muscle.

  2. In vitro and in vivo studies on biodegradable magnesium alloy

    Directory of Open Access Journals (Sweden)

    Lida Hou

    2014-10-01

    Full Text Available The microstructure, mechanical property, electrochemical behavior and biocompatibility of magnesium alloy (BioDe MSM™ were studied in the present work. The experimental results demonstrated that grain refining induced by extrusion improves the alloy strength significantly from 162 MPa for the as-cast alloy to 241 MPa for the as-extruded one. The anticorrosion properties of the as-extruded alloy also increased. Furthermore, the hemolysis ratio was decreased from 4.7% for the as-cast alloy to 2.9% for the as-extruded one, both below 5%. BioDe MSM™ alloy shows good biocompatibility after being implanted into the dorsal muscle and the femoral shaft of the New Zealand rabbit, respectively, and there are no abnormalities after short-term implantation. In vivo observation indicated that the corrosion rate of this alloy varies with different implantation positions, with higher degradation rate in the femur than in the muscle.

  3. Stem Cells

    Science.gov (United States)

    Stem cells are cells with the potential to develop into many different types of cells in the body. They serve as a repair ... body. There are two main types of stem cells: embryonic stem cells and adult stem cells. Stem ...

  4. Early roentgenological grading of femoral shortening is correlated to the late outcome after femoral neck fractures

    International Nuclear Information System (INIS)

    Using orthoradiography, the distance between the centre of the femoral head and the intercondylar notch was assessed at regular intervals in 144 patients who were followed for a 2-year period after osteosynthesis of a femoral neck fracture. Late complications, such as segmental collapse and non-union, occurred in 27% of the patients. The degree of femoral shortening was significantly correlated to the incidence of late complications. At 1 month, femoral shortening of more than 5 mm was observed in 85% of patients who developed late complications, and in only 5% of patients without such complications. Thus, the observation of a shortening of more than 5 mm predicted a greater than 6-fold increase of the incidence of late complications. The prognostic accuracy of this observation 1 month after treatment was 92%. (orig.)

  5. Early periprosthetic femoral bone remodelling using different bearing material combinations in total hip arthroplasties: a prospective randomised study

    Directory of Open Access Journals (Sweden)

    Nygaard M.

    2004-12-01

    Full Text Available The present study was performed to test the hypothesis that different bearing materials have an impact on femoral bone remodelling within the first year after a total hip arthroplasty. A total of 225 patients with osteoarthrosis of the hip or avascular necrosis of the femoral head were included in this randomised prospective study. All patients had an identical hybrid total hip arthroplasty (cemented BiMetric stem and cementless RingLoc acetabular cup except for the bearing materials: polyethylene-on-zirconia (n = 78, CoCr-on-CoCr (n = 71, or alumina-on-alumina (n = 76. Bone mineral density (BMD was measured with Dual-energy X-ray absorptiometry (DEXA in seven Gruen zones adjacent to the femoral implant. The DEXA scan was performed within one week after surgery and was repeated one year postoperatively. There was no significant difference in periprosthetic BMD change between the three groups. After twelve months the relative BMD decrease was highest in the proximal part of the femur, - 6.2% in the greater trochanter region and - 12.7% in the lesser trochanter region. In the distal zones the relative BMD decrease was -5.3, -4.2, -2.1, -2.3, and -5.6%, respectively. The use of different bearing materials had no significant impact on femoral bone remodelling adjacent to the cemented hip stem within one year after surgery.

  6. Femoral neck version affects medial femorotibial loading.

    Science.gov (United States)

    Papaioannou, T A; Digas, Georgios; Bikos, Ch; Karamoulas, V; Magnissalis, E A

    2013-01-01

    The aim of this study was to provide a preliminary evaluation of the possible effect that femoral version may have on the bearing equilibrium conditions developed on the medial tibiofemoral compartment. A digital 3D solid model of the left physiological adult femur was used to create morphological variations of different neck-shaft angles (varus 115, normal 125, and valgus 135 degrees) and version angles (-10, 0, and +10 degrees). By means of finite element modeling and analysis techniques (FEM-FEA), a virtual experiment was executed with the femoral models aligned in a neutral upright position, distally supported on a fully congruent tibial tray and proximally loaded with a vertical only hip joint load of 2800 N. Equivalent stresses and their distribution on the medial compartment were computed and comparatively evaluated. Within our context, the neck-shaft angle proved to be of rather indifferent influence. Reduction of femoral version, however, appeared as the most influencing parameter regarding the tendency of the medial compartment to establish its bearing equilibrium towards posteromedial directions, as a consequence of the corresponding anteroposterior changes of the hip centre over the horizontal tibiofemoral plane. We found a correlation between femoral anteversion and medial tibiofemoral compartment contact pressure. Our findings will be further elucidated by more sophisticated FEM-FEA and by clinical studies that are currently planned. PMID:24959355

  7. Femoral fractures in the extremely elderly

    Science.gov (United States)

    Guido, Giulio; Giannotti, Stefano; Bottai, Vanna; Ghilardi, Marco; Bianchi, Maria Giulia; Ceglia, Michael James

    2011-01-01

    Summary At the Trauma Unit of Pisa we performed an observational study reviewing nineties that about 200 patients were treated and underwent surgery for femoral neck fracture from 1998 to 2005. The clinical and radiographic results obtained were discrete, with a mortality of 42.5%, the survivors are still having a good quality of life. PMID:22461814

  8. Sequential changes in the femoral head after intracapsular fracture of the femoral neck. MRI findings

    International Nuclear Information System (INIS)

    Authors obtained T1-weighted MRI images of the femoral head after fracture of the femoral neck and classified the signals into four patterns to investigate the sequential changes of the femoral head. The T1-weighted MRI images obtained initially after femoral neck fracture showed a normal pattern in 10 of the 15 hip joints studied. MRI images obtained subsequently still showed the normal signal pattern in eight of the 10 hip joints which had shown the normal pattern in the first MRI, while two of the 10 joints subsequently showed a band pattern. The joint with the homogeneous pattern in the first MRI subsequently showed a band pattern. Of the three joints with an inhomogeneous pattern in the first MRI, two joints showed a subsequent band pattern, and the other a normal pattern. The joints which showed a band pattern continued to show a similar band pattern. Eventually, all hip joints studied showed a normal or band pattern within six months after intracapsular fracture of the femoral neck. The joints which showed a band pattern in the first MRI continued to show a similar band pattern in the subsequent MRI, without any change. Collapse occurred in one hip joint which showed an extensive band pattern. Plain X-rays showed collapse of one of the joints with a band pattern in the MRI image. It was therefore suggested that necrosis may be present histologically in the femoral head after fracture of the femoral neck even when no abnormalities are present in plain X-rays. Based on the above results, it is considered necessary to follow-up patients with femoral neck fracture with MRI for at least six months until the normal or band pattern is observed. (K.H.)

  9. Early prediction of avascular necrosis of the femoral head following femoral neck fractures

    International Nuclear Information System (INIS)

    The treatment of acute fracture of the femoral neck remains an unsolved problem. Fifty-three patients are presented using 99mTc phosphate scintigraphy with quantitative computer interpretation to predict the viability of the femoral head following acute fracture. The accuracy of prediction was 92.5%; the scans were incorrect in four patients. Armed with a safe, simple diagnostic procedure and a greater than 90% accurate prognosis, a rational program of treatment can be prescribed for the individual patient

  10. Rotational Position of Femoral and Tibial Components in TKA Using the Femoral Transepicondylar Axis

    OpenAIRE

    Aglietti, Paolo; Sensi, Lorenzo; Cuomo, Pierluigi; Ciardullo, Antonio

    2008-01-01

    Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteroposterior deformity. We obtained computed tomography scans of 100 patients with arthritis before they underwent TKA. We measured the posterior condylar angle on the femoral side and ...

  11. Biomechanical comparisons between a new avascular necrosis of femaral head stem based on Chinese patients with avascular necrosis and two other designs

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qiang; CHENG Cheng-kung; WEI Hung-wen; DONG Xiang; CHEN Yi-ting; LAI Yu-shu; WANG Yan

    2013-01-01

    Background There is a relatively high failure rate of the femoral component in patients with avascuiar necrosis at the intermediate-term follow-up.Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis.Methods We designed a specific stem,based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses,comparing the novel stem with two commercially available and commonly used stems.Results The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal,including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture.The shorter stemmed prostheses (Fitmore(R) and our stem) performed better than the longer stemmed prosthesis (VerSys(R)).Conclusions This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients.Our stem provides better stability and is theoretically beneficial to bone ingrowth,which may increase the long-term stability and fixation of the implant.

  12. STEM, STEM Education, STEMmania

    OpenAIRE

    Sanders, Mark E.

    2008-01-01

    A series of circumstances has once more created an opportunity for technology educators to develop and implement new integrative approaches to STEM education championed by STEM education reform doctrine over the past two decades.

  13. Femoral neck fracture following groin irradiation

    International Nuclear Information System (INIS)

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

  14. Good performance of a titanium femoral component in cementless hip arthroplasty in younger patients: 97 arthroplasties followed for 5-11 years

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Frank Krieger; Poulsen, Klaus;

    2003-01-01

    We performed 97 uncemented primary total hip arthroplasties in 80 patients having an average age of 50 years. The femoral implant was a titanium stem with a proximal circumferential plasma spray-coating. Three different acetabular components were used: a threaded and partly porous-coated design i...

  15. Contribution to the method for determining femoral neck axis

    Directory of Open Access Journals (Sweden)

    Anđelković Zoran

    2014-01-01

    Full Text Available Introduction. Femoral neck axis plotting is of great significance in measuring parameters that define femoral head-neck junction sphericity in the group of patients with the femoroacetabular impingement. Literature methods of femoral neck axis determination have weaknesses associated with the risk of obtaining inaccurate values of certain parameters. Objective. Method of plotting of the femoral neck axis by two parallel lines that belong to the medial quarter of the femoral neck is proposed. Method was tested on the anatomic specimens and the respective radiograms. Methods. A total of 31 anatomic specimens of the proximal femur and respective radiographs were used, on which three axes of the femoral neck were plotted; accordingly, alpha angle value was determined and tested with corresponding parametric tests, with the measurement error of less than 5% and the strength of the applied tests of 80%. Results. Alpha angle values obtained by plotting femoral neck axis using the literature and methods we have proposed were not significantly different in our series, and, in more than a half of the specimens, the two axes overlapped each other. Conclusion. The advantage of the proposed method does not depend on the position of the femoral head rotation center in relation to the femoral neck, which favors proposed method for measuring the angles of femoral head sphericity in patients with the femoral head translation. Disadvantage of the study is a small sample size for valid conclusions about the applicability of this method in clinical practice.

  16. A prospective randomised study of periprosthetic femoral bone remodeling using four different bearings in hybrid total hip arthroplasty

    DEFF Research Database (Denmark)

    Zerahn, Bo; Borgwardt, Lotte; Ribel-Madsen, Søren;

    2011-01-01

    Abstract: We performed a study to assess whether different bearing materials have an impact on femoral bone remodeling within the first four years after a hybrid total hip arthroplasty. 205 of 300 patients were available for 4 years follow-up after being randomly allocated to four prosthetic...... 1, 6, and 7.Bone remodeling after total hip arthroplasty may depend on the composition of bearing materials, but age, height, weight, and stem size are also related to changes in BMD....

  17. The Association of Femoral Neck Stress Fractures with Femoral Acetabular Impingement

    Science.gov (United States)

    Safran, Marc R.; Goldin, Michael; Anderson, Christian; Fredericson, Michael; Stevens, Kathryn J.

    2013-01-01

    Objectives: To determine if there is an increased incidence of femoral acetabular impingement (FAI) in patients presenting with stress fractures of the femoral neck. Methods: After IRB approval, the imaging studies of 25 athletes (22 females, 3 males, mean age 26, range 19 - 39 years) with femoral neck stress injuries were assessed for the presence of features suggesting FAI, including acetabular retroversion, coxa profunda, abnormal femoral head-neck junction, fibrocystic change, os acetabulae, labral tear and chondral injury. All subjects had to have an adequate AP Pelvis radiograph, a lateral radiograph of the affected hip, and an MRI of the affected hip. The alpha angle, anterior offset ratio, and center to edge (CE) angle were measured on radiographs. The grade of stress injury was determined on MR images. All images and measurements were made by a musculoskeletal fellowship trained radiologist, a fellowship trained orthopaedic surgeon, an orthopaedic sports medicine fellow and a physical medicine and rehabilitation resident. Charts were reviewed to determine treatment of the stress fracture, outcome and final follow up, as well as to determine if the patient had any further treatment for their hip. Results: Of the 25 hips (18 right, 7 left) with femoral neck stress reactions, 9 were grade 2 (bone marrow edema), 5 were grade 3 (high T2 and low T1 marrow signal), and 11 were grade 4 (stress fracture). Twenty patients (80%) had coxa profunda - where the floor of the cotyloid fossa touches or extends beyond the ilioischial line (incidence in general population is 15.2% of males, and 19.4% of females). Coxa profunda, defined by the floor of the cotyloid fossa touching or extending beyond the ilioischial line and a center edge angle of more than 35o, was present in 28% of subjects. Acetabular retroversion as assessed by the crossover sign was present in 42% (normal incidence is 5% of population). Center edge angle was greater than 35o in 20% and greater than 40 o

  18. Treatment of a femoral shaft fracture in a patient with congenital hip disease: a case report

    Directory of Open Access Journals (Sweden)

    Koutsostathis Stefanos D

    2010-07-01

    Full Text Available Abstract Introduction We present a rare case of two concomitant morbidities treated in one operation. To our knowledge, this is the first report of its kind in the literature. Case presentation A 57-year-old Greek woman was admitted to the emergency department having sustained a spiral mid-shaft femoral fracture. She also suffered from an ipsilateral hip congenital dysplasia with ankylosed hip joint due to severe arthritis. She was treated with a total hip arthroplasty using a long stem performing as an intramedullary nail. Conclusion We undertook a complex operative treatment of both co-morbidities in a one stage procedure with a satisfactory clinical result.

  19. Wear and migration of highly cross-linked and conventional cemented polyethylene cups with cobalt chrome or Oxinium femoral heads: a randomized radiostereometric study of 150 patients.

    Science.gov (United States)

    Kadar, Thomas; Hallan, Geir; Aamodt, Arild; Indrekvam, Kari; Badawy, Mona; Skredderstuen, Arne; Havelin, Leif Ivar; Stokke, Terje; Haugan, Kristin; Espehaug, Birgitte; Furnes, Ove

    2011-08-01

    This randomized study was performed to compare wear and migration of five different cemented total hip joint articulations in 150 patients. The patients received either a Charnley femoral stem with a 22.2 mm head or a Spectron EF femoral stem with a 28 mm head. The Charnley articulated with a γ-sterilized Charnley Ogee acetabular cup. The Spectron EF was used with either EtO-sterilized non-cross-linked polyethylene (Reflection All-Poly) or highly cross-linked (Reflection All-Poly XLPE) cups, combined with either cobalt chrome (CoCr) or Oxinium femoral heads. The patients were followed with repeated RSA measurements for 2 years. After 2 years, the EtO-sterilized non-cross-linked Reflection All-Poly cups had more than four times higher proximal penetration than its highly cross-linked counterpart. Use of Oxinium femoral heads did not affect penetration at 2 years compared to heads made of CoCr. Further follow-up is needed to evaluate the benefits, if any, of Oxinium femoral heads in the clinical setting. The Charnley Ogee was not outperformed by the more recently introduced implants in our study. We conclude that this prostheses still represents a standard against which new implants can be measured.

  20. Femoral head fracture without hip dislocation

    Institute of Scientific and Technical Information of China (English)

    Aditya K Aggarwal; Ashwani Soni; Daljeet Singh

    2013-01-01

    Femoral head fractures without dislocation or subluxation are extremely rare injuries.We report a neglected case of isolated comminuted fracture of femoral head without hip dislocation or subluxation of one year duration in a 36-year-old patient who sustained a high energy trauma due to road traffic accident.He presented with painful right hip and inability to bear full weight on right lower limb with Harris hip score of 39.He received cementless total hip replacement.At latest follow-up of 2.3 years,functional outcome was excellent with Harris hip score of 95.Such isolated injuries have been described only once in the literature and have not been classified till now.The purpose of this report is to highlight the extreme rarity,possible mechanism involved and a novel classification system to classify such injuries.

  1. Spontaneous stress fractures of the femoral neck

    International Nuclear Information System (INIS)

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head

  2. Multicriteria Decision Analysis in Improving Quality of Design in Femoral Component of Knee Prostheses: Influence of Interface Geometry and Material

    Directory of Open Access Journals (Sweden)

    Ali Jahan

    2015-01-01

    Full Text Available Knee prostheses as medical products require careful application of quality and design tool to ensure the best performance. Therefore, quality function deployment (QFD was proposed as a quality tool to systematically integrate consumer’s expectation to perceived needs by medical and design team and to explicitly address the translation of customer needs into engineering characteristics. In this study, full factorial design of experiment (DOE method was accompanied by finite element analysis (FEA to evaluate the effect of inner contours of femoral component on mechanical stability of the implant and biomechanical stresses within the implant components and adjacent bone areas with preservation of the outer contours for standard Co-Cr alloy and a promising functionally graded material (FGM. The ANOVA revealed that the inner shape of femoral component influenced the performance measures in which the angle between the distal and anterior cuts and the angle between the distal and posterior cuts were greatly influential. In the final ranking of alternatives, using multicriteria decision analysis (MCDA, the designs with FGM was ranked first over the Co-Cr femoral component, but the original design with Co-Cr material was not the best choice femoral component, among the top ranked design with the same material.

  3. Spontaneous enterocutaneous fistula due to femoral hernia

    OpenAIRE

    Kumar, Awanish; Pahwa, Harvinder Singh; Pandey, Anand; Kumar, Suresh

    2012-01-01

    Spontaneous enterocutaneous fistula is a rare entity. We encountered a case of spontaneous enterocutaneous fistula in the groin region due to femoral hernia. A 60-year-old man presented with spontaneous enterocutaneous fistula in the left groin region without signs of peritonitis. He was kept on conservative treatment, but on third postadmission day, he developed a swelling in his right groin, which became firm and irreducible with signs of intestinal obstruction. On exploratory laparotomy, b...

  4. Femoral midshaft fractures: expandable versus locked nailing.

    Science.gov (United States)

    Zhou, Zhen-Tao; Song, Yu-Chen; Zhou, Xiao-Zhong; Zhou, Hai-Bin; Luo, Zong-Ping; Dong, Qi-Rong

    2015-04-01

    Femoral midshaft fracture is one of the most common clinical injuries and is often caused by high-energy traffic accidents. Intramedullary nailings, plates, and external fixators are all used as treatment alternatives for a variety of patients depending on fracture location, displacement, comminution, soft tissue condition, and local tradition. Locked intramedullary nailing is currently the preferred treatment method for most diaphyseal fractures and has good clinical results. The goal of this study was to compare expandable and locked intramedullary nailing for the treatment of AO type 32A and 32B1 femoral midshaft fractures. The authors performed a retrospective analysis of 46 patients (33 men and 13 women; mean age, 32.3 years; range, 22-52 years) with femoral midshaft fractures who were divided into 2 groups-one treated with an expandable intramedullary nailing method and the other with a conventional locked intramedullary nailing. The 2 groups were compared with respect to operation time, fluoroscopic time, amount of estimated blood loss, hospitalization time, healing time, and complications. Patients were followed for at least 1 year. The results of this study showed that all of the patients achieved bone union within 12 to 24 months. Expandable nailing performed better than locked nailing in operation time, fluoroscopic time, amount of estimated blood loss, and healing time (P<.001). There was no difference in hospitalization time and no visible shortening or severe complications were observed in either group. Based on the results of this study, the expandable intramedullary nailing is an easy and effective treatment for AO type 32A and 32B1 diaphyseal femoral fractures. PMID:25901625

  5. Femoral Neck Version Affects Medial Femorotibial Loading

    OpenAIRE

    T. A. Papaioannou; Georgios Digas; Ch. Bikos; Karamoulas, V.; E. A. Magnissalis

    2013-01-01

    The aim of this study was to provide a preliminary evaluation of the possible effect that femoral version may have on the bearing equilibrium conditions developed on the medial tibiofemoral compartment. A digital 3D solid model of the left physiological adult femur was used to create morphological variations of different neck-shaft angles (varus 115, normal 125, and valgus 135 degrees) and version angles (−10, 0, and +10 degrees). By means of finite element modeling and analysis techniques (F...

  6. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  7. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  8. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study

    Directory of Open Access Journals (Sweden)

    Maini P

    2006-01-01

    Full Text Available Background : One of the most common treatments of displaced fracture of femoral neck in elderly is bipolar hemiarthroplasty. Method : Two hundred and seventy patients of displaced fracture of femoral neck were treated by bipolar hemiarthroplasty. The Mean age of the patients at the time of surgery was 69.80 years. Results : Follow up ranged between 12 months and 120 months. There were 8 cases each of acetabular erosion and protrusion with 10 cases of femoral stem loosening. Eight cases had post operative dislocation requiring open reduction. Eighteen patients got revision surgery to total hip replacement. The overall incidence of DVT/PE was 9.9% which declined after regular use of low molecular weight heparin. Eleven patients had post operative infection. There were 54.2 % excellent results, 21.0 % good results, 10.7 % fair and 3.7% poor results. Conclusion : Elderly patients with displaced fracture of neck femur are able to ambulate early after Cemented bipolar hemi arthroplasty. The complication rate is low, the component survival long and pre injury functional status is restored in majority of patients.

  9. Alumina-on-alumina total hip replacement for femoral neck fracture in healthy patients

    Directory of Open Access Journals (Sweden)

    Moretti Lorenzo

    2011-02-01

    Full Text Available Abstract Background Total hip replacement is considered the best option for treatment of displaced intracapsular fractures of the femoral neck (FFN. The size of the femoral head is an important factor that influences the outcome of a total hip arthroplasty (THA: implants with a 28 mm femoral head are more prone to dislocate than implants with a 32 mm head. Obviously, a large head coupled to a polyethylene inlay can lead to more wear, osteolysis and failure of the implant. Ceramic induces less friction and minimal wear even with larger heads. Methods A total of 35 THAs were performed for displaced intracapsular FFN, using a 32 mm alumina-alumina coupling. Results At a mean follow-up of 80 months, 33 have been clinically and radiologically reviewed. None of the implants needed revision for any reason, none of the cups were considered to have failed, no dislocations nor breakage of the ceramic components were recorded. One anatomic cementless stem was radiologically loose. Conclusions On the basis of our experience, we suggest that ceramic-on-ceramic coupling offers minimal friction and wear even with large heads.

  10. Late Nontraumatic Dissociation of the Femoral Head and Trunnion in a Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Simon J. M. Parker

    2015-01-01

    Full Text Available Background. Modular total hip arthroplasties are increasingly popular because customisation allows optimal restoration of patient biomechanics. However, the introduction of component interfaces provides greater opportunities for failure. We present a case of late nontraumatic dissociation of the head-neck interface, more than 10 years after insertion. Case Description. A 58-year-old woman had a left metal-on-metal total hip arthroplasty in 2002 for hip dysplasia. Following an uneventful 10-year period, she presented to hospital in severe pain after standing from a seated position, and radiographs demonstrated complete dissociation of the modular femoral head from the stem, with the femoral head remaining in its cup. There was no prior trauma or infection. Mild wear and metallosis were present on the articulating surface between the femoral head and trunnion. Soft tissues were unaffected. Discussion and Conclusions. This is the latest occurrence reported to date for nontraumatic component failure in such an implant by more than 7 years. The majority of cases occur in the context of dislocation and attempted closed reduction. We analyse and discuss possible mechanisms for failure, aiming to raise awareness of this potential complication and encouraging utmost care in component handling and insertion, as well as the long term follow-up of such patients.

  11. MR imaging in slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    This paper reports that conventional determination of the degree of epiphyseal slipping is not exact. Radiography and CT provide no information about the growth plate, joint effusion, or possible epiphyseal reattachment. Ten patients with slipped capital femoral epiphysis were examined in both hip joints by means of frontal T1-weighted and opposed long TR gradient-echo (GRE) sequences and parasagittal T1-weighted images along the femoral neck. Normal measurements were established in 12 healthy adolescents. The authors imaged in various positions and different parasagittal angles to rule out errors due to positioning. Exact determination of the epipyseal angle was enabled by drawing a ventral tangent to the femoral neck. The average MR imaging angle was 40.3 degrees in epiphyseolysis and 66.0 degrees on the unaffected side. Healthy male juveniles reached 77.9 degrees at age 13-17 years and 69.9 degrees at age 5-9 years. Conventional measurements on Lauenstein projection gave measurements of 55.6 degrees for epiphyseolysis and 85.7 degrees on the unaffected side. Errors due to positioning are lower than 4 degrees

  12. Prophylactic pinning for slipped capital femoral epiphysis: does it affect proximal femoral morphology?

    Science.gov (United States)

    Cousins, Gerard R; Campbell, Donald M; Wilson, Neil I L; Maclean, Jamie G B

    2016-05-01

    This study was designed to determine whether prophylactic pinning of the unaffected hip in unilateral slipped capital femoral epiphysis affects the proximal femoral morphology. Twenty-four hips prophylactically pinned were compared with 26 cases observed. The articulotrochanteric distance (ATD) and the trochanteric-trochanteric distance (TTD) were measured. Postoperative radiographs were compared with final follow-up radiographs. The final TTD : ATD ratio was higher (P=0.048) in the pinned group, suggesting relative coxa vara/breva. There was a smaller difference between the two hips in the prophylactically pinned group (0.7) as opposed to those observed (1.47). Prophylactic pinning does not cause growth to stop immediately but alters the proximal femoral morphology.

  13. MR evaluation of femoral neck version and tibial torsion

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, James Karl; Dwek, Jerry R. [University of California, San Diego, Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Pring, Maya E. [Rady Children' s Hospital, Department of Pediatric Orthopedic Surgery, San Diego, CA (United States)

    2012-01-15

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  14. Ipsilateral femoral neck and shaft fractures: An overlooked association

    International Nuclear Information System (INIS)

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

  15. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    International Nuclear Information System (INIS)

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.)

  16. Management of femoral artery pseudoaneurysm due to addictive drug injection

    Institute of Scientific and Technical Information of China (English)

    李建文; 王三明; 陈小东

    2004-01-01

    Objective: To study surgical management for patients with femoral pseudoaneurysm resulting from addictive druginjection.Methods: Clinical data of 34 patients with femoral pseudoaneurysm resulting from addictive drug injection were retrospectively reviewed.Results: Thirteen patients underwent bypass graft ( end to side) of external iliac artery and superficial femoral artery using expanded polytetrafluoroethylene (ePTFE).Three patients who had an autogenous saphenous vein graft in situs, one of whom was then performed an ePTFE graft when rupture and bleeding occurred at the anastomotic site. Color Doppler image showed patent grafted blood vessels in all the patients after operation. Eighteen patients had their femoral arteries ligated. Limbs of all the 34 patients were saved.Conclusions: Ligating femoral artery is an effective way to treat femoral artery pseudoaneurysm if autogenous saphenous vein graft or artificial vessel graft is notapplicable.

  17. Comparison of mechanical stress and change in bone mineral density between two types of femoral implant using finite element analysis.

    Science.gov (United States)

    Hirata, Yasuhide; Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Fujimaki, Hiroshi; Saito, Tomoyuki

    2013-12-01

    Stress shielding after total hip arthroplasty (THA) remains an unsolved issue. Various patterns of mechanical stress appear according to the type of femoral stem used. To compare differences in mechanical stress conditions between Zweymuller type and fit-and-fill type stems, finite element analysis (FEA) was performed. Differences in bone mineral density (BMD) changes in the femur were also compared. Maximum stress was confirmed in Gruen zone 4, whereas zone 1 had the minimum amount of stress with both types of implant. The Zweymuller stem group had less mechanical stress and lower BMD in zone 7 than the fit-and-fill stem group. In conclusion, differences in mechanical stress may be related to changes in BMD after THA. PMID:23683518

  18. Maintenance of bone mineral density after implantation of a femoral neck hip prosthesis

    Directory of Open Access Journals (Sweden)

    Zurstegge Matthias

    2008-01-01

    Full Text Available Abstract Background Stress shielding of the proximal femur has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to investigate the changes of bone-mineral density in the proximal femur and the clinical outcome after implantation of a short femoral-neck prosthesis. Methods We prospectively assessed the clinical outcome and the changes of bone mineral density of the proximal femur up to one year after implantation of a short femoral neck prosthesis in 20 patients with a mean age of 47 years (range 17 to 65. Clinical outcome was assessed using the Harris Hip Score. The WOMAC was used as a patient-relevant outcome-measure. The bone mineral density was determined using dual energy x-ray absorptiometry, performed 10 days, three months and 12 months after surgery. Results The Harris Hip Score improved from an average preoperative score of 46 to a postoperative score at 12 months of 89 points, the global WOMAC index from 5,3 preoperatively to 0,8 at 12 months postoperatively. In contrast to conventional implants, the DEXA-scans overall revealed a slight increase of bone mineral density in the proximal femur in the 12 months following the implantation. Conclusion The short femoral neck stem lead to a distinct bone reaction. This was significantly different when compared to the changes in bone mineral density reported after implantation of conventional implants.

  19. Operative Management of Crossover Femoral-femoral Graft Erosion into Bladder: A Case Report.

    Science.gov (United States)

    Motiani, Karan; Mahdy, Ayman

    2016-09-01

    Erosion of vascular grafts is not uncommon as seen in the recent literature. There have been many case reports documenting the work up and management of erosion of these grafts into bowel. We report a case of a crossover femoral-femoral graft that eroded into the anterior bladder wall and was incidentally found as an adherent bladder stone during cystoscopy. We demonstrate the importance of having a high level of clinical suspicion for eroding vascular grafts when preoperative imaging shows close proximity of graft to bladder. PMID:27462547

  20. Isolated common femoral artery aneurysm: a case report

    OpenAIRE

    Sharma, Saurabh; Nalachandran, Sanjay

    2009-01-01

    Introduction Isolated aneurysm of common femoral artery is a rare occurrence. They may mimic other common conditions like groin lymph nodes or groin hernia. Case presentation Here we present a case of 61-years-old Chinese gentleman who presented with a right groin lump, which was suspected to be groin hernia but turned out common femoral artery aneurysm. The aneurysm was surgically excised and a prosthetic vascular repair was done. Conclusion Isolated common femoral artery aneurysms are rare ...

  1. [Isolated true aneurysm of the deep femoral artery].

    Science.gov (United States)

    Salomon du Mont, L; Holzer, T; Kazandjian, C; Saucy, F; Corpataux, J M; Rinckenbach, S; Déglise, S

    2016-07-01

    Aneurysms of the deep femoral artery, accounting for 5% of all femoral aneurysms, are uncommon. There is a serious risk of rupture. We report the case of an 83-year-old patient with a painless pulsatile mass in the right groin due to an aneurysm of the deep femoral artery. History taking revealed no cardiovascular risk factors and no other aneurysms at other localizations. The etiology remained unclear because no recent history of local trauma or puncture was found. ACT angiography was performed, revealing a true isolated aneurysm of the deep femoral artery with a diameter of 90mm, beginning 1cm after its origin. There were no signs of rupture or distal emboli. Due to unsuitable anatomy for an endovascular approach, the patient underwent open surgery, with exclusion of the aneurysm and interposition of an 8-mm Dacron graft to preserve deep femoral artery flow. Due to their localization, the diagnosis and the management of aneurysms of the deep femoral artery can be difficult. Options are surgical exclusion or an endovascular approach in the absence of symptoms or as a bridging therapy. If possible, blood flow to the distal deep femoral artery should be maintained, the decision depending also on the patency of the superficial femoral artery. In case of large size, aneurysms of the deep femoral artery should be treated without any delay. PMID:27289256

  2. Treatment of ipsilateral femoral neck and shaft fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hai-qiang; HAN Yi-sheng; LI Xin-kui; LI Ming-quan; WEI Yi-yong; WU Zi-xiang

    2008-01-01

    Objective: To investigate the clinical characteristics, treatment options and causes of misdiagnosis of ipsilateral femoral neck and shaft fractures. Methods: Among 20 patients with ipsilateral femoral neck and shaft fractures, 19 were treated operatively and 1 was treated conservatively. Sixteen cases of femoral shaft fractures were treated by open reduction and internal fixation with compressive plate, and 2 cases were treated with interlocking intramedullary nailing. Eighteen femoral neck fractures were treated with cannulated screws. Another patient was treated with proximal femoral nail to fix both the neck and shaft. Delayed diagnosis for femoral neck frac tures occurred in 2 cases preoperatively. Results: A total of 19 patients were followed up. The follow up period ranged from 5 to 48 months with an average of 15 months. All the fractures were healed. Conclusion: For case of femoral shaft fracture caused by high energy injury, an AP pelvic film should be routinely taken. Once the femoral neck fracture is recognized, operative reduction and fixation should be performed in time. Femoral neck and shaft fractures should be fixed separately.

  3. A new design of cemented stem using functionally graded materials (FGM).

    Science.gov (United States)

    Hedia, H S; Aldousari, S M; Abdellatif, A K; Fouda, N

    2014-01-01

    One of the most frequent complications of total hip replacement (THR) is aseptic loosening of femoral component which is primarily due to changes of post-operative stress distribution pattern with respect to intact femur. Stress shielding of the femur is known to be a principal factor in aseptic loosening of hip replacements. Many designers show that a stiff stem shields the surrounding bone from mechanical loading causing stress shielding. Others show that reducing stem stiffness promotes higher proximal interface shear stress which increases the risk of proximal interface failure. Therefore, the task of this investigation is to solve these conflicting problems appeared in the cemented total hip replacement. The finite element method and optimization technique are used in order to find the optimal stem material which gives the optimal available stress distribution between the proximal medial femoral bone and the cement mantle interfaces. The stem is designed using the concept of functionally graded material (FGM) instead of using the conventional most common used stem material. The results showed that there are four feasible solutions from the optimization runs. The best of these designs is to use a cemented stem graded from titanium at the upper stem layer to collagen at the lower stem layer. This new cemented stem design completely eliminates the stress shielding problem at the proximal medial femoral region. The stress shielding using the cemented functionally graded stem is reduced by 98% compared to titanium stem. PMID:24840196

  4. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    2010-01-01

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  5. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

    2010-09-15

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

  6. Study on the proximal femoral parameters in the healthy Chinese

    International Nuclear Information System (INIS)

    Objective: To explore the characteristics of proximal femoral parameter in the healthy Chinese and provide anatomic basis for the design and research of the domestic prosthesis. Methods: One hundred computed radiographs perpendicular to the hip joint were selected randomly and the proximal femoral parameter were measured by means of Unisight software. These parameters include diameter of femoral head, length of femoral neck, neck-shaft angle, offset, high of femoral head, the width of bone medullary cavity at the plane of lesser trochanter, 20mm above and below the lesser trochanter, diameter and height of the narrow cavity, canal flare index(CFI) and metaphyseal canal flare index (MCFI). The proximal femoral parameters among the Chinese, American and European were compared. Results: There were significant differences in the proximal femoral parameters between ours and American and European, especially in aspect of offset, height of femoral head, diameter of femoral head, the width of bone medullary cavity at the plane of lesser trochanter, 20mm above and below the lesser trochanter and diameter of the narrow cavity. The percentage of funnel-shaped femora (CFI>4.7) in our group was larger than that of the American or the European (P<0.01), which was 20%, 8%, and 11.5% respectively, but there was no significant difference between ours and other domestic scholar's. Conclusion: Computed radiograph system facililates to the research of the morphology of the proximal femur and the measurement of relative parameters and the survey of the characteristics of Chinese femoral. It is important for research and manufacture of the domestic prosthesis fitting the features of the femurs of the Chinese femoral to set up a database of the healthy Chinese proximal femora. (authors)

  7. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  8. Eosinophilic granuloma of the capital femoral epiphysis.

    Science.gov (United States)

    Goto, Takahiro; Nemoto, Tetsuo; Ogura, Koichi; Imanishi, Jungo; Hozumi, Takahiro; Funata, Nobuaki

    2011-05-01

    Eosinophilic granuloma occurs almost exclusively in the diaphysis or metaphysis, when tubular bones are affected. The investigators present an extremely rare case of eosinophilic granuloma arising at the epiphysis of the femoral head in an 8-year-old boy. Plain radiographs and computed tomography showed a well-circumscribed radiolucent lesion, suggesting chondroblastoma or Brodie's abscess. However, the findings on magnetic resonance images were different from typical features of chondroblastoma or Brodie's abscess. The lesion was curetted. Histological diagnosis was eosinophilic granuloma. Differential diagnoses of a radiolucent lesion at the epiphysis in a child should include, though quite rare, eosinophilic granuloma.

  9. Femoral compressive neuropathy from iliopsoas haematoma complicating dengue hemorrhagic fever

    Institute of Scientific and Technical Information of China (English)

    Sneha Ganu; Yesha Mehta

    2013-01-01

    Dengue fever is a debilitating mosquito-borne disease caused by dengue virus. We reported a case of femoral compression neuropathy due to iliopsoas hematoma complicating dengue hemorrhagic fever. Iliopsoas muscle hematoma can cause femoral neuropathy with resultant pain and paralysis. Such manifestations are not well documented in the literature. The pathogenesis of hematoma and compressive neuropathy with its appropriate management is discussed.

