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Sample records for artificial disc arthroplasty

  1. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; ZHOU Fei-fei; LIU ZHONG-jun

    2013-01-01

    Background Cervical disc arthroplasty is an alternative surgery to standard cervical decompression and fusion for disc degeneration.Different types of cervical disc prosthesis are used in China.The aim of this study was to evaluate the radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.Methods Radiographic evaluation,including static and dynamic flexion-extension lateral images,was performed at baseline and at final follow-up.Results Twenty six patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 63 months (56-76 months).The range of motion at the operated level was 9.3°±3.7° at baseline and 7.3°±3.5° at final follow-up,with a significant difference (P <0.05).Seventeen of 26 levels (65.4%) developed heterotopic ossification:three were classified as grade Ⅱ,13 were classified as grade Ⅲ,and 1 as grade Ⅳ,according to McAfee's classification.Forty nine adjacent segments were evaluated by lateral Ⅹ-ray and 18 (36.7%) segments developed adjacent segment degenerations.Conclusions ProDisc-C arthroplasty had acceptable radiographic results at 5-year follow-up.The range of motion was preserved.However,more than 60% of the patients developed heterotopic ossification.

  2. 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...

  3. Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study

    Institute of Scientific and Technical Information of China (English)

    TIAN Wei; HAN Xiao; LIU Bo; LI Qin; HU Lin; LI Zhi-yu; YUAN Qiang; HE Da; XING Yong-gang

    2010-01-01

    Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years (range from 29 to 73). The median follow-up was 41.85months (range from 36.00-55.63 months). Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association (JOA) score was 14.0 before surgery, and 16.5 at the most recent follow-up (P <0.01). The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion (ROM) at the indexed level was (10.40±4.97)°, which has significantly correlated with the most recent follow-up ROM which was (8.56±4.76)° (P <0.05, r=0.33). The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of (7.52±3.37)° (P <0.05). The preoperative functional spinal unit (FSU) angulation was (-0.96±6.52)°, which was not significantly correlated with that of the most recent follow-up value of (-2.65±7.95)° (P <0.01, r=0.53). The preoperative endplate angulation was (2.61±4.85)°, which had no significant correlation with that of the most recent follow-up value of (0.71±6.41)° (p >0.05).Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical spine are well

  4. 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 ...

  5. Bryan total disc arthroplasty: a replacement disc for cervical disc disease

    OpenAIRE

    Markus Wenger; Thomas-Marc Markwalder

    2010-01-01

    Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthes...

  6. Bryan total disc arthroplasty: a replacement disc for cervical disc disease

    Directory of Open Access Journals (Sweden)

    Markus Wenger

    2010-07-01

    Full Text Available Markus Wenger1, Thomas-Marc Markwalder21Neurosurgery, Klinik Beau-Site and Salem-Spital, Berne, Switzerland; 2Attending Neurosurgeon FMH, Private Practice Spine Surgery, Berne-Muri, SwitzerlandAbstract: Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthesis, its indications, surgical technique, complications, and outcomes, as given in the literature.Keywords: cervical spine, degenerative disc disease, disc herniation, myelopathy, spine surgery, bryan prosthesis, complication, outcome

  7. 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...

  8. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... problems in up to date but this new technology with the use of an artificial disc has ... patients for many, many. Prior to this new technology, we would take out that disc and then ...

  9. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... spine problems in up to date but this new technology with the use of an artificial disc ... of patients for many, many. Prior to this new technology, we would take out that disc and ...

  10. The Research of Artificial Cervical Disc Replacement

    Institute of Scientific and Technical Information of China (English)

    Zhao Zhua; Qiang Shenb

    2008-01-01

    Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. It develops quickly during recent years. Currently there are several cervical arthroplasty devices. Each device varies in terms of materials, range of motion and constraint. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses as well as discussing issues regarding indications and technique. It is hoped that an improvement of cervical arthroplasty occurs in terms of materials and design as spinal surgeons enter a new dines of the management of cervical spine disease.

  11. The artificial disc: theory, design and materials.

    Science.gov (United States)

    Bao, Q B; McCullen, G M; Higham, P A; Dumbleton, J H; Yuan, H A

    1996-06-01

    Low back pain is one of the most common medical conditions in the Western world. Disc degeneration, an inevitable process of aging, of variable rate and degree, is one of the major causes of low back pain. Currently, there are two major surgical interventions for treating conditions related to the degenerative disc: discectomy and fusion. Although discectomy and fusion produce a relatively good short-term clinical result in relieving pain, both these surgical treatments alter the biomechanics of the spine, possibly leading to further degeneration of the surrounding tissues and the discs at adjacent levels. Over the past 35 years, a tremendous effort has been made to develop an artificial disc to replace the degenerated disc. The goal is the restoration of the natural biomechanics of the segment after disc excision, thus relieving pain and preventing further degeneration at adjacent segments. However, the artificial disc faces a complex biomechanical environment which makes replication of the biomechanics difficult and long-term survival challenging to designs and materials. The purpose of this article is to examine the factors of importance in designing a disc replacement. Topics covered include the structure and function of the natural disc, the changes that occur with disc degeneration and existing methods of treatment for the degenerative spine. The progress in achieving a functional, long-lasting disc replacement is outlined.

  12. Requirements for an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; van Donkelaar, CC; Veldhuizen, AG; van Horn, [No Value; Huyghe, JM; Verkerke, GJ

    2001-01-01

    Intervertebral disc degeneration is an important social and economic problem. Presently available artificial intervertebral discs (AIDs) are insufficient and the main surgical intervention is still spinal fusion. The objective of the present study is to present a list of requirements for the develop

  13. 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.

  14. 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...

  15. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... to delineate the exact trajectory into the disc space. So now he’s found the disc space, what he wants to do is confirm it ... has stuck a marker into this actual disc space, and the next thing he is goes to ...

  16. On the development of an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, Marcus Franciscus

    2002-01-01

    Degenerative disc disease is one of the causes of low back pain. There are two major surgical interventions: spinal fusion and implantation of an artificial intervertebral disc. Spinal fusion alters the biomechanics of the spine, which may lead to further degeneration of the surrounding tissues and

  17. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... put my handle back on, and meanwhile, the scrub nurse is preparing the actual disc itself because ... was doing that on the back table, the scrub nurse and the circulating nurse were putting together ...

  18. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the location of the diseased disc, and the soft tissues are moved away from the front of the ... a zero-profile implant that does not contact soft tissue structures after it is implanted. The technical aspect ...

  19. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... implant that is composed of two cobalt chrome alloy end plates and a polyethylene insert. The polyethylene ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  20. Lumbar disc arthroplasty: indications, biomechanics, types, and radiological criteria

    International Nuclear Information System (INIS)

    Lumbar total disc replacement (TDR) was developed to treat a painful degenerative lumbar motion segment while avoiding the disadvantages of fusion surgery, such as adjacent segment instabilities. Early clinical results with TDR have shown a significant reduction in low back pain and a significant improvement in disability scores. When compared to fusion, the results with TDR tend to be superior in the short-term follow-up and initial rehabilitation is faster. The radiological assessment is an integral part of the preoperative work-up. Plain X-rays of the lumbar spine should be complemented by flexion - extension views in order to assess residual segmental mobility. Computed tomography is used to exclude osteoarthritis of the zygapophyseal joints, Baastrup's disease (kissing spines) and other sources of low back pain. Magnetic resonance imaging is useful to exclude substantial disc protrusions; it allows for the detection of disc dehydration and bone marrow edema in the case of activated spondylochondrosis. If osteoporosis is suspected, an osteodensitometry of the lumbar spine should be performed. Postoperative plain X-rays should include antero-posterior and lateral views as well as flexion - extension views in the later postoperative course. Measurements should determine the disc space height in the lateral view, the segmental and total lumbar lordosis as well as the segmental mobility in the flexion - extension views. The ideal position of a TDR is exactly central in the ap-view and close to the dorsal border of the vertebral endplates in the lateral view. Malpositioning may cause segmental hyperlordosis and unbalanced loading of the endplates with the risk of implant subsidence and migration. (orig.)

  1. Artificial cervical disc replacement: Principles, types and techniques

    Directory of Open Access Journals (Sweden)

    Sekhon L

    2005-01-01

    Full Text Available Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

  2. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body to ... surfaces of the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to ...

  3. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... the next levels hopefully won’t feel the stress, and by not feeling the stress, they should maintain good discs, hopefully over the ... was an appropriate procedure that would work. These studies turned out well, and the FDA has approved ...

  4. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... see it gets inserted, it’s very rough. It’s titanium plasma sprayed, and this allows for the body ... the ProDisc C implant have a plasma-sprayed titanium coding to provide bony coating to promote bony ...

  5. Artificial Cervical Disc Replacement Improves Mobility

    Medline Plus

    Full Text Available ... That’s the actual disc space right there. It’s beautiful. So I’m going to take a scalpel ... And that’s where I wan it. That looks beautiful, so I’m very pleased about that. I’ ...

  6. Improving the fixation of an artificial intervertebral disc

    NARCIS (Netherlands)

    Eijkelkamp, MF; Hayen, J; Veldhuizen, AG; Van Horn, [No Value; Verkerke, GJ

    2002-01-01

    The fixation of an artificial intervertebral disc has been studied especially with respect to the dimensions, the convexity of the endplates and the size of the fixation elements. From literature and cadaveric vertebrae, the dimensions and shape of the lumbar vertebral endplates were determined and

  7. ISASS Policy Statement – Lumbar Artificial Disc

    Science.gov (United States)

    Garcia, Rolando

    2015-01-01

    Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel's recommendation was entirely based on the best evidence-based scientific research available regarding the safety and effectiveness of lumbar TDR. PMID:25785243

  8. The Incidence of Adjacent Segment Degeneration after Cervical Disc Arthroplasty (CDA): A Meta Analysis of Randomized Controlled Trials

    OpenAIRE

    Baohui Yang; Haopeng Li; Ting Zhang; Xijing He; Siyue Xu

    2012-01-01

    BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Ce...

  9. Biomechanics of a Fixed–Center of Rotation Cervical Intervertebral Disc Prosthesis

    OpenAIRE

    Crawford, Neil R; Baek, Seungwon; Sawa, Anna G.U.; Safavi-Abbasi, Sam; Sonntag, Volker K.H.; Duggal, Neil

    2012-01-01

    Background Past in vitro experiments studying artificial discs have focused on range of motion. It is also important to understand how artificial discs affect other biomechanical parameters, especially alterations to kinematics. The purpose of this in vitro investigation was to quantify how disc replacement with a ball-and-socket disc arthroplasty device (ProDisc-C; Synthes, West Chester, Pennsylvania) alters biomechanics of the spine relative to the normal condition (positive control) and si...

