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Sample records for arthroplasty devices influence

  1. Factors Influencing Range of Motion after Total Knee Arthroplasty

    OpenAIRE

    H Farahini; Moghtadaei, M; Bagheri, A; Akbarian, E

    2012-01-01

    Background The range of motion after a total knee arthroplasty is an important clinical outcome affecting the life of the patient. The aim of this study was to determine the most important factors influencing the postoperative knee flexion in Tehran, Iran. Methods Between July 2007 and January 2009, on 95 cases of total knee joint replacement (89 patients), who were followed for 1 year postoperatively, the risk factors were assessed. Patient demographics (sex, age, body mass index, previous s...

  2. Nucleus disc arthroplasty with the NUBAC™ device: 2-year clinical experience

    OpenAIRE

    Balsano, M.; Zachos, A.; Ruggiu, A.; Barca, F.; Tranquilli-Leali, P.; Doria, C.

    2011-01-01

    Low back pain (LBP) due to degenerative disc disease (DDD) is a common condition that can be treated along a continuum of care: from conservative therapies to several surgical choices. Nucleus arthroplasty is an emerging technology that could potentially fill part of the gap in the spine continuum of care. The introduction of recent technologies that allow the replacement of the degenerated disc nucleus using prosthetic devices may be considered an additional therapeutic tool that can be used...

  3. A new device used in the restoration of kinematics after total facet arthroplasty

    Directory of Open Access Journals (Sweden)

    Vermesan D

    2014-05-01

    Full Text Available D Vermesan,1 R Prejbeanu,1 C Vlad Daliborca,1 H Haragus,1 M Magureanu,2 M Marrelli,3–5 L Promenzio,4 M Caprio,6 R Cagiano,6,* M Tatullo3,5,* 1Victor Babes University of Medicine and Pharmacy, Timisoara, 2Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 3Maxillofacial Unit, Dental Center Calabrodental, 4Orthopedics and Traumatology Unit, Marrelli Hospital, 5Biomedical Section, Tecnologica Research Institute, Crotone, 6Department of Biomedical Sciences and Human Oncology, Medical Faculty, Aldo Moro University of Bari, Bari, Italy *These authors contributed equally to this work Abstract: Facet degeneration can lead to spinal stenosis and instability, and often requires stabilization. Interbody fusion is commonly performed, but it can lead to adjacent-segment disease. Dynamic posterior stabilization was performed using a total facet arthroplasty system. The total facet arthroplasty system was originally intended to restore the natural motion of the posterior stabilizers, but follow-up studies are lacking due to limited clinical use. We studied the first 14 cases (long-term follow-up treated with this new device in our clinic. All patients were diagnosed with lumbar stenosis due to hypertrophy of the articular facets on one to three levels (maximum. Disk space was of normal height. The design of this implant allows its use only at levels L3–L4 and L4–L5. We implanted nine patients at the L4–L5 level and four patients at level L3–L4. Postoperative follow-up of the patients was obtained for an average of 3.7 years. All patients reported persistent improvement of symptoms, visual analog scale score, and Oswestry Disability Index score. Functional scores and dynamic radiographic imaging demonstrated the functional efficacy of this new implant, which represents an alternative technique and a new approach to dynamic stabilization of the vertebral column after interventions for spine decompression. The total facet arthroplasty

  4. Placing a price on medical device innovation: the example of total knee arthroplasty.

    Directory of Open Access Journals (Sweden)

    Lisa G Suter

    Full Text Available BACKGROUND: Total knee arthroplasty (TKA is common, effective, and cost-effective. Innovative implants promising reduced long-term failure at increased cost are under continual development. We sought to define the implant cost and performance thresholds under which innovative TKA implants are cost-effective. METHODS: We performed a cost-effectiveness analysis using a validated, published computer simulation model of knee osteoarthritis. Model inputs were derived using published literature, Medicare claims, and National Health and Nutrition Examination Survey data. We compared projected TKA implant survival, quality-adjusted life expectancy (QALE, lifetime costs, and cost-effectiveness (incremental cost-effectiveness ratios or ICERs of standard versus innovative TKA implants. We assumed innovative implants offered 5-70% decreased long-term TKA failure rates at costs 20-400% increased above standard implants. We examined the impact of patient age, comorbidity, and potential increases in short-term failure on innovative implant cost-effectiveness. RESULTS: Implants offering ≥50% decrease in long-term TKA failure at ≤50% increased cost offered ICERs <$100,000 regardless of age or baseline comorbidity. An implant offering a 20% decrease in long-term failure at 50% increased cost provided ICERs <$150,000 per QALY gained only among healthy 50-59-year-olds. Increasing short-term failure, consistent with recent device failures, reduced cost-effectiveness across all groups. Increasing the baseline likelihood of long-term TKA failure among younger, healthier and more active individuals further enhanced innovative implant cost-effectiveness among younger patients. CONCLUSIONS: Innovative implants must decrease actual TKA failure, not just radiographic wear, by 50-55% or more over standard implants to be broadly cost-effective. Comorbidity and remaining life span significantly affect innovative implant cost-effectiveness and should be considered in the

  5. Metal-on-metal bearings in total hip arthroplasties : Influence of cobalt chromium ions on bacterial growth and biofilm formation

    NARCIS (Netherlands)

    Hosman, Anton H.; van der Mei, Henny C.; Bulstra, Sjoerd K.; Busscher, Henk J.; Neut, Danielle

    2009-01-01

    Metal-on-metal (MOM) bearings involving cobalt-chromium (Co-Cr) alloys in total hip arthroplasties are becoming more and more popular due to their low wear. Consequences of corrosion products of Co-Cr alloys are for the most part unclear, and the influence of cobalt and chromium ions on biofilm form

  6. The influence of heterotopic ossification on functional status of hip joint following total hip arthroplasty

    International Nuclear Information System (INIS)

    Purpose: The functional failure induced by heterotopic ossification (HO) following total hip arthroplasty (THA) was analyzed and correlated to the radiologic failure. Patients and methods: From July 1997 to July 2001, 315 patients (345 hips) received THA indicated by a hypertrophic osteoarthritis of higher degree (Kellgren grade III, IV). All patients were irradiated prophylactically for prevention of HO on the evening before surgery with a 7-Gy single fraction. The patients' median age was 66.3 years. Radiologic failure was assessed by comparison of pre- and postoperative hip X-rays (immediately and 6 months after surgery). Analysis of radiographs was performed according to the Brooker Score. Clinical failure was appraised by measurement of passive range of motion (ROM) of the hip joint with a standard goniometer. The t-test was used for statistical analysis. Results: 281 patients (81.5%) did not develop HO. HO of Brooker grade I or II was found in 58 patients (16.8%). Six patients (1.7%) developed HO Brooker grade III or IV. There was a significant negative correlation between the degree of radiologic and clinical failure. ROM differed significantly between patients with HO Brooker grade 0, I, II and patients with HO Brooker grade III, IV. Comparing the pre- and postoperative ROM, all patients with Brooker grade 0, I and II showed a significant improvement of flexion, internal and external rotation, abduction and adduction movement. Patients with HO Brooker grade III and IV showed no improvement of ROM in the postoperative follow-up. Conclusion: The development of HO following THA influences the physical function of the hip joint dependent on the degree of ossification. HO of lower degree (Brooker I, II) does not influence the clinical outcome, whereas HO of higher degree (Brooker III, IV) reduces the function of hip arthroplasty. Therefore, the purpose of a prophylactic therapy must be to reduce HO of higher degree. (orig.)

  7. Cost effectiveness of total hip arthroplasty in osteoarthritis: comparison of devices with differing bearing surfaces and modes of fixation.

    Science.gov (United States)

    Pulikottil-Jacob, R; Connock, M; Kandala, N-B; Mistry, H; Grove, A; Freeman, K; Costa, M; Sutcliffe, P; Clarke, A

    2015-04-01

    Many different designs of total hip arthroplasty (THA) with varying performance and cost are available. The identification of those which are the most cost-effective could allow significant cost-savings. We used an established Markov model to examine the cost effectiveness of five frequently used categories of THA which differed according to bearing surface and mode of fixation, using data from the National Joint Registry for England and Wales. Kaplan-Meier analyses of rates of revision for men and women were modelled with parametric distributions. Costs of devices were provided by the NHS Supply Chain and associated costs were taken from existing studies. Lifetime costs, lifetime quality-adjusted-life-years (QALYs) and the probability of a device being cost effective at a willingness to pay £20 000/QALY were included in the models. The differences in QALYs between different categories of implant were extremely small (< 0.0039 QALYs for men or women over the patient's lifetime) and differences in cost were also marginal (£2500 to £3000 in the same time period). As a result, the probability of any particular device being the most cost effective was very sensitive to small, plausible changes in quality of life estimates and cost. Our results suggest that available evidence does not support recommending a particular device on cost effectiveness grounds alone. We would recommend that the choice of prosthesis should be determined by the rate of revision, local costs and the preferences of the surgeon and patient. PMID:25820881

  8. Does location of patellofemoral chondral lesion influence outcome after Oxford medial compartmental knee arthroplasty?

    Science.gov (United States)

    Konan, S.; Haddad, F. S.

    2016-01-01

    Aims Medial unicompartmental knee arthroplasty (UKA) is associated with successful outcomes in carefully selected patient cohorts. We hypothesised that severity and location of patellofemoral cartilage lesions significantly influences functional outcome after Oxford medial compartmental knee arthroplasty. Patients and Methods We reviewed 100 consecutive UKAs at minimum eight-year follow-up (96 to 132). A single surgeon performed all procedures. Patients were selected based on clinical and plain radiographic assessment. All patients had end-stage medial compartment osteoarthritis (OA) with sparing of the lateral compartment and intact anterior cruciate ligaments. None of the patients had end-stage patellofemoral OA, but patients with anterior knee pain or partial thickness chondral loss were not excluded. There were 57 male and 43 female patients. The mean age at surgery was 69 years (41 to 82). At surgery the joint was carefully inspected for patellofemoral chondral loss and this was documented based on severity of cartilage loss (0 to 4 Outerbridge grading) and topographic location (medial, lateral, central, and superior or inferior). Functional scores collected included Oxford Knee Score (OKS), patient satisfaction scale and University College Hospital (UCH) knee score. Intraclass correlation was used to compare chondral damage to outcomes. Results All patients documented significant improvement in pain and improved functional scores at mid-term follow-up. There were four revisions (mean 2.9 years, 2 to 4; standard deviation (sd) 0.9) in this cohort, three for tibial loosening and one for femoral loosening. There was one infection that was treated with debridement and insert exchange. The mean OKS improved from 23.2 (sd 7.1) to 39.1 (sd 6.9); p < 0.001. The cohort with central and lateral grade 3 patellofemoral OA documented lower mean satisfaction with pain (90, sd 11.8) and function (87.5, sd 10.3) on the patient satisfaction scale. On the UCH scale, patients

  9. Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-xin; GUO Sheng-jie; LIU Qing; TANG Jing; LI Yu-jun

    2009-01-01

    Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.

  10. Does BMI influence hospital stay and morbidity after fast-track hip and knee arthroplasty?

    DEFF Research Database (Denmark)

    Husted, Henrik; Jørgensen, Christoffer C.; Gromov, Kirill;

    2016-01-01

    patients only) was associated with a LOS of >4 days (p = 0.001), but not with re-admission. No such relationship existed for TKA. Interpretation - A fast-track setting resulted in similar length of hospital stay and re-admission rates regardless of BMI, except for very obese and morbidly obese THA patients.......Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality....... Complete 90-day follow-up was achieved using national registries and review of medical records. Patients were grouped according to BMI as being underweight, of normal weight, overweight, obese, very obese, and morbidly obese. Results - Median length of stay (LOS) was 2 (IQR: 2-3) days in all BMI groups. 30...

  11. Trochanteric fractures in the elderly: the influence of primary hip arthroplasty on 1-year mortality

    OpenAIRE

    Geiger, Florian; Zimmermann-Stenzel, Monique; Heisel, Christian; Lehner, Burkhard; Daecke, Wolfgang

    2007-01-01

    Introduction The aim of the study was to compare the mortality risk and complication rate after operative treatment of pertrochanteric fractures with primary arthroplasty, dynamic hip screw (DHS) or proximal femoral nail (PFN). Patients and methods Clinical records including X-rays of all patients with trochanteric femoral fractures, except pathologic fractures and a minimum age of 60 years, which were treated between 1992 and 2005 were entered in this retrospective study. Of these 283 patien...

  12. Arthroplasty register for Germany

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2009-10-01

    /or hospitals, provide annual reports and publish scientific articles and/or presentations. The effects of the arthroplasty registers on clinical practice and on health political decisions in the time after the introduction of these registers are documented in some countries. The influence on cost savings for health services is also reported. Discussion: The most important legal and ethical aspect is the patient’s data protection and, therefore, the requirement of patient’s consent. The involvement of the physicians in the data collection process is a further organisational and legal challenge. The 100% data collection, which is the aim of the registers due to their definition, should not cause disadvantages for certain groups of patients.ConclusionThe arthroplasty registers have a large medical and health-economic potential. Aspects of the patient’s data protection and the guaranteed financial support of the registers should be clarified before the introduction of a register.

  13. The influence of metallic shell deformation on the contact mechanics of a ceramic-on-ceramic total hip arthroplasty.

    Science.gov (United States)

    Qiu, Changdong; Wang, Ling; Li, Dichen; Jin, Zhongmin

    2016-01-01

    Total hip arthroplasty of ceramic-on-ceramic bearing combinations is increasingly used clinically. The majority of these implants are used with cementless fixation that a metal-backing shell is press-fitted into the pelvic bone. This usually results in the deformation of the metallic shell, which may also influence the ceramic liner deformation and consequently the contact mechanics between the liner and the femoral head under loading. The explicit dynamic finite element method was applied to model the implantation of a cementless ceramic-on-ceramic with a titanium shell and subsequently to investigate the effect of the metallic shell deformation on the contact mechanics. A total of three impacts were found to be necessary to seat the titanium alloy shell into the pelvic bone cavity with a 1 mm diameter interference and a 1.3 kg impactor at 4500 mm s(-1) velocity. The maximum deformation of the metallic shell was found to be 160 µm in the antero-superior and postero-inferior direction and 97 µm in the antero-inferior and postero-superior direction after the press-fit. The corresponding values were slightly reduced to 67 and 45 µm after the ceramic liner was inserted and then modified to 74 and 43 µm under loading, respectively. The maximum deformation and the maximum principal stress of the ceramic liner were 31 µm and 144 MPa (tensile stress), respectively, after it was inserted into the shell and further increased to 52 µm and 245 MPa under loading. This research highlights the importance of the press-fit of the metallic shell on the contact mechanics of the ceramic liner for ceramic-on-ceramic total hip arthroplasties and potential clinical performances.

  14. Cervical Total Disc Arthroplasty

    OpenAIRE

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc...

  15. Systematic review: Do patient expectations influence treatment outcomes in total knee and total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Haanstra Tsjitske M

    2012-12-01

    Full Text Available Abstract Objective This systematic review aims to summarise all the available evidence related to the association between pre-operative patient expectations (outcome expectations, process expectations and self efficacy expectations and 5 different treatment outcomes (overall improvement, pain, function, stiffness and satisfaction in patients with total knee or total hip arthroplasty at three different follow-op periods (>6 weeks; >6 weeks- ≤6 months; >6 months. Methods English and Dutch language articles were identified through PubMed, EMBASE.com, PsycINFO, CINAHL and The Cochrane Library from inception to September 2012. Articles assessing the association between pre-operative patient expectations and treatment outcomes for TKA/THA in either adjusted or unadjusted analysis were included. Two reviewers, working independently, determined eligibility, rated methodological quality and extracted data on study design, population, expectation measurements, outcome measurements and strength of the associations. Methodological quality was rated by the same reviewers on a 19 item scale. The scores on the quality assessment were taken into account when drawing final conclusions. Results The search strategy generated 2252 unique references, 18 articles met inclusion criteria. Scores on the methodological quality assessment ranged between 6% and 79%. Great variety was seen in definitions and measurement methods of expectations. No significant associations were found between patient expectations and overall improvement, satisfaction and stiffness. Both significant positive and non-significant associations were found for the association between expectations and pain and function. Conclusions There was no consistency in the association between patients’ pre-operative expectations and treatment outcomes for TKA and THA indentified in this systematic review. There exists a need for a sound theoretical framework underlying the construct of

  16. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  17. Total ankle arthroplasty: An imaging overview

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Da Rae; Choi, Yun Sun; Chun, Ka Young; Jung, Yoon Young; Kim, Jin Su; Young, Ki Won [Eulji Hospital, Eulji University, Seoul (Korea, Republic of); Potter, Hollis G.; Li, Angela E. [Dept. of Radiology and Imaging, Hospital for Special Surgery, New York (United States)

    2016-06-15

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  18. Total Ankle Arthroplasty: An Imaging Overview.

    Science.gov (United States)

    Kim, Da-Rae; Choi, Yun Sun; Potter, Hollis G; Li, Angela E; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice.

  19. Linewidth influence in photonics logic device

    OpenAIRE

    Vivero Palmer, Tania Rosa; González Marcos, Ana; Martín Pereda, José Antonio

    2007-01-01

    Photonics logic devices are currently finding applications in most of the fields where optical signals are employed. These areas range from optical communications to optical computing, covering as well as other applications in photonics sensing and metrology. Most of the proposed configurations with photonics logic devices are based on semiconductor laser structures with “on/off” behaviors, operating in an optical amplifier configuration. They are able to offer non-linear gain or bistable ope...

  20. The Influence of Postoperative Tibiofemoral Alignment on the Clinical Results of Unicompartmental Knee Arthroplasty

    OpenAIRE

    Kim, Kyung Tae; Lee, Song; Kim, Tae Woo; Lee, Jung Soo; Boo, Kyung Hwan

    2012-01-01

    Purpose To evaluate the influence of postoperative tibiofemoral alignment on the clinical results and failure in patients who underwent unicompartmental knee athroplasty (UKA). Materials and Methods We reviewed 246 cases of medial UKA which were followed up for at least 5 years after the operation. The clinical results were compared between 5 groups classified according to the tibiofemoral angle that was measured at 3 months after surgery. We analyzed the relationship between the tibiofemoral...

  1. No influence of immigrant background on the outcome of total hip arthroplasty

    OpenAIRE

    Krupic, Ferid; Eisler, Thomas; Eliasson, Tore; Garellick, Göran; Gordon, Max; Kärrholm, Johan

    2013-01-01

    Background and purpose Total Hip Replacement (THA) is one of the most successful and cost-effective operations. Despite its benefits, marked ethnic differences in the utilization of THA are well documented. However, very little has been published on the influence of ethnicity on outcome. We investigate whether the outcome—in terms of reoperation within 2 years or revision up to 14 years after the primary operation—varies depending on ethnic background. Methods Records of total hip arthroplast...

  2. Finite Element Analysis of Mobile-bearing Unicompartmental Knee Arthroplasty: The Influence of Tibial Component Coronal Alignment

    Institute of Scientific and Technical Information of China (English)

    Guang-Duo Zhu; Wan-Shou Guo; Qi-Dong Zhang; Zhao-Hui Liu; Li-Ming Cheng

    2015-01-01

    Background:Controversies about the rational positioning of the tibial component in unicompartmental knee arthroplasty (UKA) still exist.Previous finite element (FE) studies were rare,and the results varied.This FE study aimed to analyze the influence of the tibial component coronal alignment on knee biomechanics in mobile-bearing UKA and find a ration range of inclination angles.Methods:A three-dimensional FE model of the intact knee was constructed from image data of one normal subject.A 1000 N compressive load was applied to the intact knee model for validating.Then a set of eleven UKA FE models was developed with the coronal inclination angles of the tibial tray ranging from l0° valgus to 10° varus.Tibial bone stresses and strains,contact pressures and load distribution in all UKA models were calculated and analyzed under the unified loading and boundary conditions.Results:Load distribution,contact pressures,and contact areas in intact knee model were validated.In UKA models,von Mises stress and compressive strain at proximal medial cortical bone increased significantly as the tibial tray was in valgus inclination >4°,which may increase the risk of residual pain.Compressive strains at tibial keel slot were above the high threshold with varus inclination >4°,which may result in greater risk of component migration.Tibial bone resection comer acted as a strain-raiser regardless of the inclination angles.Compressive strains at the resected surface slightly changed with the varying inclinations and were not supposed to induce bone resorption and component loosening.Contact pressures and load percentage in lateral compartment increased with the more varus inclination,which may lead to osteoarthritis progression.Conclusions:Static knee biomechanics after UKA can be greatly affected by tibial component coronal alignment.A range from 4° valgus to 4° varus inclination of tibial component can be recommended in mobile-bearing UKA.

  3. SHOULDER ARTHROPLASTY RECORDS

    Science.gov (United States)

    Filho, Geraldo Motta; Galvão, Marcus Vinicius; Monteiro, Martim; Cohen, Marcio; Brandão, Bruno

    2015-01-01

    The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. Methodology: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. Results: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus fracture. 12% of the cases required total arthroplasties and 88% partial arthroplasties. Five major complications were observed on early postoperative period. Conclusion: Shoulder arthroplasties have become a common procedure in orthopaedic practice. Surgical records are important in evidencing progressive evolution and in enabling future clinical outcomes evaluation. PMID:26998463

  4. Bicompartmental knee arthroplasty

    OpenAIRE

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect o...

  5. Influence of the pneumatic tourniquet on patella tracking in total knee arthroplasty: a prospective randomized study in 100 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Toftgaard Jensen, T

    2005-01-01

    One hundred consecutive patients with osteoarthritis of the knee joint and scheduled for primary total knee arthroplasty performed in a bloodless field were prospectively randomized to have the tourniquet inflated on either straight leg or maximally flexed knee. There was no difference in the...... number of lateral releases between the groups, and position of the knee in maximal flexion during inflation of the tourniquet did not decrease the number of lateral releases. There was no difference in clinical or radiological patella tracking between groups. If the patella was maltracking, tourniquet...... deflation led to better patella tracking and saved 5 (31%) of 16 releases with no difference between groups. We recommend tourniquet deflation and reevaluation of patella tracking before performing lateral release in patellar maltracking....

  6. Influence of different DXA acquisition modes on monitoring the changes in bone mineral density after hip resurfacing arthroplasty.

    Science.gov (United States)

    Hakulinen, Mikko A; Borg, Håkan; Häkkinen, Arja; Parviainen, Tapani; Kiviranta, Ilkka; Jurvelin, Jukka S

    2012-01-01

    Dual-energy X-ray absorptiometry (DXA) is a technique enabling the measurement of bone mineral density (BMD) around prostheses after hip resurfacing arthroplasty (HRA). In this study, we evaluated the consistency of different DXA acquisition modes with 33 patients who had undergone HRA. Patients were scanned with DXA immediately after surgery and at 3-, 6-, and 12-mo time points. All the patients were scanned with dual femur and orthopedic hip acquisition modes and analyzed using 10-region ROI model. With both acquisition modes, a statistically significant decrease (p<0.05, Wilcoxon's test) in BMD at 3mo was revealed in 3 ROIs, located to upper and lateral upper femur. Both acquisition modes detected similarly (p<0.01) preservation of the femoral bone stock within 12mo in all but 1 ROI. The applied acquisition protocols involved the use of different footplates for hip fixation. Because the differences between acquisition modes ranged between +1.6% and -7.1% and the reproducibility of BMD values can vary by as much as 28% due to hip rotation, it is proposed that both dual femur and orthopedic hip acquisition modes can be used to monitor the changes in BMD after HRA. However, the same hip rotation is recommended for all DXA measurements.

  7. [Sport activity after hip and knee arthroplasty].

    Science.gov (United States)

    Keren, Amit; Berkovich, Yaron; Berkovitch, Yaron; Soudry, Michael

    2013-11-01

    Joint arthroplasty is one of the commonest surgical procedures in orthopedic surgery. In recent years there was an increase in the number of procedures, patient satisfaction and implant survival. Originally, these operations were designed for old patients in order to relieve pain and to enable ambulation. Over the past few years, these operations have become common in younger patients which desire to return to activity, including sports activities. The importance of physical activity is a well known fact. In recent years it became clear that with the proper physical activity the outcomes of the operations are better. There are several types of arthroplasty. Many factors influence the outcome of the operation apart from the post-surgery physical activity. These factors include patient factors, surgical technique and type of arthroplasty. This review summarizes the recommendations for sports activities after hip and knee arthroplasties. These activities are evaluated according to surgeons' recommendations, stress applied on the implant and long term outcomes. The recommended sports activities after joint arthroplasties are walking, swimming and cycling. Soccer, basketball and jogging are not advised. Tennis, downhill skiing and horse riding are recommended with previous experience. There are many more sports activities that patients can participate in, and it is important that the patient discuss the different options prior to the operation. Since these operations are so common, many non-orthopedic physicians encounter these patients in their practice. They should be acquainted with the recommendations for sports activities and encourage them. PMID:24416822

  8. The influence of total knee arthroplasty geometry on mid-flexion stability: an experimental and finite element study.

    Science.gov (United States)

    Clary, Chadd W; Fitzpatrick, Clare K; Maletsky, Lorin P; Rullkoetter, Paul J

    2013-04-26

    Fluoroscopic evaluation of total knee arthroplasty (TKA) has reported sudden anterior translation of the femur relative to the tibia (paradoxical anterior motion) for some cruciate-retaining designs. This motion may be tied to abrupt changes in the femoral sagittal radius of curvature characteristic of traditional TKA designs, as the geometry transitions from a large load-bearing distal radius to a smaller posterior radius which can accommodate femoral rollback. It was hypothesized that a gradually reducing radius may attenuate sudden changes in anterior-posterior motion that occur in mid-flexion with traditional discrete-radius designs. A combined experimental and computational approach was employed to test this hypothesis. A previously developed finite element (FE) model of the Kansas knee simulator (KKS), virtually implanted with multiple implant designs, was used to predict the amount of paradoxical anterior femoral slide during a simulated deep knee bend. The model predicted kinematics demonstrated that incorporating a gradually reducing radius in mid-flexion reduced the magnitude of paradoxical anterior translation between 21% and 68%, depending on the conformity of the tibial insert. Subsequently, both a dual-radius design and a modified design incorporating gradually reducing radii were tested in vitro in the KKS for verification. The model-predicted and experimentally observed kinematics exhibited good agreement, while the average experimental kinematics demonstrated an 81% reduction in anterior translation with the modified design. The FE model demonstrated sufficient sensitivity to appropriately differentiate kinematic changes due to subtle changes in implant design, and served as a useful pre-clinical design-phase tool to improve implant kinematics. PMID:23499227

  9. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... stability and soft tissue envelope. In the early days of reverse arthroplasty, it used to be said ... often we'll drain these patients for a day to try to prevent hematoma formation, especially in ...

  10. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... to conventional arthroplasty, we often use a subscap soft tissue takedown, rather than an osteotomy because of concerns ... the tendon. We've learned that this anterior soft tissue repair is critical for the stability of the ...

  11. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... here in New York to bring you a video of a recent case of reverse shoulder arthroplasty ... helped design the system that's shown in this video, so I receive royalties and therefore have a ...

  12. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... a friction bite that if you try to work it around the corner, you can get an ... stability and soft tissue envelope. In the early days of reverse arthroplasty, it used to be said ...

  13. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... case of reverse shoulder arthroplasty for cuff deficient arthritis. You should be aware that I helped design ... in the last decade for cuff deficient shoulder arthritis in the United States. The indications are a ...

  14. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available ... for sort of common cuff arthroplasty in an elderly thin patient where the head is already rising ... cement this case, because in the typical osteoporotic elderly patient with cuff arthropathy, we would do a ...

  15. Imaging of hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T., E-mail: millertt@hss.edu [Department of Radiology and Imaging, Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 (United States)

    2012-12-15

    The imaging evaluation of the prosthetic hip begins with radiography, but arthrography, aspiration, scintigraphy, sonography, CT and MR imaging all have roles in the evaluation of the painful prosthesis. This article will review the appearance of normal hip arthroplasty including hemiarthroplasty, total arthroplasty, and hip resurfacing, as well as the appearances of potential complications such as aseptic loosening and osteolysis, dislocation, infection, periprosthetic fracture, hardware failure, and soft tissue abnormalities.

  16. Arthroplasty register for Germany

    OpenAIRE

    Hagen, Anja; Gorenoi, Vitali; Schönermark, Matthias P.

    2009-01-01

    Scientific background The annual number of joint replacement operations in Germany is high. The introduction of an arthroplasty register promises an important contribution to the improvement of the quality of patient's care. Research questions The presented report addresses the questions on organization and functioning, benefits and cost-benefits as well as on legal, ethical and social aspects of the arthroplasty registers. Methods A systematic literature search ...

  17. Bipolar hip arthroplasty.

    Science.gov (United States)

    Chang, Qing; Liu, Shubing; Guan, Changyong; Yu, Fangyuan; Wu, Shenguang; Jiang, Changliang

    2011-12-01

    Our aim was to compare hip arthroplasty with internal screw fixation in the repair of intertrochanteric fractures in elderly patients with osteoporosis. Of 112 included patient, 70 (81.81 ± 4.88 years) received hip arthroplasty with a prosthesis specially designed for intertrochanteric fractures, and 42 (83.46 ± 5.11 years) underwent plate-screw fixation. The hip arthroplasty group had significantly longer operation time, intraoperative blood loss, and total volume of blood transfused but had shorter time to beginning weight-bearing (5.94 ± 2.76 vs 23.68 ± 22.01 days) and higher postoperative Harris hip score (91.37 ± 4.80 vs 86.14 ± 5.46). In the arthroplasty group, there were 2 dislocations; and in the plate-screw fixation group, there were 5 internal fixation failures. Hip arthroplasty is preferable to internal fixation in elderly patients (age >80 years) with osteoporosis. PMID:21530148

  18. Influence of material quality and process-induced defects on semiconductor device performance and yield

    Science.gov (United States)

    Porter, W. A.; Mckee, W. R.

    1974-01-01

    An overview of major causes of device yield degradation is presented. The relationships of device types to critical processes and typical defects are discussed, and the influence of the defect on device yield and performance is demonstrated. Various defect characterization techniques are described and applied. A correlation of device failure, defect type, and cause of defect is presented in tabular form with accompanying illustrations.

  19. Bicompartmental knee arthroplasty.

    Science.gov (United States)

    Sabatini, Luigi; Giachino, Matteo; Risitano, Salvatore; Atzori, Francesco

    2016-01-01

    Total knee arthroplasty (TKA) is the most worldwide practiced surgery for knee osteoarthritis and its efficacy is mightily described by literature. Concerns about the invasiveness of TKA let the introduction of segmental resurfacing of the joint for younger patients with localized osteoarthritis. Bone stock sparing and ligaments preservation are the essence of both unicompartmental knee arthroplasty (UKA) and bicompartmental knee arthroplasty (BKA). Advantages related to BKA are the respect of knee biomechanics, lower complications rates, shorter hospital stay, faster rehabilitation. Moreover, in case of failure of the first implant the conversion to TKA is undemanding and can be compared to a standard prosthesis. Our experience suggest that BKA is a reliable technique in selected cases and especially younger people with higher functional requests can favourably profit from it. Although those results are encouraging, we still need further prospective, randomized, long-term studies to finally assess BKA indications and outcomes. PMID:26855941

  20. Influence of the tibial stem design on bone density after cemented total knee arthroplasty: a prospective seven-year follow-up study.

    Science.gov (United States)

    Hernandez-Vaquero, Daniel; Garcia-Sandoval, Manuel A; Fernandez-Carreira, Jose M; Gava, Richard

    2008-02-01

    We prospectively measured the changes in bone mineral density (BMD) in the proximal tibia of 20 total knee arthroplasties, ten with cruciform stems and ten with cylindrical stems. The measurements were made one, four and seven years after surgery. We observed a uniform density decrease in three regions of interest from one to seven years of follow-up. Cylindrical stems showed an asymmetrical density decrease between the three regions of interest, with no change in the central region, a slight decrease in the lateral region, and large decrease in the medial region. Multivariate analysis with general linear model showed the stem type factor as statistically significant for medial region of interest (p = 0.006). The cylindrical stem produces heterogeneous BMD changes under the tibial platform in knee arthroplasties, and this could be a potential risk factor for asymmetrical subsidence of this component. PMID:17115154

  1. Total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Slavković Nemanja

    2012-01-01

    Full Text Available Total hip arthroplasty is most common reconstructive hip procedure in adults. In this surgery we replace some parts of the upper femur and acetabulum with biocompatible materials. The main goal of this surgery is to eliminate pain and regain full extent of joint motion, maintaining hip stability. Surgical technique, biomaterials, design of the prosthesis and fixation techniques have evolved with time adjusting to each other. After total hip arthroplasty patients’ quality of life should be improved. There are many various postoperative complications. Some of them are fatal, and some are minor, which may become manifested years after surgery. Each next surgical procedure following previous hip surgery is associated with considerably lower chances to be successful. Therefore, in primary total hip arthroplasty, preoperative evaluation and preparation of patients are essential. Every orthopaedic surgeon needs to improve already adopted surgical skills applying them with precision and without compromise, with the main goal to achieve long-term durability of the selected implant. The number of total hip arthroplasties will also increase in future, and newer and higher quality materials will be used.

  2. Reverse Shoulder Arthroplasty

    Medline Plus

    Full Text Available Reverse Shoulder Arthroplasty Zimmer, Inc. New York City, New York March 17, 2010 Welcome to this OR Live presentation, brought to you by Zimmer. Hi. I'm ... my partner, Brad Parsons. We're here in New York to bring you a video of a ...

  3. Starch-gluten separation by shearing: Influence of device geometry

    NARCIS (Netherlands)

    Zalm, van der E.E.J.; Berghout, J.A.M.; Goot, van der A.J.; Boom, R.M.

    2012-01-01

    Wheat flour was separated into a gluten-enriched and a gluten-depleted (i.e. starch-rich) fraction within a conical shearing device. This paper describes the effect of the device geometry on the separation process. The gap distance between the two cones and the cone angle could be varied leading to

  4. The Synovial Lining and Synovial Fluid Properties after Joint Arthroplasty

    Directory of Open Access Journals (Sweden)

    Michael Shang Kung

    2015-05-01

    Full Text Available The lubrication of the cartilaginous structures in human joints is provided by a fluid from a specialized layer of cells at the surface of a delicate tissue called the synovial lining. Little is known about the characteristics of the fluids produced after a joint arthroplasty procedure. A literature review was carried out to identify papers that characterized the synovial lining and the synovial fluids formed after total hip or knee arthroplasty. Five papers about synovial lining histology and six papers about the lubricating properties of the fluids were identified. The cells making up the re-formed synovial lining, as well as the lining of interface membranes, were similar to the typical Type A and B synoviocytes of normal joints. The synovial fluids around joint replacement devices were typically lower in viscosity than pre-arthroplasty fluids but the protein concentration and phospholipid concentrations tended to be comparable, suggesting that the lining tissue function was preserved after arthroplasty. The widespread, long-term success of joint arthroplasty suggests that the lubricant formed from implanted joint synovium is adequate for good clinical performance in the majority of joints. The role the fluid plays in component wear or failure is a topic for future study.

  5. Influencing factors of knee function in osteoarthritis patients after total knee arthroplasty%膝骨关节炎患者全膝关节置换后影响关节功能恢复的因素

    Institute of Scientific and Technical Information of China (English)

    高吉海; 王江泉; 吕东维

    2016-01-01

    BACKGROUND:Functional recovery after joint arthroplasty is an important indicator to evaluate the effect and prognosis of total knee arthroplasty, and is affected by patients and many kinds of outside factors. OBJECTIVE:To investigate the influencing factors of functional recovery of knee in patients with knee osteoarthritis after total knee arthroplasty. METHODS:Clinical data of 76 osteoarthritis patients undergoing total knee arthroplasty in the Dongying People’s Hospital from August 2007 to August 2013 were retrospectively analyzed. Hospital for Special Surgery knee score, knee pain Visual Analogue Score, range of motion and posterior slop angle of tibial plateau were compared before and 6 months after surgery. Changes in anterior condylar offset were recorded before and after femoral prosthesis arthroplasty. SPSS 21.0 software was used to analyze the influential factors for Hospital for Special Surgery knee scores after arthroplasty. RESULTS AND CONCLUSION:(1) Hospital for Special Surgery knee score, knee pain Visual Analogue Score, and range of motion were significantly higher 6 months after arthroplasty than that before arthroplasty (P<0.05). (2) Pearson correlation analysis demonstrated that preoperative Hospital for Special Surgery knee score, preoperative knee pain Visual Analogue Score, preoperative range of motion, preoperative posterior slop angle of tibial plateau and preoperative and postoperative anterior condylar offset changes were positively correlated with postoperative Hospital for Special Surgery knee score (P<0.05). Body mass index and inversion deformity angle were negatively correlated with postoperative Hospital for Special Surgery knee score (P<0.05). (3) Multiple linear regression analysis showed body mass index was negatively correlated with postoperative Hospital for Special Surgery knee score (P<0.05). Preoperative Hospital for Special Surgery knee score, preoperative knee pain Visual Analogue Score and preoperative posterior slop

  6. Poled-glass devices: Influence of surfaces and interfaces

    DEFF Research Database (Denmark)

    Fage-Pedersen, Jacob; Jacobsen, Rune Shim; Kristensen, Martin

    2007-01-01

    Devices in periodically poled glass must have a large periodic variation of the built-in field. We show that the periodic variation can be severely degraded by charge dynamics taking place at the external (glass–air) interface or at internal (glass–glass) interfaces if the interfaces have imperfe...

  7. The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes

    OpenAIRE

    Koppelaar, E; Knibbe, H.J.J.; Miedema, H.S.; Burdorf, A

    2012-01-01

    OBJECTIVES: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic devices on mechanical load during patient handling activities. METHODS: For each patient, based on national guidelines, it was recorded which specific ergonomic devices were required during distin...

  8. Influence of Energy Level Matching on Device Performances of Organic Light-emitting Diodes

    Institute of Scientific and Technical Information of China (English)

    LIU Chen; ZOU Xue-cheng; YIN Sheng

    2004-01-01

    Through experiments and computer simulation, the influence of the energy levels of organic materials and electrode materials in the organic light-emitting diodes (OLEDs) on the device performances is discussed. Results show that the device performances are influenced by not only the carrier injection barriers at the electrode interface but also the barriers at the organic heterojunction interface. This result is helpful to the selection of the organic materials and their arrangement in the optimal design of OLEDs.

  9. Influence of strained drain on performance of ballistic channel devices

    International Nuclear Information System (INIS)

    We have studied the performance of ballistic channel diodes with strained channel or drain, based on Monte Carlo simulation. A larger increase in drain current and mean velocity of electrons in the drain region is observed for strained drain diode compared to strained channel diode. This is due to reduction of intervalley scattering and electrons transported with smaller transverse effective mass in the strained drain. This also results in lower heat generation and parasitic resistances in strained drain. We conclude that the strained drain is an efficient way to improve electrical characteristics of devices with ballistic channel. (paper)

  10. Ability of Low-Cost Force-Feedback Device to Influence Postural Stability.

    Science.gov (United States)

    Baud-Bovy, Gabriel; Tatti, Fabio; Borghese, Nunzio A

    2015-01-01

    Low-cost gaming technology offers promising devices for the rehabilitation of stroke patients at home. While several attempts have been made to use low-cost motion tracking devices (Kinect) or balance boards (Wii Board), the potential of low-cost haptic devices has yet to be explored in this context. The objective of this study was to investigate whether it is possible to influence postural stability with a low-cost device despite its technical limitations, and to explore the most promising modes of haptic interaction to increase and decrease postural stability. Two groups of younger subjects used a high-end (Omega.3) and a low-cost (Falcon) device respectively. A third group of older subjects used the Falcon. We show that light touch contact with the device improves stability, whereas the force tasks decrease it. The effects of the different tasks are consistent in the two age groups. Although there are differences in the participants' interaction with the two devices, the effect of the devices on postural stability is comparable. We conclude that a low-cost haptic device can be used to increase or decrease postural stability of healthy subjects with an age similar to that of typical stroke patients, in a safe and controllable way. PMID:25398181

  11. Influence of the electric field on carriers recombination zone in bilayer organic electroluminescent device

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The electroluminescence (EL) of bilayer devices (ITO/Polymer/Alq3/Al) made from two PPV derivatives (MN-PPV and MEH-PPV),respectively,and the influence of the organic layers' thickness on the characteristics of the device are investigated. Different spectra and variations are observed for different thicknesses of Alq3 layer in this bilayer organic light-emitting diodes (LEDs) as increasing applied bias. Based on the energy level and field-assisted tunneling at the interface,we attributed these phenomena to electric field redistribution in the device and field-assisted charges being transported and tunneling through energy barrier at high electric field.

  12. Influences of Device and Circuit Mismatches on Paralleling Silicon Carbide MOSFETs

    DEFF Research Database (Denmark)

    Li, Helong; Munk-Nielsen, Stig; Wang, Xiongfei;

    2016-01-01

    This paper addresses the influences of device and circuit mismatches on paralleling the Silicon Carbide (SiC) MOSFETs. Comprehensive theoretical analysis and experimental validation from paralleled discrete devices to paralleled dies in multichip power modules are first presented. Then......, the influence of circuit mismatch on paralleling SiC MOSFETs is investigated and experimentally evaluated for the first time. It is found that the mismatch of the switching loop stray inductance can also lead to on-state current unbalance with inductive output current, in addition to the on-state resistance...... of the device. It further reveals that circuit mismatches and a current coupling among the paralleled dies exist in a SiC MOSFET multichip power module, which is critical for the transient current distribution in the power module. Thus, a power module layout with an auxiliary source connection is developed...

  13. The influence of ergonomic devices on mechanical load during patient handling activities in nursing homes

    NARCIS (Netherlands)

    Koppelaar, E.; Knibbe, H.J.J.; Miedema, H.S.; Burdorf, A.

    2012-01-01

    OBJECTIVES: Mechanical load during patient handling activities is an important risk factor for low back pain among nursing personnel. The aims of this study were to describe required and actual use of ergonomic devices during patient handling activities and to assess the influence of these ergonomic

  14. Influence of various sterilization procedures on TiO2 nanotubes used for biomedical devices.

    Science.gov (United States)

    Junkar, Ita; Kulkarni, Mukta; Drašler, Barbara; Rugelj, Neža; Mazare, Anca; Flašker, Ajda; Drobne, Damjana; Humpolíček, Petr; Resnik, Matic; Schmuki, Patrik; Mozetič, Miran; Iglič, Aleš

    2016-06-01

    Sterilization is the final surface treatment procedure of all implantable devices and is one of the key factors which have to be considered before implementation. Since different sterilization procedures for all implantable devices influence mechanical properties as well as biological response, the influence of different sterilization techniques on titanium nanotubes was studied. Commonly used sterilization techniques such as autoclaving, ultra-violet light sterilization, hydrogen peroxide plasma sterilization as well as the not so frequently used gaseous oxygen plasma sterilization were used. Three different nanotube diameters; 15 nm, 50 nm and 100 nm were employed to study the effects of various sterilization techniques. It was observed that autoclave sterilization resulted in destruction of nanotubular features on all three studied nanotube diameters, while UV-light and both kinds of plasma sterilization did not cause any significant morphological changes on the surfaces. Differences between the sterilization techniques employed influenced cytocompatibility, especially in the case of nanotubes with 100 nm diameter.

  15. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... the NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR ... MIS total knee arthroplasty with the Zimmer mobile bearing knee. We invite all of you who have ...

  16. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... NexGen® LPS-Flex Mobile and LPS-Mobile Bearing Knees March 5, 2009 Welcome to this "OR Live" ... re going to be doing an MIS total knee arthroplasty with the Zimmer mobile bearing knee. We ...

  17. 405 nm light exposure of osteoblasts and inactivation of bacterial isolates from arthroplasty patients: potential for new disinfection applications?

    Directory of Open Access Journals (Sweden)

    RS McDonald

    2013-01-01

    Full Text Available Infection rates after arthroplasty surgery are between 1-4 %, rising significantly after revision procedures. To reduce the associated costs of treating these infections, and the patients’ post-operative discomfort and trauma, a new preventative method is required. High intensity narrow spectrum (HINS 405 nm light has bactericidal effects on a wide range of medically important bacteria, and it reduced bacterial bioburden when used as an environmental disinfection method in a Medical Burns Unit. To prove its safety for use for environmental disinfection in orthopaedic theatres during surgery, cultured osteoblasts were exposed to HINS-light of intensities up to 15 mW/cm2 for 1 h (54 J/cm2. Intensities of up to 5 mW/cm2 for 1 h had no effect on cell morphology, activity of alkaline phosphatase, synthesis of collagen or osteocalcin expression, demonstrating that under these conditions this dose is the maximum safe exposure for osteoblasts; after exposure to 15 mW/cm2 all parameters of osteoblast function were significantly decreased. Viability (measured by protein content and Crystal Violet staining of the osteoblasts was not influenced by exposure to 5 mW/cm2 for at least 2 h. At 5 mW/cm2 HINS-light is an effective bactericide. It killed 98.1 % of Staphylococcus aureus and 83.2 % Staphylococcus epidermis populations seeded on agar surfaces, and is active against both laboratory strains and clinical isolates from infected hip and knee arthroplasties. HINS-light could have potential for development as a method of disinfection to reduce transmission of bacteria during arthroplasty, with wider applications in diverse surgical procedures involving implantation of a medical device.

  18. Introduction of total knee arthroplasty in Lithuania

    OpenAIRE

    Tarasevicius, Sarunas; Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

    Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. Methods The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. ...

  19. Influence of Disassociation Probability on External Quantum Efficiency in Organic Electrophosphorescent Devices

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian-hua; OU YANG Jun; LI Xue-yong; LI Hong-jian

    2007-01-01

    An analytical model is presented to calculate the disassociation probability and the external quantum efficiency at high field in doped organic electrophosphorescence(EPH) devices. The charge recombination process and the triplet(T)-triplet(T) annihilation processes are taken into account in this model. The influences of applied voltage and the thickness of the device on the disassociation probability, and of current density and the thickness of the device on the external quantum efficiency are studied thoroughly by including and ignoring the disassociation of excitons. It is found that the dissociation probability of excitons will come close to 1 at high electric field, and the external EPH quantum efficiency is almost the same at low electric field. There is a large discrepancy of the external EPH quantum efficiency at high electric field for including or ignoring the disassociation of excitons.

  20. Influences of an Aluminum Covering Layer on the Performance of Cross-Like Hall Devices

    OpenAIRE

    Fei Lyu; Xinfu Liu; Yinjie Ding; Eng-Huat Toh; Zhenyan Zhang; Yifan Pan; Zhen Wang; Chengjie Li; Li Li; Jin Sha; Hongbing Pan

    2016-01-01

    This work studies the effects of an aluminum covering on the performance of cross-like Hall devices. Four different Hall sensor structures of various sizes were designed and fabricated. The sensitivity and offset of the Hall sensors, two key points impacting their performance, were characterized using a self-built measurement system. The work analyzes the influences of the aluminum covering on those two aspects of the performance. The aluminum layer covering mainly leads to an eddy-current ef...

  1. Complex influence of space environment on materials and electronic devices in the conditions of microgravity

    Science.gov (United States)

    Musabayev, T.; Zhantayev, Zh.; Grichshenko, V.

    2016-09-01

    The paper presents a new physical model describing the processes in materials and electronic devices under the influence of cosmic rays in microgravity. The model identifies specific features of formation of the area of radiation defects (ARD) in the electronic materials in microgravity. The mechanism of interaction between the ARD and memory modules in microgravity causing malfunction and failure of onboard electronics is considered. The results of failure of memory modules under real conditions are presented.

  2. Influence factors of range of motion after total knee arthroplasty%影响全膝关节置换术后关节活动度的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    曾勉东; 杨波; 谢景开; 吕玉明; 尹彪

    2012-01-01

    目的 分析全膝关节置换术后关节活动度的相关影响因素,旨在探讨如何提高术后膝关节活动范围.方法 回顾性研究2008年10月~2010年10月37例全膝关节置换术.术后1年25例膝关节屈曲度>90°的患者作为对照组,12例膝关节屈曲度<90°的患者作为实验组.两组根据年龄、性别、体重指数(BMI)、手术时间、术中出血和随访时间等进行配对病例对照研究分析影响因素.结果 两组患者年龄、性别、手术时间、术中出血、随访时间及术前合并症比较,差异无统计学意义.手术前后两组膝关节屈曲度比较,差异有显著统计学意义(P<0.01).手术前后两组的胫骨倾斜度与关节力线对位不良的比较,差异有统计学意义(P<0.05).结论 全膝关节置换术后膝关节活动度受肥胖、下肢力线对位情况和术后主动功能锻炼等因素影响,术中术后减少以上因素影响可以提高膝关节术后活动度.%Objective To analyze the related factors of the range of motion(ROM) after total knee arthroplasty and discuss how to improve the ROM of knee. Methods A retrospective review was given to the data from 37 patients undergoing total knee arthroplasty between October 2008 and October 2010. There're 25 TKA patients with greater than 90° flexion at 1 year postoperative served as control group, 12 patients with a 1 -year postoperative flexion range of less than 90° was taken as treatment group. The age, sex, body mass index, time for surgery, intraoperative bleeding, follow-up time of the control group were matched to those of the treatment group. Results No significant differences were found with regard to the age,sex,body mass index, time for surgery, intraoperative bleeding, follow-up time. Significant differences were found between preoperative flexion and postopeartive flexion (P <0.01). Preoperative and postoperative the gradient of tibial and force line of lower extremities were significantly

  3. Revision of the Gunston polycentric knee arthroplasty with total knee arthroplasty.

    Science.gov (United States)

    Memişoğlu, Kaya; Müezzinoğlu, U Sefa; Kesemenli, Cumhur Cevdet

    2010-01-01

    The Gunston polycentric knee arthroplasty, first designed and performed by Frank Gunston in 1971, is the first prosthesis considering the natural knee biomechanics. Although the polycentric knee arthroplasty showed encouraging results to relieve pain and to preserve the preoperative range of motion and joint instability, the improvements in prosthesis design and arthroplasty technology rapidly made the polycentric knee prosthesis obsolete. Herein, we report a 58-year old male patient who had revision of the Gunston polycentric knee arthroplasty with total knee arthroplasty performed 32 years after the initial operation. PMID:21343693

  4. Liquid electrolyte positioning along the device channel influences the operation of Organic Electro-Chemical Transistors

    KAUST Repository

    D'angelo, Pasquale

    2014-11-01

    In this work, we show the influence of the liquid electrolyte adsorption by porous films made of poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate), PEDOT:PSS, on the operation of an Organic Electro-Chemical Transistor with an active channel based on these polymeric films. In particular, the effect of film hydration on device performance is evaluated by studying its electrical response as a function of the spatial position between the electrolyte and the channel electrodes. This is done by depositing a PEDOT:PSS film on a super-hydrophobic surface aimed at controlling the electrolyte confinement next to the electrodes. The device response shows that the confinement of ionic liquids near to the drain electrode results in a worsening of the current modulation. This result has been interpreted in the light of studies dealing with the transport of ions in semiconducting polymers, indicating that the electrolyte adsorption by the polymeric film implies the formation of liquid pathways inside its bulk. These pathways, in particular, affect the device response because they are able to assist the drift of ionic species in the electrolyte towards the drain electrode. The effect of electrolyte adsorption on the device operation is confirmed by means of moving-front measurements, and is related to the reproducibility of the device operation curves by measuring repeatedly its electrical response.

  5. CURBSIDE CONSULTATION IN HIP ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Scott M. Sporer

    2009-03-01

    Full Text Available DESCRIPTION A user friendly reference for decision making in hip arthroplasty designed in a question formed clinical problem scenarios and answers format .The articles composed of the answers, containing current concepts and preferences of experts in primary and revision hip surgery are enhanced by several images, diagrams and references and written in the form of a curbside consultation by Scott M. Sporer, MD. and his collaborators. PURPOSE By this practical reference of hip arthroplasty, Scott M. Sporer, MD. and the contributors have aimed providing the reader practical and clinically relevant information, evidence-based advices, their preferences and opinions containing current concepts for difficult and controversial clinical situations in total hip replacement surgery which are often not addressed clearly in traditional references. FEATURES The book is composed of 9 sections and 49 articles each written by a different expert designed in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected. Second section is about preoperative acetabulum questions. Third section is about preoperative femur questions. Fourth section is about intraoperative questions. Intraoperative acetabulum question is subjected in the fifth section and the intraoperative femur questions in the sixth section. The seventh section is about postoperative questions. Eighth and ninth sections are about general questions about failure and failure of acetabulum in turn. AUDIENCE Mainly practicing orthopedic surgeons, fellows and residents who are interested in hip arthroplasty have been targeted but several carefully designed scenarios of controversial and difficult situations surrounding total hip replacement surgery and the current information will also be welcomed by experienced clinicians practicing in hip arthroplasty. ASSESSMENT Scott M. Sporer

  6. Outcomes Following Radial Head Arthroplasty.

    Science.gov (United States)

    Fowler, John R; Henry, Sarah E; Xu, Peter; Goitz, Robert J

    2016-05-01

    Most current series of radial head arthroplasty include small numbers of patients with short- to medium-term follow-up and significant heterogeneity in patients, treatments, and outcome measures. The purpose of this systematic review was to review outcomes for radial head arthroplasty based on injury chronicity, injury pattern, and type of implant used. The authors systematically searched electronic databases for studies containing radial head arthroplasty or radial head replacement and identified 19 studies for inclusion in the analysis. For each included study, a composite mean was obtained for Mayo Elbow Performance Score (MEPS) and range of motion. Outcomes were said to differ significantly if their confidence intervals did not overlap. The MEPS for acute treatment (90) was higher than that for delayed treatment (81). There was no difference in the pooled MEPS between the isolated (89) and complex injury pattern (87) groups or implant material. There was no difference in range of motion between the acute and delayed or isolated and complex groups, but the average degree of pronation was higher in patients treated with titanium implants (76°) compared with cobalt chromium implants (66°). This systematic review suggests that outcomes are improved following acute arthroplasty for treatment of radial head fractures compared with delayed treatment, based on MEPS. The lack of other significant differences detected is likely due to the significant heterogeneity and inadequate power in current studies. Further prospective studies isolating the different variables will be needed to determine their true effect on outcomes. [Orthopedics. 2016; 39(3):153-160.]. PMID:27045484

  7. Humeral windows in revision total elbow arthroplasty

    Science.gov (United States)

    Salama, Amir; Stanley, David

    2016-01-01

    The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery. PMID:27583011

  8. Wrist arthroplasty--a systematic review

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E H

    2014-01-01

    INTRODUCTION: Severely painful or dysfunctional destroyed wrists can be reconstructed by fusion, interposition of soft-tissue or by arthroplasty using artificial materials. Total and partial wrist arthroplasty (T/PWA) has been used on a regular basis since the 1960's. The objective of this study ...

  9. Simultaneous and staged bilateral total hip arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Joergensen, Christoffer Calov; Husted, Henrik;

    2013-01-01

    Bilateral total hip arthroplasty (BTHA) and bilateral simultaneous total hip arthroplasty (BSTHA) are done increasingly. Previous studies evaluating outcomes after bilateral procedures have found different results. The aim of this study was to investigate length of hospital stay (LOS), 30 days...

  10. Influence of Mobile Phones on the Quality of ECG Signal Acquired by Medical Devices

    Science.gov (United States)

    Buczkowski, T.; Janusek, D.; Zavala-Fernandez, H.; Skrok, M.; Kania, M.; Liebert, A.

    2013-10-01

    Health aspects of the use of radiating devices, like mobile phones, are still a public concern. Stand-alone electrocardiographic systems and those built-in, more sophisticated, medical devices have become a standard tool used in everyday medical practice. GSM mobile phones might be a potential source of electromagnetic interference (EMI) which may affect reliability of medical appliances. Risk of such event is particularly high in places remote from GSM base stations in which the signal received by GSM mobile phone is weak. In such locations an increase in power of transmitted radio signal is necessary to enhance quality of the communication. In consequence, the risk of interference of electronic devices increases because of the high level of EMI. In the present paper the spatial, temporal, and spectral characteristics of the interference have been examined. The influence of GSM mobile phone on multilead ECG recordings was studied. It was observed that the electrocardiographic system was vulnerable to the interference generated by the GSM mobile phone working with maximum transmit power and in DTX mode when the device was placed in a distance shorter than 7.5 cm from the ECG electrode located on the surface of the chest. Negligible EMI was encountered at any longer distance.