  10. 新型人工生物活性接骨板治疗犬股骨骨折%LIM mineralization protein 1 gene transfected bone marrow mesenchymal stem cells combined with nano-hydroxyapatite/polyamide 66 plate in the treatment of canine femoral fractures

    Institute of Scientific and Technical Information of China (English)

    徐小平; 倪卫东; 高仕长; 蒲超; 黄伟弘

    2012-01-01

    BACKGROUND: Studies have shown that nano-hydroxyapatite/polyamide 66 (n-HA/PA66) is a kind of high-strength and high-toughness composite material with excellent biocompatibility, biological safety, biological activity and bone conduction ability.OBJECTIVE: To investigate the effect and feasibility of n-HA /PA66 plate combined with bone marrow mesenchymal cells (BMSCs) transfected with human LIM mineralization protein 1 (LMP-1) gene for treatment of canine femoral fractures. METHODS: Canine BMSCs were isolated and cultured with density gradient centifugation method and adhesive culture method. The third-generation BMSCs were transfected with Adv-hLMP-1, and then combined with n-HA /PA66 plate. The dog models of femoral fractures were established in 48 dogs and were divided into four groups: Ad-LMP-1 transfection group, non-transfected group, n-HA/PA66 alone group and plate and screw groups.RESULTS AND CONCLUSION: The failure rate in the transfection group was lower than that in non-transfected group and n-HA/ PA66 plate group at 8 or 12 weeks postoperatively (P 0.05). The healing time of the transfection group was shorter than that of the other three groups. The plate in the transfection group was completely fused with canine femoral lateral cortex after 12 weeks of operation, and there was obvious bone formation between material and bone. The plate and canine lateral femoral cortex were only partially fused in the non-transfected group and n-HA/PA66 plate group, and there was no or a small amount of bone tissue formation between material and bone. The treatment of canine femoral fractures with n-HA/PA66 plate combined with BMSCs transfected with LMP-1 gene can get good fixation effects, promote the fracture healing and fusion with autogenous bone, without the need for a second operation to take out, but the strength of materials have some limitations, which must be combined with external fixation in the treatment of canine femoral fractures.%背景:研究表明纳

  11. Complete guidewire retention after femoral vein catheterization.

    Science.gov (United States)

    Cat, Bahar Gulcay; Guler, Sertac; Soyuduru, Murat; Guven, Ibrahim; Ramadan, Hayri

    2015-01-01

    Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period. PMID:26657235

  12. SEXUAL DIMORPHISM OF MAXIMUM FEMORAL LENGTH

    Directory of Open Access Journals (Sweden)

    Pandya A M

    2011-04-01

    Full Text Available Sexual identification from the skeletal parts has medico legal and anthropological importance. Present study aims to obtain values of maximum femoral length and to evaluate its possible usefulness in determining correct sexual identification. Study sample consisted of 184 dry, normal, adult, human femora (136 male & 48 female from skeletal collections of Anatomy department, M. P. Shah Medical College, Jamnagar, Gujarat. Maximum length of femur was considered as maximum vertical distance between upper end of head of femur and the lowest point on femoral condyle, measured with the osteometric board. Mean Values obtained were, 451.81 and 417.48 for right male and female, and 453.35 and 420.44 for left male and female respectively. Higher value in male was statistically highly significant (P< 0.001 on both sides. Demarking point (D.P. analysis of the data showed that right femora with maximum length more than 476.70 were definitely male and less than 379.99 were definitely female; while for left bones, femora with maximum length more than 484.49 were definitely male and less than 385.73 were definitely female. Maximum length identified 13.43% of right male femora, 4.35% of right female femora, 7.25% of left male femora and 8% of left female femora. [National J of Med Res 2011; 1(2.000: 67-70

  13. Morphological and chemical analysis of bainite in Cu-17Al-11Mn (at.%) alloys by using orthogonal FIB-SEM and double-EDS STEM.

    Science.gov (United States)

    Motomura, Shunichi; Hara, Toru; Omori, Toshihiro; Kainuma, Ryosuke; Nishida, Minoru

    2016-06-01

    In this study, new microscopy techniques were developed for understanding the mechanism for the bainitic transformation in a Cu-17Al-11Mn (at%) alloy. An orthogonally arranged focused ion beam and a scanning electron microscope were employed to observe three-dimensional (3D) morphology of the bainite phase, in addition to compositional analysis by using a scanning transmission electron microscope equipped with a double-detector energy-dispersive X-ray spectrometer system. The 3D morphology of these samples was observed at different aging times and aging temperatures; the results obtained indicated that with increasing aging time and/or aging temperature, the bainite phase at the initial stage of formation exhibits a plate-like shape, which changes to a lenticular form. A habit plane was uniquely determined as ∼{9 3 2} by the combination of 3D image reconstruction and an electron back-scattered diffraction technique. The compositional analysis revealed the spatial distribution of the compositional variation between the bainite and matrix phases in the initial stages of the transformation. In the bainite phase, the Cu concentration was higher, while the concentrations of Al and Mn were lower than those in the surrounding matrix, indicative of the diffusion of the constituent elements with the growth of the bainite phase. PMID:26884617

  14. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  15. Shape and Site Dependent in Vivo Degradation of Mg-Zn Pins in Rabbit Femoral Condyle

    Directory of Open Access Journals (Sweden)

    Pei Han

    2014-02-01

    Full Text Available A type of specially designed pin model of Mg-Zn alloy was implanted into the full thickness of lesions of New Zealand rabbits’ femoral condyles. The recovery progress, outer surface healing and in vivo degradation were characterized by various methods including radiographs, Micro-CT scan with surface rendering, SEM (scanning electron microscope with EDX (Energy Dispersive X-ray analysis and so on. The in vivo results suggested that a few but not sufficient bridges for holding force were formed between the bone and the implant if there was a preexisting gap between them. The rapid degradation of the implantation in the condyle would result in the appearance of cavities. Morphological evaluation of the specially designed pins indicated that the cusp was the most vulnerable part during degradation. Furthermore, different implantation sites with distinct components and biological functions can lead to different degradation rates of Mg-Zn alloy. The rate of Mg-Zn alloy decreases in the following order: implantation into soft tissue, less trabecular bone, more trabecular bone, and cortical bone. Because of the complexities of in vivo degradation, it is necessary for the design of biomedical Mg-Zn devices to take into consideration the implantation sites used in clinics.

  16. Subchondral insufficiency fracture of the femoral head and medial femoral condyle

    International Nuclear Information System (INIS)

    This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line. There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple occurrence of collapsed subchondral insufficiency fracture. (orig.)

  17. Bearing-Foreign Material Deposition on Retrieved Co-Cr Femoral Heads: Composition and Morphology

    Directory of Open Access Journals (Sweden)

    Nishant M. Tikekar

    2015-01-01

    Full Text Available Bearing-foreign material deposition onto a femoral head can occur from contact with an acetabular shell due to dislocation, reduction, or subluxation. The purpose of this study was to comprehensively characterize deposit regions on retrieved cobalt-chrome femoral heads from metal-on-polyethylene total hip arthroplasties that had experienced such adverse events. The morphology, topography, and composition of deposition regions were characterized using macrophotography, optical profilometry, scanning electron microscopy, energy dispersive spectroscopy, and X-ray photoelectron spectroscopy. The deposit areas were relatively large, they were much rougher than the surrounding undamaged clean areas, and they displayed several distinct morphologies. Titanium alloy elements were the predominant constituents. Calcium and phosphorous were also detected within the deposit areas, in a composition that could nucleate abrasive hydroxyapatite. In addition, tungsten-rich particles, likely present as tungsten carbide, were observed on top of the titanium deposits. The increased roughness associated with these deposition features would be expected to accelerate damage and wear of the opposing liner and hence accelerate the development of osteolysis.

  18. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  19. Modular titanium alloy neck adapter failures in hip replacement - failure mode analysis and influence of implant material

    Directory of Open Access Journals (Sweden)

    Bloemer Wilhelm

    2010-01-01

    Full Text Available Abstract Background Modular neck adapters for hip arthroplasty stems allow the surgeon to modify CCD angle, offset and femoral anteversion intraoperatively. Fretting or crevice corrosion may lead to failure of such a modular device due to high loads or surface contamination inside the modular coupling. Unfortunately we have experienced such a failure of implants and now report our clinical experience with the failures in order to advance orthopaedic material research and joint replacement surgery. The failed neck adapters were implanted between August 2004 and November 2006 a total of about 5000 devices. After this period, the titanium neck adapters were replaced by adapters out of cobalt-chromium. Until the end of 2008 in total 1.4% (n = 68 of the implanted titanium alloy neck adapters failed with an average time of 2.0 years (0.7 to 4.0 years postoperatively. All, but one, patients were male, their average age being 57.4 years (36 to 75 years and the average weight 102.3 kg (75 to 130 kg. The failures of neck adapters were divided into 66% with small CCD of 130° and 60% with head lengths of L or larger. Assuming an average time to failure of 2.8 years, the cumulative failure rate was calculated with 2.4%. Methods A series of adapter failures of titanium alloy modular neck adapters in combination with a titanium alloy modular short hip stem was investigated. For patients having received this particular implant combination risk factors were identified which were associated with the occurence of implant failure. A Kaplan-Meier survival-failure-analysis was conducted. The retrieved implants were analysed using microscopic and chemical methods. Modes of failure were simulated in biomechanical tests. Comparative tests included modular neck adapters made of titanium alloy and cobalt chrome alloy material. Results Retrieval examinations and biomechanical simulation revealed that primary micromotions initiated fretting within the modular tapered neck

  20. Analysis on Femoral Neck Fractures Using Morphological Variations

    International Nuclear Information System (INIS)

    It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF

  1. Treatment of postcatheterization femoral arteriovenous fistulas with simple prolonged bandaging

    Institute of Scientific and Technical Information of China (English)

    ZHOU Tao; LIU Zhen-jiang; ZHOU Sheng-hua; SHEN Xiang-qian; LIU Qi-ming; FANG Zhen-fei; HU Xin-qun; LI Jiang; L(U) Xiao-lin

    2007-01-01

    Background The methods for the treatment of postcatheterization femoral arteriovenous fistulas (AVF-s) - simple observation, ultrasound guided compression, covered stents implantation and coil embolization have poor outcome.Surgery is the standard method for treatment of femoral AVFs, but it is a traumatic operation. In this study, we report the results of the treatment of postcatheterization femoral AVFs by simple prolonged compressing bandage.Methods To treat iatrogenic femoral AVFs caused by transfemoral catheterization, prolonged binding with elastic or common bandage was applied in 16 cases. Catheterization was performed in 7 cases for radiofrequency current catheter ablation, in 4 for occlusion of congenital heart disease, in 3 for percutaneous coronary intervention, in 1 for coronary angiography and in 1 for right heart catheterization.Results All iatrogenic femoral AVFs were healed after simple binding with elastic or common bandage for 4-46 days (mean (15±10) days). During the period of binding, local skins ulceration occurred at puncture site in two cases and femoral vein thrombus was found in one patient. During 6-24 months (mean (11.8±3.6) months) followup with colour Doppler ultrasonography, no recurrent arteriovenous shunting or other complications were observed.Conclusion The results suggest that simple prolonged bandaging for postcatheterization femoral AVFs is an effective and economical procedure.

  2. Analysis on Femoral Neck Fractures Using Morphological Variations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ho Sang; Park, Byoung Keon; Kim, Jay Jung [Hanyang University, Seoul (Korea, Republic of); Chae, Je Wook [Agency for Defense Development, Daejeon (Korea, Republic of)

    2011-10-15

    It has been reported that the femoral morphology has a major correlation to femoral neck fractures(FNF). Previous studies to analyze these correlations have relied on mechanical testing and finite element methods. However, these methods have not been widely applied to various femur samples and models. It is because of the availability of the samples from both patients and cadavers, and also of the geometric limitations in changing the shape of the models. In this study we analyzed femoral neck fractures using a parameterized femoral model that could provide flexibility in changing the geometry of the model for the wide applications of FNF analysis. With the parameterization a variety of models could be generated by changing four major dimensions: femoral head diameter(FHD), femoral neck diameter(FND), femoral neck length(FNL), and neck-shaft angle(NSA). We have performed FEA on the models to compute the stress distributions and reaction forces, and compare them with the data previously generated from mechanical testing. The analysis results indicate that the FND is significantly related with the FNF and the FHD is not significantly related with the FNF.

  3. Femoral neck buttressing: a radiographic and histologic analysis

    International Nuclear Information System (INIS)

    Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

  4. Sequential scintimetry after femoral neck fracture

    International Nuclear Information System (INIS)

    Forty-five patients with recent cervical hip fractures were included in a prospective, clinical, radiographic and sequential scintimetric study. Striking changes in radionuclide uptake over the entire hip region on the fracture side were found during the first 5 postoperative months. Fractures that healed without complications showed the highest relative femoral head uptake at 1 week and a peak value at 6 weeks, followed by a gradual decline at the subsequent examinations. Fractures with complications (redisplacement, nonunion, or late segmental collapse) showed a lower initial uptake and a more gradual increase and only a slight tendency towards increased uptake after 3 months. The accuracy in predicting nonunion with scintimetric examination alone is high both at 1 and at 6 weeks, and the accuracy is almost equally high with combined scintimetric, radiographic, and clinical assessment 3-5 months postoperatively. (author)

  5. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration of...... the drug and metabolite ranged from below the limit of quantification to 0.058 mg/kg (median 0.0098 mg/kg). This concentration range, which largely corresponds to published in vivo plasmalevels under therapy, may serve as a reference for judgment of postmortem cases involving risperidone. In one case......, risperidone was judged to be a contributing factor to death, and the sum of concentrations was 0.29 mg/kg. This concentration is of the same order of magnitude as observed for plasma levels in clinical intoxication cases. For the remaining seven cases, the cause of death was unclear. The measurements observed...

  6. Slipped upper femoral epiphysis with hemophilia A

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    Iyer Deepa

    2007-01-01

    Full Text Available A 13-year-old boy who had hemophilia A was reported with pain in the left thigh and hip on walking. He had no history of trauma. Severe hemophilia A is diagnosed with a Factor VIII level of < 1 iu/dl. The presumptive diagnosis was that of a spontaneous bleed into the hip joint. Factor VIII mutational analysis revealed a C to G substitution at nucleotide 6683 which results in a cystine change at codon 2194. However, the symptoms persisted and an X-ray demonstrated the presence of an acute on chronic slip of the upper femoral epiphysis. The patient was transferred to the center treating his hemophilia where the hip was pinned in situ under cover with Factor VIII. This case demonstrates the need to be aware of a possible traumatic diagnosis of hip pain in a hemophiliac child with a longstanding history of spontaneous bleeding into joints.

  7. Analysis of slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    CT with multiplanar reconstruction (CT/MPR) was used to assess 25 adolescents with known or suspected slipped capital femoral epiphysis (SCFE). CT/MPR localizes the epiphysis in three planes, establishing its relationship to the acetabulum and the metaphyseal neck. MPR facilitates measurements of head-neck angles, residusal head-neck contact, and relative retrovision. CT/MPR may establish the true age of the epiphyseal failure and can reveal subtle SCFE in the face of normal plain films. Patients often present with confusing histories; clues to the true age of failure include subtle signs of healing, remodeling, or new bone buttressing. Characterization of acute versus chronic conditions influences preoperative planning. Postoperatively, CT/MPR confirms early results and follows epiphyseal fusion and remodelling. It also detects complications, such as pin or graft migration avascular necrosis (AVN), or chondrolysis

  8. FEMORAL MONONEUROPATHY: COMPLICATING A DIFFICULT PELVIC URETEROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    D. Mehraban

    1996-07-01

    Full Text Available Femoral mononeuropathy is a complication of gynecological and urological operations. Tlte objective of this citse report is to bring to the attention of fellow urologists the very existence of this complication and offer measures to prevent it. A 48 year old obese worman with a 2 year history of frequent left renal colics, anil a nonfunction left kidney on IVP underwent a retrograde ureterogram study anil a transvaginal ureterolithotomy, in an exaggerated lithotomy position. Postoperatively, a left leg paralysis required 3 weeks of care and encouragement to heal. To prevent this complication, avoid putting too long and too much pressure by retractors on the psoas muscles. During the abdomino-perineal procedures, frequent change of retractor site and monitoring of distal arterial pulses would he helpful. Also, do not use the exaggerated lithotomy position for an extended period of time.

  9. MORPHOLOGICAL STUDY OF MEDIAL CIRCUMFLEX FEMORAL ARTERY IN HUMAN CADAVERS

    Directory of Open Access Journals (Sweden)

    Brijesh R. Aghera

    2014-10-01

    Full Text Available Background: Medial circumflex femoral artery is an important branch of Profunda femoris artery. It is an important artery in supplying blood to the head and neck of the femur, the adductor muscles and form anastomosis around head of femur. So study of variation of medial circumflex femoral artery great value for surgeon and orthopaedic surgeries. Materials and Methods: The present study includes 102 lower limbs of adult formalin fixed human cadavers used for the routine dissection procedure for under graduate and post graduate students in the department of Anatomy, M.R. Medical College, KBN Medical college and H K E Homeopathic College, Gulbarga (India during 2011-2014.The study was done by dissection method as per Cunningham’s manual of practical Anatomy. Result: In present study, we found that 25 extremities (25.49% medial circumflex femoral artery was originated directly from femoral artery. In 10 extremities (9.80% a common trunk was observed form medial circumflex femoral with femoral artery. Normal study was observed in 66 extremities (64.70%. Conclusion: In present study and other past studies we conclude that knowledge of variation in this artery is very important to preventing injury to vessels during surgical procedures around hip joint and also has important value in plastic surgery operations as the vascular pedicle of grafts such as the transverse upper gracilis (TUG flap, medial thigh flap and medial circumflex femoral (gracilis perforator free flap. During case of selective arteriography in ischaemic necrosis of the femoral head to know the arterial supply of the femoral head it is used.

  10. Aneurysm of the superficial femoral artery in an infant

    International Nuclear Information System (INIS)

    An isolated arterial aneurysm in childhood is extremely rare. We report a 1-year-old girl with an aneurysm of the right superficial femoral artery, presenting as an asymptomatic mass of the thigh. The aneurysm involved the whole superficial femoral artery (9 cm in length), and surgical treatment would have required replacement of the affected artery. Conservative treatment was chosen, influenced by the patient's rapid growth at that time. Non-invasive, 3-D contrast-enhanced magnetic resonance angiography (MRA) was useful as an alternative to conventional angiography for detailed evaluation of the femoral arteries, including the aneurysm. (orig.)

  11. An Effective Approach for Optimization of a Composite Intramedullary Nail for Treating Femoral Shaft Fractures.

    Science.gov (United States)

    Samiezadeh, Saeid; Tavakkoli Avval, Pouria; Fawaz, Zouheir; Bougherara, Habiba

    2015-12-01

    The high stiffness of conventional intramedullary (IM) nails may result in stress shielding and subsequent bone loss following healing in long bone fractures. It can also delay union by reducing compressive loads at the fracture site, thereby inhibiting secondary bone healing. This paper introduces a new approach for the optimization of a fiber-reinforced composite nail made of carbon fiber (CF)/epoxy based on a combination of the classical laminate theory, beam theory, finite-element (FE) method, and bone remodeling model using irreversible thermodynamics. The optimization began by altering the composite stacking sequence and thickness to minimize axial stiffness, while maximizing torsional stiffness for a given range of bending stiffnesses. The selected candidates for the seven intervals of bending stiffness were then examined in an experimentally validated FE model to evaluate their mechanical performance in transverse and oblique femoral shaft fractures. It was found that the composite nail having an axial stiffness of 3.70 MN and bending and torsional stiffnesses of 70.3 and 70.9 N⋅m², respectively, showed an overall superiority compared to the other configurations. It increased compression at the fracture site by 344.9 N (31%) on average, while maintaining fracture stability through an average increase of only 0.6 mm (49%) in fracture shear movement in transverse and oblique fractures when compared to a conventional titanium-alloy nail. The long-term results obtained from the bone remodeling model suggest that the proposed composite IM nail reduces bone loss in the femoral shaft from 7.9% to 3.5% when compared to a conventional titanium-alloy nail. This study proposes a number of practical guidelines for the design of composite IM nails. PMID:26458035

  12. 钛合金人工关节柄烧结复合生物活性玻璃陶瓷涂层的研究%STUDY OF COMPOSITE BIOACTIVE GLASS-CERAMIC COATING ON STEM OF ARTIFICIAL HIP JOINT MADE OF TITANIUM ALLOY BY SINTERING METHOD

    Institute of Scientific and Technical Information of China (English)

    陈晓明; 李志刚; 闫玉华; 李世普; 贺建华; 王燕

    2001-01-01

    By a two-step sintering method, a composite glass-ceramic coating was made on the surface of titanium alloy which resisted penetration of tissue fluid and showed high bonding strength and good biocompatibility. The coating might be used to improve the bonding character of the stem of artificial hip joint made of titanium alloy with bone tissue.%采用两步涂烧法在钛合金表面制备出防组织液渗透,结合强度高,生物相容性好的复合生物活性陶瓷涂层,适合于改善人工髋关节柄部的骨结合特性。

  13. Stem Cells

    OpenAIRE

    Madhukar Thakur

    2009-01-01

    Objective: The objective of this presentation is to create awareness of stem cell applications in the ISORBE community and to foster a strategy of how the ISORBE community can disseminate information and promote the use of radiolabeled stem cells in biomedical applications. Methods: The continued excitement in Stem Cells, in many branches of basic and applied biomedical science, stems from the remarkable ability of stem cells to divide and develop into different types of cells in ...

  14. Quantitation of perfusion in ischemic necrosis of femoral head by fracture

    International Nuclear Information System (INIS)

    The radionuclide angiography of femoral head was measured in 10 normal controls and 12 cases of ischemic necrosis of femoral head (INFH) by fracture using 99mTc MDP bone imaging. The results demonstrated that, in normal subjects the difference of femoral perfusion index (FPI) of both femoral head was 0.4. The difference of FPI between both groups has statistical significance (P<0.001). Therefore, the measurement of perfusion index of femoral head has some help for INFH diagnosis

  15. Femoral neck fractures complicating gaucher disease in children

    International Nuclear Information System (INIS)

    In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceeded by multiple bone 'crisis' localized to the proximal femora. (orig.)

  16. The quadratus femoris graft in old transcervical femoral fractures.

    Directory of Open Access Journals (Sweden)

    Delima D

    1989-07-01

    Full Text Available Sixteen patients with an old transcervical femoral fracture were treated with the quadratus femoris muscle pedicle bone graft with supplementary autografting. The result was a good functional hip in 14 cases.

  17. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  18. Types of Stem Cells

    Science.gov (United States)

    ... PDF) Download an introduction to stem cells and stem cell research. Stem Cell Glossary Stem cell terms to know. ... stem cells blog from the International Society for Stem Cell Research. Learn About Stem Cells From Lab to You ...

  19. The threshold force required for femoral impaction grafting in revision hip surgery.

    LENUS (Irish Health Repository)

    Flannery, Olivia M

    2010-06-01

    BACKGROUND AND PURPOSE: Femoral impaction grafting requires vigorous impaction to obtain adequate stability without risk of fracture, but the force of impaction has not been determined. We determined this threshold force in a preliminary study using animal femurs. METHODS: Adult sow femurs were used because of their morphological similarity to human femurs in revision hip arthroplasty. 35 sow femurs were impacted with morselized bone chips and an increasing force was applied until the femur fractured. This allowed a threshold force to be established. 5 other femurs were impacted to this force and an Exeter stem was cemented into the neomedullary canal. A 28-mm Exeter head was attached and loaded by direct contact with a hydraulic testing machine. Axial cyclic loading was performed and the position sensor of the hydraulic testing machine measured the prosthetic head subsidence. RESULTS: 29 tests were completed successfully. The threshold force was found to be 4 kN. There was no statistically significant correlation between the load at fracture and the cortex-to-canal ratio or the bone mineral density. Following impaction with a maximum force of 4 kN, the average axial subsidence was 0.28 mm. INTERPRETATION: We achieved a stable construct without fracture. Further studies using human cadaveric femurs should be done to determine the threshold force required for femoral impaction grafting in revision hip surgery.

  20. Femoral kontroll blant idrettsaktive kvinner : testutvikling og sammenheng med skadehistorikk

    OpenAIRE

    Østvold, Mattis

    2011-01-01

    Purpose: Non-contact knee injuries are often the topic of discussion in relation to injury prevention. The purpose of this study was to develop a standardized test and a standardized analysis method for quantifying changes in the femoral control in a simple but reliable way. We also wanted to quantify the relationship between femoral control and injury history in the sample. Method: Female athletes (n = 95, age = 18 ± 1 years old) who were active in various sports, conducted two weak links...

  1. Medial circumflex femoral artery flap for ischial pressure sore

    OpenAIRE

    Palanivelu S

    2009-01-01

    A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The s...

  2. Osteochondral Fractures of the Lateral Femoral Trochlea in Young Athletes

    OpenAIRE

    Walsh, Stewart

    2016-01-01

    Method: Between May 2012 and September 2014 cluster of five patients with large osteochondral fractures of the lateral femoral trochlea were treated at our institution. These all occurred in high level male athletes, one at a decathlete and the other four soccer players. The MRI scan showed a characteristic appearance of a large subchondral fracture involving most of the lateral femoral trochlea. All patients were symptomatic. The patients were treated with open reduction and internal fixatio...

  3. Periprosthetic subtrochanteric femoral fracture in a megaprosthesis of the knee

    Directory of Open Access Journals (Sweden)

    Vaishya Raju

    2013-10-01

    Full Text Available 【Abstract】We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee, done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man. Treatment with a locking femoral plate was able to achieve primary union with a good result. Key words: Periprosthetic fractures; Femur; Femoral fractures; Knee

  4. Brodie's abscess of the femoral neck simulating osteoid osteoma.

    Science.gov (United States)

    Gulati, Yash; Maheshwari, Aditya V

    2007-10-01

    Subacute osteomyelitis (Brodie's abscess) is essentially a problem of diagnosis, and there may be considerable difficulty in distinguishing it from other benign and malignant bone lesions. Though reported in the metaphyseal region of the femur, Brodie's abscess is rarer in the femoral neck. The authors present a case of Brodie's abscess in the femoral neck, which clinico-radiologically simulated an osteoid osteoma. Retrospectively, the presence of a cortical sinus tract should have aroused suspicion.

  5. Low field magnetic resonance imaging of femoral neck fractures

    International Nuclear Information System (INIS)

    Fourteen patients with cervical hip fractures were treated with internal fixation using titanium screws. The femoral head vitality was evaluated with 99Tcm-MDP scintigraphy and scintimetry within 2 weeks postoperatively and by serial low field magnetic resonance imaging (MR). Two patients with reduced radionuclide uptake (femoral head ratio < 1.0) developed radiographic signs of femoral head necrosis. MR disclosed the definite area of the necrosis at 2 and 12 months after fracture, respectively. In three of the patients with a high scintimetric uptake (femoral head ratio ≥ 1.0), MR revealed a focal decrease of the signal intensity in the femoral head or neck at 2, 3 and 7 months after fracture, respectively. The radiographs in one of these patients were normal at 7 months after fracture. The second one showed signs of necrosis at 16 months and the last one developed delayed/non-union. With a non-ferromagnetic osteosynthesis the healing course after femoral neck fracture can be studied with low field MR equipment without disturbing artifacts. The time period between ischaemia and definite abnormalities on MR may embrace several months. (orig.)

  6. Femoral Neck Shaft Angle in Men with Fragility Fractures

    Directory of Open Access Journals (Sweden)

    S. P. Tuck

    2011-01-01

    Full Text Available Introduction. Femoral neck shaft angle (NSA has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric, symptomatic vertebral (91, and distal forearm (67 fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm2: lumbar spine, femoral neck, and total femur measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately, nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P=0.001, but larger in those with distal forearm fractures (129.8° versus 128.5°: P=0.01. Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

  7. Femoral Component Survival in Hybrid Total Knee Arthroplasty.

    Science.gov (United States)

    Perry, Clayton R; Perry, Kevin I

    2016-05-01

    Although the majority of North American surgeons perform total knee arthroplasty by cementing both the femoral and the tibial components, hybrid fixation with a press-fit femur and cemented tibia is an alternative form of total knee arthroplasty performed by some. Currently, there is a paucity of literature evaluating long-term outcomes after hybrid total knee arthroplasty. As such, the purpose of the current study was to describe the long-term results of total knee arthroplasty performed using the hybrid technique. The authors retrospectively reviewed a total of 77 hybrid total knee arthroplasties with at least 12 years of follow-up. Clinical and radiographic evaluations were performed to determine patient function and the incidence of femoral component failure after hybrid total knee arthroplasty. At the time of last follow-up, 76 of 77 (99%) of the femoral components remained in place without evidence of loosening. One femoral component failed due to aseptic loosening and was ultimately revised to a cemented femoral component without further complication. In addition, 1 tibial component and 2 patellar components failed due to aseptic loosening. Four tibial polyethylene liners were revised for polyethylene wear. In conclusion, press-fit fixation of the femoral component is a reliable and durable alternative to cemented fixation. [Orthopedics. 2016; 39(3):181-186.]. PMID:27135453

  8. Prevascular femoral hernia and its relation with inferior epigastric vessels: a rare presentation of the femoral hernia sac.

    Science.gov (United States)

    Boshnaq, Mohamed; Phan, Yih Chyn; Akhtar, Mansoor; Hamade, Ayman

    2016-01-01

    A 61-year-old man presented to the emergency department, with a 2-week history of a painful lump on his right groin. A diagnosis of an irreducible right femoral hernia was made. As such, an urgent operation was carried out on the same day, and the patient was found to have a rare prevascular femoral hernia in which the sac was lying over the femoral vessels and split by the inferior epigastric vessels into 2 components resembling 2 trouser limbs. The hernia sac presented in a different and challenging way that necessitated meticulous dissection and full orientation of the anatomy of the femoral triangle. Complete dissection and control of the inferior epigastric vessels, and complete reduction of the sac followed by repair with a prosthetic mesh plug were performed successfully. The patient was discharged home the next day. PMID:27090547

  9. Outcome of an uncemented hydroxyapatite coated hemiarthroplasty for displaced femoral neck fractures

    DEFF Research Database (Denmark)

    Eschen, Jacob; Kring, Søren; Brix, Michael;

    2012-01-01

    discouraged their use. There is limited evidence for the use of modern uncemented femoral stems in the treatment of DFNF, and we wished to investigate the clinical and radiographic performance of an uncemented hydroxyapatite coated hemiarthroplasty at 2-year follow-up. Patients and methods: We included 97...... consecutive patients who had an uncemented, hydroxyapatite coated hemiarthroplasty (Corail, Depuy) inserted during a 1-year period. Due to unwillingness or cognitive impairment (n = 6) and death before follow-up (n = 44), a total of 47 patients (39 females) with a mean age of 81 years were available. Results...... lateral thigh pain or groin pain was reported by 15 patients. The EQ-5D index score at follow-up was 0.72 (range: 0.16-1.00) and the EQ-5D Visual Analogue Score was 70 (range: 15-100). There were no signs of implant loosening in any of the 37 hips undergoing radiographic evaluation at follow...

  10. Protrusio of a ceramic femoral head through the acetabular metallic shell, extensive metallosis and 'bubble sign'.

    Science.gov (United States)

    Malizos, Konstantinos; Roidis, Nikolaos T; Poultsides, Lazaros; Basdekis, George; Moraitis, Theofanis; Xenakis, Theodoros

    2009-02-01

    A 24-year-old patient with a history of juvenile rheumatoid arthritis underwent a primary cementless left total hip arthroplasty (THA). The original THA consisted of an Optifix 54 cup with a 3-mm thick polyethylene liner, an Optifix size 4 stem (Smith & Nephew Richards, Memphis, Tennessee) and a Biolox aluminum 32-mm femoral head. Fourteen years later, radiographs demonstrated extensive wear of the polyethylene liner resulting in direct articulation and abrasion wear of the ceramic femoral head on the cup and a bubble sign. This article presents a case of a catastrophic failure of a ceramic/polyethylene bearing with destruction of the polyethylene liner and the metallic shell and protrusio of the nonfractured ceramic head through the metallic shell. To our knowledge this is the first description of extensive metallosis and subsequent radiograph bubble sign not presenting as a result of wear of a metal-on-metal articulation. At the time of revision surgery-Hydrocel TNT Monoblock 58 cup (Zimmer, Warsaw, Indiana), Wagner 265/14 stem (Zimmer), and a Co/Cr 28-mm head-copious metallic debris was seen both macroscopically and histologically, with the ceramic head protruding behind the metallic shell. Multiple factors may have been responsible for this failure including a thin polyethylene shell, a suboptimal locking mechanism, gamma in air sterilization for polyethylene, multiple screw-holes that reduce the contact surface between shell and polyethylene, the rough surface on the inside of the shell and non-articular wear at the metal polyethylene interface within the acetabular component and the high demands of this active young patient. PMID:19301791

  11. Reconstruction of femoral length from fragmentary femora

    Science.gov (United States)

    Offei, Eric Bekoe; Osabutey, Casmiel Kwabena

    2016-01-01

    The reconstruction of femoral length (FL) from fragmentary femora is an essential step in estimating stature from fragmentary skeletal remains in forensic investigations. While regression formulae for doing this have been suggested for several populations, such formulae have not been established for Ghanaian skeletal remains. This study, therefore, seeks to derive regression formulae for reconstruction of FL from fragmentary femora of skeletal samples obtained from Ghana. Six measurements (vertical head diameter, transverse head diameter, bicondylar breadth, epicondylar breadth, sub-trochanteric anterior-posterior diameter, and sub-trochanteric transverse diameter) were acquired from different anatomical portions of the femur and the relationship between each acquired measurement and FL was analyzed using linear regression. The results indicated significantly moderate-to-high correlations (r=0.580–0.818) between FL and each acquired measurement. The error estimates of the regression formulae were relatively low (i.e., standard error of estimate, 13.66–19.28 mm), suggesting that the discrepancies between actual and estimated stature were relatively low. Compared with other measurements, sub-trochanteric transverse diameter was the best estimate of FL. In the absence of a complete femur, the regression formulae based on the assessed measurements may be used to infer FL, from which stature can be estimated in forensic investigations. PMID:27722014

  12. Stem system

    Directory of Open Access Journals (Sweden)

    Shajmardanova L.R.

    2008-01-01

    Full Text Available The article shows the stem cells from the point of view of systemic anatomy, where they are united into an entire stem system. This integration shows various advantages for better understanding the stem cells role in the body. Authors, considering functions and action mechanism of stem cells, phylogeny, ontogeny, regulation of functions, explain the base for stem cells system existance. The definition and terminology, age peculiarities, relationship with other systems of organs and differences are offered. The theoretical proof of primary-integrative role of stem system is provided for all other systems in body. Of particular importance is the role of stem system as a link between neural and endocrine systems. The work helps to sistematize data on investigations of stem cells, their entire-system perception, that will ease the goals determining for further research and their clinical use.

  13. Multiplanar CT assessment of femoral head displacement in slipped capital femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Dwek, Jerry R. [Rady Children' s Hospital and Health Center, Department of Radiology, San Diego, CA (United States); Hosalkar, Harish S. [Center for Hip Preservation, Department of Orthopedic Surgery, TriCity Medical Center, Oceanside, CA (United States)

    2013-12-15

    With recent changing approaches to the management of slipped capital femoral epiphysis (SCFE), the accurate radiographic assessment of maximum extent of displacement is crucial for planning surgical treatment. To determine what plane best represents the maximum SCFE displacement as quantified by the head-neck angle difference (HNAD), whether HNAD can quantitatively differentiate the SCFE cohort from the normal cohort, based on CT, and how Southwick slip angle (SSA) compares to HNAD. We reviewed 19 children with SCFE (23 affected hips) with preoperative CT scans and 27 age- and sex-matched children undergoing abdominal CT for non-orthopedic problems. Head-neck angle (HNA), the angle between the femoral epiphysis and the neck axis, was measured in three planes on each hip and the HNAD (affected - unaffected hip) was determined. SSA was measured on radiographs. The coronal HNAD (mean 8.7 ) was less than both the axial-oblique (mean 30.7 ) and sagittal (mean 37.4 ) HNADs, which were also greater than the HNADs of the normal cohort. Grouping HNAD measurements by SSA severity classification did not consistently distinguish between SCFE severity levels. Axial-oblique and sagittal planes best represent the maximum SCFE displacement while biplanar radiograph may underestimate the extent of the displacement, thereby potentially altering the management between in situ pinning and capital realignment. (orig.)

  14. Multiplanar CT assessment of femoral head displacement in slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    With recent changing approaches to the management of slipped capital femoral epiphysis (SCFE), the accurate radiographic assessment of maximum extent of displacement is crucial for planning surgical treatment. To determine what plane best represents the maximum SCFE displacement as quantified by the head-neck angle difference (HNAD), whether HNAD can quantitatively differentiate the SCFE cohort from the normal cohort, based on CT, and how Southwick slip angle (SSA) compares to HNAD. We reviewed 19 children with SCFE (23 affected hips) with preoperative CT scans and 27 age- and sex-matched children undergoing abdominal CT for non-orthopedic problems. Head-neck angle (HNA), the angle between the femoral epiphysis and the neck axis, was measured in three planes on each hip and the HNAD (affected - unaffected hip) was determined. SSA was measured on radiographs. The coronal HNAD (mean 8.7 ) was less than both the axial-oblique (mean 30.7 ) and sagittal (mean 37.4 ) HNADs, which were also greater than the HNADs of the normal cohort. Grouping HNAD measurements by SSA severity classification did not consistently distinguish between SCFE severity levels. Axial-oblique and sagittal planes best represent the maximum SCFE displacement while biplanar radiograph may underestimate the extent of the displacement, thereby potentially altering the management between in situ pinning and capital realignment. (orig.)

  15. Femoral neck radiography: effect of flexion on visualization

    Energy Technology Data Exchange (ETDEWEB)

    Garry, S.C. [Univ. of Alberta, Dept. of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada); Jhangri, G.S. [Univ. of Alberta, Dept. Public Health Sciences, Edmonton, Alberta (Canada); Lambert, R.G.W. [Univ. of Alberta, Dept.of Radiology and Diagnostic Imaging, Walter C Mackenzie Health Sciences Centre, Edmonton, Alberta (Canada)]. E-mail: rglamber@cha.ab.ca

    2005-06-15

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15{sup o} and flexion in 10{sup o} increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0{sup o} and 20{sup o} flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation ({rho} < 0.05). Visualization of the femoral neck in the extended position progressively deteriorated from 15{sup o} internal rotation to 30{sup o} external rotation ({rho} <0.01). However, when 20{sup o} flexion was applied to bones in external rotation, visualization significantly improved at 15{sup o} ({rho} <0.05) and 30{sup o} ({rho} <0.01). Flexion of the externally rotated femur can bring the femoral neck into horizontal alignment, and a relatively small amount (20{sup o}) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  16. Structural and functional studies of bioobjects prepared from femoral heads

    International Nuclear Information System (INIS)

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%

  17. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Selahattin Ozyurek

    2015-07-01

    Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

  18. Structural and functional studies of bioobjects prepared from femoral heads

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, I. A., E-mail: IKirilova@niito.ru; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru [Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, 17, Frunze, Novosibirsk, 630091 (Russian Federation); Sharkeev, Yu. P., E-mail: sharkeev@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Popova, K. S., E-mail: kseniya@ispms.tsc.ru; Uvarkin, P. V., E-mail: uvarkin@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation)

    2015-11-17

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  19. Atypical femoral fractures and current management

    Directory of Open Access Journals (Sweden)

    Nianye Zheng

    2016-10-01

    Full Text Available With the rapid increase in patients receiving bisphosphonates (BPs for treating osteoporosis, one of the clinical complications associated with its long-term use is atypical femoral fractures (AFFs. Although the absolute risk for AFFs is low and it was a consensus that AFFs were acceptable compared with the amount of osteoporotic fractures BPs have prevented, epidemiological studies have proved that BPs had a strong association with AFFs and possibly more people were going to suffer from this adverse effect with wide prescriptions of this drug. In addition, AFFs seemed to have impaired ability to heal. Thus, to understand the mechanism(s behind AFFs is important and desirable for considering preventive measures. This article reviewed the clinical features of AFFs as well as potential underlining pathological characteristics, such as the decreased turnover rate caused by BPs that led to multiple-level alternations, e.g., changes not only at cellular and tissue levels, but also related to changes in bone micro- and macrostructure and organic/inorganic contents, leading to potentially compromised mechanical properties of cortical bone when exposed to prolonged BP therapy. Severely suppressed bone turnover may also be the underlying mechanism for impaired fracture healing in patients with AFFs. The rising concerns about the risk for AFFs in nonosteoporotic patients receiving high-dose BPs to treat cancers were also discussed. Detailed investigation will help develop potential targeted pharmacological treatments such as parathyroid hormone. In addition, potential innovative internal fixation implants were discussed with regard to dynamic and biological fixation for enhancing AFF repair.