  10. Clinical study to evaluate the safety and effectiveness of the Aesculap Activ-L™ artificial disc in the treatment of degenerative disc disease

    OpenAIRE

    Mo Fred F; Yue James J

    2010-01-01

    Abstract Background The objective of this clinical study is to evaluate the safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine in patients who have been unresponsive to at least six months of prior conservative care. The hypothesis of the study is that the Activ-L Disc is non-inferior to the control (the Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine]) with respect to t...

  11. Medium-term outcomes of artificial disc replacement for severe cervical disc narrowing

    Directory of Open Access Journals (Sweden)

    Chao-Hung Yeh

    2014-01-01

    Conclusions: Acceptable clinical outcome for treatment of severe cervical disc narrowing with cervical disc replacement technique has been performed in current study. Most patients maintained good postoperative mobility and no significant adjacent level degeneration were found. Cervical disc replacement may be applicable in treatment of severe cervical disc narrowing; however, longer follow-ups are required for ensuring the long-term efficacy of cervical disc replacement.

  12. The incidence of adjacent segment degeneration after cervical disc arthroplasty (CDA: a meta analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Baohui Yang

    Full Text Available BACKGROUND: Cervical disc arthroplasty is being used as an alternative degenerative disc disease treatment with fusion of the cervical spine in order to preserve motion. However, whether replacement arthoplasty in the spine achieves its primary patient centered objective of lowering the frequency of adjacent segment degeneration is not verified yet. METHODOLOGY: We conducted a meta-analysis according to the guidelines of the Cochrane Collaboration using databases including PubMed, Cochrane Central Register of Controlled Trials and Embase. The inclusion criteria were: 1 Randomized, controlled study of degenerative disc disease of the cervical spine involving single segment or double segments using Cervical disc arthroplasty (CDA with anterior cervical discectomy and fusion (ACDF as controls; 2 A minimum of two-year follow-up using imaging and clinical analyses; 3 Definite diagnostic evidences for "adjacent segment degeneration" and "adjacent segment disease"; 4 At least a minimum of 30 patients per population. Two authors independently selected trials; assessed methodological quality, extracted data and the results were pooled. RESULTS: No study has specifically compared the results of adjacent segment degenerative; Two papers describing 140 patients with 162 symptomatic cervical segment disorders and compared the rate of postoperative adjacent segment disease development between CDA and ACDF treatments, three publications describing the rate of adjacent-segment surgery including 1273 patients with symptomatic cervical segments. The result of the meta-analysis indicates that there were fewer the rate of adjacent segment disease and the rate for adjacent-segment surgery comparing CDA with ACDF, but the difference was not statistically significant. CONCLUSIONS: Based on available evidence, it cannot be concluded, that CDA can significantly reduce the postoperative rate of the adjacent segment degenerative and adjacent segment disease. However, due

  13. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

    Science.gov (United States)

    Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-01-01

    Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up. PMID:27441736

  14. 人工颈椎间盘植入治疗颈椎病%Artificial cervical disc replacement in cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    王贵怀; 陈思源; 杨俊

    2009-01-01

    Objective Anterior cervical fusion has been a routine method for the surgical treatment of cervical spondylosis, but concerns for the possibility of acceleration of adjacentsegment disease after fusion have been growing. The artificial cervical disc replacement provides the opportunity to preserve motion after neural decompression while providing stability, which opens a new pathway for the surgical therapy of cervical spondylosis. Method We summarized the results of 16 patients of cervical herniated disc treated by artificial cervical disc replacement after cervical microdecompression and arthroplasty from December 2005 to March 2008. The average followup time was 17 momths. Results All patients got improved neurological function postoperatively. The cervical flextion and extention X - film showed good curvature and motion. 1 patient developed temporary hoarseness and recovered within 1 week. There was no other complications. Conclusions Cervical microdecompression with Bryan disc replacement is a good choice for adequate patient of cervical degenerative disc disease.%目的 颈椎病前路融合术后颈椎活动度下降与邻近节段椎间盘退变加速越来越受到人们的重视,人工颈椎间盘置换术可在进行脊髓减压并提供稳定的同时保持手术节段颈椎的活动度,为颈椎病的外科治疗开辟了新的途径.方法 自2005年12月至2008年3月,对16例颈椎病患者进行显微减压后椎间植入Bryan人工颈椎间盘,平均随访时间17个月.结果 所有患者术后症状均明显缓解,脊髓功能明显改善,颈椎活动度良好,1例术后发生短暂声音嘶哑,无手术死亡率.结论 人工颈椎间盘植入为颈椎病的外科治疗开辟了新的手段,在提供颈椎稳定的同时保持手术节段颈椎的良好活动度,把握严格的适应证和手术技术能取得满意的效果.

  15. Application of cervical arthroplasty with Bryan cervical disc:long-term X-ray and magnetic resonance imaging follow-up results

    Institute of Scientific and Technical Information of China (English)

    ZHAO Yan-bin; SUN Yu; CHEN Zhong-qiang; LIU Zhong-jun

    2010-01-01

    Background Cervical disc arthroplasty is a new technique for treating degenerative cervical disease. Its goal is to avoid the degeneration of adjacent levels by preserving motion at the treated level. The aims of this study were to evaluate the radiologic outcomes of Bryan cervical disc replacement and the degenerative status of adjacent segments.Methods Twenty-two patients at a single center underwent discectomy and implantation of Bryan cervical disc. The mean follow-up period was 60 months (57-69 months). Twenty patients underwent single-level arthroplasty and two underwent arthroplasty at two levels. The levels of surgery included C3/4 (3 levels), C4/5 (2 levels), C5/6 (18 levels) and C6/7 (1 level). Radiographic evaluation included dynamic X-ray examination and magnetic resonance imaging (MRI) at baseline and at final follow-up.Results On X-ray examination, the range of motion (ROM) at the operated level was 7.2° (2.5°-13.0°) at baseline and 7.8° (1.0°-15.0°) at final follow-up (P >0.05). Heterotopic ossification around the prosthesis was observed in eight levels,and two levels showed loss of motion (ROM <2°). MRI showed worsening by a grade at the upper level in 2/22 patients,and worsening by a grade at the lower level in 3/22, according to Miyazaki's classification. No further impingement of the ligamentum flavum into the spinal canal was observed at adjacent levels, though the disc bulge was slightly increased at both the adjacent upper and lower levels at final follow-up.Conclusions Arthroplasty using Bryan cervical disc prosthesis resulted in favorable radiologic outcomes in this study.Disc degeneration at adjacent levels may be postponed by this technique.

  16. Differences between C3-4 and other subaxial levels of cervical disc arthroplasty: more heterotopic ossification at the 5-year follow-up.

    Science.gov (United States)

    Chang, Peng-Yuan; Chang, Hsuan-Kan; Wu, Jau-Ching; Huang, Wen-Cheng; Fay, Li-Yu; Tu, Tsung-Hsi; Wu, Ching-Lan; Cheng, Henrich

    2016-05-01

    OBJECTIVE Several large-scale clinical trials demonstrate the efficacy of 1- and 2-level cervical disc arthroplasty (CDA) for degenerative disc disease (DDD) in the subaxial cervical spine, while other studies reveal that during physiological neck flexion, the C4-5 and C5-6 discs account for more motion than the C3-4 level, causing more DDD. This study aimed to compare the results of CDA at different levels. METHODS After a review of the medical records, 94 consecutive patients who underwent single-level CDA were divided into the C3-4 and non-C3-4 CDA groups (i.e., those including C4-5, C5-6, and C6-7). Clinical outcomes were measured using the visual analog scale for neck and arm pain and by the Japanese Orthopaedic Association scores. Postoperative range of motion (ROM) and heterotopic ossification (HO) were determined by radiography and CT, respectively. RESULTS Eighty-eight patients (93.6%; mean age 45.62 ± 10.91 years), including 41 (46.6%) female patients, underwent a mean follow-up of 4.90 ± 1.13 years. There were 11 patients in the C3-4 CDA group and 77 in the non-C3-4 CDA group. Both groups had significantly improved clinical outcomes at each time point after the surgery. The mean preoperative (7.75° vs 7.03°; p = 0.58) and postoperative (8.18° vs 8.45°; p = 0.59) ROMs were similar in both groups. The C3-4 CDA group had significantly greater prevalence (90.9% vs 58.44%; p = 0.02) and higher severity grades (2.27 ± 0.3 vs 0.97 ± 0.99; p = 0.0001) of HO. CONCLUSIONS Although CDA at C3-4 was infrequent, the improved clinical outcomes of CDA were similar at C3-4 to that in the other subaxial levels of the cervical spine at the approximately 5-year follow-ups. In this Asian population, who had a propensity to have ossification of the posterior longitudinal ligament, there was more HO formation in patients who received CDA at the C3-4 level than in other subaxial levels of the cervical spine. While the type of artificial discs could have confounded the

  17. Clinical study to evaluate the safety and effectiveness of the Aesculap Activ-L™ artificial disc in the treatment of degenerative disc disease

    Directory of Open Access Journals (Sweden)

    Mo Fred F

    2010-04-01

    Full Text Available Abstract Background The objective of this clinical study is to evaluate the safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine in patients who have been unresponsive to at least six months of prior conservative care. The hypothesis of the study is that the Activ-L Disc is non-inferior to the control (the Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] with respect to the rate of individual subject success at 24 months. Individual subject success is a composite of effectiveness and safety. Methods/Design The study proposed is a prospective, randomized, single-masked, controlled, multi-center clinical trial consisting of an estimated 414 subjects with single-level DDD of the lumbar spine (L4/L5, or L5/S1 who have failed to improve with conservative treatment for at least six months prior to enrollment. After enrollment, subjects will be randomized in a 2:1 ratio to either the Activ-L Disc (investigational device or the control (Charité or ProDisc-L. Radiographic endpoints will be evaluated by an independent reviewer at an imaging core laboratory. Each subject will be followed for 5 years post-treatment. Discussion The safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine will be equivalent to Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] at 24 months. Trial Registration Current Controlled Trials NCT00589797.