  11. Acrylic bone cement in total joint arthroplasty: A review.

    Science.gov (United States)

    Saleh, Khaled J; El Othmani, Mouhanad M; Tzeng, Tony H; Mihalko, William M; Chambers, Monique C; Grupp, Thomas M

    2016-05-01

    Acrylic bone cement has a variety of applications in orthopedic surgery. Primary uses in total arthroplasties are limited to prostheses fixation and antibiotic delivery. With the large number of total joint arthroplasties expected to continue to rise, understanding the role bone cement plays in the success of total joint arthroplasty can have a significant impact on daily practice. The literature is inconclusive on whether cemented or cementless fixation technique is superior, and choice of fixation type is mainly determined by surgeon preference and experience. Surgeons should understand that if poor techniques exist, short-term outcomes of the replaced joint may be at risk. Statement of clinical significance: This article attempts to clarify some points of bone cement use through a review of the mechanical properties related to bone cement, a comparison to alternative materials, influence of additives, and the effects on surgical outcomes. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:737-744, 2016. PMID:26852143

  12. Influence of different irradiation facilities on the response of radioprotection devices

    International Nuclear Information System (INIS)

    An EIC 1 extrapolation chamber, flushed with a methan based tissue equivalent gas is presented. This measuring device serves as a reference instrument to calibrate in tissue absorbed dose beta beams from different irradiation facilities; point radioactive sources, sources used with beam flattening filters, large area sources simulated by moving a point source. The source to detector distance has to be greater than 3 cm, requiring a transfer dosemeter for smaller distances. Influence of these different irradiation geometries has been studied on several radioprotection instruments (babyline, individual dosemeter, ionisation chamber), using three radionucleides: 147Pm, 204Tl, 90Sr + 90Y

  13. Weighty data: importance information influences estimated weight of digital information storage devices.

    Directory of Open Access Journals (Sweden)

    Iris eSchneider

    2015-01-01

    Full Text Available Previous work has suggested that perceived importance of an object influences estimates of its weight. Specifically, important books were estimated to be heavier than non-important books. However, the experimental set-up of these studies may have suffered from a potential confound and findings may be confined to books only. Addressing this, we investigate the effect of importance on weight estimates by examining whether the importance of information stored on a data storage device (USB-stick or portable hard drive can alter weight estimates. Results show that people thinking a USB-stick holds important tax information (vs. expired vs. no information estimate it to be heavier (Experiment 1 compared to people who do not. Similarly, people who are told a portable hard-drive holds personally relevant information (vs. irrelevant, also estimate the drive to be heavier (Experiment 2a and 2b. The current work shows that importance influences weight perceptions beyond specific objects.

  14. Influences of an Aluminum Covering Layer on the Performance of Cross-Like Hall Devices.

    Science.gov (United States)

    Lyu, Fei; Liu, Xinfu; Ding, Yinjie; Toh, Eng-Huat; Zhang, Zhenyan; Pan, Yifan; Wang, Zhen; Li, Chengjie; Li, Li; Sha, Jin; Pan, Hongbing

    2016-01-01

    This work studies the effects of an aluminum covering on the performance of cross-like Hall devices. Four different Hall sensor structures of various sizes were designed and fabricated. The sensitivity and offset of the Hall sensors, two key points impacting their performance, were characterized using a self-built measurement system. The work analyzes the influences of the aluminum covering on those two aspects of the performance. The aluminum layer covering mainly leads to an eddy-current effect in an unstable magnetic field and an additional depletion region above the active region. Those two points have influences on the sensitivity and the offset voltage, respectively. The analysis guides the designer whether to choose covering with an aluminum layer the active region of the Hall sensor as a method to reduce the flicker noise and to improve the stability of the Hall sensor. Because Hall devices, as a reference element, always suffer from a large dispersion, improving their stability is a crucial issue. PMID:26784199

  15. Influences of an Aluminum Covering Layer on the Performance of Cross-Like Hall Devices

    Directory of Open Access Journals (Sweden)

    Fei Lyu

    2016-01-01

    Full Text Available This work studies the effects of an aluminum covering on the performance of cross-like Hall devices. Four different Hall sensor structures of various sizes were designed and fabricated. The sensitivity and offset of the Hall sensors, two key points impacting their performance, were characterized using a self-built measurement system. The work analyzes the influences of the aluminum covering on those two aspects of the performance. The aluminum layer covering mainly leads to an eddy-current effect in an unstable magnetic field and an additional depletion region above the active region. Those two points have influences on the sensitivity and the offset voltage, respectively. The analysis guides the designer whether to choose covering with an aluminum layer the active region of the Hall sensor as a method to reduce the flicker noise and to improve the stability of the Hall sensor. Because Hall devices, as a reference element, always suffer from a large dispersion, improving their stability is a crucial issue.

  16. Influence of the Type of Measuring Device in Determining the Static Modulus of Elasticity of Concrete

    Directory of Open Access Journals (Sweden)

    Suélio da Silva Araújo

    2013-01-01

    Full Text Available This paper presents a comparative analysis of the results obtained in static modulus of elasticity tests of plain concrete cylindrical specimens. The purpose of this study is to identify and evaluate the influence of several factors involved in modulus of elasticity tests such as the strain measurement device used (dial indicators, electrical surface bonded strain gages, externally fixed strain gages and linear variation displacement transducer - LVDT, the type of concrete (Class C30 and Class C60 and cylindrical specimen size (100 mm x 200 mm and 150 mm x 300 mm. The modulus tests were done in two different laboratories in the Goiânia, GO region and were performed according to code ABNT NBR 8522:2008, which describes the initial tangent modulus test, characterized by strains measured at tension values of 0.5 MPa and 30% of the ultimate load. One hundred and sixty specimens were tested with statistically satisfactory results. It was concluded that the type of strain measurement device greatly influenced the modulus of elasticity results. Tests in specimens 100 mm x 200 mm showed highest statistical variation.

  17. Revision of the Gunston polycentric knee arthroplasty with total knee arthroplasty

    OpenAIRE

    Memisoglu, Kaya; Muezzinoglu, U. Sefa; Kesemenli, Cumhur Cevdet

    2011-01-01

    The Gunston polycentric knee arthroplasty, first designed and performed by Frank Gunston in 1971, is the first prosthesis considering the natural knee biomechanics. Although the polycentric knee arthroplasty showed encouraging results to relieve pain and to preserve the preoperative range of motion and joint instability, the improvements in prosthesis design and arthroplasty technology rapidly made the polycentric knee prosthesis obsolete. Herein, we report a 58-year-old male patient who had ...

  18. Analysing the Risks and Challenges of the Pad Device as an Education Tool and Its Influence on Generation Y

    OpenAIRE

    Sun, Jingxuan

    2012-01-01

    Sun, Jingxuan 2012. Analysing the Risks and Challenges of the Pad Device as an Education Tool and Its Influence on Generation Y: Bachelor’s Thesis. Kemi-Tornio University of Applied Sciences. Business and Culture. Pages 68. Appendices 2. The objective of this research was to explore the use of the pad device as an education tool. Furthermore, the research work also intended to study the impact of the pad device among young students. The advantages of using the pad devices instead of compu...

  19. Does core mobility of lumbar total disc arthroplasty influence sagittal and frontal intervertebral displacement? Radiologic comparison with fixed-core prosthesis

    Science.gov (United States)

    Delécrin, Joël; Allain, Jérôme; Beaurain, Jacques; Steib, Jean-Paul; Chataigner, Hervé; Aubourg, Lucie; Huppert, Jean; Ameil, Marc; Nguyen, Jean-Michel

    2009-01-01

    Background An artificial disc prosthesis is thought to restore segmental motion in the lumbar spine. However, it is reported that disc prosthesis can increase the intervertebral translation (VT). The concept of the mobile-core prosthesis is to mimic the kinematic effects of the migration of the natural nucleus and therefore core mobility should minimize the VT. This study explored the hypothesis that core translation should influence VT and that a mobile core prosthesis may facilitate physiological motion. Methods Vertebral translation (measured with a new method presented here), core translation, range of motion (ROM), and distribution of flexion-extension were measured on flexion-extension, neutral standing, and lateral bending films in 89 patients (63 mobile-core [M]; 33 fixed-core [F]). Results At L4-5 levels the VT with M was lower than with F and similar to the VT of untreated levels. At L5-S1 levels the VT with M was lower than with F but was significantly different compared to untreated levels. At M levels a strong correlation was found between VT and core translation; the VT decreases as the core translation increases. At F levels the VT increases as the ROM increases. No significant difference was found between the ROM of untreated levels and levels implanted with either M or F. Regarding the mobility distribution with M and F we observed a deficit in extension at L5-S1 levels and a similar distribution at L4-5 levels compared to untreated levels. Conclusion The intervertebral mobility was different between M and F. The M at L4-5 levels succeeded to replicate mobility similar to L4-5 untreated levels. The M at L5-S1 succeeded in ROM, but failed regarding VT and mobility distribution. Nevertheless M minimized VT at L5-S1 levels. The F increased VT at both L4-5 and L5-S1. Clinical Relevance This study validates the concept that the core translation of an artificial lumbar disc prosthesis minimizes the VT. PMID:25802632

  20. Total knee arthroplasty in vascular malformation

    Directory of Open Access Journals (Sweden)

    Harish Bhende

    2015-01-01

    Full Text Available In Klippel–Trenaunay syndrome, vascular malformations are not only in skin and superficial soft tissues but also in deep tissues like muscles bones and joints. It is well documemted that these recurrent intraarticular bleeds can cause early arthritis and joint pain. Performing arthroplasty in such patients is difficult and fraught with complications. We describe such a case where navigated total knee arthroplasty was performed with success to avoid the problems of intra medullary alignment used in the presence of intra medullary vascular malformations. We also suggest certain measures when knee arthroplasty is considered in such patients.

  1. Low manipulation prevalence following fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Jørgensen, Christoffer C.; Gromov, Kirill;

    2015-01-01

    BACKGROUND AND PURPOSE: Postoperative joint stiffness following total knee arthroplasty (TKA) may compromise the outcome and necessitate manipulation. Previous studies have not been in a fast-track setting with optimized pain treatment, early mobilization, and short length of stay (LOS), which may...... have influenced the prevalence of joint stiffness and subsequent manipulation. We investigated the prevalence of manipulation following fast-track TKA and identified patients at risk of needing manipulation. PATIENTS AND METHODS: 3,145 consecutive unselected elective primary unilateral TKA patients...

  2. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA.

  3. Stiffness after total knee arthroplasty.

    Science.gov (United States)

    Manrique, Jorge; Gomez, Miguel M; Parvizi, Javad

    2015-04-01

    Stiffness after total knee arthroplasty (TKA) adversely affects outcome and impacts patient function. Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified. Management of stiffness following TKA can be challenging. The condition needs to be assessed and treated in a staged manner. A nonsurgical approach is the first step. Manipulation under anesthesia may be considered within the first 3 months after the index TKA, if physical therapy fails to improve the range of motion. Beyond this point, consideration should be given to surgical intervention such as lysis of adhesions, either arthroscopically or by open arthrotomy. If the cause of stiffness is deemed to be surgical error, such as component malpositioning, revision arthroplasty is indicated. The purpose of this article is to evaluate the various aspects of management of stiffness after TKA. PMID:25513992

  4. Weighty data: importance information influences estimated weight of digital information storage devices.

    Science.gov (United States)

    Schneider, Iris K; Parzuchowski, Michal; Wojciszke, Bogdan; Schwarz, Norbert; Koole, Sander L

    2014-01-01

    Previous work suggests that perceived importance of an object influences estimates of its weight. Specifically, important books were estimated to be heavier than non-important books. However, the experimental set-up of these studies may have suffered from a potential confound and findings may be confined to books only. Addressing this, we investigate the effect of importance on weight estimates by examining whether the importance of information stored on a data storage device (USB-stick or portable hard drive) can alter weight estimates. Results show that people thinking a USB-stick holds important tax information (vs. expired tax information vs. no information) estimate it to be heavier (Experiment 1) compared to people who do not. Similarly, people who are told a portable hard drive holds personally relevant information (vs. irrelevant), also estimate the drive to be heavier (Experiments 2A,B). PMID:25620942

  5. Influence of the Se environment on Cu-rich CIS devices

    International Nuclear Information System (INIS)

    Besides their better electronic properties, Cu-rich CuInSe2 solar cells performed worse than the Cu-poor ones. Dominated by interface recombination which lowers their open circuit voltage, they also exhibit lower current. They are indeed limited by a high native doping which leads to tunneling enhanced recombination. In order to decrease this doping, we investigate the effect of the selenium environment during the absorber growth. We demonstrate that the chemical activity of the Se during the growth strongly influences both the film microstructure and the solar cell performance via various structural and opto-electronic characterization on both the absorber and the resulting solar cells: scanning electron microscopy, energy dispersive X-ray spectrometry, X-ray diffraction in addition to classical current–voltage and quantum efficiency measurements on the solar cell devices. We show that low Se environment is beneficial to obtain better Cu-rich solar cells.

  6. The influence of assistive technology devices on the performance of activities by visually impaired

    Directory of Open Access Journals (Sweden)

    Suzana Rabello

    2014-04-01

    Full Text Available Objective: To establish the influence of assistive technology devices (ATDs on the performance of activities by visually impaired schoolchildren in the resource room. Methods: A qualitative study that comprised observation and an educational intervention in the resource room. The study population comprised six visually impaired schoolchildren aged 12 to 14 years old. The participants were subjected to an eye examination, prescribed ATDs comprising optical and non-optical devices, and provided an orientation on the use of computers. The participants were assessed based on eye/object distance, font size, and time to read a computer screen and printed text. Results: The ophthalmological conditions included corneal opacity, retinochoroiditis, retinopathy of prematurity, aniridia, and congenital cataracts. Far visual acuity varied from 20/200 to 20/800 and near visual acuity from 0.8 to 6 M. Telescopes, spherical lenses, and support magnifying glasses were prescribed. Three out of five participants with low vision after intervention could decrease the font size on the screen computer, and most participants (83.3% reduced their reading time at the second observation session. Relative to the printed text, all the participants with low vision were able to read text written in smaller font sizes and reduced their reading time at the second observation session. Conclusion: Reading skills improved after the use of ATDs, which allowed the participants to perform their school tasks equally to their classmates.

  7. Influence of a tilted cavity on quantum-dot optoelectronic active devices

    International Nuclear Information System (INIS)

    Quantum-dot laser diodes (QD-LDs) with a Fabry-Perot cavity and quantum-dot semiconductor optical amplifiers (QD-SOAs) with 70 tilted cavity were fabricated. The influence of a tilted cavity on optoelectronic active devices was also investigated. For the QD-LD, high performance was observed at room temperature. The threshold current was below 30 mA and the slope efficiency was 0.36 W/A. In contrast, the threshold current of the QD-SOA approached 1000 mA, which indicated that low facet reflectivity was obtained due to the tilted cavity design. A much more inverted carrier population was found in the QD-SOA active region at high operating current, thus offering a large optical gain and preserving the advantages of quantum dots in optical amplification and processing applications. Due to the inhomogeneity and excited state transition of quantum dots, the full width at half maximum of the electroluminescence spectrum of the QD-SOA was 81.6 nm at the injection current of 120 mA, which was ideal for broad bandwidth application in a wavelength division multiplexing system. In addition, there was more than one lasing peak in the lasing spectra of both devices and the separation of these peak positions was 6-8 nm, which is approximately equal to the homogeneous broadening of quantum dots.

  8. Introduction of total knee arthroplasty in Lithuania

    Science.gov (United States)

    Stucinskas, Justinas; Robertsson, Otto; Wingstrand, Hans

    2009-01-01

    Background and purpose We have previously reported that the first 10 years of hip arthroplasty in Lithuania resulted in a higher cumulative revision rate than that observed in Sweden. We thus compared the corresponding results after introduaction of total knee replacement in Lithuania. Methods The 10-year revision rate for the first 595 primary ScanKnee arthroplasties inserted in Klaipeda, Lithuania, was compared to that for the first 1,280 ScanKnee primary arthroplasties inserted in Sweden. As in the hip replacement study, only patients with osteoarthritis (OA) were included. Primary knee arthroplasties without patellar resurfacing were included, and the endpoint was revision for any reason other than addition of a patellar component. Results We found that the cumulative revision rate was not statistically significantly different between the groups. The revision pattern was different, however, and we observed 24 isolated patellar component additions in Sweden, but none in Klaipeda. Interpretation Contrary to the results of our previous hip arthroplasty study, the cumulative revision rate after total knee arthroplasty was similar in the two groups. This suggests that compared to hip arthroplasty, the outcome of total knee arthroplasty was less dependent on surgical experience. The large difference regarding isolated patellar component additions may be explained by long-term accumulation of severe OA cases in Lithuania. To patients subject to a newly introduced surgical treatment offering great improvement in quality of life, patellofemoral pain may be a minor problem. Furthermore, patellar problems may not have seemed particularly relevant for the surgeons, considering the disability of other patients waiting to be treated. PMID:19297790

  9. Management of complications after total shoulder arthroplasty

    OpenAIRE

    Josef K Eichinger; Galvin, Joseph W.

    2015-01-01

    The outcomes of total shoulder arthroplasty (TSA) for painful arthritis of the glenohumeral joint are excellent with significant improvement in pain and function. Increased use of total shoulder arthroplasty over the past decade has led to identification of common complications. Although the complication rate is low, accurate and timely diagnosis, appropriate management, and implementation of methods for prevention are critical to a successful long-term outcome. The most common complications ...

  10. 全膝关节置换术前本体感觉训练对术后的影响%Influence of Preoperative Proprioceptive Training for Patients with Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    皮衍玲; 王雪强; 杨树芬; 郭伟强

    2011-01-01

    Objective: To observe whether proprioceptive training can influence postoperative function in patients undergoing total knee arthroplasty (TKA). Methods: Forty-eight subjects with severe osteoarthritis of the knee scheduled for TKA were randomly divided into control group (CG) and training group (TG). Training group was given preoperative proprioceptive training. All patients with TKA were assessed with HSS and proprioceptive function before and six weeks after operation. The proprioceptive functions of all subjects were measured by a repositioning test on the Biodex IE dynamometer. The Bioedx HI isokinetic dynamometer was used to assess knee proprioceptive function: active position sense. Results: The results showed the training group had significant improvements in Hospital for Special Surgery (HSS) (P<0. 05) and active reposition sense (P<0. 05) compared to control group. Conclusion: It was concluded that preoperative proprioceptive training on patients receiving TKA can effectively improve the functions of knee and proprioception.%探讨全膝关节置换术前本体感觉训练对术后功能恢复的影响.方法:选取48例严重膝关节骨关节炎且拟行全膝关节置换术的患者,随机分为2组.训练组26例在行全膝关节置换术前6周进行本体感觉训练,包括膝屈曲位、双单腿、睁闭眼等的平板训练,固定自行车练习等.对照组22例未进行本体感觉训练.2组分别在行全膝关节置换术前后6周进行膝关节本体感觉测试(即膝关节主动复位误差角度值);术后6周进行膝关节功能评分(Hospital for Special Surgery,HSS);以Biodex 3等速系统测量2组患者双膝关节主动复位误差角度,以作为个体本体感觉能力优劣的代表.结果:术后6周训练组患膝关节主动复位误差角度值明显小于术前及对照组(P<0.05).HSS项目中的疼痛、行走功能、肌力及稳定性评分,训练组均明显高于对照组(P<0.05).结论;全膝关节置换

  11. Influence of the matrix properties on the performances of Er-doped Si nanoclusters light emitting devices

    Science.gov (United States)

    Irrera, Alessia; Iacona, Fabio; Franzò, Giorgia; Miritello, Maria; Lo Savio, Roberto; Castagna, Maria Eloisa; Coffa, Salvatore; Priolo, Francesco

    2010-03-01

    We investigated the properties of light emitting devices whose active layer consists of Er-doped Si nanoclusters (nc) generated by thermal annealing of Er-doped SiOx layers prepared by magnetron cosputtering. Differently from a widely used technique such as plasma enhanced chemical vapor deposition, sputtering allows to synthesize Er-doped Si nc embedded in an almost stoichiometric oxide matrix, so as to deeply influence the electroluminescence properties of the devices. Relevant results include the need for an unexpected low Si excess for optimizing the device efficiency and, above all, the strong reduction of the influence of Auger de-excitation, which represents the main nonradiative path which limits the performances of such devices and their application in silicon nanophotonics.

  12. MR Imaging of Knee Arthroplasty Implants.

    Science.gov (United States)

    Fritz, Jan; Lurie, Brett; Potter, Hollis G

    2015-01-01

    Primary total knee arthroplasty is a highly effective treatment that relieves pain and improves joint function in a large percentage of patients. Despite an initially satisfactory surgical outcome, pain, dysfunction, and implant failure can occur over time. Identifying the etiology of complications is vital for appropriate management and proper timing of revision. Due to the increasing number of knee arthroplasties performed and decreasing patient age at implantation, there is a demand for accurate diagnosis to determine appropriate treatment of symptomatic joints following knee arthroplasty, and for monitoring of patients at risk. Magnetic resonance (MR) imaging allows for comprehensive imaging evaluation of the tissues surrounding knee arthroplasty implants with metallic components, including the polyethylene components. Optimized conventional and advanced pulse sequences can result in substantial metallic artifact reduction and afford improved visualization of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications. In this review article, we discuss strategies for MR imaging around knee arthroplasty implants and illustrate the imaging appearances of common modes of failure, including aseptic loosening, polyethylene wear-induced synovitis and osteolysis, periprosthetic joint infections, fracture, patellar clunk syndrome, recurrent hemarthrosis, arthrofibrosis, component malalignment, extensor mechanism injury, and instability. A systematic approach is provided for evaluation of MR imaging of knee implants. MR imaging with optimized conventional pulse sequences and advanced metal artifact reduction techniques can contribute important information for diagnosis, prognosis, risk stratification, and surgical planning. PMID:26295591

  13. Real time heart rate variability assessment from Android smartphone camera photoplethysmography: Postural and device influences.

    Science.gov (United States)

    Guede-Fernandez, F; Ferrer-Mileo, V; Ramos-Castro, J; Fernandez-Chimeno, M; Garcia-Gonzalez, M A

    2015-08-01

    The aim of this paper is to present a smartphone based system for real-time pulse-to-pulse (PP) interval time series acquisition by frame-to-frame camera image processing. The developed smartphone application acquires image frames from built-in rear-camera at the maximum available rate (30 Hz) and the smartphone GPU has been used by Renderscript API for high performance frame-by-frame image acquisition and computing in order to obtain PPG signal and PP interval time series. The relative error of mean heart rate is negligible. In addition, measurement posture and the employed smartphone model influences on the beat-to-beat error measurement of heart rate and HRV indices have been analyzed. Then, the standard deviation of the beat-to-beat error (SDE) was 7.81 ± 3.81 ms in the worst case. Furthermore, in supine measurement posture, significant device influence on the SDE has been found and the SDE is lower with Samsung S5 than Motorola X. This study can be applied to analyze the reliability of different smartphone models for HRV assessment from real-time Android camera frames processing. PMID:26737985

  14. Real time heart rate variability assessment from Android smartphone camera photoplethysmography: Postural and device influences.

    Science.gov (United States)

    Guede-Fernandez, F; Ferrer-Mileo, V; Ramos-Castro, J; Fernandez-Chimeno, M; Garcia-Gonzalez, M A

    2015-01-01

    The aim of this paper is to present a smartphone based system for real-time pulse-to-pulse (PP) interval time series acquisition by frame-to-frame camera image processing. The developed smartphone application acquires image frames from built-in rear-camera at the maximum available rate (30 Hz) and the smartphone GPU has been used by Renderscript API for high performance frame-by-frame image acquisition and computing in order to obtain PPG signal and PP interval time series. The relative error of mean heart rate is negligible. In addition, measurement posture and the employed smartphone model influences on the beat-to-beat error measurement of heart rate and HRV indices have been analyzed. Then, the standard deviation of the beat-to-beat error (SDE) was 7.81 ± 3.81 ms in the worst case. Furthermore, in supine measurement posture, significant device influence on the SDE has been found and the SDE is lower with Samsung S5 than Motorola X. This study can be applied to analyze the reliability of different smartphone models for HRV assessment from real-time Android camera frames processing.

  15. Influence of Biphasic Stimulation on Olfactory Ensheathing Cells for Neuroprosthetic Devices

    Science.gov (United States)

    Hassarati, Rachelle T.; Foster, L. John R.; Green, Rylie A.

    2016-01-01

    The recent success of olfactory ensheathing cell (OEC) assisted regeneration of injured spinal cord has seen a rising interest in the use of these cells in tissue-engineered systems. Previously shown to support neural cell growth through glial scar tissue, OECs have the potential to assist neural network formation in living electrode systems to produce superior neuroprosthetic electrode surfaces. The following study sought to understand the influence of biphasic electrical stimulation (ES), inherent to bionic devices, on cell survival and function, with respect to conventional metallic and developmental conductive hydrogel (CH) coated electrodes. The CH utilized in this study was a biosynthetic hydrogel consisting of methacrylated poly(vinyl-alcohol) (PVA), heparin and gelatin through which poly(3,4-ethylenedioxythiophene) (PEDOT) was electropolymerised. OECs cultured on Pt and CH surfaces were subjected to biphasic ES. Image-based cytometry yielded little significant difference between the viability and cell cycle of OECs cultured on the stimulated and passive samples. The significantly lower voltages measured across the CH electrodes (147 ± 3 mV) compared to the Pt (317 ± 5 mV), had shown to influence a higher percentage of viable cells on CH (91–93%) compared to Pt (78–81%). To determine the functionality of these cells following electrical stimulation, OECs co-cultured with PC12 cells were found to support neural cell differentiation (an indirect measure of neurotrophic factor production) following ES. PMID:27757072

  16. Accumulation in liver and spleen of metal particles generated at nonbearing surfaces in hip arthroplasty.

    Science.gov (United States)

    Urban, Robert M; Tomlinson, Michael J; Hall, Deborah J; Jacobs, Joshua J

    2004-12-01

    Systemic migration of metal particles generated at nonbearing surfaces rather than the intended primary bearing was studied in postmortem specimens from 30 patients with total hip arthroplasty. Using light and electron microscopy with x-ray microanalysis, submicrometer metal particles were identified within macrophages in the liver and/or the spleen in 11 of 15 patients with a revised arthroplasty and in 2 of 15 patients with primary hip arthroplasty. The macrophages formed focal aggregates in the organs without apparent toxicity. Fretting at ancillary fixation devices, loose components, and modular connections can generate a substantial volume of debris. These particles are in addition to those generated at the bearing surfaces, further increasing both the local and systemic particulate burdens. While all components can be associated with the distant spread of particles and metal ions, it is the environment of revision arthroplasty that provides the greatest potential for the generation and systemic dissemination of wear debris. The long-term effects of accumulated wear particles in the liver and spleen are unknown. PMID:15578561

  17. Role of negative pressure wound therapy in total hip and knee arthroplasty.

    Science.gov (United States)

    Siqueira, Marcelo Bp; Ramanathan, Deepak; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K

    2016-01-18

    Negative-pressure wound therapy (NPWT) has been a successful modality of wound management which is in widespread use in several surgical fields. The main mechanisms of action thought to play a role in enhancing wound healing and preventing surgical site infection are macrodeformation and microdeformation of the wound bed, fluid removal, and stabilization of the wound environment. Due to the devastating consequences of infection in the setting of joint arthroplasty, there has been some interest in the use of NPWT following total hip arthroplasty and total knee arthroplasty. However, there is still a scarcity of data reporting on the use of NPWT within this field and most studies are limited by small sample sizes, high variability of clinical settings and end-points. There is little evidence to support the use of NPWT as an adjunctive treatment for surgical wound drainage, and for this reason surgical intervention should not be delayed when indicated. The prophylactic use of NPWT after arthroplasty in patients that are at high risk for postoperative wound drainage appears to have the strongest clinical evidence. Several clinical trials including single-use NPWT devices for this purpose are currently in progress and this may soon be incorporated in clinical guidelines as a mean to prevent periprosthetic joint infections. PMID:26807353

  18. ARTHROFIBROSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Ravi B. Solanki

    2014-11-01

    Full Text Available Arthrofibrosis following total knee arthroplasty is an uncommon complication defined as less than 80 degrees of knee flexion 6-8 weeks post operatively. It is characterized by abnormal scarring of the joint in which the formation of dense fibrous tissue and tissue metaplasia prevent normal range of motion. Clinical features include limited knee Range of motion with extension deficit, pain with activities of daily living and unusual amount of pain and swelling post operatively in the absence of infection, bleeding or mechanical complications. We present case of 55 years old female who undergone for total knee replacement before 3 months and presented to our department with complain of knee pain and swelling with activities of daily living. She was diagnosed on the basis of clinical examination. Her detailed evaluation was carried out and Physiotherapy treatment was started.

  19. Outcome after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig;

    2015-01-01

    BACKGROUND: Total elbow arthroplasties (TEAs) are traditionally grouped into linked and unlinked design. The aim was to analyze the difference in clinical outcomes after TEA based on implant design and indication for surgery and to evaluate primary and revision TEAs. METHODS: A total of 167 TEAs...... (126 primary and 41 revision TEAs) in 141 patients were evaluated with patient-reported outcome measure by the Oxford Elbow Score (OES) and clinically assessed with the Mayo Elbow Performance Score (MEPS), range of motion (ROM), and standard radiographs. RESULTS: The mean follow-up was 10.5 years for...... primary and 7.5 years for revision TEAs. There was no difference in OES or MEPS between linked and unlinked primary TEAs. The OES score in the social-psychological domain was significantly lower in TEAs performed due to fracture (67) compared with rheumatoid arthritis (81; P = .025). ROM in extension...

  20. Comprehensive psychological intervention on patients with hip arthroplasty negative emotions and the influence on the quality of life%综合性心理干预对人工髋关节置换术患者负性情绪和生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    张苏霞; 肖翠娥

    2011-01-01

    目的:探讨髋关节置换术后患者负性情绪及生活质量的影响.方法:87例人工髋关节置换术患者随机分为干预组45例和对照组各42例.对照组采取常规护理;干预组在常规护理的基础上,进行综合心理干预.采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和明尼苏达生活质量调查表(LiHFe),分别于入院时和干预1个月后对2组患者进行评分.结果:两组患者入院时SDS、SAS评分比较差异无统计学意义(P>0.05),1个月后干预组SDS、SAS评分显著低于干预前和对照组(P<0.01),1个月后干预组LiHFe量表中所有分值显著减少,与干预前和对照组相比有明显差异(P<0.01).结论:综合性心理干预能够改善人工髋关节置换术患者的焦虑、抑郁情绪,还能明显提高其生活质量.%Objective: Explore patients after total hip arthroplasty negative emotions and the influence on the quality of life. Methods: Patients with hip arthroplasty 87 patients were randomly divided into intervention group and control group. The control group take conventional caret In "conventional nursing intervention group based on the psychological intervention, synthetically. Using anxiety self rating scale (SAS) , depression self rating scale (SDS) and Minnesota quality of life questionnaire (LiHFe.) respectively on admission and intervention for one month after rating 2 groups of patients. Results:Two groups of patients admission SDS, SAS score comparative differences was statistically significantP>0. 05), 1 month after intervention group SDS, SAS score before and significantly below the intervention group (P<0. 01), 1 month after intervention group all LiHFe scale score significantly reduce, and intervention former compared with controls have obvious difference (P<0. 01). Conclusion:Comprehensive psychological intervention can improve patients with hip arthroplasty anxiety, depression mood, still can obviously improve the quality of life.

  1. Hip arthroplasty by matching cups.

    Science.gov (United States)

    Gerard, Y

    1978-01-01

    A total hip surface arthroplasty consisting of matching cups and uncemented prosthetic components is a noteworthy operation. The femoral cup obtains cylindrical support from the femoral head which is reamed in the shape of a cylinder. The acetabular cup is metallic with a polyethylene liner. It is mobile over the bone but its position is constrained by contact with the femoral cup and therefore "self-centering." On the femoral side, the cup must be placed strictly in the axis of the femoral neck. The main consideration in femoral head surface replacement is the vitality of the underlying bone. Necrosis was observed in the earliest clinical trials but there have been no cases of necrosis in the past 3 1/2 years. This is attributed to a more limited surgical approach in which only the anterior part of the gluteus medius is divided and all the posterior elements of the hip are preserved. The acetabulum is sufficiently reamed to receive the cup, which protrudes beyond the external margins of the acetabulum in all positions. Errors have been committed while perfecting the prosthetic material, but the results as determined by a 6 1/2 year follow-up on purely metallic cups are encouraging. Metal-polyethylene cups presently under investigation have almost a 2 year follow-up. The reaction of the acetabulum to an uncemented cup is not yet known. However, the existence of 2 sliding surfaces and the fact that the acetabular cup moves only during the extremes of hip movement, is reason to assume that if the acetabulum is not reamed to expose cancellous bone, the risks of protrusion are minimal or delayed. Total surface arthroplasty by concentric cups has been performed in 335 hips to date. The operation is especially recommended when osteotomy is no longer possible and disabling coxarthrosis is present in relatively young patients. PMID:729253

  2. Influence of Nitrogen Doping on Device Operation for TiO2-Based Solid-State Dye-Sensitized Solar Cells: Photo-Physics from Materials to Devices

    Directory of Open Access Journals (Sweden)

    Jin Wang

    2016-02-01

    Full Text Available Solid-state dye-sensitized solar cells (ssDSSC constitute a major approach to photovoltaic energy conversion with efficiencies over 8% reported thanks to the rational design of efficient porous metal oxide electrodes, organic chromophores, and hole transporters. Among the various strategies used to push the performance ahead, doping of the nanocrystalline titanium dioxide (TiO2 electrode is regularly proposed to extend the photo-activity of the materials into the visible range. However, although various beneficial effects for device performance have been observed in the literature, they remain strongly dependent on the method used for the production of the metal oxide, and the influence of nitrogen atoms on charge kinetics remains unclear. To shed light on this open question, we synthesized a set of N-doped TiO2 nanopowders with various nitrogen contents, and exploited them for the fabrication of ssDSSC. Particularly, we carefully analyzed the localization of the dopants using X-ray photo-electron spectroscopy (XPS and monitored their influence on the photo-induced charge kinetics probed both at the material and device levels. We demonstrate a strong correlation between the kinetics of photo-induced charge carriers probed both at the level of the nanopowders and at the level of working solar cells, illustrating a direct transposition of the photo-physic properties from materials to devices.

  3. Smart Devices as U-Learning Tools: Key Factors Influencing Users’ Intention

    OpenAIRE

    AZIZ, Najibullah

    2015-01-01

    There was a lack of knowledge about the user’s acceptance of smart devices as ubiquitous learning (u-learning) tools at higher education institutions in Sweden. As the mobile technology grows, the demand for mobile devices, particularly smart devices increases as well. With the increase in the usage of smart devices, the higher education institutions provide mobile learning platforms to attract more customers in the competitive industry of education. Thus, understanding the key factors from t...

  4. Cultural and Demographic Factors Influencing Noise Exposure Estimates from Use of Portable Listening Devices in an Urban Environment

    Science.gov (United States)

    Fligor, Brian J.; Levey, Sandra; Levey, Tania

    2014-01-01

    Purpose: This study examined listening levels and duration of portable listening devices (PLDs) used by people with diversity of ethnicity, education, music genre, and PLD manufacturer. The goal was to estimate participants' PLD noise exposure and identify factors influencing user behavior. Method: This study measured listening levels of 160…

  5. Online Behavior and Loyalty Program Participation-parameters Influencing the Acceptance of Contactless Payment Devices

    Directory of Open Access Journals (Sweden)

    Martin Fiedler

    2014-04-01

    Full Text Available This study explores the central perceptions of consumers influencing the decision to use contactless payment instruments. Aim is to define a customer core group narrowed down by several variables and to find a basis for a purposeful communication of advantages of the new payment process, as investment into this technology bears the risk of total loss if the customer group is declining acceptance and the image of a company might be excessively damaged. External variables in context with the usage of social online media and participation in customer loyalty programs have been selected to clarify possible impact. These factors offer comprehensive explanation and help interpreting mechanisms within the decision making process for acceptance of the payment technology. Data were collected in a survey with n = 1,294 customers in a major city in Northern Germany. Results are displayed in a technology acceptance model, using structural equation modelling and regression analysis. The study is not limited on mobile payment instruments in the traditional context respectively involving a mobile phone. On the contrary this analysis is made on the belief that any device can be enabled for contactless payment processes, such as traditional items like credit or debit cards. Customers shopping online have a higher perceived usefulness an customers participating in loyalty programs tend to understand the argument of the ease of use of the technology more than their counterparts.

  6. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying

    2006-01-01

    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  7. Imaging patellar complications after knee arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Melloni, Pietro [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)], E-mail: pmelloni@cspt.es; Valls, Rafael; Veintemillas, Maite [Unitat de Imatge d' Alta Tecnologia, Centre Diagnostic, Corporacio Parc Tauli, Universitat Autonoma de Barcelona, Sabadell (Barcelona) (Spain)

    2008-03-15

    The purpose of this study is to describe complications affecting the patella in patients with total or partial knee arthroplasty. We respectively analysed plain-film radiographs, as well as ultrasound images when acquired, in a consecutive series of 1272 patients. The mean interval from knee replacement to patellar complications was 5 years and 7 months (range, 5 months to 14 years). The complications described include fracture, instability, dislocation or luxation, necrosis of the patella, infection of the patella, erosion of the patella, patellar impingement on the prosthesis and patellar or quadricipital tendon tear. We discuss the pathological imaging findings in the patella and their differential diagnosis after knee arthroplasty. Patellar complications after knee arthroplasty are uncommon but often potentially serious.

  8. Lower limb length and offset in total hip arthroplasty.

    Science.gov (United States)

    Flecher, X; Ollivier, M; Argenson, J N

    2016-02-01

    Restoration of normal hip biomechanics is a key goal of total hip arthroplasty (THA) and favorably affects functional recovery. Furthermore, a major concern for both the surgeon and the patient is preservation or restoration of limb length equality, which must be achieved without compromising the stability of the prosthesis. Here, definitions are given for anatomic and functional limb length discrepancies and for femoral and hip offset, determined taking anteversion into account. Data on the influence of operated-limb length and offset on patient satisfaction, hip function, and prosthesis survival after THA are reviewed. Errors may adversely impact function, quality of life, and prosthetic survival and may also generate conflicts between the surgeon and patient. Surgeons rely on two- or three-dimensional preoperative templating and on intraoperative landmarks to manage offset and length. Accuracy can be improved by using computer-assisted planning or surgery and the more recently introduced EOS imaging system. The prosthetic's armamentarium now includes varus-aligned and lateralized implants, as well as implants with modular or custom-made necks, which allow restoration of the normal hip geometry, most notably in patients with coxa vara or coxa valga. Femoral anteversion must also receive careful attention. The most common errors are limb lengthening and a decrease in hip offset. When symptoms are caused by an error in length and/or offset, revision arthroplasty may deserve consideration. PMID:26797005

  9. Revision of infected knee arthroplasties in Denmark

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens;

    2016-01-01

    Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide...... basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death...

  10. Salvage arthrodesis for failed total ankle arthroplasty

    Science.gov (United States)

    Zürcher, Arthur W

    2010-01-01

    Background and purpose Total ankle arthroplasty (TAA) has gained popularity in recent years. If it fails, however, salvage arthrodesis must be reliable as a rescue procedure. We therefore investigated the clinical, radiographic, and subjective outcome after salvage arthrodesis in a consecutive group of patients, and concentrated on the influence of the method of fixation on union rate and on salvage in inflammatory joint disease. Patients and methods Between 1994 and 2005, salvage arthrodesis was performed on 18 ankles (18 patients). Diagnosis was inflammatory joint disease (IJD) in 15 cases and osteoarthritis (OA) in 3. Tibio-talar fusion was performed in 7 ankles, and tibio-talocalcaneal fusion in 11. Serial radiographs were studied for time to union. Clinical outcome at latest follow-up was measured by the AOFAS score, the foot function index (FFI) and by VAS scores for pain, function, and satisfaction. Results Blade plates were used in 7 ankles (4 IJD, 3 OA); all united. Nonunion developed in 7 of the 11 rheumatic ankles stabilized by other methods. 11 patients (8 fused ankles, 3 nonunions) were available for clinical evaluation. Their mean AOFAS score was 62 and mean overall FFI was 70. VAS score for pain was 20, for function 64, and for satisfaction 74. The scores were similar in united and non-united ankles. Interpretation Blade plate fixation is successful in salvage arthrodesis for failed TAA. A high nonunion rate was found after salvage ankle arthrodesis in IJD with other methods of fixation. Clinical results were fair to good. PMID:20175648

  11. Serum Metal Ion Concentrations in Paediatric Patients following Total Knee Arthroplasty Using Megaprostheses

    Directory of Open Access Journals (Sweden)

    Jörg Friesenbichler

    2014-01-01

    Full Text Available The purpose of this study was to determine the concentrations of cobalt, chromium, and molybdenum in the serum of paediatric tumour patients after fixed hinge total knee arthroplasty. Further, these metal ion levels were compared with serum metal ion levels of patients with other orthopaedic devices such as hip and knee prostheses with metal-on-metal or metal-on-polyethylene articulation to find differences between anatomical locations, abrasion characteristics, and bearing surfaces. After an average follow-up of 108 months (range: 67 to 163 of 11 paediatric patients with fixed hinge total knee arthroplasty, the mean concentrations for Co and Cr were significantly increased while Mo was within the limits compared to the upper values from the reference laboratory. Furthermore, these serum concentrations were significantly higher compared to patients with a standard rotating hinge device (P=0.002 and P<0.001 and preoperative controls (P<0.001. On the other hand, the serum levels of patients following MoM THA or rotating hinge arthroplasty using megaprostheses were higher. Therefore, periodic long-term follow-ups are recommended due to the rising concerns about systemic metal ion exposure in the literature. Upon the occurrence of adverse reactions to metal debris the revision of the fixed hinge implant should be considered.

  12. Analysis of the Influence of Commutation of Unidirectional Electric Machines on Telecommunication Devices

    OpenAIRE

    Jan Poliak

    2002-01-01

    Present time situation in the field of disturbing telecommunication devices is described in the preliminary chapters. The focus of the article is the description and results of the measurement of commutation demonstration on telecommunication devices with both measuring the emissions in the circuit and measuring the electromagnetic emissions.

  13. Probability and heritability estimates on primary osteoarthritis of the hip leading to total hip arthroplasty

    DEFF Research Database (Denmark)

    Skousgaard, Søren Glud; Hjelmborg, Jacob; Skytthe, Axel;

    2015-01-01

    additive genetic component of 47 % (12:79), a shared environmental component of 21 % (2:76) and a unique environment component of 32 % (21:41) accounted for the variation in population liability to total hip arthroplasty. The sex-adjusted proband-wise concordance and heritability on age indicated an...... significant and account for 68 % of the variation in the population liability to total hip arthroplasty; however, the genetic influence increases significantly from 60 years of age onwards....... for the period 1995 to 2010 were examined. Our main outcomes were the cumulative incidence, proband-wise concordance and heritability on age, within-pair correlations in monozygotic and dizygotic twin pairs, and the genetic and environmental influence estimated in models taking into account that...

  14. A Simple Mathematical Standardized Measurement of Acetabulum Anteversion after Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Chen-Kun Liaw

    2008-01-01

    Full Text Available We invented a standardization method to measure the cup's anteversion after total hip arthroplasty without the influence of patient's position. We measured 68 radiographs of 10 patients after total hip replacement (THR and calculated the error of each measurement, defined as the difference with the average of the same measuring method on the same patient. We also calculated the repeatability standard deviation (RSD of each method according to the American Society for Testing and Materials, ASTM E691.

  15. Significant Incidence of Extra-Articular Tibia Vara Affects Radiological Outcome of Total Knee Arthroplasty

    OpenAIRE

    Saibaba, Balaji; Dhillon, Mandeep S.; Chouhan, Devendra K; Kanojia, Rajendra K.; Prakash, Mahesh; Bachhal, Vikas

    2015-01-01

    Purpose To identify and quantify the presence of extra-articular tibia vara that might influence the mechanical axis alignment after total knee arthroplasty (TKA). Materials and Methods A total of 48 TKAs in 30 osteoarthritic Indian patients were prospectively evaluated. The hip-knee-ankle angle (HKA), joint line convergence angle, and varus angulation at the femur and tibia were measured from the preoperative and postoperative standing hip-to-ankle radiographs. Four different methods were us...

  16. PHYSICAL EXERCISE AFTER KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW OF CONTROLLED TRIALS

    OpenAIRE

    Pozzi, F.; Snyder-Mackler, L; Zeni, J.

    2013-01-01

    Total knee arthroplasty (TKA) is the gold standard treatment for end-stage knee osteoarthritis. Most patients report successful long-term outcomes and reduced pain after TKA, but recovery is variable and the majority of patients continue to demonstrate lower extremity muscle weakness and functional deficits compared to age-matched control subjects. Given the potential positive influence of post-operative rehabilitation and the lack of established standards for prescribing exercise paradigms a...

  17. Gait Analysis of Conventional Total Knee Arthroplasty and Bicruciate Stabilized Total Knee Arthroplasty Using a Triaxial Accelerometer

    Science.gov (United States)

    Saito, Hidetomo; Aizawa, Toshiaki; Miyakoshi, Naohisa; Shimada, Yoichi

    2016-01-01

    One component of conventional total knee arthroplasty is removal of the anterior cruciate ligament, and the knee after total knee arthroplasty has been said to be a knee with anterior cruciate ligament dysfunction. Bicruciate stabilized total knee arthroplasty is believed to reproduce anterior cruciate ligament function in the implant and provide anterior stability. Conventional total knee arthroplasty was performed on the right knee and bicruciate stabilized total knee arthroplasty was performed on the left knee in the same patient, and a triaxial accelerometer was fitted to both knees after surgery. Gait analysis was then performed and is reported here. The subject was a 78-year-old woman who underwent conventional total knee arthroplasty on her right knee and bicruciate stabilized total knee arthroplasty on her left knee. On the femoral side with bicruciate stabilized total knee arthroplasty, compared to conventional total knee arthroplasty, there was little acceleration in the x-axis direction (anteroposterior direction) in the early swing phase. Bicruciate stabilized total knee arthroplasty may be able to replace anterior cruciate ligament function due to the structure of the implant and proper anteroposterior positioning. PMID:27648328

  18. Dilemmas in Uncemented Total Hip Arthroplasty

    NARCIS (Netherlands)

    Goosen, J.H.M.

    2009-01-01

    In this thesis, different aspects that are related to the survivorship and clinical outcome in uncemented total hip arthroplasty are analysed. In Chapter 2, the survival rate, Harris Hip score and radiographic features of a proximally hydroxyapatite coated titanium alloy femoral stem (Bi-Metric, Bio

  19. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery...

  20. Hip and knee arthroplasty: quo vadis?

    NARCIS (Netherlands)

    Ho, J.; Meis, J.F.G.M.; Nabuurs-Franssen, M.H.; Voss, A.

    2015-01-01

    Despite of the steady decrease of surgical site infection (SSI) over the last two decades, the incidence of SSI after hip and knee arthroplasty has recently surged. This may be explained by technical changes that may result in an increased risk of SSI, such as the broad implementation of fast track

  1. Favorable results after total wrist arthroplasty

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E. H.; Herzberg, G.; Merser, Søren

    2013-01-01

    Background and purpose During the past 40 years, several attempts have been made with total wrist arthroplasty to avoid fusion in severely destroyed wrists. The results have often been disappointing. There is only modest clinical documentation due to the small number of patients (especially non-r...

  2. Knee Arthroplasty: With or Without Patellar Component?

    Directory of Open Access Journals (Sweden)

    Árpád Sólyom

    2015-09-01

    Full Text Available Arthroplasty is used when there is irreversible damage to the articular cartilage of the knee. It involves implanting a bicompartimental (femoral and tibial components or a tricompartimental (femoral, tibial and patellar components prosthesis. It is a very invasive and costly operation, so our objective was to evaluate the necessity of the patellar component.

  3. Prevention of infection after knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2010-01-01

    Full Text Available Scientific background: Man-made joints (joint endoprostheses, including knee endoprostheses, are used in some irreversible diseases of the human joints. The implantation of joint endoprostheses (arthroplasty is associated with an increased risk for infection. To prevent infections, different interventions without and with the use of antibiotics (hygiene procedures and antibiotic prophylaxis are used. The benefits of these interventions are not clear yet. Research questions: The presented report addresses the questions regarding the medical effectiveness, the cost-effectiveness as well as the ethical, social and legal aspects related to the use of interventions to prevent infections after knee arthroplasty. Methods: A systematic literature search is conducted in the medical electronic databases MEDLINE, EMBASE, SciSearch etc. in June 2009 and has been completed by a hand search. The analysis includes publications which describe and/or evaluate clinical data from randomized controlled trials (RCT, systematic reviews of RCT, registers of endoprostheses or databases concerning interventions to prevent infections after knee arthroplasty. The conducted literature search also aims to identify health-economic studies and publications dealing explicitly with ethical, social or legal aspects in the use of interventions to prevent infections after knee arthroplasty. The synthesis of information from different publications has been performed qualitatively. Results: The systematic literature search yields 1,030 hits. Based on the predefined inclusion and exclusion criteria a total of ten publications is included in the analysis. The presented report does not find evidence of the effectiveness of different hygiene interventions with a high evidence level. Most of the unspecific interventions are recommended on the basis of results from non-RCT, from studies for other clinical indications and/or for clinically not relevant endpoints, as well as on the basis of

  4. A THEORETICAL FRAMEWORK OF THE INFLUENCE OF MOBILITY IN CONTINUED USAGE INTENTION OF SMART MOBILE DEVICE

    Directory of Open Access Journals (Sweden)

    Vincent Cho

    2014-07-01

    Full Text Available In the face of fierce competition in the mobile device market, the only way for smart mobile device producers to maintain and expand their market share is to design and develop products that meet users’ expectations. With the increasing importance of smart mobile devices in people’s lives, mobility is likely to be a key feature that addresses the needs of mobile phone users. Therefore, this survey investigates mobility in four essential aspects: spatiality, temporality, contextuality, and social fluidity with the purpose of finding mobile device functions that users value highly. Special attention is paid to how these constructs affect continued usage intention (CUI through two intermediates: user confirmation and user satisfaction.

  5. Influence of Orientation of Side Ligand Group on Current Through Molecular Device

    Institute of Scientific and Technical Information of China (English)

    Chen H.; Note R.; Mizuseki H.; Kawazoe Y.

    2004-01-01

    1 Introduction The recent significant advances in the molecular electronics show that the molecular device is a good candidate with great potential as the successor to the silicon-based semi-conductors. After the successful experimental work made by Reed et al.[1] in which the single benzene molecule acts as the core of the molecular device, many experimental and theoretical investigations have been done on this subject[2-11].

  6. Influence of Wave State Uncertainties on Probabilistic Reliability Assessments of Wave Energy Devices

    DEFF Research Database (Denmark)

    Ambühl, Simon; Kofoed, Jens Peter; Sørensen, John Dalsgaard

    2013-01-01

    Probabilistic reliability assessments of wave energy devices (WEDs) need to consider, among others, uncertainties related to the wave states, which are often defined by the significant wave height HS and the peak period TP or the mean crossing wave period TZ or the energy period Te. Based on the ...... wind turbines. This paper focus on the Wavestar prototype for reliability assessments. This device is located at DanWEC in Hanstholm (DK)....

  7. Influencing household energy practices: a critical review of UK smart metering standards and commercial feedback devices

    OpenAIRE

    Pullinger, Martin; Lovell, Heather; Webb, Janette

    2014-01-01

    The smart metering systems currently being installed in UK households support devices that give feedback aimed at encouraging behaviour changes, specifically to reduce energy demand and spending on energy. Detailed standards specify the minimum technical capabilities of the smart meters and feedback devices. In this paper, we assess the extent to which these standards enable feedback that is likely to be effective in reducing demand. Latest research in this field, drawing on theories of socia...

  8. Computer-assisted navigation in knee arthroplasty: a critical appraisal.

    Science.gov (United States)

    Venkatesan, Muralidharan; Mahadevan, Devendra; Ashford, Robert U

    2013-10-01

    The purpose of this review was to appraise the use of computer-assisted navigation in total knee arthroplasty and to assess whether this technology has improved clinical outcomes. Studies were identified through searches in MEDLINE, Embase, and PubMed. Numerous studies have shown improved leg and component alignment using navigation systems. However, the better alignment achieved in navigated knee arthroplasty has not been shown to lead to better clinical outcomes. Navigated knee arthroplasty had lower calculated blood loss and lower incidence of fat embolism compared with conventional knee arthroplasty using intramedullary jigs. It may be most valued when dealing with complex knee deformities, revision surgery, or minimally invasive surgery. Navigated knee arthroplasty, however, is only cost-effective in centers with a high volume of joint replacements. Overall, computer-assisted navigated knee arthroplasty provides some advantages over conventional surgery, but its clinical benefits to date are unclear and remain to be defined on a larger scale.

  9. Synovial cutaneous fistula complicating a reverse total shoulder arthroplasty.

    Science.gov (United States)

    Letter, Haley P; Limback, Joseph; Wasyliw, Christopher; Bancroft, Laura; Scherer, Kurt

    2016-06-01

    Reverse total shoulder arthroplasty is becoming a common form of shoulder arthroplasty that is often performed in the setting of rotator cuff pathology. Infection is a rare complication but is more common in reverse total shoulder arthroplasty than in hemiarthroplasty or anatomic total shoulder arthroplasty. We present the case of a 69-year-old patient with a reverse total shoulder arthroplasty who presented with purulent drainage from the skin of his anterior shoulder. Computed tomography arthrogram confirmed the presence of a synovial cutaneous fistula. Synovial cutaneous fistula is a rare variant of periprosthetic infection that, to our knowledge, has not been described previously in the setting of a reverse total shoulder arthroplasty. Computed tomography arthrogram proved to be a reliable method for confirming the diagnosis and was used for operative planning to remove the hardware. PMID:27257460

  10. Mycobacterium smegmatis infection of a prosthetic total knee arthroplasty.

    Science.gov (United States)

    Saffo, Zaid; Ognjan, Anthony

    2016-01-01

    The most common organisms causing prosthetic knee joint infections are staphylococci. However, arthroplasty infections with atypical microbial pathogens, such as Mycobacteria can occur. Due to the rarity of mycobacterial prosthetic joint infections, diagnosis, treatment, and management of these atypical infections represent a clinical challenge. A 71-year old female post-operative day 40 after a left total knee arthroplasty was hospitalized secondary to left knee pain and suspected arthroplasty infection. She had failed outpatient oral antimicrobial treatment for superficial stitch abscess; and outpatient IV/Oral antimicrobials for a clinical postoperative septic bursitis. Ultimately, resection arthroplasty with operative tissue acid fast bacterial cultures demonstrated growth of the Mycobacterium smegmatis group. Post-operatively, she completed a combination course of oral doxycycline and levofloxacin and successfully completed a replacement arthroplasty with clinical and microbial resolution of the infection. To our knowledge, literature review demonstrates three case of knee arthroplasty infection caused by the Mycobacterium smegmatis group. Correspondingly, optimal surgical procedures and antimicrobial management including antimicrobial selection, treatment duration are not well defined. Presently, the best treatment options consists of two step surgical management including prosthesis hardware removal followed by extended antimicrobial therapy, followed by consideration for re-implantation arthroplasty. Our case illustrates importance of considering atypical mycobacterial infections in post-operative arthroplasty infections not responding to traditional surgical manipulations and antimicrobials. For an arthroplasty infection involving the atypical Mycobacterium smegmatis group, two step arthroplasty revision, including arthroplasty resection, with a combination of oral doxycycline and levofloxacin can lead to successful infection resolution, allowing for a

  11. The influence on the contact condition and initial fixation stability of the main design parameters of a self-expansion type anterior cruciate ligament fixation device

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Dae [Jeonju University, Jeonju (Korea, Republic of); Oh, Chae Youn; Kim, Cheol Sang [Chonbuk National University, Jeonju (Korea, Republic of)

    2008-12-15

    This paper proposes a self-expansion type anterior cruciate ligament fixation device. The proposed fixation device provides graft fixation force by maintaining contact with the bone tunnel. Since the device maintains contact with the bone tunnel by the force that expands by the self-driven elastic force of the device, the main design parameters that determine the performance of this device are the ring thickness and expansion angle. This paper develops the three-dimensional finite element models of the fixation device and bone. By simulation with the developed finite element model, this paper studies the influence of the main design parameters of the device on the maximum stress around the ring when grasping the fixation device. Through the analysis of the stress on the bone tunnel wall when the fixation device comes in contact with the bone tunnel, this paper shows the influence of the main design parameters of the fixation device on the contact condition. In addition, through the analysis of the migration that occur upon application of the pull-out force, this paper studies the influence of the main design parameters on the initial fixation stability of the fixation device

  12. Factors that influence the tribocharging of pulverulent materials in compressed-air devices

    International Nuclear Information System (INIS)

    Tribocharging of pulverulent materials in compressed-air devices is a typical multi-factorial process. This paper aims at demonstrating the interest of using the design of experiments methodology in association with virtual instrumentation for quantifying the effects of various process varaibles and of their interactions, as a prerequisite for the development of new tribocharging devices for industrial applications. The study is focused on the tribocharging of PVC powders in compressed-air devices similar to those employed in electrostatic painting. A classical 2 full-factorial design (3 factors at two levels) was employed for conducting the experiments. The response function was the charge/mass ratio of the material collected in a modified Faraday cage, at the exit of the tribocharging device. The charge/mass ratio was found to increase with the injection pressure and the vortex pressure in the tribocharging device, and to decrease with the increasing of the feed rate. In the present study an in-house design of experiments software was employed for statistical analysis of experimental data and validation of the experimental model.