  20. Imaging Findings in Symptomatic Patients with Femoral Diaphyseal Stress Injuries

    Energy Technology Data Exchange (ETDEWEB)

    Theodorou, S.J.; Theodorou, D.J.; Resnick, D. [Univ. of California, San Diego Medical Center, CA (United States). Dept. of Radiology

    2006-07-15

    Purpose: To assess the imaging findings seen in symptomatic patients with stress injuries of the femoral diaphysis. Material and Methods: Seven patients (5 F, 2 M, age range 16 to 56 years, mean 38 years) underwent imaging evaluation of the symptomatic lower extremity due to an insidious onset of thigh or groin pain unrelated to trauma. Imaging studies included radiography and magnetic resonance imaging (MRI) in seven patients, bone scintigraphy in five, and computed tomography (CT) in three. Results: Radiographs depicted three frank fractures in two patients, and revealed findings of stress injury in six patients. Available scintigraphic and CT findings were abnormal. On MR images, a solitary fracture was seen in two patients; two patients presented with bilateral stress fractures of the femoral diaphysis; and all seven patients had the imaging features of stress injury. Femoral diaphyseal stress fractures (n=6) appeared as linear regions of T1- and T2-weighted low signal intensity, surrounded by diffuse bone marrow edema. Three of the six frank fractures, with an evident fracture line, were longitudinal and parallel to the cortical surface. Conclusion: Femoral diaphyseal stress fractures are often inconspicuous with conventional radiography. MRI depicts the changes of stress injury in the femoral diaphysis, and is particularly useful in documenting the presence, morphology, and extent of fracture(s), information valuable for definitive diagnosis and appropriate management.

  1. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    2007-02-01

    Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

  2. Femoral neck radiography: effect of flexion on visualization

    International Nuclear Information System (INIS)

    To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15o and flexion in 10o increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0o and 20o flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (ρ o internal rotation to 30o external rotation (ρ o flexion was applied to bones in external rotation, visualization significantly improved at 15o (ρ o (ρ o) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

  3. Total Hip Arthroplasty Using a Polished Tapered Cemented Stem in Hereditary Multiple Exostosis

    Directory of Open Access Journals (Sweden)

    Akio Kanda

    2016-01-01

    Full Text Available A 61-year-old Japanese man underwent right total hip arthroplasty for hereditary multiple exostosis. At first presentation, he had suffered from coxalgia for a long time. On radiographic images, there was a gigantic femoral head, increased shaft angle, and large diameter of the femoral neck. He had also developed coxarthrosis and severe pain of the hip joint. The transformation of the proximal femur bone causes difficulty in setting a cementless total hip prosthesis. Therefore, total hip arthroplasty using a cemented polished tapered stem was performed via a direct lateral approach. Using a cemented polished tapered stem allowed us to deal with the femoral bone transformation and bone substance defectiveness due to exostosis and also minimized the invasiveness of the operation.

  4. Mesenchymal stem cell therapy for nonmusculoskeletal diseases: emerging applications.

    Science.gov (United States)

    Kuo, Tom K; Ho, Jennifer H; Lee, Oscar K

    2009-01-01

    Mesenchymal stem cells are stem/progenitor cells originated from the mesoderm and can different into multiple cell types of the musculoskeletal system. The vast differentiation potential and the relative ease for culture expansion have established mesenchymal stem cells as the building blocks in cell therapy and tissue engineering applications for a variety of musculoskeletal diseases, including repair of fractures and bone defects, cartilage regeneration, treatment of osteonecrosis of the femoral head, and correction of genetic diseases such as osteogenesis imperfect. However, research in the past decade has revealed differentiation potentials of mesenchymal stem cells beyond lineages of the mesoderm, suggesting broader applications than originally perceived. In this article, we review the recent developments in mesenchymal stem cell research with respect to their emerging properties and applications in nonmusculoskeletal diseases. PMID:19523328

  5. Electrical Resistance Alloys and Low-Expansion Alloys

    DEFF Research Database (Denmark)

    Kjer, Torben

    1996-01-01

    The article gives an overview of electrical resistance alloys and alloys with low thermal expansion. The electrical resistance alloys comprise resistance alloys, heating alloys and thermostat alloys. The low expansion alloys comprise alloys with very low expansion coefficients, alloys with very low...

  6. Stem Cells

    Directory of Open Access Journals (Sweden)

    Madhukar Thakur

    2015-02-01

    Full Text Available Objective: The objective of this presentation is to create awareness of stem cell applications in the ISORBE community and to foster a strategy of how the ISORBE community can disseminate information and promote the use of radiolabeled stem cells in biomedical applications. Methods: The continued excitement in Stem Cells, in many branches of basic and applied biomedical science, stems from the remarkable ability of stem cells to divide and develop into different types of cells in the body. Often called as Magic Seeds, stem cells are produced in bone marrow and circulate in blood, albeit at a relatively low concentration. These virtues together with the ability of stem cells to grow in tissue culture have paved the way for their applications to generate new and healthy tissues and to replace diseased or injured human organs. Although possibilities of stem cell applications are many, much remains yet to be understood of these remarkable magic seeds. Conclusion: This presentation shall briefly cover the origin of stem cells, the pros and cons of their growth and division, their potential application, and shall outline some examples of the contributions of radiolabeled stem cells, in this rapidly growing branch of biomedical science

  7. Bilateral midshaft femoral fractures in an adolescent baseball player.

    Science.gov (United States)

    Ju, D G; Mogayzel, P J; Sponseller, P D; Familiari, F; McFarland, E G

    2016-07-01

    Bone disease, specifically low bone mineral density, is a common and undertreated complication that begins during childhood in patients with cystic fibrosis (CF). This case describes a male baseball player, aged 14years, with undiagnosed CF who sustained a left midshaft femoral fracture while running toward base; 8months later, he sustained a right midshaft femoral fracture under similar conditions. After the second fracture, further evaluation revealed low bone mineral density and CF. There is no previously published report of pathologic fractures occurring in the femoral shaft in an athlete with undiagnosed CF. Patients with CF have a higher fracture rate. Low-energy fractures of major bones in athletically active individuals should be viewed with suspicion for an underlying process. PMID:26927602

  8. Stress fracture of the femoral neck in a child (stress fracture)

    International Nuclear Information System (INIS)

    Femoral neck stress fracture is extremely rare in childhood. We report a case of femoral neck stress fracture in an 11-year-old girl. Differentials diagnosis and a brief review of the literature follow. (orig.)

  9. Study of the titanium alloys surfaces used in orthopaedic systems

    International Nuclear Information System (INIS)

    Total hip prosthesis (THP) is a highly successful orthopaedic device. However, its durability is generally limited to a few decades due to difficult conditions in the human body and huge demands it is subjected to. A hip prosthesis is deteriorating due to high surface pressures caused by mechanical movements of the body. The aim of this project is to improve the characteristics of hip prostheses, in order to increase their functionality and their life span. This paper presents an analysis regarding the topography and tribological parameters of femoral heads structures and of femoral heads coated with TiN. We studied the tribological properties of the surfaces of some femoral heads made of Ti alloys or coated with TiN. These femoral heads were obtained from some prostheses after revision surgery. Afterwards, we used TiN nanostructured coatings for reducing the wear process. TiN thin films were deposited using physical vapour deposition (PVD) and some scratch tests have been realized on these coatings surfaces. The study of coatings surfaces was made using atomic force microscopy (AFM) that offers the possibility to obtain nanometric 3D control of thin films. Main result of these researches is that used coatings offer the possibility to improve the system properties. (authors)

  10. Subchondral bone density distribution in the human femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Wright, David A.; Meguid, Michael; Lubovsky, Omri; Whyne, Cari M. [Sunnybrook Research Institute, Orthopaedic Biomechanics Laboratory, Toronto, Ontario (Canada)

    2012-06-15

    This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p < 0.05). Significant side-to-side correlations were found for all regions (r {sup 2} = 0.81 to r {sup 2} = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

  11. Femoral neck trabecular patterns predict osteoporotic fractures

    International Nuclear Information System (INIS)

    In this paper we show that texture analysis of femoral neck trabecular patterns can be used to predict osteoporotic fractures. The study is based on a sample of 123 women aged 44-66 years with and without fractures. We analyzed trabecular patterns using the Co-occurrence Matrix texture analysis algorithm and compared the predictive utility of the textural data with densitometry. Logistic regression was used to estimate the predictive utility, exp(B), of clinical and textural data per standard deviation. Reproducibility was also demonstrated using paired films at 1-year intervals (CoV=4.5%). Bone mass estimated by DEXA measurements of the spine and hip were the most predictive of fractures giving a two-fold increase in fractures per s.d. bone mass loss (95% CI: 1.2-3.1, p<0.005). Age was also highly predictive with fracture risk increasing by 1.07-fold per year (95% CI: 1.01-1.14, p<0.02). Trabecular texture was found to give a lower, but significant, prediction of fracture of 1.5-fold per s.d. trabecular pattern loss (95% CI: 0.96-2.31, p<0.05). Combining age, weight, and trabecular texture increased the fracture prediction to 1.78-fold per s.d. (95% CI: 1.19-2.67). Combining trabecular texture with densitometry increased the predictive ability to 2.06-fold per s.d. (95% CI: 1.32-3.22) and combined with age and weight as well increased exp(B) to 2.1-fold per s.d. (95% CI: 1.32-3.35). This shows that osteoporotic trabecular texture changes can be ''measured.'' Moreover, the combination of age, weight, and trabecular texture is more predictive than either alone. We propose therefore that this trabecular texture analysis is both reproducible and clinically meaningful. The application of such methods could be used to improve the estimation of fracture risk in conjunction with other clinical data, or where densitometry data cannot be obtained (e.g., in retrospective studies)

  12. Extensively coated revision stems in proximally deficient femur: Early results in 15 patients

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2008-01-01

    Full Text Available Background: Hip replacement following failed internal fixation (dynamic hip screw for intertrochanteric fractures or previous hip arthroplasty presents a major surgical challenge. Proximal fitting revision stems do not achieve adequate fixation. Distal fixation with long-stemmed extensively coated cementless implants (like the Solution™ system affords a suitable solution. We present our early results of 15 patients treated with extensively coated cementless revision stems. Materials and Methods: Fifteen patients with severely compromised proximal femora following either failed hip arthroplasty or failed internal fixation (dynamic hip screw fixation for intertrochanteric fractures were operated by the senior author over a two-year period. Eight patients had aseptic loosening of their femoral stems following cemented hip replacements, with severe thinning of their proximal cortices and impending stress fractures. Seven had secondary hip arthritis following failure of long implants for comminuted intertrochanteric or subtrochanteric femoral fractures. All patients were treated by removal of implant (cemented stems/DHS implants and insertion of long-stemmed extensively coated cementless revision (′ Solution™; DePuy, Warsaw (IN, US′ stems along with press-fit acetabular component (Duraloc Cup, DePuy, Warsaw (IN, US. All eight hip revisions needed extended trochanteric osteotomies. Results: All patients were primarily kept in bed on physiotherapy for six weeks and then gradually progressed to weight-bearing walking over the next six to eight weeks. The Harris Hip Scores and patient satisfaction were used for final evaluation. We achieved good results in the short term studied. In our first three patients (all following failed cemented total hip replacements, we resorted to cerclage wiring to hold osteotomised segments (done to facilitate stem removal. The subsequent 12 proceeded without the need for cerclage wiring. One patient had a

  13. Parallel manipulator robot assisted femoral fracture reduction on traction table.

    Science.gov (United States)

    Lin, H; Wang, J Q; Han, W

    2013-01-01

    The principle of femoral shaft fracture reduction is to restore its pre-fractured limb length and mechanical axis. The current documented treatment method with traction table reduction does not conform to the quantitative alignment and reduction. There is also a great amount of X-Ray radiation exposure to both surgeon and patient during the procedure. For this reason, we introduced an innovated Parallel Manipulator Robot (PMR) application: A Femoral Shaft Fracture Reduction with Parallel Manipulator Robot on Traction Table. With this application, the quantitative control on fracture reduction and alignment can be achieved and the radiation exposure to both surgeons and patients can be greatly reduced. PMID:24110820

  14. Medial circumflex femoral artery flap for ischial pressure sore

    Directory of Open Access Journals (Sweden)

    Palanivelu S

    2009-01-01

    Full Text Available A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

  15. Avascular necrosis associated with nailing of femoral neck fracture

    International Nuclear Information System (INIS)

    Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. SR85-scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures. (author)

  16. Traumatic hip dislocation with associated femoral head fracture

    DEFF Research Database (Denmark)

    Dortaj, H; Emamifar, A

    2015-01-01

    Dislocation of the hip is a critical injury that results from high-energy trauma. This paper describes a case of posterior dislocation of the right hip in a 35-year-old woman with associated ipsilateral femoral head fracture. Initial treatment included reduction of the right hip through posterior...... approach and fixation of the femoral head fracture with three absorbable screws. After 15-month follow-up, a full range of motion has been achieved and there are no signs of avascular necrosis, hip instability, or limping. The authors describe their method of surgery....

  17. Modul femur prosthesis for major upper femoral bone defects

    International Nuclear Information System (INIS)

    The Koelner modul femur prosthesis MECROSET represents a device to be composed of standardised units. It allows the surgeon dealing with large bone defects of the upper femoral end to meet the special local requirements by building up the appropriate implant. This device may cope with bone losses of up to 22 cms, measured down from the tip of the major trochanter. Combination with ordinary cups is possible. Indications proven are upper femoral defects following disease, exchange of prosthesis and trauma. The ten patients thus provided did not show any complications during a 2-year period of observation. Long-term results are still to be awaited. (orig.)

  18. [Femoral head chondroblastoma and reconstruction with osteochondral allograft. Case report].

    Science.gov (United States)

    Orlando-Díaz, C; Guzmán-Vargas, R; Rincon-Cardozo, D F; Mantilla-León, N; Camacho-Casas, J A

    2014-01-01

    Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure.

  19. Patellofemoral dysbalance due to femoral deformities - diagnostic, therapy and results

    Science.gov (United States)

    Dickschas, Jörg; Strecker, Wolf; Harrer, Jörg; Ferner, Felix

    2016-01-01

    Aims and Objectives: Anterior knee pain or patellofemoral instability are typical symptoms of patellofemoral dysbalance. Beside other reasons, this pathology can be caused by a femoral deformity. The two dimensions leading to this problems are torsional- and valgus deformities. This constellation often stays unrecognized. When diagnosed and analyzed, a femoral torsional or varization-osteotomy is the adequate treatment. Aim of this study was to show the diagnostic approach, the gold standard of therapy and the follow up results. Can patellofemoral stability be archived? Is the pain relief significant and how do clinical scores develop at the follow up? Materials and Methods: 33 femoral torsional osteotomies and 18 femoral varization osteotomies were included in this study, 5 of these were combined femoral varization and torsional corrections so that 46 knees are included in 41 patients, as 5 patients were operated on both legs. Major symptoms were patellofemoral dislocations in 28 cases and anterior knee pain in 26 cases. Beside clinical and radiographic evaluation full weight bearing long leg views and a torsional computertomography was always performed. Follow up examination was after 41 (6-113) months. Visual analog scala score, Japanese Knee Society Score, Tegner activity score and Lysholm score were taken before surgery and at the follow up. Results: Mechanical femorotibial valgus was on average 6,4° (5°-10°), femoral internal torsion was in average 40,9° (29°-66°; normal: 24°). Surgical treatment was performed with an arthroscopy followed by an acute femoral varization 7,2°(5°-10°) and / or external torsion osteotomy of 13.8° (5°-26°). Tegner activity score, Japanese knee society score and Lysholm score all significantly improved. Pain relief could be demonstrated as shown by a significant decrease of the VAS score. No further dislocation was reported during the follow up period. Conclusion: Valgus or torsional deformities of the femur frequently

  20. [Femoral head chondroblastoma and reconstruction with osteochondral allograft. Case report].

    Science.gov (United States)

    Orlando-Díaz, C; Guzmán-Vargas, R; Rincon-Cardozo, D F; Mantilla-León, N; Camacho-Casas, J A

    2014-01-01

    Femoral head chondroblastoma is an infrequent tumor, accounting for approximately 1-2% of benign bone tumors. It occurs more frequently in young male patients. It's most frequent locations include the proximal humerus, proximal femur, distal femur and proximal tibia. The femoral head is the third most frequent site of this tumor. There is no specific treatment for this entity; reported treatments range from acetabular osteotomies and osteochondral grafts, to vascularized fibular grafts, all of them with good results. However, this tumor is clinically unpredictable if left untreated. We report a case managed with osteochondral graft and followed-up for three years after the surgical procedure. PMID:26016291

  1. Treatment of Pediatric Open Femoral Fractures with External Fixator Versus Flexible Intramedullary Nails

    OpenAIRE

    Hossein Aslani; Ali Tabrizi; Ali Sadighi; Ahmad R Mirbolook

    2013-01-01

      Background: In children, inappropriate treatment of open femoral fractures may induce several complications. A few studies have compared the external fixator with flexible intramedullary nails in high-grade open femoral fractures of children. The present study aims at comparing results of these two treatment methods in open femoral fractures. Methods: In this descriptive analytical study, 27 patients with open femoral fractures, who were treated using either the external fixator (n=14) or T...

  2. Modified minimally invasive two-incision total hip arthroplasty using large diameter femoral head

    Directory of Open Access Journals (Sweden)

    Kyung Soon Park

    2012-01-01

    Full Text Available Background: Minimally invasive (MI total hip arthroplasty (THA is an alternative to standard THA, but has created much controversy among orthopedic surgeons. The authors modified the original minimally invasive two-incision THA technique and used large-diameter (32 mm, 36 mm ceramic-on-ceramic articulation. Materials and Methods: One hundred and seventy patients that underwent unilateral MI two-incision THA were retrospectively reviewed, and surgical morbidity, functional recovery, radiological properties, and complications were assessed. Results: Mean Harris hip score (HHS improved from 41.8 to 96.1 at last followup, and mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC score from 66.2 to 26.9. The mean lateral opening angle of the acetabular component was 38.2° and the mean stem position was valgus 1.9°. There was an intraoperative femur fracture and one revision surgery due to stem subsidence. No patient had dislocation. Conclusions: Our data suggest that this modified technique combined with large ceramic femoral head is safe and reproducible in terms of achieving proper implant positioning and early functional recovery.

  3. Vibration transfer in the ball-stem contact interface of artificial hips.

    Science.gov (United States)

    Hothan, Arne; Lewerenz, Kathrin; Weiss, Cornelius; Hoffmann, Norbert; Morlock, Michael; Huber, Gerd

    2013-10-01

    Audible squeaking has put the reputation of ceramic bearings for total hip replacements into question. Inter-articular friction induces vibrations in the ceramic head which are transferred through the head-taper interface to the femoral stem. If excited to sufficient amplitudes, squeaking can be emitted by the stem. Hence, the damping and amplification properties of this interface have a crucial influence on stem vibrations. The aim of this study was to determine the vibration transfer behavior between the head and the taper of a femoral stem and its dependence on the assembly force, in order to assess its influence on the development of audible squeaking. A ceramic head was assembled on a titanium femoral stem taper with high and low forces. Frequency response functions characterizing the head-stem interface were determined experimentally. The interface demonstrated negligible influence on vibration transfer in the squeaking frequency range (1-5 kHz). However its damping effect in lower and higher frequency ranges was significant and some areas of amplification were also found. Although squeaking vibration was not influenced by the particular interface studied, the method established can be utilized to trace taper designs with dynamic properties that decrease the susceptibility to squeaking. PMID:23707143

  4. Factors that influence femoral neck length. Analysis of 1543 patients with advanced osteoarthritis of the hip

    NARCIS (Netherlands)

    Prins, Wybren; Kollen, Boudewijn J.; Ettema, Harmen B.; Verheyen, Cees C. P. M.

    2013-01-01

    Background and purpose: There is little known about the relationship between patient characteristic and the variance in geometrical properties of the femoral neck. The length of the femoral neck is relevant when considering a femoral neck preserving hip replacement. Based on surgical experience we h

  5. Significance of nitric oxide on the pathogenesis of steroid-induced femoral head necrosis

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@Steroid-induced femoral head necrosis is claimed to be an ischemic femoral head disease. But there is no discussion on the role of nitric oxide (NO) in the idiopathic disease. The concentration of NO indirectly in serum with steroid induced avascular necrosis of femoral head (ANFH) and in controls are studied in this article.

  6. Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results

    International Nuclear Information System (INIS)

    Different sized ROIs within the femoral head and different modes of calculation were used in [/sup 99m/Tc]MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence

  7. Early detection by sup(99m)Tc-Sn-pyrophosphate scintigraphy of femoral head necrosis following medial femoral neck fractures

    International Nuclear Information System (INIS)

    A selected series of 24 patients with displaced medial femoral neck fracture, treated with closed reduction and osteosynthesis with cancellous bone screws (ASIF), were investigated. During an observation period of 6 to 26 months, serial hip joint scintigraphies were performed and compared with serial X-ray examinations. At the first scintigraphic examination performed on average 5-6 weeks after the fracture, two separate investigators found a decreased amount of activity or no activity in the femoral head of 10 and 8 patients, respectively. At the second scintigraphic examination performed on average 11.1 weeks after the fracture both investigators found no activity or a decreased amount of activity in 8 patients. This figure declined to 7 during the following period, because one patient with decreased activity was recorded as having normal activity 15 months after the fracture. These 7 patients all developed radiological signs of femoral head collapse on average 16.3 months after the fracture (range 5-26 months), whereas their scintigrams displayed decreased or absent tracer uptake on average 1.2 months after the fracture (P<0.01). None of the patients with initially normal or increased uptake later showed decreased or absent uptake during the study and none developed radiological collapse. It may be concluded that absent or decreased uptake of sup(99m)Tc-Sn-pyrophosphate in the femoral head following medial femoral neck fracture indicates femoral head necrosis and a high risk of late segmental collapse, whereas normal or increased uptake implying preserved blood supply means that late segmental collapse will probably never develop. (author)

  8. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Institute of Scientific and Technical Information of China (English)

    Zhan-Le Zheng; Xian Yu; Wei Chen; Yue-Ju Liu; Kun-Lun Yu; Tao Wu; Ying-Ze Zhang

    2015-01-01

    Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures.Distal locking screw prominence is one of the causes for soft tissue irritation.This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P) view in detecting distal locking screw penetrations during retrograde femoral nailing.Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT) images.After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure.The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur.A-P view, lateral condyle tangential view and medial condyle tangential view were obtained.All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not.Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°.In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw) and 25.0% (medial condyle screw) at 4 mm, and 41.7% (lateral condyle screw) and 58.3% (medial condyle screw) at 6 mm.In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm.In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm.The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm) compared with the A-P view (P < 0.05).Conclusions: The femoral condyles

  9. Femoral Condyles Tangential Views: An Effective Method to Detect the Screw Penetration of Femoral Condyles After Retrograde Nailing

    Directory of Open Access Journals (Sweden)

    Zhan-Le Zheng

    2015-01-01

    Full Text Available Background: Postoperative knee soft tissue irritation is a common complication after retrograde nail fixation of femoral fractures. Distal locking screw prominence is one of the causes for soft tissue irritation. This study aimed to determine whether the use of the femoral condyles tangential views improve the diagnostic accuracy compared with anteroposterior (A-P view in detecting distal locking screw penetrations during retrograde femoral nailing. Methods: The angle between the sagittal plane and lateral aspect of the condyle and the angle between the sagittal plane and medial aspect of condyle were measured on computed tomography (CT images. After the angles were measured and recorded, cadaveric femurs were used in a simulated surgical procedure. The retrograde femoral nail was inserted into the femur and placed distal locking screws, which were left 2, 4, and 6 mm proud of the medial and lateral condyles for each femur. A-P view, lateral condyle tangential view and medial condyle tangential view were obtained. All fluoroscopic images were recorded and sent to three observers blinded to the experimental procedure to determine whether screws penetrated the condyle cortex or not. Results: According to the results of CT scan, the lateral condyle view was 20.88 ± 0.98° and the medial condyle view was 40.46 ± 3.14°. In the A-P view, we detected 0% at 2 mm penetration, 16.7% (lateral condyle screw and 25.0% (medial condyle screw at 4 mm, and 41.7% (lateral condyle screw and 58.3% (medial condyle screw at 6 mm. In the lateral tangential view, we detected 91.7% at 2 mm penetration of the lateral condyle and 100% at 4 mm and 6 mm. In the medial tangential view, we detected 66.7% at 2 mm penetration of the medial condyle and 100% at 4 mm and 6 mm. The femoral condyle tangential views provided significant improvement in detecting screw penetrations at all lengths (2, 4, and 6 mm compared with the A-P view (P < 0.05. Conclusions: The femoral condyles

  10. 9%Cr heat resistant steels: Alloy design, microstructure evolution and creep response at 650 deg. C

    International Nuclear Information System (INIS)

    Highlights: → 9Cr alloys with varying Ti and C contents were designed, produced and crept at 650 deg. C. → Sub-grain and precipitate distribution and evolution investigated by STEM-HAADF. → Correlations between microstructure evolution and mechanical properties were studied. → Coarsening of sub-grain size was larger for Ti-containing 9Cr alloys. → 9Cr alloy with low C and no Ti showed the highest creep strength of all studied alloys. - Abstract: In this work 9%Cr alloys were designed supported by computational thermodynamic methods. Two sets of alloys were produced: 9%Cr alloys with 0.1%C and 0.05%C and 9%Cr alloys containing ∼0.03% Ti with 0.1%C and 0.05%C (always wt%). Microstructure investigations showed good agreement with the predicted phases of the thermodynamic modeling. The volume fraction of precipitated M23C6 carbides is directly related to the carbon content of the alloys. For Ti-containing alloys the precipitation of nano-sized Ti-rich MX carbonitrides was observed. The microstructure evolution (sub-grain and particle size) during creep at 650 deg. C/100 MPa was investigated by STEM-HAADF. The sub-grain size evolution and the coarsening of precipitates (MX carbonitrides, M23C6 and Laves phase) were more pronounced for Ti-containing alloys. 9Cr alloys without Ti and with low carbon content presented the highest creep strength of all investigated alloys.

  11. Effect of implantation of biodegradable magnesium alloy on BMP-2 expression in bone of ovariectomized osteoporosis rats

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yue, E-mail: 373073766@qq.com [Liaoning Medical University, 40 Songpo Road, Jinzhou, 121000 (China); Ren, Ling, E-mail: lren@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016 (China); Liu, Chang, E-mail: meixifan1971@163.com [Liaoning Medical University, 40 Songpo Road, Jinzhou, 121000 (China); Yuan, Yajiang, E-mail: yuan925@163.com [Liaoning Medical University, 40 Songpo Road, Jinzhou, 121000 (China); Lin, Xiao, E-mail: linx@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016 (China); Tan, Lili, E-mail: lltan@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016 (China); Chen, Shurui, E-mail: 272146792@qq.com [Liaoning Medical University, 40 Songpo Road, Jinzhou, 121000 (China); Yang, Ke, E-mail: kyang@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, 72 Wenhua Road, Shenyang, 110016 (China); Mei, Xifan, E-mail: meixifan1971@163.com [Liaoning Medical University, 40 Songpo Road, Jinzhou, 121000 (China)

    2013-10-01

    The study was focused on the implantation of a biodegradable AZ31 magnesium alloy into the femoral periosteal of the osteoporosis modeled rats. The experimental results showed that after 4 weeks implantation of AZ31 alloy in the osteoporosis modeled rats, the expression of BMP-2 in bone tissues of the rats was much enhanced, even higher than the control group, which should promote the bone formation and be beneficial for reducing the harmful effect of osteoporosis. Results of HE stains showed that the implantation of AZ31 alloy did not have obvious pathological changes on both the liver and kidney of the animal. - Highlights: • Mg alloy greatly increased expression of BMP-2 in osteoporosis modeled rat bone. • Mg alloy showed good biological safety. • Mg alloy is beneficial for reducing the symptom of osteoporosis.

  12. Effect of implantation of biodegradable magnesium alloy on BMP-2 expression in bone of ovariectomized osteoporosis rats

    International Nuclear Information System (INIS)

    The study was focused on the implantation of a biodegradable AZ31 magnesium alloy into the femoral periosteal of the osteoporosis modeled rats. The experimental results showed that after 4 weeks implantation of AZ31 alloy in the osteoporosis modeled rats, the expression of BMP-2 in bone tissues of the rats was much enhanced, even higher than the control group, which should promote the bone formation and be beneficial for reducing the harmful effect of osteoporosis. Results of HE stains showed that the implantation of AZ31 alloy did not have obvious pathological changes on both the liver and kidney of the animal. - Highlights: • Mg alloy greatly increased expression of BMP-2 in osteoporosis modeled rat bone. • Mg alloy showed good biological safety. • Mg alloy is beneficial for reducing the symptom of osteoporosis

  13. Osteochondrosis in the lateral femoral condyles of a horse

    International Nuclear Information System (INIS)

    Osteochondrosis of the lateral femoral condyles was diagnosed radiographically in an 8-month-old, female Arabian horse, which had been presented with a hindlimb lameness. The diagnosis was confirmed by gross and microscopic pathology. The location of the lesions was considered unusual for osteochondrosis in the horse

  14. Proximal focal femoral deficiency: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Biko, David M. [National Naval Medical Center, Department of Radiology, Bethesda, MD (United States); Uniformed Services University of Health Sciences, Department of Radiology and Radiological Sciences, Bethesda, MD (United States); Davidson, Richard [The Children' s Hospital of Philadelphia, Department of Orthopedic Surgery, Philadelphia, PA (United States); Pena, Andres; Jaramillo, Diego [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2012-01-15

    Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly characterized by abnormal development of the proximal femur. The most common radiographic classification (Aitken) does not evaluate the cartilaginous and soft-tissue abnormalities. To demonstrate MR findings of PFFD focusing on features not seen with radiographs. Nine MR examinations of the hip and femurs of seven children with PFFD were retrospectively reviewed. Imaging was quantitatively and qualitatively assessed comparing the affected limb to the contralateral limb and age-matched controls. The children were classified via the Aitken classification. All children had at least mild acetabular dysplasia, and one type D patient had no acetabulum. MR demonstrated that 4/6 children had labral hypertrophy with a decreased distance from the greater trochanter to the acetabular rim, suggesting impingement (P < 0.05). The proximal femoral physis was abnormal in all cases. The connection between the femoral head and shaft if present was fibrous or fibrocartilaginous. MRI can help in evaluation of PFFD by defining the anatomy. MR demonstrates features of the acetabulum and cartilaginous femoral epiphysis and depicts ligamentous abnormalities of the knee. (orig.)

  15. Quantifying lateral femoral condyle ellipticalness in chimpanzees, gorillas, and humans.

    Science.gov (United States)

    Sylvester, Adam D; Pfisterer, Theresa

    2012-11-01

    Articular surfaces of limb bones provide information for understanding animal locomotion because their size and shape are a reflection of habitual postures and movements. Here we present a novel method for quantifying the ellipticalness (i.e., departure from perfectly circular) of the lateral femoral condyle (LFC), applying this technique to hominid femora. Three-dimensional surface models were created for 49 Homo sapiens, 34 Pan troglodytes and 25 Gorilla gorilla femora. Software was developed that fit separate cylinders to each of the femoral condyles. These cylinders were constrained to have a single axis, but could have different radii. The cylinder fit to the LFC was allowed to assume an elliptical cross-section, while the cylinder fit to the medial condyle was constrained to remain circular. The shape of the elliptical cylinder (ratio of the major and minor axes of the ellipse) was recorded, and the orientation of the elliptical cylinder quantified as angles between the major axis of the ellipse and the anatomical and mechanical axes of the femur. Species were compared using analysis of variance and post hoc multiple comparisons tests. Confirming qualitative descriptions, human LFCs are more elliptical than those of chimpanzees and gorillas. Human femora exhibit a narrow range for the angle between the major axis of the elliptical cylinder and femoral axes. Conversely, the chimpanzee sample is bimodal for these angles, exhibiting two ellipse orientations, while Gorilla shows no preferred angle. Our results suggest that like modern human femora, chimpanzee femoral condyles have preferentially used regions. PMID:23042636

  16. Adductor Canal Block versus Femoral Nerve Block and Quadriceps Strength

    DEFF Research Database (Denmark)

    Jæger, Pia Therese; Nielsen, Zbigniew Jerzy Koscielniak; Henningsen, Lene Marianne;

    2013-01-01

    : The authors hypothesized that the adductor canal block (ACB), a predominant sensory blockade, reduces quadriceps strength compared with placebo (primary endpoint, area under the curve, 0.5-6 h), but less than the femoral nerve block (FNB; secondary endpoint). Other secondary endpoints were...

  17. Management of a femoral fracture complicated by clostridial myositis

    International Nuclear Information System (INIS)

    A clinical case of clostridial myositis secondary to a comminuted femoral fracture is described. This case is unusual because, despite the severe degree of obvious muscle necrosis and gas production, the dog had minimal signs of systemic toxicity. Union of the fracture was achieved but six months postoperatively muscular contracture had resulted in permanent stifle extension

  18. Radionuclide scintimetry for diagnosis of complications following femoral neck fracture

    International Nuclear Information System (INIS)

    A scintimetric study using Tc-99m MDP was made of 54 patients with delayed union, nonunion, or late segmental collapse of the femoral head, 4-92 months after femoral neck fracture. In radiographically verified collapse, the radionuclide uptake ratio between the femoral head on the fractured and on the intact side (HHR) was significantly higher than in fractures resulting in delayed union or nonunion. On the basis of scintimetric and radiographic findings, the patients with healing disturbances could be divided into three groups, characterized by the following features: (1) Satisfactory post-reduction position of the fracture without subsequent redisplacement and a high HHR, which as a rule turned out to be delayed union; (2) The same radiographic pattern but with a lower HHR, which in most cases resulted in nonunion; (3) Inadequate reduction or early redisplacement of the fracture with a high HHR, which resulted in nonunion. The fractional precision in discriminating between different types of disturbed fracture healing by means of skeletal scintimetry was 0.86 in this study. This non-invasive and technically simple method would therefore be a valuable complement to radiography in the assessment of healing, more than 4 months after fracture of the femoral neck. (author)

  19. Blood transfusion requirement in surgery for femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    Audit of blood usage in various surgical specialities have shown that over-ordering of blood is widespread, causing unnecessary pressure on the transfusion facilities and giving growing concern over the expense of cross-matching blood. The aim of this study was to assess the blood transfusion req...... requirement in patients undergoing surgery for femoral artery aneurysms....

  20. Spontaneous Superficial Femoral Artery Pseudoaneurysm in Behcet's Disease

    Directory of Open Access Journals (Sweden)

    Murat Ugurlucan

    2014-01-01

    Full Text Available Behcet’s disease is an autoimmune multisystemic disorder on vasculitis base. Cardiovascular involvement is the most important predictor of morbidity and mortality. The treatment should be planned carefully for pathologies requiring interventions. In our report, we present a 45-year-old patient with spontaneous superficial femoral artery pseudoaneurysm, our treatment strategy, and circumstances we faced.

  1. The Femoral Hernia-a rare hernia and its treatment

    Institute of Scientific and Technical Information of China (English)

    Andreas Hoeferlin

    2009-01-01

    @@ Introduction Hernias age protrusions through weak areas of our abdominal wall.The most common hernia is Inguinal Hernia in men.A rather rare hernia is the Femoral Hernia,a protrusion into the femotal canal next to the blood vessels in our groin (Picl).

  2. Retained portion of latex glove during femoral nailing. Case report.

    Science.gov (United States)

    Sadat-Ali, M; Marwah, S; al-Habdan, I

    1996-11-01

    A case of retained glove during Kuntscher intramedullary nailing is described. An abscess around the glove could have lead to osteomyelitis. One need to be cautious feeling the top end of the nail while femoral nailing to avoid such a complication.

  3. Femoral nailing in adults : doctor and patient reported outcomes

    NARCIS (Netherlands)

    El Moumni, Mostafa

    2016-01-01

    The treatment of traumatic femoral shaft fractures using an unreamed nail is associated with good results. Both antegrade and retrograde unreamed nailing techniques result in high union rates and low rates of complications, such as non-union, deep infection and septic arthritis. These results are co

  4. MPR realignment increases accuracy when measuring femoral neck anteversion angle

    DEFF Research Database (Denmark)

    Olesen, Tommy Hemmert; Torfing, Trine; Overgaard, Søren

    2013-01-01

    To compare two methods of measuring femoral neck anteversion angle (FNA): A 2D method used at Odense University Hospital until 2010, and a method labeled 3D-OUH. The latter method makes corrections to compensate for errors introduced by the individual placement of patients in the CT scanner....

  5. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, Jens-Erik;

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovement...

  6. The accuracy of CT - determined femoral neck anteversion

    International Nuclear Information System (INIS)

    In order to establish the accuracy of CT determination of femoral neck anteversion, two models were constructed; one an idealized Plexiglas model and the other from a real femur. Experiments were carried out by pre-setting angles on the phantoms, and then determining these angles by CT. The results, which show a high degree of accuracy, are analyzed statistically. (orig.)

  7. Chondroblastoma of the femoral head: management and outcome.

    Science.gov (United States)

    Strong, D P; Grimer, R J; Carter, S R; Tillman, R M; Abudu, A

    2010-03-01

    Chondroblastoma of the femoral head presents particular problems in treatment because the tumour is surrounded by articular cartilage on one side and epiphyseal plate on the other. Ten patients underwent treatment for a chondroblastoma involving the proximal femoral capital epiphysis. The patients were aged between eight and 19 years and in four the epiphysis was not yet fused. Five had curettage via a drill hole created up the femoral neck, of whom two developed local recurrence. Five had a direct approach to the chondroblastoma through the femoral neck, and there were no local recurrences in this group. Both patients with local recurrence were under 14 years of age-one was cured by a direct approach through the neck of the femur and the other by lifting a trap door of articular cartilage. Apart from one patient with a temporary leg length discrepancy, there were no other complications. We conclude that a direct approach is likely to lead to the best outcome for this rare condition.

  8. Periprosthetic subtrochanteric femoral fracture in a megaprosthesis of the knee

    Institute of Scientific and Technical Information of China (English)

    Raju Vaishya; Ajay Pal Singh; Abhishek Vaish

    2013-01-01

    We report a rare case of periprosthetic posttraumatic fracture of subtrochanteric region of femur after a megaprosthesis of the knee,done for resistant nonunion of distal femur with secondary osteoarthrosis in a 51 years old man.Treatment with a locking femoral plate was able to achieve primary union with a good result.