  18. The activL® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

    Directory of Open Access Journals (Sweden)

    Yue JJ

    2016-05-01

    Full Text Available James J Yue,1 Rolando Garcia Jr,2 Larry E Miller3 1Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT, 2Orthopedic Care Center, Miami, FL, 3Miller Scientific Consulting, Inc., Asheville, NC, USA Abstract: Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR or lumbar fusion. Until recently, only two lumbar TDRs had been approved by the US Food and Drug Administration - the Charité Artificial Disc in 2004 and the ProDisc-L Total Disc Replacement in 2006. In June 2015, a next-generation lumbar TDR received Food and Drug Administration approval - the activL® Artificial Disc (Aesculap Implant Systems. Compared to previous-generation lumbar TDRs, the activL® Artificial Disc incorporates specific design enhancements that result in a more precise anatomical match and allow a range of motion that better mimics the healthy spine. The results of mechanical and clinical studies demonstrate that the activL® Artificial Disc results in improved mechanical and clinical outcomes versus earlier-generation artificial discs and compares favorably to lumbar fusion. The purpose of this report is to describe the activL® Artificial Disc including implant characteristics, intended use, surgical technique, postoperative care, mechanical testing, and clinical experience to date. Keywords: activL® Artificial Disc, artificial disc, degenerative disc disease, discogenic, implant, lumbar, motion preservation, pain

  19. The activL(®) Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain.

    Science.gov (United States)

    Yue, James J; Garcia, Rolando; Miller, Larry E

    2016-01-01

    Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or lumbar fusion. Until recently, only two lumbar TDRs had been approved by the US Food and Drug Administration - the Charité Artificial Disc in 2004 and the ProDisc-L Total Disc Replacement in 2006. In June 2015, a next-generation lumbar TDR received Food and Drug Administration approval - the activL(®) Artificial Disc (Aesculap Implant Systems). Compared to previous-generation lumbar TDRs, the activL(®) Artificial Disc incorporates specific design enhancements that result in a more precise anatomical match and allow a range of motion that better mimics the healthy spine. The results of mechanical and clinical studies demonstrate that the activL(®) Artificial Disc results in improved mechanical and clinical outcomes versus earlier-generation artificial discs and compares favorably to lumbar fusion. The purpose of this report is to describe the activL(®) Artificial Disc including implant characteristics, intended use, surgical technique, postoperative care, mechanical testing, and clinical experience to date.

  20. Chiropractic management of patients post-disc arthroplasty: eight case reports

    Directory of Open Access Journals (Sweden)

    Descarreaux Martin

    2010-04-01

    Full Text Available Abstract Background When conservative therapies for low back pain (LBP are not effective, elective surgery may be proposed to these patients. Over the last 20 years, a new technology, disc replacement, has become increasingly popular because it is believed to maintain or restore the integrity of spinal movement and minimize the side-effects compared to fusion. Although disc replacement may relieve a patient from pain and related disability, soreness and stiffness of the lumbopelvic region seem to be common aftermaths of the surgery. This prospective case series was undertaken to identify and describe potential adverse events of lumbar spinal manipulation, a common therapy for low back pain, in a group of patients with symptoms after disc prostheses. Cases presentation Eight patients who underwent lumbar spine total disc replacement were referred by an orthopaedic surgeon for chiropractic treatments. These patients had 1 or 2 total lumbar disc replacements and were considered stable according to the surgical protocol but presented persistent, post-surgical, non-specific LBP or pelvic pain. They were treated with lumbar spine side posture manipulations only and received 8 to 10 chiropractic treatments based on the clinical evolution and the chiropractor's judgment. Outcome measures included benign, self-limiting, and serious adverse events after low back spinal manipulative therapy. The Oswestry Disability Index, a pain scale and the fear avoidance belief questionnaire were administered to respectively assess disability, pain and fear avoidance belief about work and physical activity. This prospective case series comprised 8 patients who all had at least 1 total disc replacement at the L4/L5 or L5/S1 level and described persistent post-surgical LBP interfering with their daily activities. Commonly-reported side-effects of a benign nature included increased pain and/or stiffness of short duration in nearly half of the chiropractic treatment period

  1. The activL® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

    OpenAIRE

    Yue, James J.; Garcia, Rolando; Miller, Larry E.

    2016-01-01

    Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or lumbar fusion. Until recently, only two lumbar TDRs had been approved by the US Food and Drug Administration − the Charité Artificial Disc in 2004 and the ProDisc-L Total Disc Replacement in 2006. In June 2015, a next-generation lumbar TDR receive...

  2. Mid- to Long-Term Outcomes of Cervical Disc Arthroplasty versus Anterior Cervical Discectomy and Fusion for Treatment of Symptomatic Cervical Disc Disease: A Systematic Review and Meta-Analysis of Eight Prospective Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yan Hu

    Full Text Available This study aimed to investigate the mid- to long-term outcomes of cervical disc arthroplasty (CDA versus anterior cervical discectomy and fusion (ACDF for the treatment of 1-level or 2-level symptomatic cervical disc disease.Medline, Embase, and the Cochrane Central Register of Controlled Trials databases were searched to identify relevant randomized controlled trials that reported mid- to long-term outcomes (at least 48 months of CDA versus ACDF. All data were analyzed by Review Manager 5.3 software. The relative risk (RR and 95% confidence intervals (CIs were calculated for dichotomous variables. The weighted mean difference (WMD and 95%CIs were calculated for continuous variables. A random effect model was used for heterogeneous data; otherwise, a fixed effect model was used.Eight prospective randomized controlled trials (RCTs were retrieved in this meta-analysis, including 1317 and 1051 patients in CDA and ACDF groups, respectively. Patients after an ACDF had a significantly lower rate of follow-up than that after CDA. Pooled analysis showed patients in CDA group achieved significantly higher rates of overall success, Neck Disability Index (NDI success, neurological success and significantly lower rates of implant/surgery-related serious adverse events and secondary procedure compared with that in ACDF group. The long-term functional outcomes (NDI, Visual Analog Scale (VAS neck and arm pain scores, the Short Form 36 Health Survey physical component score (SF-36 PCS, patient satisfaction and recommendation, and the incidence of superior adjacent segment degeneration also favored patients in CDA group with statistical difference. Regarding inferior adjacent segment degeneration, patients in CDA group had a lower rate without statistical significance.This meta-analysis showed that cervical disc arthroplasty was superior over anterior discectomy and fusion for the treatment of symptomatic cervical disc disease in terms of overall success, NDI

  3. Biomechanics of Artificial Disc Replacements Adjacent to a 2-Level Fusion in 4-Level Hybrid Constructs: An In Vitro Investigation

    OpenAIRE

    Liao, Zhenhua; Fogel, Guy R.; Wei, Na; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal procedure for multilevel cervical degenerative disc diseases remains controversial. Recent studies on hybrid surgery combining anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR) for 2-level and 3-level constructs have been reported in the literature. The purpose of this study was to estimate the biomechanics of 3 kinds of 4-level hybrid constructs, which are more likely to be used clinically compared to 4-level arthrodesis. Mate...

  4. Prosthetic Lumbar disc replacement for degenerative disc disease

    Directory of Open Access Journals (Sweden)

    Kulkarni Arvind

    2005-01-01

    Full Text Available Mechanical articulated device to replace intervertebral disc as a treatment for low back pain secondary to disc degeneration has emerged as a promising tool for selected patients. The potential advantages are prevention of adjacent segment degeneration, maintenance of mobility as well as avoidance of all the complications associated with fusion. The short-term results have been comparable to that of fusion, a few mid-term results have shown mixed outcome, but information on long-term results and performance are not available at present. The rationale for lumbar disc arthroplasty, indications, contraindications, the various artificial devices in the market and the concepts intrinsic to each of them, basic technique of insertion, complications are discussed and a brief summary of our experience with one of the devices is presented.

  5. Research Progress in Functional Rehabilitation after Artificial Total Knee Arthroplasty%人工全膝关节置换术后功能康复研究进展

    Institute of Scientific and Technical Information of China (English)

    张斌; 周红

    2015-01-01

    Rehabilitation is an important measure for knee joint function after operation to achieve the expected effect, which is crucial for the clini-cal effect of artificial total knee arthroplasty postoperation. This paper analyses the progress in strength training, joint activity training, proprioceptive training and gait training after artificial total knee arthroplasty, emphasizing the importance of health education and functional training after artificial total knee arthroplasty.%康复治疗是术后膝关节功能可达到预期效果的重要措施,对人工膝关节置换术后的临床效果至关重要。本文分析人工膝关节置换术后肌力训练、关节活动度训练、本体觉训练、行走步态训练的进展,强调人工膝关节置换术后健康教育及功能锻炼的重要性。

  6. 人工全膝关节置换术后功能康复研究进展%Research Progress in Functional Rehabilitation after Artificial Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    张斌; 周红

    2015-01-01

    康复治疗是术后膝关节功能可达到预期效果的重要措施,对人工膝关节置换术后的临床效果至关重要。本文分析人工膝关节置换术后肌力训练、关节活动度训练、本体觉训练、行走步态训练的进展,强调人工膝关节置换术后健康教育及功能锻炼的重要性。%Rehabilitation is an important measure for knee joint function after operation to achieve the expected effect, which is crucial for the clini-cal effect of artificial total knee arthroplasty postoperation. This paper analyses the progress in strength training, joint activity training, proprioceptive training and gait training after artificial total knee arthroplasty, emphasizing the importance of health education and functional training after artificial total knee arthroplasty.

  7. The NEtherlands Cervical Kinematics (NECK Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blind randomised multicenter study

    Directory of Open Access Journals (Sweden)

    van den Akker Elske

    2010-06-01

    Full Text Available Abstract Background Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is a known entity on the long term. Recently, cervical disc prostheses are developed to maintain motion and possibly reduce the incidence of adjacent disc degeneration. A comparative cost-effectiveness study focused on adjacent segment degeneration and functional outcome has not been performed yet. We present the design of the NECK trial, a randomised study on cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in patients with cervical disc herniation. Methods/Design Patients (age 18-65 years presenting with radicular signs due to single level cervical disc herniation lasting more than 8 weeks are included. Patients will be randomised into 3 groups: anterior discectomy only, anterior discectomy with interbody fusion, and anterior discectomy with disc prosthesis. The primary outcome measure is symptomatic adjacent disc degeneration at 2 and 5 years after surgery. Other outcome parameters will be the Neck Disability Index, perceived recovery, arm and neck pain, complications, re-operations, quality of life, job satisfaction, anxiety and depression assessment, medical consumption, absenteeism, and costs. The study is a randomised prospective multicenter trial, in which 3 surgical techniques are compared in a parallel group design. Patients and research nurses will be kept blinded of the allocated treatment for 2 years. The follow-up period is 5 years. Discussion Currently, anterior cervical discectomy with fusion is the golden standard in the surgical treatment of cervical disc herniation. Whether additional interbody fusion or disc prothesis is necessary and cost-effective will be determined by this trial

  8. Total Disc Arthroplasty and Anterior Cervical Discectomy and Fusion in Cervical Spine: Competitive or Complimentary? Review of the Literature

    OpenAIRE

    Jawahar, Ajay; Nunley, Pierce

    2012-01-01

    Anterior cervical discectomy and arthrodesis has come to represent standard of care for patients with persistent radicular and/or myelopathic symptoms that have failed to improve with conservative treatments. One potential complication of the procedure is the accelerated degeneration of the vertebrae and the intervertebral discs adjacent to the level fused and the effects of fusion on those levels. The concern that fusion may be a contributing factor to accelerated adjacent segment degenerati...