  13. Influence of the inlet air in efficiency of photocatalytic devices for mineralization of VOCs in air-conditioning installations.

    Science.gov (United States)

    Jimenez-Relinque, E; Castellote, M

    2014-10-01

    Nowadays, a large proportion of photocatalytic oxidation (PCO) devices are being implemented in heating, ventilation and air-conditioning systems. However, no systematic studies have been carried out regarding the influence of inlet air preconditioning. To analyse the impact of the inlet air-conditions into photocatalytic efficiency, a simulated air-conditioning duct with flowing gas through inside was designed. Isobutylene was chosen as the target VOCs. The concentration in the gas phase was monitored using a photoionization detector. The influence of flow rate, relative humidity and temperature on the VOC removal efficiency was analysed. Experimental results were presented in terms of gas-removal efficiency (η) and clean air delivery rate (CADR) and analysed on a kinetic basis. From them, the weight of each parameter in the global process has been determined, from bigger to smaller contribution, flow>temperature>relative humidity. Also, the relevance of the inlet air conditions has been illustrated in a model room in order to determinate the time necessary to obtain a threshold value accomplishing with enough air quality and the energy consumption of the device. Additionally, the photocatalytic decontamination has been assimilated to the "air exchange rate", a parameter commonly used in indoor air quality studies. The results show that preconditioning of air can improve the efficiency of photocatalytic devices and bring important energy savings.

  14. Anteroposterior glide versus rotating platform low contact stress (LCS knee arthroplasty: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Wynn-Jones Charles

    2007-08-01

    Full Text Available Abstract Background Fifty thousand knee replacements are performed annually in the UK at an estimated cost of £150 million. Post-operative improvement depends on a number of factors including implant design and patient associated factors. To our knowledge there are no published study's comparing the results of AP glide and rotating platform designs of LCS knee arthroplasty. Therefore we feel that a study is required to investigate and compare the effects of two types of LCS total knee arthroplasty on joint proprioception and range of motion. Methods/Design Patients will be randomised to receive either a LCS AP glide or Rotating platform prosthesis. Clinical scores (Oxford knee score, American knee society score, EuroQol, range of motion and proprioception will be assessed prior to and at 3,6, 12 and 24 months after the operation. Proprioception will be assessed in terms of absolute error angle (mean difference between the target angle and the response angle. Knee angles will be measured in degrees using an electromagnetic tracking device, Polhemus 3Space Fastrak that detects positions of sensors placed on the test limb. Student's t-test will be used to compare the mean of two groups. Discussion Evidence is lacking concerning the best prosthesis to use for patients undergoing total knee replacement. This pragmatic randomised trial will test the null hypothesis that anteroposterior glide LCS knee arthroplasty does not result in better post operative knee motion and proprioception as compared to rotating platform LCS knee. Trial Registration ISRCTN52943804

  15. Pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities.

    Science.gov (United States)

    Mehrotra, D; Vishwakarma, K; Chellapa, A L; Mahajan, N

    2016-07-01

    The aim of this study was to evaluate the hard and soft tissue changes after pre-arthroplasty simultaneous maxillomandibular distraction osteogenesis for the correction of post-ankylotic dentofacial deformities. This prospective study included 10 patients with unilateral temporomandibular joint (TMJ) ankylosis who presented with a facial deformity and a maxillary cant. Informed patient consent was obtained for participation. Simultaneous maxillomandibular distraction was planned based on clinical and radiographic examinations. A horizontal mandibular osteotomy was performed in the ramus and the distractor device was fixed. A bilateral Le Fort I osteotomy was then performed and a four-hole straight plate was fixed on the contralateral zygomatic buttress to act as a fulcrum. After a latency period of 5 days, the distractor was activated twice daily by 0.5mm until the required vertical lengthening was achieved. Intermaxillary fixation was maintained during the entire distraction period. After a consolidation period of 8-12 weeks, the distractor was removed. The TMJ ankylosis was released and a temporal fascia interpositional arthroplasty was performed as second surgery, along with a genioplasty if needed. All patients were followed up for a period of 12-24 months. A marked improvement in the facial asymmetry was noted in all cases. The occlusal cant and mandibular retrusion improved satisfactorily, and the average postoperative inter-incisal opening was 35.6mm. Pre-arthroplasty simultaneous maxillomandibular distraction offers a good treatment outcome, as it allows improvements in facial aesthetics as well as function. PMID:26780926

  16. Numerical simulation of the influence of a left ventricular assist device on the cardiovascular system

    NARCIS (Netherlands)

    Verkerke, GJ; Geertsema, AA; Mihaylov, D; Blanksma, PK; Rakhorst, G

    2000-01-01

    The PUCA (pulsatile catheter) pump is a left ventricular assist device (LVAD) capable of unloading the left ventricle (LV) and improving coronary flow by providing a counterpulsation effect. If consists of an extracorporeal located membrane pump, coupled to a transarterial catheter that enters the b

  17. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... and drill her. And how much are you rotating there? This rotates 3 degrees externally with respect ... femoral components that can be used. With the rotating knee system, a class III device at this ...

  18. Minimally Invasive Total Knee Arthroplasty

    Medline Plus

    Full Text Available ... there’s any change that makes us concentrate and focus on ligament balancing a little more than we ... be used. With the rotating knee system, a class III device at this point, with respect to ...

  19. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.;

    1989-01-01

    the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients......The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  20. Cost Analysis in Shoulder Arthroplasty Surgery

    Directory of Open Access Journals (Sweden)

    Matthew J. Teusink

    2012-01-01

    Full Text Available Cost in shoulder surgery has taken on a new focus with passage of the Patient Protection and Affordable Care Act. As part of this law, there is a provision for Accountable Care Organizations (ACOs and the bundled payment initiative. In this model, one entity would receive a single payment for an episode of care and distribute funds to all other parties involved. Given its reproducible nature, shoulder arthroplasty is ideally situated to become a model for an episode of care. Currently, there is little research into cost in shoulder arthroplasty surgery. The current analyses do not provide surgeons with a method for determining the cost and outcomes of their interventions, which is necessary to the success of bundled payment. Surgeons are ideally positioned to become leaders in ACOs, but in order for them to do so a methodology must be developed where accurate costs and outcomes can be determined for the episode of care.

  1. Thromboembolism prophylaxis practices in orthopaedic arthroplasty patients.

    LENUS (Irish Health Repository)

    Cawley, D

    2010-10-01

    Thromboembolic events are a post-operative complication of arthroplasty surgery for up to 3 months. The incidence however, is not fully known. Some form of prophylaxis should be provided to all arthroplasty patients. Clinicians are wary of side effects, compliance profile and the associated cost. The objective of this study is to investigate practice patterns and their relevance to 3 risk groups. Ninety questionnaires were sent to orthopaedic surgeons with 3 hypothetical clinical scenarios and 10 prophylaxis regimes for thromboembolism across different risk groups. The response rate was 81\\/90 (90%). The most popular options in all 3 cases were early mobilisation, thrombo-embolism deterrant (TED) stockings and low molecular weight heparin (LMWH) (51\\/81, 62% of all cases). An inconsistent relationship exists between preferred practice and relevant guidelines. Preferred practice does not correlate with each level of risk.

  2. Disorder induced interface states and their influence on the Al/Ge nanowires Schottky devices

    Energy Technology Data Exchange (ETDEWEB)

    Simon, R. A.; Kamimura, H.; Chiquito, A. J. [NanO LaB - Departamento de Física, Universidade Federal de São Carlos, CEP 13565-905, CP 676 São Carlos, São Paulo (Brazil); Berengue, O. M. [Departamento de Física e Química, Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista Júlio de Mesquita Filho, CEP 12516-410 Guaratingueta, São Paulo (Brazil); Leite, E. R. [Laboratório Interdisciplinar de Eletroquímica e Cerâmicas, Departamento de Química, Universidade Federal de São Carlos, CEP 135665-905, CP 676 São Carlos, São Paulo (Brazil)

    2013-12-28

    It has been demonstrated that the presence of oxide monolayers in semiconductor surfaces alters the electronic potential at surfaces and, consequently, can drastically affect the electronic transport features of a practical device such as a field effect transistor. In this work experimental and theoretical approaches to characterize Al/germanium nanowire Schottky devices by using samples covered with a thin oxide layer (2 nm width) were explored. It was also demonstrated that the oxide layer on Ge causes a weak dependence of the metal work function on Schottky barrier heights indicating the presence of Fermi level pinning. From theoretical calculations the pinning factor S was estimated to range between 0.52 and 0.89, indicating a weak Fermi level pinning which is induced by the presence of charge localization at all nanowires' surface coming from interface states.

  3. The Influence of Unsteadiness on the Analysis of Pressure Gain Combustion Devices

    Science.gov (United States)

    Paxson, Daniel E.; Kaemming, Tom

    2013-01-01

    Pressure gain combustion (PGC) has been the object of scientific study for over a century due to its promise of improved thermodynamic efficiency. In many recent application concepts PGC is utilized as a component in an otherwise continuous, normally steady flow system, such as a gas turbine or ram jet engine. However, PGC is inherently unsteady. Failure to account for the effects of this periodic unsteadiness can lead to misunderstanding and errors in performance calculations. This paper seeks to provide some clarity by presenting a consistent method of thermodynamic cycle analysis for a device utilizing PGC technology. The incorporation of the unsteady PGC process into the conservation equations for a continuous flow device is presented. Most importantly, the appropriate method for computing the conservation of momentum is presented. It will be shown that proper, consistent analysis of cyclic conservation principles produces representative performance predictions.

  4. The Influence of the Construction of the Cooling System of Semiconductor Devices on the Watt-Hour Efficiency of DC-DC Converters

    Science.gov (United States)

    Zarębski, Janusz; Górecki, Krzysztof

    In the paper the influence of cooling conditions of semiconductor devices on the characteristics of a boost converter is considered. The form of the thermal model of semiconductor devices is proposed and some results of calculations and measurements of the characteristics of this converter are shown. The investigations were performed for the selected types of power MOSFETs operating at different cooling conditions.

  5. Proximal humeral fractures treated with arthroplasty

    Institute of Scientific and Technical Information of China (English)

    QIAN Qi-rong; WU Hai-shan; ZHOU Wei-jiang; LI Xiao-hua; WU Yu-li

    2005-01-01

    Objective: To explore arthroplasty in treating 3- and 4-part fractures of the proximal humerus.Methods: A total of 132 patients with proximal humeral fractures were treated in our hospital from July 1997 to February 2003. According to Neer's classification, the fractures of 45 patients (14 males and 31 females, aged 31-78 years, 56.1 years±7.8 years on an average) belonged to 3- or 4-part fractures (10 patients with 4-part fracture and 35 with 3-part comminuted fracture) and they were treated with shoulder joint arthroplasty. Unipolar prosthesis replacement of the head of humerus was made in 28 cases, while bipolar prosthesis replacement in 2 cases and total shoulder joint replacement in 15 cases. Results: During the follow-up period (range: 12-72 months, mean: 37.3 months±4.1 months), among the 45 patients who suffered from fractures of the proximal humerus and underwent arthroplasty surgery, 44 patients (97.8%) had no postoperative pain and were satisfied with the active range of motion and with the whole treatment results. And radiography showed that the prostheses were at their good position. One patient had postoperative pain because he had so narrow medullary cavity that the humeral prosthesis could not be put deeply enough and the prosthesis head was a little higher over the anatomic level. He did not have good postoperative active range of motion, either. Then he received a review surgery and got satisfied results. Temporary shoulder stiffness was observed in one patient. Manual release of these adhesions improved the shoulder function. No evidence of nonunion of the fracture segments around the humeral prosthesis stem was found. Conclusions: Shoulder arthroplasty is a dependable method to restore the comfort and function of the should joints of the patients with 3- or 4-part fractures of the proximal humerus.

  6. Infected total knee arthroplasty treatment outcome analysis

    OpenAIRE

    Radoičić Dragan; Popović Zoran; Barjaktarović Radoslav; Marinković Jugoslav

    2012-01-01

    Background/Aim. Infected total knee arthroplasty (TKA) is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA) in Belgrade. ...

  7. Future Bearing Surfaces in Total Hip Arthroplasty

    OpenAIRE

    Chang, Jun-Dong

    2014-01-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom...

  8. Patient-reported outcome after fast-track knee arthroplasty

    DEFF Research Database (Denmark)

    Larsen, Kristian; Hansen, Torben Bæk; Søballe, Kjeld;

    2012-01-01

    PURPOSE: The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we...

  9. Environmental settings and families' socioeconomic status influence mobility and the use of mobility devices by children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Valéria C. R. Cury

    2013-02-01

    Full Text Available Functional mobility of children with cerebral palsy (CP is influenced by personal and environmental factors, serving as barriers and/or facilitators and impacting on children's strategies and functional outcome. OBJECTIVES: To describe typical mobility methods used by children with CP at home, school and community and to compare them across family's socioeconomic levels (SES. METHODS: The Functional Mobility Scale was used to assess mobility of 113 children with CP of high and low SES at home, school, and community. RESULTS: Differences in mobility methods of participants classified as Gross Motor Function Classification System levels II, III and IV were found between home and community. For levels III and IV, differences were also found between home and school. At home, participants from higher SES used wheelchairs more frequently while those from lower SES used floor mobility (crawling. CONCLUSIONS: Environmental settings and families' socioeconomic status influence mobility and use of mobility devices by children with CP.

  10. Resurfacing shoulder arthroplasty for the treatment of severe rheumatoid arthritis

    DEFF Research Database (Denmark)

    Voorde, Pia C Ten; Rasmussen, Jeppe V; Olsen, Bo S;

    2015-01-01

    . INTERPRETATION: This study shows that shoulder arthroplasty, regardless of design, is a good option in terms of reducing pain and improving function in RA patients. The high revision rate in the RHA group suggests that other designs may offer better implant survival. However, this should be confirmed in larger......BACKGROUND AND PURPOSE: There is no consensus on which type of shoulder prosthesis should be used in patients with rheumatoid arthritis (RA). We describe patients with RA who were treated with shoulder replacement, regarding patient-reported outcome, prosthesis survival, and causes of revision......, and we compare outcome after resurfacing hemi-arthroplasty (RHA) and stemmed hemi-arthroplasty (SHA). PATIENTS AND METHODS: We used data from the national Danish Shoulder Arthroplasty Registry and included patients with RA who underwent shoulder arthroplasty in Denmark between 2006 and 2010. Patient...

  11. Do Mandibular Advancement Devices Influence Patients' Snoring and Obstructive Sleep Apnea?

    DEFF Research Database (Denmark)

    Marcussen, Lillian; Henriksen, Jan Erik; Thygesen, Torben

    2015-01-01

    Student's t test and the Wilcoxon signed rank test, and mixed-model analyses were performed adjusting for sleep apnea severity, type 2 diabetes, body mass index, gender, and age. RESULTS: A total of 44 patients (31 men and 13 women, age 50 ± 13 years, body mass index 31 ± 5.6 kg/m(2)) completed the trial......PURPOSE: The upper airway volume is central to the development and treatment of snoring and obstructive sleep apnea, and mandibular advancement devices (MADs) have increasingly been used as an effective alternative to continuous positive airway pressure for these 2 conditions. We investigated...

  12. Effect of clearance on cartilage tribology in hip hemi-arthroplasty.

    Science.gov (United States)

    Lizhang, Jia; Taylor, Simon D; Jin, Zhongmin; Fisher, John; Williams, Sophie

    2013-12-01

    Hemi-arthroplasty of the hip (an artificial femoral head articulating against the natural acetabulum) is used to treat fractured necks of femur; however, there is evidence that articulation causes erosion of the cartilage, resulting in pain for the patient. Parameters that may influence this cartilage erosion include head material and roughness, clearance between the head and acetabulum and activity levels of the patient. This study has assessed the effect of clearance of hemi-arthroplasty articulations on the contact stress, friction and cartilage deformation in an in vitro tribological simulation of the hemi-arthroplasty joint that applied dynamic loads and motion. It has been demonstrated that peak contact stress increased from 5.6 to 10.6 MPa as radial clearance increased from small (1.8 mm). In all samples, friction factor increased with time and was significantly less with extra-large clearances compared to small (<0.6 mm), medium (0.6-1.2 mm) and large (1.2-1.8 mm) clearances. The cartilage deformation observed was significantly greater in acetabulum samples paired to give small or extra-large clearances compared to those with medium or large clearances.

  13. Influence of gender on EVAR outcomes with new low-profile devices

    DEFF Research Database (Denmark)

    Bendermacher, B L W; Grootenboer, Nathalie; Cuypers, Ph W;

    2013-01-01

    Women have not benefitted to the same extent as men of endovascular abdominal aortic repair (EVAR). Besides differences in hormones and the higher rate of undiagnosed cardiovascular disease, there are anatomical differences between men and women influencing the outcome of endovascular treatment o...

  14. Influence of cathode material on emission characteristics of field emitters for microelectronics devices

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Junzo; Tsuji, Hiroshi; Gotoh, Yashuhito [Kyoto Univ. (Japan)] [and others

    1993-03-01

    In order to find out the cathode material suitable to vacuum microelectronics devices, dependence of cathode material of field emitters was investigated with respect to the emission characteristics. Since the field emitters for vacuum microelectronics devices are fabricated by thin film processes, the characteristics of the electron emission from deposited materials should be examined. In the present study, a dozen materials were deposited onto the tungsten needle fabricated by well-controlled electrochemical etching. Measurement of the emission was performed at the pressure of 10{sup -9} Torr range. The current-voltage characteristics and the stability measurements revealed that the gold emitters indicated excellent properties: stable and high current at low extraction voltage. The effective surface work function and the effective emission area were evaluated from the Fowler-Nordheim theory, assuming that the emission area rapidly decreases with reducing the apex radius. From this analysis, it is clarified that the gold emitter had the lowest effective work function among the examined emitters. The results can be interpreted as that in order to obtain stable emission characteristics, materials with inert surface should be selected. 13 refs., 6 figs., 1 tab.

  15. The inhalation device influences lung deposition and bronchodilating effect of terbutaline.

    Science.gov (United States)

    Borgström, L; Derom, E; Ståhl, E; Wåhlin-Boll, E; Pauwels, R

    1996-05-01

    The development of new inhalation devices for asthma drugs raises the issue of the relationship between pulmonary deposition and therapeutic effect of inhaled drugs in patients with obstructive lung diseases. We thus conducted a randomized, double-blind and double-dummy, four-period crossover study in 13 patients with moderate asthma (mean age 36 yr; FEV1 59% of predicted), who inhaled 0.25 and 0.5 mg terbutaline sulphate on separate occasions either via a pressurized metered dose inhaler (pMDI) or Turbuhaler (TBH). Pulmonary deposition was 8.1 +/- 2.7% and 8.3 +/- 2.3%, respectively, of the nominal dose for pMDI and 19.0 +/- 7.3%, and 22.0 +/- 8.1% for TBH. The FEV1 increase after 0.25 mg terbutaline sulphate via TBH was significantly greater than after 0.25 mg via pMDI. No significant differences in FEV1 increase were observed between 0.25 mg via TBH, 0.5 mg via pMDI, or 0.5 mg via TBH. Other lung function variables showed similar dose- and device-related changes. We concluded that: (1) the dose of terbutaline sulphate deposited in the lungs is dependent on which inhalation system is used; (2) TBH delivers about twice the amount of drug to the lungs as the pMDI; and (3) the observed difference in deposition is reflected in the bronchodilating effect. PMID:8630614

  16. Effect of proximal femoral osteoporosis on cementless hip arthroplasty: A short-term clinical analysis

    Institute of Scientific and Technical Information of China (English)

    LOU Xian-feng; LI Yu-hong; LIN Xiang-jin

    2007-01-01

    Objective: The aim of this retrospective investigation was to explore the influence of femoral osteoporosis on short-term curative effects of cementless hip arthroplasty and to evaluate the femoral metaphyseal bone mineral density (BMD) for femoral osteoporosis in order to guide prosthesis choice and rehabilitation. Methods: We performed 127 total arthroplasty operations between June 1999 to February 2003 and investigated 49 cementless hip replacements with the Metalcancellous cementless Lubeck Ⅱ system being used in all hips. There were twenty men and twenty-nine women whose mean age at the time of the operation was 60 years (range, 52~81 years). The patients were divided into osteoporosis or normal groups according to the femoral metaphyseal BMD measured preoperatively. The average duration of follow-up was 30 months (range, 8~52 months). We evaluated all of the patients from a clinical standpoint with use of a standard-terminology questionnaire with respect to the short-term curative effects and patients' satisfaction. Hip pain status and functional ability were important indicators of treatment efficacy. Results: Harris hip score and patients' satisfaction in femoral osteoporosis patients who underwent noncemented hip arthroplasty were lower (P=0.004, P=0.03) while the incidence of thigh pain was higher (P=0.03) than the patients with non-osteoporosis. Conclusion: The higher incidence of pain, as well as the decrease in function experienced by the patients in osteoporosis group, supports the case that cementless arthroplasty is not a better choice for those patients and that we had better select prosthesis based on the femoral metaphyseal BMD.

  17. The Influence of Graphene Curvature on Hydrogen Adsorption: Towards Hydrogen Storage Devices

    CERN Document Server

    Goler, Sarah; Tozzini, Valentina; Piazza, Vincenzo; Mashoff, Torge; Beltram, Fabio; Pellegrini, Vittorio; Heun, Stefan

    2013-01-01

    The ability of atomic hydrogen to chemisorb on graphene makes the latter a promising material for hydrogen storage. Based on scanning tunneling microscopy techniques, we report on site-selective adsorption of atomic hydrogen on convexly curved regions of monolayer graphene grown on SiC(0001). This system exhibits an intrinsic curvature owing to the interaction with the substrate. We show that at low coverage hydrogen is found on convex areas of the graphene lattice. No hydrogen is detected on concave regions. These findings are in agreement with theoretical models which suggest that both binding energy and adsorption barrier can be tuned by controlling the local curvature of the graphene lattice. This curvature-dependence combined with the known graphene flexibility may be exploited for storage and controlled release of hydrogen at room temperature making it a valuable candidate for the implementation of hydrogen-storage devices.

  18. Online Behavior and Loyalty Program Participation-parameters Influencing the Acceptance of Contactless Payment Devices

    OpenAIRE

    Martin Fiedler; Ali Öztüren

    2014-01-01

    This study explores the central perceptions of consumers influencing the decision to use contactless payment instruments. Aim is to define a customer core group narrowed down by several variables and to find a basis for a purposeful communication of advantages of the new payment process, as investment into this technology bears the risk of total loss if the customer group is declining acceptance and the image of a company might be excessively damaged. External variables in context with the us...

  19. Reliability and Validity of the Dutch Version of the International Physical Activity Questionnaire in Patients After Total Hip Arthroplasty or Total Knee Arthroplasty

    NARCIS (Netherlands)

    Blikman, Tim; Stevens, Martin; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge; Reininga, Inge H. F.

    2013-01-01

    STUDY DESIGN: Psychometric assessment. OBJECTIVES: To determine test-retest reliability and concurrent validity of the International Physical Activity Questionnaire (IPAQ) in patients after total hip arthroplasty or total knee arthroplasty. BACKGROUND: Despite recognized benefits of regular physical

  20. The influence of polydimethylsiloxane curing ratio on capillary pressure in microfluidic devices

    Energy Technology Data Exchange (ETDEWEB)

    Viola, Ilenia, E-mail: ilenia.viola@nano.cnr.it [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), c/o Dipartimento di Fisica, Universita La Sapienza, I-00185 Roma (Italy); Zacheo, Antonella [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); Universita del Salento, Dip. Matematica e Fisica ' Ennio De Giorgi' , via Arnesano, I-73100 Lecce (Italy); Arima, Valentina [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); Arico, Antonino S. [CNR-ITAE Institute, via Salita S. Lucia sopra Contesse, I-98126 Messina (Italy); Cortese, Barbara [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); Manca, Michele [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); Italian Institute of Technology (IIT), Center for Biomolecular Nanotechnologies (Italy); Zocco, Anna [STMicroelectronics, MFD Division, Application Laboratory Lecce, via Arnesano, I-73100 Lecce (Italy); Taurino, Antonietta [CNR, Istituto per la Microelettronica e Microsistemi (IMM), via Monteroni, I-73100 Lecce (Italy); Rinaldi, Ross [National Nanotechnology Laboratory-Institute Nanoscience-CNR (NNL-CNR NANO), via Arnesano, I-73100 Lecce (Italy); Universita del Salento, Dip. Matematica e Fisica ' Ennio De Giorgi' , via Arnesano, I-73100 Lecce (Italy); and others

    2012-08-01

    Investigations on surface properties of poly(dimethylsiloxane) (PDMS) are justified by its large application ranges especially as coating polymer in fluidic devices. At a micrometer scale, the liquid dynamics is strongly modified by interactions with a solid surface. A crucial parameter for this process is microchannel wettability that can be tuned by acting on surface chemistry and topography. In literature, a number of multi-step, time and cost consuming chemical and physical procedures are reported. Here we selectively modify both wetting and mechanical properties by a single step treatment. Changes of PDMS surface were investigated by X-ray photoelectron spectroscopy and atomic force microscopy and the effects of interface properties on the liquid displacement inside a microfluidic system were evaluated. The negative capillary pressure obtained tailoring the PDMS wettability is believed to be promising to accurately control sample leakage inside integrated lab-on-chip by acting on the liquid confinement and thus to reduce the sample volume, liquid drying as well as cross-contamination during the operation.

  1. People who undergo revision arthroplasty report more limitations but no decrease in physical activity compared with primary total hip arthroplasty : an observational study

    NARCIS (Netherlands)

    Stevens, Martin; Hoekstra, Tsjerk; Wagenmakers, Robert; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2009-01-01

    Question: Do people who have had revision arthroplasty report more limitations and less physical activity than those after primary total hip arthroplasty? Can degree of limitation and physical activity be predicted by revision arthroplasty, after adjustment for age, gender, and Charnley classificati

  2. Total elbow arthroplasty: a radiographic outcome study

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xue Susan [University of Washington, Department of Radiology, Box 357115, Seattle, WA (United States); Petscavage-Thomas, Jonelle M. [Penn State Hershey Medical Center, Department of Radiology, Hershey, PA (United States); Ha, Alice S. [University of Washington, Department of Radiology, Box 354755, Seattle, WA (United States)

    2016-06-15

    Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain. This is an IRB-approved retrospective review from 2005 to 2015 of all patients with semiconstrained TEA. All available elbow radiographs and clinical data were reviewed. Data analysis included descriptive statistics and Kaplan-Meier survival curves for radiographic and clinical survival. A total of 104 total elbow arthroplasties in 102 patients were reviewed; 75 % were in women and the mean patient age was 63.1 years. Mean radiographic follow-up was 826 days with average of four radiographs per patient. Seventy TEAs (67 %) developed radiographic complications, including heterotopic ossification (48 %), perihardware lucency (27 %), periprosthetic fracture (23 %), hardware subluxation/dislocation (7 %), polyethylene wear (3 %), and hardware fracture/dislodgement (3 %); 56 patients (55 %) developed symptoms of elbow pain or instability and 30 patients (30 %) underwent at least one reoperation. In patients with radiographic complications, 66 % developed elbow pain, compared to 19 % of patients with no radiologic complications (p = 0.001). Of the patients with radiographic complications, 39 % had at least one additional surgery compared to 0 % of patients without radiographic complications (p = 0.056). Radiographic complications are common in patients after total elbow arthroplasty. There is a strong positive association between post-operative radiographic findings and clinical outcome. Knowledge of common postoperative radiographic findings is important for the practicing radiologist. (orig.)

  3. Introduction of two novel devices for investigating the influence of non-mechanical components such as therapeutic qi in acupuncture

    Institute of Scientific and Technical Information of China (English)

    Raphael J.Hochstrasser; P.Christian Endler; Sabine D.Klein

    2013-01-01

    OBJECITVE:Acupuncture is a complex intervention consisting of specific and non-specific components.Acupuncture studies more frequently focus on collecting data from the patients'perspective and response,but the acupuncturist's role remains relatively unclear.In order to investigate potential non-mechanical active factors originating from the acupuncturist and transmitted to the patient during treatment,two novel devices for basic research in acupuncture were designed.The Acuplicator allows the researcher to insert needles without touching the needles themselves,while the Veliusator locks the needle in its place so that no mechanical movement can be transferred.METHODS:The Acuplicator was used to insert needles at Neiguan (PC6) on the right forearm of 23 volunteers.The insertion depth was measured using a depth gauge.The transfer of mechanical movements from the handle to the tip was detected with a precision length gauge with a motoric-tactile sensor.RESULTS:The mean insertion depth was (12.3 ± 1.5) mm (range 9.5 to 15.0 mm).Even with intense manipulation of the needle handle,no movements within ± 1 μm could be detected at the tip when the needle was locked.CONCLUSION:With these two devices it will be possible to investigate the influence of nonmechanical components such as therapeutic qi in acupuncture.

  4. Total Hip Arthroplasty in Mucopolysaccharidosis Type IH

    Directory of Open Access Journals (Sweden)

    S. O'hEireamhoin

    2011-01-01

    Full Text Available Children affected by mucopolysaccharidosis (MPS type IH (Hurler Syndrome, an autosomal recessive metabolic disorder, are known to experience a range of musculoskeletal manifestations including spinal abnormalities, hand abnormalities, generalised joint stiffness, genu valgum, and hip dysplasia and avascular necrosis. Enzyme therapy, in the form of bone marrow transplantation, significantly increases life expectancy but does not prevent the development of the associated musculoskeletal disorders. We present the case of a 23-year-old woman with a diagnosis of Hurler syndrome with a satisfactory result following uncemented total hip arthroplasty.

  5. Navigated minimally invasive unicompartmental knee arthroplasty.

    Science.gov (United States)

    Jenny, Jean-Yves; Müller, Peter E; Weyer, R; John, Michael; Weber, Patrick; Ciobanu, Eugène; Schmitz, Andreas; Bacher, Thomas; Neumann, Wolfram; Jansson, Volkmar

    2006-10-01

    Unicompartmental knee arthroplasty (UKA) is an alternative procedure to high tibial osteotomy. This study assessed the procedure using computer navigation to improve implantation accuracy and presents early radiological results of a group of patients implanted with the univation UKA (B. Braun Aesculap, Tuttlingen, Germany) with navigation instrumentation and a minimally invasive approach. The authors concluded that navigated implantation of a UKA using a nonimage-based system improved radiologic accuracy implantation without significant inconvenience and minimal change in the conventional operating technique. PMID:17407935

  6. Vaginal mass following uncemented total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Young-Soo Shin

    2014-01-01

    Full Text Available A 53-year-old woman developed a vaginal mass following an uncemented total hip arthroplasty. The mass was in direct communication with the hip through an acetabular medial wall defect after loosening of the acetabular component. The mass formation was caused simultaneously by changes secondary to polyethylene wear, a tiny delamination of the porous titanium mesh coating and a broken antirotational tab on the acetabular cup, all of which may have served as sources of metal particles. A careful evaluation of the patient′s history, symptoms, X-ray findings and computed tomography scans should always be performed to ensure accurate diagnosis.

  7. Hip and knee arthroplasty: quo vadis?

    OpenAIRE

    Ho, J; Meis, J. F. G. M.; Nabuurs-Franssen, M.H.; Voss, A.

    2015-01-01

    Despite of the steady decrease of surgical site infection (SSI) over the last two decades, the incidence of SSI after hip and knee arthroplasty has recently surged. This may be explained by technical changes that may result in an increased risk of SSI, such as the broad implementation of fast track programs, and/or early interventions on suspected SSI. By definition, early intervention may lead to a higher SSI score, even in the absence of a true SSI. In any case, the reverse trend of SSI war...

  8. Superficial wound closure complications with barbed sutures following knee arthroplasty.

    Science.gov (United States)

    Campbell, Abigail L; Patrick, David A; Liabaud, Barthelemy; Geller, Jeffrey A

    2014-05-01

    As quality measures may be increasingly used in knee surgery reimbursement, an important focus in outcome assessment will shift toward minimizing complications and increasing efficiency in knee arthroplasty reconstruction. The purpose of this study was to evaluate the efficacy of barbed, absorbable sutures in closure of the longitudinal surgical incision following knee arthroplasty, using post-operative complication occurrences. In 416 operations, primary outcomes assessed were deep infection, superficial infection, dehiscence, or stitch abscesses. Secondary outcomes included self-limiting eschar, severe effusion, arthrofibrosis, and keloid formation. Evaluation of overall primary outcomes showed a higher rate of wound complications using barbed sutures (P knee arthroplasty should be avoided. PMID:24184326

  9. Factors that shape the patient's hospital experience and satisfaction with lower limb arthroplasty: an exploratory thematic analysis

    OpenAIRE

    Lane, J V; Hamilton, D. F.; MacDonald, D J; Ellis, C; Howie, C R

    2016-01-01

    Objective It is generally accepted that the patients’ hospital experience can influence their overall satisfaction with the outcome of lower limb arthroplasty; however, little is known about the factors that shape the hospital experience. The aim of this study was to develop an understanding of what patients like and do not like about their hospital experience with a view to providing insight into where service improvements could have the potential to improve the patient experience and their ...

  10. Initial Results of an Acetabular Center Axis Registration Technique in Navigated Hip Arthroplasty with Deformed Acetabular Rims

    OpenAIRE

    Wada, Hiroshi; Mishima, Hajime; Yoshizawa, Tomohiro; Sugaya, Hisashi; Nishino, Tomofumi; Yamazaki, Masashi

    2016-01-01

    Background In cementless total hip arthroplasty, imageless computer-assisted navigation is usually used to register the anterior pelvic plane (APP). The accuracy of this method is influenced by the subcutaneous tissues overlying the registration landmarks. On the other hand, the acetabular center axis (ACA) is determined from the acetabular rim. Precise registration of the ACA is possible because of direct palpation using a pointer. Imageless navigation using the ACA usually targets patients ...

  11. Persistent pain after total knee or hip arthroplasty: differential study of prevalence, nature, and impact

    Directory of Open Access Journals (Sweden)

    Pinto PR

    2013-09-01

    Full Text Available Patrícia R Pinto,1–3 Teresa McIntyre,4,5 Ramón Ferrero,6 Vera Araújo-Soares,3,7 Armando Almeida1,2 1Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal; 2Life and Health Sciences Research Institute/3Bs, PT Government Associate, Braga/Guimarães, Portugal; 3Health Psychology Group, Newcastle University, Newcastle, UK; 4Texas Institute for Measurement, Evaluation and Statistics, 5Department of Psychology, University of Houston, TX, USA; 6Alto Ave Hospital Center, Orthopedics Unit, Guimarães, Portugal; 7Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle, UK Abstract: This study compares the incidence, nature, and impact of persistent post-surgical pain after total knee arthroplasty (TKA and total hip arthroplasty (THA and investigates differences between these procedures, with the focus on potential presurgical and post-surgical issues that could be related to the distinct persistent post-surgical pain outcomes between these two groups. A consecutive sample of 92 patients was assessed prospectively 24 hours before, 48 hours, and 4–6 months after surgery. The data show that TKA patients had a higher likelihood of developing persistent post-surgical pain, of reporting higher pain levels, and of using more neuropathic descriptors when classifying their pain. In addition, TKA patients more often reported interference from pain on functional domains, including general activity, walking ability, and normal work. Demographic factors, like gender and age, along with presurgical clinical factors like disease onset, existence of medical comorbidities, and other pain problems, may have contributed to these differences, whereas baseline psychologic factors and functionality levels did not seem to exert an influence. Heightened acute post-surgical pain experience among TKA patients could also be related to distinct outcomes for persistent post

  12. 髋关节假体聚乙烯磨损及其影响因素的相关性分析%Correlations between polyethylene wear direction and other influencing factors in total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    兰天; 肖军; 史占军

    2014-01-01

    目的 探讨磨损与假体植入参数的相关性.方法 1997年4月至2006年3月对南方医科大学附属南方医院关节与骨病外科58髋Zweymuller双锥面非骨水泥螺旋臼假体进行临床和影像学检查,以计算机辅助测量方法测量髋关节假体聚乙烯内衬的线性磨损,平均随访时间为7.3年.利用股骨头假体中心相对于髋臼杯开口平面轴线的矢量位移,来决定线性磨损的大小和方向.分析髋臼外展角、股骨偏心距、髋臼前倾角对线性磨损方向和大小的影响.结果 平均线性磨损率为(0.17 ±0.08) mm/年,平均线性磨损方向与髋臼杯轴线的夹角为(34.2±29.3)°.线性磨损方向与外展角存在正相关性(r =0.480,P=0.000),与术后Harris评分存在负相关性(r=-0.314,P=0.016).外展角>45°组的线性磨损方向较外展角< 45°组更加偏离髋臼轴心(P =0.001).术中股骨偏心距得到重建组的线性磨损率小于未得到重建组(P =0.043).结论 该计算机辅助测量方法适用于各种髋臼杯假体聚乙烯内衬的二维磨损测量.人工全髋关节置换术中合理的髋臼杯外展角和恢复正常偏心距可以减少聚乙烯内衬线性磨损率,增加髋关节假体的稳定性,改善远期效果.%Objective To explore the correlations between polyethylene wear direction and implanted parameters of prosthesis in total hip arthroplasty (THA) by computer-assisted measurement techniques.Methods Retrospective analyses were performed for 58 uncemented THAs from April 1997 to March 2006.The sagittal displacement of femoral head to axis of acetabulum opening plane was examined to determine the direction and degree of linear polyethylene wear.Radiographs were assessed for femoral offset,acetabular abduction,acetabular anteversion and conventional polyethylene wear.The linear polyethylene wear directions were compared between different parameter groups.Results The average linear wear rate was 0.17 ± 0.08 mm/year and the

  13. UnconStrained ShoUlder arthroplasty

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To evaluate the results of 36unconstrained shoulder arthroplasties. Methods: In the series, 24 total and 12 hemiarthroplasties of the shoulders were performed with unconstrained shoulder prostheses in 29 patients who suffered from glenohumeral degenerative arthritis, rheumatoid arthritis, avascular necrosis and proximal fracture of humerus, respectively. Follow-up averaged 6.2years. All patients were evaluated pre- and post-operatively using the rating system of the Society of American Shoulder and Elbow Surgeons which assesses the severity of pain,strength of muscles around shoulder, stability, range of motion and functional activities of daily living. Radiolucent line and migration of prostheses were observed postoperatively on X-rays. Results: Postoperatively, the rate of pain relief was 91.3%, and active range of motion increased by 47° inforward flexion, 43° in abduction , 30° in external rotation,and 4 segments in internal rotation. Preoperatively the average points of 6 functional activities patients could perform was 0.8, and postoperatively 3.1. On postoperative X-ray, proximal migration of the humerus was seen in 8 shoulders, 6 of which had either a torn or absent rotator cuff. Radiolucent lines were seen around 1humeral component and 9 glenoid components. Onehumeral and 2 glenoid components loosened. Conclusions: These results suggest that unconstrained shoulder arthroplasty is a satisfactory and safe technique.

  14. Robot-assisted unicompartmental knee arthroplasty.

    Science.gov (United States)

    Pearle, Andrew D; O'Loughlin, Padhraig F; Kendoff, Daniel O

    2010-02-01

    The outcomes of unicompartmental knee arthroplasties (UKAs) have demonstrated inconsistent long-term survival. We report the first clinical series of UKA using a semiactive robotic system for the implantation of an inlay unicondylar knee arthroplasty. Ten patients were selected for this study. Preoperative mechanical leg alignment values ranged from 0.3 degrees varus to 9.8 degrees varus. A haptic guidance system was used; a detailed description is given in the manuscript. The setup time for the robot was 41 minutes; intraoperative registration process, 7.5 minutes (6-13 minutes); skin incision, 8 cm; robot-assisted burring, 34.8 minutes (18-50 minutes); mean tourniquet time, 87.4 minutes (68-113 minutes); and overall operation time, 132 minutes (118-152 minutes). The planned and intraoperative tibiofemoral angle was within 1 degrees. The postoperative long leg axis radiographs were within 1.6 degrees. Haptic guidance in combination with a navigation module allows for precise planning and execution of both inlay components in UKA. PMID:19056227

  15. Radiographic analysis of shoulder anatomical arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Merolla, Giovanni [Unit of Shoulder and Elbow Surgery, ' D. Cervesi' Hospital, L. Van Beethoven 46 Street, 47841 Cattolica (Italy)], E-mail: gmerolla@shouldertech.it; Di Pietto, Francesco; Romano, Stefania [Department of Diagnostic Imaging, ' A. Cardarelli' Hospital, Naples (Italy); Paladini, Paolo; Campi, Fabrizio; Porcellini, Giuseppe [Unit of Shoulder and Elbow Surgery, ' D. Cervesi' Hospital, L. Van Beethoven 46 Street, 47841 Cattolica (Italy)

    2008-10-15

    Arthroplasty is the standard treatment for advanced shoulder osteoarthritis. Modern prostheses designs have modular features whose size, shaft/head and body morphology can be adjusted. Total Shoulder Arthroplasty (TSA) provides better results. A complete X-ray follow-up is essential to assess the results and evaluate the survival rates of a shoulder prosthesis. Antero-posterior at 40 deg. in both internal and external rotation (true AP view) and axillary view are recommended to assess the following parameters: orientation and translation of the humeral component, offset, size and height of the humeral head, acromio-humeral distance, distribution and fixation of the cement, stress shielding and cortical resorption, radiolucent lines, subsidence and tilt, glenoid wear and 'bone stock', prostheses instability, glenoid component shift. Shoulder hemiarthroplasty can lead to glenoid wear; the true AP film at 40 deg. of internal rotation provides the best profile of gleno-humeral joint to depict glenoid erosion. Shift of the glenoid component in TSA is identified as tilting or medial migration on true AP and axillary views in the early postoperative period (1-2 months) and at minimum of 2 years. An exhaustive radiographic analysis remains essential to monitor the prosthetic implant and detect early and late complications or risk factors of prosthetic loosening.

  16. The Cruciate Ligaments in Total Knee Arthroplasty.

    Science.gov (United States)

    Parcells, Bertrand W; Tria, Alfred J

    2016-01-01

    The early knee replacements were hinge designs that ignored the ligaments of the knee and resurfaced the joint, allowing freedom of motion in a single plane. Advances in implant fixation paved the way for modern designs, including the posterior-stabilized (PS) total knee arthroplasty (TKA) that sacrifices both cruciate ligaments while substituting for the posterior cruciate ligament (PCL), and the cruciate-retaining (CR) TKA designs that sacrifice the anterior cruciate ligament but retain the PCL. The early bicruciate retaining (BCR) TKA designs suffered from loosening and early failures. Townley and Cartier designed BCR knees that had better clinical results but the surgical techniques were challenging.Kinematic studies suggest that normal motion relies on preservation of both cruciate ligaments. Unicompartmental knee arthroplasty retains all knee ligaments and closely matches normal motion, while PS and CR TKA deviate further from normal. The 15% to 20% dissatisfaction rate with current TKA has renewed interest in the BCR design. Replication of normal knee kinematics and proprioception may address some of the dissatisfaction. PMID:27327919

  17. [Primary radial head arthroplasty in trauma : Complications].

    Science.gov (United States)

    Schmidt-Horlohé, K; Buschbeck, S; Wincheringer, D; Weißenberger, M; Hoffmann, R

    2016-10-01

    Radial head fractures are common injuries in elbow trauma. Non-displaced fractures are best treated conservatively. Simple but displaced fractures require anatomic reduction and fixation, typically using screws. The treatment course for complex fractures with multiple fragments is still being debated, as results are less predictable. Radial head resection is not advised if concomitant injuries of the coronoid process or the collateral ligaments with instability are present. Favorable outcomes following open reduction and fixation using plates were reported recently. However, complication rates are very high. Radial head replacement is a valuable tool in treating complex fractures of the radial head with predominantly good and excellent results. Patients who suffer radial head fractures are typically of a younger age, resulting in high functional demands. Certainly, unspecific and specific complications related to radial head arthroplasty were reported in up to 40 % of cases in an acute fracture setting. This article highlights common complications in radial head arthroplasty and aims to present strategies to avoid them. PMID:27600571

  18. Is cold therapy really efficient after knee arthroplasty?

    Directory of Open Access Journals (Sweden)

    Ersin Kuyucu

    2015-12-01

    Conclusion: After knee arthroplasty, the preoperative and postoperative use of cryotherapy is effective in terms of the pain control and functional knee scores without a significant change in surgical blood loss.

  19. Reverse Shoulder Arthroplasty for Trauma: When, Where, and How.

    Science.gov (United States)

    Szerlip, Benjamin W; Morris, Brent J; Edwards, T Bradley

    2016-01-01

    Reverse shoulder arthroplasty has become increasingly popular for the treatment of complex shoulder injuries, including proximal humerus fractures and fixed glenohumeral dislocation, in the elderly population. The early to midterm results of reverse shoulder arthroplasty for the treatment of proximal humerus fractures are promising compared with the results of unconstrained humeral head replacement, and patients may have more predictable improvement with less dependence on bone healing and rehabilitation. However, long-term follow-up is needed, and surgeons must be familiar with various complications that are specific to reverse shoulder arthroplasty. To achieve optimal patient outcomes for the management of traumatic shoulder injuries, surgeons must have a comprehensive understanding of the current implant options, indications, and surgical techniques for reverse shoulder arthroplasty. PMID:27049189

  20. Rural vs. urban utilization of total joint arthroplasty.

    Science.gov (United States)

    Banerjee, Devraj; Illingworth, Kenneth David; Novicoff, Wendy M; Scaife, Steven L; Jones, Braden K; Saleh, Khaled J

    2013-06-01

    The purpose of this study was to analyze the association between patient demographics and hospital demographics on utilization of total joint arthroplasty in rural and urban populations from the National Inpatient Sample database. Any patient that was discharged after a primary total hip or primary total knee arthroplasty was included in this study. Results showed that rural patients living in a Northeastern hospital region compared to West, less than 65 years of age, females, Blacks and Hispanics were less likely to undergo total joint arthroplasty compared to their urban counterparts. Rural patient were more likely to undergo total joint arthroplasty compared to their urban counterparts if they were in the Midwest and had Medicare as their primary payer provider.

  1. Myofascial Pain in Patients Waitlisted for Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Richard Henry

    2012-01-01

    Full Text Available BACKGROUND: Knee pain is one of the major sources of pain and disability in developed countries, particularly in aging populations, and is the primary indication for total knee arthroplasty (TKA in patients with osteoarthritis (OA.

  2. Total knee arthroplasty in patients with a previous patellectomy.

    Science.gov (United States)

    Maslow, Jed; Zuckerman, Joseph D; Immerman, Igor

    2013-01-01

    Post-patellectomy patients represent a specific subgroup of patients that may develop arthritis and persistent knee pain and potentially require treatment with total knee arthroplasty. This article reviews the treatment and functional outcomes following total knee arthroplasty in patients with prior patellectomy. A case report is presented as an example of the clinical management of a post-patellectomy patient with significant knee pain and disability treated with total knee arthroplasty. Emphasis will be placed in decision- making, specifically with the use of a posterior stabilized implant. In addition, postoperative strengthening of the quadriceps is essential to compensate for the lack of the patella and increase the success of total knee arthroplasty in this subgroup of patients. PMID:24151951

  3. The influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthroplasty treatment%股骨转子间骨折内固定失败的相关因素及全髋关节置换术治疗效果分析

    Institute of Scientific and Technical Information of China (English)

    张喜海; 叶俊武; 卓乃强

    2015-01-01

    Objective To investigate the influence factors of fixation failure in the proximal femoral and the clinical effect total hip arthro-plasty treatment. Methods A retrospective analysis were performed in our hospital from 2010 to 2012. Total 119 cases of femoral intertrochanteric fractures and tibial fractures were admitted. The information in all patients were collected included basic information and clinical data. A statisti-cally significant indicators were choosen into multiple Logistic regression model,adjusting for confounding variables,and exploring the factors that may affect patients with hip fracture fixation failure. Results Univariate analysis showed that the medial bone type,bone mass,fractures reason, a fixed location,extent and reset after cortical distance were the main risk factors affecting the patient fixation failure. A significant factors were in-cluded in the Logistic regression model. The results showed that the type of fracture,bone mass,bone fixation failure reset extent the impact of hip fracture patients were the main risk factors. Among them,the fracture type is the biggest factor( OR = 5. 331). After fixation failure,patients were treated with total hip arthroplasty. The results showed that Harris score,pain score,walking score,score,activity scores were significantly higher compared with patients before surgery( P ﹤ 0. 05). Conclusion The type of fracture,bone mass,bone reset extent were the main risk factors for hip fracture patient fixation. Among them,the fracture type is the biggest factor(OR = 5. 331). After fixation failure in the patients with total hip arthroplasty for re - treatment can obtain satisfactory results.%目的:探讨股骨转子间骨折内固定失败的相关因素及全髋关节置换术的治疗效果。方法回顾性分析2010~2012年收治得股骨转子间骨折及股骨胫骨骨折患者119例,收集其基本信息及临床资料,将单因素分析结果具有统计学意义的指标纳入到 Logistic

  4. Association between trochanteric bursitis, osteoarthrosis and total hip arthroplasty,

    OpenAIRE

    Carlos Roberto Schwartsmann; Felipe Loss; Leandro de Freitas Spinelli; Roque Furian; Marcelo Faria Silva; Júlia Mazzuchello Zanatta; Leonardo Carbonera Boschin; Ramiro Zilles Gonçalves; Anthony Kerbes Yépez

    2014-01-01

    OBJECTIVE: this was an epidemiological study on trochanteric bursitis at the time of performing total hip arthroplasty.METHODS: sixty-two sequential patients who underwent total hip arthroplasty due to osteoarthrosis, without any previous history of trochanteric bursitis, were evaluated. The bursas were collected and evaluated histologically.RESULTS: there were 35 female patients (56.5%) and 27 male patients (43.5%), with a mean age of 65 years (±11). Trochanteric bursitis was conformed histo...

  5. TROCHANTERIC ARTHROPLASTY IN THE SEPTIC ARTHRITIC SEOUELA OF THE HIP

    OpenAIRE

    Cakmak, Mehmet; Karamehmetoglu, Mahmut; Taser, Omer; Alturfan, Aziz

    2004-01-01

    7 cases have been treated with trochanteric arthroplasty, in which femoral neads and necks were lost due to the septic arthritic sequela of the hip. These seven cases have been followed for 2,7 years with 1,5 being the youngest 4 the oldest made on the fact that in those cases in which heads and necks are lost in combination, the best solution can be obtained by trochanteric arthroplasty.

  6. Fungal prosthetic joint infection after total knee arthroplasty

    OpenAIRE

    Reddy, Kankanala J; Shah, Jay D; Rohit V Kale; T Jayakrishna Reddy

    2013-01-01

    Fungal prosthetic joint infection after total knee arthroplasty (TKA) is a rare complication. Lacunae exist in the management of this complication. 62 year old lady presented with pain and swelling in left knee and was diagnosed as Candida tropicalis fungal infection after TKA. She underwent debridement, resection arthroplasty and antifungal plus antibiotic loaded cement spacer insertion, antifungal therapy with fluconazole followed by delayed revision TKA and further fluconazole therapy. Tot...

  7. MOBILE TIBIAL POLYETHYLENE BEARING IN TOTAL KNEE ARTHROPLASTY

    OpenAIRE

    de Araújo Barros Cobra, Hugo Alexandre; da Palma, Idemar Monteiro

    2015-01-01

    Debris of polyethylene tibial bearings have been recognized as a major cause for the onset of the cascade of biological events leading to osteolysis and loosening of prosthetic components after total knee arthroplasty. Since then, research has been focused on alternative bearing surfaces in order to minimize the amount and rate of polyethylene wear off and, in doing so, increasing the survivorship rate for knee arthroplasties. One such option is to have a mobile tibial bearing allowing more c...

  8. Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

    OpenAIRE

    Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

    2007-01-01

    Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not been reported previously after unicompartmental knee arthroplasty in the literature. Low level of suspicion may delay the diagnosis, as popliteal vascular injury and compartment syndrome are not well ...

  9. Popliteal Artery Pseudoaneurysm Following Primary Total Knee Arthroplasty

    OpenAIRE

    Shin, Young-Soo; Hwang, Yeok-Gu; Savale, Abhijit Prakash; Han, Seung-Beom

    2014-01-01

    An early diagnosis of popliteal artery pseudoaneurysm-a sequela of popliteal artery trauma-is difficult owing to its late presentation following total knee arthroplasty. The incidence of a popliteal artery pseudoaneurysm with a hematoma presenting only a peripheral nerve injury after total knee arthroplasty is also uncommon in the absence of common diagnostic features such as a pulsatile swelling with an audible bruit on auscultation. In the present report, we describe popliteal artery pseudo...

  10. SCREW MIGRATION IN TOTAL KNEE ARTHROPLASTY: CLINICAL REPORT

    OpenAIRE

    Fonseca, Fernando; Tomé, José; Barreto, Manuel

    2015-01-01

    Complications from total knee arthroplasty caused by the implanted material are rare, with the exception of polyethylene wear. Descriptions of screw migration into the knee joint cavity are very rare. The authors report intra-articular migration of a polyethylene safety screw in a case of total knee arthroplasty, with sacrifice of the posterior cruciate ligament (TKA Performance; Biomet, Warsaw, IN, USA), which necessitated new surgery to remove the screw, replace the polyethylene insert and ...

  11. Heterotopic Ossification Causing Radiculopathy after Lumbar Total Disc Arthroplasty

    OpenAIRE

    Jackson, Keith L.; Hire, Justin M; Jacobs, Jeremy M.; Key, Charles C.; DeVine, John G.

    2015-01-01

    To date, no reports have presented radiculopathy secondary to heterotopic ossification following lumbar total disc arthroplasty. The authors present a previously unpublished complication of lumbar total disk arthroplasty (TDA) secondary to heterotopic ossification (HO) in the spinal canal, and they propose a modification to the McAfee classification of HO. The patient had undergone an L5/S1 lumbar TDA two years prior due to discogenic back pain. His preoperative back pain was significantly re...

  12. Total Disc Arthroplasty for Treating Lumbar Degenerative Disc Disease

    OpenAIRE

    Mostofi, Keyvan

    2015-01-01

    Study Design Lumber disc arthroplasty is a technological advancement that has occurred in the last decade to treat lumbar degenerative disk diseases. Purpose The aim of this retrospective study was to establish the impact and outcomes of managing patients with lumbar degenerative disk disease who have been treated with lumbar total disc arthroplasty (TDA). Overview of Literature Several studies have shown promising results following this surgery. Methods We reviewed the files of 104 patients ...

  13. COMPARION OF GAP ARTHROPLASTY AND INTERPOSITIONAL GAP ARTHROPLASTY ON THE TEMPOROMANDIBULAR JOINT ANKYLOSIS

    OpenAIRE

    M. Ramezanian T. Yavary

    2006-01-01

    Temporomandibular joint ankylosis causes limitation in mouth opening and establishes severe deformity and asymmetry in patient’s face, especially in children. Surgery is the only treatment. This study was conducted to compare the effect of two surgical approaches, gap arthropasty and interpositional gap arthroplasty, on rate of maximum interincisal opening in temporomandibular joint ankylosis. We also evaluated the relapse rate of these two surgical approaches. A total of 48 patients were enr...

  14. 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

  15. Patients' perception of leg length discrepancy post total hip arthroplasty.

    Science.gov (United States)

    Sykes, Alice; Hill, Janet; Orr, John; Humphreys, Patricia; Rooney, Aidan; Morrow, Esther; Beverland, David

    2015-01-01

    Perception of a leg length discrepancy post total hip arthroplasty (THA) is one of the most common sources of patient dissatisfaction and can have a direct influence on the considered success of the operation.This research examined postoperative perception of imposed limb discrepancies in a group of THA patients compared to a group of participants with no previous hip surgery. Two subgroups of THA patients were involved: those who did not perceive a difference in limb length following THA and those that did.Discrepancies were imposed in 2.5 mm increments. For discrepancies ≥5 mm, a significant number of participants were aware of a difference (74%). There was no significant difference in perception of imposed discrepancies between THA patients and participants with no previous hip surgery. THA patients who perceived a difference in their limb lengths postoperatively had significantly worse pain and oxford scores when compared to THA patients who perceived their limb lengths to be equal. Knowing the boundaries between LLDs that go undetected and those that patients are aware of could guide surgeons when evaluating the balance between correct soft tissue tension and the resulting unequal leg length. From these findings, discrepancies >5 mm are likely to be perceived. Whether this perception would lead directly to a negative outcome score and patient dissatisfaction is more complex to project and likely to be patient specific. Intraoperative methods to aid the controlled positioning of implanted components could help maintain and restore leg length to within an acceptable amount that patients cannot perceive.