  9. Progressive slippage after pinning for slipped capital femoral epiphysis.

    Science.gov (United States)

    Sanders, James O; Smith, William J; Stanley, Earl A; Bueche, Matthew J; Karol, Lori A; Chambers, Henry G

    2002-01-01

    The authors retrospectively reviewed seven cases of progressive slipped capital femoral epiphysis after screw fixation. All seven patients initially presented with chronic symptoms, and five had an acute exacerbation of symptoms with the appearance of an acute-on-chronic slip. Of the other two, one had obvious motion at the proximal femoral physis and the other had increased symptoms but did not have an obvious acute slip radiographically. All underwent percutaneous screw fixation. In four patients a single screw was placed, and in three patients two screws were placed. No patient became symptom-free after surgery. Slip progression was noted on average 5 months after treatment. Radiographs in all patients revealed an increase in slip severity and loss of screw purchase in the femoral neck while fixation in the proximal femoral epiphysis remained secure. One patient had hypothyroidism and another Cushing disease, both diagnosed after the slipped epiphysis. Slips occurring in children with underlying endocrinopathies, and unstable slips in children with a history of antecedent knee or hip pain (commonly called an acute-on-chronic slip) may be susceptible to screw fixation failure. In such patients, close radiographic follow-up, particularly in the presence of continued symptoms, is required to document slip progression and fixation failure as soon as possible.

  10. Femoral fractures : indications an[d] biomechanics of external fixation

    NARCIS (Netherlands)

    A.H. Broekhuizen (Tom); B. van Linge

    1988-01-01

    textabstractInternal fixation can be carried out in various ways. For femoral shaft fractures, an (interlocking) nail is becoming increasingly popular, instead of open realignment of the fracture. External fixation, which has become a generally accepted method of treating fractures of the lower leg,

  11. Blood flow and microdialysis in the human femoral head

    DEFF Research Database (Denmark)

    Bøgehøj, Morten; Emmeluth, Claus; Overgaard, Søren

    2007-01-01

    BACKGROUND: If it would be possible to detect lack of flow and/or the development of ischemia in bone, we might have a way of predicting whether a broken bone will heal. We established microdialysis (MD) and laser Doppler (LD) flow measurement in the human femoral head in order to be able to detect...

  12. Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, Friederike; Benz-Bohm, Gabriele [University of Cologne, Department of Paediatric Radiology, Cologne (Germany); Schoenau, Eckard [University of Cologne, Department of Paediatrics, Cologne (Germany); Horwitz, A.Eldad [Klinikum Krefeld, Department of Paediatric Radiology, Krefeld (Germany)

    2005-06-01

    The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

  13. Expiration induced femoral flow in neonatal coarctation of aorta.

    OpenAIRE

    McNicholl, B.; Kennedy, J. D.

    1983-01-01

    In a 3 day old infant with coarctation of the aorta a loud Doppler signal synchronous with expiration was present for some hours in the femoral vessels, with only barely audible signals synchronous with cardiac systole. It is suggested that in the presence of severe aortic constriction and temporary ductal closure, blood was pumped through the infradiaphragmatic arteries by increased intrathoracic expiratory pressure.

  14. Mechanical properties of femoral trabecular bone in dogs

    Directory of Open Access Journals (Sweden)

    Nolte Ingo

    2005-03-01

    Full Text Available Abstract Background Studying mechanical properties of canine trabecular bone is important for a better understanding of fracture mechanics or bone disorders and is also needed for numerical simulation of canine femora. No detailed data about elastic moduli and degrees of anisotropy of canine femoral trabecular bone has been published so far, hence the purpose of this study was to measure the elastic modulus of trabecular bone in canine femoral heads by ultrasound testing and to assess whether assuming isotropy of the cancellous bone in femoral heads in dogs is a valid simplification. Methods From 8 euthanized dogs, both femora were obtained and cubic specimens were cut from the centre of the femoral head which were oriented along the main pressure and tension trajectories. The specimens were tested using a 100 MHz ultrasound transducer in all three orthogonal directions. The directional elastic moduli of trabecular bone tissue and degrees of anisotropy were calculated. Results The elastic modulus along principal bone trajectories was found to be 11.2 GPa ± 0.4, 10.5 ± 2.1 GPa and 10.5 ± 1.8 GPa, respectively. The mean density of the specimens was 1.40 ± 0.09 g/cm3. The degrees of anisotropy revealed a significant inverse relationship with specimen densities. No significant differences were found between the elastic moduli in x, y and z directions, suggesting an effective isotropy of trabecular bone tissue in canine femoral heads. Discussion This study presents detailed data about elastic moduli of trabecular bone tissue obtained from canine femoral heads. Limitations of the study are the relatively small number of animals investigated and the measurement of whole specimen densities instead of trabecular bone densities which might lead to an underestimation of Young's moduli. Publications on elastic moduli of trabecular bone tissue present results that are similar to our data. Conclusion This study provides data about directional elastic

  15. Study of the anatomical position of the femoral nerve by magnetic resonance imaging in patients with fractured neck of femur: relevance to femoral nerve block.

    LENUS (Irish Health Repository)

    Mehmood, Shehzad

    2012-01-31

    STUDY OBJECTIVE: To determine the anatomical location of the femoral nerve in patients who have sustained fracture of the neck of femur, and its relevance to femoral nerve block technique. DESIGN: Prospective, observational clinical study. SETTING: Orthopedic and Radiology departments of a regional hospital. SUBJECTS: 10 consecutive adult ASA physical status II and III patients (mean age, 78.5 yrs) and 4 adult healthy volunteers. INTERVENTIONS: A T1 magnetic resonance imaging scan was performed of both upper thighs in patients and healthy volunteers successfully. MEASUREMENTS: The distance (mm) between the midpoint of the femoral artery and the midpoint of the femoral nerve, and the distance of the femoral nerve from the skin was measured at the mid-inguinal ligament, the pubic tubercle, and at the mid-inguinal crease. Data are shown as means (SD). Differences between both sides were compared using paired Student\\'s t-tests. P < 0.05 was significant. MAIN RESULTS: In patients the mean distance (mm) between the midpoint of the femoral nerve from the midpoint of femoral artery at the mid-inguinal crease on the fractured and non-fractured sides was 10.7 and 11.0, respectively (P = 0.87). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the mid-inguinal ligament on the fractured and non-fractured sides was 9.64 and 12.5, respectively (P = 0.03). The mean distance (mm) between the midpoint of the femoral nerve from the midpoint of the femoral artery at the pubic tubercle on the fractured and non-fractured sides was 8.74 and 10.49, respectively (P = 0.18). CONCLUSIONS: Blockade of the femoral nerve may be easier to perform at the mid-inguinal crease in patients with fractured neck of femur.

  16. Radiographic and functional results of osteosynthesis using the proximal femoral nail antirotation (PFNA) in the treatment of unstable intertrochanteric femoral fractures

    OpenAIRE

    Sahin, Suner; Erturer, Erden; Ozturk, Irfan; Toker, Serdar; Seckin, Faik; Akman, Senol

    2004-01-01

    Objectives: We evaluated the radiographic and functional results of the proximal femoral nail antirotation (PFNA) system in patients with unstable intertrochanteric femoral fractures. Methods: The study included 45 patients (25 women, 20 men; mean age 72 years; range 27 to 97 years) who underwent osteosynthesis using the PFNA for unstable intertrochanteric femoral fractures. The fractures were in the right hip in 25 patients, and in the left hip in 20 patients. The fractures were classifie...

  17. Modular titanium alloy neck failure in total hip replacement: analysis of a relapse case.

    Science.gov (United States)

    Ceretti, Marco; Falez, Francesco

    2016-01-01

    Modular neck hip prosthesis born in the 1990 with the aim of allowing the surgeon to modify CCD angle, offset and femoral anteversion intra-operatively restoring patient's original biomechanics. In order to achieve the best biomechanics of the reconstructed hip, preoperative planning is essential. In the last few years modularity has been questioned and an argument made for the return to mono block stems due to events of breakage or disconnection of modular components. Fretting or crevice corrosion may lead to failure of such modular device due to the contamination inside the modular coupling or to high loads. We present a case of repetitive modular femoral neck prosthesis fracture. PMID:27163109

  18. STUDY ON NECK SHAFT ANGLE AND FEMORAL LENGTH OF SOUTH INDIAN FEMURS

    OpenAIRE

    Shakil Mohamad Khan; Shaik Hussain Saheb

    2014-01-01

    Back ground: Femoral nek anteversion describes the angle subtended by the femoral neck with reference to the transcondylar plane of the distal end of the femur and is usually 15° to 45°. This along with the neck shaft angle, hip axis length, femoral neck width influence the risk of femoral neck fracture. Femoral neck anteversion angle has to be taken into consideration when reduction and fixation is selected as a method of treatment. Objectives: The objectives of present study to find out ...

  19. Learn About Stem Cells

    Science.gov (United States)

    ... PDF) Download an introduction to stem cells and stem cell research. Stem Cell Glossary Stem cell terms to know. ... ISSCR Get Involved Media © 2015 International Society for Stem Cell Research Terms of Use Disclaimer Privacy Policy

  20. Stem Cell Basics

    Science.gov (United States)

    ... Information Stem Cell Basics Stem Cell Basics: Introduction Stem Cell Information General Information Clinical Trials Funding Information Current Research Policy Glossary Site Map Stem Cell Basics Introduction: What are stem cells, and why ...

  1. Pentosan reduces osteonecrosis of femoral head in SHRSP.

    Science.gov (United States)

    Miyata, Noriaki; Kumagai, Kenji; Osaki, Makoto; Murata, Masakazu; Tomita, Masato; Hozumi, Akira; Nozaki, Yoshihiro; Niwa, Masami

    2010-01-01

    Increased oxidative stress is considered one of the main causes of steroid-induced osteonecrosis of the femoral head (ONFH). The aim of this study was to evaluate the effects of a steroid hormone and pentosan polysulfate sodium (pentosan), a heparin analog, in stroke-prone spontaneously hypertensive rats (SHRSP) as a model of ONFH. One hundred twenty-three 13-week-old male SHRSP/Izm rats were divided into four groups: a control group (group C), pentosan-administered group (group P), steroid-administered group (group S), and group administered pentosan plus steroid (group PS). Methylprednisolone acetate, as the steroid hormone, at a dose of 4 mg (15 mg/kg) was administered at 15 weeks of age. Pentosan at a dose of 3 mg/day/kg was continuously administered intraperitoneally from 13 weeks of age for 4 weeks. Rats were sacrificed at 17 weeks of age, and heart blood and both femora were collected. Triglyceride levels were significantly lower in group PS than in group S, indicating that pentosan improves lipid metabolism. The incidence of histologic ONFH was significantly lower in group P, at 14.8% (10/71 femoral heads), than in group C, at 30.4% (17/56 femoral heads), and significantly lower in group PS, at 40.8% (29/71 femoral heads), than in group S, at 91.3% (42/46 femoral heads), indicating that pentosan markedly inhibits ONFH. Immunohistochemical staining for oxidative stress showed that the stainability was significantly lower in group PS than in group S. Pentosan seems to reduce the incidence of ONFH in SHRSP by improving lipid metabolism and decreasing oxidative stress.

  2. Current concepts on osteonecrosis of the femoral head.

    Science.gov (United States)

    Moya-Angeler, Joaquin; Gianakos, Arianna L; Villa, Jordan C; Ni, Amelia; Lane, Joseph M

    2015-09-18

    It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States. The lack of level 1 evidence in the literature makes it difficult to identify optimal treatment protocols to manage patients with pre-collapse avascular necrosis of the femoral head, and early intervention prior to collapse is critical to successful outcomes in joint preserving procedures. There have been a variety of traumatic and atraumatic factors that have been identified as risk factors for osteonecrosis, but the etiology and pathogenesis still remains unclear. Current osteonecrosis diagnosis is dependent upon plain anteroposterior and frog-leg lateral radiographs of the hip, followed by magnetic resonance imaging (MRI). Generally, the first radiographic changes seen by radiograph will be cystic and sclerotic changes in the femoral head. Although the diagnosis may be made by radiograph, plain radiographs are generally insufficient for early diagnosis, therefore MRI is considered the most accurate benchmark. Treatment options include pharmacologic agents such as bisphosphonates and statins, biophysical treatments, as well as joint-preserving and joint-replacing surgeries. the surgical treatment of osteonecrosis of the femoral head can be divided into two major branches: femoral head sparing procedures (FHSP) and femoral head replacement procedures (FHRP). In general, FHSP are indicated at pre-collapse stages with minimal symptoms whereas FHRP are preferred at post-collapse symptomatic stages. It is difficult to know whether any treatment modality changes the natural history of core decompression since the true natural history of core decompression has not been delineated. PMID:26396935

  3. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    Science.gov (United States)

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale and IKDC scores after surgery. The mean improvement in Marx Activity Scale was 7 (mean pre-op: 4, mean post-op: 11, p < 0.01), and the mean improvement in IKDC score was 36 (mean pre-op: 53, mean post-op: 89, p < 0.01). Conclusion: Valgus knee malalignment results in overload of the lateral compartment and can severely limit one’s ability to participate in athletic activities. Correction of valgus knee malalignment through distal femoral varus osteotomy - either medial closing wedge or lateral opening wedge - can reliably result in improvement in function and return to sport, provided that concomitant chondral, meniscal, and ligamentous pathology is addressed. Therefore, distal

  4. Prognostic precision in postoperative 99mTc-MDP scintimetry after femoral neck fracture

    International Nuclear Information System (INIS)

    A 2-year follow-up regarding healing complications, such as redisplacement, nonunion, and segmental collapse of the femoral head, was performed in 306 patients operated on for femoral neck fracture and examined with 99mTechnetium-MDP scintimetry within 2 weeks postoperatively. Scintimetric evaluation was performed by selecting regions of interest over the femoral head on the fracture side and the intact side and by comparing the uptake. A femoral head ratio fractured/intact side thus was obtained. Of 199 patients with an intact femoral head uptake (ratio ≤ 1.0), 181 showed no signs of healing complications at 2 years, whereas 18 had developed healing complications. Of 107 cases with a deficient femoral-head uptake (ratio 99mTc-MDP scintimetry performed within 2 weeks from femoral neck fracture can predict the outcome of the healing course with a prognostic accuracy of 91 per cent. (author)

  5. Microhardness of Bone Tissue After Different Alloy Implantation

    Directory of Open Access Journals (Sweden)

    Nataliia Zaitseva

    2015-09-01

    Full Text Available Integral indicator of bone quality is microhardness, which depends both on the condition of the inorganic component and the quality of the extracellular organic matrix. There are a lot of researches indicated microhardness changes around the metal implants, but it is not clear how it change distant from injured place. The aim of our research was to determine the microhardness of the femoral bone at different terms after the implantation of metal alloys with different composition. 65 rabbits were random in 5 groups – intact, control (bone defect and 3 experimental. We used TiVT6 alloy with high elasticity module and β- (Ti-Zr alloy with low Young module for the experimental groups. All alloys were implanted in distal epiphysis of femur. Bone microhardness was detected in periimplanted zone as well as in middle of diaphysis and proximal epiphysis. Injury of bone leads to a decrease in the hardness in the zone of the defec as well as in distal zones, followed by recovery up to 6 month. Use the classic high-modulus alloy TiVT6 leads to a significant decrease in the microhardness of all sections of bone in the early and late postoperative period. Implantation of low modulus alloy β (Ti-Zr leads to a reduction of hardness just after 1 and 3 months after the injury, and the use of hydroxyapatite coating significantly reduces the loss of bone quality at all times after implantation.

  6. Corrosion and Fretting of a Modular Hip System: A Retrieval Analysis of 60 Rejuvenate Stems.

    Science.gov (United States)

    De Martino, Ivan; Assini, Joseph B; Elpers, Marcella E; Wright, Timothy M; Westrich, Geoffrey H

    2015-08-01

    Femoral stems with dual-taper modularity were introduced to allow independent control of length, offset, and version. Corrosion and fretting related to micromotion at the neck-stem junction are thought to stimulate an adverse local tissue reaction (ALTR). Analysis of 60 consecutively retrieved modular-neck stem implants (Rejuvenate, Stryker) revised primarily for ALTR was done to determine the variables influencing corrosion and fretting patterns at the neck-stem interface. Taper damage evaluation was performed with stereomicrocopic analysis with two observers. Evidence of fretting and corrosion was seen at the neck-stem taper in all implants, including three implants revised for periprosthetic fractures within four weeks of the index surgery indicating that this process starts early. Femoral stems paired with the long overall neck lengths had significantly higher corrosion scores. Correlation of the corrosion severity at particular locations with the length of implantation suggests that the neck-stem junction experiences cyclic cantilever bending in vivo. The positive correlation between the length of implantation and fretting/corrosion scores bodes poorly for patients who still have this implant. Scanning electron microscopy on a subset of specimens was also performed to evaluate the black corrosion material. We strongly urge frequent follow-up exams for every patient with this particular modular hip stem.

  7. Comparison of Various Functionally Graded Femoral Prostheses by Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Azim Ataollahi Oshkour

    2014-01-01

    Full Text Available This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.

  8. Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study

    Directory of Open Access Journals (Sweden)

    Xiu-yun Su

    2015-01-01

    Full Text Available Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D space. Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium. The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly. Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r=0.24, p<0.01 and between the femoral length and the isthmus height (r=0.6, p<0.01. Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus. Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants.

  9. A Case of a C-Stem Fracture at the Head-Neck Junction and a Review of the Literature

    Directory of Open Access Journals (Sweden)

    David Morley

    2012-01-01

    Full Text Available We report the first case of a fracture of the standard C-stem in combination with a large metal-on-metal articulation. This occurred at the head-neck junction. Analysis of the fractured stem showed evidence of fatigue failure with possible corrosion. The use of large femoral heads with neck adaptors and narrow tapers should be used with caution, especially in heavy, active patients.

  10. Hydrocele of Femoral Hernial Sac-an Extremely Rare Case.

    Science.gov (United States)

    Madhivanan, S; Jain, Ravindra Kumar

    2016-06-01

    A previously healthy 40-year-old woman presented with a right groin swelling for the last 2 years. Diagnosed preoperatively as uncomplicated, irreducible epiplocele of right femoral hernia, later per-operatively was diagnosed as hydrocele of femoral hernial sac also known as "femorocele"; ultrasound abdomen and groin demonstrated as a cystic mass right groin with no precise origin. All other basic line investigations within normal limits, except anemia 7 gm %, corrected to 10 gm %, by preoperative transfusions of 2 units of complete fresh blood. After low approach incision, excision of hydrocele sac, and feormal hernia repair were done with approximation of iliopectineal ligament to inguinal ligament, patient was discharged on 5th postoperative day with satisfactory wound healing and uneventful hospitalization. PMID:27358521

  11. Subchondral insufficiency fracture of the femoral head after liver transplantation

    International Nuclear Information System (INIS)

    A 53-year-old woman developed a subchondral insufficiency fracture of the right femoral head after undergoing a liver transplantation. Radiographs obtained at her first visit demonstrated a slight subchondral collapse in the superolateral portion of the femoral head. Magnetic resonance imaging (MRI) disclosed an irregular, discontinuous, low-intensity band on the T1-weighted image. After 7 months of conservative treatment, the hip pain and the radiograph abnormalities had both disappeared. On the follow-up T1-weighted MR image obtained 17 months after the onset, the band of low signal intensity was not obvious. A subchondral insufficiency fracture is one of the diagnoses to be considered in patients presenting with hip pain after a liver transplantation. (orig.)

  12. Effect of reaming medullary cavity on femoral fracture healing

    International Nuclear Information System (INIS)

    To study the effect of reaming medullary cavity on blood supply of femoral fracture and fracture healing. Methods: Animal model was developed through breaking the femur and nailing the fracture in twenty mature rabbits, half of them with medullary reamed cavity. Authors injected model 185 MBq of 99Tcm on the third day, the first, second and fourth week after operation, then conducted observation of blood supply through ECT. Authors also made histological and EM observation in different stages 1 week, 2 weeks, 4 weeks and 8 weeks after fracture. Results: Three days after operation, the ratio of 99Tcm uptaken amount was significantly decreased in the reaming medullary group. Immunohistochemistry study also revealed the processing of fracture healing was slower. Conclusion: After reaming of medullary cavity, the blood supply of femoral fracture is reduced, and fracture healing is delayed

  13. Subchondral insufficiency fracture of the femoral head after liver transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Kenyu; Yamamoto, Takuaki; Nakashima, Yasuharu; Mawatari, Taro; Motomura, Goro; Ikemura, Satoshi; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2009-09-15

    A 53-year-old woman developed a subchondral insufficiency fracture of the right femoral head after undergoing a liver transplantation. Radiographs obtained at her first visit demonstrated a slight subchondral collapse in the superolateral portion of the femoral head. Magnetic resonance imaging (MRI) disclosed an irregular, discontinuous, low-intensity band on the T1-weighted image. After 7 months of conservative treatment, the hip pain and the radiograph abnormalities had both disappeared. On the follow-up T1-weighted MR image obtained 17 months after the onset, the band of low signal intensity was not obvious. A subchondral insufficiency fracture is one of the diagnoses to be considered in patients presenting with hip pain after a liver transplantation. (orig.)

  14. Osteochondral Fractures of the Lateral Femoral Trochlea in Young Athletes

    Science.gov (United States)

    Walsh, Stewart

    2016-01-01

    Method: Between May 2012 and September 2014 cluster of five patients with large osteochondral fractures of the lateral femoral trochlea were treated at our institution. These all occurred in high level male athletes, one at a decathlete and the other four soccer players. The MRI scan showed a characteristic appearance of a large subchondral fracture involving most of the lateral femoral trochlea. All patients were symptomatic. The patients were treated with open reduction and internal fixation using headless compression screws. The operative technique and short term results will be outlined. Results: Fixation appears successful in most cases. Conclusion: This appears to be a repetitive trauma related injury that occurs in young high-level athletes.

  15. A Case of Femoral Fracture in Klippel Trenaunay Syndrome

    Directory of Open Access Journals (Sweden)

    Sam Nahas

    2014-01-01

    Full Text Available We present a case of Klippel Trenaunay syndrome (KTS who presented with severe bilateral knee osteoarthritis (OA. Preoperative planning was commenced for a total knee replacement (TKR. Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed to progress to union, and so open reduction and internal fixation was performed. This subsequently resulted in on-going delayed union, which was subsequently managed with low intensity pulsed ultrasound (LIPUS, otherwise known as Exogen (Bioventus. exogen. Secondary exogen, 2012. There are only two previous documented cases of femoral fracture in KTS. This is the first report of a patient with this rare syndrome receiving this treatment. We discuss the management of fracture in this challenging group of patients.

  16. Quality of life in old patients with proximal femoral fractures

    Directory of Open Access Journals (Sweden)

    T A Raskina

    2012-01-01

    Full Text Available Objective: to study quality of life in Kemerovo old patients with proximal femoral fractures. Patients and methods. Quality of life in osteoporotic fractures was analyzed in 219 patients (173 women and 46 men who had sustained the injury in January 2004 to December 2008. Results. In the patients with hip fractures, the lowest (41.94+31.16 scores values were recorded by the physical functioning scale reflecting the degree to which their health limited the performance of physical exercises (self-service, walking, going upstairs, weight carriage, etc.. The role functioning and life activity scales showed the highest values (50.96+19.04 and 51.44+26.51 scores, respectively. The mean value of the physical component scale was 46.42+28.26 scores. That of the psychological component scale was 49.56+19.55 scores. Conclusion. The patients with proximal femoral fractures were found to have lower scores on all SF-36 dimensions.

  17. Confronting hip resurfacing and big femoral head replacement gait analysis

    Directory of Open Access Journals (Sweden)

    Panagiotis K. Karampinas

    2014-03-01

    Full Text Available Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS. On the other hand, hip kinematics with standard total hip replacement (THR is optimized with large diameter femoral heads (BFH-THR. The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.

  18. Conservative management of femoral shaft fractures in children.

    Science.gov (United States)

    Moses, T; Pan, K L; Razak, M

    1998-09-01

    Thirty-two children with femoral shaft fractures were treated conservatively with initial skin traction followed by an additional period in a spica cast. After 12 to 20 months of follow up, none had any pain and all of them were attending school without problems. Shortening of more than 2 cm occurred in 6 (19%) of the 32 patients. The most important factor associated with shortening was an overlap of more than 2 cm of shortening of the fracture ends at the time of cast fitting. The average compensatory overgrowth at final assessment was 7 mm. Angular deformity did not pose a problem. This is a safe, simple and practical method to treat childhood femoral shaft fractures.

  19. Magnetic resonance imaging of idiopathic osteonecrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Yamazoe, Shoichi [Kyoto Prefectural Univ. of Medicine (Japan)

    1995-02-01

    Idiopathic osteonecrosis of the femoral head (IONF) can result in disability due to bone collapse and destruction. Therefore, early diagnosis of IONF and prognosis assessment are essential for treatment planning. This study investigated the early characteristic pattern of IONF on magnetic resonance imaging (MRI) and its correlation to the prognosis of the femoral head. MRI was performed repeatedly on fifty-one patients who had undergone renal transplantation. Three abnormal patterns were found in the T{sub 1}-weighted images: a band-like low-signal pattern (band pattern), an irregular low-signal pattern (mottled pattern), and a homogeneous low-signal area localized in the subchondral region (homogeneous pattern). Abnormal changes were detected in thirteen patients; twenty-three hips (25.5%). Most changes were evident within six months after transplantation. The earliest was found six weeks after transplantation. A band pattern was the initial finding in all hips showing abnormal changes. The band pattern did not spread peripherally as time passed. There was no progression from a mottled or homogeneous pattern to a band pattern either. Band-like patterns were subclassified into four types: MR-A, MR-B, MR-C and MR-D. Each of types according to the size and location of the band in relation to the weight bearing portion of the acetabulum was correlated to the prognosis of the femoral head. Three fourths of femoral heads with MR-C resulted in collapse on roentgenographs. These results show that MRI is useful for the diagnosis and evaluation of prognosis in IONF. (author).

  20. Avascular necrosis of the femoral head presenting as trochanteric bursitis.

    OpenAIRE

    Mandell, B F

    1990-01-01

    Five patients are described with avascular necrosis of the femoral head who presented with ipsilateral trochanteric bursitis, in the absence of clearcut hip joint disease. Avascular necrosis was indicated by magnetic resonance imaging. It is suggested that clinical trochanteric bursitis, especially when refractory to local corticosteroid treatment, may be the initial sign of hip disease. In the patient with risk factor(s) for avascular necrosis that diagnosis should be considered and evaluate...

  1. Successful Return to Sport Following Distal Femoral Varus Osteotomy

    Science.gov (United States)

    Voleti, Pramod Babu; Degen, Ryan; Tetreault, Danielle; Krych, Aaron John; Williams, Riley J.

    2016-01-01

    Objectives: Distal femoral varus osteotomy is an effective treatment for unloading valgus knee malalignment; however, there is limited evidence on the ability for patients to return to athletics following this procedure. The purpose of this study is to report the functional outcomes and return to sport for athletic patients that underwent distal femoral varus osteotomy. Methods: A consecutive series of athletic patients that had undergone distal femoral varus osteotomy for symptomatic lateral compartment overload and valgus knee malalignment were prospectively reviewed. All patients had a minimum of 2-year follow-up. Radiographs were assessed to determine pre-operative and post-operative alignment. Details regarding sport of interest, ability to return to sport, and timing of return were obtained from the patients. Prospective institutional registries were utilized to collect pre-operative and post-operative Marx Activity Scale and International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) scores; these values were compared using paired t-tests with p allografts, 2 partial lateral meniscectomies, 1 lateral meniscus allograft transplantation, and 1 revision anterior cruciate ligament reconstruction. All patients were able to successfully return to their sport of choice (4 soccer, 2 softball, 2 running, 1 football, 1 basketball, 1 ice hockey, 1 volleyball, 1 rowing) at a mean of 11 months (range: 9-13). Furthermore, all 13 patients demonstrated an improvement in both Marx Activity Scale and IKDC scores after surgery. The mean improvement in Marx Activity Scale was 7 (mean pre-op: 4, mean post-op: 11, p ligamentous pathology is addressed. Therefore, distal femoral varus osteotomy should be considered in the athletic population for correction of symptomatic valgus knee malalignment.

  2. Strangulated Femoral Hernia Turned to Be Peritoneal Cyst

    OpenAIRE

    Dionysios Dellaportas; George Polymeneas; Christina Dastamani; Evi Kairi-Vasilatou; Ioannis Papaconstantinou

    2012-01-01

    Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination reveal...

  3. EPIDEMIOLOGY AND SOCIAL BURDEN OF THE FEMORAL NECK FRACTURES.

    Directory of Open Access Journals (Sweden)

    Orlin Filipov

    2014-07-01

    Full Text Available The incidence of femoral neck fractures, one of the most common traumatic injuries in the elderly increases continuously due to the ageing of population on the planet and urbanization. In terms of global economic instability, increasingly more funds would have to be paid by the health systems for treatment of those fractures. Probably it will be necessary to revise and optimize some current therapeutic standards.

  4. Subchondral insufficiency fracture of the femoral head in younger adults

    International Nuclear Information System (INIS)

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  5. Subchondral insufficiency fracture of the femoral head in younger adults

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Nakashima, Yasuharu; Shuto, Toshihide; Jingushi, Seiya; Iwamoto, Yukihide [Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)

    2007-06-15

    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  6. Cortical bone distribution in the femoral neck of strepsirhine primates.

    Science.gov (United States)

    Demes, B; Jungers, W L; Walker, C

    2000-10-01

    The thickness of the inferior and superior cortices of the femoral neck was measured on X-rays of 181 strepsirhine primate femora representing 24 species. Neck length, neck depth and neck-shaft angle were also measured. The strength of the femoral neck in frontal bending was estimated by modeling the neck as a hollow cylinder, with neck depth as the outer diameter and cortical thickness representing the superior and inferior shell dimensions. Results indicate that the inferior cortex is always thicker than the superior cortex. The ratio of superior to inferior cortical thickness is highly variable but distinguishes two of the three locomotor groups in the sample. Vertical clingers and leapers have higher ratios (i.e., a more even distribution of cortical bone) than quadrupeds. The slow climbers tend to have the lowest ratios, although they do not differ significantly from the leapers and quadrupeds. These results do not confirm prior theoretical expectations and reported data for anthropoid primates that link greater asymmetry of the cortical shell to more stereotypical hip excursions. The ratio of superior to inferior cortical thickness is unrelated to body mass, femoral neck length, and neck-shaft angle, calling into question whether the short neck of strepsirhine primates acts as a cantilever beam in bending. On the other hand, the estimated section moduli are highly correlated with body mass and neck length, a correlation that is driven primarily by body mass. In conclusion, we believe that an alternative interpretation to the cantilever beam model is needed to explain the asymmetry in bone distribution in the femoral neck, at least in strepsirhine primates (e.g., a thicker inferior cortex is required to reinforce the strongly curved inferior surface). As in prior studies of cross-sectional geometry of long bones, we found slightly positive allometry of cortical dimensions with body mass. PMID:11006046

  7. Midterm Outcome of Femoral Artery Stenting and Factors Affecting Patency

    OpenAIRE

    Yu, Jae Seoung; Park, Keun-Myoung; Jeon, Yong Sun; Cho, Soon Gu; Hong, Kee Chun; Shin, Woo Young; Choe, Yun-Mee; Shin, Seok-Hwan; Kim, Kyung Rae

    2015-01-01

    Purpose: The purpose of this study was to evaluate the early and midterm results of superficial femoral artery (SFA) stenting with self-expanding nitinol stents and to identify the factors affecting patency. Materials and Methods: SFA stenting was performed in 165 limbs of 117 patients from January 2009 to December 2013. Patients were followed-up for the first occurrence of occlusion or stenosis based on computed tomography and duplex scan results and a decrease in ankle brachial index of >15...

  8. DXA and QCT geometric structural measurements of proximal femoral strength

    International Nuclear Information System (INIS)

    The worldwide annual incidence of hip fracture is approximately 1.7 million and the projected increase by 2050 is 6.26 million. In the presence bone mineral density (BMD) measurements have provided the gold standard of assessing the risk of fracture, but this approach does not reflect to bone geometry and clinical risk factors. Proximal femoral strength consists of the distribution of bone mass, diameter, area, length and angle of the femoral neck. Commercial software applications calculate bone distribution variables such as CSMI, CSA, HAL, angle of femoral neck or femur strength index (FSI). They can be either obtained by dual energy X-ray absorptiometry (DXA) absorption curves (2D measurement) or by qualitative computed tomography (QCT) scans (3D measurement). 93 clinic and outpatient individuals (cross sectional, not population based) were consecutively measured with a mean age of 67.6±11.97 years with femur neck BMD between 0.452 to 1.171 g/cm2 (mean 0.795±0.126 g/cm2). DXA measurements (Lunar iDXA) were compared with CT scans (Mindways QCT Pro). The study population showed high correlations for CSMI (r=0.91), CSA (r=0.87), and HAL (r=0.94) between the two measurement systems. After splitting into normal, osteogenic, osteoporotic subgroups the correlations became weaker by decreasing T-score, especially at femoral neck BMD. The coefficient of variance of QCT on cortical thickness, cortical BMD and center of mass was highly significant within the three groups. DXA and QCT have very high correlations on parameters of bone strength and biomechanical quality, but they have different approaches of measurement (X-ray absorption curves versus structural measurement). Also assessment of clinical risk factors must be considered as part of the patient's individual risk of sustaining an osteoporotic fracture. (author)

  9. Titanium elastic nailing in pediatric femoral diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Singh Roop

    2006-01-01

    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  10. Optimization of Ecg Gating in Quantitative Femoral Angiography

    International Nuclear Information System (INIS)

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase

  11. Optimization of Ecg Gating in Quantitative Femoral Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, S.; Berglund, I.; Erikson, U. [Univ. Hospital, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology; Johansson, J.; Walldius, G. [Karolinska Hospital, Stockholm (Sweden). King Gustav V Research Inst.

    2003-09-01

    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase.

  12. Diagnostic methods in ischemic necrosis of the femoral head

    International Nuclear Information System (INIS)

    Ischemic necrosis of the femoral head (INFH) must be diagnosed at an early stage of development, when therapeutic approaches such as forage biopsy or osteotomy can prevent or slow the normal progression of the disease to arthrosis. In this article, on the basis of the pathological changes that characterize process, we review the advantages and limitations of the principal diagnostic techniques (table I) currently employed in the study of INFH. (Author)

  13. Femoral neck non-union treatment by valgus intertrochanteric osteotomy

    Science.gov (United States)

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT OBJECTIVE : The purpose of this study was to evaluate the performance of valgus intertrochanteric osteotomy in femoral neck non-union. METHODS : Forty-two patients with femoral neck fractures with non-union treated using Pauwels' intertrochanteric osteotomy were reviewed. Demographics, time elapsed between fracture and surgery, follow--up, osteosynthesis used, Garden's classification, limb shortening, and x-rays were evaluated. RESULTS : Twenty-two men and 20 women were reviewed. The youngest patient was 18 years old and the oldest 65 years old, with a mean age of 42.4 years (±11.2). The minimum follow-up was 2 years, with a mean of 10.2 years. The average time elapsed between initial fracture and osteotomy was 6.5 months. Twel-ve cases were neglected femoral neck fractures. Nineteen patients were classified as Garden III, and 23 patients as Garden IV. After valgus osteotomy, non-union healing was observed in 38 patients (38/42; 90.4%). Healing of thirty-seven cases of pseudoarthrosis were obtained after the first-attempt osteotomy, and one case required two operations for healing. The osteotomy failed in four cases. Conside-ring the healed osteotomies, good to excellent functional results were achieved in 80.9% (34/42) of the patients. Total hip replacement was subsequently performed in 14.2% (6/42) of the patients for unfavoura-ble outcomes (two for cutting out, two for osteonecrosis, and two for osteoarthritis). CONCLUSIONS : Valgus intertrochanteric osteotomy has a high success rate in archiving healing in femoral neck non-union with good functional results. It is a biological and effective method. Level of Evidence IV, Therapeutic Study. PMID:27057146

  14. Rehabilitation in peripheral non femoral fractures: a review

    OpenAIRE

    Mangone, Giuseppe; Postiglione, Marco; Pasquetti, Pietro

    2010-01-01

    This paper is a short review of the available information on peripheral non femoral fractures (PNFF) which are strictly related to osteoporosis. Particular attention is focused on wrist fractures in view of their frequent occurrence as indicated by world wide statistics. Of special interest is the definition of risk groups (old age), risk areas (developed countries) and risk factors. Reference is made to 2008 WHO guidelines for fracture risk assessment. PNFF are a serious concern to health au...

  15. Pediatric femoral shaft fractures treated by flexible intramedullary nailing

    Institute of Scientific and Technical Information of China (English)

    K.C.Kapil Mani; R.C.Dirgha Raj; Acharya Parimal

    2015-01-01

    Background:Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization.Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail,or external fixators in the case of open fractures.The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.Methods:There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy.Long leg cast was applied at the time of fixation.Partial weight bearing was started 2 weeks after surgery.Patients were evaluated in follow-up study to observe the alignment of fracture,infection,delayed union,nonunion,limb length discrepancy,motion of knee joint,and time to unite the fracture.Results:We were able to follow up 28 out of 32 patients.The patients were 8.14 years of age on average.The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks.There were 3 cases of varus angulation,2 cases of anterior angulation,and 4 cases of limb lengthening.Conclusion:Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery,short rehabilitation period,less immobilization and psychological impact,and cost-effective.

  16. Trans-femoral thromboaspiration for upper extremity ischemia

    OpenAIRE

    Gordhan, Ajeet

    2015-01-01

    Introduction Endovascular trans-femoral access catheter aspiration of thrombus within the proximal subclavian, brachial, radial and ulnar arteries for symptomatic upper extremity ischemic pain has not been previously reported. We describe a case in which a successful clinical outcome was achieved using long length neuro-endovascular aspiration catheters. Presentation of case A 45 year old female presented with diffuse left upper limb pain. Sonography revealed compromised upper extremity blood...