  9. Lumbar disc arthroplasty: indications, biomechanics, types, and radiological criteria; Lumbale Bandscheibenendoprothesen: Indikationen, Biomechanik, Typen und radiologische Kriterien

    Energy Technology Data Exchange (ETDEWEB)

    Baur-Melnyk, A.; Reiser, M.F. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Orthopaedische Klinik und Poliklinik, Muenchen (Germany); Birkenmaier, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2006-09-15

    Lumbar total disc replacement (TDR) was developed to treat a painful degenerative lumbar motion segment while avoiding the disadvantages of fusion surgery, such as adjacent segment instabilities. Early clinical results with TDR have shown a significant reduction in low back pain and a significant improvement in disability scores. When compared to fusion, the results with TDR tend to be superior in the short-term follow-up and initial rehabilitation is faster. The radiological assessment is an integral part of the preoperative work-up. Plain X-rays of the lumbar spine should be complemented by flexion - extension views in order to assess residual segmental mobility. Computed tomography is used to exclude osteoarthritis of the zygapophyseal joints, Baastrup's disease (kissing spines) and other sources of low back pain. Magnetic resonance imaging is useful to exclude substantial disc protrusions; it allows for the detection of disc dehydration and bone marrow edema in the case of activated spondylochondrosis. If osteoporosis is suspected, an osteodensitometry of the lumbar spine should be performed. Postoperative plain X-rays should include antero-posterior and lateral views as well as flexion - extension views in the later postoperative course. Measurements should determine the disc space height in the lateral view, the segmental and total lumbar lordosis as well as the segmental mobility in the flexion - extension views. The ideal position of a TDR is exactly central in the ap-view and close to the dorsal border of the vertebral endplates in the lateral view. Malpositioning may cause segmental hyperlordosis and unbalanced loading of the endplates with the risk of implant subsidence and migration. (orig.) [German] Die lumbale Bandscheibenendoprothese (LBEP) wurde entwickelt, um ein schmerzhaftes lumbales Bewegungssegment unter Vermeidung der Nachteile einer Fusionsoperation zu behandeln. Erste klinische Ergebnisse der LBEP zeigen eine signifikante Reduktion der

  10. 颈椎间盘置换治疗颈椎病的疗效观察%Efficacy evaluation of treating cervical spondylopathy with the Discover artificial cervical disc prosthesis

    Institute of Scientific and Technical Information of China (English)

    方礼明; 张亚军; 张军; 李勤

    2013-01-01

    Objective To explore the clinical and radiological outcomes of Discover artificial cervical disc arthroplasty and the range of motion status on adjacent segments for cervical spondylosis causing radiculopathy or myelopathy.Methods A total of 18 consecutive patients underwent cervical arthroplasty with the Discover artificial cervical disc at our hospital.Clinical and radiological follow-ups were conducted.Their radiographic parameters of treatment and adjacent segments were evaluated at Month 1,3,6,12,18 post-operation.And the Japanese Orthopedic Association (JOA) score,visual analog scale (VAS) pain score and Odom's scale were recorded and analyzed.Results During follow-ups over an average of 15 months,there was no occurrence of vascular injury,severe complications or prosthesis displacement and loosening.The score of JOA was 7.2 ± 1.8 at preoperation and 16.7 ± 4.5 at postoperation.And the score of VAS was 8.15 ± 1.65 at preoperation and 2.03 ± 1.12 at postoperation.Conclusion Discover artificial cervical disc arthroplasty is efficacious and the patients recover quickly.Targeted cervical segments may be stabilized and their physiological ranges of motion preserved.%目的 探讨颈椎人工间盘治疗脊髓型和神经根型颈椎病术后的临床效果.方法 2008年6月至2010年6月,武警北京市总队第二医院骨科18例保守治疗无效的颈椎病患者行DiscoverTM人工颈椎间盘置换术,术后按计划随访术后1、3、6、12、18个月,记录术前和术后每个时间点JOA评分,Odom分级及VAS评分.术前、术后3、6、12、18个月登记颈椎正侧及动力位X线片,分析评价椎间盘的位置.结果 18例患者均获得随访,平均随访15个月,术后未出现血管神经损伤,无严重并发症发生.术后患者未发现假体松动和移位.JOA评分从术前(7.2±1.8)分到术后(16.7±4.5)分,VAS评分从术前(8.4±1.4)分到术后(2.0±1.1)分,术后手术效果按照Odom分级都是优良结果,优16例,良2

  11. Artificial disc and vertebra system: a novel motion preservation device for cervical spinal disease after vertebral corpectomy

    Directory of Open Access Journals (Sweden)

    Jun Dong

    2015-07-01

    Full Text Available OBJECTIVE: To determine the range of motion and stability of the human cadaveric cervical spine after the implantation of a novel artificial disc and vertebra system by comparing an intact group and a fusion group. METHODS: Biomechanical tests were conducted on 18 human cadaveric cervical specimens. The range of motion and the stability index range of motion were measured to study the function and stability of the artificial disc and vertebra system of the intact group compared with the fusion group. RESULTS: In all cases, the artificial disc and vertebra system maintained intervertebral motion and reestablished vertebral height at the operative level. After its implantation, there was no significant difference in the range of motion (ROM of C3-7 in all directions in the non-fusion group compared with the intact group (p>0.05, but significant differences were detected in flexion, extension and axial rotation compared with the fusion group (p<0.05. The ROM of adjacent segments (C3-4, C6-7 of the non-fusion group decreased significantly in some directions compared with the fusion group (p<0.05. Significant differences in the C4-6 ROM in some directions were detected between the non-fusion group and the intact group. In the fusion group, the C4-6 ROM in all directions decreased significantly compared with the intact and non-fusion groups (p<0.01. The stability index ROM (SI-ROM of some directions was negative in the non-fusion group, and a significant difference in SI-ROM was only found in the C4-6 segment of the non-fusion group compared with the fusion group. CONCLUSION: An artificial disc and vertebra system could restore vertebral height and preserve the dynamic function of the surgical area and could theoretically reduce the risk of adjacent segment degeneration compared with the anterior fusion procedure. However, our results should be considered with caution because of the low power of the study. The use of a larger sample should be

  12. 人工颈椎间盘置换术患者围手术期护理体会%Cervical intervertebral disc arthroplasty patients perioperative nursing experience

    Institute of Scientific and Technical Information of China (English)

    刘丹

    2015-01-01

    颈椎间盘突出症是一种常见的退化性病变,它可以引起脊髓和神经根病变,脊髓病变甚至可能造成四肢运动功能损害、感觉异常等。人工间盘的设计理念之一是保留手术节段的活动,另一设计理念是降低临近节段退变的发生,它既能保持脊柱节段的稳定性和活动功能,又能避免临近关节受到连累,对于提高患者生活质量有实际意义。2013年11月,我科成功为一名严重脊髓型颈椎病患者实施了经颈前路减压、人工椎间盘置换术,围手术期的系统、精密的观察和护理,对手术成功起到重要作用,术后患者恢复良好,患者及其家属对手术效果均感到满意,现总结护理经验如下。%The cervical intervertebral disc herniation is a common degradation lesions, it can cause spinal cord and nerve root lesions, limb motor function caused by spinal cord lesions and may even damage, paresthesia, etc. Between artificial disc is one of the design concept of conservative surgery section of the activity, a design concept is to reduce the happening of the adjacent segment degeneration, it can maintain the stability of the spinal segment and function of activity, and can avoid near joints, small area, to improve the patients quality of life has a practical significance. In November 2013, I division success as a serious spondylotic myelopathy successfully implemented by decompression and anterior portion of artificial intervertebral disc replacement, through system, precision of perioperative observation and nursing care, for the success rate of surgery play an important role, the patient recovered well postoperatively, patients and their families were satisfied with the surgical effects are, summarized nursing experience is as follows.

  13. 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

  14. Biomechanics of Artificial Disc Replacements Adjacent to a 2-Level Fusion in 4-Level Hybrid Constructs: An In Vitro Investigation.

    Science.gov (United States)

    Liao, Zhenhua; Fogel, Guy R; Wei, Na; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    BACKGROUND The ideal procedure for multilevel cervical degenerative disc diseases remains controversial. Recent studies on hybrid surgery combining anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR) for 2-level and 3-level constructs have been reported in the literature. The purpose of this study was to estimate the biomechanics of 3 kinds of 4-level hybrid constructs, which are more likely to be used clinically compared to 4-level arthrodesis. MATERIAL AND METHODS Eighteen human cadaveric spines (C2-T1) were evaluated in different testing conditions: intact, with 3 kinds of 4-level hybrid constructs (hybrid C3-4 ACDR+C4-6 ACDF+C6-7ACDR; hybrid C3-5ACDF+C5-6ACDR+C6-7ACDR; hybrid C3-4ACDR+C4-5ACDR+C5-7ACDF); and 4-level fusion. RESULTS Four-level fusion resulted in significant decrease in the C3-C7 ROM compared with the intact spine. The 3 different 4-level hybrid treatment groups caused only slight change at the instrumented levels compared to intact except for flexion. At the adjacent levels, 4-level fusion resulted in significant increase of contribution of both upper and lower adjacent levels. However, for the 3 hybrid constructs, significant changes of motion increase far lower than 4P at adjacent levels were only noted in partial loading conditions. No destabilizing effect or hypermobility were observed in any 4-level hybrid construct. CONCLUSIONS Four-level fusion significantly eliminated motion within the construct and increased motion at the adjacent segments. For all 3 different 4-level hybrid constructs, ACDR normalized motion of the index segment and adjacent segments with no significant hypermobility. Compared with the 4-level ACDF condition, the artificial discs in 4-level hybrid constructs had biomechanical advantages compared to fusion in normalizing adjacent level motion. PMID:26694835

  15. 颈椎人工椎间盘置换后对相邻节段退变的影响%Effect of cervical disc arthroplasty on adjacent segment degeneration

    Institute of Scientific and Technical Information of China (English)