  16. Neurologic injuries after primary total ankle arthroplasty: prevalence and effect on outcomes

    OpenAIRE

    Primadi, Andri; Xu, He-Xing; Yoon, Taek-Rim; Ryu, Je-Hwang; Lee, Keun-Bae

    2015-01-01

    Background Neurologic injuries are complications that can arise after total joint arthroplasty. However, no comprehensive study has been conducted on peripheral nerve injuries after total ankle arthroplasty. The purpose of the present study was to identify the prevalence of neurologic injury following primary total ankle arthroplasty, the predisposing factors, and evaluate the effect on clinical outcomes. Methods We retrospectively analyzed 150 consecutive primary total ankle arthroplasty usi...

  17. Hemodynamic influence of tilting disc valve type on pump performance with the NIPRO-ventricular assist device.

    Science.gov (United States)

    Kimura, Mitsutoshi; Nishimura, Takashi; Kinoshita, Osamu; Kashiwa, Koichi; Kyo, Shunei; Ono, Minoru

    2012-06-01

    The NIPRO-ventricular assist device (NIPRO-VAD) is an external pulsatile flow pump. Formerly, Sorin Carbocast, a monoleaflet tilting disc valve (SC valve), was used at the inlet/outlet parts of the pump, but Medtronic Hall (MH valve) is now used. We studied the differences in performance among pumps with different artificial valves. Six NIPRO pumps with SC valves and six with MH valves were examined using mock circuits. The systolic flow of the pump was measured with the ultrasonic flowmeter by changing the systolic fraction. Six patients wearing the NIPRO-VAD underwent periodic pump exchange from a pump with an SC valve to the one with an MH valve. The pump blood flow was measured at pre- and post-pump exchanges using an ultrasonic flowmeter. Blood pressure, serum LDH and AST levels were also compared before and after the pump exchange. Blood flow was significantly increased by using the NIPRO-VAD with the MH valve as compared to the SC valve in vitro. Under the same drive conditions pump flow tended to increase in six patients. No difference was found in patients' blood pressure, serum LDH or AST levels when using the SC or MH valve. From these results, the hemodynamic influence on patients due to replacement of the SC valve with the MH valve in the NIPRO-VAD is considered to be insignificant. PMID:22076421

  18. Influence by different tranexamic acid administration time on intraoperative and postoperative bleeding volume of total hip arthroplasty%氨甲环酸不同给药时间对全髋关节置换术中及术后失血量的影响

    Institute of Scientific and Technical Information of China (English)

    许小志; 谢学文

    2016-01-01

    目的:探讨氨甲环酸不同给药时间对全髋关节置换(THA)术中及术后失血量的影响。方法300例行THA患者,随机分为A、B、C三组,各100例。A组不给予氨甲环酸, B组手术前10 min给予氨甲环酸1 g, C 组手术结束前10 min给予氨甲环酸1 g, B、C两组均术后6 h再次给予氨甲环酸1 g。记录三组的术中、术后失血量及深静脉血栓形成(DVT)发生情况。结果 B组术中、术后失血量均少于A、C组(P0.05)。结论氨甲环酸可有效减少THA术中、术后失血量,且手术前10 min、术后6 h使用止血效果更佳。%ObjectiveTo investigate influence by different tranexamic acid administration time on intraoperative and postoperative bleeding volume of total hip arthroplasty (THA).MethodsA total of 300 THA patients were randomly divided into groups A, B and C, with 100 cases in each group. Group A received no tranexamic acid, group B received 1 g tranexamic acid in preoperative 10 min, and group C received 1 g tranexamic acid at 10 min before operation ending. Both groups B and C received additional 1 g tranexamic acid in postoperative 6 h. Records were made on intraoperative and postoperative bleeding volume and occurred deep venous thrombosis (DVT) in three groups.ResultsGroup B had all less intraoperative and postoperative bleeding volume than groups A and C (P0.05). ConclusionTranexamic acid can effective reduce intraoperative and postoperative bleeding volume in THA, and its administration in preoperative 10 min and postoperative 6 h provides precisely hemostatic effect.

  19. Endotoxins in surgical instruments of hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vania Regina Goveia

    2016-06-01

    Full Text Available Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.

  20. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  1. Implant survival after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig;

    2014-01-01

    in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared......BACKGROUND: Total elbow arthroplasty (TEA) is an established treatment for late-stage arthritis of the elbow. Indications have expanded to osteoarthritis and nonunion in distal humeral fractures. Information on implant survival and risk factors for revision is still sparse. The aim of this study...... was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980...

  2. Fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik

    2012-01-01

    ; patient-characteristics to predict outcome; and traditions which may be barriers in optimizing outcomes. Patients should be informed and motivated to be active participants and their expectations should be modulated in order to improve satisfaction. Also, organizational aspects need to be analyzed...... and optimized. New logistical approaches should be implemented; the ward ideally (re)structured to only admit arthroplasties; the staff educated to have a uniform approach; extensive preoperative information given including discharge criteria and intended length of stay. This thesis includes 9 papers...... degrees of safety (morbidity/mortality) and patient satisfaction. Future research strategies are multiple and include both research strategies as efforts to implement the fast-track methodology on a wider basis. Research areas include improvements in pain treatment, blood saving strategies, fluid plans...

  3. Fracture Blisters After Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Halawi, Mohamad J

    2015-08-01

    Fracture blisters are tense vesicles that arise on markedly swollen skin overlying traumatized soft tissue. While this relatively uncommon complication has been well described in the trauma literature, this article reports for the first time a case of fracture blisters after primary total knee arthroplasty. The fracture blisters developed within 36 hours of surgery and were associated with profound swelling and erythema. There was no evidence of vascular injury, compartment syndrome, iatrogenic fracture, or deep venous thrombosis. The patient was treated with leg elevation, loosely applied nonadhesive dressings, and a short course of oral antibiotics after skin desquamation. Blood-filled blisters required longer time to reepithelialization than fluid-filled blisters. Knee stiffness developed because of pain and fear of participation with physical therapy, but the patient was able to resume intensive rehabilitation after resolution of the blisters. Patient factors, surgical factors, and review of the literature are discussed. PMID:26251947

  4. Revision of infected knee arthroplasties in Denmark.

    Science.gov (United States)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Bagger, Jens; Schrøder, Henrik M; Kehlet, Henrik

    2016-08-01

    Background and purpose - The surgical treatment of periprosthetic knee infection is generally either a partial revision procedure (open debridement and exchange of the tibial insert) or a 2-stage exchange arthroplasty procedure. We describe the failure rates of these procedures on a nationwide basis. Patients and methods - 105 partial revisions (100 patients) and 215 potential 2-stage revision procedures (205 patients) performed due to infection from July 1, 2011 to June 30, 2013 were identified from the Danish Knee Arthroplasty Register (DKR). Failure was defined as surgically related death ≤ 90 days postoperatively, re-revision due to infection, or not reaching the second stage for a planned 2-stage procedure within a median follow-up period of 3.2 (2.2-4.2) years. Results - The failure rate of the partial revisions was 43%. 71 of the partial revisions (67%) were revisions of a primary prosthesis with a re-revision rate due to infection of 34%, as compared to 55% in revisions of a revision prosthesis (p = 0.05). The failure rate of the 2-stage revisions was 30%. Median time interval between stages was 84 (9-597) days. 117 (54%) of the 2-stage revisions were revisions of a primary prosthesis with a re-revision rate due to infection of 21%, as compared to 29% in revisions of a previously revised prosthesis (p = 0.1). Overall postoperative mortality was 0.6% in high-volume centers (> 30 procedures within 2 years) as opposed to 7% in the remaining centers (p = 0.003). Interpretation - The failure rates of 43% after the partial revision procedures and 30% after the 2-stage revisions in combination with the higher mortality outside high-volume centers call for centralization and reconsideration of surgical strategies. PMID:26900908

  5. Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

    Science.gov (United States)

    Malcolm, Tennison L; Bederman, S Samuel; Schwarzkopf, Ran

    2016-01-01

    The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses.

  6. Fretting and Corrosion in Modular Shoulder Arthroplasty: A Retrieval Analysis

    Science.gov (United States)

    Panzram, Benjamin

    2016-01-01

    Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual's clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined. PMID:27433471

  7. Infected primary knee arthroplasty: Risk factors for surgical treatment failure

    Directory of Open Access Journals (Sweden)

    Joao Gabriel Duarte Paes Pradella

    2013-09-01

    Full Text Available OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days or unfavorable (arthrodesis or death infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016 and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032 were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis and diabetics had higher odds of death after infection of primary knee arthroplasties.

  8. Hip arthroplasty for failed treatment of proximal femoral fractures.

    Science.gov (United States)

    D'Arrigo, Carmelo; Perugia, Dario; Carcangiu, Alessandro; Monaco, Edoardo; Speranza, Attilio; Ferretti, Andrea

    2010-10-01

    Failed treatment of an intertrochanteric fracture typically leads to profound functional disability and pain. Salvage treatment with hip arthroplasty may be considered. The aim of this study was to evaluate the results and complications of hip arthroplasty performed as a salvage procedure after the failed treatment of an intertrochanteric hip fracture. Twenty-one patients were treated in our hospital with hip arthroplasty for failed treatment of intertrochanteric hip fracture. There were sixteen women and five men with a mean age of 75.8 years (range 61-85 years). Fourteen patients had failure of a previous nail fixation procedure, five had failure of a plate fixation, one of hip screws fixation and one of Ender nail fixation. In 19 out of 21 patients we performed a total hip arthroplasty-14 cases used modular implants with long-stems and five cases used a standard straight stem. In 2 of 21 cases we used a bipolar hemiarthroplasty. A statistically significant improvement was found comparing pre and postoperative conditions (p < 0.05). Our experience confirms that total hip arthroplasty is a satisfactory salvage procedure after failed treatment of an intertrochanteric fracture in elderly patients with few serious orthopaedic complications and acceptable clinical outcomes. PMID:19572131

  9. Diagnostic Algorithm for Residual Pain After Total Knee Arthroplasty.

    Science.gov (United States)

    Park, Caroline N; White, Peter B; Meftah, Morteza; Ranawat, Amar S; Ranawat, Chitranjan S

    2016-01-01

    Although total knee arthroplasty is a successful and cost-effective procedure, patient dissatisfaction remains as high as 50%. Postoperative residual knee pain after total knee arthroplasty, with or without crepitation, is a major factor that contributes to patient dissatisfaction. The most common location for residual pain after total knee arthroplasty is anteriorly. Because residual pain has been associated with an un-resurfaced patella, this review includes only registry data and total knee arthroplasty with patella replacement. Some suggest that the pathogenesis of residual knee pain may be related to mechanical stimuli that activate free nerve endings around the patellofemoral joint. Various etiologies have been implicated in residual pain, including (1) low-grade infection, (2) midflexion instability, and (3) component malalignment with patellar maltracking. Less common causes include (4) crepitation and patellar clunk syndrome; (5) patellofemoral symptoms, including overstuffing and avascular necrosis of the patella; (6) early aseptic loosening; (7) hypersensitivity to metal or cement; (8) complex regional pain syndrome; and (9) pseudoaneurysm. Because all of these conditions can lead to residual pain, identifying the etiology can be a difficult diagnostic challenge. Often, patients with persistent pain and normal findings on radiographs and laboratory workup may benefit from a diagnostic injection or further imaging. However, up to 10% to 15% of patients with residual pain may have unexplained pain. This literature review summarizes the findings on the causes of residual pain and presents a diagnostic algorithm to facilitate an accurate diagnosis for residual pain after total knee arthroplasty. PMID:26811953

  10. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

    Directory of Open Access Journals (Sweden)

    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  11. Highly conforming polyethylene inlays reduce the in vivo variability of knee joint kinematics after total knee arthroplasty.

    Science.gov (United States)

    Daniilidis, Kiriakos; Skwara, Adrian; Vieth, Volker; Fuchs-Winkelmann, Susanne; Heindel, Walter; Stückmann, Volker; Tibesku, Carsten O

    2012-08-01

    The use of highly conforming polyethylene inlays in total knee arthroplasty (TKA) provides improved anteroposterior stability. The aim of this fluoroscopic study was to investigate the in vivo kinematics during unloaded and loaded active extension with a highly conforming inlay and a flat inlay after cruciate retaining (CR) total knee arthroplasty (TKA). Thirty one patients (50 knees) received a fixed-bearing cruciate retaining total knee arthroplasty (Genesis II, Smith & Nephew, Schenefeld, Germany) for primary knee osteoarthritis. Twenty two of them received a flat polyethylene inlay (PE), nine a deep dished PE and 19 were in the control group (physiological knees). The mean age at the time of surgery was 62 years. Dynamic examination with fluoroscopy was performed to assess the "patella tendon angle" in relation to the knee flexion angle (measure of anteroposterior translation) and the "kinematic index" (measure of reproducibility). Fluoroscopy was performed under active extension and flexion, during unloaded movement, and under full weight bearing, simulated by step climbing. No significant difference was observed between both types of polyethylene inlay designs and the physiological knee during unloaded movement. Anteroposterior (AP) instability was found during weight-bearing movement. The deep-dish inlay resulted in lower AP translation and a non-physiological rollback. Neither inlay types could restore physiological kinematics of the knee. Despite the fact that deep dished inlays reduce the AP translation, centralisation of contact pressure results in non-physiological rollback. The influence of kinematic pattern variability on clinical results warrants further investigation.

  12. Inferior outcome after hip resurfacing arthroplasty than after conventional arthroplasty. Evidence from the Nordic Arthroplasty Register Association (NARA) database, 1995 to 2007

    DEFF Research Database (Denmark)

    Johanson, Per-Erik; Fenstad, Anne Marie; Furnes, Ove;

    2010-01-01

    The reported outcomes of hip resurfacing arthroplasty (HRA) vary. The frequency of this procedure in Denmark, Norway, and Sweden is low. We therefore determined the outcome of HRA in the NARA database, which is common to all 3 countries, and compared it to the outcome of conventional total hip ar...

  13. Risk factors for lower limb swelling after primary total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    GAO Fu-qiang; LI Zi-jian; ZHANG Ke; David Huang; LIU Zhong-jun

    2011-01-01

    Background Total knee arthroplasty (TKA) is a successful surgical technique for patients with advanced knee osteoarthritis; however,some peri-operative complications can not be predicted or avoided completely.This study aimed to investigate the factors affecting limb swelling after primary total knee arthroplasty,to guide and improve patient rehabilitation.Methods Using a hospital database,we retroactively analyzed the mean changes in limb circumferences of 286 consecutive patients who underwent primary unilateral total knee arthroplasty between October 2007 and August 2009.The lower limb circumference change was calculated and analyzed statistically.The influence of age,gender,body mass index,the presence of deep vein thrombosis,methods of anti-coagulation,operation time,hidden blood loss,and type of prosthesis on post-operative lower limb swelling was studied.Results Swelling was most pronounced from the third to the fifth post-operative day and usually occurred in both lower limbs.Swelling was significantly more pronounced in the operated limb than in the non-operated limb.The swelling above the knee was also significantly greater than that below the knee.The change in limb circumference at 10 cm above the knee was significantly different between the patients with body mass index <25 kg/m2 and those with body mass index >25 kg/m2.However,the change in limb circumference at 10 cm below the knee was not significantly different between the two groups.There was no statistically significant difference in limb swelling between different age groups (P >0.05).Similarly,gender,methods of anti-coagulation,the presence of deep vein thrombosis,the type of prosthesis,and operation time did not significantly affect post-operative limb swelling.Multivariate linear regression showed that the factors affecting post-operative limb swelling were body mass index and hidden blood loss.Conclusions Lower limb swelling after total knee arthroplasty is related to early post

  14. Femoral rotation influences dynamic alignment of the lower extremity in total knee arthroplasty%全膝关节置换中股骨外旋截骨对下肢动态力线的影响

    Institute of Scientific and Technical Information of China (English)

    刘扬德; 赵宇驰; 王维光; 张树栋

    2015-01-01

    目的 通过计算机导航技术分析下肢动态力线的变化形式及其影响因素.方法 回顾性分析2013年7月至2013年8月接受计算机导航辅助下初次单侧人工全膝关节置换手术的76例膝关节骨关节炎患者病历资料,男46例,女30例;年龄64~78岁,平均71岁.手术均由同一名熟练掌握计算机导航技术的关节外科医生主刀完成.术中应用后稳定型旋转平台膝关节假体(RP,Depuy,强生公司,美国);计算机导航系统应用美国Stryker(R) Navigation SystemⅡ-Cart.术前运用CT扫描测量股骨远端髁间轴线(intraoperative transepicondylar axis,TEA)与后髁线(posterior condyle axis,PCA)间的夹角,即外旋角(external rotation angle,ERA);术中参考CT测量的ERA、计算机导航系统测量的TEA及Whiteside线进行股骨远端外旋截骨,假体骨水泥固定后记录膝关节在被动、无张力情况下屈曲活动过程中的髋-膝-踝(hip-knee-ankle,HKA)变化,即下肢动态力线的变化数据,并利用回归分析评价其影响因素.结果 与术前CT测量的ERA比较,术中分别以胫骨的前后轴线(股骨滑车最低点与髁间窝最高点之间的连线,AP线)、TEA及AP线与TEA均值(分别以TEA及AP线为参考进行股骨远端外旋截骨所得到ERA的平均值)为参考,由导航系统测量的ERA分别为5.54°±2.86°,5.21°±2.60°,5.34°±2.38 °;几种测量方法得到的结果并无统计学差异.TKA术中膝关节由伸直0°至屈曲90°的过程中下肢动态力线的变化与股骨远端外旋截骨密切相关.根据股骨远端外旋截骨角度的不同,下肢动态力线呈现出内翻、外翻及中立位波动三种变化趋势.结论 膝关节在屈伸过程中下肢力线发生变化;TKA术中股骨远端外旋截骨影响下肢动态力线的变化,其数学模型为反正弦三角函数.%Objective To evaluate the influences of femoral rotation on dynamic alignment of the lower extremity in TKA by computer assisted surgical

  15. The Influence of Self-Efficacies on Readers' Intention to Use E-Reading Devices: An Empirical Study

    Science.gov (United States)

    Tsai, Bor-Yuan; Yen, Jung-Nan

    2014-01-01

    E-books and e-Reading Devices (E-RDs) markets have been enlarged due to the rapid progress of digital technologies. What are the possible factors to increase readers' willingness to use electronic devices? To improve the predictive value of the original TAM model, this study incorporates three additional constructs to form e-Reading Device…

  16. Early total hip arthroplasty for severe displaced acetabular fractures

    Institute of Scientific and Technical Information of China (English)

    YANG Shu-hua; ZHANG Yu-kun; XU Wei-hua; LI Jin; LIU Guo-hui; YANG Cao; LIU Yong; TIAN Hong-tao

    2006-01-01

    Objective : To investigate the effect of early total hip arthroplasty for severe displaced acetabular fractures.Methods: Total hip arthroplasty was performed on 17 cases of severe fracture of the acetabulum from 1997 to 2003. The mean follow-up was 2.1 years (1-6 years) and the average period from fracture to operation was 8 days (5-21 day). The average age of the patients was 53 years (26-69 years).Results: At the final follow-up the Harris hip score averaged 82(69-100) points and 15 cases have got a good outcome. There was one case of heterotopic bone formation. There were no radiographic evidences of late loosening of the prosthesis. One patient had severe central displacement of the cup.Conclusions: In patients with severe displaced acetabular fractures, particularly in elderly patients, early total hip arthroplasty is probably an alternative efficient way to achieve a painless and stable hip.

  17. Association between trochanteric bursitis, osteoarthrosis and total hip arthroplasty,

    Directory of Open Access Journals (Sweden)

    Carlos Roberto Schwartsmann

    2014-06-01

    Full Text Available OBJECTIVE: this was an epidemiological study on trochanteric bursitis at the time of performing total hip arthroplasty.METHODS: sixty-two sequential patients who underwent total hip arthroplasty due to osteoarthrosis, without any previous history of trochanteric bursitis, were evaluated. The bursas were collected and evaluated histologically.RESULTS: there were 35 female patients (56.5% and 27 male patients (43.5%, with a mean age of 65 years (±11. Trochanteric bursitis was conformed histologically in nine patients (14.5%, of whom six were female (66.7% and three were male (33.3%.CONCLUSIONS: 14.5% of the bursas analyzed presented inflammation at the time that the primary total hip arthroplasty due to osteoarthrosis was performed, and the majority of the cases of bursitis were detected in female patients.

  18. DIAGNOSTIC AND THERAPEUTIC ARTHROSCOPY IN SYMPTOMATIC PATIENTS AFTER KNEE ARTHROPLASTY

    Science.gov (United States)

    Severino, Fabricio Roberto; Souza, Clodoaldo José Duarte de; Severino, Nilson Roberto

    2015-01-01

    Objectives: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. Methods: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. Results: The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis (“cyclops”) or synovitis, which can be treated by using the same procedure, resulting in pain relief. PMID:27022517

  19. TMJ ANKYLOSIS: MANAGEMENT WITH RECONSTRUCTION AND INTERPOSITIONAL ARTHROPLASTY.

    Science.gov (United States)

    Madhumati, Singh; Shruthi, R; Mitul, Sojitra; Karan, Abhishek; Aziz, Abdul

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing. Trauma and Infections are usually responsible. If trauma occurs in young age, it leads to disturbance in growth & facial asymmetry. Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic block (arthroplasty) or interpositional arthroplasty using autogenous or alloplastic materials. Early mobilization, physiotherapy & strict follow up are essential to prevent postop adhesions. In our cases fascia lata was used as an interpositional grafting material. One case was treated by gap arthroplasty, second case by costochondral graft & third case was managed with titanium condylar prosthesis. PMID:27487617

  20. Transfusion practice in hip arthroplasty - a nationwide study

    DEFF Research Database (Denmark)

    Jans, Øivind; Kehlet, H; Hussain, Zubair Butt;

    2011-01-01

    Background and Objectives The optimal transfusion strategy in hip arthroplasty remains controversial despite existing guidelines. The aim of this study was to evaluate the transfusion practice in patients undergoing primary total hip arthroplasty (THA) or revision total hip arthroplasty (RTHA......) in Denmark. Materials and Methods We performed a retrospective cohort study of all patients undergoing THA or RTHA in Denmark in 2008. Primary outcomes were intercentre variation in red blood cell (RBC) transfusion rates and the timing of transfusion related to surgery. Results Six thousand nine hundred...... thirty-two THA patients and 1132 RTHA patients were included for analysis of which 1674 (24%) THA and 689 (61%) RTHA patients received RBC transfusion. Of these, 47% of THA and 73% of RTHA patients received transfusion on the day of surgery. Transfusion rates between centres varied from 7 to 71...

  1. Stemless shoulder arthroplasty-current results and designs.

    Science.gov (United States)

    Churchill, R Sean; Athwal, George S

    2016-03-01

    Stemless shoulder arthroplasty was originally introduced in 2004 by a single manufacturer. Now, over a decade later, numerous designs are available outside the USA, but as yet, only one implant has been cleared by the Food and Drug Administration (FDA) and is available for use within the USA. Often referred to as "canal sparing," these implants are designed for metaphyseal fixation to minimize humeral bone removal, avoid intraoperative and postoperative humeral fracture complications, and to decrease morbidity associated with revision operations. Recently, the second generation of stemless arthroplasty, a convertible implant allowing use in either anatomic or reverse arthroplasty configuration, was released for use outside the USA. This paper will review the available designs, reported results, and raise potential concerns for this emerging technology.

  2. Shoulder arthroplasty. Part 1: Prosthesis terminology and classification

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, B.D., E-mail: bdsheridan@hotmail.com [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom); Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P. [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom)

    2012-07-15

    Shoulder arthroplasty is the third most common joint replacement procedure in the UK, and there are a number of different implant options available to surgeons to treat a variety of shoulder disorders. With an increasing burden placed on clinical follow-up, more patients are remaining under the care of their general practitioners and musculoskeletal triage assessment services and are not necessarily being seen by specialists. Referrals to orthopaedic specialists are therefore often prompted by radiological reports describing evidence of implant failure. This article is the first of two reviews on shoulder arthroplasty, concentrating on implant features and the indications for their use. The second article will address the modes of failure of shoulder arthroplasty and describe the relevant associated radiological features.

  3. Pelvic pseudotumor following total hip arthroplasty – case report,

    Directory of Open Access Journals (Sweden)

    Nelson Franco Filho

    2014-10-01

    Full Text Available Loosening is a well-known complication of total hip arthroplasty. The accumulation of detritus resulting from mechanical wear forms inflammatory cells that have the function of phagocytizing this debris. Over the long term, these cells may give rise to a local granulomatous reaction. Here, we present a report on a case of pelvic pseudotumor subsequent to total hip arthroplasty, which is considered rare in the literature. The patient was a 48-year-old black man who started to be followed up medically eight months earlier because of uncharacteristic abdominal pains, dysuria and pollakiuria. He had undergone left total hip arthroplasty 17 years previously. Through clinical investigation and complementary examinations, an extra-articular granulomatous mass was diagnosed, constituting a pelvic pseudotumor.

  4. Computer-Navigated Total Knee Arthroplasty Utilization.

    Science.gov (United States)

    Bala, Abiram; Penrose, Colin Thomas; Seyler, Thorsten Markus; Mather, Richard Chad; Wellman, Samuel Secord; Bolognesi, Michael Paul

    2016-07-01

    Computer-navigated total knee arthroplasty (CN-TKA) has been used to improve component alignment, though the evidence is currently mixed on whether there are clinically significant differences in long-term outcomes. Given the established increased costs and operative time, we hypothesized that the utilization rate of CN-TKA would be decreasing relative to standard TKA in the Medicare population given the current health care economic environment. We queried 1,914,514 primary TKAs performed in the entire Medicare database from 2005 to 2012. Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify and separate CN-TKAs. Utilization of TKA was compared by year, gender, and region. Average change in cases per year and compound annual growth rate (CAGR) were used to evaluate trends in utilization of the procedure. We identified 30,773 CN-TKAs performed over this time period. There was an increase in utilization of CN-TKA per year from 984 to 5,352 (average = 572/year, R (2) = 0.85, CAGR = 23.58%) from 2005 to 2012. In contrast, there was a slight decrease in overall TKA utilization from 264,345 to 230,654 (average = 4297/year, R (2) = 0.74, CAGR = - 1.69%). When comparing proportion of CN-TKA to all TKAs, there was an increase from 0.37 to 2.32% (average 0.26%/year, R (2) = 0.88, CAGR = 25.70%). CN-TKA growth in males and females was comparable at 24.42 and 23.11%, respectively. The South region had the highest growth rate at 28.76%, whereas the Midwest had the lowest growth rate at 15.51%. The Midwest was the only region that peaked (2008) with a slow decline in utilization until 2012. Despite increased costs with unclear clinical benefit, CN-TKA is increasing in utilization among Medicare patients. Reasons could include patient preference, advertising, proper of coding the procedure, and increased publicly available information about

  5. Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency

    Science.gov (United States)

    RANDELLI, PIETRO; RANDELLI, FILIPPO; COMPAGNONI, RICCARDO; CABITZA, PAOLO; RAGONE, VINCENZA; PULICI, LUCA; BANFI, GIUSEPPE

    2015-01-01

    Purpose the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency. Methods a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis. Results nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%. Conclusions RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain. Level of evidence level IV, systematic review of level I–IV studies. PMID:26151037

  6. Functional Outcomes of Revision Total Knee Arthroplasty Following Failed Unicompartmental Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Chris Ironside

    2014-12-01

    Full Text Available Introduction: Unicompartmental knee arthroplasty (UKA can be used to treat medial compartment osteoarthritis of the knee. Some of these knees will eventually fail, and need to be revised. There is controversy about using UKA in younger patients as a definitive procedure or as a means to delay total knee arthroplasty (TKA because the outcomes of subsequent revision surgery may be inferior to a primary TKA. Methods: We retrospectively reviewed a series of 46 revision TKA patients following failed UKA (UKA revisions using functional outcomes questionnaires and compared the results with a cohort of age and gender matched primary TKA patients. Our hypothesis was that UKA revision surgery would be inferior to primary TKA surgery. Results: Data was collected on 33 knees after a mean follow-up period of five years. There was no significant difference in the Oxford Knee Score (33.7 vs 37.1, p = 0.09 or the Western Ontario and MacMasters Universities Arthritis Index (WOMAC (24.8 vs. 19.1, p = 0.22. A subgroup analysis demonstrated that UKAs, which fail early, are more likely to produce an inferior outcome following revision surgery than those that survive more than five years. Discussion: We conclude that UKA can be used effectively in appropriately selected patients, as the functional outcome of their subsequent revision to TKA is not significantly inferior to a primary TKA.

  7. Pelvic Discontinuity Caused by Acetabular Overreaming during Primary Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Iori Takigami

    2011-01-01

    Full Text Available Intraoperative acetabular fracture is a rare complication of primary total hip arthroplasty (THA, typically occurring during impaction of the cementless acetabular component. Here we report an unusual case of pelvic discontinuity caused by overreaming of the acetabulum during primary THA. Restoration of posterior columnar continuity was achieved with an autologous fibular graft and a reconstruction plate. Wall defects and cavitary defects were reconstructed with metal mesh and femoral head allograft, followed by placement and fixation of a Kerboull-type acetabular reinforcement device. Previous reports of acetabular fracture during THA have indicated that it has a relatively good prognosis without extensive treatment. However, to our knowledge, there has been no report of pelvic discontinuity necessitating acetabular reconstruction surgery as an intraoperative complication of primary THA.

  8. Mid-Term Results of Oxford Medial Unicompartmental Knee Arthroplasty

    OpenAIRE

    Choy, Won-Sik; Kim, Kap Jung; Lee, Sang Ki; Yang, Dae Suk; Lee, Neung Ki

    2011-01-01

    Background This study examined the clinical and radiologic mid-term results of patients treated by Oxford minimally invasive unicompartmental knee arthroplasty. Methods One hundred and eighty-eight knees of unicompartmental knee arthroplasties with Oxford Uni® in 166 patients (16 males and 150 females), which were performed between 2002 and 2005, were reviewed. The mean age was 65.3 years (range, 44 to 82 years) and the mean follow-up period was 79.8 months (range, 56 to 103 months). The preo...

  9. Reverse shoulder arthroplasty: radiological and clinical short–term results

    OpenAIRE

    Atalar, Ata Can; Salduz, Ahmet; Cil, Hilal; Sungur, Mustafa; Celik, Derya; Demirhan, Mehmet

    2014-01-01

    Objective: The aim of this study was to examine the radiological and clinical short term results of the patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy. Methods: The study included 14 (2 male, 12 female) patients who underwent reverse shoulder arthroplasty for rotator cuff arthropathy between 2009 and 2010. The mean age of the patients was 74 (57–80) years and the mean follow–up period was 32 (21–40) months. Radiological methods as well as the range of mot...

  10. Shoulder arthroplasty. Part 2: Normal and abnormal radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Sheridan, B.D., E-mail: bdsheridan@hotmail.com [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom); Ahearn, N.; Tasker, A.; Wakeley, C.; Sarangi, P. [Department of Orthopaedic Surgery, Bristol Royal Infirmary, Bristol (United Kingdom)

    2012-07-15

    Frequently, the decision made by general practitioners or musculoskeletal triage assessment services to refer patients for specialist review is initiated by a radiological report. Following shoulder arthroplasty it is important to ensure that any patient with asymptomatic evidence of a failing prosthesis is referred for review so that revision surgery can be contemplated and planned before the situation becomes unsalvageable. The first paper in this series described the various types of shoulder arthroplasty and indications for each. This follow-up paper will concentrate on their modes of failure and the associated radiographic features, and is aimed at radiology trainees and non-musculoskeletal specialist radiologists.

  11. Can technology improve alignment during knee arthroplasty.

    Science.gov (United States)

    Thienpont, Emmanuel; Fennema, Peter; Price, Andrew

    2013-09-01

    Component malalignment remains a concern in total knee arthroplasty (TKA); therefore, a series of technologies have been developed to improve alignment. The authors conducted a systematic review to compare computer-assisted navigation with conventional instrumentation, and assess the current evidence for patient-matched instrumentation and robot-assisted implantation. An extensive search of the PubMed database for relevant meta-analyses, systematic reviews and original articles was performed, with each study scrutinised by two reviewers. Data on study characteristics and outcomes were extracted from each study and compared. In total 30 studies were included: 10 meta-analyses comparing computer-assisted navigation and conventional instrumentation, 13 studies examining patient-matched instrumentation, and seven investigating robot-assisted implantation. Computer-assisted navigation showed significant and reproducible improvements in mechanical alignment over conventional instrumentation. Patient-matched instrumentation appeared to achieve a high degree of mechanical alignment, although the majority of studies were of poor quality. The data for robot-assisted surgery was less indicative. Computer-assisted navigation improves alignment during TKA over conventional instrumentation. For patient-matched instrumentation and robot-assisted implantation, alignment benefits have not been reliably demonstrated. For all three technologies, clinical benefits cannot currently be assumed, and further studies are required. Although current technologies to improve alignment during TKA appear to result in intra-operative benefits, their clinical impact remains unclear, and surgeons should take this into account when considering their adoption.

  12. 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.

  13. Total Knee Arthroplasty in the Combined Contracture

    Directory of Open Access Journals (Sweden)

    O.J. Voskresensky

    2009-09-01

    Full Text Available We have offered modified access to a knee to work out a method for restoration of extensive apparatus of the knee. 91 patients with degenerative damages of the knee were under out su-pervision. All patients were differentiated in groups according to the form of access and pa-thology of the knee. At all stages of studying the following method of investigation were made: goniometry — for estimation of the knee functional condition; electroneiromyography — for reveling deficiency of muscular activity and determination of its kind. Patient's satisfac-tion by operation was defined by means of WOMAC scale subjective indexes. The received digital material was subjected to statistical processing. Thus, it has been proved that applica-tion of the modified access to a knee offered by us in total knee arthroplasty in patients with combined contracture in comparison with traditionally applied technologies of extensive ap-paratus releasing allows in short terms to restore the volume and force of movements in a knee that reduces time of rehabilitation and improves quality of patient's life

  14. Muscular strength after total hip arthroplasty

    Science.gov (United States)

    Winther, Siri B; Husby, Vigdis S; Foss, Olav A; Wik, Tina S; Svenningsen, Svein; Engdal, Monika; Haugan, Kristin; Husby, Otto S

    2016-01-01

    Background and purpose Minimizing the decrease in muscular strength after total hip arthroplasty (THA) might allow patients to recover faster. We evaluated muscular strength in patients who were operated on using 3 surgical approaches. Patients and methods In a prospective cohort study, 60 patients scheduled for primary THA were allocated to the direct lateral, posterior, or anterior approach. Leg press and abduction strength were evaluated 2 weeks or less preoperatively, 2 and 8 days postoperatively, and at 6-week and 3-month follow-up. Results Differences in maximal strength change were greatest after 2 and 8 days. The posterior and anterior approaches produced less decrease in muscular strength than the direct lateral approach. 6 weeks postoperatively, the posterior approach produced greater increase in muscular strength than the direct lateral approach, and resulted in a greater increase in abduction strength than the anterior approach. At 3-month follow-up, no statistically significant differences between the groups were found. The operated legs were 18% weaker in leg press and 15% weaker in abduction than the unoperated legs, and the results were similar between groups. Interpretation The posterior and anterior approaches appeared to have the least negative effect on abduction and leg press muscular strength in the first postoperative week; the posterior approach had the least negative effect, even up to 6 weeks postoperatively. THA patients have reduced muscle strength in the operated leg (compared to the unoperated leg) 3 months after surgery. PMID:26141371

  15. Emerging technologies in arthroplasty: additive manufacturing.

    Science.gov (United States)

    Banerjee, Samik; Kulesha, Gene; Kester, Mark; Mont, Michael A

    2014-06-01

    Additive manufacturing is an industrial technology whereby three-dimensional visual computer models are fabricated into physical components by selectively curing, depositing, or consolidating various materials in consecutive layers. Although initially developed for production of simulated models, the technology has undergone vast improvements and is currently increasingly being used for the production of end-use components in various aerospace, automotive, and biomedical specialties. The ability of this technology to be used for the manufacture of solid-mesh-foam monolithic and coated components of complex geometries previously considered unmanufacturable has attracted the attention of implant manufacturers, bioengineers, and orthopedic surgeons. Currently, there is a paucity of reports describing this fabrication method in the orthopedic literature. Therefore, we aimed to briefly describe this technology, some of the applications in other orthopedic subspecialties, its present use in hip and knee arthroplasty, and concerns with the present form of the technology. As there are few reports of clinical trials presently available, the true benefits of this technology can only be realized when studies evaluating the clinical and radiographic outcomes of cementless implants manufactured with additive manufacturing report durable fixation, less stress shielding, and better implant survivorship. Nevertheless, the authors believe that this technology holds great promise and may potentially change the conventional methods of casting, machining, and tooling for implant manufacturing in the future. PMID:24764230

  16. Emerging technologies in arthroplasty: additive manufacturing.

    Science.gov (United States)

    Banerjee, Samik; Kulesha, Gene; Kester, Mark; Mont, Michael A

    2014-06-01

    Additive manufacturing is an industrial technology whereby three-dimensional visual computer models are fabricated into physical components by selectively curing, depositing, or consolidating various materials in consecutive layers. Although initially developed for production of simulated models, the technology has undergone vast improvements and is currently increasingly being used for the production of end-use components in various aerospace, automotive, and biomedical specialties. The ability of this technology to be used for the manufacture of solid-mesh-foam monolithic and coated components of complex geometries previously considered unmanufacturable has attracted the attention of implant manufacturers, bioengineers, and orthopedic surgeons. Currently, there is a paucity of reports describing this fabrication method in the orthopedic literature. Therefore, we aimed to briefly describe this technology, some of the applications in other orthopedic subspecialties, its present use in hip and knee arthroplasty, and concerns with the present form of the technology. As there are few reports of clinical trials presently available, the true benefits of this technology can only be realized when studies evaluating the clinical and radiographic outcomes of cementless implants manufactured with additive manufacturing report durable fixation, less stress shielding, and better implant survivorship. Nevertheless, the authors believe that this technology holds great promise and may potentially change the conventional methods of casting, machining, and tooling for implant manufacturing in the future.

  17. Surgical approaches for total knee arthroplasty.

    Science.gov (United States)

    Vaishya, Raju; Vijay, Vipul; Demesugh, Daniel Mue; Agarwal, Amit Kumar

    2016-01-01

    There are various surgical approaches to the knee joint and its surrounding structures and such approaches are generally designed to allow the best access to an area of pathology whilst safeguarding important surrounding structures. Controversy currently surrounds the optimal surgical approach for total knee arthroplasty (TKA). The medial parapatellar arthrotomy, or anteromedial approach, has been the most used and has been regarded as the standard approach for exposure of the knee joint. It provides extensive exposure and is useful for open anterior cruciate ligament reconstruction, total knee replacement, and fixation of intra-articular fractures. Because this approach has been implicated in compromise of the patellar circulation, some authors have advocated the subvastus, midvastus, and trivector approaches for exposure of the knee joint. While these approaches expose the knee from the medial side, the anterolateral approach exposes the knee joint from the lateral side. With careful planning and arthrotomy selection, the anterior aspect of the joint can be adequately exposed for TKA in different clinical scenarios. PMID:27182142

  18. CURBSIDE CONSULTATION IN KNEE ARTHROPLASTY: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Craig J. Della Vale

    2008-12-01

    Full Text Available A user- friendly reference for decision making in complicated cases of knee arthroplasty desingned in a question and answers format composed of articles containing current concepts and preferences of experts in total knee replacement surgery, enhanced by several images, diagrams and references and written in the form of a casual advice by Craig J. Della Vale, MD. and his collaborators. PURPOSE By this practical reference of knee arthroplasty, the editor and the contributors have aimed providing straightforward and brief answers, evidence-based advices, their preference and opinions containing current concepts for unanswered questions about complicated cases in total knee replacement surgery which are often controversial and not addressed clearly in traditional knee arthroplasty references. FEATURES There are 49 subjects each written by a different expert designed in 4 sections in a question and answers format including several images and diagrams and also essential references at the end of each article. In the first section preoperative questions is subjected including indications, unicompartmental osteoarthritis of the knee, patient with vascular problems, donating blood, bilateral arthroplasty, patellar resurfacing, range of motion, bearing surface, contraindications, teaching class for patients prior surgery. The second section is about intraoperative questions including skin incision, patella femoral maltracking, femoral component rotation, tibial component rotation, lateral release, femoral component sizing, flexion instability, varus deformity, and valgus deformity, tightness in extension, iatrogenic MCL injury, antibiotic-loaded cement, and perioperative pain. The third section subjects postoperative questions including wound drainage, preventing tromboembolic events, vascular complications, foot drop, manipulation under anesthesia, patella fractures, supracondylar femur fractures, acute extensor mechanism disruptions. In the fourth

  19. Influence of fear of movement on total knee arthroplasty outcome.

    Science.gov (United States)

    Kocic, Mirjana; Stankovic, Anita; Lazovic, Milica; Dimitrijevic, Lidija; Stankovic, Ivona; Spalevic, Marija; Stojiljkovic, Predrag; Milenkovic, Marina; Stojanovic, Zorica; Nikolic, Dejan

    2015-01-01

    RiassuntoLo scopo dello studio è quello di verificare l’incidenza del timore postoperatorio ai movimenti nei pazienti sottoposti ad artroplastica totale del ginocchio (TKA) e di determinare l’associazione di questo timore con i provvedimenti da adottare. Lo studio prospettico riguarda 78 pazienti sottoposti ad TKA primaria per osteoartrite. L’incidenza di timore al movimento è stata detenninata con l’uso della Tampa Scale of Kinesiophobia (TSK). I pazienti sono stati valutati in tre fasi temporali: 2 settimane. 4 settimane e 6 mesi dopo l’intervento chirurgico. In tutte e tre le fasi sono stati valutati il dolore e l’entità della flessione, mentre l’aspetto funzionale è stato preso in considerazione soltanto sei mesi dopo l’intervento, secondo la Oxford knee score 1. Il timore al movimento è stato registrato in 17 pazienti (21,8%). Quelli con maggiore entità di timore hanno dimostrato di conseguire risultati significativamente meno buoni in termini di dolore, grado di flessione e funzionalità rispetto a quelli con limitata paura. Miglioramento del dolore e della flessione sono stati progressivamente conseguiti nel tempo in entrambi i gruppi, ma i risultati migliori vengono raggiunti nel gruppo con minore paura al movimento. Lo studio ha dimostrato che la paura postoperatoria alla motilità si associa significativamente con il dolore, l’entità della flessione e la funzionalità del ginocchio. Altri Autori haImo rilevato che il timore preoperatorio alla motilità del ginocchio fa prevedere limitazioni funzionali postoperatorie. In conclusione il timore della motilità si rileva in una significativa proporzione dei pazienti dopo TKA e si associa con gonalgia, e minore flessione e funzionalità, e dunaue questa paura rappresenta un richio di scarsi risultati dopo artroplastica totale del ginocchio.

  20. Rehabilitation of total knee arthroplasty: clinical and rehabilitation differences between two analgesic treatments (Riabilitazione di artroprotesi totale di ginocchio: differenze cliniche e riabilitative tra due trattamenti analgesici)

    OpenAIRE

    Germana Mojica; Luisa Patrevita; Annalisa Coppo; Federica Taddei; Giuseppe Massazza

    2014-01-01

    Pain is a significant problem in a patient who has undergone total knee arthroplasty (PTG), since it influences the quality of life and the rehabilitation and functional recovery of the patient. In our study, we compared due different treatments with opioid analgesics in patients operated of PTG, with the aim of determining any clinical and rehabilitation differences. 56 post-PTG rehabilitative inpatients were chosen and randomised into two groups of analgesic treatment with a fixed administr...

  1. Importance of Attenuating Quadriceps Activation Deficits after Total Knee Arthroplasty

    OpenAIRE

    Thomas, Abbey C.; Jennifer E Stevens-Lapsley

    2012-01-01

    Total knee arthroplasty (TKA) is associated with persistent quadriceps dysfunction. Since quadriceps dysfunction impairs functional performance, minimizing quadriceps dysfunction by attenuating central activation deficits early after surgery may improve function later in life. Rehabilitation strategies incorporating neuromuscular electrical stimulation and early, aggressive quadriceps strengthening may prove beneficial. Further, surgical approaches such as minimally invasive TKA may minimize ...

  2. Alternative outcome measures in young total hip arthroplasty patients

    DEFF Research Database (Denmark)

    Klit, Jakob; Jacobsen, Steffen; Schmiegelow, Victoria;

    2015-01-01

    In this prospective multicentre cohort study we studied subjects younger than 60 years of age scheduled for primary total hip arthroplasty (THA). The study assessed patients' overall satisfaction, fulfillment of preoperative expectations, the effect on socioeconomic parameters, and quality of sex...

  3. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  4. Fast-track knee arthroplasty – status and future challenges

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Thienpont, Emmanuel

    2013-01-01

    Fast-track programs have been developed for different surgical procedures leading to higher patient satisfaction and lower morbidity. This concept has been extended to knee arthroplasty in recent years. The purpose of this narrative review was to discuss the different aspects of fast-track knee a...

  5. The association between metal allergy, total hip arthroplasty, and revision

    DEFF Research Database (Denmark)

    Thyssen, Jacob Pontoppidan; Jakobsen, Stig Storgaard; Engkilde, Kåre;

    2009-01-01

    BACKGROUND AND PURPOSE: It has been speculated that the prevalence of metal allergy may be higher in patients with implant failure. We compared the prevalence and cause of revisions following total hip arthroplasty (THA) in dermatitis patients suspected to have contact allergy and in patients in ...

  6. Periprosthetic fractures of the femur after total knee arthroplasty

    OpenAIRE

    McGraw, Phil; Kumar, Arun

    2010-01-01

    Periprosthetic fracture following total knee arthroplasty is a potentially serious complication. This injury can involve the distal femur, proximal tibia or the patella. This review article analyzes the prevalence, risk factors, classification and treatment options for periprosthetic fractures of the femur.

  7. Compartment syndrome and popliteal vascular injury complicating unicompartmental knee arthroplasty

    NARCIS (Netherlands)

    Kort, Nanne Pieter; Van Raay, Jos J. J. A. M.; van Horn, Jim R.

    2007-01-01

    Popliteal vascular injury and the compartment syndrome of the leg are rare but important complications of knee arthroplasties. Early diagnosis and treatment are of paramount importance in preventing the devastating complications of these conditions. To our knowledge, these complications have not bee

  8. Wear simulation strategies for reverse shoulder arthroplasty implants.

    Science.gov (United States)

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty.

  9. Wear simulation strategies for reverse shoulder arthroplasty implants.

    Science.gov (United States)

    Langohr, G Daniel G; Athwal, George S; Johnson, James A; Medley, John B

    2016-05-01

    Reverse total shoulder arthroplasty is a clinically accepted surgical procedure; however, its long-term wear performance is not known. The purpose of this work is to review wear simulator testing of reverse total shoulder arthroplasty, to develop a wear simulator protocol for reverse total shoulder arthroplasty, and to test it by performing a pilot study. The review of wear simulator testing in the literature revealed considerable variation in protocols. A combination of our own cadaveric testing and those of other research groups helped in determining the magnitude and direction of joint loading for the development of the present protocol. A MATCO orbital-bearing simulator was adapted using custom fixtures to simulate a circumduction motion of the shoulder under mildly adverse conditions, and a pilot study gave wear rates within the wide range found in the literature. Arguments were presented in support of the currently developed protocol, but it was also suggested that, rather than rely on one protocol, a series of simulator wear protocols should be developed to fully test the implant wear performance in reverse total shoulder arthroplasty. PMID:27160563

  10. Total knee arthroplasty after high tibial osteotomy. A systematic review

    NARCIS (Netherlands)

    T.M. van Raaij (Tom); M. Reijman (Max); A. Furlan (Alessandro); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractBackground: Previous osteotomy may compromise subsequent knee replacement, but no guidelines considering knee arthroplasty after prior osteotomy have been developed. We describe a systematic review of non-randomized studies to analyze the effect of high tibial osteotomy on total knee art

  11. The role of shoulder fusion in the era of arthroplasty

    OpenAIRE

    González-Díaz, R.; Rodríguez-Merchán, E. C.; Gilbert, M. S.

    1997-01-01

    The indications, surgical techniques, results and complications of shoulder fusion are described. The indications are bacterial infection, paralytic disorders in infancy, combined deltoid and rotator cuff paralysis, post-traumatic brachial plexus lesions, inflammatory arthritis with severe rotator cuff involvement, failed arthroplasty, recurrent dislocation, after resection of tumours, irreparable rotator cuff tear, painful arthritis in a patient whose activities requi...

  12. Influence of etching processes on electronic transport in mesoscopic InAs/GaSb quantum well devices

    Directory of Open Access Journals (Sweden)

    Atindra Nath Pal

    2015-07-01

    Full Text Available We report the electronic characterization of mesoscopic Hall bar devices fabricated from coupled InAs/GaSb quantum wells sandwiched between AlSb barriers, an emerging candidate for two-dimensional topological insulators. The electronic width of the etched structures was determined from the low field magneto-resistance peak, a characteristic signature of partially diffusive boundary scattering in the ballistic limit. In case of dry-etching the electronic width was found to decrease with electron density. In contrast, for wet etched devices it stayed constant with density. Moreover, the boundary scattering was found to be more specular for wet-etched devices, which may be relevant for studying topological edge states.

  13. Safe storage of pesticides in Sri Lanka - identifying important design features influencing community acceptance and use of safe storage devices

    DEFF Research Database (Denmark)

    Weerasinghe, Manjula; Pieris, Ravi; Eddleston, Michael;

    2008-01-01

    BACKGROUND: Self-poisoning with pesticides is the cause of an estimated 300,000 deaths annually in rural Asia. The great majority of these deaths are from impulsive acts of self-harm using pesticides that are readily available in the home. The secure storage of pesticides under lock has been...... of the device reduced over time. A large proportion of pesticides stored within the compound after the introduction of the device may have implications for accessibility to pesticides in the domestic environment. The ability of other household members, including children, to easily find the key is also worrying....... emphasized as a possible answer to the problem. This aspect, however, has been poorly researched. In this paper, we report on the design and use, in rural Sri Lanka, of a variety of different lockable storage devices. METHODS: Following a baseline survey of pesticide storage practices, randomly selected...

  14. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty : design of a randomized controlled trial

    NARCIS (Netherlands)

    Zijlstra, Wierd P.; Bos, Nanne; van Raaij, Jos J. A. M.

    2008-01-01

    Background: Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyet

  15. Infected total knee arthroplasty treatment outcome analysis

    Directory of Open Access Journals (Sweden)

    Radoičić Dragan

    2012-01-01

    Full Text Available Background/Aim. Infected total knee arthroplasty (TKA is a topic of great importance, because its diagnosing and treatment requires a lot of resources, and often has an unsatisfactory outcome. The aim of this study was to analyze the outcome of the treatment of infection developed following TKA. Methods. This retrospective study of infected TKAs was performed in the period from 1998 to 2008 in the Orthopedics & Traumatology Clinic of the Military Medical Academy (MMA in Belgrade. A total of 654 primary and revised TKAs were performed in the said period. We registered and surgically treated 28 infected TKAs (primary TKAs: MMA - 22, other institutions - 6. The incidence of TKA infection in the MMA was 3.36%. The most common pathogens were: Staphylococcus aureus - 14 (50% cases, and Staph. epidermidis - 3 (10.7% cases. Other isolated pathogens were: Enterococcus faecalis, Klebsiella pneum., Klebsiella spp., Streptoccocus viridans, Seratia spp, Micrococcus luteus and Peptostreptococcus spp. In one case we had mixed anaerobic flora, and in 3 cases cultures were negative. We analyzed diagnostic challenges, risk factors (such as age and previous viscosupplementation and treatment outcomes in our series of infected TKAs. Results. In our series 2 infections healed after iv antibiotics and debridement, 1 patient responded to open debridement with component retention, 4 patients responded fully to one-stage reimplantation, 10 cases responded fully to two-stage reimplantation, 11 patients ended with arthrodesis and we had 1 patient with above knee amputation. Conclusion. Two-stage reimplantation remains gold standard for treatment of infected TKA, and we recommend it as treatment of choice for eradication of infection. The antibiotic loaded spacer prothesis concept in most cases allows infection eradication, good function and high patient satisfaction.

  16. Future bearing surfaces in total hip arthroplasty.

    Science.gov (United States)

    Chang, Jun-Dong

    2014-03-01

    One of the most important issues in the modern total hip arthroplasty (THA) is the bearing surface. Extensive research on bearing surfaces is being conducted to seek an ideal bearing surface for THA. The ideal bearing surface for THA should have superior wear characteristics and should be durable, bio-inert, cost-effective, and easy to implant. However, bearing surfaces that are currently being implemented do not completely fulfill these requirements, especially for young individuals for whom implant longevity is paramount. Even though various new bearing surfaces have been investigated, research is still ongoing, and only short-term results have been reported from clinical trials. Future bearing surfaces can be developed in the following ways: (1) change in design, (2) further improvement of polyethylene, (3) surface modification of the metal, (4) improvement in the ceramic, and (5) use of alternative, new materials. One way to reduce wear and impingement in THA is to make changes in its design by using a large femoral head, a monobloc metal shell with preassembled ceramic liner, dual mobility cups, a combination of different bearing surfaces, etc. Polyethylene has improved over time with the development of highly crosslinked polyethylene. Further improvements can be made by reinforcing it with vitamin E or multiwalled carbon nanotubes and by performing a surface modification with a biomembrane. Surface modifications with titanium nitride or titanium niobium nitride are implemented to try to improve the metal bearings. The advance to the fourth generation ceramics has shown relatively promising results, even in young patients. Nevertheless, further improvement is required to reduce fragility and squeaking. Alternative materials like diamond coatings on surfaces, carbon based composite materials, oxidized zirconium, silicon nitride, and sapphire are being sought. However, long-term studies are necessary to confirm the efficacy of these surfaces after enhancements

  17. Difference in clinical outcome between total shoulder arthroplasty and reverse shoulder arthroplasty used in hemiarthroplasty revision surgery

    NARCIS (Netherlands)

    Hartel, B.P.; Alta, T.D.; Sewnath, M.E.; Willems, W.J.H.

    2015-01-01

    INTRODUCTION: The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision indicatio

  18. Surrogate markers of long-term outcome in primary total hip arthroplasty

    Science.gov (United States)

    Malak, T. T.; Broomfield, J. A. J.; Palmer, A. J. R.; Hopewell, S.; Carr, A.; Brown, C.; Prieto-Alhambra, D.

    2016-01-01

    Objectives High failure rates of metal-on-metal hip arthroplasty implants have highlighted the need for more careful introduction and monitoring of new implants and for the evaluation of the safety of medical devices. The National Joint Registry and other regulatory services are unable to detect failing implants at an early enough stage. We aimed to identify validated surrogate markers of long-term outcome in patients undergoing primary total hip arthroplasty (THA). Methods We conducted a systematic review of studies evaluating surrogate markers for predicting long-term outcome in primary THA. Long-term outcome was defined as revision rate of an implant at ten years according to National Institute of Health and Care Excellence guidelines. We conducted a search of Medline and Embase (OVID) databases. Separate search strategies were devised for the Cochrane database and Google Scholar. Each search was performed to include articles from the date of their inception to June 8, 2015. Results Our search strategy identified 1082 studies of which 115 studies were included for full article review. Following review, 17 articles were found that investigated surrogate markers of long-term outcome. These included one systematic review, one randomised control trial (RCT), one case control study and 13 case series. Validated surrogate markers included Radiostereometric Analysis (RSA) and Einzel-Bild-Röntgen-Analyse (EBRA), each measuring implant migration and wear. We identified five RSA studies (one systematic review and four case series) and four EBRA studies (one RCT and three case series). Patient Reported Outcome Measures (PROMs) at six months have been investigated but have not been validated against long-term outcomes. Conclusions This systematic review identified two validated surrogate markers of long-term primary THA outcome: RSA and EBRA, each measuring implant migration and wear. We recommend the consideration of RSA in the pre-market testing of new implants. EBRA can

  19. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    OpenAIRE

    Singh Alka; Singh Yashwant; Singh Pankaj; Singh Vinay; Javed Sadaf; Abdunabi Murad

    2010-01-01

    Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in...

  20. TOTAL KNEE ARTHROPLASTY IN A PATIENT WITH HOFFA FRACTURE PSEUDARTHROSIS: CASE REPORT

    OpenAIRE

    Rodrigo Pires e Albuquerque; Giordano, Vincenzo; Amaral, Ney Pecegueiro do; Carvalho, Antônio Carlos Pires; Barretto, João Maurício

    2015-01-01

    A rare occurrence of a case of Hoffa fracture pseudarthrosis in an alcoholic patient with genu valgum associated with venous insufficiency who underwent total knee arthroplasty is reported. The literature is reviewed and the main factors for surgical indication of total knee arthroplasty after a fracture of the knee are discussed. Total knee arthroplasty was a viable option in a 60-year-old patient with Hoffa fracture pseudarthrosis and comorbidities.