  17. The migration of femoral components after total hip replacement surgery: accuracy and precision of software-aided measurements

    Energy Technology Data Exchange (ETDEWEB)

    Decking, J. [Dept. of Orthopaedic Surgery, Univ. of Mainz School of Medicine, Mainz (Germany); Schuetz, U.; Decking, R.; Puhl, W. [Orthopaedic Dept., Univ. of Ulm, School of Medicine (Germany)

    2003-09-01

    Objective: To assess the accuracy and precision of a software-aided system to measure migration of femoral components after total hip replacement (THR) on digitised radiographs. Design and patients: Subsidence and varus-valgus tilt of THR stems within the femur were measured on digitised anteroposterior pelvic radiographs. The measuring software (UMA, GEMED, Germany) relies on bony landmarks and comparability parameters of two consecutive radiographs. Its accuracy and precision were calculated by comparing it with the gold standard in migration measurements, radiostereometric analysis (RSA). Radiographs and corresponding RSA measurements were performed in 60 patients (38-69 years) following cementless THR surgery. Results and conclusions: The UMA software measured the subsidence of the stems with an accuracy of {+-}2.5 mm and varus-valgus tilt with an accuracy of {+-}1.8 (95% confidence interval). A good interobserver and intraobserver reliability was calculated with Cronbach's alpha ranging from 0.86 to 0.97. Measuring the subsidence of THR stems within the femur is an important parameter in the diagnosis of implant loosening. Software systems such as UMA improve the accuracy of migration measurements and are easy to use on routinely performed radiographs of operated hip joints. (orig.)

  18. Osteonecrosis of the femoral head after bone marrow transplantation

    International Nuclear Information System (INIS)

    To retrospectively review findings of osteonecrosis of the femoral head after bone marrow transplantation. We reviewed the clinical and MR findings of osteonecrosis of the femoral head in 23 of 1112 patients who underwent marrow transplantation during a five-year follow-up period lasting from 1996 to 2000. Mean age at the time of diagnosis was 31 (range, 20-47) years, and the mean time from transplant to diagnosis was 17 months. All patients developed variable graft-versus-host disease and seventeen were treated with high-dose prednisolone and/or cysclosporin for severe acute or extensive chronic graft versus host disease. Osteonecrosis was diagnosed by magnetic resonance (MR) imaging, which allowed early detection of disease assessment of its stage. At the time of diagnosis, 15 hips were at stage I, 28 at stage II, two at stage III, and none at stage IV, according to the international ARCO classification system. Osteonecrosis of femoral diaphyses, the lower lumbar spine, or pelvic bones in the MR field was also found to have occurred in 11 patients. Initial treatment was conservative: 21 hips underwent surgery [core decompression (n=10), vascularized fibular bone graft (n=5), and joint replacement (n=6)]. In patients receiving high-dose steroids for the treatment of graft-versus-host disease, MR screening might help detect osteonecrosis at an early stage

  19. Osteonecrosis of the femoral head after bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Mi; Jun, Jeong Su; Park, Chang Suk; Kim, Yong Sik; Kwon, Soon Yong; Kim, Yoo Jin; Kim, Chun Choo [The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2003-07-01

    To retrospectively review findings of osteonecrosis of the femoral head after bone marrow transplantation. We reviewed the clinical and MR findings of osteonecrosis of the femoral head in 23 of 1112 patients who underwent marrow transplantation during a five-year follow-up period lasting from 1996 to 2000. Mean age at the time of diagnosis was 31 (range, 20-47) years, and the mean time from transplant to diagnosis was 17 months. All patients developed variable graft-versus-host disease and seventeen were treated with high-dose prednisolone and/or cysclosporin for severe acute or extensive chronic graft versus host disease. Osteonecrosis was diagnosed by magnetic resonance (MR) imaging, which allowed early detection of disease assessment of its stage. At the time of diagnosis, 15 hips were at stage I, 28 at stage II, two at stage III, and none at stage IV, according to the international ARCO classification system. Osteonecrosis of femoral diaphyses, the lower lumbar spine, or pelvic bones in the MR field was also found to have occurred in 11 patients. Initial treatment was conservative: 21 hips underwent surgery [core decompression (n=10), vascularized fibular bone graft (n=5), and joint replacement (n=6)]. In patients receiving high-dose steroids for the treatment of graft-versus-host disease, MR screening might help detect osteonecrosis at an early stage.

  20. An Advanced Quantitative Echosound Methodology for Femoral Neck Densitometry.

    Science.gov (United States)

    Casciaro, Sergio; Peccarisi, Marco; Pisani, Paola; Franchini, Roberto; Greco, Antonio; De Marco, Tommaso; Grimaldi, Antonella; Quarta, Laura; Quarta, Eugenio; Muratore, Maruizio; Conversano, Francesco

    2016-06-01

    The aim of this paper was to investigate the clinical feasibility and the accuracy in femoral neck densitometry of the Osteoporosis Score (O.S.), an ultrasound (US) parameter for osteoporosis diagnosis that has been recently introduced for lumbar spine applications. A total of 377 female patients (aged 61-70 y) underwent both a femoral dual X-ray absorptiometry (DXA) and an echographic scan of the proximal femur. Recruited patients were sub-divided into a reference database used for ultrasound spectral model construction and a study population for repeatability assessments and accuracy evaluations. Echographic images and radiofrequency signals were analyzed through a fully automatic algorithm that performed a series of combined spectral and statistical analyses, providing as a final output the O.S. value of the femoral neck. Assuming DXA as a gold standard reference, the accuracy of O.S.-based diagnoses resulted 94.7%, with k = 0.898 (p < 0.0001). Significant correlations were also found between O.S.-estimated bone mineral density and corresponding DXA values, with r(2) up to 0.79 and root mean square error = 5.9-7.4%. The reported accuracy levels, combined with the proven ease of use and very good measurement repeatability, provide the adopted method with a potential for clinical routine application in osteoporosis diagnosis.

  1. Natural frequency analysis of osseointegration for trans-femoral implant.

    Science.gov (United States)

    Shao, F; Xu, W; Crocombe, A; Ewins, D

    2007-05-01

    Osseointegration trans-femoral implants are a new orthopaedic anchoring method to attach prosthetic limbs. The clinical success of this promising technique depends on the effectiveness of osseointegration achieved after implantation. The aim of this study is to use the resonant characteristics of the implant system to determine the changes in stability as a reflection of boundary condition of the implant. With a small mechanical excitation, Vibration responses of the trans-femoral implant to a small mechanical excitation were measured using an accelerometer and the vibration signal was analyzed using Fast Fourier Transform (FFT) software to obtain the fundamental natural frequency (NF) of the implant system. In-vitro study was conducted using different silicone rubbers to simulate the interface condition. The result showed that a high NF corresponded to a high elastic modulus of the interface material between the implant and bone. A preliminary in-vivo study with one osseointegration trans-femoral implant patient showed that there was a decrease of NF after initial weight bearing rehabilitation. After continued weight bearing, the NF gradually returned to the pre-loading level at around day 24 and the general trend of the NF reached a stable state 38 days after the first weight bearing exercise. PMID:17377843

  2. Strangulated Femoral Hernia Turned to Be Peritoneal Cyst

    Directory of Open Access Journals (Sweden)

    Dionysios Dellaportas

    2012-01-01

    Full Text Available Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein. Case Presentation. The patient was admitted to our hospital suffering from a palpable groin mass on the right, which became painful and caused great discomfort for the last hours. Physical examination revealed a tender and tense, irreducible groin mass. An inguinal operative approach was selected and the mass was found protruding through the femoral ring. After careful dissection it turned out to be a large unilocular cyst, containing serous fluid, probably originating from the peritoneum. McVay procedure was used to reapproximate the femoral ring. Histologic examination showed a peritoneal inclusion cyst. Discussion. Peritoneal inclusion cysts are usually asymptomatic but occasionally present with various, nonspecific symptoms according to their size. Our case highlights that high index of clinical suspicion and careful exploration during repair of a hernia is mandatory in order to reach the correct diagnosis about hernia’s contents.

  3. Unstable femoral neck fractures in children - A new treatment option

    Directory of Open Access Journals (Sweden)

    Pruthi K

    2006-01-01

    Full Text Available Background : Femoral neck fractures in children are an uncommon but difficult situation. The aim of our study was to evaluate clinical results of closed reduction internal fixation and primary valgus osteotomy fixed with a tension band wire loop in high angled pediatric femoral neck fractures. Methods : In a prospective nonrandomized study conducted at 2 centres, sixteen children and adolescents with a Pauwel type 2/3 fracture neck femur were taken as participants. The femoral neck fractures were stabilized using closed reduction and internal fixation (6.5 mm noncannulated screw and a primary valgus osteotomy fixed with a tension band wire loop preferably within 24-36 hours of injury. Patients were evaluated to determine complications, clinical and radiological outcome. Results : At a mean post operative follow up of 5 years, union was achieved in all cases. Three patients had AVN and one developed coxavara. Results were evaluated using IOWA hip scores. Thirteen patients had an excellent result while 3 patients had a good result. Conclusion : Use of this technique holds promise in treating these difficult unstable fractures. Although results from a larger series are still awaited yet the use of this technique can safely be extended to stable fractures also, to minimize the incidence of complications as nonunion and AVN.

  4. Developing a sensation information message for femoral arteriography.

    Science.gov (United States)

    Clark, C R; Gregor, F M

    1988-03-01

    Sensation information is proposed as a way of decreasing the patient's distress during a threatening health care event. A first step in developing a sensation information message is to determine the content of the message. This study, using a systematic theory-based methodology, was conducted to describe and validate the common physical sensations experienced by patients undergoing the diagnostic procedure of femoral arteriography. (A conceptual framework based on how an individual perceives or senses a situation was used.) A three-stage survey design was used including: (1) tool development following observation of the procedure and pilot-testing of the interview schedule, (2) interview of patients who had undergone femoral arteriography about the sensations experienced during the procedure, and (3) validation of the responses. Twenty-one steps in the femoral arteriography procedure of which patients were aware were identified. Nine 'feeling' sensations commonly experienced during the procedure and the sights and sounds associated with the procedure were determined. The sequencing and duration of procedure steps were observed and the environment in which the procedure was performed was described.

  5. Magnetic resonance imaging of avascular necrosis of the femoral head

    International Nuclear Information System (INIS)

    To evaluate the diagnostic value and limitation of magnetic resonance imaging (MRI) in avascular necrosis of the femoral head (ANF), clinical stages and types were examined on MRI scans of 68 femoral heads of 46 ANF patients. Stage 1 patients fell into two groups: (1) stage 1-A group of real ANF in which abnormal findings were observed on both MRI and bone scanning and (2) stage 1-B group of asymptomatic ANF in which MRI detected abnormality that was missed by bone scanning. In these groups, MRI showed inhomogeneous, band, and spotty patterns. Stage 2 or 3 patients tended to have homogeneous or ring-pattern hypointensities on MRI. Histological examination showed that repair reaction at the marginal site of hypointensity was partly responsible for the occurrence of hypointensities. In Stage 4 patients, not only femoral head but also acetabular site was visible as homogeneous hypointensity, which was similar to that in osteoarthritis. Because repair areas, as well as necrotic areas, were frequently visualized as hypointensities in Stages 2 or more, MRI might overestimate necrotic areas. (N.K.)

  6. Management of Infected femoral pseudoaneurysm in intravenous drug abusers

    Directory of Open Access Journals (Sweden)

    F. Mahjoub

    2006-08-01

    Full Text Available Background: A plan for management of infected arterial pseudoaneurysm has evolved from our experience with forty two cases of such aneurysms treated between 1378 and 1382. Methods: Clinical data of 42 patients with femoral pseudoaneurysm resulting from addictive drug injection who presented in emergency department of Sina Hospital between 1378 and 1383 were retrospectively reviewed. Results: All patients were men with the mean age of 36.9 years. Twenty eight patients were referred from other medical centers. The mean time of delay in presentation was 17.3 days. The mean duration of drug injection was 14 months. Primary repair and emergent vascular bypass were performed in 3(7.1% and 2(4.8% patients, respectively. 5(11.9% patients undergone delayed revascularization. Thirty two (76.2% patients returned to their normal lifestyle without any vascular bypass. One patient required amputation and one patient died due to sepsis and acute renal insufficiency. Conclusion: Management of infected femoral pseudoaneurysms is simple ligation of the external iliac or femoral artery. When Doppler is not available “Operation Room and postoperative Direct Observation” is recommended in such patients to avoid unnecessary revascularization surgery.

  7. A Case of Bilateral Aseptic Necrosis of the Femoral Head

    Science.gov (United States)

    KAMAL, DIANA; TRĂISTARU, RODICA; KAMAL, C.K.; ALEXANDRU, D.O.; MOGOANTĂ, L.; GRECU, D.C.

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment. PMID:26788359

  8. A Case of Bilateral Aseptic Necrosis of the Femoral Head.

    Science.gov (United States)

    Kamal, Diana; Trăistaru, Rodica; Kamal, C K; Alexandru, D O; Mogoantă, L; Grecu, D C

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO stage IV, and in just six months after the diagnosis and hip arthroplasty, he suffers an injury which leads to the same diagnosis in the contralateral hip. We want to emphasize that for all patients with a high index of suspicion there should be an MRI examination, because the plane radiographs or CT are most often not relevant in detecting early signs of this condition. Diagnosis of aseptic necrosis of the femoral head in the early stages is a necessity in order to obtain an optimal result of conservative treatment.

  9. Radiographic features of teriparatide-induced healing of femoral fractures

    Directory of Open Access Journals (Sweden)

    Youngwoo Kim

    2015-12-01

    Full Text Available Teriparatide is a drug that is used to increase bone remodeling, formation, and density for the treatment of osteoporosis. We present three cases of patients with a femoral insufficiency fracture. The patients were administered teripatatide in an attempt to treat severe osteoporosis and to enhance fracture healing. We found several radiographic features around the femoral fractures during the healing period. 1 Callus formation was found at a very early stage in the treatment. Teriparatide substantially increased the unusually abundant callus formation around the fracture site at 2 weeks. Moreover, this callus formation continued for 8 weeks and led to healing of the fracture. 2 Abundant callus formation was found circumferentially around the cortex with a ‘cloud-like’ appearance. 3 Remodeling of the teriparatide-induced callus formation was found to be part of the normal fracture healing process. After 1 year, normal remodeling was observed on plain radiographs. These findings indicate that teriparatide can be used as an adjuvant therapy in the management of femoral insufficiency fractures.

  10. Clinical application of mesenchymal stem cells for aseptic bone necrosis

    Directory of Open Access Journals (Sweden)

    Tomoki Aoyama

    2008-11-01

    Full Text Available Since 2007, we had started clinical trial using mesenchymal stem cell (MSCs for the treatment of aseptic bone necrosis as a first clinical trial permitted by Japanese Health, Labour and Welfare Ministry.Aseptic bone necrosis of the femoral head commonly occurs in patients with two to four decades, causing severe musculoskeletal disability. Although its diagnosis is easy with X-ray and MRI, there has been no gold standard invented for treatment of this disease. MSCs represent a stem cell population in adult tissues that can be isolated and expanded in culture, and differentiate into cells with different nature. Combination with β-tri-calcium phosphate and vascularized bone graft, we succeeded to treat bone necrosis of the femoral head.Regenerative medicine using stem cells is hopeful and shed a light on intractable disease. To become widespread, Basic, Translational, Application, and Developmental study is needed.? From an experience of cell therapy using MSCs, we started to research induced pluripotent stem cell (iPS for clinical application.

  11. Microstructure and elemental composition of electrochemically formed dendrites on lead-free micro-alloyed low Ag solder alloys used in electronics

    International Nuclear Information System (INIS)

    Highlights: • The electrochemical migration is investigated on micro-alloyed low Ag solders. • Transmission electron microscopy is applied to investigate dendrites. • Antimony (micro-alloy) takes part during electrochemical migration processes. • The electrochemical migration model of antimony is established. - Abstract: The Electrochemical Migration (ECM) behaviour of lead-free, micro-alloyed, low Ag solder alloys was investigated using Scanning Transmission Electron Microscopy (STEM), Energy Disperse X-ray Spectroscopy (EDS) and electron diffraction methods. Different solder alloys were investigated by Water Drop (WD) tests to stimulate ECM failure mechanism. After WD tests, differently structured dendrites were formed depending on the solder alloy types. The results showed that micro-alloying components (e.g. Sb) also played role during the ECM processes. The novelty of this study is the demonstration that Sb can take part in the ECM process; the ECM model of Sb is also discussed

  12. Diagnostic methods in ischemic necrosis of the femoral head. Metodos de diagnostico en la necrosis isquemica de la cabeza femoral

    Energy Technology Data Exchange (ETDEWEB)

    Parra Blanco, J.A.; Pagola Serrano, M.A.; Delgado Macias, M.T. (Hospital Universitario Marques de Valdecilla, Santander (Spain))

    1994-01-01

    Ischemic necrosis of the femoral head (INFH) must be diagnosed at an early stage of development, when therapeutic approaches such as forage biopsy or osteotomy can prevent or slow the normal progression of the disease to arthrosis. In this article, on the basis of the pathological changes that characterize process, we review the advantages and limitations of the principal diagnostic techniques (table I) currently employed in the study of INFH. (Author)

  13. Femoral head viability following hip fracture. Prognostic role of radionuclide bone imaging

    International Nuclear Information System (INIS)

    A retrospective study was made of all radionuclide (RN) bone images performed at our institution over a two-year period to evaluate femoral head viability after nonpathologic fracture of the femoral neck. Twelve patients had avascular femoral heads during the perioperative period, of which nine had adequate follow-up. Seven of these nine patients had follow-up bone images. Revascularization occurred in four patients, while three had persistent absence of femoral head uptake. With clinical follow-up ranging from four to 29 months (median: 14 months), only two of these nine patients developed clinical or radiographic evidence of osteonecrosis. RN bone imaging performed in the perioperative period does not reliably predict the development of post-traumatic osteonecrosis of the femoral head and, at present, should not be used to determine prospectively method of treatment of femoral neck fracture

  14. MR imaging measurement of the femoral anteversional angle as a PACS image viewer

    International Nuclear Information System (INIS)

    The accurate measurement of the femoral anteversion is very important to the practice of orthopedic and osteotomy. It is measured by means of the axis of head and neck of the femur and the knee axis. At the present time, widely used computed tomography method of measuring anteversion on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In September and October 2002, 5 patients 28 to 36 years of age were randomly selected from Seoul National University Hospital. The purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing PACS image viewer program in the MR imaging. Significant difference was observed between the right and left side the image viewer measurement of femoral anteversion. In conclusion, MR imaging very usefulness in the measured the angle of the femoral anteversion

  15. Analysis of using antirotational device on cephalomedullary nail for proximal femoral fractures☆☆☆

    Science.gov (United States)

    Takano, Marcelo Itiro; de Moraes, Ramon Candeloro Pedroso; de Almeida, Luis Gustavo Morato Pinto; Queiroz, Roberto Dantas

    2014-01-01

    Objective To analyze the influence of femoral neck diameter in the positioning of the sliding screw in cefalomedulares nails for treatment of unstable transtrochanteric fractures. Methods Prospectively throughout 2011, patients with unstable fractures transtrochanteric undergoing osteosynthesis with cephalomedullary nail using antirotacional device. They were evaluated for sex, age and fracture classification according to Tronzo. Through digital radiographs angle reduction, tip apex distance (TAD), stem diameter and measures between the positioning of the screws and the limits of the cervix were measured. Results Of the 58 patients, 42 (72.4%) were female and 16 (27.6%) were male. 33 patients were classified as Tronzo III (56.9%), 6 patients as Tronzo IV (10.4%) and 19 as Tronzo V (19.8%). The majority were in between the eighth and ninth decade of life. The average reduction in the angle was 130.05° for females and 129.4° for males. The TAD average was 19.7 mm for females and 21.6 for males. The average diameter of the neck and head vary with statistical significance between men and women. In 19 patients the placement of the sliding bolt can be optimal. If the ideal positioning was not possible, the mean displacement for non‐infringement of higher cortical neck was 4.06 mm. Conclusion The optimal placement would not be possible for the majority of the population, for the average diameter of the neck of the sample. PMID:26229767

  16. MR evaluation of the articular cartilage of the femoral head during traction. Correlation with resected femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, K. [Osaka Seamens Insurance Hospital (Japan). Dept. of Radiology; Tanaka, H.; Narumi, Y.; Nakamura, H. [Osaka Univ. Medical School (Japan). Dept. of Radiology; Nishii, T.; Masuhara, K. [Osaka Univ. Medical School (Japan). Dept. of Orthopedic Surgery

    1999-01-01

    Objective: The purpose was to evaluate the articular cartilage of the hip joint with MR during traction and compare the findings with the resected specimen or arthroscopic findings. Material and Methods: Eight healthy volunteers, 5 patients with osteonecrosis, 5 with acetabular dysplasia, and 5 with advanced osteoarthrosis underwent MR imaging to evaluate the articular cartilage of the hip joint. Coronal fat-suppressed 3D spoiled gradient-echo (SPGR) images were obtained during traction. Identical imaging was performed of all the resected femoral heads of the osteonecrosis and advanced osteoarthrosis patients, and was correlated with the macroscopic pathological findings. Results: The traction was effective and the femoral articular cartilage was clearly identified in all 8 control subjects, and in all cases of osteonecrosis and acetabular dysplasia. In 4 cases of osteonecrosis, chondral fracture was identified in the boundary between the necrosis and the normal area. In all cases of advanced osteoarthrosis, cartilage was identified only at the medial side. The MR images of osteonecrosis and advanced osteoarthrosis corresponded well with the MR images of the resected femoral heads and the macroscopic findings. (orig.)

  17. Metal alloy identifier

    Science.gov (United States)

    Riley, William D.; Brown, Jr., Robert D.

    1987-01-01

    To identify the composition of a metal alloy, sparks generated from the alloy are optically observed and spectrographically analyzed. The spectrographic data, in the form of a full-spectrum plot of intensity versus wavelength, provide the "signature" of the metal alloy. This signature can be compared with similar plots for alloys of known composition to establish the unknown composition by a positive match with a known alloy. An alternative method is to form intensity ratios for pairs of predetermined wavelengths within the observed spectrum and to then compare the values of such ratios with similar values for known alloy compositions, thereby to positively identify the unknown alloy composition.

  18. Factors influencing the stability of stems fixed with impaction graft in vitro.

    Science.gov (United States)

    Ohashi, Hirotsugu; Matsuura, Masanori; Ebara, Tsuneyuki; Okamoto, Yusaku; Kou, Hironori

    2009-09-01

    Mechanical stability of the stem is believed to be an important factor in successful impaction grafting in revision THA. We asked whether particle size, femoral bone deficiencies, stem design, graft composition, and impaction technique influenced the initial stability of the stem in vitro using model femora and human bone particles. Bone particles made with a reciprocating blade-type bone mill contained larger particles with a broader size distribution than those made by a rotating drum-type bone mill and had higher stiffness on compression testing. The stiffness on torsional testing decreased as the degree of proximal-medial segmental deficiencies increased. The stiffness and maximum torque in a stem with a rectangular cross section and wide anteroposterior surface were higher in torsional tests. Adding hydroxyapatite granules to the bone particles increased the torsional stability. To facilitate compact bone particles, we developed a spacer between the guidewire and modified femoral packers. This spacer facilitated compacting bone particles from the middle up to the proximal and the technique increased the amount of impacted bone particles at the middle of the stem and also improved the initial stability of the stem. Stem design and degree of deficiencies influenced stiffness in the torsional test and the addition of hydroxyapatite granules enhanced torsional stiffness. PMID:19184265

  19. Effects of gas produced by degradation of Mg–Zn–Zr Alloy on cancellous bone tissue

    International Nuclear Information System (INIS)

    Mg–Zn–Zr alloy cylinders were implanted into the femoral condyles of Japanese big-ear white rabbits. X-ray showed that by 12 weeks following implantation the implant became obscure, around which the low-density area appeared and enlarged. By 24 weeks, the implant was more obscure and the density of the surrounding cancellous bone increased. Scanning electron microscopy examination showed bone tissue on the surface of the alloy attached by living fibers at 12 weeks. Micro-CT confirmed that new bone tissue on the surface of the residual alloy implant increased from 12 weeks to 24 weeks. By 12 weeks, many cavities in the cancellous bone tissue around the implant were noted with a CT value, similar to gas value, and increasing by 24 weeks (P < 0.01). Histological examination of hard tissue slices showed that bone tissue was visibly attached to the alloy in the femoral condyle at 12 weeks. The trabecular bone tissues became more intact and dense, and the cavities were filled with soft tissue at 24 weeks. In general, gas produced by the degradation of the Mg–Zn–Zr alloy can cause cavitation within cancellous bone, which does not affect osteogenesis of Mg alloy. - Highlights: • The degradation of Mg alloy in cancellous bone causes cavitation around the alloy. • At first, the CT value of the cavities is similar to the gas value. • The area of the cavities enlarges gradually by 12 weeks. • The cavities are filled with bone tissue and soft tissue gradually

  20. Effects of gas produced by degradation of Mg–Zn–Zr Alloy on cancellous bone tissue

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jingbo; Jiang, Hongfeng [Tianjin Hospital, 300211 Tianjin (China); Bi, Yanze; Sun, Jin e; Chen, Minfang; Liu, Debao [School of Materials Science and Engineering, Tianjin University of Technology, 300384 Tianjin (China)

    2015-10-01

    Mg–Zn–Zr alloy cylinders were implanted into the femoral condyles of Japanese big-ear white rabbits. X-ray showed that by 12 weeks following implantation the implant became obscure, around which the low-density area appeared and enlarged. By 24 weeks, the implant was more obscure and the density of the surrounding cancellous bone increased. Scanning electron microscopy examination showed bone tissue on the surface of the alloy attached by living fibers at 12 weeks. Micro-CT confirmed that new bone tissue on the surface of the residual alloy implant increased from 12 weeks to 24 weeks. By 12 weeks, many cavities in the cancellous bone tissue around the implant were noted with a CT value, similar to gas value, and increasing by 24 weeks (P < 0.01). Histological examination of hard tissue slices showed that bone tissue was visibly attached to the alloy in the femoral condyle at 12 weeks. The trabecular bone tissues became more intact and dense, and the cavities were filled with soft tissue at 24 weeks. In general, gas produced by the degradation of the Mg–Zn–Zr alloy can cause cavitation within cancellous bone, which does not affect osteogenesis of Mg alloy. - Highlights: • The degradation of Mg alloy in cancellous bone causes cavitation around the alloy. • At first, the CT value of the cavities is similar to the gas value. • The area of the cavities enlarges gradually by 12 weeks. • The cavities are filled with bone tissue and soft tissue gradually.

  1. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail

    Directory of Open Access Journals (Sweden)

    Pedro Luciano Teixeira Gomes

    2016-08-01

    Full Text Available ABSTRACT Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  2. In Vitro Testing of Femoral Impaction Grafting With Porous Titanium Particles: A Pilot Study

    OpenAIRE

    Aquarius, René; Walschot, Luc; Buma, Pieter; Schreurs, Berend Willem; Verdonschot, Nico

    2009-01-01

    The disadvantages of allografts to restore femoral bone defects during revision hip surgery have led to the search for alternative materials. We investigated the feasibility of using porous titanium particles and posed the following questions: (1) Is it possible to create a high-quality femoral graft of porous titanium particles in terms of graft thickness, cement thickness, and cement penetration? (2) Does this titanium particle graft layer provide initial stability when a femoral cemented s...

  3. Summary of the various treatments for osteonecrosis of the femoral head by mechanism: A review

    OpenAIRE

    Wang, Cheng; Peng, Jiang; Lu, Shibi

    2014-01-01

    Osteonecrosis of the femoral head (ONFH), also known as femoral head avascular necrosis, is a pathological state with a number of possible etiologies including steroid administration, alcohol abuse, traumatic events, vascular injury and idiopathic origins. ONFH causes a reduction in the vascular supply to the subchondral bone of the femoral head, which results in osteocyte death and the collapse of the articular surface. Treatments for ONFH include non-weight-bearing therapy, physical support...

  4. Individual and typological morphogeometric features of the proximal of femoral bone

    OpenAIRE

    V.N. Nikolenko; О.А. Fomicheva; R.S. Zhmurko; N.M. Yakovlev; O.S. Bessonova; S. V. Pavlov

    2010-01-01

    The aim of this study was to examine the relationship between the structure of the proximal femur and its individual anatomical variability, namely the size of the femoral neck and the angle of torsion. These results suggest that the mor-phogeometry of the femur (the femoral neck axis length and width of the neck) may influence on the risk of fractures of the femoral neck in people of different body type

  5. Femoral anteversion measured by the Dunlap/Rippstein and Norman methods

    International Nuclear Information System (INIS)

    Measurements of femoral anteversion obtained with the Dunlap/Rippstein method in adults were compared with measurements using the Norman method. By definition, different angles are measured by the two methods. The Norman method gave angles for the femoral anteversion which were on average 12.8 degrees higher than those obtained with the Dunlap-Rippstein method, and the methods correlated poorly. It is concluded that measurements of femoral anteversion with these methods do not accurately reflect each other. (orig.)

  6. Individual and typological morphogeometric features of the proximal of femoral bone

    Directory of Open Access Journals (Sweden)

    V.N. Nikolenko

    2010-03-01

    Full Text Available The aim of this study was to examine the relationship between the structure of the proximal femur and its individual anatomical variability, namely the size of the femoral neck and the angle of torsion. These results suggest that the mor-phogeometry of the femur (the femoral neck axis length and width of the neck may influence on the risk of fractures of the femoral neck in people of different body type

  7. Pelvic migration of the helical blade after treatment of transtrochanteric fracture using a proximal femoral nail.

    Science.gov (United States)

    Gomes, Pedro Luciano Teixeira; Castelo, Luís Sá; Lopes, António Lemos; Maio, Marta; Miranda, Adélia; Dias, António Marques

    2016-01-01

    Proximal femoral nails with a helical blade are a new generation of implants used for treating transtrochanteric fractures. The blade design provides rotational and angular stability for the fracture. Despite greater biomechanical resistance, they sometimes present complications. In the literature, there are some reports of cases of perforation of the femoral head caused by helical blades. Here, a clinical case of medial migration of the helical blade through the femoral head and acetabulum into the pelvic cavity is presented.

  8. Stem Cells

    DEFF Research Database (Denmark)

    Sommerlund, Julie

    2004-01-01

    In his influential essay on markets, An essay on framing and overflowing (1998), Michel Callon writes that `the growing complexity of industrialized societies [is] due in large part to the movements of the technosciences, which are causing connections and interdependencies to proliferate'. This p...... and tantalizing than stem cells, in research, in medicine, or as products.......'. This paper is about tech-noscience, and about the proliferation of connections and interdependencies created by it.More specifically, the paper is about stem cells. Biotechnology in general has the power to capture the imagination. Within the field of biotechnology nothing seems more provocative...

  9. The clinical application of radionuclide bone scan in patients with femoral neck fracture

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of bone scan for evaluation of patients with femoral neck fracture. Methods: The data of bone scan, surgical operation, and osteonecrosis of the femoral head after operation of 420 patients were statistically analyzed. The region of interest (ROI) ratios of the fractured head of femur to contralateral counterpart, head to shaft of femur and head to anterior superior iliac spine were calculated and compared with those of controls. Results: The rate of internal fixation operation performed on the patients without femoral head ischemia was higher than those with femoral head ischemia, and the rate of hip arthroplasty was lower. In patients with femoral head ischemia prior to operation, more patients suffered osteonecrosis of the femoral head after operation compared with the patients without femoral head ischemia. The ROI ratio of patients with femoral head ischemia was significantly lower than that of controls. Conclusion: For fractured femoral neck, bone scan prior to the operation has certain significance for selecting surgical program in clinical practice, and also has important value in predicting prognosis. (authors)

  10. Preoperative sup(99m)Tc-MDP scintimetry of femoral neck fractures

    International Nuclear Information System (INIS)

    Preoperative sup(99m)Tc-MDP-scintimetry was performed in 117 patients with femoral neck fractures. Scintimetry was shown to be superior to visual evaluation. The ratio was calculated of the uptake in the femoral head of the fractured side over that in the unfractured side, with compensation for the increased trochanteric femoral activity found on the fractured side. A ratio above 0.90 correlated well with uneventful healing in both undisplaced and displaced fractures. Preoperative scintimetry is of great value in the choice of primary treatment of femoral neck fractures. (author)

  11. The role of bone scintigraphy in predicting femoral head collapse following cervical fractures in children

    International Nuclear Information System (INIS)

    Bone scintigraphy was performed before or after osteosynthesis or both in 11 children aged 9 to 14 years with femoral neck fractures. The role of bone scintigraphy in predicting development of femoral head necrosis with subsequent collapse was studied. Scintigraphy was not a useful study of this purpose. The explanation of this may be that reposition and osteosynthesis jeopardize the blood supply to the femoral head and invalidates the findings at the pre-operative scan. The childhood femoral head also has a strong potential for revascularization and complete reconstruction of the necrotic bone. (orig.)

  12. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Min Hee; Han, Gi Seok; Kim, Sung Jin; Park, Kil Sun; Cha, Sang Hoon; Bae, Il Hun; Lee, Seung Young [College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju (Korea, Republic of)

    2006-07-15

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 ({+-} 0.03). The mean femoral head ratio was 0.08 ({+-} 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 {+-} 0.033, women: 0.44 {+-} 0.031, {rho} < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery.

  13. Outcome of Kidney Allografts in Recipients With a Femoral Arteriovenous Fistula: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Denise M.D. Özdemir-van Brunschot

    2016-09-01

    Full Text Available Two patients, who were on hemodialysis over a femoral arteriovenous fistula, were transplanted in our center. Despite adequate blood pressure, perfusion of the renal allograft remained poor after completion of the vascular anastomoses. Ligation of the femoral arteriovenous fistula (1.6 L/min led to adequate perfusion. Initial graft function was good. Although it remains unclear whether ischemia of a renal allograft is caused by venous hypertension or vascular steal due to a femoral arteriovenous fistula, it might be necessary to ligate a femoral arteriovenous fistula to obtain adequate graft perfusion.

  14. Cystic Disease of the Groin Presenting as Compression of a Femoral Vessel

    Science.gov (United States)

    Kim, Hyung-Kee; Hwang, Deokbi; Park, Sujin; Jeong, Won-Ju; Seo, An Na; Huh, Seung

    2016-01-01

    In this study, we describe our diagnosis and treatment of two patients who presented with femoral vessel compression caused by a cystic lesion in the groin. One case was diagnosed as adventitial cystic disease (ACD) of the common femoral artery resulting in leg claudication and the other was diagnosed as a ganglion cyst (GC) causing femoral vein compression and unilateral leg swelling. The operative findings differed between these two cases with respect to the dissection of the cyst and femoral vessel, but the postoperative histological examination results were similar. The pathogenesis of ACD and GC is not fully understood, and further investigation is needed to delineate the exact pathology of these uncommon conditions.

  15. Why STEM?

    Science.gov (United States)

    Mitts, Charles R.

    2016-01-01

    The International Technology and Engineering Educators Association (ITEEA) defines STEM as a new transdisciplinary subject in schools that integrates the disciplines of science, technology, engineering, and mathematics into a single course of study. There are three major problems with this definition: There is no consensus in support of the ITEEA…

  16. Hipercrescimento femoral no tratamento cirúrgico do quadril displásico inveterado Femoral overgrowth following surgical treatment of long-established dysplasia of the hip

    OpenAIRE

    João Paulo Freire Martins de Moura; Renato de Figueiredo Radaeli; Oreste Lemos Carrazone; Eiffel Tsuyoshi Dobashi; Carlo Milani; Akira Ishida

    2009-01-01

    OBJETIVO: Medir radiograficamente através de escanometria o hipercrescimento femoral em pacientes portadores de Displasia do Desenvolvimento do Quadril inveterada tratados cirurgicamente com encurtamento femoral, redução cruenta e acetabuloplastia. MÉTODOS: Avaliamos 30 crianças (33 quadris) submetidas à redução cruenta pela técnica de Scaglietti e Calandriello, ostectomia para encurtamento femoral e acetabuloplastia de Salter. Haviam 29 do sexo feminino e 1 do sexo masculino, com idade média...

  17. Alloyed steel

    International Nuclear Information System (INIS)

    The composition and properties are listed of alloyed steel for use in the manufacture of steam generators, collectors, spacers, emergency tanks, and other components of nuclear power plants. The steel consists of 0.08 to 0.11% w.w. C, 0.6 to 1.4% w.w. Mn, 0.35 to 0.6% w.w. Mo, 0.02 to 0.07% w.w. Al, 0.17 to 0.37% w.w. Si, 1.7 to 2.7% w.w. Ni, 0.03 to 0.07% w.w. V, 0.005 to 0.012% w.w. N, and the rest is Fe. The said steel showed a sufficiently low transition temperature between brittle and tough structures, a greater depth of hardenability, and better weldability than similar steels. (B.S.)

  18. The importance of a thick cement mantle depends on stem geometry and stem-cement interfacial bonding.

    Science.gov (United States)

    Caruana, J; Janssen, D; Verdonschot, N; Blunn, G W

    2009-04-01

    The thickness of the cement mantle around the femoral component of total hip replacements is a contributing factor to aseptic loosening and revision. Nevertheless, various designs of stems and surgical tooling lead to cement mantles of different thicknesses. Opinion is divided on whether a thick mantle enhances implant longevity. This study investigates the effect of cement mantle thickness on accumulated damage in the cement, and how this is influenced by the presence or absence of a proximal collar and on whether the stem-cement interface remains bonded. Three-dimensional finite element simulations incorporating creep and non-linear damage accumulation were performed to investigate cracking in the cement mantles around Stanmore Hips under physiologically informed stair-climbing and gait loads. Cement mantle thickness, stem-cement interfacial bonding, and collar design were varied to assess the interactive effects of these parameters. In all cases, damage levels were three to six times higher when the stem-cement interface remained bonded. Cement mantle thickness had little effect on cement damage accumulation around debonded collared stems but was critical in both bonded and collarless cases, where a thicker mantle reduced cement cracking. Damage around a smooth debonded stem with a collar is thus much less sensitive to cement thickness than around bonded or collarless stems. PMID:19405437

  19. Clinical characteristics and risk factors of periprosthetic femoral fractures associated with hip arthroplasty: A retrospective study.

    Science.gov (United States)

    Zhang, Zhendong; Zhuo, Qi; Chai, Wei; Ni, Ming; Li, Heng; Chen, Jiying

    2016-08-01

    Periprosthetic femoral fracture (PFF) is a complicated complication of both primary and revision hip arthroplasty with an increasing incidence. The present study aimed to summarize the clinical characteristics and identify the risk factors for PFF which would be potentially helpful in the prevention and treatment of PFF.We retrospectively analyzed the clinical data of 89 cases of PFF, and a case-control study was designed to identify the potential risk for intraoperative and postoperative PFF in both primary and revision hip arthroplasty.The overall incidence of PFF was 2.08% (intraoperative: 1.77%, postoperative: 0.30%, revision: 13.60%, and primary: 0.97%). The most commonly used treatment strategy was fixation with cerclage wire or band for intraoperative PFF, whereas long stem revision with plate or cortical allograft strut fixation was the main treatment strategy for postoperative PFF. The risk factors for intraoperative PFF in primary total hip arthroplasty (THA) included the diagnosis of development dysplasia of the hip (DDH) (odds ratio [OR] = 5.01, 95%CI, 1.218-20.563, P=0.03) and CBR ≥ 0.49 (OR = 3.34, 95%CI, 1.138-9.784, P = 0.03). The increased age was associated with increased incidence of postoperative PFF in primary THA (OR = 1.09, 95%CI, 1.001-1.194, P = 0.04). As for the intraoperative PFF in revision THA, we found that receiving multiple operations before revision (OR = 2.45, 95%CI, 1.06-5.66, P = 0.04), revisions due to prosthetic joint infection (OR = 6.72, 95%CI, 1.007-44.832, P = 0.04), the presence of cementless implant before revision (OR = 13.54, 95%CI, 3.103-59.08, P = 0.001), and femoral deformity (OR = 8.03, 95%CI, 1.656-38.966, P = 0.01) were all risk factors.Screening for high-risk patients, preoperative templating, and detailed discharge instructions may be the potential strategies to reduce the incidence of PFF. The treatment of PFFs should take into account Vancouver

  20. Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture

    Science.gov (United States)

    Han, Jun

    2016-01-01

    Background Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD. Methods This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed. Results There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD. Conclusions We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD.