    孙宇; 赵衍斌; 周非非; 张凤山; 潘胜发; 周方; 刘忠军

    2011-01-01

    Objective:To investigate the adjacent segment degeneration after single level cervical disc arthroplasty. Method : Patients received single level cervical arthroplasty in our institute were reviewed retrospectively. Up to October 2010,a total of 80 patients gained at least 20 months' follow-up.There were 8 cases of C3/4,15 C4/5,49 C5/6 and 8 C6/7.41 patents received Bryan Disc cervical prosthesis and 39 received ProDisc-C prosthesis. Adjacent segment degeneration was evaluated on X-ray and magnetic resonance imaging (MRI) at preoperative and final follow-up.X-ray based adjacent segment degeneration included the presence of aoy of the following parameters:narrowing of disc space>10%,new anterior or/and extended osteophyte formation,calcification of anterior longitudinal ligament. Cervical disc degeneration was evaluated according to Miyazaki's grading system based on T2-weighted MRI.Result:The mean follow-up period was 38 months (range,20-64 months).Of 160 segments at final follow-up,8 distal adjacent segments were excluded due to unavailability of X-ray,adjacent segment degeneration was observed in 21 of 152 segments(13.8%) based on X-ray findings.The rate of adjacent segment degeneration for Bryan disc group was 10.0%,which was lower than that of ProDisc-C group (18.1%).47 patients gained MRI follow-up,and adjacent segment degeneration was observed in 14 of 94 segments (14.9%).The rate of MRI-based adjacent segment degeneration for Bryan Disc group was 12.5%,which was also lower than that of ProDisc-C group (22.7%).No adjacent segment disease developed at final follow-up. Conclusion:Less than 15% cases develop adjacent segment degeneration 38 months after cervical disc arthroplasty,and the effect may vary between different prosthesis.%目的:观察单节段颈椎人工椎间盘置换术后相邻节段退变情况.方法:截止到2010年10月在我院行单节段颈椎人工椎间盘置换术后随访20个月以上且资料完整、既

  16. Crack Orientation and Depth Estimation in a Low-Pressure Turbine Disc Using a Phased Array Ultrasonic Transducer and an Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Wenshuang Chang

    2013-09-01

    Full Text Available Stress corrosion cracks (SCC in low-pressure steam turbine discs are serious hidden dangers to production safety in the power plants, and knowing the orientation and depth of the initial cracks is essential for the evaluation of the crack growth rate, propagation direction and working life of the turbine disc. In this paper, a method based on phased array ultrasonic transducer and artificial neural network (ANN, is proposed to estimate both the depth and orientation of initial cracks in the turbine discs. Echo signals from cracks with different depths and orientations were collected by a phased array ultrasonic transducer, and the feature vectors were extracted by wavelet packet, fractal technology and peak amplitude methods. The radial basis function (RBF neural network was investigated and used in this application. The final results demonstrated that the method presented was efficient in crack estimation tasks.

  17. 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 ...

  18. Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease: opposite or complementary techniques?

    OpenAIRE

    Barbagallo, Giuseppe M. V.; Assietti, Roberto; Corbino, Leonardo; Olindo, Giuseppe; Foti, Pietro V.; Russo, Vittorio; Albanese, Vincenzo

    2009-01-01

    We report the clinical and radiological results on the safety and efficacy of an unusual surgical strategy coupling anterior cervical discectomy and fusion and total disc replacement in a single-stage procedure, in patients with symptomatic, multilevel cervical degenerative disc disease (DDD). The proposed hybrid, single-stage, fusion–nonfusion technique aims either at restoring or maintaining motion where appropriate or favouring bony fusion when indicated by degenerative changes. Twenty-fou...

  19. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle. PMID:27423250

  20. Quadruple-component superficial circumflex iliac artery perforator (SCIP) flap: A chimeric SCIP flap for complex ankle reconstruction of an exposed artificial joint after total ankle arthroplasty.

    Science.gov (United States)

    Yamamoto, Takumi; Saito, Takafumi; Ishiura, Ryohei; Iida, Takuya

    2016-09-01

    Total ankle arthroplasty (TAA) is becoming popular in patients with rheumatoid arthritis (RA)-associated ankle joint degeneration. However, ankle wound complications can occur after TAA, which sometimes requires challenging reconstruction due to anatomical complexity of the ankle. Superficial circumflex iliac artery (SCIA) perforator (SCIP) flap has been reported to be useful for various reconstructions, but no case has been reported regarding a chimeric SCIP flap for complex ankle reconstruction. We report a case of complex ankle defect successfully reconstructed with a free quadruple-component chimeric SCIP flap. A 73-year-old female patient with RA underwent TAA, and suffered from an extensive ankle soft tissue defect (13 × 5 cm) with exposure of the implanted artificial joint and the extensor tendons. A chimeric SCIP flap was raised based on the deep branch and the superficial branch of the SCIA, which included chimeric portions of the sartorius muscle, the deep fascia, the inguinal lymph node (ILN), and the skin/fat. The flap was transferred to the recipient ankle. The sartorius muscle was used to cover the artificial joint, the deep fascia to reconstruct the extensor retinaculum, the ILN to prevent postoperative lymphedema, and the adiposal tissue to put around the extensor tendons for prevention of postoperative adhesion. Postoperatively, the patient could walk by herself without persistent leg edema or bowstringing of the extensor tendons, and was satisfied with the concealable donor scar. Although further studies are required to confirm efficacy, multicomponent chimeric SCIP has a potential to be a useful option for complex defects of the ankle.

  1. 人工颈椎间盘的假体结构及应用特点%Prosthesis structure and application features of artificial cervical disc

    Institute of Scientific and Technical Information of China (English)

    颜端国

    2014-01-01

    背景:目前人工颈椎间盘假体设计和使用都得到了很大的发展,主要有低磨擦滑动面、弹簧系统、橡胶制成的人工颈椎间盘及其他各种弹性假体。目的:总结人工颈椎间盘假体结构特点及在骨科的应用现状。方法:由第一作者以“人工颈椎间盘;假体;椎间盘突出症”和“Artificial Cervical Disc;prosthesis;intervertebral disc herniation;the surgical therapy”为关键词,分别在CNKI(2000至2013年)和PubMed数据库(1960至2013年)http://www.ncbi.nlm.nih.gov/PubMed)检索近年文献,检索内容为人工颈椎间盘假体在骨科的应用。计算机在CNKI数据库检索出200篇文献,在PubMed数据库检索出56篇文献,阅读标题和进行筛选,保留符合纳入标准的40篇归纳总结。结果与结论:人工颈椎间盘假体类似椎间盘生理功能,材料具有耐磨损、耐疲劳、抗腐蚀等特点,它类似于人体椎间盘的生理和生物力学载荷功能,保持了脊柱的稳定和运动功能,避免了邻近节段的退变加速。文章重点对Bryan、Mobi-C、PCM、Prodisc-C、Prestige及CerviCore人工颈椎间盘结构做了介绍。人工颈椎间盘置换的短期疗效已得到认可,但是它不能完全替代颈前路植骨融合内固定,是治疗颈椎退变性椎间盘疾病的又一主要手段。%BACKGROUND:The design and use of artificial cervical disc prosthesis have great development, such as rubber-made artificial cervical disc with low-friction sliding surface and spring system, and other various elastic prostheses. OBJECTIVE:To summarize structural characteristics and present application of artificial cervical disc prosthesis. METHODS:The first author searched CNKI (2000-2013) and PubMed databases (1960-2013) http://www.ncbi.nlm.nih.gov/PubMed for literatures on application of artificial cervical disc prosthesis. The key words included artificial cervical disc, prosthesis, intervertebral disc

  2. Analysis of mid-long term clinical efficacy and complications of Bryan artificial cervical disc replacement%Bryan人工颈椎椎间盘置换术后中长期临床疗效及相关问题分析

    Institute of Scientific and Technical Information of China (English)

    蒋涛; 任先军; 王卫东; 初同伟; 李长青

    2011-01-01

    目的 探讨Bryan人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎椎间盘突出症的中长期临床疗效及并发症发生情况.方法 回顾分析13例颈椎椎间盘突出症患者,采用Bryan ACDR治疗,单节段11例,双节段2例,共置换了15个节段.术后定期随访,依照Odom评级和日本骨科学会(Japanese Orthopaedic Association,JOA)评分评定临床疗效和神经功能改善情况,通过影像学资料观察假体位移、假体周围骨吸收、异位骨化、假体活动度及颈椎生理曲度变化.结果 经过5年以上的随访,患者神经症状有明显缓解,Odom评级临床优良率达到92.3%,JOA评分由术前的11.6分增加到的15.6分.术后X线片示假体稳定,没有出现假体前后位移>2mm.术后1例出现自发性融合;1例在置换节段上位椎体前下缘有明显骨吸收,接近2.5mm,并伴椎体后缘的异位骨化.末次随访时置换假体活动度平均为9.2°,邻近节段活动度与术前相当.结论 通过5~7年的中长期随访,Bryan ACDR术治疗颈椎椎间盘突出症具有较好的临床疗效,并发症少,安全可靠.%Objective To evaluate the mid-long term clinical efficacy and complications of Bryan artificial cervical arthro-plasty replacement (ACDR) for treatment of cervical disc herniation. Methods Thirteen cases of cervical disc herniation were retrospectively analyzed. A total of 15 sets of Bryan cervical disc prosthesis were implanted into 13 cases, including single level disc replacement in 11 cases and bi-level in 2 cases. During follow-up, the clinical efficacy and neurological function were evaluated by Odom's criteria and Japanese Orthopaedic Association (JOA)score; the mobility, resorption, heteropic ossification, physiological lordosis and range of motion of the implanted and adjacent segment were observed on dynamic radiograph. Results After more than 5 years of follow-up, all cases showed significant improvement in neurological

  3. The activL® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

    OpenAIRE

    Yue JJ; Garcia Jr R; Miller LE

    2016-01-01

    James J Yue,1 Rolando Garcia Jr,2 Larry E Miller3 1Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT, 2Orthopedic Care Center, Miami, FL, 3Miller Scientific Consulting, Inc., Asheville, NC, USA Abstract: Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or lumbar f...

  4. The activL® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

    OpenAIRE

    Miller, Larry E.

    2016-01-01

    James J Yue,1 Rolando Garcia Jr,2 Larry E Miller3 1Department of Orthopaedic Surgery, Yale School of Medicine, New Haven, CT, 2Orthopedic Care Center, Miami, FL, 3Miller Scientific Consulting, Inc., Asheville, NC, USA Abstract: Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or ...