  1. Revision to reverse shoulder arthroplasty with retention of the humeral component

    OpenAIRE

    Werner, Birgit S.; Boehm, Dorota; Gohlke, Frank

    2013-01-01

    Background Revision in failed shoulder arthroplasty often requires removal of the humeral component with a significant risk of fracture and bone loss. Newer modular systems allow conversion from anatomic to reverse shoulder arthroplasty with retention of a well-fixed humeral stem. We report on a prospectively evaluated series of conversions from hemiarthroplasty to reverse shoulder arthroplasty. Methods In 14 cases of failed hemiarthroplasty due to rotator cuff deficiency and painful pseudopa...

  2. Detrimental influence of catalyst seeding on the device properties of CVD-grown 2D layered materials: A case study on MoSe{sub 2}

    Energy Technology Data Exchange (ETDEWEB)

    Utama, M. Iqbal Bakti; Lu, Xin; Yuan, Yanwen [Division of Physics and Applied Physics, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore 637371 (Singapore); Xiong, Qihua, E-mail: Qihua@ntu.edu.sg [Division of Physics and Applied Physics, School of Physical and Mathematical Sciences, Nanyang Technological University, Singapore 637371 (Singapore); NOVITAS, Nanoelectronics Centre of Excellence, School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore 639798 (Singapore)

    2014-12-22

    Seed catalyst such as perylene-3,4,9,10-tetracarboxylic acid tetrapotassium (PTAS) salt has been used for promoting the growth of atomically thin layered materials in chemical vapor deposition (CVD) synthesis. However, the ramifications from the usage of such catalyst are not known comprehensively. Here, we report the influence of PTAS seeding on the transistor device performance from few-layered CVD-grown molybdenum diselenide (MoSe{sub 2}) flakes. While better repeatability and higher yield can be obtained with the use of PTAS seeds in synthesis, we observed that PTAS-seeded flakes contain particle impurities. Moreover, devices from PTAS-seeded MoSe{sub 2} flakes consistently displayed poorer field-effect mobility, current on-off ratio, and subthreshold swing as compared to unseeded flakes.

  3. Postoperative anemia and early functional outcomes after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Bandholm, Thomas; Kurbegovic, Sorel;

    2016-01-01

    BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative...... anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age. Mobility and Qol were assessed pre- and postoperatively by the 6-minute...... walk test (6MWT; primary outcome), the timed up-and-go test, and the FACT-anemia subscale. Twenty-four-hour mobility at home was assessed by activity monitoring on Days 1 to 6 after discharge. Hemoglobin (Hb) at discharge (HbD) and the Hb decrease from preoperatively (ΔHb) were compared to mobility...

  4. Finite element analysis of hip resurfacing arthroplasty with different implant angles

    International Nuclear Information System (INIS)

    Objective: To explore the biomechanical influences of femoral prosthesis implantation angle in 3-dimensional finite element (3D FE) models of Hip Resurfacing Arthroplasty (HRSA). Methods: Five different implant angles of HRSA 3D FE models were constructed based on the human anatomical data from multislice spiral CT. The femoral prosthesis implantation angle was 120°, 125°, 130°, 135°, 140°, and 145° respectively. Pressure was added on each model to simulate status in normal walking. The patterns of the stress distribution on each model were analyzed. Results: The stress concentration presented at head-neck junction part of the resurfaced femur. The maximum Von Mises stress value was decreased while increasing the femoral implant angles. However, the change was not obviously when the angle range from 135° to 145°. Conclusion: The optimal angle of femoral prosthesis implantation in HRSA is from 135° to 145°. (authors)

  5. What is the optimal alignment of the tibial and femoral components in knee arthroplasty?

    DEFF Research Database (Denmark)

    Gromov, Kirill; Korchi, Mounim; Thomsen, Morten G;

    2014-01-01

    Background - Surgeon-dependent factors such as optimal implant alignment are thought to play a significant role in outcome following primary total knee arthroplasty (TKA). Exact definitions and references for optimal alignment are, however, still being debated. This overview of the literature...... components and their role in outcome and implant survival. Methods - We performed a literature search for original and review articles on implant positioning following primary TKA. Definitions for coronal, sagittal, and rotational placement of femoral and tibial components were summarized and the influence...... of positioning on survival and functional outcome was considered. Results - Many definitions exist when evaluating placement of femoral and tibial components. Implant alignment plays a role in both survival and functional outcome following primary TKA, as component malalignment can lead to increased failure...

  6. Heart rate response during sleep in elderly patients after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Krenk, Lene; Sørensen, Gertrud Laura; Kehlet, Henrik;

    2015-01-01

    in the patients' home preoperatively, during hospitalization on the first postoperative night, and on the fourth postoperative night at home. HRR was reduced (P REM stage 2 sleep on the first postoperative night, and was still reduced on the fourth postoperative night compared...... to preoperative level (P = 0.01). HRR during arousal from REM sleep was not different between the preoperative and fourth postoperative night (P = 0.92), while this could not be determined on the first postoperative night where REM sleep disappeared. The reduced HRR during sleep arousal after major arthroplasty......Variability in heart rate response (HRR) can be used as a measure for autonomic nervous system function, which may influence sleep disturbances and the recovery phase after major surgery. The aim of this study was to evaluate autonomic function by assessment of HRR during sleep arousals...

  7. Influence of the active layer nanomorphology on device performance for ternary PbS(x)Se(1-x) quantum dots based solution-processed infrared photodetector.

    Science.gov (United States)

    Song, Taojian; Cheng, Haijuan; Fu, Chunjie; He, Bo; Li, Weile; Xu, Junfeng; Tang, Yi; Yang, Shengyi; Zou, Bingsuo

    2016-04-22

    In this paper, the influence of the active layer nanomorphology on device performance for ternary PbS(x)Se(1-x) quantum dot-based solution-processed infrared photodetector is presented. Firstly, ternary PbS(x)Se(1-x) quantum dots (QDs) in various chemical composition were synthesized and the bandgap of the ternary PbS(x)Se(1-x) QDs can be controlled by the component ratio of S/(S + Se), and then field-effect transistor (FET) based photodetectors Au/PbS0.4Se0.6:P3HT/PMMA/Al, in which ternary PbS0.4Se0.6 QDs doped with poly(3-hexylthiophene) (P3HT) act as the active layer and poly(methyl methacrylate) (PMMA) as the dielectric layer, were presented. By changing the weight ratio of P3HT to PbS0.4Se0.6 QDs (K = M(P3HT):M(QDs)) in dichlorobenzene solution, we found that the device with K = 2:1 shows optimal electrical property in dark; however, the device with K = 1:2 demonstrated optimal performance under illumination, showing a maximum responsivity and specific detectivity of 55.98 mA W(-1) and 1.02 × 10(10) Jones, respectively, at low V(DS) = -10 V and V(G) = 3 V under 980 nm laser with an illumination intensity of 0.1 mW cm(-2). By measuring the atomic force microscopy phase images of PbS0.4Se0.6:P3HT films in different weight ratio K, our experimental data show that the active layer nanomorphology has a great influence on the device performance. Also, it provides an easy way to fabricate high performance solution-processed infrared photodetector.

  8. Influence of the active layer nanomorphology on device performance for ternary PbS(x)Se(1-x) quantum dots based solution-processed infrared photodetector.

    Science.gov (United States)

    Song, Taojian; Cheng, Haijuan; Fu, Chunjie; He, Bo; Li, Weile; Xu, Junfeng; Tang, Yi; Yang, Shengyi; Zou, Bingsuo

    2016-04-22

    In this paper, the influence of the active layer nanomorphology on device performance for ternary PbS(x)Se(1-x) quantum dot-based solution-processed infrared photodetector is presented. Firstly, ternary PbS(x)Se(1-x) quantum dots (QDs) in various chemical composition were synthesized and the bandgap of the ternary PbS(x)Se(1-x) QDs can be controlled by the component ratio of S/(S + Se), and then field-effect transistor (FET) based photodetectors Au/PbS0.4Se0.6:P3HT/PMMA/Al, in which ternary PbS0.4Se0.6 QDs doped with poly(3-hexylthiophene) (P3HT) act as the active layer and poly(methyl methacrylate) (PMMA) as the dielectric layer, were presented. By changing the weight ratio of P3HT to PbS0.4Se0.6 QDs (K = M(P3HT):M(QDs)) in dichlorobenzene solution, we found that the device with K = 2:1 shows optimal electrical property in dark; however, the device with K = 1:2 demonstrated optimal performance under illumination, showing a maximum responsivity and specific detectivity of 55.98 mA W(-1) and 1.02 × 10(10) Jones, respectively, at low V(DS) = -10 V and V(G) = 3 V under 980 nm laser with an illumination intensity of 0.1 mW cm(-2). By measuring the atomic force microscopy phase images of PbS0.4Se0.6:P3HT films in different weight ratio K, our experimental data show that the active layer nanomorphology has a great influence on the device performance. Also, it provides an easy way to fabricate high performance solution-processed infrared photodetector. PMID:26963474

  9. Influence of the active layer nanomorphology on device performance for ternary PbS x Se1-x quantum dots based solution-processed infrared photodetector

    Science.gov (United States)

    Song, Taojian; Cheng, Haijuan; Fu, Chunjie; He, Bo; Li, Weile; Xu, Junfeng; Tang, Yi; Yang, Shengyi; Zou, Bingsuo

    2016-04-01

    In this paper, the influence of the active layer nanomorphology on device performance for ternary PbS x Se1-x quantum dot-based solution-processed infrared photodetector is presented. Firstly, ternary PbS x Se1-x quantum dots (QDs) in various chemical composition were synthesized and the bandgap of the ternary PbS x Se1-x QDs can be controlled by the component ratio of S/(S + Se), and then field-effect transistor (FET) based photodetectors Au/PbS0.4Se0.6:P3HT/PMMA/Al, in which ternary PbS0.4Se0.6 QDs doped with poly(3-hexylthiophene) (P3HT) act as the active layer and poly(methyl methacrylate) (PMMA) as the dielectric layer, were presented. By changing the weight ratio of P3HT to PbS0.4Se0.6 QDs (K = MP3HT:MQDs) in dichlorobenzene solution, we found that the device with K = 2:1 shows optimal electrical property in dark; however, the device with K = 1:2 demonstrated optimal performance under illumination, showing a maximum responsivity and specific detectivity of 55.98 mA W-1 and 1.02 × 1010 Jones, respectively, at low V DS = -10 V and V G = 3 V under 980 nm laser with an illumination intensity of 0.1 mW cm-2. By measuring the atomic force microscopy phase images of PbS0.4Se0.6:P3HT films in different weight ratio K, our experimental data show that the active layer nanomorphology has a great influence on the device performance. Also, it provides an easy way to fabricate high performance solution-processed infrared photodetector.

  10. 空间使用环境对火工装置性能的影响%Influence of the Aerospace Environment on the Performance of Pyrotechnics Devices

    Institute of Scientific and Technical Information of China (English)

    张醒; 张修科; 杨树彬; 鲍国苗

    2013-01-01

    随着航天新型号的发展,空间站、月球探测、探火星金星等领域陆续进入研究和研制阶段,火工装置工作前在轨存放时间越来越长。由于空间环境的复杂性和未知性,其对火工装置性能影响的研究需求日益紧迫。通过部分产品研制过程中发现的问题,介绍了影响火工装置性能的主要空间环境因素,分析了目前我国火工装置空间环境适应性研究的现状,并展望今后火工装置空间环境适应性研究的发展趋势。%As the development of new generation of aerospace products, a series of projects in fields of the TG space station, the lunar exploration and the Mars and Venus exploration have been engaging into forward stages in China, the pyrotechnics devices would be kept longer and longer on the track before working. In space environment, some complex and unknown factors probably influence the operation of the pyrotechnics device, which plays a critical role in products, while the research on these influences is limited in current. Based on some practical problems in the course of product development, the main effect factors existing in the aerospace on the performance of the pyrotechnics device are proposed, and the current situation of the adaptation research for the pyrotechnics devices in aerospace are analyzed. At last, the further adaptation research tendency is put forward.

  11. Fast track in total hip and knee arthroplasty--experiences from Hvidovre University Hospital, Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte

    2006-01-01

    This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the track....... 307 patients who sustained 329 hip and knee arthroplasties were included in the study with the main material constituted from 243 primary unilateral THA and TKA arthroplasties. ANORAK-HH includes pre-operative patient clinic, patient motivation, dedicated staff, unchanged criteria for discharge and a...

  12. Dust particles in controlled fusion devices: morphology, observations in the plasma and influence on the plasma performance

    Science.gov (United States)

    Rubel, M.; Cecconello, M.; Malmberg, J. A.; Sergienko, G.; Biel, W.; Drake, J. R.; Hedqvist, A.; Huber, A.; Philipps, V.

    2001-08-01

    The formation and release of particle agglomerates, i.e. debris and dusty objects, from plasma facing components and the impact of such materials on plasma operation in controlled fusion devices has been studied in the Extrap T2 reversed field pinch and the TEXTOR tokamak. Several plasma diagnostic techniques, camera observations and surface analysis methods were applied for in situ and ex situ investigation. The results are discussed in terms of processes that are decisive for dust transfer: localized power deposition connected with wall locked modes causing emission of carbon granules, brittle destruction of graphite and detachment of thick flaking co-deposited layers. The consequences for large next step devices are also addressed.

  13. Influence of the effectiveness of raw materials on the reliability of thermoelectric cooling devices. Part I: single-stage TEDs

    Directory of Open Access Journals (Sweden)

    Zaikov V. P.

    2015-02-01

    Full Text Available Increase of the reliability of information systems depends on the reliability improvement of their component elements, including cooling devices, providing efficiency of thermally loaded components. Thermoelectric devices based on the Peltier effect have significant advantages compared with air and liquid systems for thermal modes of the radio-electronic equipment. This happens due to the absence of moving parts, which account for the failure rate. The article presents research results on how thermoelectric efficiency modules affect the failure rate and the probability of non-failure operation in the range of working temperature of thermoelectric coolers. The authors investigate a model of relative failure rate and the probability of failure-free operation single-stage thermoelectric devices depending on the main relevant parameters: the operating current flowing through the thermocouple and resistance, temperature changes, the magnitude of the heat load and the number of elements in the module. It is shown that the increase in the thermoelectric efficiency of the primary material for a variety of thermocouple temperature changes causes the following: maximum temperature difference increases by 18%; the number of elements in the module decreases; cooling coefficient increases; failure rate reduces and the probability of non-failure operation of thermoelectric cooling device increases. Material efficiency increase by 1% allows reducing failure rate by 2,6—4,3% in maximum refrigeration capacity mode and by 4,2—5,0% in minimal failure rate mode when temperature difference changes in the range of 40—60 K. Thus, the increase in the thermoelectric efficiency of initial materials of thermocouples can significantly reduce the failure rate and increase the probability of failure of thermoelectric coolers depending on the temperature difference and the current operating mode.

  14. 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

  15. [Diagnosis in patients with a painful arthroplasty].

    Science.gov (United States)

    Carrega, Giuliana; Antonini, Andrea; Burastero, Giorgio; Casalino-Finocchio, Giorgetta; Ronca, Agostina; Salomone, Carlo; Riccio, Giovanni

    2015-06-01

    The differential diagnosis between asepting loosening or prosthetic joint infection is not always easy. Tc-99m-labelled leucocyte scans, frozen section and histology can help recognise doubtful cases. We report the experience of the Unit for Infectious Diseases and Septic Orthopaedics of the ASL-2 Liguria, Italy, with a Tc-99m-labelled leucocyte scan and intraoperative frozen section to choose the best therapeutic approach: one-stage or two-stage exchange or arthrodesis-arthroplastica. All cases underwent histology and intraoperative cultures to confirm the diagnosis, and the effectiveness of the approach was evaluated at follow up after 18 months. From January 2011 to December 2012, 36 patients were evaluated (21 hip and 15 knee arthroprosthesis). The Tc-99m-labelled leukocyte scan was positive in 31 and negative in 5 patients. Frozen section was negative in 7 patients. Five of them were patients with a negative Tc-99m-labelled leucocyte scan and were treated successfully with one-stage exchange, even if, in one of them, Enterococcus faecalis was isolated at replacement and suppressive antibiotic treatment was needed. The other 31 patients were treated with arthrodesis arthroplasty (3 patients) or a two-stage exchange. In this group the Tc-99m-labelled leucocyte scan was positive in all patients and the frozen section was positive in 29/31 cases with 6% false negative. Histology was positive in 27/31 with 13% of false negative. The sensitivity and specificity value was respectively 90% and 100% in the frozen section, 84% and 100% in histology. Cultures were positive in 23/31 cases. Patients subjected to two-stage exchange were evaluated again during prosthesis replacement but the results of the Tc-99m-labelled leucocyte scan and histology showed unclear results more frequently: the Tc-99m-labelled leucocyte scan was positive in two cases, the frozen section in three and histology in seven in spite of positive culture in three cases and one relapse in a patient

  16. Registro de artroplastias do ombro Shoulder arthroplasty records

    Directory of Open Access Journals (Sweden)

    Geraldo Motta Filho

    2009-04-01

    Full Text Available OBJETIVO: Determinar as características clínico-cirúrgicas referentes a 145 artroplastias do ombro realizadas no período entre julho de 2004 a dezembro de 2006. MÉTODOS: No período de estudo foram realizadas 145 artroplastias de ombro. Através de protocolo prospectivo, informações demográficas, da anamnese, exame físico e exame radiográfico foram armazenadas em um banco de dados. Os dados coletados foram organizados em três grandes grupos: doenças articulares degenerativas, fraturas e seqüelas traumáticas. Esses dados foram correlacionados a fim de definir o perfil epidemiológico dos pacientes, das lesões e artroplastias. RESULTADOS: Das 145 artroplastias de ombro realizadas 37% foram por seqüelas traumáticas, 30% por doença articular degenerativa e 33% com diagnóstico de fratura. Foram 12% artroplastias totais e 88% parciais. Ocorreram cinco complicações no pós-operatório recente. CONCLUSÃO: As artroplastias de ombro tornaram-se um procedimento frequente na prática ortopédica. Registros cirúrgicos são importantes a fim de demonstrar essa evolução progressiva e permitir avaliações de resultados clínicos no futuro.OBJECTIVE: The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. METHODOLOGY: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. RESULTS: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus

  17. Wave Propagation Direction and c-Axis Tilt Angle Influence on the Performance of ScAlN/Sapphire-Based SAW Devices.

    Science.gov (United States)

    Kochhar, Abhay; Yamamoto, Yasuo; Teshigahara, Akihiko; Hashimoto, Ken-Ya; Tanaka, Shuji; Esashi, Masayoshi

    2016-07-01

    Some previously reported surface acoustic wave (SAW) devices using bulk piezoelectric substrates showed higher acoustic power radiated in either forward or backward wave propagation direction depending on their crystal orientations and are called natural single-phase unidirectional transducers (NSPUDT). While these reports were based on bulk piezoelectric substrates, we report directionality in the c-axis tilted 44% scandium doped aluminum nitride thin piezoelectric film-based SAW devices on sapphire. It is worth noting that our observance of directionality is specifically in Sezawa mode. We produced a c-axis tilt up to 5.5° over the single wafer and examined the directionality by comparing the forward and backward insertion loss utilizing split finger electrodes as a receiver. The wave propagation direction and c-axis tilt angle influence on the performance of SAW devices is evaluated. Furthermore, return loss and insertion loss data are presented for various SAW propagation directions and c-axis tilt angles. Finally, the comparison for both acoustic modes, i.e., Rayleigh and Sezawa, is reported. PMID:26978772

  18. Influence of the sampling device on somatic cell count variation in cow milk samples (by official recording

    Directory of Open Access Journals (Sweden)

    María J. Vilar

    2016-03-01

    Full Text Available The objective of this study was to investigate the variability in cow´s milk somatic cell counts (SCC depending on the type of milk meter used by dairy farms for official milk recording. The study was performed in 2011 and 2012 in the major cattle area of Spain. In total, 137,846 lactations of Holstein-Friesian cows were analysed at 1,912 farms. A generalised least squares regression model was used for data analysis. The model showed that the milk meter had a substantial effect on the SCC for individual milk samples obtained for official milk recording. The results suggested an overestimation of the SCC in milk samples from farms that had electronic devices in comparison with farms that used portable devices and underestimation when volumetric meters are used. A weak positive correlation was observed between the SCC and the percentage of fat in individual milk samples. The results underline the importance of considering this variable when using SCC data from milk recording in the dairy herd improvement program or in quality milk programs.

  19. Early recovery after fast-track Oxford unicompartmental knee arthroplasty

    DEFF Research Database (Denmark)

    Munk, Stig; Dalsgaard, Jesper; Bjerggaard, Karin;

    2012-01-01

    performance reached the preoperative level after 1 month. Only slight postoperative knee swelling was observed with rapid restoration of knee flexion and function. A high level of pain during the first postoperative night and day fell considerably thereafter. None of the patients needed physiotherapy...... supervision in the first month after discharge. Interpretation Fast-track MIS Oxford UKA with discharge on the day after surgery is safe and leads to early recovery of knee motion and strength even when no physiotherapy is used.......Background and purpose After total knee arthroplasty with conventional surgical approach, more than half of the quadriceps extension strength is lost in the first postoperative month. Unicompartmental knee arthroplasty (UKA) operated with minimally invasive surgery (MIS) results in less operative...

  20. Nursing in fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Specht, Kirsten; Kjaersgaard-Andersen, Per; Kehlet, Henrik;

    2015-01-01

    must still focus on the individual patient. Nurses need to have enough education to manage the complex tasks and increased responsibility. To prevent undesirable outcomes in the future, there is a need to pay attention to the nursing quality in balance with the nursing budget. It may, therefore......AIM: To describe the increased activity in total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2002 to 2012 in a single orthopaedic department, the organisation of fast-track and its consequences for nursing care. METHODS: Retrospective, descriptive design. Data collection; from...... gained tasks from surgeons and physiotherapists and thus gained more responsibility, for example, for pain management and mobilisation. Staffing levels in the ward in 2002 and 2012 were almost unchanged; 16.0 and 15.8 respectively. Nurses were undertaking more complicated tasks. CONCLUSION: Nursing care...

  1. Catastrophic failure of ceramic-polyethylene bearing total hip arthroplasty.

    Science.gov (United States)

    Needham, Justin; Burns, Travis; Gerlinger, Tad

    2008-06-01

    Complications of ceramic-polyethylene bearing total hip arthroplasty (THA) include osteolysis, loosening, dislocation, and component failure. Catastrophic acetabular component failure involves severe damage to both the polyethylene liner and metal shell. This case study presents the first reported complete wear-through of the acetabular portion of a ceramic-polyethylene arthroplasty presenting as a dislocation and a review of the literature. In this study, a patient's alumina ceramic femoral head penetrated the polyethylene liner and titanium shell and presented as a dislocated THA. The contributing factors for this catastrophic failure include young patient age, high activity level, thin polyethylene liner, backside wear, component positioning, polyethylene sterilization with gamma irradiation in air, and lack of appropriate follow-up. Revision THA was performed without complications. PMID:18514888

  2. Knitted outer gloves in primary hip and knee arthroplasty.

    Science.gov (United States)

    Tanner, J; Wraighte, P; Howard, P

    2006-01-01

    A randomised trial was carried out to determine the rate of perforation to inner gloves when comparing latex with knitted gloves during hip and knee arthroplasty. Members of the surgical team were randomised to wear either two pairs of latex gloves (standard double gloving) or a knitted glove on top of a latex glove. In addition, participants completed a visual analogue assessment of their overall satisfaction with the gloves. A total of 406 inner gloves were tested for perforations over a four-month period: 23% of inner gloves were perforated when latex outer gloves were used and 6% of inner gloves were perforated when knitted outer gloves were used. In total, there were 64 perforations to the inner gloves; only one of these perforations was detected by the glove wearer. Wearing knitted outer gloves during hip and knee arthroplasty statistically significantly reduces the risk of perforation to inner latex gloves (p<0.0001).

  3. Conventional Versus Cross-Linked Polyethylene for Total Hip Arthroplasty.

    Science.gov (United States)

    Surace, Michele F; Monestier, Luca; Vulcano, Ettore; Harwin, Steven F; Cherubino, Paolo

    2015-09-01

    The clinical and radiographic outcomes of 88 patients who underwent primary total hip arthroplasty with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer were compared. There were no significant differences between the 2 subpopulations regarding average age, gender, side affected, or prosthetic stem and cup size. The average follow-up was 104 months (range, 55 to 131 months). To the authors' knowledge, this is the longest follow-up for this particular insert. Clinical and radiographic evaluations were performed at 1, 3, 6, and 12 months and then annually. Results showed that XLPE has a significantly greater wear reduction than that of standard polyethylene in primary total hip arthroplasty. At the longest available follow-up for these specific inserts, XLPE proved to be effective in reducing wear. PMID:26375527

  4. Modification of the total first metatarsophalangeal joint implant arthroplasty.

    Science.gov (United States)

    Corrigan, G; Kanat, I O

    1989-01-01

    The Swanson Silastic HP 100 Flexible Hinge Toe Implant (Dow Corning Wright, Arlington Tennessee) displays superior tensile, elongation and tear propagation strength in comparison to other silicone implant materials. It is, however, subject to many factors which may shorten its life-span. One reason for such failure has been attributed to the irregular contour of bone ends created after metatarsophalangeal joint arthroplasty, resulting in abrasion shards and shearing fractures of the implant stems and hinge. Titanium grommets were developed to alleviate this factor. This case report demonstrates a complication subsequent to total first metatarsophalangeal joint implant arthroplasty and the effectiveness of the Swanson Flexible Hinge Toe Joint Grommet. (Dow Corning Wright, Arlington, Tennessee). PMID:2794361

  5. Can pelvic tilting be ignored in total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Won Yong Shon

    2014-01-01

    CONCLUSION: The sagittal position of pelvis is a key factor in impingement and dislocation after total hip arthroplasty. Pelvic tilting affects the position of acetabular component in the sagittal plane of the body as compared with its anatomic position in the pelvis. We suggest a preoperative lateral view of spine-pelvis, in upright and supine position for evaluation of a corrective adaptation of the acetabular cup accordingly with pelvic balance.

  6. Increasing risk of prosthetic joint infection after total hip arthroplasty

    DEFF Research Database (Denmark)

    Dale, Håvard; Fenstad, Anne M; Hallan, Geir;

    2012-01-01

    Background and purpose The risk of revision due to infection after primary total hip arthroplasty (THA) has been reported to be increasing in Norway. We investigated whether this increase is a common feature in the Nordic countries (Denmark, Finland, Norway, and Sweden). Materials and methods The...... explain this increase. We believe that there has been an actual increase in the incidence of prosthetic joint infections after THA....

  7. Spontaneous Knee Ankylosis through Heterotopic Ossification after Total Knee Arthroplasty

    OpenAIRE

    Samuel Boulezaz; Emmanuel Gibon; Philippe Loriaut; Laurent Casabianca; Romain Rousseau; Benjamin Dallaudiere; Hugues Pascal-Moussellard

    2016-01-01

    This paper reports on a case of total ankylosis of the knee after a cruciate-sacrificing cemented total knee arthroplasty (TKA). An 82-year-old female patient previously underwent primary TKA for osteoarthritis twenty years ago in our institution. She had recovered uneventfully and returned to her regular activities. There was no history of postsurgical trauma; however, she progressively lost knee range of motion. Radiographs revealed severe bridging heterotopic ossification.

  8. Recovery of physical functioning after total hip arthroplasty

    OpenAIRE

    2014-01-01

    Purpose. The overall aim of this thesis was to examine recovery of physical functioning in patients with hip osteoarthritis (OA) during the first year after total hip arthroplasty (THA). The specific aims were 1) to examine the desires of a group of patients regarding improvements in physical functioning before they underwent THA and at three and 12 months after surgery, 2) to examine changes in physical functioning during the first year of recovery and examine which preoperative measures pre...

  9. Spontaneous arteriorrhexis in affected lower limb following total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ya-feng; JIANG Qing; WANG Jun-fei

    2008-01-01

    @@ Total knee arthroplasty ( TKA) is now a standard treatment for serious osteoarthritis all over the world. Although it is a standard treatment, it has many complications, among which deep vein thrombosis ( DVT) is the exclusive blood vessel complication that has been reported.1,2 However, we found a new blood vessel complication of TKA in this study, which is spontaneous arteriorrhexis in the affected lower limb.

  10. Do pessimists report worse outcomes after total hip arthroplasty?

    OpenAIRE

    Singh, Jasvinder A; Colligan, Robert C.; O’Byrne, Megan M.; David G Lewallen

    2016-01-01

    Background Seligman’s theory of causal attribution predicts that patients with a pessimistic explanatory style will have less favorable health outcomes. We investigated this hypothesis using self-reported hip pain and hip function 2- years after total hip arthroplasty (THA). Methods Most THA patients had completed the Minnesota Multiphasic Personality Inventory (MMPI) during their usual clinical care long before THA (median, 14.7 to 16.6 years). Scores from the MMPI Optimism-Pessimism (PSM) s...

  11. Short-Term Results of Medial Unicondylar Knee Arthroplasty

    OpenAIRE

    Murat Yılmaz; Samed Ordu; Erhan Bayram; İbrahim Sungur; Ercan Çetinus

    2014-01-01

    Aim: This study aimed to determine the short-term clinical and radiologic results of medial unicondylar knee arthroplasty (UKA). Methods: We retrospectively evaluated hospital records of eight patients who have undergone Oxford phase-3 medial UKA between 2011 and 2013. We included seven patients (two males and five females) in the study. The mean age of the patients was 63 years and the mean follow-up period was 17 months. The patients underwent UKA with the Oxford phase 3 cemented mobile ...

  12. Management of failed metal-on-metal total hip arthroplasty

    OpenAIRE

    Griffin, Justin W.; D’Apuzzo, Michele; Browne, James A.

    2012-01-01

    The theoretical advantages of metal-on-metal (MOM) bearing couples in total hip arthroplasty (THA) have been recently balanced by concerns regarding adverse local and systemic effects. Higher than anticipated early revision rates have been reported by several joint registries. Failed MOM hips present with a spectrum of symptoms and findings and traditional methods of failure must be considered in addition to the failure modes that appear to be unique to the MOM bearing couple. Metal hypersens...

  13. 冷疗加压系统使用时间对行人工全膝关节置换术患者关节肿胀疼痛与睡眠质量的影响%Influence of cold flow pressurized systemˊs using time on joint swelling and pain and sleep quality of patients with total artificial knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    贺文

    2016-01-01

    Objective To study the influence of cold flow pressurized systemˊs using time on joint swelling and pain and sleep quality of patients with total artificial knee arthroplasty ( TKA) . Methods A total of 98 patients who were treated with routine artificial total knee replacement lens in our hospital from April 2014 to May 2015 were chosen as the research objects, and were randomly divided into observation group and control group, 49 cases in each group. Patients of the observation group were treated with the circulative pressure cold therapy within 24 hours after the surgery and the time interval was 8 hours at a time, 30 minutes at a time, and were given conventional nursing care;while the patients of the control group underwent circulative pressure cold therapy within 48 hours after the surgery, the time interval was 8 hours at a time, 30 minutes at a time, and were given routine care as well. The visual simulation e-valuation ( visual analogue scale score, VAS) system were used to assess the level of pain 12 hours, 24 hours, 48 hours and 72 hours after the surgery, and swelling degree was assessed by diametersˊdifference between the healthy thigh and diseased thigh, and the sleeping quality was assessed with Pittsburgh Sleep Quality Index ( PSQI) . Results The VAS scores 12 hours, 24 hours and 48 hours after the surgery of the patients of the observation group were significantly lower than that of the control group, and the difference was statistically significant (P<0. 05);the swelling degree 24 hours, 48 hours and 72 hours after the surgery of the patients of the observation group was significantly lower than that of the control group, and the difference was statistically significant (P<0. 05);the sleep quality 2 days and 3 days after sur-gery of the patients of the observation group was better than that of the control group, and the difference was statistically significant ( P<0. 05 ) . Conclusions Circulating intermittent pressure cold treatment applied in

  14. THE IMPORTANCE OF PREOPERATIVE RISK FACTORS IN THE RECOVERY OF PATIENTS WITH DEFORMITIES FOLLOWING TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Savin L.

    2015-08-01

    Full Text Available A retrospective observational study has been conducted on 457 patients diagnosed with advanced knee osteoarthritis and that underwent knee arthroplasty. Two groups of patients have been observed: the first group presented deformities (varus, valgus while the second group did not. There have been evaluated the prevalence of general risk factors (age, sex and local ones (obesity, muscle tone, deformities in the occurrence of advanced gonarthrosis requiring radical surgery and the influence of these factors on the evolution of patients¬ that underwent total knee arthroplasty. 53.6 % of patients had their knees correctly aligned while 39.8% presented a varus misalignment and only 6.1% a valgus misalignment. Within the group of patients included in the study, the average age of patients was 66 years and the highest frequency was found in patients aged over 70 years, both in genu varum and genu valgum. The female patients represent 74.4% of the total number of patients and more frequently affected by the occurrence of deformities. Obesity has been observed in 32 – 38% of the patients with deformities. Postoperative pain has been evaluated using the Visual Analogue Scale (VAS. In 50% of the cases, patients with varus and valgus accused early intense and severe postoperative pain (VAS 7-10. 32. 64% of the female patients accused level of pain marked as 7 – 10 VAS, while only 30.84% of the male patients accused the same levels of pain. Intense and severe pain is more frequently found in elderly patients. The deformities did not cause any important changes on early postoperative pain, obesity and muscular hypotrophy being the risk factors in increasing the level of pain. Postoperative recovery in patents with knee arthroplasty largely depends on preoperative planning, the surgical technique and, not lastly, the correct management of bleeding and pain.

  15. Applications of porous tantalum in total hip arthroplasty.

    Science.gov (United States)

    Levine, Brett; Della Valle, Craig J; Jacobs, Joshua J

    2006-11-01

    Porous tantalum is an alternative metal for total joint arthroplasty components that offers several unique properties. Its high volumetric porosity (70% to 80%), low modulus of elasticity (3 MPa), and high frictional characteristics make it conducive to biologic fixation. Tantalum has excellent biocompatibility and is safe to use in vivo. The low modulus of elasticity allows for more physiologic load transfer and relative preservation of bone stock. Because of its bioactive nature and ingrowth properties, tantalum is used in primary as well as revision total hip arthroplasty components, with good to excellent early clinical results. In revision arthroplasty, standard and custom augments may serve as a structural bone graft substitute. Formation of a bone-like apatite coating in vivo affords strong fibrous ingrowth properties and allows for substantial soft-tissue attachment, indicating potential for use in cases requiring reattachment of muscles and tendons to a prosthesis. Development of modular components and femoral stems also is being evaluated. The initial clinical data and basic science studies support further investigation of porous tantalum as an alternative to traditional implant materials. PMID:17077337

  16. DIAGNOSTIC AND THERAPEUTIC ARTHROSCOPY IN SYMPTOMATIC PATIENTS AFTER KNEE ARTHROPLASTY

    Science.gov (United States)

    Severino, Fabricio Roberto; Souza, Clodoaldo José Duarte de; Severino, Nilson Roberto

    2015-01-01

    Objectives: Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. Methods: Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. Results: The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p < 0.001). Most of the patients (12) were arthroscopically diagnosed with fibrosis known as “cyclop”; on the remaining five patients, anterior synovitis was found. All patients were treated by resection. Conclusions: Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis (“cyclops”) or synovitis, which can be treated by using the same procedure, resulting in pain relief. PMID:27022517

  17. [Recovery from total knee arthroplasty through continuous passive motion].

    Science.gov (United States)

    Sánchez Mayo, B; Rodríguez-Mansilla, J; González Sánchez, B

    2015-01-01

    The purpose of this study was to know the effects of continuous passive mobilization in patients who underwent total knee arthroplasty. A search strategy was developed to retrieve all clinical trials, written in English and/or Spanish, published in the electronic search databases PubMed, Cochrane Library Plus, Dialnet, CSIC and PEDro. The inclusion criteria were: clinical trials published from January 2000 until November 2014 in English or Spanish. Out of 537 clinical trials that were potentially relevant, a total of 12 were included in this review. The evaluation of 1,153 patients shows that there is no significant difference in improving the range of the joint, pain, balance, motion, healing and hospital stay using continuous passive mobilization against the regular physiotherapy treatment for total knee arthroplasty. The application of continuous passive mobilization in the long-term does not provide any benefit in terms of the breadth of the range of the joint, pain and improvement of standing and motion in comparison with conventional postoperative physiotherapy treatment in total knee arthroplasty. In the short term an improvement is obtained in the range of joint motion in knee flexion. PMID:26486536

  18. Outcome of total knee arthroplasty with insall burstein-11 prosthesis

    International Nuclear Information System (INIS)

    Patients with severe degenerative knee joint disease often require knee arthroplasty to reduce pain, improve stability and restore function. Insall Burstein II prosthesis is posteriorly stabilized condylar prosthesis, which provide posterior cruciate ligament substitution. It was designed to improve range of motion, stair climbing ability and to prevent posterior subluxation. Evaluate the functional outcome of total knee arthroplasty with IB II prosthesis and Evaluate the alignment of prosthetic components by radiological parameters and its correlation with functional outcome. Sixty knees of sixty patients were replaced by using Insall Burstein II prosthesis. Postoperative radiographs were evaluated for alignment of knee and prosthetic components by criteria selected from knee society roentogenographic evaluation system. Functional outcome was evaluated by rationale of knee society knee rating system. Prosthetic component was aligned in 93% and mal-alignment in 7% of the cases. There was significant improvement in functions core from mean score 33.83 +-15.5 to 59.5+-17.7 and knee score from 37 +- 12.5 to 76.4 +-2.2. Postoperative functional score was found correlated with alignment significantly. Conclusion: Total knee arthroplasty with I-B-II prosthesis is a safe durable and predictable procedure with proper surgical technique and expertise good alignment and satisfactory functional out come can be achieved. (author)

  19. Review of Arthroscopic and Histological Findings Following Knee Inlay Arthroplasty.

    Science.gov (United States)

    Markarian, Gregory G; Kambour, Michael T; Uribe, John W

    2016-01-01

    The phenomenon of cartilage rim loading in defects exceeding the threshold diameter of 10 mm is well documented. Contoured defect fill off-loads the perimeter and counteracts further delamination and progression of defects. When biological procedures have failed, inlay arthroplasty follows these concepts. The human biological response to contoured metallic surface implants has not been described. Four patients underwent non-implant-related, second-look arthroscopy following inlay arthroplasty for bi- (n=3) and tricompartmental (n=1) knee arthrosis without subchondral bone collapse. Arthroscopic probing of the implant-cartilage interface of nine prosthetic components did not show signs of implant-cartilage gap formation, loosening, or subsidence. The implant periphery was consistently covered by cartilage confluence leading to a reduction of the original defect size diameter. Femoral condyle cartilage flow appeared to have more hyaline characteristics. Trochlear cartilage flow showed greater histological variability and less organization with fibrocartilage and synovialized scar tissue. This review reconfirmed previous basic science results and demonstrated effective defect fill and rim off-loading with inlay arthroplasty.

  20. Triplet formation in fullerene multi-adduct blends for organic solar cells and its influence on device performance

    Energy Technology Data Exchange (ETDEWEB)

    Dyer-Smith, Clare [Department of Physics, Imperial College London, Blackett Laboratory, Prince Consort Road, London SW7 2AZ (United Kingdom); Department of Chemistry, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Grantham Institute for Climate Change, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Reynolds, Luke X. [Department of Chemistry, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Grantham Institute for Climate Change, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Bruno, Annalisa; Haque, Saif A. [Department of Chemistry, Imperial College London, South Kensington Campus, London, SW7 2AZ (United Kingdom); Bradley, Donal D.C.; Nelson, Jenny [Department of Physics, Imperial College London, Blackett Laboratory, Prince Consort Road, London SW7 2AZ (United Kingdom)

    2010-08-23

    In organic solar cells, high open circuit voltages may be obtained by choosing materials with a high offset between the donor highest occupied molecular orbital (HOMO) and acceptor lowest unoccupied molecular orbital (LUMO). However, increasing this energy offset can also lead to photophysical processes that compete with charge separation. In this paper the formation of triplet states is addressed in blends of polyfluorene polymers with a series of PCBM multi-adducts. Specifically, it is demonstrated that the formation of such triplets occurs when the offset energy between donor ionization potential and acceptor electron affinity is {proportional_to}1.6 eV or greater. Spectroscopic measurements support a mechanism of resonance energy transfer for triplet formation, influenced by the energy levels of the materials, but also demonstrate that the competition between processes at the donor-acceptor interface is strongly influenced by morphology. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  1. Influence of craniofacial and upper spine morphology on mandibular advancement device treatment outcome in patients with obstructive sleep apnoea

    DEFF Research Database (Denmark)

    Svanholt, Palle; Petri, Niels; Wildschiødtz, Gordon;

    2015-01-01

    Summary BACKGROUND/OBJECTIVES: The aim of the study was to assess cephalometric predictive markers in terms of craniofacial morphology including posterior cranial fossa and upper spine morphology for mandibular advancement device (MAD) treatment outcome in patients with obstructive sleep apnoea...... patients and the no success treatment group of 19 patients. Before MAD treatment lateral cephalograms were taken and analyses of the craniofacial morphology including the posterior cranial fossa and upper spine morphology were performed. Differences between the groups were analysed by Fisher's exact test......, t-test, and multiple regression analysis. RESULTS: Upper spine morphological deviations occurred non-significantly in 25 per cent in the success treatment group and in 42.1 per cent in the no success treatment group. Body mass index (BMI; P

  2. Care principles at four fast-track arthroplasty departments in Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Solgaard, Søren; Hansen, Torben Bæk;

    2010-01-01

    The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery.......The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery....

  3. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten T; Bencke, Jesper;

    2010-01-01

    To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA).......To examine whether changes in knee-extension strength and functional performance are related to knee swelling after total knee arthroplasty (TKA)....

  4. Adductor canal block for postoperative pain treatment after revision knee arthroplasty

    DEFF Research Database (Denmark)

    Jæger, Pia; Koscielniak-Nielsen, Zbigniew J; Schrøder, Henrik M;

    2014-01-01

    BACKGROUND: Revision knee arthroplasty is assumed to be even more painful than primary knee arthroplasty and predominantly performed in chronic pain patients, which challenges postoperative pain treatment. We hypothesized that the adductor canal block, effective for pain relief after primary tota...

  5. Validation of the diagnosis 'prosthetic joint infection' in the Danish Hip Arthroplasty Register

    DEFF Research Database (Denmark)

    Gundtoft, P H; Pedersen, Alma Becic; Schønheyder, H C;

    2016-01-01

    AIMS: The purpose of this study was to validate the diagnosis of periprosthetic joint infection (PJI) in the Danish Hip Arthroplasty Register (DHR). PATIENTS AND METHODS: We identified a cohort of patients from the DHR who had undergone primary total hip arthroplasty (THA) since 1 January 2005 an...

  6. Cirrhosis patients have increased risk of complications after hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Deleuran, T.; Vilstrup, H.; Overgaard, Søren;

    2015-01-01

    Background and purpose: The risk of complications in cirrhosis patients after orthopedic surgery is unclear. We examined this risk after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patients and methods: Using Danish healthcare registries, we identified all Danish residents who...

  7. Role of patient characteristics for fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C C; Kehlet, H

    2013-01-01

    BACKGROUND: /st>Patient age and comorbidity have been found to increase the length of hospital stay (LOS), readmissions, and mortality after surgery, including in elective primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Whether the same applies in fast-track THA and TKA...

  8. The role of pain for early rehabilitation in fast track total knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Myhrmann, Lis;

    2010-01-01

    To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA).......To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA)....

  9. Small increase of actual physical activity 6 months after total hip or knee arthroplasty

    NARCIS (Netherlands)

    I.B. de Groot (Ingrid); J.B.J. Bussmann (Hans); H.J. Stam (Henk); J.A.N. Verhaar (Jan)

    2008-01-01

    textabstractLimitation in daily physical activity is one of the reasons for total hip arthroplasty (THA) or total knee arthroplasty (TKA). However, studies of the effects of THA or TKA generally do not determine actual daily activity as part of physical functioning. We determined the effect of THA o

  10. Minimally Invasive Total Hip and Knee Arthroplasty-Implications for the Elderly Patient

    NARCIS (Netherlands)

    Reininga, Inge H. F.; Stevens, Martin; Wagenmakers, Robert; Bulstra, Sjoerd K.; van den Akker-Scheek, Inge

    2012-01-01

    Total hip arthroplasty and total knee arthroplasty have proven to be effective surgical procedures for the treatment of hip and knee osteoarthritis. In recent decades, there have been considerable efforts to improve the component designs, modes of fixation, and surgical techniques. Minimally invasiv

  11. Low risk of thromboembolic complications after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B;

    2010-01-01

    Pharmacological prophylaxis can reduce the risk of deep venous thrombosis (DVT), pulmonary embolism (PE), and death, and it is recommended 10–35 days after total hip arthroplasty (THA) and at least 10 days after total knee arthroplasty (TKA). However, early mobilization might also reduce the risk...

  12. Prevention of post-operative anaemia in hip and knee arthroplasty - a systematic review

    DEFF Research Database (Denmark)

    Khan, Nissa; Troelsen, Anders; Husted, Henrik

    2015-01-01

    and minimised the length of stay. A similar result was found for fibrin spray in total hip arthroplasty. However, for total knee arthroplasty, the outcome was blurred. Tourniquet use was uniformly not significant in the measured parameters. CONCLUSIONS: Tranexamic acid is useful in managing anaemia and blood...

  13. Influence of Dopant Concentration on Electroluminescent Performance of Organic White-Light-Emitting Device with Double-Emissive-Layered Structure

    Institute of Scientific and Technical Information of China (English)

    WU Xiao-Ming; HUA Yu-Lin; YIN Shou-Gen; ZHANG Li-Juan; WANG Yu; HOU Qing-Chuan; ZHANG Jun-Mei

    2008-01-01

    A novel phosphorescent organic white-light-emitting device(WOLED)with configuration of ITO/NPB/CBP:TBPe:rubrene/Zn(BTZ)2:Ir(piq)2(acac)/Zn(BTZ)2/Mg:Ag is fabricated successfully,where the phosphorescent dye bis(1-(phenyl)isoquinoline)iridium(Ⅲ)acetylanetonate(Ir(piq)2(acac))doped into bis-(2-(2-hydroxyphenyl)benzothiazole)zinc(Zn (BTZ)2)(greenish-blue emitting material with electron transport character)as the red emitting layer,and fluorescent dye2,5,8,11-tetra-tertbutylperylene(TBPe)and5,6,11,12-tetraphenyl-naphthacene(rubrene)together doped into 4,4'-N,N'-dicarbazole-biphenyl(CBP)(ambipolar conductivity material)as the blue-orange emitting layer,respectively.The two emitting layers are sandwiched between the hole-transport layer N,N'-biphenyl-N,N'-bis(1-naphthyl)-(1,1'-biphenyl)-4,4'-diamine(NPB)and electron-transport layer(Zn(BTZ)2).The optimum device turns on at the driving voltage of 4.5V.A maximum external quantum efficiency of 1.53%and brightness 15000 cd/m2 are presented.The best point of the Commission Internationale de l'Eclairage(CIE)coordinates locates at (0.335,0.338)at about 13 V. Moreover,we also discuss how to achieve the bright pure white light through optimizing the doping concentration of each dye from the viewpoint of energy transfer process.

  14. The metaphyseal bone defect predicts outcome in reverse shoulder arthroplasty for proximal humerus fracture sequelae.

    Science.gov (United States)

    Greiner, Stefan; Uschok, Stephan; Herrmann, Sebastian; Gwinner, Clemens; Perka, Carsten; Scheibel, Markus

    2014-06-01

    Reverse shoulder arthroplasty (RSA) represents an established procedure for treatment of fracture sequelae (FS) after proximal humerus fractures. The present work evaluates which factors are of influence for the clinical outcome. Fifty cases (mean age 69, range 44-89) have been evaluated postoperatively clinically [Constant Score (CS)] and radiographically (mean FU 34; range 24-93 months). The type of primary treatment, the amount of a metaphyseal bone defect, the preoperative status of the rotator cuff, the number of previous operative interventions and the type of FS according to Boileau were analysed whether they are of influence for clinical outcome. The mean CS increased significantly from 16.9 ± 6.7 preoperatively to 54.1 ± 15.7 points postoperatively. The CS of primary conservative treatment was significantly higher in comparison to primary operative treatment. Patients with a metaphyseal bone defect of more than 3 cm had significantly lower CS results. Degenerative changes of the teres minor muscle also had a significant negative influence on clinical results. Score results decreased with increasing number of previous operations. There were no significant difference in between patients classified as Boileau type I and II (category 1) compared to types III and IV (category 2). RSA significantly improved the clinical result. A metaphyseal bone defect and preoperative degeneration of the teres minor showed to be negative prognostic factors. Primary operative treatment and the number of previous operations also negatively influenced the clinical result.

  15. Complications of fixed infrared emitters in computer-assisted total knee arthroplasties

    Directory of Open Access Journals (Sweden)

    Suárez-Vázquez Abelardo

    2007-07-01

    Full Text Available Abstract Background The first stage in the implant of a total knee arthroplasty with computer-assisted surgery is to fasten the emitters to the femur and the tibia. These trackers must be hard-fixed to the bone. The objectives of our study are to evaluate the technical problems and complications of these tracker-pins, the necessary time to fix them to the bone and the possible advantages of a new femoral-fixed tracker-pin. Methods Three hundred and sixty seven tracker-pins were used in one hundred and fifty one computer-assisted total knee replacements. A bicortical screw was used to fix the tracker to the tibia in all cases; in the femur, however, a bicortical tracker was used in 112 cases, while a new device (OrthoLock with percutaneous fixation pins was employed in the remaining 39. Results Technical problems related to the fixing of the trackers appeared in nine cases (2.5%. The mean surgery time to fix the tracker pin to the tibia was 3 minutes (range 2–7, and 5 minutes in the case of the femoral pin (range: 4–11, although with the new tool it was only three minutes (range 2–4 (p Conclusion The incidence of problems and complications with the fixing systems used in knee navigation is very small. The use of a new device with percutaneous pins facilitates the fixing of femoral trackers and decreases the time needed to place them.

  16. ELIGIBILITY FOR THE HIP-RESURFACING ARTHROPLASTY PROCEDURE: AN EVALUATION ON 592 HIPS

    Science.gov (United States)

    Queiroz, Roberto Dantas; Faria, Rafael Salomon Silva; Duarte, David Marcelo; Takano, Marcelo Itiro; Sugiyama, Mauricio Morita

    2015-01-01

    Objective: To investigate the percentage of ideal patients who would be eligible for hip-resurfacing surgery at a reference service for hip arthroplasty. Methods: Out of all the cases of hip arthroplasty operated at Hospital do Servidor Público Estadual de São Paulo (HSPE) between January 2009 and December 2010, we assessed a total of 592 procedures that would fit the criteria for indication for resurfacing arthroplasty, after clinical and radiological evaluation according to the criteria established by the Food and Drug Administration (FDA) and by Seyler et al. Results: Among the total number of hip replacement arthroplasty cases, 5.74% of the patients were eligible. Among the patients who underwent primary arthroplasty, we found that 8.23% presented ideal conditions for this procedure. Conclusion: The study demonstrated that this type of surgery still has a limited role among hip surgery methods. PMID:27047851

  17. Arthroplasty Utilization in the United States is Predicted by Age-Specific Population Groups.

    Science.gov (United States)

    Bashinskaya, Bronislava; Zimmerman, Ryan M; Walcott, Brian P; Antoci, Valentin

    2012-01-01

    Osteoarthritis is a common indication for hip and knee arthroplasty. An accurate assessment of current trends in healthcare utilization as they relate to arthroplasty may predict the needs of a growing elderly population in the United States. First, incidence data was queried from the United States Nationwide Inpatient Sample from 1993 to 2009. Patients undergoing total knee and hip arthroplasty were identified. Then, the United States Census Bureau was queried for population data from the same study period as well as to provide future projections. Arthroplasty followed linear regression models with the population group >64 years in both hip and knee groups. Projections for procedure incidence in the year 2050 based on these models were calculated to be 1,859,553 cases (hip) and 4,174,554 cases (knee). The need for hip and knee arthroplasty is expected to grow significantly in the upcoming years, given population growth predictions.

  18. Inter-tester Reliability of the Hand-held dynamometer and the Leg Extensor Power Rig applied on Patients after Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Mechlenburg, Inger; Petersen, Annemette Krintel;

    INTRODUCTION: Rehabilitation has an increasing focus on intensive resistance training early after joint replacement (1,2). This increases the requests for measuring changes in the muscle strength and muscle power over time. Hand-held dynamometer (HHD) is a device used to measure isometric muscle...... strength and Leg Extensor Power Rig (LEPR) is a tool for measuring muscle power. OBJECTIVES: To test the inter-tester reliability of the HHD in hip abduction and the LEPR in Total Hip Arthroplasty (THA) patients. METHODS: Two groups each consisting 20 subjects were included. Mean age was 68.4 years. All...

  19. Inter-tester Reliability of the Hand-held dynamometer and the Leg Extensor Power Rig applied on Patients after Total Hip Arthroplasty

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Mikkelsen, Søren Søndergaard;

    Background: Rehabilitation has an increasing focus on intensive resistance training early after joint replacement. This increases the requests for measuring changes in the muscle strength and muscle power over time. Hand-held dynamometer (HHD) is a device used to measure isometric muscle strength...... and Leg Extensor Power Rig (LEPR) is a tool for measuring muscle power. Purpose / Aim of Study: To test the inter-tester reliability of the HHD and the LEPR in Total Hip Arthroplasty (THA) patients. Materials and Methods: Two groups each consisting 20 subjects were included. Mean age was 68.4 years. All...

  20. Using semi-permeable membrane devices and stable nitrogen isotopes to detect anthropogenic influences on the Truckee River, USA

    Science.gov (United States)

    Saito, L.; Rosen, Michael R.; Chandra, S.; Fritsen, C.H.; Arufe, J.A.; Redd, C.

    2008-01-01

    Stable nitrogen isotopes (??15N) and semipermeable membrane devices (SPMDs) were used together to provide evidence of potential anthropogenic connections to aquatic organisms in the Truckee River, which flows through the Reno/Sparks metropolitan area in Nevada. Crayfish, snail, and periphyton ??15N values, and SPMD toxicity data collected during high and low flow periods at seven primary sites on the river were used with water quality and flow data for the assessment. All biota showed an increase of ??15N on both dates at sites downstream of inflows of a water-quality impaired tributary and urban drain relative to upstream. In addition, most of the lowest ??15N values on each date occurred at the most downstream site on the river. SPMDs sample lipophilic organic contaminants and can be used to assess organic contaminant toxicity to aquatic organisms because they use a membrane that mimics organic contaminant uptake by fish. In this study, results from a fluoroscan test [pyrene index (PI)] of SPMD extracts that responds to higher molecular weight polycyclic aromatic hydrocarbons (PAHs) showed patterns similar to stable isotope data, although observed peaks in PI values occurred in the urban area upstream of where peak ??15N values occurred. The CYP1A biomarker test, which responds to PAHs, certain polychlorinated biphenyls (PCBs), and organochlorines, showed peak toxic equivalents (TEQ) values farther downstream of the urban area. Thus, it is likely that PAHs were contributing to toxicity in the urban area, whereas other nonurban sources of organic carbon may have been present farther downstream. The combined use of stable isotope measurements and SPMDs provided a means of simultaneously examining whether aquatic biota are incorporating constituents from potential food sources (via stable isotopes) or exposure through water (via SPMDs). ?? Mary Ann Liebert, Inc. 2008.

  1. Eradication of multidrug-resistant Acinetobacter baumannii in a female patient with total hip arthroplasty, with debridement and retention: a case report

    Directory of Open Access Journals (Sweden)

    Beieler Alison M

    2009-02-01

    Full Text Available Abstract Introduction Multidrug-resistant Acinetobacter baumannii has become a significant cause of healthcare-associated infections, but few reports have addressed Acinetobacter baumannii infections associated with orthopedic devices. The current recommended treatment for complicated infections due to orthopedic devices, including resistant gram-negative rods, consists of antimicrobial therapy with debridement and removal of implants. Case presentation The patient, a 47-year-old woman, had previously had a prior total hip arthroplasty at 16 years of age for a complex femoral neck fracture, and multiple subsequent revisions. This time, she underwent a fifth revision secondary to pain. Surgery was complicated by hypotension resulting in transfer to the intensive care unit and prolonged respiratory failure. She received peri-operative cefazolin but postoperatively developed surgical wound drainage requiring debridement of a hematoma. Cultures of this grew ampicillin-sensitive Enterococcus and Acinetobacter baumannii (sensitive only to amikacin and imipenem. The patient was started on imipenem. Removal of the total hip arthroplasty was not recommended because of the recent surgical complications, and the patient was eventually discharged home. She was seen weekly for laboratory tests and examinations and, after 4 months of therapy, the imipenem was discontinued. She did well clinically for 7 months before recurrent pain led to removal of the total hip arthroplasty. Intra-operative cultures grew ampicillin-sensitive Enterococcus and coagulase-negative Staphylococcus but no multidrug-resistant Acinetobacter baumannii. The patient received ampicillin for 8 weeks and had not had recurrent infection at the time of writing, 37 months after discontinuing imipenem. Conclusion We describe the successful treatment of an acute infection from multidrug-resistant Acinetobacter baumannii with debridement and retention of the total hip arthroplasty, using

  2. The influence of RF power on the electrical properties of sputtered amorphous InGa-Zn-O thin films and devices

    Institute of Scientific and Technical Information of China (English)

    Shi Junfei; Dong Chengyuan; Dai Wenjun; Wu Jie; Chen Yuting; Zhan Runze

    2013-01-01

    The influence of radio frequency (RF) power on the properties of magnetron sputtered amorphous indium gallium zinc oxide (a-IGZO) thin films and the related thin-film transistor (TFT) devices is investigated comprehensively.A series of a-IGZO thin films prepared with magnetron sputtering at various RF powers are examined.The results prove that the deposition rate sensitively depends on RF power.In addition,the carrier concentration increases from 0.91 × 1019 to 2.15 × 1019 cm-3 with the RF power rising from 40 to 80 W,which may account for the corresponding decrease in the resistivity of the a-IGZO thin films.No evident impacts of RF power are observed on the surface roughness,crystalline nature and stoichiometry of the a-IGZO samples.On the other hand,optical transmittance is apparently influenced by RF power where the extracted optical band-gap value increases from 3.48 to 3.56 eV with RF power varying from 40 to 80 W,as is supposed to result from the carrierinduced band-filling effect.The rise in RF power can also affect the performance of a-IGZO TFTs,in particular by increasing the field-effect mobility clearly,which is assumed to be due to the alteration of the extended states in a-IGZO thin films.