  1. Histological analysis of femoral bones in rabbits administered by amygdalin

    Directory of Open Access Journals (Sweden)

    Veronika Kováčová

    2016-07-01

    Full Text Available Cyanogenic glycosides are present in several economically important plant foods. Amygdalin, one of the most common cyanoglucoside, can be found abundantly in the seeds of apples, bitter almonds, apricots, peaches, various beans, cereals, cassava and sorghum. Amygdalin has been used for the treatment of cancer, it shows killing effects on cancer cells by release of cyanide. However, its effect on bone structure has not been investigated to date. Therefore, the objective of this study was to determine a possible effect of amygdalin application on femoral bone microstructure in adult rabbits. Four month old rabbits were randomly divided into two groups of three animals each. Rabbits from E group received amygdalin intramuscularly at a dose 0.6 mg.kg-1 body weight (bw (group E, n = 3 one time per day during 28 days. The second group of rabbits without amygdalin supplementation served as a control (group C, n = 3. After 28 days, histological structure of femoral bones in both groups of rabbits was analysed and compared. Rabbits from E group displayed different microstructure in middle part of the compact bone and near endosteal bone surface. For endosteal border, an absence of the primary vascular longitudinal bone tissue was typical. This part of the bone was formed by irregular Haversian and/or by dense Haversian bone tissues. In the middle part of substantia compacta, primary vascular longitudinal bone tissue was observed. Cortical bone thickness did not change between rabbits from E and C groups. However, rabbits from E group had a significantly lower values of primary osteons' vascular canals and secondary osteons as compared to the C group. On the other hand, all measured parameters of Haversian canals did not differ between rabbits from both groups. Our results demonstrate that intramuscular application of amygdalin at the dose used in our study affects femoral bone microstructure in rabbits.

  2. [Local vascular complications after iatrogenic femoral artery puncture].

    Science.gov (United States)

    Fruhwirth, J; Pascher, O; Hauser, H; Amann, W

    1996-01-01

    Over a period of 5 years 81 vascular complications after 15,460 catheterizations of the femoral artery for diagnostic (n = 11,883) or therapeutic (n = 3577) procedures were registered. The following complications were observed in declining frequency: 1. False aneurysm (n = 65), 2. arterial occlusion (dissection, embolia, thrombosis) (n = 8), 3. vascular lesion causing profuse bleeding (n = 7), 4. AV-fistula (n = 1). The total complication rate was 0.52%. The complication rate was significantly higher in therapeutical procedures (1,03%) than in diagnostic investigations (0.37%). Pseudoaneurysms were complicated by thrombosis of the femoral vein (n = 3), lymphatic fistula (n = 3) and deep wound infection (n = 9); secondary complication rate 18.5%. Risk factors for local vascular complications are old age, female gender, high grade arteriosclerosis at the puncture site, overweight, manifest arterial hypertension and medication with cumarin, acetylsalicylic acid or heparin. Further complicating factors are connected with technical risks such as duration of the procedure. French size of the catheter, the catheter sheath and multiple punctures. Vascular repair was performed by simple angiography in most cases, but in 14.8% more extensive surgical procedures were required. In patients with signs of occlusive vascular disease the external iliac artery was replaced by a PTFE-vascular access graft in 4 cases and an arterioplasty of the deep femoral artery was performed in 2 patients. 36% of the operations were undertaken as emergencies. Reintervention was necessary for a postoperative bleeding complication in 1 case (surgical complication rate 1.2%). A female patient suffering from aortic valve stenosis died during emergency operation due to massive retroperitoneal hemorrhage after cardiac catheterization (mortality rate 1.2%). Over a median follow-up period of 37 months no late complications of the intervention were recorded, nor recurrences of peripheral arterial occlusive

  3. Medial Femoral Condyle Degeneration Associated with a Mediopatellar Plica

    Directory of Open Access Journals (Sweden)

    Mehmet Balik

    2014-03-01

    Full Text Available Sixty-years-old female patient complaining from knee pain since 15 years. The patient could not localize the pain at first. Since 10 years, she experiences a temporary pain localized at the medial side of tibiofemoral joint during twisting her knee. Also, pain persists at the medial patellar region at semi-flexed position of her knee. The patient did not benefit from conversative treatment with the diagnosis of gonarthrosis. We performed knee artrhroplasty. During arthroplasty, we observed that the medial femoral condyle was damaged due to long term mediopatellar plica impingement.

  4. Differences in brachial and femoral artery responses to prolonged sitting

    OpenAIRE

    Thosar, Saurabh S.; Bielko, Sylvanna L.; Wiggins, Chad C.; Wallace, Janet P

    2014-01-01

    Introduction It is unknown if there are limb differences in vascular function during prolonged sitting. Purpose This study was designed to test whether the effects of prolonged sitting on brachial artery (BA) and the superficial femoral artery (SFA) are similar. Methods Twelve men (24.2 ± 4 yrs.) participated in a 3 hr prolonged sitting trial (SIT). SFA and BA flow mediated dilation (FMD) and respective flow patterns were measured at baseline, 1 hr, 2 hr and 3 hr. Results By a one-way ANOVA t...

  5. Surgical treatment of noniatrogenic trauma of the femoral arteries.

    Science.gov (United States)

    Wolosker, N; Guadêncio, A; Kuzniec, S; Rosoky, R A; Kalume, C; Neves, C A; Aun, R; Langer, B

    1996-01-01

    Trauma to the femoral arteries corresponds to 30 percent of all arterial traumas. The authors reviewed 74 patients with noniatrogenic trauma of the femoral arteries treated from January 1991 to December 1993. Ages ranged from 11 to 50 years, with a mean of 24. Seventy-one patients were male and three female. Fifty-two patients (70.2 percent) were white, 20 (27 percent) were black and two (2.8 percent) were Asian. Trauma due to firearms had the highest incidence, with 61 cases (82.4 percent). Absence of pulse was the most frequent clinical symptom (62.5 percent). Severe ischemia, with risk of loss of limb, was found in 66.2 percent of the cases. The superficial femoral artery was impaired in 77 percent of the cases. A preoperative arteriography was performed on only five patients, victims of multiple penetrating trauma or an asymptomatic penetrating wound along a vessel passage. In six cases, arterial and venous ligature was the chosen procedure. In three cases, a primary arterial anantomosis was performed. Simple arterriorraphy was feasible in one patient. In 64 of the patients, a venous graft was undertaken using a segment of the inverted great saphenous vein withdrawn from the other lower limb. Fasciotomoy was used in 32 patients (43.2 percent), all of whom exhibited pasting of the lower limb muscles at admission. One patient died during the immediate postoperative period as the result of multiple organ failure caused by polytraumatism. Preservation of the limb was attained in 72 patients (97.3 percent) Severe, previously-incurred ischemia was responsible for the only two amputations, aggravated by an exceedingly long delay between the time of injury and surgery. One of these patients, in addition to severe ischemia, had extensive injuries to the soft tissues. We conclude that trauma of the femoral arteries, attended while the limb still maintains its vitality, has a positive clinical outcome with a high rate of limb preservation. Mortality usually results from

  6. Subchondral stress fracture of femoral head in a healthy adult

    Directory of Open Access Journals (Sweden)

    Anand Ashish

    2010-01-01

    Full Text Available Subchondral fracture of the femoral head is an uncommon entity and usually occurs as an insufficiency fracture associated with poor bone quality or as a fatigue fracture in young military recruits. This condition should be considered in the differential diagnosis of acute hip pain in young patients along with transient osteoporosis and avascular necrosis of the hip. We report a case of acute onset hip pain in an asymptomatic healthy adult in which the diagnosis was made by magnetic resonance imaging and the patient responded well to conservative treatment.

  7. Mechanical alloying in immiscible alloy systems

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    In recent years, mechanical alloying (MA) of immiscible alloy systems characterized by positive heat of mixing has been extensively investigated. The present article reviews the latest progress in MA of immiscible alloy systems including the mechanisms of non-equilibrium phase transformation and metastable phase formation of the MA-driven supersaturated solid solutions, amorphous phases and nanophase composites as well as their mechanical and physical properties related to those metastable phases.

  8. Pluripotent stem cell lines

    OpenAIRE

    Yu, Junying; Thomson, James A.

    2008-01-01

    The derivation of human embryonic stem cells 10 years ago ignited an explosion of public interest in stem cells, yet this achievement depended on prior decades of research on mouse embryonic carcinoma cells and embryonic stem cells. In turn, the recent derivation of mouse and human induced pluripotent stem cells depended on the prior studies on mouse and human embryonic stem cells. Both human embryonic stem cells and induced pluripotent stem cells can self-renew indefinitely in vitro while ma...

  9. A biomechanical evaluation of proximal femoral nail antirotation with respect to helical blade position in femoral head: A cadaveric study

    Directory of Open Access Journals (Sweden)

    Jin-Ho Hwang

    2012-01-01

    Full Text Available Objective: Despite new developments in the management of osteoporotic fractures, complications like screw cutout are still found in the fixation of proximal femur fractures even with biomechanically proven better implants like proximal femoral nail antirotation (PFNA. The purpose of this cadaveric study was to investigate the biomechanical stability of this device in relation to two common positions (center-center and inferior-center of the helical blade in the femoral head in unstable trochanteric fractures. Materials and Methods: Eight pairs of human cadaveric femurs were used; in one group [center-center (C-C group], the helical blade of PFNA was fixed randomly in central position both in anteroposterior and lateral view, whereas in the other group it was fixed in inferior one-third position in anteroposterior and in central position in lateral view [inferior-center (I-C group]. Unstable intertrochanteric fracture was created and each specimen was loaded cyclically till load to failure Results: Angular and rotational displacements were significantly higher within the C-C group compared to the I-C group in both unloaded and loaded condition. Loading to failure was higher in the I-C group compared to the C-C group. No statistical significance was found for this parameter. Correlations between tip apex distance, cyclic loading which lead to femoral head displacement, and ultimate load to failure showed a significant positive relationship. Conclusion: The I-C group was superior to the C-C group and provided better biomechanical stability for angular and rotational displacement. This study would be a stimulus for further experimental studies with larger number specimens and complex loading protocols at multicentres.

  10. Iliopsoas bursitis with compression of the common femoral vein resulting in acute lower leg edema

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seung Bae; Kwak, Hyo Sung; Han, Young Min; Lee, Sang Yong; Jeong, Yeon Jun [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2006-08-15

    The clinical manifestations related to iliopsoas bursitis can vary due to compression of the adjacent structure such as the common femoral vein, nerve and bladder. We report here on a rare case of iliopsoas bursitis with compression of the common femoral vein that resulted in acute lower leg edema.

  11. Histopathology and serum clinical chemistry evaluation of broilers with femoral head separation disorder

    Science.gov (United States)

    Femoral head disarticulation (FHD) and necrosis is a sporadic leg problem of unknown etiology in broiler breeders. To determine the underlying physiology of FHD, the blood chemistry and the histopathology of the femoral heads of the affected chickens were compared with their age matched controls. Ch...

  12. Serum chemistry and histopathology of broiler femoral head necrosis and tibial dyschondroplasia

    Science.gov (United States)

    Femoral head necrosis (FHN) and tibial dyschondroplasia (TD) are two major leg problems in young meat type poultry which cause lameness, bone deformity and infections. Whereas FHN results from disarticulation of the femoral growth plate from the articular cartilage, TD lesions are characterized by i...

  13. The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy

    Science.gov (United States)

    Karabicak, Gul Oznur; Balcı, Nilay Comuk; Gulsen, Mustafa; Ozturk, Basar; Cetin, Nuri

    2016-01-01

    [Purpose] The aim of the study was to investigate the relationships between femoral anteversion and functional balance and postural control in children with spastic cerebral palsy. [Subjects and Methods] Twenty children with spastic cerebral palsy (mean age=12.4 ± 4.5) with grosss motor functional classification system levels I, II, and III were recruited for this study. Functional balance was evaluated using the Pediatric Balance Scale, postural control was evaluated using the Trunk Control Measurement Scale, and femoral anteversion was assessed with a handheld goniometer using the great trochanter prominence method. [Results] The results indicated that there was significant correlation between femoral anteversion and Trunk Control Measurement Scale dynamic reaching score. There were no significant correlation between femoral anteversion and the Trunk Control Measurement Scale static sitting balance, Trunk Control Measurement Scale selective movement control, total Trunk Control Measurement Scale and Pediatric Balance Scale results. [Conclusion] Increased femoral anteversion has not correlation with functional balance, static sitting, and selective control of the trunk. Femoral anteversion is related to dynamic reaching activities of the trunk, and this may be the result of excessive internal pelvic rotation. It is important for the health professionals to understand that increased femoral anteversion needs to be corrected because in addition to leading to femoral internal rotation during walking, it also effects dynamic reaching activities of spastic children with cerebral palsy. PMID:27390397

  14. Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik;

    2014-01-01

    for a femoral hernia. RESULTS: A total of 3970 primary femoral hernia repairs were analyzed; 27.3% occurred in men. There were 2413 elective repairs (60.8%) and 1557 emergency procedures (39.2%). In a multivariate analysis, laparoscopic repair was found to result in reduced risk of reoperation (hazard ratio, 0...

  15. Proteomic changes in plasma of broiler chickens with femoral head necrosis

    Science.gov (United States)

    Femoral head necrosis (FHN) is a skeletal problem in broiler chickens where the proximal femoral head cartilage shows susceptibility to separation from its growth plate. The FHN selected birds showed higher bodyweights and reduced plasma cholesterol. The proteomic differences in the plasma of health...

  16. Trans-femoral amputee pilots: criteria for return to the fighter cockpit.

    Science.gov (United States)

    Grossman, Alon; Goldstein, Liav; Heim, Michael; Barenboim, Erez; Dudkiewicz, Israel

    2005-04-01

    Proximal lower limb amputations (trans-femoral) usually leave amputees with significant functional disturbances. This article contains information regarding three pilots with trans-femoral amputations that returned swiftly to continue their aeronautical careers despite their disabilities. Adaptations are needed in the limb prostheses to enable the amputees to access the minimally spaced cockpit.

  17. Femoral artery recanalisation with percutaneous angioplasty and segmentally enclosed plasminogen activator

    DEFF Research Database (Denmark)

    Jørgensen, B; Tønnesen, K H; Bülow, J;

    1989-01-01

    To establish whether re-occlusion of the femoral artery could be prevented, in 6 consecutive patients undergoing percutaneous transluminal angioplasty (PTA) for superficial femoral artery occlusion the recanalised segment was isolated, with a 7-French double-balloon catheter. 5 mg recombined human...

  18. Effect of intracapsular hyperpressure on femoral head blood flow. Laser Doppler flowmetry in dogs.

    Science.gov (United States)

    Vegter, J; Klopper, P J

    1991-08-01

    Intracapsular hyperpressure in the hip joint of dogs affected femoral head blood flow, especially in the juvenile animals. Graphic recording of the laser Doppler signal curve using rapid sampling time demonstrated venous hip joint tamponade in both juvenile and adult dogs. Laser Doppler flowmetry seems to be a sensitive and reproducible method to demonstrate femoral-head blood-flow changes.

  19. Ultrasonographic Measurement of the Femoral Cartilage Thickness in Hemiparetic Patients after Stroke

    Science.gov (United States)

    Tunc, Hakan; Oken, Oznur; Kara, Murat; Tiftik, Tulay; Dogu, Beril; Unlu, Zeliha; Ozcakar, Levent

    2012-01-01

    The aim of the study was to evaluate the femoral cartilage thicknesses of hemiparetic patients after stroke using musculoskeletal ultrasonography and to determine whether there is any correlation between cartilage thicknesses and the clinical characteristics of the patients. Femoral cartilage thicknesses of both knees were measured in 87 (33…

  20. Long-term functional outcome following intramedullary nailing of femoral shaft fractures

    NARCIS (Netherlands)

    el Moumni, Mostafa; Voogd, Emma Heather; ten Duis, Henk Jan; Wendt, Klaus Wilhelm

    2012-01-01

    Background: The management of femoral shaft fractures using intramedullary nailing is a popular method. The purpose of this study was to evaluate the long-term functional outcome after antegrade or retrograde intramedullary nailing of traumatic femoral shaft fractures. We further determined predicto

  1. False aneurysm of perforating branch of the deep femoral artery—Report of two cases

    Directory of Open Access Journals (Sweden)

    H. Naouli

    2015-01-01

    Full Text Available Pseudoaneurysms of the deep femoral artery are uncommon and occur as a late complication of various traumas. Usually associated with femoral fractures, We report two cases of profunda femoris artery injury which presented as false aneurysm secondary to penetrating trauma. Because of its insidious onset, awareness and careful follow-up are the key issues for the early diagnosis.

  2. 21 CFR 888.3400 - Hip joint femoral (hemi-hip) metallic resurfacing prosthesis.

    Science.gov (United States)

    2010-04-01

    ... prosthesis. 888.3400 Section 888.3400 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... femoral (hemi-hip) metallic resurfacing prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic resurfacing prosthesis is a device intended to be implanted to replace a portion of the hip...

  3. 21 CFR 888.3360 - Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis.

    Science.gov (United States)

    2010-04-01

    ... uncemented prosthesis. 888.3360 Section 888.3360 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF... Hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis. (a) Identification. A hip joint femoral (hemi-hip) metallic cemented or uncemented prosthesis is a device intended to be...

  4. A new osteonecrosis animal model of the femoral head induced by microwave heating and repaired with tissue engineered bone

    OpenAIRE

    Li, Yanlin; Han, Rui; Geng, Chengkui; Wang, Yongnian; Wei, Lei

    2008-01-01

    The objective of this research was to induce a new animal model of osteonecrosis of the femoral head (ONFH) by microwave heating and then repair with tissue engineered bone. The bilateral femoral heads of 84 rabbits were heated by microwave at various temperatures. Tissue engineered bone was used to repair the osteonecrosis of femoral heads induced by microwave heating. The roentgenographic and histological examinations were used to evaluate the results. The femoral heads heated at 55°C for t...

  5. The trabecular heterogeneity of femoral head in male osteoporotic fracture

    International Nuclear Information System (INIS)

    Objective: The aim of this study was to investigate the femoral head trabecular heterogeneity in Chinese male patients with osteoporotic fracture and their effects on osteoporotic fracture. Methods: Human femoral heads were obtained from 11 male osteoporotic fracture (OP) patients ranged from 51 to 82 years old [average age (65±9) years old], and 7 male trauma (TM) patients ranged from 46 to 75 years old [average age (61±11) years old] who underwent total hip arthroplasty within two hours after either osteoporotie or trauma hip fracture. The OP was defined as having a fragility fracture. After laying femoral head as living body position and locating mark, nine trabecular specimens were obtained from femoral heads, each of 6 mm x 6 mm x 7 mm. The cortical shell was not included in each specimen. One cube was selected as the primary compressive trabecular region and the other 8 specimens as non-primary compressive trabecular region. These cubes were scanned using high-resolution microcomputed tomography scanner (μCT). After scanning, the data of total cubes, primary compressive trabecular region and non- compressive trabecular region were used for analysis by t test. Results: In OP group volumetric bone mineral density(vBmD) [(182.15 ± 66.00) mg/mm3 vs (223.97±70.92) mg/mm3, t=3.041], tissue bone mineral density (tBMD) [(538.76±64.72) mg/mm3 vs (580.01±63.86) mg/mm3, t=3.160], bone volume fraction (TV/BV) [(0.22±0.06)% vs (0.26±0.07)%, t=2.821], trabecular thickness (Tb. Th.) [(161.07±42.75) μm vs (205.47±74.44) μm, t=3.233] were significantly decreased while bone surface/bone volume (BS/BV) [(13.75±2.55) mm-1 vs (12.28±2.70) mm-1, t= -2.777] was significantly increased in the non-primary compressive trabecular region than that in the primary compressive trabecular region (P3 vs (248.05± 105.48) mg/mm3 t=-3.598] tBMD [(538.76±64.72) mg/mm3 vs (570.54±100.32) mg/mm3 t=-2.108], TV/BV [(0.22±0.06)% vs (0.28±0.12)%, t=-3.466], Th. Th. [(161.07± 42

  6. Femoral neck stress fractures (fnsf) in military recruits

    International Nuclear Information System (INIS)

    Objective: To identify patterns of Femoral Neck Stress Fractures (FNSF), its presentation and outcome of its treatment in PMA (Pakistan Military Academy) cadets. These findings would help suggest guidelines for their appropriate management. Study design: Case Series Place and duration of study: CMH Abbottabad and CMH Rawalpindi from May 2005 to January 2008. Materials and Methods: Twenty cases (20 hips in 18 patients) of FNSF were included in the study. Only male cadets from Pakistan Military Academy (PMA) were included. Diagnosis was made clinically and was confirmed by radiographs or bone scan. Incomplete fractures were managed conservatively where as complete fractures were fixed surgically. Results: All compression fractures healed conservatively where as tension fractures needed surgical fixation in all the cases, except one where fracture remained incomplete. Rest of tension fractures converted from incomplete fractures to complete fractures and hence needed surgical stabilization. There was no problem of avascular necrosis of femoral head (AVNFH) in any patient. Conclusion: FNSF are uncommon injuries with potentially serious complications and are difficult to diagnose clinically. When diagnosed early and managed appropriately, they carry good prognosis. (author)

  7. Nursing care for the patient after femoral popliteal bypass grafting

    Institute of Scientific and Technical Information of China (English)

    Guo Xiaohui

    2003-01-01

    Objective: To share my knowledge, regarding the nursing care for the patients after femoral popliteal bypass grafting, with my Chinese colleagues who have never been abroad. Methods: From August 1998 to September 2002, five patients (including 1 female and 4 male) were summarized retrospectively on postoperative care by assessment, nursing implementation and evaluation. Results: All patients were followed up for 3 to 6 months. The results were evaluated as follows: patient's condition and the function of the operated leg were improved. The leg pain was released. The peripheral pulses were present and strong. The color, temperature and sensation of the skin were normal. None of further complications was noted. Conclusion: For Nursing the patient after femoral popliteal bypass grafting, the nurses should focus their attention on the circulatory status of the operated leg, anticoagulant therapy and signs of bleeding from the graft site. Meanwhile, provide a quiet、comfortable and safety environment for the patient. Asall of these are the main points of the postoperative care. A good nursing careoffer to a patient not only can ease the patient's physical suffering, but alsocan avoid some complications occurring.

  8. Mechanical properties of femoral cortical bone following cemented hip replacement.

    Science.gov (United States)

    Ni, G X; Lu, W W; Chiu, P K Y; Wang, Y; Li, Z Y; Zhang, Y G; Xu, B; Deng, L F; Luk, K D K

    2007-11-01

    Femoral bone remodeling following total hip replacement is a big concern and has never been examined mechanically. In this study, six goats underwent unilateral cemented hip hemiarthroplasty with polymethyl methacrylate (PMMA) bone cement. Nine months later animals were sacrificed, and the femoral cortical bone slices at different levels were analysed using microhardness testing and microcomputed tomography (micro-CT) scanning. Implanted femurs were compared to contralateral nonimplanted femurs. Extensive bone remodeling was demonstrated at both the proximal and middle levels, but not at the distal level. Compared with the nonimplanted side, significant decreases were found in the implanted femur in cortical bone area, bone mineral density, and cortical bone hardness at the proximal level, as well as in bone mineral density and bone hardness at the middle level. However, no significant difference was observed in either variable for the distal level. In addition, similar proximal-to-distal gradient changes were revealed both in cortical bone microhardness and bone mineral density. From the mechanical point of view, the results of the present study suggested that stress shielding is an important mechanical factor associated with bone adaptation following total hip replacement. PMID:17506504

  9. Wear and degradation on retrieved zirconia femoral heads.

    Science.gov (United States)

    Nogiwa-Valdez, A A; Rainforth, W M; Stewart, T D

    2014-03-01

    Zirconia femoral heads retrieved from patients after different implantation periods (up to 13 years) were analysed using vertical scanning interferometry, atomic force microscopy and Raman microspectroscopy. A range of topographical and compositional changes on the surface of the retrievals are reported in this work. The study revealed that changes in roughness are the result of a combination of factors, i.e. scratching, surface upheaval due to transformation to the monoclinic phase and grain pull-out. Clusters of transformed monoclinic grains were observed on heads implanted for more than 3 years. The phase composition of these clusters was confirmed by Raman microspectroscopy. Increased abrasive wear and a higher monoclinic phase content concentrated on the pole of the femoral heads, confirming that the tetragonal to monoclinic phase transformation was not only induced by the tetragonal phase metastability and environmental conditions but mechanical and tribological factors, also affected the transformation kinetics. Additionally, the head implanted for 13 years showed evidence of a self-polishing mechanism leading to a considerable smoothening of the surface. These observations provide an insight into the interrelated mechanisms underlying the wear and transformation process on zirconia ceramics during implantation. PMID:24140384

  10. Radial Versus Femoral Access for Acute Coronary Syndromes.

    Science.gov (United States)

    Routledge, Helen; Sastry, Sanjay

    2015-12-01

    The feasibility and safety of transradial coronary intervention was demonstrated soon after the description of the transfemoral approach, despite which the use of the femoral artery still dominates in acute coronary syndrome intervention. The advantages of using the radial artery are virtual elimination of access site complications and an important reduction in bleeding, both of which are of utmost importance to the patient with myocardial infarction. Randomised controlled trials have now documented what seems inherent; that transradial intervention should bring with it an advantage in terms of morbidity and mortality in this cohort. The potential disadvantages in terms of speed of procedure and radiation exposure are negated by operator experience. Registries have illustrated that conversion on a large scale from the femoral to the transradial approach is safe and saves lives, most convincingly so in acute coronary syndrome intervention. This review discusses the potential benefits and risks of the alternative access sites in acute patients and explores how these are borne out in the published data.

  11. Femoral nerve block for patient undergoing total knee arthroplasty

    Science.gov (United States)

    Heo, Bong Ha; Lee, Hyeon Jung; Lee, Hyung Gon; Kim, Man Young; Park, Keun Suk; Choi, Jeong Il; Yoon, Myung Ha; Kim, Woong Mo

    2016-01-01

    Abstract Background: The existence of peripheral opioid receptors and its effectiveness in peripheral nerve block remain controversial. The aim of this prospective, randomized, double-blinded study was to examine the analgesic effects of adding fentanyl to ropivacaine for continuous femoral nerve block (CFNB) using patient-controlled analgesia after total knee arthroplasty (TKA). Methods: The patients were divided into 2 groups, each with n = 40 in ropivacaine (R) group and n = 42 in R with fentanyl (R + F) group. After operation, the patients in each group received R + F and R alone via a femoral nerve catheter, respectively. We assessed the visual analog scale (VAS) pain immediately before administration (baseline) and at 15, 30, and 60 minutes on postanesthesia care unit (PACU), and resting and ambulatory VAS score up to 24 hours. Results: Overall, the average VAS scores in the R + F group were slightly lower than those of the R group. However, the VAS score differences between groups were not statistically significant, except for 30 minutes (P = 0.009) in PACU. R group showed higher supplemental analgesics consumption in average compared with R + F group, but not significant. Conclusion: Additional fentanyl did not show prominent enhancement of analgesic effect in the field of CFNB after TKA. PMID:27603376

  12. Retrograde interlocking intramedullary nailing under arthroscopy for supracondylar femoral fracture

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To evaluate the therapeutic effects of retrograde interlocking intramedullary nailing under arthroscopy on supracondylar femoral fractures.   Methods: From June 1999 to December 2000, 17 patients with supracondylar femoral fracture were treated with arthroscopically assisted implantation of retrograde interlocking intramedullary nail and close reduction.   Results: More than 6-month follow-up study after operation in 11 patients revealed that the average healing time was 3 months. Average range of the knee motion for all the patients was more than 90 degrees. There was no implant breakage and infection.   Conclusions: This new method, combining the advantage of arthroscope and retrograde interlocking intramedullary nail, can provide a stable and reliable fixation, and meanwhile is less invasive to the soft tissue and knee, less operative time and blood loss, minimal disruption of the blood supply in fracture site. It is conducive to the fracture healing and the functional recovery of the knee joint and worthwhile to be recommended.

  13. Implant Size Availability Affects Reproduction of Distal Femoral Anatomy.

    Science.gov (United States)

    Morris, William Z; Gebhart, Jeremy J; Goldberg, Victor M; Wera, Glenn D

    2016-07-01

    A total knee arthroplasty system offers more distal femoral implant anterior-posterior (AP) sizes than its predecessor. The purpose of this study is to investigate the impact of increased size availability on an implant system's ability to reproduce the AP dimension of the native distal femur. We measured 200 cadaveric femora with the AP-sizing guides of Zimmer (Warsaw, IN) NexGen (8 sizes) and Zimmer Persona (12 sizes) total knee arthroplasty systems. We defined "size deviation" as the difference in the AP dimension between the anatomic size of the native femur and the closest implant size. We defined satisfactory reproduction of distal femoral dimensions as Persona (p Persona. Only 1/200 specimens (0.5%) was a poor fit by Persona, but a satisfactory fit by NexGen (p < 0.001). The novel knee system with 12 versus 8 sizes reproduces the AP dimension of the native distal femur more closely than its predecessor. Further study is needed to determine the clinical impact of these differences.

  14. Transverse femoral implant prominence: four cases demonstrating a preventable complication for ACL reconstruction.

    Science.gov (United States)

    Argintar, Evan; Scherer, Benjamin; Jordan, Tom; Klimkiewicz, John

    2010-12-01

    Anterior cruciate ligament (ACL) tear is a commonly occurring injury that often demands surgical reconstruction. Although the utility of this operation is widely accepted, many specific components, including graft fixation technique, remain controversial. Many clinicians favor transverse femoral implant fixation for soft tissue ACL grafts. This technique can be accomplished successfully; however, in a minority of the cases, the femoral implant can be excessively prominent, leading to iatrogenic postoperative iliotibial band syndrome. This article presents 4 patients that developed postoperative iliotibial band syndrome resulting from transverse femoral implant prominence. Despite achievement of knee ligamentous stability, implant prominence compromised final clinical results following ACL reconstruction. Through change in Lysholm value, we reviewed the clinical outcomes of these patients following femoral implant hardware removal for treatment of iliotibial band syndrome. On hardware removal, all patients demonstrated complete symptomatic improvement, mirroring an average Lysholm value increase of 38. We believe transverse femoral implant prominence is avoidable, and subsequent iliotibial band syndrome is a preventable postoperative complication.

  15. Integrity of the lateral femoral wall in intertrochanteric hip fractures: an important predictor of a reoperation

    DEFF Research Database (Denmark)

    Palm, Henrik; Jacobsen, Steffen; Sonne-Holm, Stig;

    2007-01-01

    compression hip screw with a four-hole side-plate between 2002 and 2004. The fractures were classified on preoperative radiographs according to the AO/OTA classification system. The status of the greater and lesser trochanters, the integrity of the lateral femoral wall, and the position of the implant were...... lateral femoral wall were operated on again (p logistic regression analyses combining demographic and biomechanical parameters showed a compromised lateral femoral wall to be a significant predictor of a reoperation (p = 0.010). Seventy-four percent (thirty-four) of the forty...... of the lateral femoral wall are not treated adequately with a sliding compression hip-screw device, and intertrochanteric fractures should therefore be classified according to the integrity of the lateral femoral wall, especially in randomized trials comparing fracture implants....

  16. Intraoperative measurement of rotational stability of femoral components of total hip arthroplasty.

    Science.gov (United States)

    Harris, W H; Mulroy, R D; Maloney, W J; Burke, D W; Chandler, H P; Zalenski, E B

    1991-05-01

    High out-of-plane forces acting on the hip joint can produce important rotational micromotion of the femoral component. This micromotion at the prosthesis interface may be detrimental to the stability of the implant. In cementless femoral implants this could prevent bone ingrowth, and in the cemented component this could cause generation of particulate debris, lysis, and loosening. The introduction of the torque wrench micrometer for assessment of intraoperative femoral component stability can quantify the initial stability of primary cementless femoral components and critically evaluate the stability (at either the initial or revision arthroplasty) of both cemented and cementless femoral components. It allows the surgeon to produce a known torque in the direction and magnitude of the out-of-plane forces that load the hip in vivo. PMID:2019039

  17. Effects of a physiological GH pulse on interstitial glycerol in abdominal and femoral adipose tissue

    DEFF Research Database (Denmark)

    Gravhølt, C H; Schmitz, Ole; Simonsen, L;

    1999-01-01

    .0005). Administration of GH induced an increase in interstitial glycerol in both abdominal and femoral adipose tissue (ANOVA: abdominal, P = 0. 04; femoral, P = 0.03). There was no overall difference in the response to GH in the two regions during the study period as a whole (ANOVA: P = 0.5), but during peak...... stimulation of lipolysis abdominal adipose tissue was, in absolute but not in relative terms, stimulated more markedly than femoral adipose tissue (ANOVA: P = 0. 03 from 45 to 225 min). Peak interstitial glycerol values of 253 +/- 37 and 336 +/- 74 micromol/l were seen after 135 and 165 min in femoral...... and abdominal adipose tissue, respectively. ATBF was not statistically different in the two situations (ANOVA: P = 0.7). In conclusion, we have shown that a physiological pulse of GH increases interstitial glycerol concentrations in both femoral and abdominal adipose tissue, indicating activated lipolysis...

  18. Cure of an old pediatric femoral neck fracture: a case report

    Institute of Scientific and Technical Information of China (English)

    AN Zhi-quan; ZENG Bing-fang

    2005-01-01

    @@ The femoral neck in children is much stronger than that in adults and can only be fractured by a severe force. It is therefore rare and often associated with severe injury once it takes place. Besides, as the blood supply to the femoral head is precarious, the fracture can lead to a high incidence of post-traumatic avascular necrosis of the femoral head.1,2 So, much attention should be paid to the treatment of femoral fractures in children. The authors have successfully cured an old femoral neck fracture of a girl by open reduction and internal fixation with 3 Kirschner wires supplemented by an external fixator across the hip joint and cancellous allograft at the fracture site. The patient has gotten a satisfactory functional recovery of the hip.

  19. Glucocorticoids affect the metabolism of bone marrow stromal cells and lead to osteonecrosis of the femoral head: a review

    Institute of Scientific and Technical Information of China (English)

    TAN Gang; KANG Peng-de; PEI Fu-xing

    2012-01-01

    Objective To review the recent developments in the mechanisms of glucocorticoids induced osteonecrosis of femoral head (ONFH) and introduce a new theory of ONFH.Data sources Both Chinese- and English-language literatures were searched using MEDLINE (1997-2011),Pubmed (1997-2011 ) and the Index of Chinese-language Literature (1997-2011 ).Study selection Data from published articles about mechanisms of glucocorticoids induced ONFH in recent domestic and foreign literature were selected.Data extraction Data were mainly extracted from 61 articles which are listed in the reference section of this review.Results Glucocorticoids are steroid hormones secreted by the adrenal cortex that play a pivotal role in the regulation of a variety of developmental,metabolic and immune functions.However,high dose of exogenous glucocorticoids usage is the most common non-traumatic cause of ON FH.Glucocorticoids can affect the metabolisms of osteoblasts,osteoclasts,bone marrow stromal cells and adipocytes which decrease osteoblasts formation but increase adipocytes formation and cause ONFH finally.Conclusions Glucocorticoids affect the differentiation of mesenchymal stem cells,through activating or inhibiting the related transcript regulators of osteogenesis and adipogenesis.At last,the size and volume of mesenchymal stem cells derived adipocytes will increase amazingly,but the osteoblasts will be decreased obviously.In the meantime,the activity of the osteoclasts will be activated.So,these mechanisms work together and lead to ONFH.

  20. Alloy Fabrication Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — At NETL’s Alloy Fabrication Facility in Albany, OR, researchers conduct DOE research projects to produce new alloys suited to a variety of applications, from gas...

  1. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    NARCIS (Netherlands)

    Zijden, A.M. van der; Groen, B.E.; Tanck, E.J.M.; Nienhuis, B.; Verdonschot, N.J.J.; Weerdesteijn, V.G.M.

    2012-01-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force).

  2. Partitioning of bone marrow into stem cell regulatory domains.

    OpenAIRE

    Maloney, M A; Lamela, R A; Banda, M J; Patt, H M

    1982-01-01

    To examine the hypothesis that bone marrow consists of discrete stem cell regulatory volumes or domains, we studied spleen colony-forming unit (CFU-S) population growth kinetics in unirradiated WBB6F1-W/Wv mice receiving various doses of +/+ bone marrow cells. Assay of femoral marrow CFU-S content in the eight recipient dose groups revealed a family of growth curves having an initial dose-independent exponential phase and a subsequent dose-dependent deceleration phase. CFU-S content at the gr...

  3. PLUTONIUM-THORIUM ALLOYS

    Science.gov (United States)

    Schonfeld, F.W.

    1959-09-15

    New plutonium-base binary alloys useful as liquid reactor fuel are described. The alloys consist of 50 to 98 at.% thorium with the remainder plutonium. The stated advantages of these alloys over unalloyed plutonium for reactor fuel use are easy fabrication, phase stability, and the accompanying advantuge of providing a means for converting Th/sup 232/ into U/sup 233/.

  4. Evaluation of Corrosion Resistance of Titanium Alloys Used for Medical Implants

    Directory of Open Access Journals (Sweden)

    Szewczenko J.

    2016-06-01

    Full Text Available The study presents the results of investigations of modeling the usable properties of implant surfaces made of Ti6Al7Nb alloy, using the example of a dynamic hip screw (DHS applied in surgical treatment of intertrochanteric femoral neck fractures. Numerical simulation has been performed for the model load of femoral fixation with DHS screw. The load simulation results provided the basis to select mechanical properties of the fixator elements and to define those fixation areas which are mostly susceptible to development of corrosion. The surfaces of Ti6Al7Nb alloy were ground, vibro-abrasive machined, mechanically polished, sandblasted, anode oxidized at different voltage values and steam sterilized. Results of surface topography evaluation, resistance to pitting and crevice corrosion as well as degradation kinetics of the outer layer were presented. Usability of the formed passive layer in clinical applications was evaluated through wear and corrosion tests of the femoral fixation model. The test results proved usefulness of the proposed surface modification methods for clinical application of different size and shape implants

  5. Distal femoral derotational osteotomy with external fixation for correction of excessive femoral anteversion in patients with cerebral palsy.