  5. 人工腰椎间盘置换治疗退行性腰椎间盘疾病16例分析%Preliminary clinical results of artificial disc replacement for degenerative disc disease in 16 cases

    Institute of Scientific and Technical Information of China (English)

    吴亮; 孙晓亮; 张雷; 吴国峰; 周剑; Yve Cartonne; Pascal Moussellard

    2012-01-01

    背景:与传统的单纯腰椎间盘切除和脊柱融合治疗方法相比,人工腰椎间盘置换具有明显的理论优势,已成为治疗退行性腰椎间盘疾病的最有希望的方法.目的:总结人工腰椎间盘置换治疗退行性腰椎间盘疾病的初步临床疗效.方法:2007-05/2010-10行人工腰椎间盘置换治疗退行性腰椎间盘疾病16例,其中男9例,女7例,平均年龄40.5岁(28~55岁).结果与结论:随访时间6~36个月,置换后目测类比评分、Oswestry功能障碍指数、椎间隙高度均较置换前有显著改善(P 0.05).结果显示人工腰椎间盘置换治疗退行性腰椎间盘疾病的初步临床结果令人满意,但其远期效果尚待进一步观察.%BACKGROUND: Simple discectomy and spinal fusion surgery were the classical methods for the degenerative disc disease.Comparing to them, artificial disc replacement (ADR) showed more theoretical superiority.OBJECTIVE: To present the preliminary clinical results of ADR for the treatment of degenerative disc disease.METHODS: From May 2007 to October 2010, ADR were preformed on 16 cases for the treatment of degenerative disc disease. 9 males and 7 females with average age of 40.5 years underwent ADR.RESULTS AND CONCLUSION: The follow-up time averaged 21.5 months (6 -36 months). Postoperative visual analogue scale,Oswestry Disability Index and intervertebral height were significantly improved as compared with those in preoperation (P 0.05). ADR can acquire satisfactory preliminary clinical results for the treatment of degenerative disc disease. However, further research is needed to study its long-term impact.

  6. A Meta-analysis of Cervical Disc Arthroplasty Compared to Anterior Cervical Discectomy and Fu-sion for Degenerative Cervical Disc Disease%颈椎间盘置换与融合治疗退变性颈椎间盘疾病的 Meta 分析

    Institute of Scientific and Technical Information of China (English)

    石青鹏; 朱永林

    2016-01-01

    Objective To systematically compare the outcomes of cervical disc arthroplasty with anterior cervical discecto-my and fusion in the treatment of single-level degenerative cervical disc disease. Methods The references concerning cervical disc arthroplasty and anterior cervical discectomy and fusion for the singel-level degenerative cervical disc disease were re-trieved through PubMed,Cochrane Library,Ovid,SpringerLink,the China Biological Medicine Database,Wafang Database and Weipu Database,as well as by manually searching the related journals and literature. The eligible trials were extracted accord-ing to the inclusion and exclusion criteria. The methodological quality of the included trials were evaluated. RevMan5. 1 soft-ware was used for data analysis. Results Eight randomized controlled trials were included in the final Meta-analysis. The re-sults of Meta-analysis showed that statistically difference between these procedures in the SF-36(MD = 0. 98,95% CI:- 0. 33~ - 2. 29,Z = 1. 46,P = 0. 14),complications(OR = 0. 60,95% CI:0. 34 ~ 1. 04,P = 0. 07),reoperation rate(OR = 0. 52, 95% CI:0. 26 ~ 1. 05,Z = 1. 83,P = 0. 07). There were no statistically difference in the neck disability index(MD = - 2. 74, 95% CI:- 4. 57 ~ - 0. 91,Z = 2. 93,P = 0. 003),neck VAS(MD = - 2. 84,95% CI:- 4. 85 ~ - 0. 84,Z = 2. 78,P = 0. 005) and arm pain VAS(MD = - 1. 84,95% CI:- 3. 07 ~ - 0. 61,Z = 2. 92,P = 0. 003). Conclusion In treatment of single-level degenerative cervical disc disease,cervical disc arthroplasty has better outcomes in the improvement of pain symptom and neck function,but no superiority in complications,reoperation rate and SF-36 scores.%目的:系统性评价颈椎间盘置换与颈椎间盘摘除和融合治疗单节段退变性颈椎间盘疾病的效果。方法计算机检索 PubMed、Cochrane Library、Ovid、SpringerLink、中国生物医学文献数据库、万方、维普等数据库,手工检索相关杂志及纳入研究的参考文献,制

  7. Wear studies on ZrO2-filled PEEK as coating bearing materials for artificial cervical discs of Ti6Al4V.

    Science.gov (United States)

    Song, Jian; Liu, Yuhong; Liao, Zhenhua; Wang, Song; Tyagi, Rajnesh; Liu, Weiqiang

    2016-12-01

    Polyetheretherketone (PEEK) and its composite coatings are believed to be the potential candidates' bio-implant materials. However, these coatings have not yet been used on the surface of titanium-based orthopedics and joint products and very few investigations on the tribological characteristics could be found in the published literature till date. In this study, the wettabilities, composition and micro-hardness were characterized using contact angle measurement, scanning electron microscopy (SEM) and hardness tester. The tribological tests were conducted using a ball-on-disc contact pair under 25% newborn calf serum (NCS) lubricated condition. For comparison, bare Ti6Al4V was studied. The obtained results revealed that those PEEK/ZrO2 composite coatings could improve the tribological properties of Ti6Al4V significantly. Adhesive wear and mild abrasive wear might be the dominant wear and failure mechanisms for PEEK/ZrO2 composite coatings in NCS lubricated condition. After comprehensive evaluation in the present study, 5wt.% ZrO2 nanoparticles filled PEEK coating displayed the optimum tribological characteristics and could be taken as a potential candidate for the bearing material of artificial cervical disc.

  8. Minimizing cryopreservation-induced loss of disc cell activity for storage of whole intervertebral discs

    OpenAIRE

    SCW Chan; SKL Lam; VYL Leung; Chan, D.; KDK Luk; KMC Cheung

    2010-01-01

    Severe intervertebral disc (IVD) degeneration often requires disc excision and spinal fusion, which leads to loss of spinal segment mobility. Implantation of an allograft disc or tissue engineered disc construct emerges as an alternative to artificial disc replacement for preserving the motion of the degenerated level. Establishment of a bank of cadaveric or engineered cryopreserved discs enables size matching, and facilitates clinical management. However, there is a lack of understanding of ...

  9. Early efficacy of Prestige LP artificial disc replacement on cervical disc gegenerative diseases%Prestige LP颈椎人工椎间盘置换治疗颈椎病的初期疗效

    Institute of Scientific and Technical Information of China (English)

    张亮; 冯新民; 倪斌; 卢旭华; 杨建东; 王永祥; 孙钰

    2013-01-01

    目的 探讨应用Prestige LP人工椎间盘置换治疗颈椎病的初期疗效.方法 采用Prestige LP人工颈椎间盘置换术治疗颈椎病14例,统计并分析患者术前和术后随访时相关指标并进行比较.结果 所有患者均为单节段置换,术后随访平均15.6个月.术后JOA评分由(10.3±2.1)分提高到(15.2±4.4)分,NDI评分由(42.30±10.15)%改善到(16.54±8.16)%,颈部疼痛VAS评分由(5.2±1.4)分改善到(1.6±0.7)分,上肢疼痛由(5.3±1.7)分改善到(1.7±0.8)分,差异均有统计学意义(P<0.05);术后患者生存质量明显改善,SF-36中物理评分从(34.2±5.1)%改善至(52.3±6.5)%,心理评分从(39.2±3.7)%改善至(55.3±4.6)%(P<0.05).术后手术节段颈椎曲度由(7.1±2.4)°改善至(12.8±3.1)°(P<0.05),颈椎的整体曲度由前(15.7±5.3)°改善至(17.1±6.0)°(P>0.05);手术前后手术节段活动度、手术节段邻近节段活动度无明显变化(P>0.05).结论 应用Prestige LP人工椎间盘置换术治疗颈椎病初期临床疗效良好,中远期疗效有待进一步观察.%Objective To evaluate the short-term radiological and functional outcome of Prestige LP artificial disc replacement for cervical disc degenerative diseases.Methods Fourteen patients with cervical disc degenerative diseases underwent Prestige LP artificial disc replacement.The JOA score,NDI score,VAS score for neck and arm pain,SF-36 scores were reviewed respectively preoperatively and postoperatively.The angulation of the treated level,the global cervical and the adjacent level above and below the treated level were also reviewed preoperatively and at the last follow-up.Results At an average of 15.6 month follow-up,the JOA score and NDI score were significantly improved from (10.3±2.1) to (15.2±4.4) and from (42.30±10.15)% to (16.54±8.16)%.The VAS for neck and arm pain were all significantly improved from (5.2±1.4) and (5.3±1.7) to (1.6±0.7) and (1.7±0.8) respectively.The mean

  10. The NEtherlands Cervical Kinematics (NECK) Trial. Cost-effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; A double-blind randomised multicenter study

    NARCIS (Netherlands)

    M.P. Arts (Mark); R. Brand (René); B.W. Koes (Bart); W.C. Peul (Wilco); M.E. van den Akker (Elske)

    2010-01-01

    textabstractBackground. Patients with cervical radicular syndrome due to disc herniation refractory to conservative treatment are offered surgical treatment. Anterior cervical discectomy is the standard procedure, often in combination with interbody fusion. Accelerated adjacent disc degeneration is

  11. Application of finite element analysis in a biomechanical study on artificial lumbar disc%有限元分析在腰椎人工椎间盘生物力学研究中的应用

    Institute of Scientific and Technical Information of China (English)

    陈小龙; 海涌; 关立; 刘玉增

    2015-01-01

    Lumbar disc herniation is one of the major causes of chronic low back pain. Fusion surgery is the gold standard in surgical treatment of the disease, while adjacent segment degeneration is often resulted from the fusion surgery. In order to keep normal motion of the disc, artiifcial disc replacement has been put forward. In the past 50 years, the technology has developed from basic research and animal experiment stage to clinical application stage, which has become a routine treatment option for chronic low back pain. In recent 20 years, there has been many clinical and biomechanical research reports at home and abroad. Along with the advance of the technology, finite element method has been increasingly used in the biomechanical study on artificial lumbar disc. A large number of studies show that the clinical outcomes of disc prostheses are good, while the design and application of artiifcial intervertebral disc remain to be improved. By using three-dimensional ( 3 D ) ifnite element method, the mechanical properties can be obtained through the simulated body condition and simple physical experiment of artiifcialdisc prostheses, so as to reflect the mechanical changes of artificial disc in the process of physiological and pathological processes. The ifnite elementmethod can be used to analyze the stress and strain of components with complex morphology, structure, material and loading condition, with the advantages of comprehensive mechanical properties, repeatability, high-level controllability, etc. In this paper, the characteristics of several kinds of commonly used ifnite element analysis softwares are introduced, and the research results of ifnite elementmethod in artiifcial disc replacement and the effects of artiifcial disc implantation on spinal biomechanics are summarized. When compared with in vitro experiment, the finite element method has its own advantages and disadvantages. It is thought that more meaningful results can be achieved through the