  3. THERAPEUTIC STRATEGY IN THE REHABILITATION OF THE DYSPLASTIC HIP THROUGH ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Liliana SAVIN

    2012-07-01

    Full Text Available Total hip arthroplasty in degenerative pathology secondary to congenital dysplasia differentiates itself amongtotal arthroplasties by the frequent technical difficulties it poses and the site where it is performed. The existence of aform of congenital dysplasia that remained untreated or insufficiently treated in childhood leads to irreversibledeformities in adulthood. Partial or total loss of joint congruence causes, in time, degenerative changes with theimpairment of hip mobility and is associated with a number of progressive deformations (limb length discrepancy,abnormal rotation, asymmetric lesions, periarticular muscle failure, which gradually reduce the quality of the patient’slife. This study aims at investigating the incidence of prosthetic hip arthroplasty for osteoarthritis secondary todysplastic hip in the total number of arthroplasties, the age when surgery is performed, the type of deformity andprosthetic components used, and the postoperative and long-term functional results. The study was conducted on 110patients who received total hip arthroplasty due to osteoarthritis secondary to hip dysplasia, between 1994 and 2011, inthe Orthopaedics Trauma Department of the Rehabilitation Hospital of Iasi, the incidence being of 3.34% of the totalnumber of arthroplasties, with a prevalence of 65% under the age of 50 years. The functional results were assessed,according to the Harris-hip-score parameters, as good or very good in proportion of 82%. The complexity of the areawhere the total hip arthroplasty is performed requires a good management consisting of thorough preoperativeplanning, determining the operatory indication, and specialized and individualized medical recovery.

  4. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ Implant Arthroplasty

    Directory of Open Access Journals (Sweden)

    Amir Reza Kachooei

    2014-09-01

    Full Text Available Background:  Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna.  The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months. Also, patients were contacted prospectively by phone in order to  minister the disabilities of the armshoulder and hand (DASH, patient rated wrist evaluation (PRWE, and visual analogue scale (VAS, and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median followup time of 60 months (range: 2 to 102 months.  Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation.

  5. Imaging of hip joint arthroplasty; Bildgebung bei Hueftgelenkendoprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Mayerhoefer, M.E.; Fruehwald-Pallamar, J.; Czerny, C. [Univ.-Klinik fuer Radiodiagnostik, Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Wien (Austria)

    2009-05-15

    The hip joint is the largest joint in the human body and consequently, its evaluation by diagnostic imaging is highly important. This includes imaging of hip joint arthroplasty, which is used to avoid joint immobility following a wide spectrum of diseases, such as end-stage degenerative disease, avascular necrosis of the femoral head or post-traumatic fractures. Conventional radiography is still the standard imaging modality for the evaluation of hip arthroplasty both directly following surgery and for periodical follow-up. In the majority of cases conventional radiography enables adequate assessment of early and late complications that can arise following hip arthroplasty, such as loosening, prosthetic or periprosthetic fracture, luxation, infection and soft tissue calcification. If the diagnosis cannot be established by means of radiography, advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), with or without injection of contrast media, may provide additional information. This is particularly true for the depiction of inflammatory processes. Regardless of the imaging modality used patients' clinical symptoms must also be taken into account in order to establish the correct diagnosis. (orig.) [German] Dem Hueftgelenk als groesstem Gelenk des menschlichen Koerpers kommt eine besondere Bedeutung in der muskuloskelettalen Radiologie zu. Entsprechend wichtig ist auch die radiologische Beurteilung von Hueftgelenkendoprothesen, die z. B. infolge degenerativer Gelenkerkrankungen, einer Hueftkopfnekrose oder einer Fraktur eingesetzt werden. Die Projektionsradiographie ist weiterhin die primaere Modalitaet zur Beurteilung von Hueftgelenkendoprothesen, direkt postoperativ und zur laengerfristigen Verlaufskontrolle. Diese Methode erlaubt in der Mehrzahl der Faelle eine suffiziente Antwort auf die Frage nach Lockerung, periprothetischer Fraktur oder Prothesenmaterialbruch, Luxation, Infektion und Weichteilkalzifikation

  6. Patient-reported outcome measures in arthroplasty registries.

    Science.gov (United States)

    Rolfson, Ola; Eresian Chenok, Kate; Bohm, Eric; Lübbeke, Anne; Denissen, Geke; Dunn, Jennifer; Lyman, Stephen; Franklin, Patricia; Dunbar, Michael; Overgaard, Søren; Garellick, Göran; Dawson, Jill

    2016-07-01

    The International Society of Arthroplasty Registries (ISAR) Steering Committee established the Patient-Reported Outcome Measures (PROMs) Working Group to convene, evaluate, and advise on best practices in the selection, administration, and interpretation of PROMs and to support the adoption and use of PROMs for hip and knee arthroplasty in registries worldwide. The 2 main types of PROMs include generic (general health) PROMs, which provide a measure of general health for any health state, and specific PROMs, which focus on specific symptoms, diseases, organs, body regions, or body functions. The establishment of a PROM instrument requires the fulfillment of methodological standards and rigorous testing to ensure that it is valid, reliable, responsive, and acceptable to the intended population. A survey of the 41 ISAR member registries showed that 8 registries administered a PROMs program that covered all elective hip or knee arthroplasty patients and 6 registries collected PROMs for sample populations; 1 other registry had planned but had not started collection of PROMs. The most common generic instruments used were the EuroQol 5 dimension health outcome survey (EQ-5D) and the Short Form 12 health survey (SF-12) or the similar Veterans RAND 12-item health survey (VR-12). The most common specific PROMs were the Hip disability and Osteoarthritis Outcome Score (HOOS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Oxford Hip Score (OHS), the Oxford Knee Score (OKS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the University of California at Los Angeles Activity Score (UCLA). PMID:27168175

  7. Internal iliac artery pseudoaneurysm in primary total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2016-01-01

    Full Text Available Vascular injury is one of the rare complications of primary total hip arthroplasty (THA. We report an unusual case of lobulated pseudoaneurysm arising from one of the branches of the left internal iliac artery during acetabulum preparation in THA, which was successfully treated with coil embolization and multidisciplinary care. After 6 years follow up, patient did not have any symptoms related to the hip replacement. We recommend that surgeons should be extremely cautious while drilling medial wall of the acetabulum for depth assessment. Aggressive multidisciplinary approach, including possible support from an interventional radiologist is required for the treatment of such vascular injuries.

  8. Chronic pain following total hip arthroplasty: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Nikolajsen, Lone; Brandsborg, Birgitte; Lucht, Ulf;

    2006-01-01

    of chronic pain after THA in relation to pre-operative pain and early post-operative pain. METHODS: A questionnaire was sent to 1231 consecutive patients who had undergone THA 12-18 months previously, and whose operations had been reported to the Danish Hip Arthroplasty Registry. RESULTS: The response rate...... was 93.6%. Two hundred and ninety-four patients (28.1%) had chronic ipsilateral hip pain at the time of completion of the questionnaire, and pain limited daily activities to a moderate, severe or very severe degree in 12.1%. The chronic pain state was related to the recalled intensity of early post...

  9. Evaluation and management of the painful total ankle arthroplasty.

    Science.gov (United States)

    Hsu, Andrew R; Haddad, Steven L; Myerson, Mark S

    2015-05-01

    Total ankle arthroplasty (TAA) is an increasingly popular treatment option for patients with end-stage ankle arthritis. Although improved short- and long-term clinical and radiographic outcomes have been achieved with TAA, revision surgery may be necessary in the setting of aseptic loosening, subsidence, impingement, arthrofibrosis, or infection. Factors such as patient selection, implant design, and surgical technique can all contribute to TAA failure. Treatment of patients with a painful TAA is complex and requires careful consideration of symptom history, workup, and nonsurgical and surgical treatment options. Surgical management of failed TAA includes arthrodesis, revision surgery, or below-knee amputation. PMID:25829450

  10. Two Case Studies Related to Total Knee Arthroplasty

    Science.gov (United States)

    Hale, David

    2016-01-01

    Objectives: Report on Two Case Studies related to Total Knee Arthroplasty Previously Discussed by AKS Members Methods: Case Series Case 1: A 76 year old woman requiring a right total knee replacement in the presence of marked dystrophic calcification affecting the quadriceps tendon on a background of having sustained a post operative quadriceps tendon rupture post left TKR in 2013 Case 2: Management issues related to performing a TKR in a 80 year old woman with a possible past history of TB affecting the joint Conclusion: Both procedures went smoothly and particularly as advice was given by AKS members, these are presented largely for feedback.

  11. Early morbidity after simultaneous and staged bilateral total knee arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer Calov; Husted, Henrik;

    2015-01-01

    PURPOSE: The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime. METHODS: The Danish National Patient Registry was searched for all...... with 14 % (CI 11.5-20.1) after bilateral staged TKA within 7-18 months. CONCLUSIONS: The results from this nationwide study indicate that bilateral simultaneous TKA can safely be performed in a fast-track set-up....

  12. Acute Failure of a Glenoid Component in Anatomic Shoulder Arthroplasty.

    Science.gov (United States)

    Daner Iii, William E; Boardman Iii, Norman D

    2016-01-01

    Glenoid loosening is the most common cause of failure in primary total shoulder arthroplasty (TSA) and often occurs years after the initial surgery. It is rare for a glenoid component to fail acutely. Several case reports of complete glenoid dissociation appear in the literature. It is important to report these failures to identify technical errors or component design flaws to improve outcomes in TSA. In this case report, we present an unrecognized acute failure of a cemented hybrid glenoid component at the time of surgery. PMID:27555976

  13. GAP ARTHROPLASTY IN TEMPOROMANDIBULAR JOINT ANKYLOSIS: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Himanshu

    2015-03-01

    Full Text Available Temporomandibular joint (TMJ ankylosis is a disorder that leads to a restriction of the mouth opening from partial reduc tion to complete immobility of the jaw. The author retrospectively analyzed 20 patients with TMJ ankylosis which were treated by gap a rthroplasty in department of surgery, Government Medical Colleg e, Haldwani from March 2008 to J an 2015. Mean follow up was at least twenty - four months ( M inimum 24 and maximum 48 months. The purpose of this paper was to show that gap arthroplasty improve m outh opening when treating TMJ ankylosis. This was the first study in Kumaon region of U ttarakhand .

  14. Inflammatory pseudotumor of the hip: a complication of arthroplasty to be recognized by the radiologist

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    Raquel de Melo Santos Vilas Boas

    2015-10-01

    Full Text Available AbstractSoft tissue complications following hip arthroplasty may occur either in cases of total hip arthroplasty or in hip resurfacing, a technique that has become popular in cases involving young patients. Both orthopedic and radiological literatures are now calling attention to these symptomatic periprosthetic soft tissue masses called inflammatory pseudotumors or aseptic lymphocytic vasculites-associated lesions. Pseudotumors are associated with pain, instability, neuropathy, and premature loosening of prosthetic components, frequently requiring early and difficult reoperation. Magnetic resonance imaging plays a relevant role in the evaluation of soft tissue changes in the painful hip after arthroplasty, ranging from early periprosthetic fluid collections to necrosis and more extensive tissue damage.

  15. Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee Arthroplasty.

    Science.gov (United States)

    Bagsby, Deren T; Samujh, Christopher A; Vissing, Jacqueline L; Empson, Janene A; Pomeroy, Donald L; Malkani, Arthur L

    2015-12-01

    Blood management for simultaneous bilateral total knee arthroplasty (TKA) patients is more challenging than in unilateral arthroplasty. We examined if administration of tranexamic acid (TXA) to patients undergoing simultaneous bilateral TKA would reduce blood loss and decrease allogeneic blood transfusion requirements. A retrospective review of 103 patients, 57 in the control and 46 in the TXA group, was performed. There was higher postoperative day 1 hemoglobin in patients receiving TXA (2.95±1.33 versus 4.33±1.19, Ptransfusion incidence with administration of TXA (17.4% versus 57.9%, Ptransfusion rates by almost 70% in simultaneous bilateral total knee arthroplasty.

  16. The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    A. Giurea

    2016-01-01

    Full Text Available Ten to twenty percent of patients with total knee arthroplasty (TKA are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied. 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R. Postoperative examination included Knee Society Score (KSS, Western Ontario and McMaster University Osteoarthritis Index (WOMAC, and the Visual Analogue Scale (VAS. Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p=0.006, performance orientation (p=0.015, somatic distress (p=0.001, and emotional stability (p=0.002. All clinical scores (VAS, WOMAC, and KSS showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA.

  17. Design of a medical non-linear drilling device: the influence of twist and wear on the fatigue behaviour of NiTi wires subjected to bending rotation

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, M.; Frenzel, J.; Eggeler, G. [Lehrstuhl Werkstoffwissenschaften, Ruhr-Universitaet Bochum, 44780 Bochum (Germany); Richter, J.; Groenemeyer, D. [Institut fuer Mikrotherapie, Universitaet Witten/ Herdecke (Germany)

    2004-05-01

    This paper considers fundamental and experimental aspects associated with the engineering design of a medical, non-linear drilling device which exploits shape memory pseudoelasticity of NiTi wires. For this application it is important that the NiTi wires have a good fatigue resistance. This is why the present authors have previously determined the influence of various parameters on cyclic life, crack growth and stress state of pseudoelastic wires subjected to bending rotation fatigue. The actual drilling device has to withstand twist in addition to bending rotation because the free rotation is constrained by friction between the drill head and the bone material. In addition, friction between the wire and a NiTi guiding tube results in wear and this may well promote fatigue crack nucleation. In this paper, we explain the function of the medical drill. We then report results on the effect of the additional parameters (1) twist and (2) wear on the fatigue life of thin pseudoelastic NiTi wires. We finally discuss the implications of our experimental results for the design process of the medical drilling device. (Abstract Copyright [2004], Wiley Periodicals, Inc.) [German] Dieser Artikel behandelt Voruntersuchungen fuer die Entwicklung eines medizinischen nicht-linearen Bohrsystems. Aus materialwissenschaftlicher Sicht spielt die Ermuedung der mechanischen Komponenten aus NiTi eine wichtige Rolle. Die Autoren haben in bisherigen Studien den Einfluss verschiedener Parameter auf Lebensdauer, Risswachstum und Spannungszustand in pseudoelastischen Draehten waehrend Umlaufbiegung ermittelt. Der Draht im eigentlichen Bohrsystem wird jedoch nicht ausschliesslich durch reine Umlaufbiegung, sondern zusaetzlich durch eine Verdrillung aufgrund der Reibung zwischen Bohrkopf und Knochengewebe, belastet. Ausserdem bewirkt die Reibung zwischen dem Draht und einem Fuehrungsrohr aus NiTi Verschleiss; diese Materialschaedigung stellt einen weiteren Mechanismus zur Risseinleitung dar. In

  18. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  19. Alpine Skiing With total knee ArthroPlasty (ASWAP)

    DEFF Research Database (Denmark)

    Koesters, A.; Poetzelsberger, B.; Dela, F.;

    2015-01-01

    The aim of this study was to monitor the long-term effects of skiing on health-related parameters and implant related factors like loosening and wear in patients with total knee arthroplasty. This paper describes the overall study design, general demographics, and physiological demand of the inte......The aim of this study was to monitor the long-term effects of skiing on health-related parameters and implant related factors like loosening and wear in patients with total knee arthroplasty. This paper describes the overall study design, general demographics, and physiological demand...... of intervention, an average of 25.5 days of guided skiing was conducted by each patient. Daily heart rate (HR) profiles and global positioning system data throughout the ski day were recorded. The intervention group completed an average of 3393 vertical meters of downhill skiing, with a total skiing distance...... of 33.6 km/day. Average skiing speed was 8.2 m/s. In the skiing phase, the average physiological load was 75.9 ± 6.6% of HRmax. Further effects of the 12-week skiing intervention on the tested parameters will be reported in the following papers of this supplementum....

  20. Door Opening Affects Operating Room Pressure During Joint Arthroplasty.

    Science.gov (United States)

    Mears, Simon C; Blanding, Renee; Belkoff, Stephen M

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at Poperating room. Total time with the door open significantly affected the minimum pressure recorded in the room (Poperating room sterility. The causes of excessive operating room traffic must be evaluated to identify ways to reduce this traffic and the associated risks.

  1. Blood Conservation Strategies in Total Hip and Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    David Liu

    2015-01-01

    Full Text Available Peri-operative blood management is one of a number of components important for successful patient care in total joint arthroplasty and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risks of blood transfusion whilst at the same time maximizing haemaglobin in the post-operative period, thereby leading to a positive effect on early and long term outcomes and costs. An individualized strategy based on patient specific risk factors, anticipated blood loss and co-morbidities is useful in achieving this aim. Multiple blood conservation strategies are available in the pre-operative, intra-operative and post-operative periods and can be utilised either individually or in combination. Recent literature has highlighted the importance of identifying and correcting pre-operative anaemia, salvaging peri-operative red cells and the use of tranexamic acid in reducing blood loss. Given total hip and knee arthroplasty is an elective procedure, a zero allogenic blood transfusion rate should be the aim and an achievable goal.

  2. Door Opening Affects Operating Room Pressure During Joint Arthroplasty.

    Science.gov (United States)

    Mears, Simon C; Blanding, Renee; Belkoff, Stephen M

    2015-11-01

    Many resources are expended to ensure a sterile operating room environment. Efforts are made to prevent exposure of patients to personnel and to achieve positive room pressure to keep out airborne contaminants. Foot traffic into and out of the operating room during surgery can undermine these efforts. The authors investigated the number and duration of operating room door openings during hip and knee arthroplasty procedures and the effect of the door openings on room pressure. They tested the hypothesis that door openings defeat positive pressure, permitting air flow into the room. Room pressure and door status were monitored electronically during 191 hip and knee arthroplasty procedures. Operating room staff were unaware that data were being collected. The authors evaluated the data with regression analysis to determine whether the number and duration of door openings had an effect on room pressure. Significance was set at Pflow to reverse into the operating room. Total time with the door open significantly affected the minimum pressure recorded in the room (Ptraffic must be evaluated to identify ways to reduce this traffic and the associated risks. PMID:26558679

  3. Functional rehabilitation after total hip arthroplasty with uncemented prosthesis

    Directory of Open Access Journals (Sweden)

    Nicolae-Bogdan Negru-Aman

    2011-12-01

    Full Text Available Arthritis is a disease that acts irreversibly on joint surfaces with significant consequences especially in the third quarter of life. About 7% of our population is affected by arthritis localized at a certain level and stage of development, and this percentage is expected to reach a much higher value in future years. Aim: The aim of this study is to propose a rehabilitation program for functional recovery after total hip arthroplasty and a set of recommendations for post surgery period. Material and methods: There were included 13 subjects (10 female and 3 male aged between 51 and 78 years old, ready for total hip arthroplasty with uncemented prosthesis. The subjects were selected in Orthopaedics and Traumatology department of Military Clinical Emergency Hospital ”Dr. Victor Popescu” Timisoara. The evaluations regarding programs’ efficiency were made using 3 questionnaires (Oxford Hip Score, Harris Hip Score, Outcome Hip Score and goniometry. The subjects were tested initially before the surgery and 3 times after (at one month, at 3 months and at 6 months. Results: The results showed a remarcable increase for the scores of majority, in both questionnaire and goniometry values. Conclusions: functional rehabilitation exercises proved to be particularly important in regaining independence, control of the prosthetic leg, pain reduction and functional and social reintegration.

  4. Wear debris pseudotumor following total knee arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Kontovazenitis Panayiotis

    2009-11-01

    Full Text Available Abstract Introduction In patients who have undergone a total joint replacement, any mass occurring in or adjacent to the joint needs thorough investigation and a wear debris-induced cyst should be suspected. Case presentation An 81-year-old man presented with a painful and enlarging mass at the popliteal fossa and calf of his right knee. He had had a total right knee replacement seven years previously. Plain radiographs showed narrowing of the medial compartment. Magnetic resonance imaging showed a cystic lesion at the postero-medial aspect of the knee joint mimicking popliteal cyst or soft tissue sarcoma. Fine needle aspiration was non-diagnostic. A core-needle biopsy showed metallosis. Intraoperative findings revealed massive metallosis related to extensive polyethylene wear, delamination and deformation. Revision knee and patella arthroplasty was carried out after a thorough debridement of the knee joint. Conclusion Long-term follow-up is critical for patients with total joint replacement for early detection of occult polyethylene wear and prosthesis loosening. In these cases, revision arthroplasty may provide a satisfactory knee function.

  5. Influence of the application timing in tranexamic acid therapy on the blood loss of patients with total hip arthroplasty%氨甲环酸应用时机对髋关节置换手术患者失血量影响的研究

    Institute of Scientific and Technical Information of China (English)

    甘伟伟; 刘斌; 谢贵杰

    2014-01-01

    Objective To discuss the impact of the application timing in tranexamic acid therapy on the blood loss of patients with pre-liminary total hip arthroplasty.Methods Ninety patients with preliminary total hip arthroplasty were assigned into early stage group (n=30,tranexamic acid at preoperative one hour),advanced stage group (n=30,tranexamic acid in operation),and control group (n=30,without tranexamic acid).The visible red blood cell loss,hidden red blood cell loss,and total red blood cell loss were analyzed.Re-sults (1)The visible red blood cell loss in control group (96.3 ±21.7)mL was significantly more than early stage group (45.9 ± 9.7)mL and advanced stage group (46.2 ±9.5)mL,Ps0.05).(2)The hidden red blood cell loss in early stage group (140.6 ±21.1)mL and advanced stage group (216.7 ±48.6)mL were significantly lower than control group (335.1 ±60.3)mL,Ps<0.01.Moreover,hidden red blood cell loss in early stage group was significantly lower than advanced stage group (P<0.01).(3)The total red blood cell loss in early stage group (236.7 ±42.4)mL and advanced stage group (344.0 ±51.5)mL were significantly lower than control group (492.8 ±65.1) mL,Ps<0.01.The total red blood cell loss in early stage group was significantly lower than advanced stage group (P<0.01).Conclu-sions Tranexamic acid reduces the blood loss in preliminary total hip arthroplasty,especially reducing hidden blood loss when used at preoperative one hour.%目的:探讨不同时间使用氨甲环酸对初次行髋关节置换术患者失血量的影响。方法将90例初次行髋关节置换术的患者按随机数字表法分为:早期组(30例,氨甲环酸术前1 h使用)、晚期组(30例,氨甲环酸术中使用)和对照组(30例,不使用)。统计分析患者的显性红细胞丢失量、隐性红细胞丢失量与总红细胞丢失量。结果(1)对照组(96.3±21.7)mL的显性失血量显著多于早期组(45.9±9.7)mL、晚期组(46

  6. The influence of knee function to patella replacement and patellar plasty in totle knee arthroplasty%全膝关节置换术中髌骨置换与髌骨成形对膝关节功能的影响

    Institute of Scientific and Technical Information of China (English)

    杨小春; 郝邵文; 马晓军; 金群华

    2013-01-01

    Objective To investigate the effects on knee function between patella plasty and patellar replacement in total knee arthroplasty.Methods From August 2010 to November 2010,48 patients (69 knees) of osteoarthritis performed TKA were covered in this study.All the patients were randomly assigned to the following two groups:one group contained 24 patients (34 knees) performed patella plasty,and the other group contained other 24 patients (35 knees) performed patellar replacement.There was no significant difference between the two groups in age,weight,height,BMI,patellar score and the American Knee Society Score (KSS).Every patient was followed up for 6 weeks,3 months,6 months,one year,and two years.All the results,which were used to compare the difference between the two groups,in KSS knee score,knee function score,patellar score,the incidence of anterior knee pain,and imaging findings.Results In this clinical study,20 patients (30 knees) in patellar replacement group and 20 patients (29 knees) in patella plasty group were followed up.No significant difference was found in the postoperative KSS knee score between 2 groups at each time point.The KSS knee function score in replacement group was significantly higher than that in arthroplasty group at 6,12 and 24 months after operation.The incidence of anterior knee pain after the surgery in replacement group was significant different from the plasty group at every time point after operation.There was no significant difference in tibiofemoral angle,patellar ligament ratio,patellar tilt angle,congruence angle and lateral patellar displacement between two groups at last follow-up.Conclusion Total knee arthroplasty with patella replacement can improve both knee function and patella function,and reduce the incidence of postoperative anterior knee pain.%目的 探讨髌骨置换与髌骨成形对全膝关节置换术后膝关节功能的影响.方法 对2010年8月至11月拟行全膝关节置换术的48例(69膝)膝关节骨

  7. Favorable outcome of a total hip arthroplasty with insufficient bone coverage of the roof reinforcement ring

    Directory of Open Access Journals (Sweden)

    Fernando M. Judas

    2015-01-01

    Conclusion: This result can be supported by the good fixation of the metal ring to the pelvis with screws, the adequate orientation of both components of the total hip arthroplasty, and the bone graft incorporation.

  8. The Isolated Effect of Adductor Canal Block on Quadriceps Femoris Muscle Strength After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Sørensen, Johan Kløvgaard; Jæger, Pia; Dahl, Jørgen Berg;

    2016-01-01

    BACKGROUND: Using peripheral nerve block after total knee arthroplasty (TKA), without impeding mobility, is challenging. We hypothesized that the analgesic effect of adductor canal block (ACB) could increase the maximum voluntary isometric contraction (MVIC) of the quadriceps femoris muscle after...

  9. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Karen V; Bak, Marie; Christensen, Birgitte V;

    2010-01-01

    There have been few studies describing wound infiltration with additional intraarticular administration of multimodal analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion...

  10. Atraumatic patellar prosthesis dislocation with patellar tendon injury following a total knee arthroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Singh Alka

    2010-01-01

    Full Text Available Abstract Introduction Total knee arthroplasty is a well-established procedure with gratifying results. There is no consensus in the literature whether to routinely resurface the patella while performing total knee arthroplasty or not. Although an extremely rare occurrence in clinical practice, patellar prosthesis dislocation is a possible complication resulting from total knee arthroplasty. Case presentation We report a rare case of atraumatic spontaneous dislocation of patellar prosthesis in a 63-year-old Caucasian man of British origin with patellar tendon injury. The patient was treated successfully through a revision of the patellar component and tendon repair. In two years follow-up the patient is asymptomatic with no sign of loosening of his patellar prosthesis. Conclusions A thorough understanding of knee biomechanics is imperative in performing total knee arthroplasty in order to achieve a better functional outcome and to prevent early prosthetic failure.

  11. Perioperative Pain Management in Total Hip Arthroplasty: Korean Hip Society Guidelines.

    Science.gov (United States)

    Min, Byung-Woo; Kim, Yeesuk; Cho, Hong-Man; Park, Kyung-Soon; Yoon, Pil Whan; Nho, Jae-Hwi; Kim, Sang-Min; Lee, Kyung-Jae; Moon, Kyong-Ho

    2016-03-01

    Effective perioperative pain management techniques and accelerated rehabilitation programs can improve health-related quality of life and functional status of patients after total hip arthroplasty. Traditionally, postoperative analgesia following arthroplasty was provided by intravenous patient-controlled analgesia or epidural analgesia. Recently, peripheral nerve blockade has emerged alternative analgesic approach. Multimodal analgesia strategy combines analgesics with different mechanisms of action to improve pain management. Intraoperative periarticular injection of multimodal drugs is one of the most important procedures in perioperative pain control for total hip arthroplasty. The goal of this review article is to provide a concise overview of the principles of multimodal pain management regimens as a practical guide for the perioperative pain management for total hip arthroplasty. PMID:27536639

  12. Transfusion-related mortality after primary hip arthroplasty - an analysis of mechanisms and confounders

    DEFF Research Database (Denmark)

    Jans, O; Kehlet, H; Johansson, P I

    2012-01-01

    Background and Objectives Bleeding and postoperative anaemia after total hip arthroplasty (THA) may trigger transfusion of red blood cells (RBC). However, large observational studies have reported associations between RBC transfusion and increased postoperative morbidity and mortality. As major b...

  13. Reabilitação em cães submetidos a artroplastia do joelho Rehabilitation in dogs submitted to knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Soraia Figueiredo de Souza

    2006-10-01

    Full Text Available Com o objetivo de avaliar um protocolo de reabilitação em cães submetidos a homoimplante ortotópico tenopatelar conservado em glicerina a 98%, seguido de imobilização rígida temporária da articulação do joelho, oito cães foram distribuídos em dois grupos de igual número, denominados I ou tratados e II ou controle. Após a remoção do aparelho de fixação externa biplanar, os cães do grupo I foram submetidos a terapia física durante 15 dias, que consistiu de hidroterapia, massageamento, movimentação passiva da articulação do joelho, alongamento passivo e exercícios de caminhada. Na avaliação clínica da articulação do joelho e dos tecidos adjacentes, foi observado que os cães do grupo I apresentaram menores rigidez articular e contratura da musculatura da coxa em relação ao grupo II. Decorridos 90 dias de pós-operatório, foi observado que a amplitude de movimento foi maior em extensão no grupo tratado (PThe objective of this study was to evaluate the influence of a rehabilitation procedure in eight dogs undergone to arthroplasty followed by rigid immobilization of the knee joint. The dogs were alocated into a treated group (Group I and a control group (Group II. After the removal of the biplanar external skeletal fixation device, the dogs from Group I were submitted to physical therapy during 15 days, that consisted of hydrotherapy, massage, passive movement of the knee joint, passive stretching and controlled walking exercises. The clinical evaluation of the knee and adjacent tissues of Group I showed less articular rigidity and thigh muscle contraction when compared with Group II. Ninety days after the operation, the evaluation of the range of motion demonstrated that the group of treated animals reached a greater extension (P<0.01. As for the evaluation of the march, all of the treated animals (n=4 reached a grade of V (functional use of the member, whereas of the control group, only one animal reached the same

  14. TABLET DEVICES, SMARTPHONES, GAME CONSOLES INFLUENCE ON CHILDREN’S SOCIALIZATION, PLAY ACTIVITY AND CHILD-PARENT RELATIONSHIPS OF CHILDREN IN TENDER AGE AND PRESCHOOL AGE

    Directory of Open Access Journals (Sweden)

    Belousova, M.V.

    2016-07-01

    Full Text Available Results of research of 130 families having children of early and preschool age are given. The contingent of investigated has been divided into 2 groups: group №1 - children without speech and cognitive violations (n=80, group № 2 - are diagnosed manifestations of the general underdevelopment of the speech combined with like-autistic disturbances (n=50. All the children were divided into 2 groups: group №1 (n = 80, children are without speech disorders, group №2 (n = 50: signs of general underdevelopment of children’s speech are diagnosed, combined with like-autistic disturbances. Features of formation of skills of social interaction, development of a subject role-playing game and the child parent relations at against the active use of tablet devices and smartphones by them are studied. In both groups intensive and unfairly early game interaction with gadgets is marked. There is a clear hierarchy transformation of the family system towards the loss of parents dominant influence on children without an ability to use gadget as an obedience and encourage. Patterns of parental behavior in the study families demonstrate the priority of spending time with the gadget to joint leisure time and active integration of the gadget into child's life with delegating him an authority of development and game interaction with him.

  15. A Scandinavian Experience of Register Collaboration: The Nordic Arthroplasty Register Association (NARA)

    DEFF Research Database (Denmark)

    Havelin, Leif I; Robertsson, Otto; Fenstad, Anne M;

    2011-01-01

    The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research.......The Nordic (Scandinavian) countries have had working arthroplasty registers for several years. However, the small numbers of inhabitants and the conformity within each country with respect to preferred prosthesis brands and techniques have limited register research....

  16. Subacute pain and function after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Lasse Østergaard; Gaarn-Larsen, L; Kristensen, B B;

    2009-01-01

    In a well-defined fast-track setup for total hip and knee arthroplasty, with a multimodal analgesic regimen consisting of intra-operative local anaesthetic infiltration and oral celecoxib, gabapentin and paracetamol for 6 days postoperatively, we conducted a prospective, consecutive, observationa...... walking 1 month after surgery with a concomitant increase in the use of strong opioids. These results emphasise the need for improvement in analgesia after discharge following total knee arthroplasty, to facilitate rehabilitation....

  17. Scapular Spine Stress Fracture as a Complication of Reverse Shoulder Arthroplasty

    OpenAIRE

    Burkholz, Kimberly J.; Roberts, Catherine C.; Hattrup, Steven J.

    2015-01-01

    We report a case of a stress fracture of the scapular spine which developed as a late complication of a reverse shoulder arthroplasty. After initially doing well after surgery, our patient developed pain and decreased shoulder function. A nondisplaced scapular spine fracture was noted on radiographs. Because reverse shoulder arthroplasty is a relatively new procedure in this country, radiologists may be unfamiliar with its potential complications. Stress or insufficiency fractures of the scap...

  18. Obesity is a Major Risk Factor for Prosthetic Infection after Primary Hip Arthroplasty

    OpenAIRE

    Dowsey, Michelle M.; Choong, Peter F M

    2008-01-01

    The incidence of obesity and the number of hip arthroplasties being performed in Australia each year are increasing. Although uncommon, periprosthetic infection after surgery can have a devastating effect on patient outcomes. We therefore asked whether obesity correlated with periprosthetic infection after primary hip arthroplasty. We further asked whether variables such as patient comorbidities, operative time, blood transfusions, use of drains, and cementation practices correlated with peri...

  19. Initial Stability of Subtrochanteric Oblique Osteotomy in Uncemented Total Hip Arthroplasty: A Preliminary Finite Element Study

    OpenAIRE

    Li, Liangtao; Yu, Mingyang; Ma, Renshi; Zhu, Dong; Gu, Guishan

    2015-01-01

    Background Subtrochanteric oblique osteotomy (SOO) has been widely used to reconstruct highly dislocated hips in uncemented total hip arthroplasty. The occurrence of complications can be attributed to the instability of the osteotomy region. The aim of this study was to evaluate the initial stability of SOO in uncemented total hip arthroplasty. Material/Methods A 3-dimensional finite element femur-stem model was created, and a virtual SOO was performed at 4 oblique angles: 30°, 45°, 60°, and ...

  20. Investigation of Pain in Hip Disease Patients before and after Arthroplasty

    OpenAIRE

    MORIMOTO,Yosuke(Researcher of Graduate School of Kyoto University ); Kondo, Yasutaka; Shimosako, Junpei; Kozu, Ryo; Kataoka, Hideki; Sakamoto, Junya; Nakano, Jiro; Okita, Minoru

    2011-01-01

    [Purpose] This study examined pain in patients with hip disease before and after arthroplasty and whether the pain was induced in the hip joint itself. [Subjects and Methods] Fifty-two patients presenting with hip disease who did not exhibit dementia, disease of the lower limbs or lumbar disease were included in this investigation. Regional pain, the site of maximum pain and Visual Analogue Scale (VAS) of the site of maximum pain before and after arthroplasty were evaluated. [Results] Groin d...

  1. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report

    OpenAIRE

    Finger, Eric; Willis, F Buck

    2008-01-01

    Total Knee Arthroplasty operations are increasing in frequency, and knee flexion contracture is a common pathology, both pre-existing and post-operative. A 61-year-old male presented with knee flexion contracture following a total knee arthroplasty. Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. After 28 physical therapy sessions, the active range of motion improved from -20° to -12° (stiff ...

  2. Absence of Flexor Carpi Radialis during an Elective Carpometacarpal Arthroplasty of the Thumb: A Rare Anatomical Variation

    Directory of Open Access Journals (Sweden)

    Stratos S. Sofos

    2016-01-01

    Full Text Available Purpose. We present an extremely rare anatomical variation of unilateral flexor carpi radialis (FCR absence. This rare anatomical variation posed a clinical dilemma to us and we highlight the importance of the surgeon being aware of this anatomical variation of an important structure both as a reconstruction tool and as an anatomical landmark. Methods. This anatomical variation of the unilaterally absent FCR was found upon dissection during a carpometacarpal arthroplasty of the thumb. Results. Upon the discovery of an absent FCR tendon, we proceeded with a simple trapeziectomy. Conclusions. We present an extremely rare anatomical variation of unilateral FCR absence. This rare anatomical variation may pose clinical dilemmas to the operating surgeon who aims to utilise the FCR either for tendon transfer, for tendon graft, or, as seen in our case, in the reconstruction of a carpometacarpal excision at the thumb. We highlight this diagnosis of suspicion, which may influence the clinical procedure.

  3. Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty.

    Science.gov (United States)

    Leitner, Lukas; Musser, Ewald; Kastner, Norbert; Friesenbichler, Jörg; Hirzberger, Daniela; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

    2016-01-01

    Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss. PMID:27488941

  4. Anxiety in patients undergoing fast-track knee arthroplasty in the light of recent literature

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    Ziętek, Paweł

    2014-10-01

    Full Text Available The rapid progress in knee implants technology and operational techniques go together with more and more modern medical programs, designed to optimize the patients’ care and shorten their stay in hospital. However, this does not guarantee any elimination of perioperative stress in patients. Anxiety is a negative emotional state arising from stressful circumstances accompanied by activation of the autonomous nervous system. Anxiety causes negative physiological changes, including wound healing, resistance to anesthetic induction, it is associated with an increased perioperative pain and prolong recovery period. The purpose of this work is to present the current state of knowledge on the preoperative anxiety and discuss its impact on pain and other parameters in patients undergoing fast-track arthroplasty of big joints. The work also shows selected issues of anxiety pathomechanism, and actual methods reducing preoperative anxiety in hospitalized patients. The common prevalence of anxiety in patients undergoing surgery induces the attempt to routinely identify patients with higher anxiety, which may be a predictive factor of worse results after TKA. Undertaking widely understood psychological support in these patients before and after the operation could be a favorable element, which would influence the final result of the treatment of patients after big joints arthroplastics.

  5. Unexpected positive cultures including isolation of Propionibacterium acnes in revision shoulder arthroplasty

    Institute of Scientific and Technical Information of China (English)

    Seung Ju Kim; Jong Hun Kim

    2014-01-01

    Objective Little information is available to guide treatment strategies regarding patients with unexpected positive cultures (UPC),including Propionibacterium acnes (PA),without overt signs of infection in revision shoulder arthroplasty (RSA).The purpose of our study was to analyze the prevalence,clinical meaning,treatment and prognosis of UPC in RSA.Data sources and study selection We performed a systematic review of the literature between 1950 and 2013 for all studies reporting on UPC for PA.Studies with the prevalence and prognosis of patients with UPC in RSA were analyzed.Results Six studies meeting our inclusion criteria yielded data for 1 402 patients who underwent a total of 1405 RSA.Based on the available data,following RSA 235 shoulders had UPCs with a pooled percentage of 16.7% (235/1405).The most commonly isolated bacteria from shoulders following RSA with UPCs was PA with pooled percentages of 63.4% (149/235).Occurrence of true infection from UPCs after RSA was seen in 24 shoulders (24/235,10.2%).Antibiotic use did not influence the rate of the occurrence of true infection from UPCs (P=0.498).Conclusions Our study showed a low risk of having a true infection from UPCs after RSA without clinical signs of preoperative infection at the time of the surgery.Therefore,prolonged antibiotic therapy may not be necessary in these patients.

  6. Soft tissue artifact assessment during treadmill walking in subjects with total knee arthroplasty.

    Science.gov (United States)

    Barre, Arnaud; Thiran, Jean-Philippe; Jolles, Brigitte M; Theumann, Nicolas; Aminian, Kamiar

    2013-11-01

    Accurate measurement of knee kinematics during functional activities suffers mainly from soft tissue artifact (STA): the combination of local surface deformations and rigid movement of markers relative to the underlying bone (also called rigid STA movement: RSTAM). This study proposes to assess RSTAM on the thigh, shank, and knee joint and to observe possible features between subjects. Nineteen subjects with knee arthroplasty were asked to walk on a treadmill while a biplane fluoroscopic system (X-rays) and a stereophotogrammetric system (skin markers) recorded their knee movement. The RSTAM was defined as the rigid movement of the cluster of skin markers relative to the prosthesis. The results showed that RSTAM amplitude represents approximately 80-100% of the STA. The vertical axis of the anatomical frame of the femur was influenced the most by RSTAM. Combined with tibial error, internal/external rotation angle and distraction-compression were the knee kinematics parameters most affected by RSTAM during the gait cycle, with average rms values of 3.8° and 11.1 mm. This study highlighted higher RSTAM during the swing phase particularly in the thigh segment and suggests new features for RSTAM such as the particular shape of some RSTAM waveforms and the absence of RSTAM in certain kinematics during the gait phases. The comparison of coefficient of multiple correlations showed some similarities of RSTAM between subjects, while some correlations were found with gait speed and BMI. These new insights could potentially allow the development of new methods of compensation to avoid STA.

  7. Bilateral hip arthroplasty: is 1-week staging the optimum strategy?

    Directory of Open Access Journals (Sweden)

    Willis-Owen Charles A

    2010-11-01

    Full Text Available Abstract Seventy-nine patients underwent bilateral hip arthroplasty staged either at 1 week (Group 1 or after greater intervals (as suggested by the patients, mean 44 weeks, range 16-88 weeks (Group 2, over a five year period at one Institution. Sixty-eight patients (29 bilateral hip resurfacings and 39 total hip replacements completed questionnaires regarding their post-operative recovery, complications and overall satisfaction with the staging of their surgery. There was no significant age or ASA grade difference between the patient groups. Complication rates in the two groups were similar and overall satisfaction rates were 84% in Group 1 (n = 32 and 89% in Group 2 (n = 36. Cumulative hospital lengths of stay were significantly longer in Group 1 patients (11.9 days vs 9.1 days(p The mean time to return to part-time work was 16.4 weeks for Group 1, and a cumulative 17.2 weeks (8.8 and 8.4 weeks for Group 2. The time to return to full-time work was significantly shorter for Group 1 patients (21.0 weeks, compared with a cumulative 29.7 weeks for Group 2(p Hip resurfacing patients in Group 2 had significantly shorter durations of postoperative pain and were able to return to part-time and full time work sooner than total hip arthroplasty patients. There was a general trend towards a faster recovery and resumption of normal activities following the second operation in Group 2 patients, compared with the first operation. Bilateral hip arthroplasty staged at a 1-week interval resulted in an earlier resolution of hip pain, and an earlier return to full-time work (particularly following total hip replacement surgery, with high levels of patient satisfaction and no increased risk in complications; however the hospital length of stay was significantly longer. The decision for the timing of staged bilateral surgery should be made in conjunction with the patient, making adjustments to accommodate their occupational needs and functional demands.

  8. 10-year survival of total ankle arthroplasties

    Science.gov (United States)

    2011-01-01

    Background and purpose There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Patients and methods Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint—excluding incidental exchange of the polyethylene meniscus. Results Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79–0.83) at 5 years to 0.69 (95% CI: 0.67–0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. Interpretation The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements—even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results. PMID:22066551

  9. How accurate is image-free computer navigation for hip resurfacing arthroplasty? An anatomical investigation

    International Nuclear Information System (INIS)

    The existing studies concerning image-free navigated implantation of hip resurfacing arthroplasty are based on analysis of the accuracy of conventional biplane radiography. Studies have shown that these measurements in biplane radiography are imprecise and that precision is improved by use of three-dimensional (3D) computer tomography (CT) scans. To date, the accuracy of image-free navigation devices for hip resurfacing has not been investigated using CT scans, and anteversion accuracy has not been assessed at all. Furthermore, no study has tested the reliability of the navigation software concerning the automatically calculated implant position. The purpose of our study was to analyze the accuracy of varus-valgus and anteversion using an image-free hip resurfacing navigation device. The reliability of the software-calculated implant position was also determined. A total of 32 femoral hip resurfacing components were implanted on embalmed human femurs using an image-free navigation device. In all, 16 prostheses were implanted with the proposed position generated by the navigation software; the 16 prostheses were inserted in an optimized valgus position. A 3D CT scan was undertaken before and after operation. The difference between the measured and planned varus-valgus angle averaged 1 deg (mean±standard deviation (SD): group I, 1 deg±2 deg; group II, 1 deg±1 deg). The mean±SD difference between femoral neck anteversion and anteversion of the implant was 4 deg (group I, 4 deg±4 deg; group II, 4 deg±3 deg). The software-calculated implant position differed 7 deg±8 deg from the measured neck-shaft angle. These measured accuracies did not differ significantly between the two groups. Our study proved the high accuracy of the navigation device concerning the most important biomechanical factor: the varus-valgus angle. The software calculation of the proposed implant position has been shown to be inaccurate and needs improvement. Hence, manual adjustment of the

  10. Shoulder arthroplasty in complex acute and chronic proximal humeral fractures

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Søjbjerg, J.O.; Sneppen, O.

    1991-01-01

    From 1983 to 1988, 42 shoulder arthroplasties were performed on comminuted acute or chronic proximal humeral fractures. Patients were categorized according to the post-fracture operative delay; there were 15 four-part fractures, with median post-fracture delay of 13 days (range: 7 to 21), and 27......-system and classified into four groups. Pain relief was satisfactory in the acute group, but was unpredictable in the chronic group. The results in the acute group were significantly superior (P less than .05). In the acute group, 3 (20%) patients had an excellent result and 6 patients (40%) had a good result, compared...... instability were seen in shoulders formerly treated with osteosynthesis (one acute and four chronic cases). Two of these cases developed an infection. Good results can be expected after prosthetic replacement in acute proximal humeral fractures. Failed primary treatment reduces the possibility of a good...

  11. Posttraumatic pseudoaneurysm of popliteal artery following total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Sanjay R Agarwala

    2013-01-01

    Full Text Available We report a case of posttraumatic false aneurysm of popliteal artery after a total knee arthroplasty in an 82-year-old woman. This case is characterized by the distinct history of trauma to the popliteal fossa in the immediate postoperative period and the location of false aneurysm. In addition, the clinical symptoms were similar to those of deep vein thrombosis. The ultrasonographic examination and computed tomography (CT angiography confirmed the diagnosis on 6 th day after the surgery. Ultrasonographic examination 1 day later revealed no increase in the size of false aneurysm. She was treated with open surgical repair. Presenting the difficulty in the diagnosis, unusual location, etiology, and its management is the intention of this case report.

  12. Alpine Skiing With total knee ArthroPlasty (ASWAP)

    DEFF Research Database (Denmark)

    Kristensen, M.; Pötzelsberger, B.; Scheiber, P.;

    2015-01-01

    We investigated the effect of alpine skiing for 12 weeks on skeletal muscle characteristics and biomarkers of glucose homeostasis and cardiovascular risk factors. Twenty-three patients with a total knee arthroplasty (TKA) were studied 2.9 ± 0.9 years (mean ± SD) after the operation. Fourteen...... patients participated in the intervention group (IG) and nine in the control group (CG). Blood samples and muscle biopsies were obtained before (PRE) and 7.3 ± 0.8 days after (POST) the intervention, and blood samples again after a retention (RET) phase of 8 weeks. With skiing, glucose homeostasis improved...... I fibers increased with skiing in IG with no change in CG. Inflammatory biomarkers, plasma lipids, and mitochondrial proteins and activity did not change. Alpine skiing is metabolically beneficial and can be used as a training modality by elderly people with TKA....

  13. The association between metal allergy, total knee arthroplasty, and revision

    DEFF Research Database (Denmark)

    Münch, Henrik J; Jacobsen, Stig; Olesen, Jens T;

    2015-01-01

    database from the greater Copenhagen area (n = 27,020). RESULTS: 327 patients were registered in both databases. The prevalence of contact allergy to nickel, chromium, and cobalt was comparable in patients with and without revision surgery. However, in patients with 2 or more episodes of revision surgery......, the prevalence of cobalt and chromium allergy was markedly higher. Metal allergy that was diagnosed before implant surgery appeared not to increase the risk of implant failure and revision surgery. INTERPRETATION: While we could not confirm that a positive patch test reaction to common metals is associated...... with complications and revision surgery after knee arthroplasty, metal allergy may be a contributor to the multifactorial pathogenesis of implant failure in some cases. In cases with multiple revisions, cobalt and chromium allergies appear to be more frequent....

  14. Analysis of stem tip pain in revision total knee arthroplasty.

    Science.gov (United States)

    Kimpton, Christine I; Crocombe, Andrew David; Bradley, William Neil; Gavin Huw Owen, Brigstocke

    2013-06-01

    Stem tip pain following revision total knee arthroplasty is a significant cause of patient dissatisfaction, which in the presence of an aseptic well-fixed component has no widely accepted surgical solution. A definitive cause of stem tip pain remains elusive, however it has been suggested that high stress concentrations within the region of the stem tip may play a role. This paper reports a finite element study of a novel clinical technique where a plate is attached to the tibia within the region of the stem tip to reduce stem tip pain. The results demonstrate that the plate reduces stress concentrations in the bone at the stem tip of the implant. The magnitude of stress reduction is dependent upon plate location, material and attachment method. PMID:23523204

  15. Mobile bearing and fixed bearing total knee arthroplasty

    Science.gov (United States)

    Dolfin, Marco; Saccia, Francesco

    2016-01-01

    The mobile bearing (MB) concept in total knee arthroplasty (TKA) was developed as an alternative to fixed bearing (FB) implants in order to reduce wear and improve range of motion (ROM), especially focused on younger patients. Unfortunately, its theoretical advantages are still controversial. In this paper we exhibit a review of the more recent literature available comparing FB and MB designs in biomechanical and clinical aspects, including observational studies, clinical trials, national and international registries analyses, randomized controlled trials, meta-analyses and Cochrane reviews. Except for some minor aspects, none of the studies published so far has reported a significant improvement related to MBs regarding patient satisfaction, clinical, functional and radiological outcome or medium and long-term survivorship. Thus the presumed superiority of MBs over FBs appears largely inconsistent. The routine use of MB is not currently supported by adequate evidences; implant choice should be therefore made on the basis of other factors, including cost and surgeon experience. PMID:27162777

  16. Total Hip Arthroplasty – over 100 years of operative history

    Directory of Open Access Journals (Sweden)

    Stephen Richard Knight

    2011-11-01

    Full Text Available Total hip arthroplasty (THA has completely revolutionised the nature in which the arthritic hip is treated, and is considered to be one of the most successful orthopaedic interventions of its generation (1. With over 100 years of operative history, this review examines the progression of the operation from its origins, together with highlighting the materials and techniques that have contributed to its development. Knowledge of its history contributes to a greater understanding of THA, such as the reasons behind selection of prosthetic materials in certain patient groups, while demonstrating the importance of critically analyzing research to continually determine best operative practice. Finally, we describe current areas of research being undertaken to further advance techniques and improve outcomes.

  17. The difficult primary total knee arthroplasty: a review.

    Science.gov (United States)

    Baldini, A; Castellani, L; Traverso, F; Balatri, A; Balato, G; Franceschini, V

    2015-10-01

    Primary total knee arthroplasty (TKA) is a reliable procedure with reproducible long-term results. Nevertheless, there are conditions related to the type of patient or local conditions of the knee that can make it a difficult procedure. The most common scenarios that make it difficult are discussed in this review. These include patients with many previous operations and incisions, and those with severe coronal deformities, genu recurvatum, a stiff knee, extra-articular deformities and those who have previously undergone osteotomy around the knee and those with chronic dislocation of the patella. Each condition is analysed according to the characteristics of the patient, the pre-operative planning and the reported outcomes. When approaching the difficult primary TKA surgeons should use a systematic approach, which begins with the review of the existing literature for each specific clinical situation.

  18. The constraints on day-case total knee arthroplasty

    DEFF Research Database (Denmark)

    Thienpont, E; Lavand'homme, P; Kehlet, H

    2015-01-01

    -case TKA. These constraints may be social, linked to patient's comorbidities, or due to surgery-related adverse events (e.g. pain, post-operative nausea and vomiting, etc.). Using patient stratification, tailored surgical techniques and multimodal opioid-sparing analgesia, day-case TKA might be achievable......Total knee arthroplasty (TKA) is a major orthopaedic intervention. The length of a patient's stay has been progressively reduced with the introduction of enhanced recovery protocols: day-case surgery has become the ultimate challenge. This narrative review shows the potential limitations of day...... of the group of potential day-case patients. The cost reduction achieved by day-case TKA needs to be balanced against any increase in morbidity and mortality and the cost of advanced follow-up at a distance with new technology. These factors need to be evaluated before adopting this ultimate 'fast...

  19. Short term outcomes of revision total knee arthroplasty.

    Science.gov (United States)

    Dieterich, James D; Fields, Adam C; Moucha, Calin S

    2014-11-01

    Few studies have assessed postoperative complications in revision total knee arthroplasty (rTKA). The aim of this study was to assess which preoperative factors are associated with postoperative complications in rTKA. Using the National Surgical Quality Improvement (NSQIP) database, we identified patients undergoing rTKA from 2010 to 2012. Patient demographics, comorbidities, and complications within thirty days of surgery were analyzed. A total of 3421 patients underwent rTKA. After adjusted analysis, dialysis (P = 0.016) was associated with minor complications. Male gender (P = 0.03), older age (P = 0.029), ASA class >2 (P = 0.017), wound class >2 (P < 0.0001), emergency operation (P = 0.038), and pulmonary comorbidity (P = 0.047) were associated with major complications.

  20. Current Strategies in Anesthesia and Analgesia for Total Knee Arthroplasty.

    Science.gov (United States)

    Moucha, Calin Stefan; Weiser, Mitchell C; Levin, Emily J

    2016-02-01

    Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia--incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperative and postoperative periods--can provide superior pain control while minimizing opioid-related adverse effects, improving patient satisfaction, and reducing the risk of postoperative complications.

  1. Reverse shoulder arthroplasty in acute fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig; Rasmussen, Jeppe; Olsen, Bo Sanderhoff;

    2013-01-01

    arthroplasty (RSA) has been suggested. We aimed to review clinical studies reporting benefits and harms of RSA in acute fractures. A systematic review. We included 18 studies containing 430 RSA in acute fractures. We found no randomized clinical trials. Four studies compared outcome after RSA with a historical......, and baseplate failure. Scapular notching was reported in 11 studies with a median value of 25% (range 0-94). Heterogeneity of study designs and lack of primary data precluded statistical pooling of data. No high quality evidence was identified. Based on the available evidence the use of RSA in acute...... fractures is questionable. The complication rate was high and the clinical implications of long term scapular notching are worrying. Randomized studies with long term follow up using the latest techniques of tubercular reinsertion in RSA toward HA should be encouraged....

  2. Hip arthroplasty. Part 1: prosthesis terminology and classification

    International Nuclear Information System (INIS)

    Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion.

  3. Tantalum cones and bone defects in revision total knee arthroplasty.

    Science.gov (United States)

    Boureau, F; Putman, S; Arnould, A; Dereudre, G; Migaud, H; Pasquier, G

    2015-04-01

    Management of bone loss is a major challenge in revision total knee arthroplasty (TKA). The development of preformed porous tantalum cones offers new possibilities, because they seem to have biological and mechanical qualities that facilitate osseointegration. Compared to the original procedure, when metaphyseal bone defects are too severe, a single tantalum cone may not be enough and we have developed a technique that could extend the indications for this cone in these cases. We used 2 cones to fill femoral bone defects in 7 patients. There were no complications due to wear of the tantalum cones. Radiological follow-up did show any migration or loosening. The short-term results confirm the interest of porous tantalum cones and suggest that they can be an alternative to allografts or megaprostheses in case of massive bone defects.