    Science.gov (United States)

    Skiak, Eyad; Karakasli, Ahmet; Basci, Onur; Satoglu, Ismail S; Ertem, Fatih; Havitcioglu, Hasan

    2015-09-01

    Patients with cerebral palsy (CP) disorder often develop rotational hip deformity. Increasing deformities impair already diminished walking abilities; femoral osteotomies are often performed to maintain and improve walking abilities. Fixation of osteotomies with condylar plates has been used successfully, but does not often enable immediate postoperative full weight-bearing. To avoid considerable postoperative rehabilitation deficit and additional bone loss because of inactivity, a postoperative treatment with full weight-bearing, is therefore, desirable. Self-tapping Schanz screws with a unilateral external fixator crossing the knee joint providing stronger anchoring in osteopenic bone might fulfill these demands. A retrospective study was carried out on 27 ambulatory CP patients, mean age 17.5 years (range 9-22 years); 11 patients with bilateral severe intoeing deformities underwent a supracondylar femoral osteotomy between September 2008 and April 2012. All patients were allowed to bear their full weight postoperatively. The aim of this study was to describe the technique, the results of this technique, to evaluate the time required for bone healing, and the type of complications associated with a distal derotational femoral osteotomy fixed with a uniaxial external fixator crossing the knee joint. A total of 27 patients were studied [mean weight 48.8 kg (range 29.8-75 kg)]. The mean preoperative rotation included internal rotation of 69° and external rotation of 17°. All patients were evaluated clinically and radiographically for a minimum of 1 year after surgery. There was a significant decrease in the mean medial rotation from 69° to 32° (P=0.00034). The lateral rotation increased significantly from preoperative 17° to postoperative 45° (P=0.0011). The femoral anteversion decreased significantly from a mean of 55° preoperatively to a mean 17° postoperatively (P=0.030). All patients, except one, achieved solid fusion uneventfully. One patient was a

  6. Interface Micromotion of Cementless Hip Stems in Simulated Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohammed R.A. Kadir

    2009-01-01

    Full Text Available Problem statement: The design of hip prostheses has evolved over time due to various complications found after hip replacement surgery. The currently commercially available cementless femoral stems can be categorized into one of three major types, straight cylindrical, tapered rectangular and anatomical. Each type proposes a unique concept to achieve primary stability-a major requirement for bone healing process. Virtual analyses have been made on individual implants, but comparison between the three major types is required to determine the strength and weaknesses of the design concepts. Approach: Three types of implants were modeled in three dimensions-the straight cylindrical, rectangular taper and anatomical. The size of the three implants was carefully designed to fit and fill the canal of a femur reconstructed from a computed tomography image dataset. Hip arthroplasty was simulated virtually by inserting the hip stem into the femoral canal. Finite element method was used in conjunction with a specialized sub-routine to measure micromotion at the bone-implant interface under loads simulating physiological walking and stair-climbing. Another sub-routine was used to assign bone properties based on the grayscale values of the CT image. Results: All the three types of cementless hip stems were found to be stable under both walking and stair climbing activities. Large micromotion values concentrated around the proximal and distal part of the stems. Conclusion/Recommendations: The three major types of hip stems were compared in this study and all of them were found to be stable after simulated physiological activities.

  7. Is there added risk in resurfacing a femoral head with cysts?

    Directory of Open Access Journals (Sweden)

    Liu Fei

    2011-10-01

    Full Text Available Abstract Background Femoral head cysts have been identified as a risk factor for early femoral failures after metal-on-metal hip resurfacing arthroplasty (HRA based on limited scientific data. However, we routinely performed HRA if less than 1/3 of the femoral head appeared destroyed by cysts on the preoperative radiograph. This study was undertaken to analyze whether there was an added risk of early femoral failures in HRA when femoral head cysts were present. Methods This retrospective case-control study included 939 MOM HRAs operated by a single surgeon with use of the posterior minimally invasive surgical (MIS approach between November 2005 and January 2009. Patients with all diagnoses except osteonecrosis were included. Among them, 117 HRAs had femoral head cysts ≥ 1 cm identified in surgery. All cysts were treated with bone grafting using acetabular reamings packed into the cavitary defect (instead of filling the cysts with cement. The control group, which had no cyst observed at the time of surgery, was randomly selected from our database using computer algorithms to match those cases in the study group for the parameters of surgical date, age, gender, body mass index, diagnosis, femoral fixation method, and the size of the femoral component. Results The minimum follow-up was 24 months for both groups. The early femoral failure rate in the study group was 3/117 (2.6% and 0/117 in the control group; there was no statistical difference between these two groups (P = 0.08. In the study group, there were two femoral neck fractures (revised: both occurred in patients having a cyst size of 1 cm3; and there was one femoral component loosening at 3-year follow up in a patient having a cyst size of 2 cm3. Conclusion Although the risk of early femoral failures among the group with cysts appeared higher than the group without cysts, we could not demonstrate a significant statistical difference between the two groups. It is possible that bone

  8. Periprosthetic femoral fracture within two years after total hip replacement:

    DEFF Research Database (Denmark)

    Thien, T. M.; Chatziagorou, G.; Garellick, G.;

    2014-01-01

    for revision of cemented stems, but revision in the uncemented group increased with increasing age. A cemented stem was associated with a higher risk in male patients compared with female patients (hazard ratio, 1.95 [95% confidence interval, 1.51 to 2.53]; p ... with a reduced risk in male patients compared with female patients (hazard ratio, 0.74 [95% confidence interval, 0.62 to 0.89]; p = 0.001). The risk for revision due to early periprosthetic fracture increased during the 2003 to 2009 period compared with the 1995 to 2002 period both before and after adjustment...... for demographic factors and fixation (relative risk, 1.44 [95% confidence interval, 1.18 to 1.69]; p hazard ratio for the Exeter stem was about five times higher than that for the Lubinus SP II stem (hazard ratio, 5.03 [95% confidence interval, 3.29 to 7.70]; p

  9. Symptomatic atypical femoral fractures are related to underlying hip geometry.

    Science.gov (United States)

    Taormina, David P; Marcano, Alejandro I; Karia, Raj; Egol, Kenneth A; Tejwani, Nirmal C

    2014-06-01

    The benefits of bisphosphonates are well documented, but prolonged use has been associated with atypical femur fractures. Radiographic markers for fracture predisposition could potentially aid in safer medication use. In this case-control designed study, we compared hip radiographic parameters and the demographic characteristics of chronic bisphosphonate users who sustained an atypical femoral fracture with a group of chronic bisphosphonate users who did not sustain an atypical femur fracture and also a group who sustained an intertrochanteric hip fracture. Radiographic parameters included were neck-shaft angle (NSA), hip-axis length (HAL) and center-edge angle (CE). Multivariate regression was used to evaluate the relationship between radiographic measures and femur fracture. Receiver-operating characteristic analysis determined cut-off points for neck-shaft angle and risk of atypical femur fracture. Ultimately, pre-fracture radiographs of 53 bisphosphonate users who developed atypical fracture were compared with 43 asymptomatic chronic bisphosphonate users and 64 intertrochanteric fracture patients. Duration of bisphosphonate use did not statistically differ between users sustaining atypical fracture and those without fracture (7.9 [±3.5] vs. 7.7 [±3.3] years, p=0.7). Bisphosphonate users who fractured had acute/varus pre-fracture neck-shaft angles (p<0.001), shorter hip-axis length (p<0.01), and narrower center-edge angles (p<0.01). Regression analysis revealed associations between neck-shaft angle (OR=0.89 [95% CI=0.81-0.97; p=0.01), center edge angle (OR=0.89 [95% CI=0.80-0.99]; p=0.03), and BMI (OR=1.15 [95% CI=1.02-1.31; p=0.03) with fracture development. ROC curve analysis (AUC=0.67 [95% CI=0.56-0.79]) determined that a cut-off point for neck-shaft angle <128.3° yielded 69% sensitivity and 63% specificity for development of atypical femoral fracture. Ultimately, an acute/varus angle of the femoral neck, high BMI, and narrow center-edge angle were

  10. ROLE OF SUPRACONDYLAR NAILING IN DISTAL FEMORAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Abhishek

    2014-08-01

    Full Text Available : BACKGROUND: Fractures of distal femur are complex injuries that can be difficult to manage. Due to poor bone stock, less cortical bone in this region, wide medullary cavity and frequently associated severe soft tissue damage. METHODS: From June 2008 to April 2012, a prospective study of 46 patients, with distal femoral fractures, including supracondylar and inter condylar fractures, treated with intramedullary supracondylar nail, was done to evaluate its results and final functional outcome and its applicability in open as well as closed distal femoral fractures. Four cases were lost to follow up; six had followed up for less than six months. These ten cases were excluded from the study hence effectively the study included total thirty six cases. Average age of patients was 41.7 yrs. with Male: Female ratio of 2.6:1. Among 36 fractures 16.6% were of type A1, 44.4% were of type A2, 27.7% were of type A3 and 11.1% were of type C1. 27.7% fractures were open and associated injuries were present in 22.2% of cases. Second generation supracondylar nail was used for definitive fixation in all eighteen cases, through percutaneous patellar tendon splitting approach in 26 patients and medial parapatellar arthrotomy approach in ten patients. RESULTS: At an average follow up of 9 months, final functional outcome was evaluated as per Neer’s criteria (1967. Average time of union was 17.5 weeks, with an average range of movement being 101.38. Functional results were excellent in 20 (55.5% cases, satisfactory in 10 (27.7% cases, unsatisfactory in 2 (5.5% and poor in 4 (11.1% cases. No significant correlation was observed in this study between the age of the patient, fracture type and the final functional outcome achieved. Similarly no significant difference was observed between the final functional outcomes achieved in open versus closed fracture. However patients treated with medial parapatellar arthrotomy approach were found to be associated with increased

  11. Tissue-engineered calcium phosphate cement in rabbit femoral condylar bone defects

    Institute of Scientific and Technical Information of China (English)

    LIU Chun-rong; MIAO Jun; XIA Qun; HUANG Hong-chao; GONG Chen; YANG Qiang; LI Lan-ying

    2012-01-01

    Background Calcium phosphate cement (CPC) is a favorable bone-graft substitute,with excellent biocompatibility and osteoconductivity.However,its reduced osteoinductive ability may limit the utility of CPC.To increase its osteoinductive potential,this study aimed to prepare tissue-engineered CPC and evaluate its use in the repair of bone defects.The fate of transplanted seed cells in vivo was observed at the same time.Methods Tissue-engineered CPC was prepared by seeding CPC with encapsulated bone mesenchymal stem cells (BMSCs) expressing recombinant human bone morphogenetic protein-2 (rhBMP-2) and green fluorescent protein (GFP).Tissue-engineered CPC and pure CPC were implanted into rabbit femoral condyle bone defects respectively.Twelve weeks later,radiographs,morphological observations,histomorphometrical evaluations,and in vivo tracing were performed.Results The radiographs revealed better absorption and faster new bone formation for tissue-engineered CPC than pure CPC.Morphological and histomorphometrical evaluations indicated that tissue-engineered CPC separated into numerous small blocks,with active absorption and recorstruction noted,whereas the residual CPC area was larger in the group treated with pure CPC.In the tissue-engineered CPC group,in vivo tracing revealed numerous cells expressing both GFP and rhBMP-2 that were distributed in the medullar cavity and on the surface of bony trabeculae.Conclusion Tissue-engineered CPC can effectively repair bone defects,with allogenic seeded cells able to grow and differentiate in vivo after transplantation.

  12. High strength alloys

    Energy Technology Data Exchange (ETDEWEB)

    Maziasz, Phillip James; Shingledecker, John Paul; Santella, Michael Leonard; Schneibel, Joachim Hugo; Sikka, Vinod Kumar; Vinegar, Harold J.; John, Randy Carl; Kim, Dong Sub

    2012-06-05

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tublar that is at least partially made from a material containing at least one of the metal alloys.

  13. High strength alloys

    Energy Technology Data Exchange (ETDEWEB)

    Maziasz, Phillip James [Oak Ridge, TN; Shingledecker, John Paul [Knoxville, TN; Santella, Michael Leonard [Knoxville, TN; Schneibel, Joachim Hugo [Knoxville, TN; Sikka, Vinod Kumar [Oak Ridge, TN; Vinegar, Harold J [Bellaire, TX; John, Randy Carl [Houston, TX; Kim, Dong Sub [Sugar Land, TX

    2010-08-31

    High strength metal alloys are described herein. At least one composition of a metal alloy includes chromium, nickel, copper, manganese, silicon, niobium, tungsten and iron. System, methods, and heaters that include the high strength metal alloys are described herein. At least one heater system may include a canister at least partially made from material containing at least one of the metal alloys. At least one system for heating a subterranean formation may include a tubular that is at least partially made from a material containing at least one of the metal alloys.

  14. Development of a method for measuring femoral torsion using real-time ultrasound

    International Nuclear Information System (INIS)

    Excessive femoral torsion has been associated with various musculoskeletal and neurological problems. To explore this relationship, it is essential to be able to measure femoral torsion in the clinic accurately. Computerized tomography (CT) and magnetic resonance imaging (MRI) are thought to provide the most accurate measurements but CT involves significant radiation exposure and MRI is expensive. The aim of this study was to design a method for measuring femoral torsion in the clinic, and to determine the reliability of this method. Details of design process, including construction of a jig, the protocol developed and the reliability of the method are presented. The protocol developed used ultrasound to image a ridge on the greater trochanter, and a customized jig placed on the femoral condyles as reference points. An inclinometer attached to the customized jig allowed quantification of the degree of femoral torsion. Measurements taken with this protocol had excellent intra- and inter-rater reliability (ICC2,1 = 0.98 and 0.97, respectively). This method of measuring femoral torsion also permitted measurement of femoral torsion with a high degree of accuracy. This method is applicable to the research setting and, with minor adjustments, will be applicable to the clinical setting. (paper)

  15. Treatment of ipsilateral hip and femoral shaft fractures with reconstructive intramedullary interlocking nail

    Institute of Scientific and Technical Information of China (English)

    吴立东; 吴琼华; 严世贵; 潘志军

    2004-01-01

    Objective: To evaluate the results of reconstructive intramedullary interlocking nail in the treatment of ipsilateral hip and femoral shaft fractures. Methods: From August 1997 to November 2001, 13 patients were treated with the reconstructive intramedullary interlocking nail. Nine patients were associated with ipsilateral femoral neck fractures, three with ipsilateral intertrochanteric fractures, and one with subtrochanteric fracture. Results: The follow-up time was from 6 to 38 months with an average of 14 months. All the femoral shaft and hip fractures healed up well. There was no nonunion of the femoral neck, and only one varus malunion. No patient had avascular necrosis of the femoral head. The average healing time for femoral neck fracture was 4.6 months and for shaft fracture 5.8 months. The joint movement and other functions were fairly resumed. Conclusions: The reconstructive intramedullary interlocking nail, with less trauma, reliable fixation, and high rate of fracture healing, is an ideal method of choice in the treatment of ipsilateral hip and femoral shaft fractures.

  16. Prognostic value of dynamic MRI in assessing post-traumatic femoral head vascularity

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Abhishek; Varghese, Mathew [St Stephen' s Hospital, Department of Orthopaedics, Delhi, New Delhi (India); Sankaran, Balu [St Stephen' s Hospital, Delhi, New Delhi (India)

    2009-06-15

    The vascular status of femoral heads in the post-traumatic period of intracapsular femoral neck fracture (ICFNF) remains uncertain until the patient actually develops avascular necrosis (AVN). Several methods for predicting the viability of femoral head have been reported, that are not effective or widely used because of unreliability, potential complications, and technical difficulties. The present study involved the use of Dynamic MRI (DMRI) in assessing femoral head vascularity to predict AVN. The role of DMRI was studied prospectively in 30 patients with 31 ICFNF. Fractures were divided in to three types (Type A, B, or C) based on the femoral head vascularity shown by dynamic curve patterns on MRI evaluation. Type A was preserved vascularity, Type B was some decrease in vascularity but still viable while Type C was significantly reduced vascularity. These were followed-up for 6 months to 2 years to observe the final outcome in terms of union, non-union, or AVN. We found that Type A curves correlate well with vascular status and Type C curves correlate well with poor vascularity of the femoral heads. No AVN was seen in any of Type A (13/31) or Type B (eight out of 31). Five cases showed AVN and all of them were of Type C dynamic curves. Dynamic MRI is a reliable tool to evaluate vascularity of femoral heads and thus reduces the uncertainty of outcome of treatment of ICFNFs. DMRI can be a useful tool to formulate a treatment algorithm in management of ICFNF. (orig.)

  17. Avascularity of the femoral head following intracapsular fracture: a comparative scintigraphic and bioptic study

    International Nuclear Information System (INIS)

    Bioptic and scintigraphic methods of diagnosing avascular necrosis of the femoral head following intracapsular fracture of the femoral neck were compared. During operative treatment of patients, biospy samples of bone marrow were taken from the femoral head about 2 hours after the intravenous injection of sup(99m)Tc-Sn-pyrophosphate; histological examination of the biopsies were also performed. Scintigrams of the femoral head using sup(99m)Tc-pyrophosphate were performed 2 days, 7 days and 6 weeks post-operatively. The biopsies confirmed no morphological changes being apparent in the first few days. The biopsy samples indicated two groups of patients with either high or low activity in the femoral head. However, it was concluded that the use of bone-seeking radionuclides with this technique might be more reliable. Scintigraphic trends divided the patients into three groups, one with persistently normal, another with varying, and a third with decreased activity in the femoral head. It was concluded that very early scintigraphy is probably not the method of choice since the images were often difficult to interpret. For the present, assessment of the viability of the femoral head should rest upon scintigraphic examinations performed about 6 weeks or 3 months after the injury. (UK)

  18. Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate radiation dose and patient discomfort/pain in radial artery access vs femoral artery access in percutaneous coronary intervention (PCI). Dose-area product (DAP) was measured non-randomised for 114 procedures using femoral access and for 55 using radial access. The patients also responded to a questionnaire concerning discomfort and pain during and after the procedure. The mean DAP was 69.8 Gy cm2 using femoral access and 70.5 Gy cm2 using radial access. Separating the access site from confounding factors with a multiple regression, there was a 13% reduction in DAP when using radial access (p=0.038). Procedure times did not differ (p=0.81). Bed confinement was much longer in the femoral access group (448 vs 76 min, p=0.000). With femoral access, there was a significantly higher patient grading for chest (p=0.001) and back pain (p=0.003) during the procedure and for access site (p=0.000) and back pain (p=0.000) after the procedure. Thirty-two femoral access patients (28%) were given morphine-type analgesics in the post-procedure period compared to three radial access patients (5%, p=0.001). DAP does not increase when using radial instead of femoral access and the patients grade discomfort and pain much lower when using radial access. Radial access is thus beneficial to use. (orig.)

  19. CT measurement of anteversion in the femoral neck. The influence of femur positioning

    International Nuclear Information System (INIS)

    Purpose: To evaluate CT methods of measuring anteversion in the femoral neck with respect to measurement accuracy and with respect to the influence exerted by different femoral shaft positions; and to describe a new CT measurement concept that introduces a mathematical adjustment for different femoral shaft positions. The new technique facilitates the taking of measurements in patients who cannot be correctly positioned in traditional methods. Material and Methods: CT examinations of previously measured anteversions in the femoral neck were reviewed in retrospect in 30 patients with fractures of the femoral neck. The position of the femoral shaft was assessed. A reference angle was compared with direct traditional measurements and with measurements adjusted for the actual position of the femoral shaft by means of a 3D mathematical reconstruction. Reproducibility and inter- and intraobserver variability were assessed in 10 cases. Results: All femurs varied in position within the gantry. The mean difference between the direct CT measurement and the adjusted CT measurement compared to the reference angle were -8.8 (range -35.0-16.3 ) and -0.1 (range -1.4-1.4 ), respectively. For the adjusted CT method, reproducibility and inter-and intraobserver variability were 1.4 , 1.6 and 1.4 (SD of difference), respectively. (orig.)

  20. [Progress in diagnosis and treatment of ipsilateral femoral neck and shaft fracture].

    Science.gov (United States)

    Du, C G; Zhang, Y Z; Chen, W

    2016-07-01

    Ipsilateral femoral neck and shaft fractures are rare injuries, which are often caused by high-energy trauma and combined with multiple injuries, such as thoracic and abdominal injury, head injuries, and fractures of other sites.Delayed or missed diagnosis of the ipsilateral femoral neck fracture often occurs.When patients with femoral shaft fractures caused by high-energy trauma are admitted into hospital, physical examination should be conducted carefully.In addition to femoral shaft fractures, radiographs of the ipsilater hip and knee joints should been taken, simultaneously taking into consideration the potential effect of anteversion angle on the demonstration of femoral neck fracture.Computed tomograph and magnetic resonance imaging are advised to perform if necessary to facilitate early and accurate diagnosis of ipsilateral femoral neck fracture.Comprehensive evaluation should be done based on age, physical condition, associated injuries as well as fracture site, classification and injury severity.Accordingly, proper and reasonable surgical plan is made.During the operation, anatomical reduction of the fractures, especially femoral neck fractures, should be achieved, and then fixed with appropriate internal implants.Besides, attention should also be paid to the treatment of associated injuries as well as the prevention and management of complications. PMID:27373484

  1. Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Haakan [Department of Radiology, Oerebro University Hospital, 701 85, Oerebro (Sweden); Persliden, Jan [Department of Medical Physics, Oerebro University Hospital, 701 85, Oerebro (Sweden); Department of Medicine and Care, Faculty of Health Sciences, Linkoeping University, 581 85, Linkoeping (Sweden)

    2004-09-01

    The aim of this study was to evaluate radiation dose and patient discomfort/pain in radial artery access vs femoral artery access in percutaneous coronary intervention (PCI). Dose-area product (DAP) was measured non-randomised for 114 procedures using femoral access and for 55 using radial access. The patients also responded to a questionnaire concerning discomfort and pain during and after the procedure. The mean DAP was 69.8 Gy cm{sup 2} using femoral access and 70.5 Gy cm{sup 2} using radial access. Separating the access site from confounding factors with a multiple regression, there was a 13% reduction in DAP when using radial access (p=0.038). Procedure times did not differ (p=0.81). Bed confinement was much longer in the femoral access group (448 vs 76 min, p=0.000). With femoral access, there was a significantly higher patient grading for chest (p=0.001) and back pain (p=0.003) during the procedure and for access site (p=0.000) and back pain (p=0.000) after the procedure. Thirty-two femoral access patients (28%) were given morphine-type analgesics in the post-procedure period compared to three radial access patients (5%, p=0.001). DAP does not increase when using radial instead of femoral access and the patients grade discomfort and pain much lower when using radial access. Radial access is thus beneficial to use. (orig.)

  2. Creep Resistant Zinc Alloy

    Energy Technology Data Exchange (ETDEWEB)

    Frank E. Goodwin

    2002-12-31

    This report covers the development of Hot Chamber Die Castable Zinc Alloys with High Creep Strengths. This project commenced in 2000, with the primary objective of developing a hot chamber zinc die-casting alloy, capable of satisfactory service at 140 C. The core objectives of the development program were to: (1) fill in missing alloy data areas and develop a more complete empirical model of the influence of alloy composition on creep strength and other selected properties, and (2) based on the results from this model, examine promising alloy composition areas, for further development and for meeting the property combination targets, with the view to designing an optimized alloy composition. The target properties identified by ILZRO for an improved creep resistant zinc die-casting alloy were identified as follows: (1) temperature capability of 1470 C; (2) creep stress of 31 MPa (4500 psi); (3) exposure time of 1000 hours; and (4) maximum creep elongation under these conditions of 1%. The project was broadly divided into three tasks: (1) Task 1--General and Modeling, covering Experimental design of a first batch of alloys, alloy preparation and characterization. (2) Task 2--Refinement and Optimization, covering Experimental design of a second batch of alloys. (3) Task 3--Creep Testing and Technology transfer, covering the finalization of testing and the transfer of technology to the Zinc industry should have at least one improved alloy result from this work.

  3. Biocompatibility of dental alloys

    Energy Technology Data Exchange (ETDEWEB)

    Braemer, W. [Heraeus Kulzer GmbH and Co. KG, Hanau (Germany)

    2001-10-01

    Modern dental alloys have been used for 50 years to produce prosthetic dental restorations. Generally, the crowns and frames of a prosthesis are prepared in dental alloys, and then veneered by feldspar ceramics or composites. In use, the alloys are exposed to the corrosive influence of saliva and bacteria. Metallic dental materials can be classified as precious and non-precious alloys. Precious alloys consist of gold, platinum, and small amounts of non-precious components such as copper, tin, or zinc. The non-precious alloys are based on either nickel or cobalt, alloyed with chrome, molybdenum, manganese, etc. Titanium is used as Grade 2 quality for dental purposes. As well as the dental casting alloys, high purity electroplated gold (99.8 wt.-%) is used in dental technology. This review discusses the corrosion behavior of metallic dental materials with saliva in ''in vitro'' tests and the influence of alloy components on bacteria (Lactobacillus casei and Streptococcus mutans). The test results show that alloys with high gold content, cobalt-based alloys, titanium, and electroplated gold are suitable for use as dental materials. (orig.)

  4. Radiologic analysis of femoral acetabular impingement: from radiography to MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dwek, Jerry R. [University of California at San Diego, Department of Radiology, Rady Children' s Hospital and Health Center, San Diego, CA (United States); San Diego Imaging, San Diego, CA (United States); Monazzam, Shafagh [Rady Children' s Hospital and Health Center, Department of Orthopedics, San Diego, CA (United States); Chung, Christine B. [University of California at San Diego, Department of Radiology, San Diego, CA (United States)

    2013-03-15

    Femoral acetabular impingement is a set of morphologic abnormalities that are considered to be a major cause of degenerative disease in the hip joint. Early changes are already present in adolescence when it is the pediatric radiologist who must assess current damage with the aim of averting progression to more severe and debilitating osteoarthritis. A multimodality approach is used for diagnosis, that includes conventional radiography and CT to assess the osseous structures. MR arthrography is the primary advanced imaging modality for assessment of morphologic changes as well as injuries of the labrum and articular cartilage. Details of radiologic imaging are offered to guide the radiologist and provide an avenue for the accurate description of the osseous and articular alterations and injury. (orig.)

  5. Fractures of the proximal femoral physis in dogs

    International Nuclear Information System (INIS)

    Fractures of the proximal femoral physis are common in dogs, particularly young ones. The goals of surgical treatment are accurate anatomicreduction; rigid fracture stability to promote rapid fracture healing; early return to function and activity; and, in the case of articularfractures, preservation of a normal pain-free joint. Early repair techniques centered around the use of external coaptation but are no longer accepted as appropriate options. Today, internal fracture fixation is the treatment of choice. To realize successful repair, the surgeon must understand the development and anatomy of the coxofemoral joint and the structure of the normal physis. The anatomy of and blood supplyto the coxofemoral joint are reviewed, as is the anatomy of the normal physis in dogs. Treatment and repair options are presented, complications are addressed, and prognostic indicators are discussed

  6. Femoral Lengthening by Ilizarov Technique: Results and Complications

    Directory of Open Access Journals (Sweden)

    Altaf A. Kawoosa, Suhail Majid, Manzoor A. Halwai, Mohd. Ramzan Mir, G.R. Mir

    2004-07-01

    Full Text Available Femoral lengthening using Ilizarov technique was performed in ten patients comprising of 6 femalesand 4 males in an age group of 10-19 years with an average shortening of 6.8 cms. The etiology ofshortening was post-infective in 8 patients and post-traumatic in two patients. The desired lengthwas achieved in six patients and in four patients the final limb length discrepancy ranged between 1to 3 cms. The total duration of external fixation ranged from 24 weeks to 90 weeks with an averagehealing index of 6.23 weeks/cm. There were 10 problems and 2 true complications. Temporarydecrease in knee range of motion was a common difficulty encountered during lengthening. Resultswere rated as excellent in five, good in two, fair in two and poor in one patient.

  7. Automatic Quantification of Tibio-Femoral Contact Area and Congruity

    DEFF Research Database (Denmark)

    Tummala, Sudhakar; Nielsen, Mads; Lillholm, M.;

    2012-01-01

    We present methods to quantify the medial tibio- femoral (MTF) joint contact area (CA) and congruity index (CI) from low-field magnetic resonance imaging (MRI). Firstly, based on the segmented MTF cartilage compartments, we computed the contact area using the Euclidian distance transformation...... distance between the local normal vectors (first-order features) scaled by the local normal curvatures (second-order features) along the local direction of principal knee motion in a local reference coordinate system formed by the directions of principal curvature and the surface normal vector....... The abilities of the CA and the CI for diagnosing osteoarthritis (OA) at different levels (disease severity was assessed using the Kellgren and Lawrence Index, KL) were cross-validated on 288 knees at baseline. Longitudinal analysis was performed on 245 knees. The precision quantified on 31 scan-rescan pairs...

  8. Nonunion of coronal shear fracture of femoral condyle

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Raju Vaishya; Anil Kumar Jain; Arun Pal Singh; Prashant Modi

    2011-01-01

    Isolated coronal fractures of femoral condyle are rare in adults and nonunion of Hoffa fracture is reported only a few times in the literature. We analyzed six cases of nonunion of Hoffa fractures over a period of three years. Three patients were treated conservatively and three patients had fixation failures. Delay of presentation was 2 months to one year. Treatment protocol consisted of open reduction, excision of pseudoarthrosis, bone grafting and internal fixation along with knee arthrolysis. Union was achieved in all patients at mean 16 weeks. The treatment of nonunion of Hoffa fractures requires careful preoperative planning and meticulous surgical technique. The literature regarding the controversies in fracture management and surgical technique are reviewed.

  9. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, T. [Clinic for Orthopaedics and Sports Traumatology, Dreifaltigkeits-Krankenhaus GmbH, Aachener Str. 445-449, 50933 Koeln (Germany); Drescher, W. [Department of Orthopaedics, Christian Albrechts University, Kiel (Germany); Becker, C. [Department of Orthopaedics, Heinrich Heine University, Duesseldorf (Germany); Sangill, R.; Stoedkilde-Joergensen, H. [Institute for Magnetic Resonance Imaging Tomography, University of Aarhus, Skejby Hospital, Aarhus (Denmark); Heydthausen, M. [Computing Center, Heinrich Heine University, Duesseldorf (Germany); Hansen, E.S.; Buenger, C. [Spine Section, Department of Orthopaedics, University of Aarhus (Denmark)

    2003-02-01

    To examine the potential of gadolinium (Gd)-enhanced dynamic MRI in the detection of early femoral head ischemia. Furthermore, to apply a three-compartment model to achieve a clinically applicable MR index for femoral head perfusion during the steady state and arterial hip joint tamponade.Design and materials In a porcine model femoral head perfusion was measured by radioactive tracer microspheres and by using a dynamic Gd-enhanced MRI protocol. Femoral head perfusion measurements and MRI tests were performed unilaterally before, during and after the experimentally induced ischemia of one of the hip joints. Ischemia was induced by increasing intra-articular pressure to 250 mmHg. All pigs showed ischemia of the femoral head epiphysis under hip joint tamponade followed by reperfusion to the same level as before joint tamponade. In two cases perfusion after removal of tamponade continued to be low. In dynamic MRI measurements increases in signal intensity were seen after intravenous infusion of Gd-DTPA, followed by a slow decrease in signal intensity. The signal-intensity curve during femoral head ischemia had a minor increase. Also the coefficient determined was a helpful indicator of femoral head ischemia. Femoral head blood flow as measured by microspheres fell significantly under joint tamponade. Early detection of this disturbed regional blood flow was possible using a dynamic MRI procedure. A biomathematical model resulted from the evaluation of the intervals of signal intensity over time which allows detection of bone blood flow changes at a very early stage. Using this new method earlier detection of femoral head necrosis may be possible. (orig.)

  10. B-cell Lymphoma in retrieved femoral heads: a long term follow up

    Directory of Open Access Journals (Sweden)

    van Kemenade Folkert J

    2009-05-01

    Full Text Available Abstract Background A relatively high incidence of pathological conditions in retrieved femoral heads, including a group of patients having low grade B-cell lymphoma, has been described before. At short term follow up none of these patients with low-grade B-cell lymphoma showed evidence of systemic disease. However, the long term follow up of these patients is not known. Methods From November 1994 up to and including December 2005 we screened all femoral heads removed at the time of primary total hip replacement histopathologically and included them in the bone banking protocol according to the guidelines of the American Associations of Tissue Banks (AATB and the European Association of Musculo-Skeletal Transplantation (EAMST. We determined the percentage of B-cell lymphoma in all femoral heads and in the group that fulfilled all criteria of the bone banking protocol and report on the long-term follow-up. Results Of 852 femoral heads fourteen (1.6% were highly suspicious for low-grade B-cell lymphoma. Of these 852 femoral heads, 504 were eligible for bone transplantation according to the guidelines of the AATB and the EAMST. Six femoral heads of this group of 504 were highly suspicious for low-grade B-cell lymphoma (1.2%. At long term follow up two (0.2% of all patients developed systemic malignant disease and one of them needed medical treatment for her condition. Conclusion In routine histopathological screening we found variable numbers of low-grade B-cell lymphoma throughout the years, even in a group of femoral heads that were eligible for bone transplantation. Allogenic transmission of malignancy has not yet been reported on, but surviving viruses are proven to be transmissible. Therefore, we recommend the routine histopathological evaluation of all femoral heads removed at primary total hip arthroplasty as a tool for quality control, whether the femoral head is used for bone banking or not.

  11. Anatomic landmarks of fluoroscopy guided puncture of the pulseless femoral artery

    International Nuclear Information System (INIS)

    We wanted to improve puncturing the pulseless femoral artery by evaluating the anatomic landmarks that suggest the course of the femoral artery on fluoroscopy. We analyzed 37 hemipelvis spot images that were centered on the arterial sheath after puncture of the femoral artery. The inguinal angles were measured between the inguinal line connecting the anterior superior iliac spine and the symphysis pubis, and the line of the arterial sheath. Inguinal ligament ratios were measured as the distance from the symphysis pubis to the arterial sheath to the length of the inguinal ligament on the inguinal line. The femoral head ratios were measured as the distance from the medial margin of the femur head to the arterial sheath to the transverse length of the femur head. The mean inguinal angle was 66.5 and the mean inguinal ligament ratio was 0.42 (± 0.03). The mean femoral head ratio was 0.08 (± 0.18). In comparing the men and women, there was no significant difference in the inguinal angle and the femoral head ratio, but the inguinal distance ratio was larger in women (men: 0.41 ± 0.033, women: 0.44 ± 0.031, ρ < 0.05). The femoral artery generally courses just lateral to the medial margin of the femur head (femoral head ratio: 0.08) and the medial 40% of the inguinal ligament (inguinal ligament ratio: 0.42). So, consideration of these relations may be helpful for puncturing the pulseless femoral artery

  12. Unstable Pelvic Fractures Associated with Femoral Shaft Fractures: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Chun-Liang Wu

    2013-04-01

    Full Text Available Background: Both pelvic fractures and femoral shaft fractures are caused by high-energy injuries. When unstable pelvic fractures and femoral shaft fractures occur concomitantly, the optimal treatment method is controversial. The aim of this study was to establish a reasonable principle for treating such complicated injuries. Methods: Forty patients sustaining unstable pelvic fractures and concomitant femoral shaft fractures were treated in a 7-year period. The initial management of the fractures was started at the emergency service according to the Advanced Trauma Life Support protocol. Unstable pelvic fractures were wrapped by cloth sheets and femoral shaft fractures were immobilized with a splint. Angiography was performed on patients with unstable hemodynamic status. The definitive treatment for combined fractures was performed after stabilizing the hemodynamics. Closed nailing was used for femoral shaft fractures, and pelvic fractures were treated with various techniques. Results: The mortality rate was 12.5% (5/40 during admission. Thirty-three patients were followed up for an average of 32 months (range, 12-76 months. There were 33 cases of unstable pelvic fractures and 36 instances of femoral shaft fractures. The union rate for pelvic fractures was 100% (33/33, while femoral shaft fractures had a 94.4% (34/36 union rate. The average healing time was 3.3 months (range, 1.6-8.1 months and 4.1 months (range, 2.5-18.2 months for pelvic and femoral shaft fractures, respectively. After fracture, 34 hips (94% achieved a satisfactory result in the Harris hip score and 30 knees (83% achieved a satisfactory result in the Mize knee score. Conclusions: Stabilization of the hemodynamics in patients with combined fractures should be the first aim. Angiography to stop arterial bleeding in the pelvis is often life-saving. The definitive treatment for combined fractures, such as pelvic fractures and femoral shaft fractures, should wait until hemodynamics

  13. Dynamic Response of Femoral Cartilage in Knees With Unicompartmental Osteoarthritis

    Directory of Open Access Journals (Sweden)

    A. Vidal-Lesso

    2011-08-01

    Full Text Available The objective of the present work was to determine the dynamic indentation response, stiffness and relaxation curvesfor the shear and the bulk modulus of femoral knee cartilage with no visual damage in cases under unicompartmentalosteoarthritis.A cyclic displacement of 0.5 mm in axial direction was applied with a 3 mm plane-ended cylindrical indenter at specificpoints in the femoral knee cartilage specimens of seven patients with unicompartmental osteoarthritis (UOA. Theindentation force over time was recorded and next the maximum stiffness in all cycles was obtained and compared.Also, the relaxation curves for the shear and the bulk modulus of cartilage were obtained in this work.A decrease in the maximum indentation force was observed comparing between indentation cycles; it was of 6.75 ±0.71% from cycle 1 to cycle 2 and 4.70 ± 0.31% for cycle 2 to cycle 3. Stiffness values changed with a mean of 3.35 ±0.39% from cycle 1 to cycle 2 and 1.40 ± 0.71% from cycle 2 to cycle 3. Moreover, relaxation curves for the shearmodulus and the bulk modulus showed the nonlinear behavior of articular cartilage with UOA.Our results showed that cartilage specimens with no visual damage in UOA preserve a nonlinear viscoelastic behaviorand its stiffness increases through the loading cycles. Our work provides experimental values for generating a morerealistic cartilage behavior than those currently used in computer cartilage models for the study of UOA.