  12. 人工腰椎间盘置换术恢复脊柱运动和载荷能力的意义%Significance of recovering spinal motion and carrying ability by artificial lumbar intervertebral disc replacement

    Institute of Scientific and Technical Information of China (English)

    苏培强; 黄东生; 李春海; 马若凡; 彭焰; 刘尚礼

    2003-01-01

    Aim To introduce and apply artificial lumbar interverte-brai disc replacement for the treatment of lumbar disc degenerative diseasesand lumbar disc herniation accompanying evident disc space narrowing andinvestigate the regulation of its recovering spinal motion and carrying a-bility. Methods Thirty-one cases (37 discs) of artificial lumbar disc re-placement were performed using SB Charite Ⅲ from April 1998 to April2000. Among them, disc degenerative diseases were in 16 cases (18discs), disc herniation accompanying evident disc space narrowing in 13cases ( 17 discs), rec urrent dise herniation in 2 cases. The rehabilitationtraining was done under postoperative instructions. Results All the caseswere followed up from 17 to 41 months (averagely 26 months) untilSeptember 2001. The clinical outcomes were excellent in 23 cases, goodin 6 cases, fair in 2 cases. The mobility of the operated level had 4.0°anterior flexion and 5. 1° posterior extension after operation and 9.1° ontotal mobility. Meanwhile, the operated intervertebral space got an average4. 2 mm higher than that before. Because of technical problem, a slightdisplacement of the core occurred in one case without any clinical symp-toms and signs. Conclusion Artificial lumbar disc replacement can re-covery spinal motion and carrying capacity and provides a new kind ofoperation for the treatment of lumbar disc degenerative diseases and discherniation accompanying evident disc space narrowing.%目的应用人工腰椎间盘置换术治疗腰椎间盘退行性变疾病,探讨恢复脊柱运动功能和载荷能力的规律性.方法1998-04/2000-04,应用改良型SB ChariteⅢ型人工腰椎间盘行腰椎间盘置换术共31例37个间隙,其中腰椎间盘退变16例18个间隙、合并椎间隙狭窄的腰椎间盘突出症13例17间隙、复发性腰椎间盘突出症2例,术后指导进行康复训练.结果随访率100%,截止至2001-09,随访17~41个月(平均26个月).临床评价优23例,良6

  13. Fusion around cervical disc prosthesis: case report.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.

    2005-01-01

    OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a righ

  14. Artroplastia total de disco cervical com prótese de Bryan: resultados clínicos e funcionais Artroplastía cervical total con prótesis de Bryan: resultados clínicos y funcionales Cervical total disc arthroplasty with Bryan disc: clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Eduardo Machado de Menezes

    2012-09-01

    resultados buenos y excelentes, 10% satisfactorios y el 7% malos. Hubo sólo una complicación (3%, que se revirtió con artrodesis anterior. CONCLUSIONES: La artroplastia discal cervical ha demostrado ser un método seguro y eficaz para el tratamiento de casos seleccionados de hernia de disco cervical asociada a la radiculopatía y/o a compresión de la médula espinal en el corto y mediano plazo.OBJECTIVE: To evaluate results of cervical disc arthroplasty with the Bryan prosthesis for treatment of cervicobrachial pain (radiculopathy and spinal cord compression (myelopathy. METHODS: From 2002 to 2007, the CECOL surgical staff has operated 65 patients. Only 28 patients were found in 2010 to a new data collection. The pre- and post-operative evaluation was conducted using the CSOQ questionnaire (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to local culture. RESULTS: There was a significant symptomatic and functional improvement in most patients. The reduction of neck pain (axial and brachial pain (radicular was similar. Odom criteria showed 82.1% good and excellent results, 10% satisfactory and 7% poor. There was only one complication (3% which was reversed with anterior arthrodesis. CONCLUSIONS: The total cervical disc arthroplasty has proved to be a safe and effective method to treat selected cases of cervical disc herniation with radiculopathy and/or myelopathy in the short and medium term.

  15. Research Progress on Biotribological Studies in Artificial Disc Prosthesis: The Method by Using Spinal Simulators%人工椎间盘生物摩擦学研究进展:脊柱模拟试验机方法

    Institute of Scientific and Technical Information of China (English)

    王松; 廖振华; 刘宇宏; 刘伟强; 温诗铸

    2013-01-01

    A lot of methods have been used for evaluation on biotribological performance in artificial disc, one of them is the application of spinal simulators,which has been widely used to study the medium and long - term wear performance of disc prosthesis. This review showed the current literatures regarding to the study about the wear performance in disc prosthesis by using spinal simulators, introduced the types of spinal simulators, research methods as well as relative test standards. In particular, it also presented the updated information about the research progress on effect factors of wear performance in disc prosthesis (structural design, materials for joint prosthesis, surface treatment, load/motion/frequency, lubricating liquid, wear time, etc. ) , and summarized some research results about wear performance in cervical/lumbar artificial disc prosthesis.%人工椎间盘生物摩擦学性能评估有多种研究方法,其中使用脊柱模拟试验机是评估椎间盘假体中长期磨损性能的主要手段.本文整理了近年来使用脊柱模拟试验机进行椎间盘假体磨损性能评估的研究文献,介绍了现有脊柱模拟试验机种类和研究方法以及相关试验标准;分析了近年来针对影响假体磨损性能主要因素(假体结构设计、关节材料、材料表面处理、载荷/运动/频率、润滑液、磨损时间等)所取得的研究进展;综述了主要颈腰椎人工椎间盘假体的磨损性能.

  16. Clinical Analysis of 16 cases of Artificial Knee Joint Arthroplasty%人工膝关节表面置换术16例临床分析

    Institute of Scientific and Technical Information of China (English)

    吴双宝

    2014-01-01

    目的:介绍膝关节表面置换治疗膝关节炎的方法,探讨其疗效.方法:我院自2009年10月~2013年8月,对16例患者22个膝关节施行膝关节表面置换术.结果:随访资料完备,随访5~18个月,平均10.7个月,膝关节(HSS)评分,均增加到80分以上;膝关节活动范围(ROM)增加至90°以上.术中1例发生早期并发症.结论:人工膝关节表面置换术(TEA)可有效缓解关节疼痛,改善膝关节活动度,并矫正膝关节畸形,是治疗终末期膝关节疾病的有效方法,可以在基层医院推广应用.%Objective:To introduce the method of total knee arthroplasty(TEA)in the treatment of knee osteoarthritis, and to investigate its efficacy. Methods:From October 2009 to August 2013, 16 patients(22 knees)were treated with total knee arthroplasty. Results:The follow-up data was complete and the follow-up period was 5 to 18 months with an average of 10.7 months. The patients’hospital for special surgery(HSS)score was increased to 80 points or more;range of motion(ROM)of knee joint increased to 90° or more. Early complications occurred in 1 case. Conclusion:TEA can effectively relieve joint pain, improve knee joint ROM, and correct the knee joint deformity, so it is an effec-tive method for the treatment of end-stage knee joint disease, and it is can be generalized in the primary hospital.

  17. 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

  18. 10%盐水冰袋联合弹力绷带持续加压冷敷用于全膝关节置换术后关节肿痛%Continued pressured cold therapy by using elastic bandage to secure 10% saline ice pack for pain and swelling after artificial total knee arthroplasty

    Institute of Scientific and Technical Information of China (English)

    王春萍; 田琴; 李英

    2012-01-01

    Objective To safely and effectively minimize swelling and pain after artificial total knee arthroplasty. Methods Totally, 60 patients with knee joint osteoarthritis scheduled for total knee arthroplasty were divided into 2 groups commensurateiy (odd registration ID number for the observation group, and even number for the control group). After arthroplasty, a common gauze roller bandage was applied to the surgical site of the control group and then a 10% saline ice pack was placed above the bandage. An elastic compression bandage was applied lo the surgical site of the observation group, and was topped by a 10.% saline ice pack, which was secured to the operated knee by another roll of elastic compression bandage. Results Swelling and pain after artificial total knee arthroplasty in the observation group were significantly milder than those in the control group, and the time it took for swelling and pain to subside in the observation group was significantly shortened than in the control group CPartificial to tal knee arthroplasty and boost them to subside.%目的 探讨安全经济有效的减轻全膝关节置换术后关节肿胀及疼痛的方法.方法 将60例膝关节骨性关节炎实施全膝关节置换术患者按住院号单双数分为观察组和对照组各30例.术后对照组采用绷带包扎,10%盐水冰袋冷敷;观察组用弹力绷带包裹患肢后用10%盐水冰袋冷敷,再用弹力绷带加压包扎,均持续3d.结果 观察组下肢肿胀、疼痛程度显著轻于对照组,肿胀及疼痛消退时间显著短于对照组(均P<0.01).结论 10%盐水冰袋联合弹力绷带持续加压冷敷可有效减轻全膝关节置换术后膝关节肿胀和疼痛,加快肿胀、疼痛消退.

  19. 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...

  20. Design principle and development tendency of artificial lumbar disc prosthesis%人工腰椎间盘假体设计原理研究及未来趋势发展

    Institute of Scientific and Technical Information of China (English)

    董可欣; 马德春; 李秋菊; 张丽; 李磊

    2014-01-01

    BACKGROUND:Artificial lumbar disc replacement is a new choice for the treatment of degenerative disc disease, and preserves lumbar vertebra’s biomechanical characteristics during pain elimination. The design of the prosthesis structure and material needs further study and validation. OBJECTIVE:To review the structure and material types of presently designed artificial lumbar discs, then to discuss the trends in the optimization design of prosthesis. METHODS:The PubMed database, China National Knowledge Infrastructure database and Chinese BioMedical Literature Database were searched for related articles concerning artificial lumbar disc and type and biomechanics of nucleus pulposus prosthesis material published from January 2005 to February 2013 by the first author. Key words were“artificial lumbar disc, principle of prosthesis design, structure, material, clinical trials”in Chinese and“artificial lumbar disc, total disc replacement, structure, material, clinical trial”in English. Repetitive and old studies were excluded. 135 articles were found, but 36 articles were included for review. RESULTS AND CONCLUSION:At present, the materials for intervertebral discs include cobalt-chromium al oy, ceramics, stainless steel, titanium al oy and ultrahigh molecular weight polyethylene. Artificial lumbar disc is commonly made by different materials. Bryan prosthesis is most commonly used in the clinic. Three-dimensional finite element analysis, in vitro trial and clinical studies verified its good biomechanical property. The successful rate of replacement was high. Nucleus prosthesis contains prefabricated type and situ polymerization type, and obtains smal injury, so it is a hot focus in present study, but it cannot achieve biomechanical function of human nucleus pulposus. To dig novel material is a future direction for designing individual prosthesis. The prosthetic structure and biomaterial design experience constant improvement and development. This study