  4. Genu Recurvatum versus Fixed Flexion after Total Knee Arthroplasty

    Science.gov (United States)

    Silva, Amila; Chong, Hwei Chi; Chin, Pak Lin; Chia, Shi Lu; Lo, Ngai Ngung; Yeo, Seng Jin

    2016-01-01

    Background To date, there is no study comparing outcomes between post-total knee replacement genu recurvatum and fixed flexion. This study aims to provide data that will help in deciding which side to err on when neutral extension is not achieved. Methods A prospective cohort study of primary total knee arthroplasties was performed, which compared the 6-month and 2-year clinical outcomes between fixed flexion and genu recurvatum deformities at 6 months. Results At 6 months, knees in genu recurvatum did better than knees in fixed flexion deformity in terms of knee flexion. However, at 2 years, knees in fixed flexion deformity did better in terms of knee scores and showed better improvement in the degree of deformity. Conclusions We conclude that it is better to err on the side of fixed flexion deformity if neutral alignment cannot be achieved. PMID:27583106

  5. Hydrotherapy after total knee arthroplasty. A follow-up study.

    Science.gov (United States)

    Giaquinto, S; Ciotola, E; Dall'Armi, V; Margutti, F

    2010-01-01

    The study evaluated the subjective functional outcome following total knee arthroplasty (TKA) in participants who underwent hydrotherapy (HT) six months after discharge from a rehabilitation unit. A total of 70 subjects, 12 of which were lost at follow-up, were randomly assigned to either a conventional gym treatment (N=30) or HT (N=28). A prospective design was performed. Participants were interviewed with Western-Ontario McMasters Universities Osteoarthritis Index (WOMAC) at admission, at discharge and six months later. Kruskal-Wallis and Wilcoxon tests were applied for statistical analysis. Both groups improved. The WOMAC subscales, namely pain, stiffness and function, were all positively affected. Statistical analysis indicates that scores on all subscales were significantly lower for the HT group. The benefits gained by the time of discharge were still found after six months. HT is recommended after TKA in a geriatric population.

  6. Mobile bearing and fixed bearing total knee arthroplasty.

    Science.gov (United States)

    Capella, Marcello; Dolfin, Marco; Saccia, Francesco

    2016-04-01

    The mobile bearing (MB) concept in total knee arthroplasty (TKA) was developed as an alternative to fixed bearing (FB) implants in order to reduce wear and improve range of motion (ROM), especially focused on younger patients. Unfortunately, its theoretical advantages are still controversial. In this paper we exhibit a review of the more recent literature available comparing FB and MB designs in biomechanical and clinical aspects, including observational studies, clinical trials, national and international registries analyses, randomized controlled trials, meta-analyses and Cochrane reviews. Except for some minor aspects, none of the studies published so far has reported a significant improvement related to MBs regarding patient satisfaction, clinical, functional and radiological outcome or medium and long-term survivorship. Thus the presumed superiority of MBs over FBs appears largely inconsistent. The routine use of MB is not currently supported by adequate evidences; implant choice should be therefore made on the basis of other factors, including cost and surgeon experience. PMID:27162777

  7. Porous metals and alternate bearing surfaces in shoulder arthroplasty.

    Science.gov (United States)

    Carpenter, Shannon R; Urits, Ivan; Murthi, Anand M

    2016-03-01

    Total shoulder arthroplasty (TSA) provides an effective solution for the treatment of glenohumeral arthritis. However, long-term outcomes have been limited by glenoid component aseptic loosening and polyethylene (PE) wear. Previous attempts to improve glenoid fixation with metal-backed glenoids resulted in inferior results. Newer component designs that contain porous metal allow for biological ingrowth of the prosthesis, potentially improving longevity and overall outcomes. Porous metal can also improve humeral component fixation, obviating the need for cement and simplifying revision surgery. Advances such as highly cross-linked polyethylene (HXLPE), vitamin E-doped HXLPE, and alternate bearing surfaces like ceramics and pyrolytic carbon have proven to provide superior wear characteristics in other joint replacements and may prove beneficial in the shoulder as well. PMID:26797775

  8. Predictors of bone loss in revision total knee arthroplasty.

    Science.gov (United States)

    Bloomfield, Michael R; Klika, Alison K; Lee, Ho H; Joyce, David M; Mehta, Priyesh; Barsoum, Wael K

    2010-03-01

    Revision total knee arthroplasty (RTKA) requires preoperative planning to enable the reconstruction of bony deficiencies. The objective of this project was to identify predictors of bone loss management at RTKA based on the preoperative failure mode and patient demographics known preoperatively. We retrospectively reviewed 245 consecutive RTKA procedures in which the same revision knee system was utilized. Patient demographic and treatment data were recorded, and locations of bone loss were identified based on the reconstructive management. We identified significant predictors for use of femoral augments at all four positions. Several predictors significantly predisposed to use of a thick (>19 mm) polyethylene; however, no predictors of tibial augments were significant. Although the reconstruction of bone loss is primarily based on the intraoperative assessment, these findings may provide additional information to help the surgeon prepare for difficult revision procedures. PMID:20812582

  9. Fulminant Nonocclusive Mesenteric Ischemia Just after Hip Arthroplasty

    Science.gov (United States)

    Auxiliadora-Martins, Maria; Alkmin-Teixeira, Gil Cezar; Feres, Omar; Martins-Filho, Olindo Assis; Basile-Filho, Anibal

    2010-01-01

    Nonocclusive mesenteric ischemia (NOMI) is not a rare clinical entity in intensive medicine, and it can be a consequence of several clinical or surgical situations. This pathology results from reduced intestinal microvascular blood supply associated with an acute inflammatory process, culminating with bowel necrosis. This is a case on a female patient who developed immediate postsurgical NOMI following hip arthroplasty and died. Since diagnosis of this potentially fatal condition remains a dilemma, NOMI should always be considered an eventual postoperative complication in high-risk surgical patients such as elderly individuals with previous history of nicotine abuse, congestive heart failure, and essential hypertension. The present paper highlights the importance of early diagnosis and prompt adequate treatment of NOMI in subjects with diminished cardiac output and severe abdominal pain. PMID:20300426

  10. Total Ankle Arthroplasty: An Overview of the Canadian Experience.

    Science.gov (United States)

    Latham, Warren C W; Lau, Johnny T C

    2016-06-01

    Total ankle arthroplasty use has increased across Canada over the last two decades. Multiple implant designs are readily available and implanted across Canada. Although arthrodesis is a reliable procedure for treating end-stage ankle arthritis, ankle replacement is often the preferred surgical treatment by patients. A recent prospective study evaluated intermediate-term outcomes of ankle replacement and arthrodesis at multiple centers across Canada, with variability in prosthesis type, surgeon, and surgical technique. Intermediate-term clinical outcomes of total ankle replacement and ankle arthrodesis were comparable in a diverse cohort in which treatment was tailored to patient presentation; however, rates of reoperation and major complications were higher after ankle replacement.

  11. The Validity of Administrative BMI Data in Total Joint Arthroplasty.

    Science.gov (United States)

    Lau, Edmund C; Son, Min-Sun; Mossad, David; Toossi, Nader; Johanson, Norman A; Gonzalez, Mark H; Meller, Menachem M

    2015-10-01

    Identifying BMI via administrative data is a useful way to evaluate outcomes in total joint arthroplasty (TJA) for varying degrees of obesity. The purpose of this study was to evaluate the concordance between BMI coding in administrative claims data and actual clinical BMI measurements in the medical record for patients undergoing TJA. Clinical BMI value was shown to be a significant determinant of whether ICD-9 codes were used to report the patient's obesity status (P<0.01). Although a higher clinical BMI strongly increased the likelihood of having either of the ICD-9 diagnosis codes used to identify obesity status, only the accuracy of the V85 code increased with increasing levels of BMI. PMID:26088396

  12. Complications in primary total hip arthroplasty: avoidance and management: wear.

    Science.gov (United States)

    Ries, Michael D

    2003-01-01

    Many factors, including polyethylene processing, sterilization method, counterface material, femoral head size, femoral offset, acetabular component position, implant design, and patient activity level, affect the rate of wear in total hip arthroplasty. For patients with life expectancy that exceeds the longevity of the conventional implant materials, an alternative bearing surface (highly cross-linked polyethylene, metal-on-metal, or ceramic-on-ceramic) may be considered. Although laboratory wear tests with these materials are very favorable, clinical outcomes have not been clearly established. When osteolysis does develop in response to particulate debris, the location and progression of the lesions may be quite variable. Asymptomatic stable lesions can be followed clinically and radiographically while symptomatic or enlarging lesions or those that may compromise the integrity of the periprosthetic bone stock require surgery. If acetabular component revision is necessary and an adequate rim of host bone is maintained to support a revision acetabular component, defects can be filled with particulate bone graft. Large segmental defects generally require structural allografts. If the acetabular shell is well fixed in good position and the osteolytic defects are accessible, treatment with curettage and bone grafting of the lesions with liner revision is appropriate to avoid use of a structural allograft. Proximal femoral defects around a well-fixed stem can be managed in a similar manner with curettage and bone grafting. Distal lesions associated with risk of periprosthetic femur fracture or implant loosening require stem revision. Osteoclastic resportion of bone in response to particulate debris can be impaired with use of some drugs such as alendronate. However, the safety and efficacy of alendronate in the clinical management of osteolysis associated with total hip arthroplasty has not been established. PMID:12690853

  13. Intrathecal ketorolac enhances intrathecal morphine analgesia following total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Gabriela R Lauretti

    2013-01-01

    Full Text Available Background: Total knee arthroplasty represents one of the most painful surgeries. The aim of the study was to compare analgesia and adverse effects of intrathecal (IT ketorolac versus IT morphine, versus the combination of IT ketorolac and morphine. Materials and Methods: After ethical approval and patient consent, 80 patients undergoing knee arthroplasty were randomized to one of 4 groups. All groups received 15 mg IT bupivacaine plus IT test drug (2 ml. The control group (CG received saline as IT test drug. The morphine group (MG received IT 200 g morphine, the ketorolac group (KG IT 2 mg ketorolac and the morphine-ketorolac group (MKG 200 g morphine + 2 mg ketorolac as test drugs. Pain and adverse effects were evaluated. P < 0.05 was considered significant. Results: The MG and KG were similar in their times to time to first rescue analgesic (440 ± 38 min and 381 ± 44 min, respectively. Both groups were longer when compared to the CG (170 ± 13 min (P < 0.01. The MG and KG had lesser ketoprofen consumption compared to the CG (P < 0.05. The time to first rescue analgesic was longer to the MKG (926 ± 222 min (15 h compared to CG (P < 0.001 and to the MG and the KG (P < 0.01. MKG displayed lesser ketoprofen consumption compared to MG and KG (P < 0.05 and to the CG (P < 0.02. Conclusions: The data suggest a role for spinal ketorolac and morphine in orthopaedic surgery because this combination of agents provided 15 h of analgesia compared to 7 h after each drug alone, with no significant side-effects.

  14. Platelet-rich plasma (PRP applied during total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    João Paulo Fernandes Guerreiro

    2015-04-01

    Full Text Available OBJECTIVE: To evaluate the efficacy of platelet-rich plasma regarding healing, pain and hemostasis after total knee arthroplasty, by means of a blinded randomized controlled and blinded clinical study.METHODS: Forty patients who were going to undergo implantation of a total knee prosthesis were selected and randomized. In 20 of these patients, platelet-rich plasma was applied before the joint capsule was closed. The hemoglobin (mg/dL and hematocrit (% levels were assayed before the operation and 24 and 48 h afterwards. The Womac questionnaire and a verbal pain scale were applied and knee range of motion measurements were made up to the second postoperative month. The statistical analysis compared the results with the aim of determining whether there were any differences between the groups at each of the evaluation times.RESULTS: The hemoglobin (mg/dL and hematocrit (% measurements made before the operation and 24 and 48 h afterwards did not show any significant differences between the groups (p > 0.05. The Womac questionnaire and the range of motion measured before the operation and up to the first two months also did not show any statistical differences between the groups (p > 0.05. The pain evaluation using the verbal scale showed that there was an advantage for the group that received platelet-rich plasma, 24 h, 48 h, one week, three weeks and two months after the operation (p < 0.05.CONCLUSIONS: In the manner in which the platelet-rich plasma was used, it was not shown to be effective for reducing bleeding or improving knee function after arthroplasty, in comparison with the controls. There was an advantage on the postoperative verbal pain scale.

  15. Does rural residence impact total ankle arthroplasty utilization and outcomes?

    Science.gov (United States)

    Singh, Jasvinder A; Ramachandaran, Rekha

    2016-02-01

    The objective of this study was to compare total ankle arthroplasty (TAA) utilization and outcomes by patient residence. We used the Nationwide Inpatient Sample (NIS) from 2003 to 2011 to compare utilization and outcomes (post-arthroplasty discharge disposition, length of hospitalization, and mortality) by rural vs. urban residence. Ten thousand eight hundred thirty-three patients in urban and 3,324 patients in rural area underwent TAA. Compared to rural residents, urban residents had: lower mean age, 62.4 vs. 61.8 years (p < 0.0001); higher percent of women, 49 vs. 56 % (p = 0.0008); and lower proportion of Whites, 93 vs. 86 % (p = 0.0005). There were rural-urban disparities in TAA utilization in 2003 (0.32 vs. 0.39/100,000; p = 0.021), but not in 2011 (1.19 vs. 1.17/100,00; p = 0.80). TAA outcomes did not differ by rural vs. urban residence: (1) 11.3 % rural vs. 14.2 % urban residents were discharged to an inpatient facility (p = 0.098); (2) length of hospital stay above the median stay, was 44.8 vs. 42.2 % (p = 0.30); and (3) mortality was 0.2 vs. 0.1 %, respectively (p = 0.81). Multivariable-adjusted logistic regression models did not show any significant differences in discharge to home, length of stay, or mortality, by residence. Our study demonstrated an absence of any evidence of rural-urban differences in TAA outcomes. The rural-urban differences in TAA utilization noted in 2003 were no longer significant in 2011.

  16. Dislocation following total knee arthroplasty: A report of six cases

    Directory of Open Access Journals (Sweden)

    Villanueva Manuel

    2010-01-01

    Full Text Available Background: Dislocation following total knee arthroplasty (TKA is the worst form of instability. The incidence is from 0.15 to 0.5%. We report six cases of TKA dislocation and analyze the patterns of dislocation and the factors related to each of them. Materials and Methods: Six patients with dislocation of knee following TKA are reported. The causes for the dislocations were an imbalance of the flexion gap (n=4, an inadequate selection of implants (n=1, malrotation of components (n=1 leading to incompetence of the extensor mechanism, or rupture of the medial collateral ligament (MCC. The patients presented complained of pain, giving way episodes, joint effusion and difficulty in climbing stairs. Five patients suffered posterior dislocation while one anterior dislocation. An urgent closed reduction of dislocation was performed under general anaesthesia in all patients. All patients were operated for residual instability by revision arthroplasty after a period of conservative treatment. Results: One patient had deep infection and knee was arthrodesed. Two patients have a minimal residual lag for active extension, including a patient with a previous patellectomy. Result was considered excellent or good in four cases and fair in one, without residual instability. Five out of six patients in our series had a cruciate retaining (CR TKA designs: four were revised to a posterior stabilized (PS TKA and one to a rotating hinge design because of the presence of a ruptured MCL. Conclusion: Further episodes of dislocation or instability will be prevented by identifying and treating major causes of instability. The increase in the level of constraint and correction of previous technical mistakes is mandatory.

  17. Similar incidence of periprosthetic fluid collections after ceramic-on-polyethylene total hip arthroplasties and metal-on-metal resurfacing arthroplasties: results of a screening metal artefact reduction sequence-MRI study

    NARCIS (Netherlands)

    Bisseling, P.; Wit, B.W. de; Hol, A.M.; Gorp, M.J. van; Kampen, A. van; Susante, J.L. van

    2015-01-01

    Patients from a randomised trial on resurfacing hip arthroplasty (RHA) (n = 36, 19 males; median age 57 years, 24 to 65) comparing a conventional 28 mm metal-on-metal total hip arthroplasty (MoM THA) (n = 28, 17 males; median age 59 years, 37 to 65) and a matched control group of asymptomatic patien

  18. Patella Eversion Reduces Early Knee Range of Motion and Muscle Torque Recovery after Total Knee Arthroplasty: Comparison between Minimally Invasive Total Knee Arthroplasty and Conventional Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Tokifumi Majima

    2011-01-01

    Full Text Available We hypothesized that patella eversion during total knee arthroplasty (TKA reduces early return of active knee extension and flexion, quadriceps muscle strength, and postoperative pain. In 100 conventional TKA knees and 100 minimally invasive TKA (MIS TKA knees, we compared knee range of motion (ROM, postoperative pain, and quadriceps muscle strength at 1 day, 4 days, 1 week, 2 weeks, 3 weeks, 4 weeks, 12 weeks, 1 year, and 5 years after surgery. The differences of surgical approach between MIS TKA and conventional TKA of this study are length of skin incision with subcutaneal flap and patella eversion. In MIS TKA, skin incision is shorter than conventional TKA. Furthermore, patella is not everted in MIS TKA procedure. There were no significant differences in preoperative factors. Postoperative improvement of ROM, postoperative muscle strength recovery, and postoperative improvement of visual analog scale were faster in patients with MIS TKA when compared to that in patients with conventional TKA. On the other hand, no significant difference was observed in complication, 5-year clinical results of subjective knee function score, and the postoperative component angle and lower leg alignment. These results indicate that patella eversion may affect muscle strength recovery and postoperative pain.

  19. Photovoltaic device

    Science.gov (United States)

    Reese, Jason A.; Keenihan, James R.; Gaston, Ryan S.; Kauffmann, Keith L.; Langmaid, Joseph A.; Lopez, Leonardo C.; Maak, Kevin D.; Mills, Michael E.; Ramesh, Narayan; Teli, Samar R.

    2015-06-02

    The present invention is premised upon an improved photovoltaic device ("PV device"), more particularly to an improved photovoltaic device with a multilayered photovoltaic cell assembly and a body portion joined at an interface region and including an intermediate layer, at least one interconnecting structural member, relieving feature, unique component geometry, or any combination thereof.

  20. Concentration device

    DEFF Research Database (Denmark)

    2013-01-01

    A concentration device (2) for filter filtration concentration of particles (4) from a volume of a fluid (6). The concentration device (2) comprises a filter (8) configured to filter particles (4) of a predefined size in the volume of the fluid (6). The concentration device (2) comprises...

  1. Early outcomes of twin-peg mobile-bearing unicompartmental knee arthroplasty compared with primary total knee arthroplasty

    Science.gov (United States)

    Lum, Z. C.; Lombardi, A. V.; Hurst, J. M.; Morris, M. J.; Adams, J. B.; Berend, K. R.

    2016-01-01

    Aims Since redesign of the Oxford phase III mobile-bearing unicompartmental knee arthroplasty (UKA) femoral component to a twin-peg design, there has not been a direct comparison to total knee arthroplasty (TKA). Thus, we explored differences between the two cohorts. Patients and Methods A total of 168 patients (201 knees) underwent medial UKA with the Oxford Partial Knee Twin-Peg. These patients were compared with a randomly selected group of 177 patients (189 knees) with primary Vanguard TKA. Patient demographics, Knee Society (KS) scores and range of movement (ROM) were compared between the two cohorts. Additionally, revision, re-operation and manipulation under anaesthesia rates were analysed. Results The mean follow-up for UKA and TKA groups was 5.4 and 5.5 years, respectively. Six TKA (3.2%) versus three UKAs (1.5%) were revised which was not significant (p = 0.269). Manipulation was more frequent after TKA (16; 8.5%) versus none in the UKA group (p < 0.001). UKA patients had higher post-operative KS function scores versus TKA patients (78 versus 66, p < 0.001) with a trend toward greater improvement, but there was no difference in ROM and KS clinical improvement (p = 0.382 and 0.420, respectively). Conclusion We found fewer manipulations, and higher functional outcomes for patients treated with medial mobile-bearing UKA compared with TKA. TKA had twice the revision rate as UKA although this did not reach statistical significance with the numbers available. Cite this article: Bone Joint J 2016;98-B(10 Suppl B):28–33. PMID:27694513

  2. Outcome of total hip arthroplasty, but not of total knee arthroplasty, is related to the preoperative radiographic severity of osteoarthritis

    Science.gov (United States)

    Tilbury, Claire; Holtslag, Maarten J; Tordoir, Rutger L; Leichtenberg, Claudia S; Verdegaal, Suzan H M; Kroon, Herman M; Fiocco, Marta; Nelissen, Rob G H H; Vliet Vlieland, Thea P M

    2016-01-01

    Background and purpose There is no consensus on the impact of radiographic severity of hip and knee osteoarthritis (OA) on the clinical outcome of total hip arthroplasty (THA) and total knee arthroplasty (TKA). We assessed whether preoperative radiographic severity of OA is related to improvements in functioning, pain, and health-related quality of life (HRQoL) 1 year after THA or TKA. Patients and methods This prospective cohort study included 302 THA patients and 271 TKA patients with hip or knee OA. In the THA patients, preoperatively 26% had mild OA and 74% had severe OA; in the TKA patients, preoperatively 27% had mild OA and 73% had severe OA. Radiographic severity was determined according to the Kellgren and Lawrence (KL) classification. Clinical assessments preoperatively and 1 year postoperatively included: sociodemographic characteristics and patient-reported outcomes (PROMs): Oxford hip/knee score, hip/knee injury and osteoarthritis outcome score (HOOS/KOOS), SF36, and EQ5D. Change scores of PROMs were compared with mild OA (KL 0–2) and severe OA (KL 3–4) using a multivariate linear regression model. Results Adjusted for sex, age, preoperative scores, BMI, and Charnley score, radiographic severity of OA in THA was associated with improvement in HOOS “Activities of daily living”, “Pain”, and “Symptoms”, and SF36 physical component summary (“PCS”) scale. In TKA, we found no such associations. Interpretation The decrease in pain and improvement in function in THA patients, but not in TKA patients, was positively associated with the preoperative radiographic severity of OA. PMID:26484651

  3. A force-sensing device for assistance in soft-tissue balancing during knee arthroplasty

    OpenAIRE

    Crottet, Denis

    2006-01-01

    Nowadays, the large majority of the instrumentation for orthopaedic surgery consists of mechanical tools with varying degrees of complexity. To increase the accuracy and the safety of orthopaedic interventions, sensors and computers were recently introduced in the operating room. Computer Assisted Orthopaedic Surgery (CAOS) uses a navigation system that tracks the movements of surgical instruments in real-time and displays their exact location in relation to the operative area. Such technolog...

  4. Treatment of Severe Bone Defects During Revision Total Knee Arthroplasty with Structural Allografts and Porous Metal Cones

    DEFF Research Database (Denmark)

    Beckmann, Nicholas A; Mueller, Sebastian; Gondan, Matthias;

    2015-01-01

    Aseptic loosening and focal osteolysis are the most common reasons for knee arthroplasty failure. The best treatment remains unclear. We reviewed the literature on the treatment of revision knee arthroplasty using bony structural allografts (476 cases) and porous metal cones (223 cases) to determ...

  5. The "true" incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl;

    2015-01-01

    BACKGROUND AND PURPOSE: It has been suggested that the risk of prosthetic joint infection (PJI) in patients with total hip arthroplasty (THA) may be underestimated if based only on arthroplasty registry data. We therefore wanted to estimate the "true" incidence of PJI in THA using several data...

  6. Recovery after short-stay total hip and knee arthroplasty. Evaluation of a support program and outcome determination

    NARCIS (Netherlands)

    Akker-Scheek, Inge van den

    2007-01-01

    As a result of the increasing demand for total hip arthroplasties (THA) and total knee arthroplasties (TKA), waiting lists are growing. To cope with this problem, many hospitals have introduced short-stay programs; a consequence is increased responsibility of the patient regarding his own rehabilita

  7. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P;

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla...

  8. 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...

  9. Failure of cervical arthroplasty in a patient with adjacent segment disease associated with Klippel-Feil syndrome

    Directory of Open Access Journals (Sweden)

    Ioannis D Papanastassiou

    2011-01-01

    Full Text Available Cervical arthroplasty may be justified in patients with Klippel-Feil syndrome (KFS in order to preserve cervical motion. The aim of this paper is to report an arthroplasty failure in a patient with KFS. A 36-year-old woman with KFS underwent two-level arthroplasty for adjacent segment disc degeneration. Anterior migration of the cranial prosthesis was encountered 5 months postoperatively and was successfully revised with anterior cervical fusion. Cervical arthroplasty in an extensively stiff and fused neck is challenging and may lead to catastrophic failure. Although motion preservation is desirable in KFS, the special biomechanical features may hinder arthroplasty. Fusion or hybrid constructs may represent more reasonable options, especially when multiple fused segments are present.

  10. Failed Reverse Total Shoulder Arthroplasty Caused by Recurrent Candida glabrata Infection with Prior Serratia marcescens Coinfection

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2014-01-01

    Full Text Available This report describes a 58-year-old insulin-dependent diabetic male patient who initially sustained a proximal humerus fracture from a fall. The fracture fixation failed and then was converted to a humeral hemiarthroplasty, which became infected with Candida glabrata and Serratia marcescens. After these infections were believed to be cured with antibacterial and antifungal treatments and two-stage irrigation and debridement, he underwent conversion to a reverse total shoulder arthroplasty. Unfortunately, the C. glabrata infection recurred and, nearly 1.5 years after implantation of the reverse total shoulder, he had a resection arthroplasty (removal of all implants and cement. His surgical and pharmacologic treatment concluded with (1 placement of a tobramycin-impregnated cement spacer also loaded with amphotericin B, with no plan for revision arthroplasty (i.e., the spacer was chronically retained, and (2 chronic use of daily oral fluconazole. We located only three reported cases of Candida species causing infection in shoulder arthroplasties (two C. albicans, one C. parapsilosis. To our knowledge, a total shoulder arthroplasty infected with C. glabrata has not been reported, nor has a case of a C. glabrata and S. marcescens periprosthetic coinfection in any joint. In addition, it is well known that S. marcescens infections are uncommon in periprosthetic joint infections.

  11. Bilateral custom-fit total knee arthroplasty in a patient with poliomyelitis.

    Science.gov (United States)

    Tardy, Nicolas; Chambat, Pierre; Murphy, Colin G; Fayard, Jean-Marie

    2014-09-01

    In limbs affected by poliomyelitis, total knee arthroplasty results in satisfactory pain relief. However, the risk of failure is high, especially if the preoperative quadriceps power is low. Therefore, treating osteoarthritis in the current patient represented a challenging procedure. A 66-year-old man presented with tricompartmental osteoarthritis of both knees, with valgus deformity of 14° on the left knee and 11° on the right knee. He walked with a bilateral knee recurvatum of 30° and a grade 1 quadriceps power. The authors treated both knees with cemented custom-fit hinged total knee arthroplasty with 30° of recurvatum in the tibial keel. Clinical scores showed good results 1 year postoperatively, especially on the subjective data of quality of life and function. At follow-up, radiographs showed good total knee arthroplasty positioning on the right side and a small mechanical loosening at the end of the tibial keel on the left side. Only 5 studies (Patterson and Insall; Moran; Giori and Lewallen; Jordan et al; and Tigani et al) have reported total knee arthroplasty results in patients with poliomyelitis. This study reports an original case of bilateral custom-fit hinged total knee arthroplasty in a patient with poliomyelitis. To the authors' knowledge, this is the first report of this type of procedure in the literature. The key point is the degree of recurvatum that is needed to allow walking, avoiding excessive constraints on the implants that can lead to early mechanical failure.

  12. Cemented versus Uncemented Oxford Unicompartmental Knee Arthroplasty: Is There a Difference?

    Directory of Open Access Journals (Sweden)

    Burak Akan

    2013-01-01

    Full Text Available Purpose. The use of uncemented unicompartmental knee prostheses has recently increased. However, few studies on the outcomes of uncemented unicompartmental knee prostheses have been performed. The purpose of this study was to compare the outcomes of cemented and uncemented Oxford unicompartmental knee arthroplasty. Materials and Methods. This retrospective observational study evaluated the clinical and radiological outcomes of 263 medial Oxford unicompartmental prostheses (141 cemented, 122 uncemented implanted in 235 patients. The mean follow-up was 42 months in the cemented group and 30 months in the uncemented group. Results. At the last follow-up, there were no significant differences in the clinical results or survival rates between the two groups. However, the operation time in the uncemented unicompartmental knee arthroplasty group was shorter than that in the cemented unicompartmental knee arthroplasty group. In addition, the cost of uncemented arthroplasty was greater. Conclusion. Despite the successful midterm results in the uncemented unicompartmental knee arthroplasty group, a longer follow-up period is required to determine the best fixation mode.

  13. Infection of a total hip arthroplasty with actinomyces israelii: Report of a case

    Directory of Open Access Journals (Sweden)

    Feiran Wu

    2011-01-01

    Full Text Available Context : Infection of following total hip arthroplasties can be classified based on the timing of infection. Late infections with Actinomyces israelii are extremely rare with only 3 previously reported cases in literature. We present another case of a late infection with Actinomyces israelii in a total hip arthroplasty 9 years following implantation. Case Report : A 71-year-old male with diabetes mellitus presented with right hip pain 9 years following a total hip arthroplasty. Physical examination revealed localised pain and biochemical investigations showed elevated inflammatory markers. X-rays were suspicious for infection and a collection around the prosthesis was confirmed by MRI scan. The patient underwent debridement and removal of prosthesis. Peri-operative specimen cultures isolated Actinomyces israelii. The patient responded to a combination of vancomycin followed by ciprofloxacin and linezolid therapy before undergoing a successful second-stage reimplantation surgery. Conclusion : This is the first reported case of late haematogenous infection by Actinomyces israelii in a total hip arthroplasty in a patient with diabetes mellitus as the only risk factor. The patient was successfully treated with antibiotic therapy and two-stage reimplantation arthroplasty.

  14. Metal ion levels in large-diameter total hip and resurfacing hip arthroplasty-Preliminary results of a prospective five year study after two years of follow-up

    Directory of Open Access Journals (Sweden)

    Maurer-Ertl W

    2012-04-01

    Full Text Available Abstract Background Metal-on-metal hip resurfacing is an alternative to metal-on-metal total hip arthroplasty, especially for young and physically active patients. However, wear which might be detected by increased serum ion levels is a matter of concern. Methods The aims of this preliminary study were to determine the raise of metal ion levels at 2-years follow-up in a prospective setting and to evaluate differences between patients with either resurfacing or total hip arthroplasty. Furthermore we investigated if the inclination of the acetabular component and the arc of cover would influence these findings. Therefore, 36 patients were followed prospectively. Results The results showed increments for Co and Cr in both implant groups. Patients treated with large-diameter total hip arthroplasty showed fourfold and threefold, respectively, higher levels for Co and Cr compared to the resurfacing group (Co: p  Discussion In order to clarify the biologic effects of ion dissemination and to identify risks concerning long-term toxicity of metals, the exposure should be monitored carefully. Therefore, long-term studies have to be done to determine adverse effects of Co and Cr following metal-on-metal hip replacement.

  15. Mobile input device type, texting style and screen size influence upper extremity and trapezius muscle activity, and cervical posture while texting.

    Science.gov (United States)

    Kietrys, David M; Gerg, Michael J; Dropkin, Jonathan; Gold, Judith E

    2015-09-01

    This study aimed to determine the effects of input device type, texting style, and screen size on upper extremity and trapezius muscle activity and cervical posture during a short texting task in college students. Users of a physical keypad produced greater thumb, finger flexor, and wrist extensor muscle activity than when texting with a touch screen device of similar dimensions. Texting on either device produced greater wrist extensor muscle activity when texting with 1 hand/thumb compared with both hands/thumbs. As touch screen size increased, more participants held the device on their lap, and chose to use both thumbs less. There was also a trend for greater finger flexor, wrist extensor, and trapezius muscle activity as touch screen size increased, and for greater cervical flexion, although mean differences for cervical flexion were small. Future research can help inform whether the ergonomic stressors observed during texting are associated with musculoskeletal disorder risk. PMID:25959323

  16. Influence of Damp Heat on the Electrical, Optical, and Morphological Properties of Encapsulated CuInGaSe2 Devices: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Sundaramoorthy, R.; Pern, F. J.; Teeter, G.; Li, J. V.; Young, M.; Kuciauskas, D.; Call, N.; Yan, F.; To, B.; Johnston, S.; Noufi, R.; Gessert, T. A.

    2011-08-01

    CuInGaSe2 (CIGS) devices, encapsulated with different backsheets having different water vapor transmission rates (WVTR), were exposed to damp heat (DH) at 85C and 85% relative humidity (RH) and characterized periodically to understand junction degradation induced by moisture ingress. Performance degradation of the devices was primarily driven by an increase in series resistance within first 50 h of exposure, resulting in a decrease in fill factor and, accompanied loss in carrier concentration and widening of depletion width. Surface analysis of the devices after 700-h DH exposure showed the formation of Zn(OH)2 from hydrolysis of the Al-doped ZnO (AZO) window layer by the moisture, which was detrimental to the collection of minority carriers. Minority carrier lifetimes observed for the CIGS devices using time resolved photoluminescence (TRPL) remained relatively long after DH exposure. By etching the DH-exposed devices and re-fabricating with new component layers, the performance of reworked devices improved significantly, further indicating that DH-induced degradation of the AZO layer and/or the CdS buffer was the primary performance-degrading factor.

  17. Microfluidic Device

    Science.gov (United States)

    Tai, Yu-Chong (Inventor); Zheng, Siyang (Inventor); Lin, Jeffrey Chun-Hui (Inventor); Kasdan, Harvey L. (Inventor)

    2016-01-01

    Described herein are particular embodiments relating to a microfluidic device that may be utilized for cell sensing, counting, and/or sorting. Particular aspects relate to a microfabricated device that is capable of differentiating single cell types from dense cell populations. One particular embodiment relates a device and methods of using the same for sensing, counting, and/or sorting leukocytes from whole, undiluted blood samples.

  18. The use of the Gait Deviation Index for the evaluation of participants following total hip arthroplasty

    DEFF Research Database (Denmark)

    Jensen, Carsten; Rosenlund, Signe; Nielsen, Dennis B;

    2015-01-01

    INTRODUCTION: In this paper, the Gait Deviation Index (GDI) was used as a convenient method to evaluate pre-to-postoperative gait pattern changes after total hip arthroplasty and identify factors which might be predictive of outcome. DESIGN: Three-dimensional gait data from a randomized clinical...... trial was used to determine changes in gait quality in participants walking at self-selected speed. Upon completion of the first assessment, the participants were randomly assigned to either resurfacing hip arthroplasty or conventional hip arthroplasty. The outcome was changes in overall gait 'quality......-operated and the operated limbs; 0.3 [95%CI: -2.3 to 1.7]. However, the score for the two groups (pooled data) improved after surgery by 4.4 [95%CI: 1.8-7.0]. The single level regression analysis identified the preoperative GDI score as a strong predictor of outcome (p

  19. Physiotherapy Exercise After Fast-Track Total Hip and Knee Arthroplasty: Time for Reconsideration?

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Kehlet, Henrik

    2012-01-01

    Bandholm T, Kehlet H. Physiotherapy exercise after fast-track total hip and knee arthroplasty: time for reconsideration? Major surgery, including total hip arthroplasty (THA) and total knee arthroplasty (TKA), is followed by a convalescence period, during which the loss of muscle strength......-track methodology or enhanced recovery programs. It is the nature of this methodology to systematically and scientifically optimize all perioperative care components, with the overall goal of enhancing recovery. This is also the case for the care component "physiotherapy exercise" after THA and TKA. The 2 latest...... meta-analyses on the effectiveness of physiotherapy exercise after THA and TKA generally conclude that physiotherapy exercise after THA and TKA either does not work or is not very effective. The reason for this may be that the "pill" of physiotherapy exercise typically offered after THA and TKA does...

  20. A Literature Review of Total Hip Arthroplasty in Patients with Ankylosing Spondylitis: Perioperative Considerations and Outcome.

    Science.gov (United States)

    Putnis, S E; Wartemberg, G K; Khan, W S; Agarwal, S

    2015-01-01

    Ankylosing spondylitis is a spondyloarthropathy affecting the sacro-iliac joints with subsequent progression to the spine and the hip joints. The hip joints are affected by synovitis, enthesial inflammation, involvement of medullary bone, progressive degeneration and secondary osteoarthritis. Clinical presentation is usually in the form of pain and stiffness progressing to disabling fixed flexion contractures and in some instances, complete ankylosis. Hip arthroplasty should be considered for hip pain, postural and functional disability, or pain in adjacent joints due to hip stiffness. We conducted a literature review to determine peri-operative considerations and outcome in ankylosing spondylitis patients undergoing hip arthroplasty. In this review, we have discussed pre-operative surgical planning, thromboprophylaxis, anaesthetic considerations and heterotopic ossification. Outcomes of arthroplasty include range of movement, pain relief, survivorship and complications. PMID:26587066

  1. Anterior Longitudinal Osteotomy of the Greater Trochanter in Total Hip Arthroplasty.

    Science.gov (United States)

    Surace, Michele F; Regazzola, Gianmarco M V; Vulcano, Ettore; Monestier, Luca; Cherubino, Paolo

    2015-08-01

    The extra-articular impingement of the greater trochanter against the ileum is an underrated cause of early dislocation in total hip arthroplasty. In this preliminary study, the authors assess the effectiveness of an anterior longitudinal osteotomy of the greater trochanter for preventing dislocation. A total of 115 patients underwent a total hip arthroplasty through a posterolateral approach. All patients underwent clinical and radiological follow-up at 1, 3, and 6 months. No dislocation was reported. All patients demonstrated fast recovery of range of motion and walking. No trochanter fractures were observed. The osteotomy of the greater trochanter is an effective surgical technique that decreases anterior impingement and consequently lowers the dislocation rate in primary total hip arthroplasty. [Orthopedics. 2015; 38(8):490-493.]. PMID:26313167

  2. Effect of compression therapy on knee swelling and pain after total knee arthroplasty

    DEFF Research Database (Denmark)

    Munk, Stig; Jensen, Niels J F; Andersen, Ida;

    2013-01-01

    or no stocking from the first postoperative day and the following 4 weeks after total knee arthroplasty. Outcome measures were knee, calf and ankle swelling, knee flexion, pain and patient-reported knee function. RESULTS: Seventy per cent of the swelling had occurred before application of the stocking the day......PURPOSE: Knee swelling after total knee arthroplasty may impair postoperative mobilisation and training, and as medical elastic compression stockings are well tolerated and effective to prevent oedema, haematoma and postoperative pain after venous surgery, we wanted to study whether this effect...... could be transferred to total knee arthroplasty surgery reducing postoperative swelling and pain and thereby facilitating mobilisation and improving patient-reported knee function. METHODS: In a randomised controlled study, 88 patients were randomised to use either a medical elastic compression stocking...

  3. Efficacy and safety of rivaroxaban thromboprophylaxis after arthroplasty of the hip or knee: retrospective cohort study.

    Science.gov (United States)

    Loganathan, L; Hua, A; Patel, S; Gibbons, C; Vizcaychipi, M P

    2016-09-01

    Introduction Venous thromboembolism (VTE) is a potentially fatal complication of hip arthroplasty and knee arthroplasty. The National Institute for Health and Care Excellence recommend rivaroxaban for VTE prevention. Amid concerns over bleeding complications, the modified thromboprophylaxis policy of Chelsea and Westminster Hospital (CWH; London, UK) advises enoxaparin given after surgery in the inpatient setting followed by rivaroxaban upon hospital discharge. This retrospective study investigated the efficacy and safety of rivaroxaban in this novel, modified venous-prophylaxis regimen in a surgical orthopaedic cohort at CWH. Methods A total of 479 patients who received modified thromboprophylaxis treatment at CWH after hip arthroplasty or knee arthroplasty between April 2013 and October 2014 formed the study cohort. Seven outcomes based on efficacy and safety while undergoing treatment with rivaroxaban were investigated: symptomatic deep-vein thrombosis (DVT), pulmonary embolism (PE), death, stroke, myocardial infarction (MI), major bleeding episodes (MBEs) and non-major bleeding episodes (NMBEs). Median follow-up was 369 days. Fisher's exact and Mann-Whitney U-tests were adopted to identify associations with these outcomes. Results Prevalence of symptomatic PE, DVT, death, stroke and MI during treatment was zero. One (0.2%) MBE and nine (1.9%) NMBEs occurred. The MBE (a wound haematoma) required a return to theatre for aspiration. Off-treatment VTEs occurred in four (0.8%) patients after completion of a course of rivaroxaban, and were associated with known risk factors. Conclusions Rivaroxaban is an effective and safe anticoagulant for thromboprophylaxis after hip arthroplasty or knee arthroplasty if used in a modified regimen involving enoxaparin administered in the inpatient setting followed by rivaroxaban upon hospital discharge.

  4. Increased Long-Term Cardiovascular Risk After Total Hip Arthroplasty: A Nationwide Cohort Study.

    Science.gov (United States)

    Gordon, Max; Rysinska, Agata; Garland, Anne; Rolfson, Ola; Aspberg, Sara; Eisler, Thomas; Garellick, Göran; Stark, André; Hailer, Nils P; Sköldenberg, Olof

    2016-02-01

    Total hip arthroplasty is a common and important treatment for osteoarthritis patients. Long-term cardiovascular effects elicited by osteoarthritis or the implant itself remain unknown. The purpose of the present study was to determine if there is an increased risk of late cardiovascular mortality and morbidity after total hip arthroplasty surgery.A nationwide matched cohort study with data on 91,527 osteoarthritis patients operated on, obtained from the Swedish Hip Arthroplasty Register. A control cohort (n = 270,688) from the general Swedish population was matched 1:3 to each case by sex, age, and residence. Mean follow-up time was 10 years (range, 7-21).The exposure was presence of a hip replacement for more than 5 years. The primary outcome was cardiovascular mortality after 5 years. Secondary outcomes were total mortality and re-admissions due to cardiovascular events.During the first 5 to 9 years, the arthroplasty cohort had a lower cardiovascular mortality risk compared with the control cohort. However, the risk in the arthroplasty cohort increased over time and was higher than in controls after 8.8 years (95% confidence interval [CI] 7.0-10.5). Between 9 and 13 years postoperatively, the hazard ratio was 1.11 (95% CI 1.05-1.17). Arthroplasty patients were also more frequently admitted to hospital for cardiovascular reasons compared with controls, with a rate ratio of 1.08 (95% CI 1.06-1.11).Patients with surgically treated osteoarthritis of the hip have an increased risk of cardiovascular morbidity and mortality many years after the operation when compared with controls. PMID:26871792

  5. Removal versus preservation of the posterior longitudinal ligament in Bryan cervical disc arthroplasty

    Institute of Scientific and Technical Information of China (English)

    YANG Da-long; DING Wen-yuan; ZHANG Ying-ze; ZHANG Wei; XU Jia-xin; SHEN Yong

    2013-01-01

    Background Bryan cervical disc arthroplasty can be used to restore and maintain the mobility and function of the involved cervical spinal segments.The efficiency of posterior longitudinal ligament (PLL) resection in anterior cervical decompression and fusion has been demonstrated.However,no clinical reports have compared PLL removal with preservation in Bryan cervical disc arthroplasty.This study aimed to assess the role of removal of PLL in Bryan cervical disc arthroplasty at an 18-month follow-up.Methods We performed a prospective investigation of clinical and radiological outcomes in patients after Bryan cervical disc arthroplasty.Sixty patients who underwent Bryan cervical disc arthroplasty were included.The PLL was removed in 35 patients (investigational group) and preserved in 25 patients (control group).All of the patients were followed up for more than 18 months.Clinical (Japanese Orthopedic Association score and Visual Analogue Scale pain score) and radiological (functional spinal unit (FSU) angle,range of movement (ROM),and diameter of the spinal cord) parameters were compared between the two groups before and after surgery (18 months).Results Clinical outcomes in the investigational group were significantly superior to those in the control group.There were no significant differences in the FSU angle and ROM (P=-0.41 and 0.16,respectively) between the two groups.However,the increase in diameter of the spinal cord in the investigational group was significantly greater than that in the control group (P <0.01).Conclusions Removal of the PLL can improve the clinical outcomes of Bryan cervical disc arthroplasty.This procedure does not have a large effect on imbalance and motion of the cervical spine.

  6. Effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty

    Science.gov (United States)

    2013-01-01

    Background Ankle osteoarthritis commonly involves sagittal malalignment with anterior translation of the talus relative to the tibia. Total ankle arthroplasty has become an increasingly popular treatment for patients with symptomatic ankle osteoarthritis. However, no comprehensive study has been conducted on the outcomes of total ankle arthroplasty for osteoarthritis with preoperative sagittal malalignment. The purpose of this study was to evaluate the effect of anterior translation of the talus on outcomes of three-component total ankle arthroplasty. Methods One hundred and four osteoarthritic ankles in 104 patients who underwent three-component total ankle arthroplasty were included in this study. The 104 ankles were divided into 2 groups: ankles with anteriorly translated talus (50 ankles), and ankles with non-translated talus (54 ankles). Clinical and radiographic outcomes were assessed in both groups. The mean follow-up duration was 42.8 ± 17.9 months (range, 24 to 95 months). Results Forty-six (92%) of 50 ankles with anterior translation of the talus showed relocation of the talus within the mortise at 6 months, and 48 (96%) ankles were relocated at 12 months after total ankle arthroplasty. But, 2 (4%) ankles were not relocated until the final follow-up. The AOFAS scores, ankle range of motion, and radiographic outcomes showed no significant difference between the two groups at the final follow-up (p > 0.05 for each). Conclusions In majority of cases, the anteriorly translated talus in osteoarthritic ankles was restored to an anatomical position within 6 months after successful three-component total ankle arthroplasty. The clinical and radiographic outcomes in the osteoarthritic ankles with anteriorly translated talus group were comparable with those in non-translated talus group. PMID:24007555

  7. Malassezia species infection of the synovium after total knee arthroplasty surgery

    Science.gov (United States)

    Leylabadlo, Hamed Ebrahimzadeh; Zeinalzadeh, Elham; Akbari, Najibeh Asl Rahnemaii; Kafil, Hossein Samadi

    2016-01-01

    Infection is a serious complication after implantation of total knee-prostheses. However, fungal infection is rarely found in periprosthetic joints, and in most reports, the infecting organism is a Candida species. This is a case report of infection after left knee total arthroplasty caused by Malassezia species. The patient is still undergoing antifungal therapy with voriconazole and is still being followed-up. To the authors’ knowledge, the present case is the first report of Malassezia species in a patient after total knee arthroplasty. PMID:27730027

  8. Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

    Science.gov (United States)

    Wijeratna, Malin D; Ek, Eugene T; Hoy, Gregory A; Chehata, Ash

    2015-10-01

    The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure. We describe an efficient method of creating the fenestration between the olecranon fossa and coronoid fossa during an arthroscopic ulnohumeral arthroplasty, or Outerbridge-Kashiwagi procedure, that also reduces the amount of residual bone debris produced during the resection.

  9. Pre-Operative Patient Education is Associated With Decreased Risk of Arthrofibrosis After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Livbjerg, Anna Emilie; Frøkjær, Sara; Simonsen, Ole;

    2013-01-01

    The purpose was to investigate risk factors for postoperative stiffness and long-term outcome following manipulation under anaesthesia (MUA). In one of the five Danish regions, all patients in a 4-year period who received MUA following total knee arthroplasty (N=36) were included in two case......-control studies. Data on potential risk factors were extracted from the Danish Knee arthroplasty Register and from a postal questionnaire including long-term outcome measures regarding pain, function and quality of life (Oxford Knee Score and EQ-5D). Previous knee surgery and a high preoperative Knee Society...

  10. Analgesic efficacy of local anaesthetic wound administration in knee arthroplasty: volume vs concentration

    DEFF Research Database (Denmark)

    Andersen, L Ø; Gaarn-Larsen, L; Kristensen, B B;

    2010-01-01

    Wound administration of local anaesthetic may be effective for postoperative pain management in knee arthroplasty, but the analgesic efficacy of local anaesthetic in relation to volume vs concentration has not been determined. In a double-blinded trial, 48 patients scheduled for total knee...... arthroplasty were randomly assigned to receive either a high volume/low concentration solution of ropivacaine (20 ml, 0.5%) or a low volume/high concentration solution of ropivacaine (10 ml, 1%), 6 and 24 h postoperatively through an intracapsular catheter. Pain was assessed for 2 h after administration. Pain...

  11. Total arthroplasty in patients with developmental dysplasia of hip fractures: Two case reports

    OpenAIRE

    Çitlak, Atilla; KERİMOĞLU, Servet; BAKİ, Mehmet Emre

    2015-01-01

    Treatment of fractures in patients with developmental dysplasia of hip is not clear. In patients without any pre-existing hip pathology, open or closed reduction and internal fixation is used to treat hip fractures. Total arthroplasty is used as a salvage procedure in hip fractures of young patients. Total arthroplasty serves perfect functional results in elderly patients with developmental dysplasia of hip. We presented two multi-trauma patients with developmental dysplasia of hip, and their...

  12. Three-step sequential management for knee arthroplasty after severe ballistic injury: Two cases.

    Science.gov (United States)

    Herry, Y; Boucher, F; Neyret, P; Ferry, T; Lustig, S

    2016-02-01

    Management of knee bone loss after gunshot trauma requires a multidisciplinary approach. Two cases of knee arthroplasty after devastating ballistic trauma are reported. Treatment comprised several steps: sampling, bone resection, reinforced cement spacer, latent sepsis control, and prosthetic reconstruction. The patients showed no neurovascular disorder and had a functioning extensor mechanism. At follow-up of at least 2 years, results were satisfactory, with return to unaided walking and mean International Knee Society (IKS) score improved from 18 to 59 points. In light of these observations, knee reconstruction arthroplasty using a sequential strategy can provide satisfactory functional outcome after severe ballistic trauma. PMID:26774900

  13. Revision Arthroplasty Using a MUTARS® Prosthesis in Comminuted Periprosthetic Fracture of the Distal Femur.

    Science.gov (United States)

    Choi, Hyung Suk; Nho, Jae Hwi; Kim, Chung Hyun; Kwon, Sai Won; Park, Jong Seok; Suh, You Sung

    2016-11-01

    Periprosthetic fractures after total knee arthroplasty (TKA) are gradually increasing, reflecting extended lifespan, osteoporosis, and the increasing proportion of the elderly during the past decade. Supracondylar periprosthetic femoral fracture is a potential complication after TKA. Generally, open reduction and internal fixation are the conventional option for periprosthetic fracture after TKA. However, the presence of severe comminution with component loosening can cause failure of internal fixation. Although the current concept for periprosthetic fracture is open reduction and internal fixation, we introduce an unusual case of revision arthroplasty using a MUTARS® prosthesis for a comminuted periprosthetic fracture in the distal femur after TKA, with technical tips. PMID:27593884

  14. An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Mohammad Saeed Mosleh-shirazi

    2015-01-01

    Full Text Available Total hip arthroplasty (THA has improved the quality of life of patients with hip arthritis. Orthopedic community is striving for excellence to improve surgical techniques and postoperative care. Despite these efforts, patients continue facing postoperative complications. In particular, patients with rheumatoid arthritis display a higher risk of certain complications such as dislocation, periprosthetic infection, and shorter prosthesis durability. In this review we present the current knowledge of hip arthroplasty in patients with rheumatoid arthritis with more insight into common practices and interventions directed at enhancing recovery of these patients and current shortfalls.

  15. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report.

    Science.gov (United States)

    Finger, Eric; Willis, F Buck

    2008-01-01

    Total Knee Arthroplasty operations are increasing in frequency, and knee flexion contracture is a common pathology, both pre-existing and post-operative. A 61-year-old male presented with knee flexion contracture following a total knee arthroplasty. Physical therapy alone did not fully reduce the contracture and dynamic splinting was then prescribed for daily low-load, prolonged-duration stretch. After 28 physical therapy sessions, the active range of motion improved from -20 degrees to -12 degrees (stiff knee still lacking full extension), and after eight additional weeks with nightly wear of dynamic splint, the patient regained full knee extension, (active extension improved from -12 degrees to 0 degrees ).

  16. Influence of Different Sol-gel Spin Coating Speed on Memristive Behaviour of Pt/TiO2/ZnO/ITO Device

    Science.gov (United States)

    Kasim, S. M. M.; Shaari, N. A. A.; Bakar, R. A.; Aznilinda, Z.; Mohamad, Zulfakri; Herman, S. H.

    2015-11-01

    Composite titanium dioxide (TiO2) and zinc oxide (ZnO) thin films were deposited on indium tin oxide (ITO) substrates using sol-gel spin coating technique. The electrical and physical characterizations of three different sol-gel spin coating speed were investigated using two-probe current-voltage (I-V) measurement, field emission scanning electron microscopy (FESEM) and surface profiler (SP) respectively. The I-V measurement results showed the pinched hysteresis loop for every single of devices thus indicate that all the devices are memristive. ROFF/RON ratio which was defined from the hysteresis loop of device with higher spin speed was slightly higher compared to others.

  17. Predictors of physical functioning after total hip arthroplasty: a systematic review

    Science.gov (United States)

    Buirs, L D; Van Beers, L W A H; Scholtes, V A B; Pastoors, T; Sprague, S; Poolman, R W

    2016-01-01

    Objective The objective of this systematic review of the literature was to identify the predictors of functional outcome after total hip arthroplasty (THA). Method A systematic literature search in Web of Science, CINAHL, EMBASE and PubMed was conducted on 23 June 2015. The articles were selected based on their quality, relevance and measurement of the predictive factor. The level of evidence of all studies was determined using the GRADE rating scheme. Results The initial search resulted in 1092 citations. After application of the inclusion and exclusion criteria, 33 articles met our eligibility criteria and were graded. Included studies were classified as level of evidence low (11), moderate (17) or high (5). Of the included studies, 18 evaluated body mass index (BMI), 17 evaluated preoperative physical functions, 15 evaluated age, 15 evaluated gender and 13 evaluated comorbidity. There was strong evidence suggesting an association between BMI, age, comorbidity, preoperative physical functions and mental health with functional outcome after THA. There was weak evidence suggesting an association between quadriceps strength and education with functional outcome after THA. The evidence was inconsistent for associations with gender and socioeconomic status and functional outcome following THA. We found limited evidence suggesting that alcohol consumption, vitamin D insufficiency and allergies were predictors of functional outcome following THA. Conclusions We have identified multiple predictors of functional outcome after THA, which will enable general practitioners and orthopaedic surgeons to better predict the improvement in physical functioning for their patients with THA. They can use this information to provide patient-specific advice regarding the referral for THA and the expected outcomes after THA. Further research with consistent measurement tools, outcomes and duration of follow-up across studies is needed to confirm the influence of these factors. PMID

  18. Sciatic nerve palsy associated with total hip arthroplasty.

    Science.gov (United States)

    Dhillon, M S; Nagi, O N

    1992-01-01

    Six cases of clinically evident sciatic or peroneal nerve palsy occurred in a consecutive series of 380 total hip arthroplasties (THA). An additional eight cases of peroneal nerve palsy due to pressure from Thomas splint or tight bandages were seen. Factors apparently causing nerve palsy were significant lateralization and lengthening in four cases and dislocation of the hip in one case. The cases with neuroapraxia of the peroneal nerve were seen from the third to the fifth day of Thomas splint immobilization. EMG studies were conducted in all six group 1 patients; at the end of one year the results were good in two cases, fair in three cases, and poor in one case. The results suggest that limb lengthening should be limited to 4 cm to minimize this complication. It was also seen that patients with peroneal nerve palsy due to local compression do well, though some are bothered by mild residual dysesthesia over the dorsum of the foot. In contrast, patients with sciatic nerve palsy do not have such a good outlook. PMID:1345646

  19. Gonyautoxins: First evidence in pain management in total knee arthroplasty.

    Science.gov (United States)

    Hinzpeter, Jaime; Barrientos, Cristián; Zamorano, Álvaro; Martinez, Álvaro; Palet, Miguel; Wulf, Rodrigo; Barahona, Maximiliano; Sepúlveda, Joaquín M; Guerra, Matias; Bustamante, Tamara; Del Campo, Miguel; Tapia, Eric; Lagos, Nestor

    2016-09-01

    Improvements in pain management techniques in the last decade have had a major impact on the practice of total knee arthroplasty (TKA). Gonyautoxin are phycotoxins, whose molecular mechanism of action is a reversible block of the voltage-gated sodium channels at the axonal level, impeding nerve impulse propagation. This study was designed to evaluate the clinical efficacy of Gonyautoxin infiltration, as a long acting pain blocker in TKA. Fifteen patients received a total dose of 40 μg of Gonyautoxin during the TKA operation. Postoperatively, all patients were given a standard painkiller protocol: 100 mg of intravenous ketoprofen and 1000 mg of oral acetaminophen every 8 hours for 3 days. The Visual Analog Scale (VAS) pain score and range of motion were recorded 12, 36, and 60 hours post-surgery. All patients reported pain of 2 or less on the VAS 12 and 36 hours post-surgery. Moreover, all scored were less than 4 at 60 hours post-surgery. All patients achieved full knee extension at all times. No side effects or adverse reactions to Gonyautoxin were detected in the follow-up period. The median hospital stay was 3 days. For the first time, this study has shown the effect of blocking the neuronal transmission of pain by locally infiltrating Gonyautoxin during TKA. All patients successfully responded to the pain control. The Gonyautoxin infiltration was safe and effective, and patients experienced pain relief without the use of opioids.