  14. In vivo experimental study of hollow porous femoral prosthesis filled with rhBMP-2%中空多孔股骨柄假体骨长入方式的在体实验研究

    Institute of Scientific and Technical Information of China (English)

    蔡谞; 王达文; 樊宇平; 赵斌; 王岩

    2008-01-01

    Objective To study hone formation and osteointegration at the interface and inside the hollow porous femoral porsthesis filled with recombinant human bone morphogentic protein-2 (rhBMP-2). Methods 18 health adult hybrid dogs were divided into 3 groups randomly. Each animal received total hip arthroplasty at right hip joint. The femoral stems implanted were solid center prosthesis (group A), hollow porous prosthesis filled with cancellous bone taken from the femur head and neck (group B), and hollow porous prosthesis filled with gelfoam and 5 mg rhBMP-2(group C), respectively. All prosthesis were made of CoCrMo alloy with hydroxyapatite coating at the proximal half. The animals were sacrificed at 2,4,8 months post operation and X-ray of the femur samples were taken. The histological changes, interface osseointega- tion rate and bone ingrowth rate round and inside prosthesis were evaluated. Results The bone formation of group C was faster than group A and B histologically. The interface osteointegration rate of group C was sig- nificantly higher than that of group A and B (P< 0.05) at 2, 4 months, but there was no significantly differ- ence between them at 8 months (P 0.05). Also the bone ingrowth rate of group C was higher than that of group B(P<0.05), but no significant difference at 8 months(P 0.05). There was nosignificant difference be- tween goup A and B at interface osteointegration rate. Conclusion The hollow porous femoral prosthesis filled with rhBMP-2 can enhance interface osteointegration and bone ingrowth effectively, which can make the prosthesis fast fixed in the bone bed right at the early stage. And this may provide reliable experimental evidence for developing a kind of hollow porous femoral prosthesis for human.%目的 观察多孔中空人工股骨柄假体周围骨床骨质经界面长入金属空腔及其在腔室内成骨的特征,比较腔内复合骨诱导因子(rhBMP-2)与自身骨长入的成骨差异.方法 健康成年杂交犬18

  15. Effects of Sclerostin Antibody on the Healing of Femoral Fractures in Ovariectomised Rats.

    Science.gov (United States)

    Liu, Yang; Rui, Yunfeng; Cheng, Tin Yan; Huang, Shuo; Xu, Liangliang; Meng, Fanbiao; Lee, Wayne Yuk Wai; Zhang, Ting; Li, Nan; Li, Chaoyang; Ke, Huazhu; Li, Gang

    2016-03-01

    The inhibition of sclerostin by the systemic administration of a monoclonal antibody (Scl-Ab) significantly increased bone mass and strength in fractured bones in animal models and non-fractured bones in ovariectomised (OVX) rats. In this study, the effects of Scl-Ab on healing were examined in a closed fracture model in OVX rats. Sixty Sprague-Dawley rats underwent an ovariectomy or a sham operation at 4 months of age, and a closed fracture of the right femur was performed 3 months later. Subcutaneous injections with Scl-Ab (25 mg/kg) or saline were then administered on day 1 after the fracture and twice a week for 8 weeks (n = 20 per group), at which time the fractured femurs were harvested for micro-computed tomography analysis, four-point bending mechanical testing and histomorphometric analysis to examine bone mass, bone strength and dynamic bone formation at the fracture site. The angiogenesis at the fracture site was also examined. Bone marrow stem cells were also isolated from the fractured bone to perform a colony-forming unit (CFU) assay and an alkaline phosphatase-positive (ALP(+)) CFU assay. OVX rats treated with Scl-Ab for 8 weeks had significantly increased bone mineral density and relative bone volume compared with OVX rats treated with saline. Similarly, maximum loading, energy to maximum load and stiffness in Scl-Ab-treated OVX rats were significantly higher than those in saline controls. The mineral apposition rate (MAR), mineralising surface (MS/BS) and bone formation rate (BFR/BS) were also significantly increased in Scl-Ab-treated group compared with the saline-treated group in OVX rats. Furthermore, the Scl-Ab-treated group had more CFUs and ALP(+) CFUs than the saline-treated group in OVX rats. No significant difference in angiogenesis at the fracture site was found between the groups. Our study demonstrated that Scl-Ab helped to increase bone mass, bone strength and bone formation at the fracture site in a closed femoral fracture

  16. A technique for repair of femoral capital epiphyseal fractures in the dog

    International Nuclear Information System (INIS)

    new method for repair of femoral capital epiphyseal fractures in the immature dog is described. The technique employs two small AO/ASIF cortical screws inserted in lag fashion from the articular surface into the femoral neck. The screw heads are countersunk, so as not to project from the articular cartilage of the femoral epiphyseal fragment, While this is an early report it is hoped that it will prompt the use of the technique by others so that its long term assessment may be more rapidly determined than by one clinic working alone

  17. Measurement of femoral torsion and tibial torsion using magnetic resonance imaging (MRI)

    International Nuclear Information System (INIS)

    A new MRI method for the measurement of femoral torsion and tibial torsion is presented. Axial images were generated using a standard gradient echo sequence (FLASH 2D). Otherwise measurement of femoral and tibial torsion was performed according to an established CT method. The torsion angles measured using MRI were in accordance with the angles measured using the CT method. The MRI method was not more time-consuming than the CT method. In respect of radiation exposure, MRI determination of femoral and tibial torsion should be considered particularly in children and patients who have to undergo repeated torsion measurements. (orig.)

  18. The Reliability of the Symax Method of Measuring the Radiographic Femoral Varus Angle

    DEFF Research Database (Denmark)

    Allpass, Maja; Miles, James Edward; Schmökel, Hugo

    2014-01-01

    Objective: To determine the practicability of curved osteotomy to correct femoral varus in small breed dogs, and to assess the reliability of the Symax method of measuring the radiographic femoral varus angle (FVA). Methods: Eleven cadaveric femora plus one clinical case were included in this study....... The FVA was measured using the Symax method on craniocaudal femoral radiographs. CORA principles were used to plan the curved osteotomy. Following osteotomy and planned correction of the FVA to 0º, the femur was stabilized with a 2.4 mm locking plate and screws (cadavers) or 2.0mm SOP plate (patient...

  19. Posterior dislocation of the hip with ipsilateral displaced femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    Vivek Trikha; Tarun Goyal; Ram K.Jha

    2011-01-01

    Traumatic posterior dislocation of hip associated with ipsilateral displaced femoral neck fracture is a rare injury. Moreover, the management of such patients evokes strong views regarding primary replacement or preserving the femoral head. We presented a case of young adult with such an injury. He was operated upon with reduction of the dislocation and fixation of femoral neck fracture with the help of cancellous screws. Two years later, the fracture had united and the patient was asymptomatic. We further proposed the mechanism of injury for such a fracture and discussed the management in the changing trauma scenario of the developing world.

  20. Brodie's abscess of the proximal femoral epiphysis in an adult woman with systemic lupus erythematosus.

    Science.gov (United States)

    Miyanishi, Keita; Yamamoto, Takuaki; Irisa, Takahiko; Jingushi, Seiya; Noguchi, Yasuo; Iwamoto, Yukihide

    2002-06-01

    We report an unusual case of pathologically proved femoral head Brodie's abscess mimicking avascular necrosis of bone in a 51-year-old woman with a 2-year history of corticosteroid treatment for systemic lupus erythematosus. On plain radiographs, a rounded lucency and thin sclerotic margins together with subchondral collapse and a lytic region were observed in the femoral head. The histopathologic examination revealed a central abscess formation surrounded by fibrous tissue with the aggregation of neutrophils and plasma cells. To our knowledge, this is the first case report describing a Brodie's abscess which had developed within the proximal femoral epiphysis in an adult.

  1. Quantitative CT assessment of proximal femoral bone density. An experimental study concerning its correlation to breaking load for femoral neck fractures

    International Nuclear Information System (INIS)

    Purpose: In an experimental study, the correlation between the trabecular bone density of the different regions of the proximal femur and the fracture load in the setting of femoral neck fractures was examined. Methods: The bone mineral density 41 random proximal human femora was estimated by single-energy quanitative CT (SE-QCT). The trabecular bone density was measured at the greatest possible extracortical volume at midcapital, midneck and intertrochanteric level and in the 1 cm3 volumes of the centres of these regions in a standardised 10 mm thick slice in the middle of the femoral neck axis (in mg/ml Ca-hydroxyl apatite). The proximal femora were then isolated and mounted on a compression/bending device under two-legged stand conditions and loaded up to the point when a femoral neck fracture occurred. Results: Statistical analysis revealed a linear correlation between the trabecular bone density and the fracture load for the greater regions, with the highest value in the maximal area of the head (coefficient factor r=0.76). Conclusion: According to our data, the measurement of the trabecular bone by SE-QCT at the femoral head is a more confident adjunct than the neck or trochanteric area to predict a femoral neck fracture. (orig.)

  2. Our Experience with Short Stem Hip Replacement Surgery

    Directory of Open Access Journals (Sweden)

    Sumeet Rastogi

    2016-07-01

    Full Text Available Context- A short anatomical metaphyseal femoral stem is a desirable hip implant for bone and soft tissue preserving hip replacing surgery in young arthritic patients. Physiological loading of the proximal femur prevents stress shielding and preserves bone stock of the femur in the long run. Thus it is an ideal hip implant suited for conservative hip surgeries in active young adults with arthritic hips. Materials and methods- 50 Proxima hip replacements were performed on 41 patients with a mean age of 45 over a 3-year period (between July 2006 and September 2009. Diagnosis of hip pathologies varied from osteoarthritis secondary to avascular necrosis, rheumatoid arthritis, post-tubercular arthritis to dysplastic hips. 9 of these patients had symptomatic bilateral hip involvement and underwent bilateral hip replacement in a single sitting. All patient had a Proxima metaphyseal stem implantation( DePuy, Warsaw with either a large diameter metal on metal or pinnacle articulation. Clinical and radiological evaluation was done at 3 months, 6 months, 1 year and then yearly thereafter. Statiscal analysis used- VAS and Harris hip score formed the basis of evaluation Results- These patients were followed up for a mean period of 49 months (Range 36-72 months. The average incision size was 14.38 cm (10-18 cm and blood loss was 269 ml (175-450 ml. There was no peri-operative mortality or serious morbidity in any patients. One patient had an intraoperative lateral cortex crack that required only delayed rehabilitation. Five of the 41 patients (12.1 % had complications with three recovering completely and one requiring revision of femoral stem for aseptic loosening. One patient was lost in follow-up. Harris hip score improved from 52 to 89.3 at last follow-up. Overall 95.1% (39/41 patients had an excellent outcome at last follow-up. Conclusion- We conclude that Proxima metaphyseal stem provided clinically and radiologically stable fixation through snug fit

  3. High origin of the deep femoral artery: a case report and literature review Origem alta da artéria femoral profunda: relato de caso e revisão da literatura

    Directory of Open Access Journals (Sweden)

    Vishal Kumar

    2011-09-01

    Full Text Available Arterial variations of the femoral triangle are rarely reported in the literature. In the present article, we have reported a case of high origin of the deep femoral artery, which was originating just lower to the inguinal ligament. It was also observed that the lateral circumflex femoral artery arose directly from the femoral artery instead from the deep femoral artery. We have discussed the anatomy, embryological basis, and clinical implications of these variations along with relevant literature review. The importance of knowledge about these variations in therapeutic and diagnostic interventions is discussed.Variações arteriais no triângulo femoral têm sido pouco relatadas na literatura. No presente artigo, relatou-se um caso de origem alta da artéria femoral profunda, que estava se originando pouco abaixo do ligamento inguinal. Também foi observado que a artéria femoral circunflexa originava-se diretamente da artéria femoral, ao invés de ser originada da artéria femoral profunda. Discutiu-se sobre anatomia, base embriológica e implicações clínicas dessas variações junto com uma revisão da literatura pertinente. A importância do conhecimento sobre essas variações no quadro das intervenções diagnósticas e terapêuticas é discutida.

  4. A novel method of removal of a broken drill bit in the femoral medullary canal during internal fixation of a type C distal femoral fracture: a case report

    Directory of Open Access Journals (Sweden)

    Mounasamy Varatharaj

    2012-11-01

    Full Text Available 【Abstract】 Breakage of surgical instruments and implants during operative procedures is not uncommon in any surgical discipline. The need for removal and the out-come of leaving the broken instruments and implants in the surgical area have not been described in detail. Few studies have suggested removal if they are lying loosely in the tis-sues or joint, close to neurovascular structures. Challenges and the amount of time spent in the retrieval of broken in-struments and implants are well known among surgeons, so most choose to leave them in situ. We reported a novel method of retrieval of a broken drill bit in the femoral medul-lary canal during internal fixation of a type C distal femoral fracture. Key words: Fracture fixation, internal; Femoral fractures; Surgical instruments

  5. Case report 549: Case 1: Ischemic necrosis femoral heads with pathological fracture right femur. Case 2: Ischemic necrosis femoral heads with fracture bilaterally

    International Nuclear Information System (INIS)

    Two cases have been presented in which ischemic necrosis was the cause of pathologic fractures of the femoral necks. Because these patients had primary malignancies that frequently seed in bone, metastatic disease was suspected to be responsible for the pathologic fractures. However, a history of use of corticosteroids and the absence of other skeletal lesions were the clues to the correct diagnosis in both cases. In Case 1, a patient with unilateral femoral head fracture, an MRI examination revealed ischemic necrosis in the asymptomatic contralateral hip. Currently, MRI and SPECT scanning are the most sensitive imaging methods for the diagnosis of ischemic necrosis. Ischemic necrosis should be considered in the differential diagnosis of pathological fracture of the femoral head when a patient has a history of predisposition for osteonecrosis. (orig.)

  6. Case report 549: Case 1: Ischemic necrosis femoral heads with pathological fracture right femur. Case 2: Ischemic necrosis femoral heads with fracture bilaterally

    Energy Technology Data Exchange (ETDEWEB)

    McGlade, C.T.; Bassett, L.W.; Mirra, J.; Gold, R.H. (California Univ., Los Angeles (USA). Dept. of Radiological Sciences)

    1989-07-01

    Two cases have been presented in which ischemic necrosis was the cause of pathologic fractures of the femoral necks. Because these patients had primary malignancies that frequently seed in bone, metastatic disease was suspected to be responsible for the pathologic fractures. However, a history of use of corticosteroids and the absence of other skeletal lesions were the clues to the correct diagnosis in both cases. In Case 1, a patient with unilateral femoral head fracture, an MRI examination revealed ischemic necrosis in the asymptomatic contralateral hip. Currently, MRI and SPECT scanning are the most sensitive imaging methods for the diagnosis of ischemic necrosis. Ischemic necrosis should be considered in the differential diagnosis of pathological fracture of the femoral head when a patient has a history of predisposition for osteonecrosis. (orig.).

  7. Simultaneous bilateral femoral neck fractures after electrical shock injury: a case report

    Institute of Scientific and Technical Information of China (English)

    Harminder Singh Sohal; Darsh Goyal

    2013-01-01

    Simultaneous bilateral fractures of the femoral necks are rare injuries,especially when there is no underlying pathological condition.We report a 20-year-old man who sustained bilateral femoral neck fractures resulting from an accidental electric shock with 440 Ⅴ direct current.Simultaneous bilateral femoral neck fractures after electrical shock injury without falling from a height are rather uncommon in clinic.The main cause of the fracture may be muscle contraction.This case highlights that even in the absence of primary and secondary bone disease,bilateral fractures of the femoral necks can occur following electric shock injury.We successfully managed this case with bilateral cannulated screw fixation without bone grafting.Surgeons caring for patients with electrical injury should be aware of the possibility of skeletal injuries which can go unnoticed,leading to delay in diagnosis and increased risk of complications.

  8. INCREASED CONCENTRATION OF NITRITE IN SYNOVIAL FLUID AND SERUM SAMPLES IN STEROID INDUCED FEMORAL HEAD NECROSIS

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    To investigate the role of nitric oxide (NO) in steroid-induced femoral head necrosis, NO production was measured indirectly as nitrite in serum and synovial fluid samples from patients with steroid-induced femoral head necrosis together with serum samples from healthy volunteers matched for age and sex. The results showed that:① serum nitrite concentration in patients with femoral head necrosis were significantly lower than that in controls (P<0.001); ② nitrite level of synovial fluid was markedly higher than that of serum. In addition, there was a positive correlation between them (r=0.378,P<0.05). We reach the conclusion:① NO is synthesized by synovium and chondrocytes; ② the decreased NO concentration in serum suggests a protective role in steroid-induced femoral head necrosis.

  9. [8-year experience in 40 patients with an axillary-femoral graft].

    Science.gov (United States)

    Bialostozky, L; Rish, L; Legaspi, R; Gutiérrez Bosque, R; Archundia, A; Morales, F; Oropeza, G

    1977-01-01

    The 8 years (1967-1975) experience with axillary-femoral and femoro-femoral grafts in 40 patients is presented; 6 females and 34 males, between 50 and 90 years of age, with arteriosclerosis, all complicated by chronic illnesses. The results have been satisfactory, as the grafts are functioning from 2 months to 80 months (6 years, 8 months), most of them being more than 12 months old. Twenty eight of the 40 patients operated are alive. Four patients (10%) had infection of their grafts. In 6 (15%) the graft closed because of severe progresive distal obstruction. Three patients (7.5%) died in the first 32 post-operative days. In 9 (22.5%) the deaths were not related to surgery. The indications for placement of axillary-femoral and femoro-femoral grafts is established.

  10. Balloon catheterization for hemostasis during the operation of ruptured femoral artery pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    SHI De-bing; FU Wei-guo; WANG Yu-qi; GUO Da-qiao; CHEN Bin; SHI Zhen-yu

    2007-01-01

    @@ Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations,especially for the patients with poor general health.

  11. Insufficiency fractures of the femoral head. Contribution of magnetic resonance imaging to the diagnosis

    International Nuclear Information System (INIS)

    Four insufficiency fractures of the femoral head were diagnosed in three women, including two under fluoride therapy. Pain at the root of the limb and a limp were the presenting symptoms. Serial roentgenograms failed to demonstrate epiphyseal sclerosis; flattening of the head was seen initially or as a residual anomaly in two cases. Radionuclide bone scans showed hyperactivity of the entire femoral head, with extension to the femoral neck in some instances, suggesting reflex sympathetic dystrophy and osteonecrosis. Magnetic resonance imaging (MRI) established the diagnosis by showing a linear area of decreased signal intensity on T1 and T2 images. The outcome was consistently favorable within one month of elimination of weight-bearing. The epiphyseal medullary anomalies visible on MRI displays resolved in every case. Residual flattening of the femoral head was seen in two cases. The two main differential diagnoses are reflex sympathetic dystrophy syndrome and osteonecrosis. (authors). 9 refs., 5 figs

  12. Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); UDIAT, c/ Parc Tauli, s/n, 08208 Sabadell (Barcelona) (Spain); Valls, Rafael [Servei de Diagnostic per Imatge, Unitat de Diagnostic d' Alta Tecnologia (UDIAT), Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Yuguero, Mariano [Servei de Traumatologia i Ortopedia, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain); Saez, Amparo [Servei de Anatomia Patologica, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2004-06-01

    We report a case of a mucoid degeneration of the anterior cruciate ligament (ACL) that produced osseous erosion of the medial aspect of the lateral femoral condyle. The MRI findings and differential diagnosis are discussed. (orig.)

  13. Total Hip Arthroplasty for Implant Rupture after Surgery for Atypical Subtrochanteric Femoral Fracture

    Directory of Open Access Journals (Sweden)

    Yu Ozaki

    2016-01-01

    Full Text Available Treatment methods for delayed union and nonunion of atypical femoral fracture are still controversial. Moreover, no treatment method has been established for implant rupture caused by delayed union and nonunion. We encountered a 74-year-old female in whom nonunion-induced implant rupture occurred after treatment of atypical subtrochanteric femoral fracture with internal fixation using a long femoral nail. It was unlikely that sufficient fixation could be obtained by repeating osteosynthesis alone. Moreover, the patient was elderly and early weight-bearing activity was essential for early recovery of ADL. Based on these reasons, we selected one-stage surgery with total hip arthroplasty and osteosynthesis with inverted condylar locking plate as salvage procedures. Bone union was achieved at 6 months after surgery. This case illustrated that osteosynthesis-combined one-staged total hip arthroplasty could be considered as one of the options for nonunion-induced implant rupture of atypical femoral subtrochanteric fracture.

  14. Atypical femoral neck stress fracture in a marathon runner: a case report and literature review.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: Femoral neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We present the case of a basicervical femoral neck stress fracture occurring in a 23-year-old marathon runner. The pathophysiology and practical management issues related to this unusual injury pattern are discussed. CONCLUSION: The growing interest in amateur athletic activities should raise the index of suspicion for stress fractures of the femoral neck in healthy adults with atypical hip pain. Increased levels of patient education and physician awareness can reduce the incidence of long-term morbidity in cases of this unusual sports-related injury.

  15. 'Femoral head necrosis' in metabolic and hormonal osteopathies

    Energy Technology Data Exchange (ETDEWEB)

    Heuck, F.H.W.; Treugut, H.

    1984-07-01

    The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. 90 refs.

  16. Low Temperature Preparation and Cold Manufacturing Techniques for Femoral Head of Al2O3 Ceramic

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The hip joint femoral head prosthesis was prepared using the Al2O3 material, which was synthesized by high purity alumina micro-powder and Mg- Zr- Y composite additives, the cold manufacturing techniques of lathe turning, grade polishing and the matching size correction of the sintered femoral head were studied. The results showed, after being pressed under 200 MPa cold isostatic pressure and being pre-sintered at 1 150 ℃, the biscuit' s strength can meet the demands of lathe turning; After being grade polished by SiC micro-powder and diamond abrading agent and being size corrected by special instruments, the femoral head prosthesis of Al2O3 ceramic has good surface degree of finish and articulates tightly with femoral handle.

  17. Avascular necrosis of the femoral head at 2 years after pertrochanteric fracture surgery: Case report

    Directory of Open Access Journals (Sweden)

    Bogdan Deleanu

    2016-02-01

    Conclusion: The avascular necrosis of the femoral head is a complication of pertrochanteric fractures that can not be foreseen or avoided. The optimal treatment in these cases is uncemented total hip arthroplasty.

  18. Optimising femoral-head osteochondral allograft transplantation in a preclinical model

    Directory of Open Access Journals (Sweden)

    Brett D. Crist

    2016-04-01

    Conclusion: These data provide initial translational and clinical evidence for large osteochondral allografts as a potential option for functional resurfacing of full-thickness cartilage defects of the femoral head.

  19. Multiple bony lesions other than femoral heads on {sup 99m}Tc-MDP bone scan in patients with avascular necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young; Yang, Seoung Oh; Moon, Dae Hyuk; Ryu, Jin Sook; Weon, Young Cheol; Shin, Myung Jin; Lee, Soo Ho; Lee, Hee Kyung [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Chun, Hae Kyung [St. Francisco Hospital, Seoul (Korea, Republic of)

    1997-03-01

    To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. One hundred and seventy three patients with clinical diagnosis of avascular necrosis of the emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of in volvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8%); the location of 79 lesions was other than the femoral head. This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to aveid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.

  20. Reuse of Occluded Veins During Permanent Pacemaker Lead Extraction: A New Indication for Femoral Lead Extraction

    OpenAIRE

    Staniforth, Andrew D; Schilling, Richard J

    2002-01-01

    Objectives: This study examined the utility of a novel technique for reuse of thrombosed veins when extracting permanent pacemaker leads via a femoral vein approach. Background: Although lead extraction permanent pacemaker using a femoral approach has advantages over the subclavian approach, it cannot be used to provide access for a new lead using currently employed techniques. This is important because up to 23% of patients have occluded veins after permanent pacemaker implantation. M...

  1. Cadaveric study: study of lateral circumflex femoral arterial origin in Rajkot

    Directory of Open Access Journals (Sweden)

    Pradip Rameshbhai Chauhan

    2015-05-01

    Full Text Available Background: Lateral circumflex femoral artery contributes cruciate, trochanteric and knee joint anastomosis. In addition Lateral circumflex femoral artery flaps are used for the reconstruction of large tissue loss in the head and neck region, aortopopliteal bypass, coronary artery bypass grafting and extracranial intracranial bypass surgery. This work was carried out (a to study the origin of lateral circumflex femoral artery and (b to measure and compare (between male and female the circumference at its origin. Methods: In this cross sectional study, 51 femoral triangles from 26 (18 male and 08 female human adult cadavers were dissected and studied at P.D.U. government medical college, Rajkot, Gujarat. Site of origin of lateral circumflex femoral artery was identified and noted. The distance of origin of the artery from the origin of profunda femoris artery was measured and noted. Circumference at the level of origin was measured and diameter was calculated. Collected data was analysed by standard statistical formulas with the help of Microsoft excel 2013 and Epi info 7TM software. Results: 90.19% lateral circumflex femoral arteries originated from the profunda femoris artery and remaining 9.81% from the femoral artery. The mean distance of origin of the artery from the origin of profunda femoris artery was 18.44 mm. Lateral circumflex femoral artery circumference and diameter were significantly different between male and female (95% confidence interval, P <0.05. Conclusion: In this presented study maximum distance of origin of the artery from the origin was 65 mm while minimum distance of origin was 6 mm. In addition difference in circumference of the artery was statistically significant. [Int J Res Med Sci 2015; 3(5.000: 1066-1069

  2. Incarcerated femoral hernia containing ovary and fallopian tube in a 54-year-old

    OpenAIRE

    Coyle, David; Kavanagh, Nora; Mahmoud, Akthar; Lowery, Aoife J.; Khan, Waqar; Barry, Kevin

    2011-01-01

    While accounting for a small proportion of groin hernias, femoral hernias have the greatest propensity to incarcerate and strangulate leading to significant morbidity and mortality. The authors present a case of a 54-year-old multiparous female presenting with a new firm painful left-sided groin lump for 1 day. Incarcerated femoral hernia was diagnosed clinically and open surgical repair was undertaken. At surgery a viable ovary and fallopian tube were found in the hernial sac and returned to...

  3. Evaluation of Short Term Outcomes of Transportal Femoral Cross Pin Fixation in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Zehir, Sinan; Şahin, Ercan; Çalbıyık, Murat; Kalem, Mahmut; İpek, Deniz; Songür, Murat

    2014-01-01

    Objectives: Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation. Methods: Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treate...

  4. A three-dimensional axis for the study of femoral neck orientation

    Science.gov (United States)

    Bonneau, Noémie; Libourel, Paul-Antoine; Simonis, Caroline; Puymerail, Laurent; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

    2012-01-01

    A common problem in the quantification of the orientation of the femoral neck is the difficulty to determine its true axis; however, this axis is typically estimated visually only. Moreover, the orientation of the femoral neck is commonly analysed using angles that are dependent on anatomical planes of reference and only quantify the orientation in two dimensions. The purpose of this study is to establish a method to determine the three-dimensional orientation of the femoral neck using a three-dimensional model. An accurate determination of the femoral neck axis requires a reconsideration of the complex architecture of the proximal femur. The morphology of the femoral neck results from both the medial and arcuate trabecular systems, and the asymmetry of the cortical bone. Given these considerations, two alternative models, in addition to the cylindrical one frequently assumed, were tested. The surface geometry of the femoral neck was subsequently used to fit one cylinder, two cylinders and successive cross-sectional ellipses. The model based on successive ellipses provided a significantly smaller average deviation than the two other models (P < 0.001) and reduced the observer-induced measurement error. Comparisons with traditional measurements and analyses on a sample of 91 femora were also performed to assess the validity of the model based on successive ellipses. This study provides a semi-automatic and accurate method for the determination of the functional three-dimensional femoral neck orientation avoiding the use of a reference plane. This innovative method has important implications for future studies that aim to document and understand the change in the orientation of the femoral neck associated with the acquisition of a bipedal gait in humans. Moreover, the precise determination of the three-dimensional orientation has implications in current research involved in developing clinical applications in diagnosis, hip surgery and rehabilitation. PMID:22967192

  5. Fixation of femoral capital physeal fractures with 7.0 mm cannulated screws in five bulls

    International Nuclear Information System (INIS)

    Salter-Harris type I fractures of the femoral capital physis were repaired in five Holstein bulls with three 7.0 mm cannulated screws placed in lag fashion. Radiographically at months 7 to 10, the fractures were healed and there was periarticular bone production on the femoral necks and the dorsal acetabular rims. Four bulls had normal gaits, and one bull had muscle atrophy and barely detectable lameness

  6. A case report of bilateral post irradiation femoral neck fractures with complicated clinical course

    International Nuclear Information System (INIS)

    A 65-year-old female patient had bilateral femoral neck fractures 2 years after radiotherapy with 6,000 rad of 60Co following radical surgery for cancer of the uterine cervix. She had replacement of bilateral artificial femoral necks. Since she developed infection in the deep site complicated by central dislocation one year and a half after replacement, the artificial necks were removed. (Namekawa, K.)

  7. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    OpenAIRE

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical...

  8. Maintenance of bone mineral density after implantation of a femoral neck hip prosthesis

    OpenAIRE

    Zurstegge Matthias; Rokahr Christoph; Decking Ralf; Simon Ulrich; Decking Jens

    2008-01-01

    Abstract Background Stress shielding of the proximal femur has been observed in a number of conventional cementless implants used in total hip arthroplasty. Short femoral-neck implants are claiming less interference with the biomechanics of the proximal femur. The goal of this study was to investigate the changes of bone-mineral density in the proximal femur and the clinical outcome after implantation of a short femoral-neck prosthesis. Methods We prospectively assessed the clinical outcome a...

  9. Treatment of 43 Cases of Lateral Femoral Cutaneous Neuritis with Pricking and Cupping Therapy

    Institute of Scientific and Technical Information of China (English)

    王秀珍; 朱冬霞; 洪珏

    2009-01-01

    @@ Lateral femoral cutaneous neuritis, also named as meralgia paresthetica or Roth syndrome, is marked by cutaneous pain or paresthesia such as formication or numbness in one or both thighs, which can be aggravated by prolonged standing or walking; it is also characterized by hypoesthesia or skin sensibility without muscular atrophy or dyskinesia. Forty-three cases of lateral femoral cutaneous neuritis have been treated by pricking and cupping therapy since 1996. Now it was reported as follows.

  10. Open Surgical Bypass for Superficial Femoral Artery Occlusion Caused by Blunt Trauma

    OpenAIRE

    Ikeda, Akihiko; Kudo, Yohei; Maeda, Michihiro; Tochiki, Aito; Ichimura, Haruto; Uesugi, Masafumi; Jikuya, Tomoaki

    2015-01-01

    Blunt vascular trauma of the lower extremities brings about a high amputation rate, because other organ injuries disturb revascularization. We experienced a case of a superficial femoral artery occlusion caused by blunt trauma. The patient also had a femoral bone fracture and a large skin defect with deep muscular injuries of the thigh. We performed a femoropopliteal (FP) bypass using a saphenous vein which was routed through the contaminated wound. Postoperative vacuum-assisted closure thera...

  11. STUDY ON NECK SHAFT ANGLE AND FEMORAL LENGTH OF SOUTH INDIAN FEMURS

    Directory of Open Access Journals (Sweden)

    Shakil Mohamad Khan

    2014-10-01

    Full Text Available Back ground: Femoral nek anteversion describes the angle subtended by the femoral neck with reference to the transcondylar plane of the distal end of the femur and is usually 15° to 45°. This along with the neck shaft angle, hip axis length, femoral neck width influence the risk of femoral neck fracture. Femoral neck anteversion angle has to be taken into consideration when reduction and fixation is selected as a method of treatment. Objectives: The objectives of present study to find out the measurements of Neck shaft angle, Femoral Length and Neck Length of femur. Materials and Methods: In present study have used 250 femurs from different colleges in south India. The following measurements were conducted Neck shaft angle, Femoral Length and Neck Length of femur. Results: The results of present study are the length of femur was 446.2+26.39mm, right femur was 446.6+26.66mm and left femur was 445.8+26.12mm, the Neck Length femur was 36.3+4.2mm, right femur was 36.1+4.1mm and left femur was 36.4+4.3m. the neck shaft angle of femur was 137.10 , right femur was 137.30 and left femur was 136.90. Conclusion: There is no significance difference between right and left femur measurements. Orthopaedists and Radiologists use the normal range and means of the neck shaft angle in the diagnosis and treatment of the disease of the hip. The angle is increased in congenital subluxation and dislocation of the hip, poliomyelitis, cerebral palsy and idiopathic scoliosis and decreased in the congenital coxavara , post traumatic coxa vara due to malunited femoral neck and inter trochanteric fractures.

  12. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

    OpenAIRE

    Narender Kumar Magu; Sarita Magu; Rajesh Kumar Rohilla; Amit Batra; Abhishek Jaipuria; Amanpreet Singh

    2014-01-01

    Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT) is a...

  13. Successful Ultrasound-Guided Femoral Nerve Blockade and Catheterization in a Patient with Von Willebrand Disease

    OpenAIRE

    DiStefano, Youmna E.; Lazar, Michael D.

    2015-01-01

    Peripheral nerve blockade (PNB) is superior to neuraxial anesthesia and/or opioid therapy for perioperative analgesia in total knee replacement (TKR). Evidence on the safety of PNB in patients with coagulopathy is lacking. We describe the first documented account of continuous femoral PNB for perioperative analgesia in a patient with Von Willebrand Disease (vWD). Given her history of opioid tolerance and after an informative discussion, a continuous femoral PNB was planned for in this 34-year...

  14. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    Science.gov (United States)

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results. PMID:27026955

  15. UNSTABLE FEMORAL FRACTURES TREATED WITH TITANIUM ELASTIC INTRAMEDULLARY NAILS, IN CHILDREN

    OpenAIRE

    Soni, Jamil Faissal; Schelle, Gisele; Valenza, Weverley; Pavelec, Anna Carolina; Souza, Camila Deneka Arantes

    2015-01-01

    Objective: To evaluate the indications, epidemiology, associated lesions, complications and prognosis among children with unstable femoral diaphysis fractures who were treated with titanium elastic intramedullary nails. Method: This was a retrospective analysis on 24 patients aged 5-12 years with unstable femoral diaphysis fractures who underwent surgical treatment with elastic titanium intramedullary nails at the Cajuru University Hospital, Curitiba-PR, between April 2002 and March 2008, wit...

  16. Femoroacetabular impingement: bone marrow oedema associated with fibrocystic change of the femoral head and neck junction

    Energy Technology Data Exchange (ETDEWEB)

    James, S.L.J. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom) and Department of Radiology, Royal Orthopaedic Hospital, Birmingham (United Kingdom)]. E-mail: jamesslj@email.com; Connell, D.A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); O' Donnell, P. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom); Saifuddin, A. [Department of Radiology, RNOH Stanmore, Stanmore, Middlesex (United Kingdom)

    2007-05-15

    Aim: To describe the association of bone marrow oedema adjacent to areas of fibrocystic change at the femoral head and neck junction in patients with femoroacetabular impingement. Materials and methods: The clinical and imaging findings in six patients with bone marrow oedema adjacent to an area of fibrocystic change at the femoral head and neck junction are presented. There were five males and one female (age range 19-42 years, mean age 34.5 years). Three patients were referred with a clinical suspicion of femoroacetabular impingement, two with suspected osteoid osteoma and one with a clinical diagnosis of sciatica. The volume of bone marrow oedema (grade 1: 0-25%, grade 2: 26-50%, grade 3: 51-75% and grade 4: 76-100% of the femoral neck width), presence of labral and articular cartilage abnormality, joint effusion, and femoral head and neck morphology were recorded. Results: Magnetic resonance imaging (MRI) identified fibrocystic change in the anterolateral aspect of the femoral head and neck junction in all cases (mean size 9 mm, range 5-14 mm, three multilocular and three unilocular cysts). The volume of oedema was variable (one grade 1, two grade 2, one grade 3 and two grade 4). All patients had abnormality of the anterosuperior labrum with five patients demonstrating chondral loss. An abnormal femoral head and neck junction was identified in five patients. Conclusion: The radiological finding of fibrocystic change at the anterosuperior femoral neck with or without bone marrow oedema should prompt the search for femoroacetabular impingement. Bone marrow oedema may rarely be identified adjacent to these areas of cystic change and should be considered in the differential diagnosis of bone marrow oedema in the femoral neck.

  17. Superplasticity in titanium alloys

    OpenAIRE

    J. Sieniawski; Motyka, M.

    2007-01-01

    Purpose: The paper reports characteristic of superplasticity phenomenon in titanium alloys and possibility of its applications.Design/methodology/approach: The main objective of the paper is to show features of superplastic forming of titanium alloys and current research trends aiming at widespread application of this technology.Findings: In the paper characteristic of selected superplastic titanium alloys was presented. The effect of microstructural parameters on superplasticity was consider...

  18. PLUTONIUM-ZIRCONIUM ALLOYS

    Science.gov (United States)

    Schonfeld, F.W.; Waber, J.T.

    1960-08-30

    A series of nuclear reactor fuel alloys consisting of from about 5 to about 50 at.% zirconium (or higher zirconium alloys such as Zircaloy), balance plutonium, and having the structural composition of a plutonium are described. Zirconium is a satisfactory diluent because it alloys readily with plutonium and has desirable nuclear properties. Additional advantages are corrosion resistance, excellent fabrication propenties, an isotropie structure, and initial softness.

  19. Logistic regression in estimates of femoral neck fracture by fall

    Directory of Open Access Journals (Sweden)

    Jaroslava Wendlová

    2010-04-01

    Full Text Available Jaroslava WendlováDerer’s University Hospital and Policlinic, Osteological Unit, Bratislava, SlovakiaAbstract: The latest methods in estimating the probability (absolute risk of osteoporotic fractures include several logistic regression models, based on qualitative risk factors plus bone mineral density (BMD, and the probability estimate of fracture in the future. The Slovak logistic regression model, in contrast to other models, is created from quantitative variables of the proximal femur (in International System of Units and estimates the probability of fracture by fall.Objectives: The first objective of this study was to order selected independent variables according to the intensity of their influence (statistical significance upon the occurrence of values of the dependent variable: femur strength index (FSI. The second objective was to determine, using logistic regression, whether the odds of FSI acquiring a pathological value (femoral neck fracture by fall increased or declined if the value of the variables (T–score total hip, BMI, alpha angle, theta angle and HAL were raised by one unit.Patients and methods: Bone densitometer measurements using dual energy X–ray absorptiometry (DXA, (Prodigy, Primo, GE, USA of the left proximal femur were obtained from 3 216 East Slovak women with primary or secondary osteoporosis or osteopenia, aged 20–89 years (mean age 58.9; 95% CI: −58.42; 59.38. The following variables were measured: FSI, T-score total hip BMD, body mass index (BMI, as were the geometrical variables of proximal femur alpha angle (α angle, theta angle (θ angle, and hip axis length (HAL.Statistical analysis: Logistic regression was used to measure the influence of the independent variables (T-score total hip, alpha angle, theta angle, HAL, BMI upon the dependent variable (FSI.Results: The order of independent variables according to the intensity of their influence (greatest to least upon the occurrence of values of the

  20. Stem Cell Networks

    OpenAIRE

    Werner, Eric

    2016-01-01

    We present a general computational theory of stem cell networks and their developmental dynamics. Stem cell networks are special cases of developmental control networks. Our theory generates a natural classification of all possible stem cell networks based on their network architecture. Each stem cell network has a unique topology and semantics and developmental dynamics that result in distinct phenotypes. We show that the ideal growth dynamics of multicellular systems generated by stem cell ...