  20. RESULTS FROM BI-CONTACT® TOTAL ELBOW ARTHROPLASTY: MULTICENTER STUDY

    Science.gov (United States)

    Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emilio Conforto; de Sousa, Augusto Tadeu Barros; Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Ikemoto, Roberto Yukio; Murachovsky, Joel; Matsumoto, Marcelo Hide; Tamaoki, Marcel Jun Sugawara; Neto, Arnaldo Amado Ferreira

    2015-01-01

    Objective: To describe the initial experience of four orthopedic clinics from using Bi-Contact® total elbow arthroplasty (TEA), reporting the results and complications of the procedure. Methods: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMUSP. Forty-six elbows (45 patients) that were operated at four orthopedic clinics between 2000 and 2009 were evaluated. Results: The majority of the patients were female (74%), and the median age was 62.5 years. The diagnoses encountered were trauma sequelae (47.83%), rheumatoid arthritis (32.61%), primary osteoarthrosis (8.7%), acute fractures (6.52%) and heterotopic ossification (2.17%). The median length of follow-up was 2.08 years (0.25-9). The procedure significantly alleviated pain and improved range of motion. It was observed that at least one complication was present in 69.57% of the cases, and the main ones were infection (28.26%), need for revision (28.26%), intraoperative fracture (15.22%) and aseptic loosening (15.22%). Conclusion: Bi-Contact® TEA provided significant alleviation of pain and improvement of range of motion in the present series. The complication rate was high, and the most frequently observed complications were infection, aseptic loosening and intraoperative fracture. PMID:27027055

  1. Knee Muscles Power Evolution in Patients with Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Ileana Monica BORDA

    2012-09-01

    Full Text Available Purpose: To measure changes in muscle power from before to 6 months after total knee arthroplasty and to compare outcomes with those from a control group of healthy adults. Material and Methods: 26 patients who underwent a total knee replacement were compared with 12 healthy age-matched adults in a prospective cohort study. Patients’ assessment was performed preoperatively, as well as at 1, 2 and 6 months postoperatively, by the isokinetic method. Healthy adults were assessed once by the same method. Isokinetic evaluation of knee extensor and flexor muscles was performed using a Gimnex Iso 2 dynamometer. After a warm-up protocol, measurements were done at angular velocities of 90 and 180°/sec. Results: Compared to healthy adults, patients performed significantly worse at all evaluation times, for both extensors and flexors of the knee, except for the 6-month evaluation at 180°/sec. One month postoperatively losses from preoperative levels were registered in patients, but without statistically significance, except for extension at 180°/sec. At 6 months postoperatively patients surpassed the preoperative levels, with statistical significance at 180°/sec. Conclusions: Power is an important parameter to follow after TKA, in parallel with peak torque. Increasing muscle power should be one of the central issues to address during postoperative rehabilitation.

  2. Computer-navigated total knee arthroplasty in haemophilic arthropathy.

    Science.gov (United States)

    Cho, K-Y; Kim, K-I; Khurana, S; Cho, S-W; Kang, D-G

    2013-03-01

    Total knee arthroplasty (TKA) in end-stage haemophilic arthropathy is complex and challenging due to the altered bony anatomy, arthrofibrosis and muscle contractures. Computer navigation is especially advocated in patients with deformity or altered anatomy to improve alignment and to assist in ligament balancing. The objective of this study was to evaluate the results of computer-navigated TKA in haemophilic arthropathy. A consecutive series of computer-assisted TKA for the end-stage haemophilic arthropathy between February 2007 and December 2009 were evaluated. A total of 27 TKA were performed in 25 patients. Pre- and postoperative full-length weight-bearing radiographs were assessed for the axial limb alignment. The orientation of the components was measured on anteroposterior radiographs. Clinically, Knee Society score and Short Form-36 were evaluated. The mechanical axis of the leg was within a range of ±3° varus/valgus in 92% of the TKA. The coronal alignment of the femoral and tibial components was within a range of ±3 degrees in 96% of the knees. The clinical outcomes were significantly improved after the operation. There were no complications specific to the computer navigation. Computer-navigated TKA helps in restoring the mechanical axis and improves accuracy of orientation of the components in patients with end-stage haemophilic arthropathy. Potential benefits in long-term outcome require further investigation. PMID:23171356

  3. Fibrosis is a common outcome following total knee arthroplasty.

    Science.gov (United States)

    Abdul, Nicole; Dixon, David; Walker, Andrew; Horabin, Joanna; Smith, Nick; Weir, David J; Brewster, Nigel T; Deehan, David J; Mann, Derek A; Borthwick, Lee A

    2015-01-01

    Total knee arthroplasty (TKA) is one of the most successful orthopaedic procedures that alleviates pain and restores function in patients with degenerative knee joint diseases. Arthrofibrosis, abnormal scarring in which dense fibrous tissue prevents normal range of motion, develops in ~3-10% of TKA patients. No prophylactic intervention is available and treatment is restricted to aggressive physiotherapy or revision surgery. Tissue was collected from patients undergoing primary (n = 30) or revision (n = 27) TKA. Revision patients were stratified as non-arthrofibrotic and arthrofibrotic. Tissue was macroscopically and histologically compared to improve our understanding of the pathophysiology of arthrofibrosis. Macroscopically, tissue from primary TKA presents as homogenous, fatty tissue whereas tissue from revision TKA presents as dense, pigmented tissue. Histologically, there was dramatic tissue remodelling, increased collagen deposition and increased (myo)fibroblast staining in tissue from revision TKA. Significantly, tissue architecture was similar between revision patients regardless of clinically diagnosis. There are significant differences in architecture and composition of tissue from revision TKA over primary TKA. Surprisingly, whether revision TKA were clinically diagnosed as arthrofibrotic or non-arthrofibrotic there were still significant differences in fibrotic markers compared to primary TKA suggesting an ongoing fibrotic process in all revision knees. PMID:26553967

  4. An Unexpected Complication of Hip Arthroplasty: Knee Dislocation

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz

    2015-01-01

    Full Text Available An increasing number of patients with hip fracture have been seen with osteoporosis associated with osteoarthritis. Although knee dislocation is related to high-energy trauma, low-grade injuries can also lead to knee dislocation which is defined as “ultra-low velocity dislocation.” The case reported here is of an 82-year-old patient who presented with a left intertrochanteric hip fracture. Partial arthroplasty was planned because of osteoporosis. In the course of surgery, degenerative arthritic knee was dislocated during the hip reduction maneuver with the application of long traction. The neurovascular examination was intact, but the knee was grossly unstable and was dislocated even in a brace; thus a hinged knee prosthesis was applied nine days after surgery. The patient was mobilized with crutches after the knee prosthesis but exercise tolerance was diminished. In conclusion, it should be emphasized that overtraction must be avoided during the hip reduction maneuver in patients with advanced osteoarthritic knee.

  5. Three-dimensional measured cutting method in total knee arthroplasty

    International Nuclear Information System (INIS)

    Authors have developed a unique three-dimensional (3D) measured cutting method in total knee arthroplasty without navigation (TKA), using estimates obtained by preoperative planning and the cooperative jig during operation. In the present study, examined is the usefulness of this intra-operative assistance system for accuracy improvement of TKA: The procedure is; 3D bone model of femur and tibia is reconstructed from CT images of the whole lower limb, then the bone component form model is obtained by adapting to the 3D preoperative planning software (LEXI Co.) and to data of computer aided design of the bones for determination of the target volume and angle, and the direction of insertion of intramedullary alignment rod and the angles/volumes of ostectomy are preoperatively defined. During operation, quantitative angle and volume estimates are reproduced for confirmation with the specific cooperative jig (Wright Medical Tech. Inc.). The TKA method was applied in 16 knees of 12 female patients (average age, 71 y) with osteoarthritis and was found for its utility and efficacy to be comparative to the method with navigation hitherto. (R.T.)

  6. 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

  7. 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...

  8. Iatrogenic vascular injuries during arthroplasty of the hip.

    Science.gov (United States)

    Alshameeri, Z; Bajekal, R; Varty, K; Khanduja, V

    2015-11-01

    Vascular injuries during total hip arthroplasty (THA) are rare but when they occur, have serious consequences. These have traditionally been managed with open exploration and repair, but more recently there has been a trend towards percutaneous endovascular management. We performed a systematic review of the literature to assess if this change in trend has led to an improvement in the overall reported rates of morbidity and mortality during the last 22 years in comparison with the reviews of the literature published previously. We found a total of 61 articles describing 138 vascular injuries in 124 patients. Injuries because of a laceration were the most prevalent (n = 51, 44%) and the most common presenting feature, when recorded, was bleeding (n = 41, 53.3%). Delay in diagnosis was associated with the type of vascular lesion (p < 0.001) and the clinical presentation (p = 0.002). Open exploration and repair was the most common form of management, however percutaneous endovascular intervention was used in one third of the injuries and more constantly during the last 13 years. The main overall reported complications included death (n = 9, 7.3%), amputation (n = 2, 1.6%), and persistent ischaemia (n = 9, 7.3%). When compared with previous reviews there was a similar rate of mortality but lower rates of amputation and permanent disability, especially in patients managed by endovascular strategies. PMID:26530643

  9. Computed tomography in evaluation of revision hip arthroplasty outcomes.

    Science.gov (United States)

    Kochman, Andrzej; Morawska-Kochman, Monika; Guziński, Maciej; Drobniewski, Marek; Sibiński, Marcin; Synder, Marek

    2014-01-01

    Background. This study aimed to assess contact between Recon Shell reinforcement cages used in revision hip arthroplasty and the bony base. Radiographic examinations were performed with the use of multi-energy computed tomography. Material and methods. We tentatively assess the fixation of Burch-Schneider reinforcement cages (Recon Shell made by Aesculap company) implanted in 10 patients, using two methods of evaluation. An analysis of dual energy CT scans enabled us to assess contact between the reinforcement cages and the bony base. Results. The two methods of evaluation produced different results. The evaluation method based on the division of the acetabular component into a weight-bearing zone and a non-weight-bearing zone (accounting for screw fixation) showed lack of support in the weight-bearing zone in 6 out of 10 cases and direct contact with the implant bed in only one case. The assessment of contact at anchorage holes of reinforcement cages fixed at primary procedures revealed no such support in only one case and the presence of direct contact in 5 cases. There was no correlation between the radiological outcomes and clinical results based on the Harris Hip Score. Conclusions. 1. Multi-energy computed tomography (MARS) is useful in evaluating results of revision hip allo-plasty. 2. The introduction of new imaging techniques for the evaluation of revision procedures demonstrates a need for new, unified methods of outcome assessment adjusted to the characteristics of a particular procedure. PMID:25406920

  10. Anterior knee pain following primary total knee arthroplasty.

    Science.gov (United States)

    Shervin, David; Pratt, Katelyn; Healey, Travis; Nguyen, Samantha; Mihalko, William M; El-Othmani, Mouhanad M; Saleh, Khaled J

    2015-11-18

    Despite improvements in technique and technology for total knee arthroplasty (TKA), anterior knee pain impacts patient outcomes and satisfaction. Addressing the prosthetic and surgical technique related causes of pain after TKA, specifically as it relates to anterior knee pain, can aid surgeons in addressing these issues with their patients. Design features of the femoral and patellar components which have been reported as pain generators include: Improper femoral as well as patellar component sizing or designs that result in patellofemoral stuffing; a shortened trochlear groove distance from the flange to the intercondylar box; and then surgical technique related issues resulting in: Lateral patellar facet syndrome; overstuffed patella/flange combination; asymmetric patellar resurfacing, improper transverse plane component rotation resulting in patellar subluxation/tilt. Any design consideration that allows impingement of extensor mechanism anatomical elements has the possibility of impacting outcome by becoming a pain generator. As the number of TKA procedures continues to increase, it is increasingly critical to develop improved, evidence based prostheses that maximize function and patient satisfaction while minimizing pain and other complications. PMID:26601061

  11. Gonyautoxins: First evidence in pain management in total knee arthroplasty.

    Science.gov (United States)

    Hinzpeter, Jaime; Barrientos, Cristián; Zamorano, Álvaro; Martinez, Álvaro; Palet, Miguel; Wulf, Rodrigo; Barahona, Maximiliano; Sepúlveda, Joaquín M; Guerra, Matias; Bustamante, Tamara; Del Campo, Miguel; Tapia, Eric; Lagos, Nestor

    2016-09-01

    Improvements in pain management techniques in the last decade have had a major impact on the practice of total knee arthroplasty (TKA). Gonyautoxin are phycotoxins, whose molecular mechanism of action is a reversible block of the voltage-gated sodium channels at the axonal level, impeding nerve impulse propagation. This study was designed to evaluate the clinical efficacy of Gonyautoxin infiltration, as a long acting pain blocker in TKA. Fifteen patients received a total dose of 40 μg of Gonyautoxin during the TKA operation. Postoperatively, all patients were given a standard painkiller protocol: 100 mg of intravenous ketoprofen and 1000 mg of oral acetaminophen every 8 hours for 3 days. The Visual Analog Scale (VAS) pain score and range of motion were recorded 12, 36, and 60 hours post-surgery. All patients reported pain of 2 or less on the VAS 12 and 36 hours post-surgery. Moreover, all scored were less than 4 at 60 hours post-surgery. All patients achieved full knee extension at all times. No side effects or adverse reactions to Gonyautoxin were detected in the follow-up period. The median hospital stay was 3 days. For the first time, this study has shown the effect of blocking the neuronal transmission of pain by locally infiltrating Gonyautoxin during TKA. All patients successfully responded to the pain control. The Gonyautoxin infiltration was safe and effective, and patients experienced pain relief without the use of opioids. PMID:27317871

  12. Cost Analysis of Hemiarthroplasty Versus Reverse Shoulder Arthroplasty for Fractures.

    Science.gov (United States)

    Solomon, Jason A; Joseph, Sheeba M; Shishani, Yousef; Victoroff, Brian N; Wilber, John H; Gobezie, Reuben; Gillespie, Robert J

    2016-07-01

    Complex proximal humerus fractures in older patients can be treated with hemiarthroplasty (HA) or reverse shoulder arthroplasty (RSA), with both providing good pain relief and function. This study compared the costs, complications, and outcomes of HA vs RSA after proximal humerus fracture in older patients. Patients 65 years or older who were admitted between January 2007 and August 2011 with a 3- or 4-part proximal humerus fracture and treated with HA or RSA were identified. Surgeries were performed at the same institution by 1 of 3 surgeons trained in trauma or shoulder surgery. Operating room costs, implant costs, total costs to the patient and hospital, and range of motion were compared. In the study group, 8 patients (7 women and 1 man; mean age, 77 years) received HA and 16 patients (13 women and 3 men; mean age, 77 years) received RSA. Hemiarthroplasty implant cost and operating room cost were $9140 and $8900 less than those of RSA, respectively (PRSA (PRSA restored function similar to HA and resulted in better pain and outcome scores. However, RSA had a significantly higher cost to both the patient and the hospital compared with HA. Further investigation of postsurgical rehabilitation costs, skilled nursing needs, or revision surgery will elucidate whether there is long-term functional or financial benefits to RSA over HA. [Orthopedics. 2016; 39(4):230-234.]. PMID:27322171

  13. Comparison of patient and surgeon expectations of total hip arthroplasty.

    Directory of Open Access Journals (Sweden)

    Claire Jourdan

    Full Text Available OBJECTIVES: Analysis of discrepancies between patient and surgeon expectations before total hip arthroplasty (THA should enable a better understanding of motives of dissatisfaction about surgery, but this question has been seldom studied. Our objectives were to compare surgeons' and patients' expectations before THA, and to study factors which affected surgeon-patient agreement. METHODS: 132 adults (mean age 62.8+/-13.7 years, 52% men on waiting list for THA in three tertiary care centres and their 16 surgeons were interviewed to assess their expectations using the Hospital for Special Surgery Total Hip Replacement Expectations Survey (range 0-100. Patients' and surgeons' answers were compared, for the total score and for the score of each item. Univariate analyses tested the effect of patients' characteristics on surgeons' and patients' expectations separately, and on surgeon-patient differences. RESULTS: Surgeon and patient expectations' mean scores were high (respectively 90.9+/-11.1 and 90.0+/-11.6 over 100. Surgeons' and patients' expectations showed no systematic difference, but there was little agreement on Bland and Altman graph and correlation coefficient was low. Patients had higher expectations than surgeons for sports. Patients rated their expectations according to trust in physician and mental quality of life, surgeons considered disability. More disabled patients and patients from a low-income professional category were often "more optimistic" than their surgeons. CONCLUSION: Surgeons and patients often do not agree on what to expect from THA. More disabled patients expect better outcomes than their surgeons.

  14. Acromial and scapular spine fractures after reverse total shoulder arthroplasty.

    Science.gov (United States)

    Mayne, Ian P; Bell, Simon N; Wright, Warwick; Coghlan, Jennifer A

    2016-04-01

    Acromial and scapular spine fractures after reverse total shoulder arthroplasty occur predominantly as a result of bony insufficiency secondary to patient and intra-operative technical factors. The spectrum of the pathology can range from a stress reaction to an undisplaced or displaced fracture. Prompt diagnosis of these fractures requires a high suspicion in the postoperative patient with a clinical presentation of acute onset of pain along the acromion or scapular spine and/or deterioration of shoulder function. Conventional shoulder radiographs are frequently unreliable in identifying these fractures, especially if they are undisplaced. Computed tomography (CT) and/or single photon emission computed tomography/CT scans are useful imaging modalities for obtaining a definitive diagnosis. Early diagnosis and non-operative treatment of a stress reaction or undisplaced fracture is essential for preventing further displacement and potential disability. The management of displaced fractures is challenging for the orthopaedic surgeon as a result of high rates of mal-union or non-union, decreased functional outcomes, and variable results after open reduction and internal fixation. Strategies for preventing these fractures include optimizing the patient's bone health, correct glenoid baseplate screw length and position, and avoiding excessive deltoid tension. Further research is required to identify the specific patient and fracture characteristics that will benefit from conservative versus operative management. PMID:27583005

  15. Fixed or mobile-bearing total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Liau Jiann-Jong

    2007-01-01

    Full Text Available Abstract Fixed and mobile-bearing in total knee arthroplasty are still discussed controversially. In this article, biomechanical and clinical aspects in both fixed and mobile-bearing designs were reviewed. In biomechanical aspect, the mobile-bearing design has proved to provide less tibiofemoral contact stresses under tibiofemoral malalignment conditions. It also provides less wear rate in in-vitro simulator test. Patients with posterior stabilized mobile-bearing knees had more axial tibiofemoral rotation than patients with posterior stabilized fixed-bearing knees during gait as well as in a deep knee-bend activity. However, in clinical aspect, the mid-term or long-term survivorship of mobile-bearing knees has no superiority over that of fixed-bearing knees. The theoretical advantages for mobile-bearing design to provide a long-term durability have not been demonstrated by any outcome studies. Finally, the fixed-bearing design with all-polyethylene tibial component is suggested for relatively inactive, elder people. The mobile-bearing design is suggested for younger or higher-demand patients due to the potential for reduced polyethylene wear and more normal kinematics response after joint replacement. For younger surgeon, the fixed-bearing design is suggested due to less demand for surgical technique. For experienced surgeon, one familiar surgical protocol and instrumentation is suggested rather than implant design, either fixed-bearing or mobile-bearing.

  16. Elbow arthroplasty: where are we today? A narrative review.

    Science.gov (United States)

    Degreef, Ilse

    2016-04-01

    Background The elbow joint is a complex compound articulation, with a linking role within the upper limb kinematics. Its hinge function allows for proper placement of our working instrument (the hand) in the space surrounding us, directed by the shoulder joint. Both reliable mobility and stability are essential elements to allow for consistent bridging of the distance we aim to achieve in common daily activities. Sufficient flexion and extension are required to ensure both the patients' independence and the dignity. Next to the hinge, a radio-ulnar rotation with precise co-operation of forearm and wrist spin enhances the linking function with accurate precision instrument manipulation. Arthritis of the elbow joint or cubarthritis, whether primary or secondary, may not be as highly prevalent as hip or knee arthritis, but its impact on daily live certainly cannot be underestimated. Methods Current treatment options for failing cubarthritis are reviewed. Results Surgical techniques to reconstruct or replace the elbow joint are currently increasingly efficient with mounting long-term outcome reports. Debridement techniques including open or arthroscopic Outerbridge-Kashiwaghi procedure often delays joint replacement. Implants for joint arthroplasty focus on the ulna-humeral joint mostly with semi-constrained linked techniques, but there is a trend towards total joint replacement including the radiocapitellar joint. Conclusion In this independent review article, elbow joint failure due to cubarthritis and an overview of its current state-of-the-art orthopaedic treatment algorithm is presented, with its indications, advantages, risks and outcome.

  17. Ballooning osteolysis in 71 failed total ankle arthroplasties.

    Science.gov (United States)

    Singh, Gurpal; Reichard, Theresa; Hameister, Rita; Awiszus, Friedemann; Schenk, Katja; Feuerstein, Bernd; Roessner, Albert; Lohmann, Christoph

    2016-08-01

    Background and purpose - Aseptic loosening is a major cause of failure in total ankle arthroplasty (TAA). In contrast to other total joint replacements, large periarticular cysts (ballooning osteolysis) have frequently been observed in this context. We investigated periprosthetic tissue responses in failed TAA, and performed an element analysis of retrieved tissues in failed TAA. Patients and methods - The study cohort consisted of 71 patients undergoing revision surgery for failed TAA, all with hydroxyapatite-coated implants. In addition, 5 patients undergoing primary TAA served as a control group. Radiologically, patients were classified into those with ballooning osteolysis and those without, according to defined criteria. Histomorphometric, immunohistochemical, and elemental analysis of tissues was performed. Von Kossa staining and digital microscopy was performed on all tissue samples. Results - Patients without ballooning osteolysis showed a generally higher expression of lymphocytes, and CD3+, CD11c+, CD20+, and CD68+ cells in a perivascular distribution, compared to diffuse expression. The odds of having ballooning osteolysis was 300 times higher in patients with calcium content >0.5 mg/g in periprosthetic tissue than in patients with calcium content ≤0.5 mg/g (p < 0.001). Interpretation - There have been very few studies investigating the pathomechanisms of failed TAA and the cause-effect nature of ballooning osteolysis in this context. Our data suggest that the hydroxyapatite coating of the implant may be a contributory factor.

  18. TOTAL ANKLE ARTHROPLASTY: BRAZILIAN EXPERIENCE WITH THE HINTEGRA PROSTHESIS.

    Science.gov (United States)

    Nery, Caio; Fernandes, Túlio Diniz; Réssio, Cibele; Fuchs, Mauro Luiz; Godoy Santos, Alexandre Leme de; Ortiz, Rafael Trevisan

    2010-01-01

    Ankle arthrosis is becoming more and more common. The search for solutions that preserve joint function has led to a new generation of prosthesis with three components and more degrees of freedom. This paper presents the results achieved for ten patients treated with the HINTEGRA Prosthesis (Integra, New Deal), through collaborative action between the Foot and Ankle Groups of the Orthopedics and Traumatology divisions of Escola Paulista de Medicina, Unifesp, and the School of Medicine of the University of São Paulo (USP). The ten patients (six women and four men, aged between 29 and 66 years), underwent a surgical procedure consisting of Hintermann's technique, between January and June 2005. They were evaluated at prearranged intervals, and the data were subjected to statistical analysis. The surgery led to a significant improvement in ankle mobility. Radiological evaluation showed no signs of loosening or failure in the prosthetic components in any of the patients studied. Although the complication rate in our sample was high, it was equivalent to the rates found by other authors, and directly represents the learning curve associate with this kind of procedure. Four years after the procedure, it was found that the patients pain levels had significantly decreased, and that their functional patterns had significantly improved, with AOFAS and Hintermann scores indicating results that were excellent for 20%, good for 70% and poor for 10%. Treatment of ankle arthritis by means of total arthroplasty using the HINTEGRA prosthesis was capable of providing good results over an average observation period of four years.

  19. Influence of layout parameters on snapback characteristic for a gate-grounded NMOS device in 0.13-μm silicide CMOS technology

    Institute of Scientific and Technical Information of China (English)

    Jiang Yuxi; Li Jiao; Ran Feng; Cao Jialin; Yang Dianxiong

    2009-01-01

    r of the GGNMOS devices under high ESD current stress, and design area-efficient ESD protection circuits to sustain the required ESD level.Optimized layout rules for ESD protection in 0.13-μm silicide CMOS technology are also presented.

  20. A Finite-Element Study of Metal Backing and Tibial Resection Depth in a Composite Tibia Following Total Knee Arthroplasty.

    Science.gov (United States)

    Tokunaga, Susumu; Rogge, Renee D; Small, Scott R; Berend, Michael E; Ritter, Merrill A

    2016-04-01

    Prosthetic alignment, patient characteristics, and implant design are all factors in long-term survival of total knee arthroplasty (TKA), yet the level at which each of these factors contribute to implant loosening has not been fully described. Prior clinical and biomechanical studies have indicated tibial overload as a cause of early TKA revision. The purpose of this study was to determine the relationship between tibial component design and bone resection on tibial loading. Finite-element analysis (FEA) was performed after simulated implantation of metal backed (MB) and all-polyethylene (AP) TKA components in 5 and 15 mm of tibial resection into a validated intact tibia model. Proximal tibial strains significantly increased between 13% and 199% when implanted with AP components (p < 0.05). Strain significantly increased between 12% and 209% in the posterior tibial compartment with increased bone resection (p < 0.05). This study indicates elevated strains in AP implanted tibias across the entirety of the proximal tibial cortex, as well as a posterior shift in tibial loading in instances of increased resection depth. These results are consistent with trends observed in prior biomechanical studies and may associate the documented device history of tibial collapse in AP components with increased bone strain and overload beneath the prosthesis. PMID:26810930

  1. Ferroelectric devices

    CERN Document Server

    Uchino, Kenji

    2009-01-01

    Updating its bestselling predecessor, Ferroelectric Devices, Second Edition assesses the last decade of developments-and setbacks-in the commercialization of ferroelectricity. Field pioneer and esteemed author Uchino provides insight into why this relatively nascent and interdisciplinary process has failed so far without a systematic accumulation of fundamental knowledge regarding materials and device development.Filling the informational void, this collection of information reviews state-of-the-art research and development trends reflecting nano and optical technologies, environmental regulat

  2. Evaluation of Hallux Interphalangeal Joint Arthroplasty Compared With Nonoperative Treatment of Recalcitrant Hallux Ulceration.

    Science.gov (United States)

    Lew, Eric; Nicolosi, Nicole; McKee, Patrick

    2015-01-01

    Patients with chronic diabetes can develop plantar hallux ulcerations secondary to neuropathy, increased pressure, and deformity. The present retrospective study evaluated the efficacy of hallux interphalangeal joint (HIPJ) arthroplasty to address recalcitrant ulceration. Two groups of patients with diabetes were compared: a surgical group of 13 patients and a nonsurgical standard therapy group of 13 patients. The patients in the surgical group underwent HIPJ arthroplasty. All the patients in the standard therapy group received local wound care and offloading. The mean duration of follow-up was 19.5 (range 1.2 to 47.9) months, and the mean age was 55 ± 13.0 years. Statistical significance was found in the surgical group for faster time to healing (3.5 weeks [2.5, 4.25] vs 9 weeks [2, 17.29], p = .033) and lower incidence of ulcer recurrence (8% ± 7.69 vs 54% ± 53.85, p = .031). There were also fewer amputations in the surgical group (0% ± 0 vs 38% ± 38.6, p = .063). To our knowledge, only 1 other published study has evaluated HIPJ arthroplasty as a treatment of recalcitrant hallux ulceration. The present study adds comparison data from a nonoperative standard therapy group and found that HIPJ arthroplasty is an effective curative treatment option to address chronic plantar hallux ulcerations in diabetic patients with neuropathy.

  3. Physical functioning before and after total hip arthroplasty : Perception and performance

    NARCIS (Netherlands)

    van den Akker-Scheek, Inge; Zijlstra, Wiebren; Groothoff, Johan W.; Bulstra, Sjoerd K.; Stevens, Martin

    2008-01-01

    Background and Purpose. Self-report and performance-based measures of physical functioning in people before and after total hip arthroplasty seem to present different information. The relationship between these different measures is not well understood, and little information is available about chan

  4. Physical Activity Participation Among Patients After Total Hip and Knee Arthroplasty

    NARCIS (Netherlands)

    Stevens, Martin; Reininga, Inge H. F.; Bulstra, Sjoerd K.; Wagenmakers, Robert; van den Akker-Scheek, Inge

    2012-01-01

    Total hip (THA) and knee arthroplasty (TKA) are successful operative interventions, yet little is known about the physical activity behavior of patients after THA/TKA. For older adults, there are beneficial effects of regular physical activity after THA/TKA. The objective of this paper is to review

  5. Habitual physical activity behavior of patients after primary total hip arthroplasty

    NARCIS (Netherlands)

    Wagenmakers, Robert; Stevens, Martin; Zijlstra, Wiebren; Jacobs, Monique L.; van den Akker-Scheek, Inge; Groothoff, Johan W.; Bulstra, Sjoerd K.

    2008-01-01

    Background and Purpose. Despite recognized health benefits of physical activity, little is known about the habitual physical activity behavior of patients after total hip arthroplasty (THA). The purpose of this study was to analyze this behavior and the fulfillment of guidelines for health-enhancing

  6. The use of postoperative suction drainage in total knee arthroplasty: a systematic review.

    LENUS (Irish Health Repository)

    Quinn, Mark

    2014-07-16

    The purpose of this systematic review and meta-analysis of randomised controlled trials is to assess the effectiveness of no drainage when compared to drainage in total knee arthroplasty, in terms of recovery of knee flexion, reduction in swelling, length of hospital stay and haemoglobin levels following TKA.

  7. Groningen orthopaedic exit strategy : Validation of a support program after total hip or knee arthroplasty

    NARCIS (Netherlands)

    van den Akker-Scheek, Inge; Zijlstra, Wiebren; Groothoff, Johan W.; van Horn, Jim R.; Bulstra, Sjoerd K.; Stevens, Martin

    2007-01-01

    Objective: Validation of the program theory of the Groningen orthopaedic exit strategy (GOES), a theory-driven program aiming to improve the rehabilitation of total hip and knee arthroplasty patients after shortened hospital stay. First part of the program theory is the action theory, hypothesising

  8. Similar range of motion and function after resurfacing large-head or standard total hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Varmarken, Jens-Erik;

    2013-01-01

    BACKGROUND AND PURPOSE: Large-size hip articulations may improve range of motion (ROM) and function compared to a 28-mm THA, and the low risk of dislocation allows the patients more activity postoperatively. On the other hand, the greater extent of surgery for resurfacing hip arthroplasty (RHA) c...

  9. Smith-Petersen Vitallium mould arthroplasty: a 62-year follow-up.

    LENUS (Irish Health Repository)

    Baker, J F

    2011-09-01

    A variety of materials were used for early hip prostheses. The introduction of Vitallium by Smith-Petersen represented a further advance in this surgical field. We present the longest known follow-up of a Smith-Petersen Vitallium mould arthroplasty.

  10. Combined Intra-Articular and Intravenous Tranexamic Acid Reduces Blood Loss in Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Jans, Øivind; Ørsnes, Thue;

    2016-01-01

    BACKGROUND: In total knee arthroplasty, both intravenous (IV) and intra-articular (IA) administration of tranexamic acid (TXA) have been shown to reduce blood loss in several randomized controlled trials, although routine use of systemic TXA is considerably more common. However, to our knowledge...

  11. Solid organ transplant patients experience high rates of infection and other complications after total knee arthroplasty.

    Science.gov (United States)

    Klatt, Brian A; Steele, G Daxton; Fedorka, Catherine J; Sánchez, Alvaro I; Chen, Antonia F; Crossett, Lawrence S

    2013-06-01

    Survival after solid organ transplants in the United States is increasing, and there is a need to understand the complications in knee arthroplasty patients who underwent organ transplantation. A retrospective study was conducted from 1993-2008 on 19 patients (23 knee arthroplasties) with previous successful solid organ transplants. Eleven knee arthroplasties were performed after renal transplantation, and 12 after nonrenal solid organ transplant (seven liver, four heart, one lung). Complications occurred in 9/23 patients (39.1%) and infections occurred in 4/23 patients (17.3%). Of the infected knees, two had MRSA, one had MSSA, and one Escherichia coli. Noninfectious complications (5/24, 21.7%) include aseptic loosening, quadriceps rupture, femoral fracture, hemarthrosis, and arthrofibrosis. All patients with complications were on immunosuppressant medications at the time of arthroplasty. There was a significantly higher rate of infection in the renal group compared to the non-renal group (P = 0.022). There was also a higher overall complication rate in the renal group however this did not reach significance. PMID:23558242

  12. Can total wrist arthroplasty be an option in the treatment of the severely destroyed posttraumatic wrist?

    DEFF Research Database (Denmark)

    Boeckstyns, Michel E H; Herzberg, Guillaume; Sørensen, Allan Ibsen;

    2013-01-01

    Background Severely destroyed posttraumatic wrists are usually treated by partial or total wrist fusion or proximal row carpectomy. The indications for and longevity of total wrist arthroplasty (TWA) are still unclear. Case Description The aim of this study was to analyze a series in which one la...

  13. Imaging of ceramic liner fractures in total hip arthroplasty: the value of CT

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Yoshimi; Mintz, Douglas N. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States); Renner, Lisa; Schmidt-Braekling, Tom; Boettner, Friedrich [Hospital for Special Surgery, Adult Reconstruction and Joint Replacement Division, New York, NY (United States)

    2015-08-15

    Fracture of a ceramic liner of a total hip arthroplasty is rare and is radiographically occult if not displaced. We report on two patients in whom ceramic liner fracture was radiographically occult but was diagnosed on subsequent CT scan through appropriate windowing. (orig.)

  14. Periarticular regional analgesia in total knee arthroplasty: a review of the neuroanatomy and injection technique.

    Science.gov (United States)

    Guild, George N; Galindo, Rubin P; Marino, Joseph; Cushner, Fred D; Scuderi, Giles R

    2015-01-01

    Postoperative pain control after total knee arthroplasty may be insufficient, resulting in insomnia, antalgic ambulation, and difficulty with rehabilitation. Current strategies, including the use of femoral nerve catheters, may control pain but have been associated with falls, motor blockade, and quadriceps inhibition. Periarticular infiltration using the appropriate technique and knowledge of intraarticular knee anatomy may increase pain control and maximize rehabilitation. PMID:25435030

  15. Bipolar hip arthroplasty for avascular necrosis of femoral head in young adults

    Directory of Open Access Journals (Sweden)

    Baldev Dudani

    2015-01-01

    Conclusion: Bipolar hip arthroplasty (BHA using tight fitting cup and acetabular reaming in AVN hip has a low incidence of groin pain, acetabular erosion and revision in midterm followup. Good outcome and mid term survival can be achieved irrespective of the Ficat Stage.

  16. Bone mineral density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim;

    2010-01-01

    Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position....

  17. Biomechanical analysis of posterior cruciate ligament retaining high-flexion total knee arthroplasty

    NARCIS (Netherlands)

    Zelle, J.; Zanden, van der A.C.; De Waal Malefijt, M.; Verdonschot, N.

    2009-01-01

    Background High-flexion knee replacements have been developed to accommodate a large range of flexion (>120°) after total knee arthroplasty. Both posterior cruciate ligament retaining and sacrificing high-flexion knee designs have been marketed. The main objective of this study was to evaluate the b

  18. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders;

    2014-01-01

    supervised neuromuscular exercise prior to total joint arthroplasty (TJA) of the hip or knee did not confer additional benefits 3 months postoperatively compared with TJA alone. However, the intervention group experienced a statistically significant short-term benefit in ADL and pain, suggesting an earlier...

  19. Total joint arthroplasty in nonagenarians--a retrospective review of complications and resource use.

    LENUS (Irish Health Repository)

    Baker, Joseph F

    2012-12-01

    Increased age brings with it the potential for increased surgical risk. Assessment of specific age cohorts is necessary to plan future service provision and this is the case in hip and knee arthroplasty as the demand for these procedures is anticipated to increase. We retrospectively reviewed the outcomes, including complications, length of stay and blood transfusion rate, in a cohort of 35 nonagenarians undergoing primary or revision total hip and knee arthroplasty. All patients were pre-assessed by anaesthetists before being deemed suitable to undergo surgery in the unit. The mean length of hospital stay was 13.7 +\\/- 10 days (range 2-56). Thirty-one percent of patients required a blood transfusion. Patients who underwent primary total hip arthroplasty reported improved joint specific functional scores. In this appropriately selected group of nonagenarians, we found no evidence to suggest surgery be withheld on the basis of age alone. However, patients with multiple medical comorbidities warrant appropriate assessment and surgical intervention in an institution with appropriate support. Future planning needs to take into account the predicted increase in demand for arthroplasty surgery in this age group.

  20. Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomised trial

    DEFF Research Database (Denmark)

    Turpie, Alexander G G; Lassen, Michael R; Davidson, Bruce L;

    2009-01-01

    BACKGROUND: Prophylaxis for venous thromboembolism is recommended for at least 10 days after total knee arthroplasty; oral regimens could enable shorter hospital stays. We aimed to test the efficacy and safety of oral rivaroxaban for the prevention of venous thromboembolism after total knee arthr...

  1. Outcome assessment of total hip arthroplasty in The Netherlands and Sweden

    NARCIS (Netherlands)

    Ostendorf, Marieke

    2004-01-01

    From the studies described in this thesis, investigating different aspects of outcome assessment in total hip arthroplasty, the following conclusions and recommendations can be made: To ensure good quality of life and adequate mobility for future elderly generations, adequate measures need to be ta

  2. Formation of a pseudotumor in total hip arthroplasty using a tribological metal–polyethylene pair☆

    Science.gov (United States)

    Fagotti, Lorenzo; Vicente, José Ricardo Negreiros; Miyahara, Helder Souza; de Oliveira, Pedro Vitoriano; Bernabé, Antônio Carlos; Croci, Alberto Tesconi

    2015-01-01

    The aim here was to report a case of a young adult patient who evolved with tumor formation in the left thigh, 14 years after revision surgery on hip arthroplasty. Davies in 2005 made the first description of this disease in patients undergoing metal-on-metal hip arthroplasty. Over the last decade, however, pseudotumors around metal-on-polyethylene surfaces have become more prevalent. Our patient presented with increased volume of the left thigh 8 years after hip arthroplasty revision surgery. Two years before the arising of the tumor in the thigh, a nodule in the inguinal region was investigated to rule out a malignant neoplastic process, but the results were inconclusive. The main preoperative complaints were pain, functional limitation and marked reduction in the range of motion of the left hip. Plain radiographs showed loosening of acetabular and femoral, and a large mass between the muscle planes was revealed through magnetic resonance imaging of the left thigh. The surgical procedure consisted of resection of the lesion and removal of the components through lateral approach. In respect of total hip arthroplasty, pseudotumors are benign neoplasms in which the bearing surface consists of metal-on-metal, but they can also occur in different tribological pairs, as presented in this case. PMID:27218090

  3. Review of quality of x-rays for templating for total hip arthroplasty.

    Science.gov (United States)

    Khan, Faiz; Ahmad, Tayyab; Condon, Finbarr; Lenehan, Brian

    2015-03-01

    Digital templating of x-rays for total hip arthroplasty is used routinely for pre-operative planning. This is to assure that appropriately sized implants are selected to replicate patient's hip biomechanics. Multiple studies have shown that templating does not always correspond to the final implants used. The aim of this study was to assess the suitability of the x-rays taken pre-operatively for templating for total hip arthroplasty. We undertook a review of a series of pre-operative templating pelvis x-rays in 100 consecutive patients undergoing total hip arthroplasty. These x-rays were compared against set criteria to determine their suitability for use for templating. We determined that six x-rays met the criteria whereas ninety four x-rays did not meet the criteria for suitable x-rays. Twenty patients had repeat x-rays. The reasons for unsuitability were inadequate opposite femur (66%), absence or incomplete template (54%), inadequate femur length (47%), external rotation (39%), absence of opposite hip (4%). The twenty repeated x-rays were also reviewed for the same parameters and two (10%) satisfied the established criteria. It is imperative that x-rays for templating for total hip arthroplasty are done to a strict standard to obtain an x-ray that is appropriate for templating and there is minimal exposure of the patient to irradiation.

  4. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Science.gov (United States)

    2011-01-01

    Background Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient. PMID:21995682

  5. Mobile-bearing total ankle arthroplasty : a fundamental assessment of the clinical, radiographic and functional outcomes

    NARCIS (Netherlands)

    Doets, Hendrik Cornelis

    2009-01-01

    Ankle arthritis often leads to significant impairments for the patient. As total ankle arthroplasty (TAA) with use of fixed-bearing (2-component) total ankle prostheses has a high rate of early failures, fusion of the ankle joint is, until today, considered to be the standard surgical treatment for

  6. Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

    Directory of Open Access Journals (Sweden)

    Hintermann Beat

    2011-10-01

    Full Text Available Abstract Background Simultaneous osteoarthritis (OA of the ankle joint complicates primary total knee arthroplasty (TKA. In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week and hospital stay (12 days of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

  7. Which Are the Most Frequently Used Outcome Instruments in Studies on Total Ankle Arthroplasty?

    Science.gov (United States)

    Impellizzeri, Franco M.; Rippstein, Pascal F.

    2009-01-01

    The number of studies reporting on outcomes after total ankle arthroplasty is continuously increasing. As the use of valid outcome measures represents the cornerstone for successful clinical research, we aimed to identify the most frequently used outcome instruments in ankle arthroplasty studies and to analyze the evidence to support their use in terms of different quality criteria. A systematic review of the literature identified 15 outcome instruments reported in 79 original studies. The most commonly used measures were the American Orthopaedic Foot and Ankle Society hindfoot score (n = 41), the Kofoed ankle score (n = 21), a visual analog scale assessing pain (n = 15), and the generic SF-36 (n = 6). Eight additional instruments were used only once or twice. The American Orthopaedic Foot and Ankle Society and Kofoed instruments include a clinical examination and score up to 100 points. Evidence to support their use in terms of validity, reliability, responsiveness, and interpretability is limited, raising the question whether their use is justified. Self-reported questionnaires related to ankle osteoarthritis or arthroplasty are rather disregarded in the current literature, and only the Foot Function Index is associated with evidence in terms of the above-mentioned quality criteria. Future research is warranted to improve the outcome assessment after total ankle arthroplasty. PMID:19672670

  8. Pre-Operative Patient Education is Associated With Decreased Risk of Arthrofibrosis After Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Livbjerg, Anna Emilie; Frøkjær, Sara; Simonsen, Ole;

    2013-01-01

    The purpose was to investigate risk factors for postoperative stiffness and long-term outcome following manipulation under anaesthesia (MUA). In one of the five Danish regions, all patients in a 4-year period who received MUA following total knee arthroplasty (N=36) were included in two case-cont...

  9. Influence assessment of the of passive restraint system devices of the passenger locomotive on its dynamic loading during accidenton the railroad

    Directory of Open Access Journals (Sweden)

    N.E.Naumenko

    2013-02-01

    Full Text Available The purpose. To evaluate the work of passenger locomotive protective devices in the test scenarios of collisions adopted in the Russian requirements to the passive safety system. Methodology. Minimization of the effects of incident collisions is done by inclusion of the passive safety devices designed to absorb the kinetic energy of collision in the car bodies bearing constructions. To estimate the maximum accelerations of the train, as well as the compressing longitudinal forces arising in the intercar connection during collisions the discrete mass model of the train is used. Interaction of the train cars was simulated by introducing intercar connections. Findings. At collision of a locomotive at 20 km/h speed (both in separate and in standard train, which does not have a passive safety system, with a vehicle of 10 tones weight the plastic deformations in the locomotive structural elements are observed. At collision of a locomotive with a vehicle, which a mass is comparable to the mass of the loaded car, the plastic deformations in the locomotive structural elements occur at the 10 km/h speed of collision. Originality. It is shown that to decrease the maximum longitudinal force occurring between the locomotive and an obstacle like a freight car of 80 tons mass to the standard value it is necessary to equip the end parts of locomotive with safety devices, which deformation is about 1.5 m. Practical value. To preserve the car structures integrity and passengers, staff and locomotive brigade safety at the incident collisions, a new generation passenger locomotives have to be equipped with the passive safety system devices. On this basis, it is necessary to conduct further researches in the field of passive safety systems for carriages.

  10. Influence of the Properties of Conductive Adhesive on Delamination of the Devices%导电胶性能对器件分层的影响

    Institute of Scientific and Technical Information of China (English)

    石海忠; 张学兵; 张蓓蓓; 聂蕾

    2011-01-01

    近年来客户对器件可靠性要求越来越高,而分层对可靠性的影响至关重要。跟分层密切相关的两种主要封装材料分别为塑封料和导电胶,文中重点对LQFP类导电胶进行性能比较、分层试验和相关性分析,明确了导电胶的相关性能对器件分层的影响程度,从而选择合适的导电胶来改善和提高器件的可靠性。%The customers are having higher and higher reliability requirements on devices in recent years. Delamination is critical to the reliability and two main assembly materials, molding compound and conductive adhesive are closely related to the delamination. This article elaborates the property comparisons of the conductive adhesive of LQFP package, delamination evaluations and correlativity analysis between them, definitude influece of the properties of conductive adhesive on delamination of the devices in order to select a proper conductive adhesive to improve and enhance the reliability of the devices.

  11. Ligament reconstruction with tendon interposition arthroplasty for first carpometacarpal joint osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    Yang Yong; Huey Y.Tien; Kannan K.Kumar; Chen Shanlin; Li Zhongzhe; Tian Wen; Tian Guanglei

    2014-01-01

    Background Ligament reconstruction tendon interposition (LRTI) is the most commonly performed surgical procedure for first carpometacarpal joint osteoarthdtis.The purpose of this study was to examine the radiographic and clinical outcomes of LRTI arthroplasty and document the clinical results based on metacarpal subsidence.Methods From January 2008 to January 2011,19 patients (21 thumbs) underwent surgery for thumb carpometacarpal arthritis using ligament reconstruction tendon interposition arthroplasty with flexor carpi radialis (FCR) in Kleinert Kutz Hand Care Center of Louisville University,USA.The follow-up period was an average of 13.9 months.Pain,grip strength,tip pinch strength,range of motion,and radiographic measurements were recorded.Based on first metacarpal subsidence,the cases were classified in to mild,moderate,and severe.Clinical outcomes of the groups were evaluated and compared.Results Grip strength improved from 18.6 kg to 20.5 kg,and tip pinch strength increased from 4.4 kg to 4.5 kg after the surgery.Radial abduction and palmar abduction improved after surgery.Radial abduction increased from 55.7° to 60.6° and palmar abduction improved from 56.7° to 63.5° after the procedure.Visual analogue scores (VAS) were significantly reduced,from 6.6 to 0.5.Compared with the preoperative radiographs the first metacarpal had subsided about 54.6% of the arthroplasty space.The height of arthroplasty space and index of the arthroplasty space significantly decreased from 12.4 mm to 5.6 mm and from 0.27 to 0.12 respectively.Between the various groups (mild,moderate and severe metacarpal subsidence),there was no difference in grip strength,tip pinch strength,thumb range of motion,and VAS.Conclusions Ligament reconstruction tendon interposition arthroplasty resulted in excellent relief of pain and increase in range of motion.However,LRTI cannot maintain the arthroplasty space.Compared with the preoperative radiographs,the metacarpal subsided more than 50

  12. Bipolar hip arthroplasty as salvage treatment for loosening of the acetabular cup with significant bone defects

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2016-04-01

    Full Text Available Introduction: Revision arthroplasty of the hip is becoming increasingly important in recent years. Early primary arthroplasty and longer life expectancy of the patients increases the number of revision surgery. Revision surgery of hip arthroplasty is major surgery for the patients, especially the elderly, with significant risks concerning the general condition of the patient. The aim of this work is to evaluate the outcome of bipolar hip arthroplasty as a salvage procedure for treatment of loosening of the acetabular cup with significant acetabular bone defects after total hip replacement (THR in multi-morbid patients.Patients and methods: During the period from January 1 2007 to December 31 2011 19 revision hip surgeries were performed in , in which the loosened acetabular cup was replaced by a bipolar head. The examined patient group consisted exclusively of female patients with an average of 75 years. The predominant diagnosis was “aseptic loosening” (84.2%. All patients in our study were multi-morbid. We decided to resort to bipolar hip arthroplasty due to the compromised general condition of patients and the major acetabular bone defects, which were confirmed intraoperatively. The postoperative follow-up ranged from 0.5 to 67 months (average 19.1 months. Results: Evaluation of the modified Harris Hip Score showed an overall improvement of the function of the hip joint after surgery of approximately 45%.Surgery was less time consuming and thus adequate for patients with significantly poor general health condition. We noticed different complications in a significant amount of patients (68.4%. The most common complication encountered was the proximal migration of the bipolar head.The rate of revision following the use of bipolar hip arthroplasty in revision surgery of the hip in our patients was high (21%. Despite the high number of complications reported in our study, we have noticed significant improvement of hip joint function as well

  13. Effects of Tourniquet Release on Total Knee Arthroplasty.

    Science.gov (United States)

    Tie, Kai; Hu, Dongcai; Qi, Yongjian; Wang, Hua; Chen, Liaobin

    2016-07-01

    This study investigated the clinical outcomes of early and late tourniquet release (tourniquet release after cementing the prosthesis vs tourniquet release after wound closure and pressure dressing) in total knee arthroplasty (TKA). The study was conducted by searching PubMed, Embase, Web of Science, and Cochrane Central databases for articles on randomized controlled trials comparing early and late tourniquet release in primary TKA that were published from 1966 to March 2015. Relevant data were extracted, and the Physiotherapy Evidence Database (PEDro) Scale was used to assess the methodologic quality. Stata software (StatCorp, College Station, Texas) was used to perform a meta-analysis. Sixteen articles were included with a total of 1073 patients and 1097 knees. For blood loss, there were no significant differences between the 2 groups in calculated blood loss, decrease in hemoglobin level, drop in hematocrit level, and measured postoperative blood loss, although total measured blood loss and postoperative blood transfusion rate were significantly higher in the early tourniquet release group than in the late tourniquet release group. No statistical differences were found for operative time and incidence of deep venous thrombosis (DVT) between the 2 groups. Wound complication rate in the early tourniquet release group was significantly lower than in the late tourniquet release group. Primary TKA with early tourniquet release is similar to TKA with late tourniquet release regarding perioperative blood loss, operative time, and incidence of DVT. Early tourniquet release reduced the incidence of wound complications compared with late tourniquet release. [Orthopedics. 2016; 39(4):e642-e650.]. PMID:27286051

  14. 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.

  15. 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

  16. Total Knee Arthroplasty in Patients With Valgus Deformity

    Directory of Open Access Journals (Sweden)

    Mahmoud Jabalameli

    2016-05-01

    Full Text Available Background Valgus deformity (more than 10° valgus on anatomical measurement is seen in about 10% of patients undergoing total knee arthroplasty (TKA. Valgus deformity is a challenge for the surgeons both for gap balancing and constraint choice. Objectives The aim of this study was to describe a surgical technique to perform TKA in valgus knee. Patients and Methods We retrospectively reviewed 32 primary TKA in 27 patients (25 females and 2 males, with valgus knee deformity performed since 2006 to 2014. All procedures have been done by the senior author. In the balancing stage of each procedure, the iliotibial band has been released completely in the first step, and then step by step pie crusting of other lateral structures has been done as needed. Preoperative and postoperative data were obtained retrospectively through chart review and review of radiographs. All patients were clinically examined by the senior author. Preoperative and postoperative knee society scores (KSSs and functional knee society score (functional KSS were obtained accordingly. Results The patients had an average age of 68 years (range, 52 - 83 years with an average postoperative follow-up period of 47.5 months (range, 12 - 100 months. The average KSS improved significantly postoperatively from 42 (range, 20 - 69 to 90 (range, 67 - 99 (P < 0.0001. The average functional KSS improved significantly (P < 0.0001 from 51.4 (range, 35 - 70 to 85.5 (range, 45 - 100 during follow-up. An average preoperative range of motion also improved by 15.6 degrees during the last follow-up visit (P < 0.001. We had no complication in our patients. Conclusions The results of our study show that complete release of the iliotibial band and step by step pie-crusting of other lateral structures correct valgus deformities in a safe and simple manner with high success rate and less constrained prosthesis.

  17. Salvage of infected total knee arthroplasty with Ilizarov external fixator

    Directory of Open Access Journals (Sweden)

    Venkata Gurava Reddy

    2011-01-01

    Full Text Available Background: Knee arthrodesis may be the only option of treatment in cases of chronic infected total knee arthroplasty (TKA with concomitant irreparable extensor mechanism disruption, extensive bone loss or severe systemic morbidities. Circular external fixation offers possible progressive adjustment to stimulate the bony fusion and to make corrections in alignment. We evaluated the results of knee arthrodesis with one or two stage circular external fixator for infected TKA. Materials and Methods: 16 cases of femoro-tibial fusion were retrospectively evaluated. Male-to-female ratio was 10:6. Mean age of the patients was 62.2 years. Cierney-Mader classification was used for anatomical and physiological evaluation while the bone stock deficiency was classified into mild, moderate and severe. Surgical technique involved either single or two stage arthrodesis using circular external fixator. Results: Union was achieved in 15 patients (93.75%. The mean duration for union (frame application time in these patients was 28.33 weeks (range 22 to 36 weeks. Analysis showed that in the group with frame application time of less than 28 weeks, the incidence of mild to moderate bone deficiency was 83.33%, while in the frame application time more than 28 weeks group the incidence was 20% (P-value 0.034. Similarly the incidence of Cierney-Mader 4B (Bl, Bs, Bls was found to be 33.33% in the group of frame application time of less than 28 weeks, while it was 90% in the group with frame application time more than 28 weeks (P-value 0.035. Conclusion: Circular external fixator is a safe and reliable method to achieve knee arthrodesis in cases of deep infection following TKA. Severe bone stock deficiency and Cierney- Mader type B host are likely risk factors for prolonged frame application time. We recommend a two-stage procedure especially when there is compromised host or severe bone loss.

  18. 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.

  19. Short-Term Results of Medial Unicondylar Knee Arthroplasty

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    Murat Yılmaz

    2014-09-01

    Full Text Available Aim: This study aimed to determine the short-term clinical and radiologic results of medial unicondylar knee arthroplasty (UKA. Methods: We retrospectively evaluated hospital records of eight patients who have undergone Oxford phase-3 medial UKA between 2011 and 2013. We included seven patients (two males and five females in the study. The mean age of the patients was 63 years and the mean follow-up period was 17 months. The patients underwent UKA with the Oxford phase 3 cemented mobile insert unicondylar prosthesis using minimally invasive surgery technique. The patients were assessed preoperatively, postoperatively and at final controls according to the Knee Society’s clinical and Functional Scoring system (KSS. The mean anatomic tibiofemoral angle was measured preoperatively and postoperatively and any complication was recorded. Results: The mean knee score according to the KSS was 37.50 preoperatively and was 90.75 at the final follow-up; the mean function score according to the KSS was 31.88 preoperatively and was 93.12 at the final follow-up. The mean anatomic tibiofemoral angle was improved from 4.37 degree varus to 4.75 degree valgus. There was no complication in any patient except one with superficial infection who was treated by simply antibiotic treatment. Conclusion: UKA is a favorable surgical technique for appropriately selected patients with medial unicompartmental knee osteoarthritis. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 191-4

  20. Epidemiology of Total Ankle Arthroplasty: Trends in New York State.

    Science.gov (United States)

    Seaworth, Christine M; Do, Huong T; Vulcano, Ettore; Mani, Sriniwasan B; Lyman, Stephen L; Ellis, Scott J

    2016-05-01

    The rate of total ankle arthroplasty (TAA) is increasing in the United States as its popularity and indications expand. There currently is no national joint registry available to monitor outcomes, and few studies have addressed the challenges faced with TAA. The purpose of this study was to evaluate the incidence, complications, and survival rates associated with TAA using a large statewide administrative discharge database. Individuals who underwent primary TAA from 1997 to 2010 were identified in the Statewide Planning and Research Cooperative System database from the New York State Department of Health. The age, sex, comorbidities, state of residence, primary diagnosis, and readmissions within 90 days were analyzed for patients with an ICD-9-CM procedure code of 81.56 (TAA). Failure of a TAA implant was defined as revision, tibiotalar arthrodesis, amputation, or implant removal. During the 14-year period, 420 patients underwent 444 TAAs (mean patient age of 61 years, 59% women, mean Charlson-Deyo comorbidity score of 0.45, and 86% New York State residents). The primary diagnosis was 37.4% osteoarthritis, 34.3% traumatic arthritis, and 15.5% rheumatoid arthritis. Surgery for failure was associated only with a younger age (56.5 vs 62 years, P=.005). The rate of subsequent failure procedures following TAAs performed in New York State was 13.8%. The incidence of TAAs is steadily increasing. The overall survival rate in New York State is better than rates reported in other national registries, but it is not yet comparable to those of hip and knee replacements. [Orthopedics. 2016; 39(3):170-176.]. PMID:27135448