  1. Discover人工颈椎间盘置换治疗颈椎间盘退变性疾病的临床疗效%Outcome of discover cervical artificial disc replacement for degenerativedisc disease of the cervical spine

    Institute of Scientific and Technical Information of China (English)

    何智勇; 李开南; 聂海; 母建松; 兰海

    2012-01-01

    Objective To estimate the clinical effects on Discover cervical artificial disc replacement for degenerative disc disease of the cervical spine. Methods A total of 20 patients with cervical disc degeneration, whose pain is not relieved adequately with six weeks of conservative care and daily activities become difficult, were chosed in this study between January 2007 and August 2011. The clinical outcomes were assessed using neck disable index (NDI) and visual analogue scale ( VAS) and Odora scale before surgery and 1、6、12、24 months after surgery. Imageological examination included X ray, cervical CT scanning and MR imaging. Results There are 26 levels in 20 patients performing cervical disc replacement and the follow-up period was 24 months. The NDI, VAS of neck pain, VAS of arm pain were from (23. 82 ±2. 87)、(5.90 ±0. 35)、(5. 91 ±1.63) before sugery to (5. 21 ± 1. 12)、(1. 62 ±0. 87)、(0. 97 ±0. 65) 2 years after sugery. Odom scale were excellent or good in all palienls. The operation time was 60-210 minutes and the estimated blood loss was 70 - 350 milliliter. The motion function of cervical artificial disc implanted was very good with imageology evaluation. The prosthesis moved forward 3 mm in one patient, and another patient had heterotopic ossification 12 months after surgery. Conclusion Discover cervical artificial disc replacement for degenerative disc disease of the cervical spine is safe and effective, however, further study should be conducted to determine the long term outcome.%目的 评价Discover人工颈椎间盘置换治疗颈椎间盘退变性疾病的临床疗效.方法 2007年1月~2011年8月,20例颈椎间盘退变突出经保守治疗无效的患者行人工颈椎间盘置换术.患者术前、术后1、6、12、24个月时使用颈椎功能障碍指数(neck disable index,NDI)、疼痛视觉模拟疼痛量表(visual analogue scale,VAS)进行疗效评估,手术效果采用Odom法评价.影像学检查包括颈椎动力位X

  2. Incidence of secondary surgical procedures after cervical disc arthroplasty compared to fusion: a meta-analysis%颈椎人工椎间盘置换术与前路减压融合固定术再手术率的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姜东杰; 顾庆国; 王占超; 王新伟; 袁文

    2015-01-01

    目的 比较颈椎人工椎间盘置换术与前路减压融合固定术治疗单节段颈椎病术后相邻节段和手术节段再手术的发生率.方法 计算机检索Pubmed、Medline、Ovid、Embase、Cochrane Library和中国生物医学文献数据库、万方、维普等数据库,英文检索词为"cervical"、"replacement OR arthroplasty OR prosthesis’,、"fusion OR arthrodesis","reoperation ORsecondary surgical procedure",中文检索词为"颈椎"、"间盘置换"、"融合"、"再手术".由2名评价者严格按照纳入及排除标准进行文献筛选,收集关于颈椎人工椎间盘置换术与前路减压融合固定术再手术发生率的前瞻性随机对照研究.根据Cochrane Reviews Handbook 5.1.0的RCT偏倚风险评价标准对纳入文献的偏倚风险进行独立评价,并采用Review Manager5.2软件进行统计分析相邻节段和手术节段的再手术发生率.结果12篇文献纳入研究,短期(2年)随机对照研究6篇,中远期(4~8.8年)随机对照研究6篇.4篇为低偏倚风险,7篇为中偏倚风险,1篇为高偏倚风险.Meta分析显示,短期随访结果 中两种术式在相邻节段的再手术发生率无明显差异,而中远期随访结果显示非融合组术后相邻节段再手术率低于融合组;非融合组手术节段再手术率均低于融合组.短期随访中两组患者采用Removal翻修方法的例数无差别;中远期随访中融合组患者采用该翻修方法进行翻修的人数多于非融合组.结论 非融合术式能在一定程度上降低相邻节段再手术的发生率,但是在短期(2年)内对降低邻近节段再手术的发生率效果并不明显.减少融合术后假关节形成是降低融合术式手术节段再手术率的有效方法.%Objective To compare the incidence of secondary surgical procedures after cervical disc arthroplasty vs anterior cervical discectomy with fusion in patients treated for symptomatic single level cervical spondylosis.Methods An online

  3. 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 ...

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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.

  10. 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 ...

  11. The short-term efficacy of Prestige LP artificial disc single-level replacement for cervical spondylosis%Prestige LP人工椎间盘置换治疗单节段颈椎病的近期疗效

    Institute of Scientific and Technical Information of China (English)

    黄波; 卢一生; 施建东; 徐静芳; 刘振刚

    2014-01-01

    Objective To evaluate the short-term radiological and functional outcome of artifi-cial disc single-level replacement for cervical disc degenerative diseases. Methods 15 patients with cervical disc degenerative diseases underwent Prestige LP artificial disc replacement were se-lected in this study. There were 8 cases of cervical spondylotic myelopathy and 7 cases of nerve root cervical syndrome. The range of motion(ROM) of the cervical spine,ROM of treated segment and lordosis of cervical spine were reviewed respectively at preoperation and 1 month,3 months and 12 months postoperation,and the NDI scores,VAS for neck and arm pain were also reviewed respectively preoperation and the last follow-up. Results At an average of 16.3 months(range 6-24 months) follow-up,the neurologic symptom and sign in all cases had significant improvement. The NDI was significantly improved from(47.80±11.52)% to(16.20±9.34)%(P<0.05),the VAS for neck and arm pain were all significantly improved from(5.13±1.44) and (6.30±1.51) to (1.46±0. 81) and (1.14 ±0.57) respectively (P<0.05). The lordosis of cervical spine was significantly in-creased at follow up (P<0.05). The ROM of the cervical spine and ROM of treated segment re-covered to the preoperative level. There was no neurological complication during operation,and no ossification in the replaced level and no prosthesis displacement and loosening . Conclusion Our findings suggest that the Prestige LP cervical disc replacement in the treatment of cervical disc degenerative diseases has good functional short-term results, further follow-up is necessary to e-valuate mid- and long-term outcome.%目的:探讨应用Prestige LP人工椎间盘置换治疗单节段颈椎病的近期临床疗效。方法治疗单节段颈椎病患者15例,统计并分析患者术前和术后1、3、12个月随访时JOA评分、NDI脊髓功能评分、颈部及上肢疼痛VAS评分、置换节段活动度、颈椎运动范围、颈椎生理曲度等指标

  12. Cross-shear implementation in sliding-distance-coupled finite element analysis of wear in metal-on-polyethylene total joint arthroplasty: intervertebral total disc replacement as an illustrative application.

    Science.gov (United States)

    Goreham-Voss, Curtis M; Hyde, Philip J; Hall, Richard M; Fisher, John; Brown, Thomas D

    2010-06-18

    Computational simulations of wear of orthopaedic total joint replacement implants have proven to valuably complement laboratory physical simulators, for pre-clinical estimation of abrasive/adhesive wear propensity. This class of numerical formulations has primarily involved implementation of the Archard/Lancaster relationship, with local wear computed as the product of (finite element) contact stress, sliding speed, and a bearing-couple-dependent wear factor. The present study introduces an augmentation, whereby the influence of interface cross-shearing motion transverse to the prevailing molecular orientation of the polyethylene articular surface is taken into account in assigning the instantaneous local wear factor. The formulation augment is implemented within a widely utilized commercial finite element software environment (ABAQUS). Using a contemporary metal-on-polyethylene total disc replacement (ProDisc-L) as an illustrative implant, physically validated computational results are presented to document the role of cross-shearing effects in alternative laboratory consensus testing protocols. Going forward, this formulation permits systematically accounting for cross-shear effects in parametric computational wear studies of metal-on-polyethylene joint replacements, heretofore a substantial limitation of such analyses.

  13. Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up%颈椎人工间盘置换与前路减压融合修复单节段颈椎间盘突出症:3年随访

    Institute of Scientific and Technical Information of China (English)

    程俊杰; 眭江涛; 马原; 田慧中

    2015-01-01

    stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration. These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P0.05). The

  14. Recent development on surface modification of artificial disc material for wear resistance%人工椎间盘关节材料表面耐磨改性研究进展

    Institute of Scientific and Technical Information of China (English)

    王松; 廖振华; 刘宇宏; 刘伟强

    2013-01-01

    Generally titanium alloy and ultra-high molecular weight polyethylene (UHMWPE) are software materials in artificial disc joint material pairing, so their surface modification is important to improve the wear resistance and long-term stability of the prosthesis. The recent development to improve surface hardness and wear resistance of the titanium alloy by using heat treatment, micro-arc oxidation, surface infiltration elements, plated DLC films, laser surface modification and ion implantation technology are reviewed. Then the research to improve surface hardness and wear resistance of UHMWPE by plating DLC films are introduced. At last, the future trends of the artificial disc prosthesis wear resistance are analyzed.%钛合金和超高分子量聚乙烯(UHMWPE)在人工椎间盘关节材料配对中一般是软体材料,其表面改性对提高假体耐磨性能及长期稳定性有重要意义.主要介绍了采用热处理、微弧氧化、表面渗元素、表面镀DLC膜、激光表面改性、离子注入技术提高钛合金表面硬度和耐磨性的研究进展,以及采用表面镀DLC膜等提高UHMWPE表面硬度和耐磨性的研究现状,展望了人工椎间盘假体耐磨性研究的发展趋势.

  15. 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.

  16. Arthroplasty register for Germany

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2009-10-01

    Full Text Available 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 was conducted in September 2008 in the medical databases MEDLINE, EMBASE etc. and was complemented with a hand search. Documents describing arthroplasty registers and/or their relevance as well as papers on legal, ethical and social aspects of such registers were included in the evaluation. The most important information was extracted and analysed. Results: Data concerning 30 arthroplasty registers in 19 countries as well as one international arthroplasty register were identified. Most of the arthroplasty registers are maintained by national orthopedic societies, others by health authorities or by their cooperation. Mostly, registries are financially supported by governments and rarely by other sources.The participation of the orthopedists in the data collection process of the arthroplasty registry is voluntary in most countries. The consent of the patients is usually required. The unique patient identification is ensured in nearly all registers.Each data set consists of patient and clinic identification numbers, data on diagnosis, the performed intervention, the operation date and implanted prostheses. The use of clinical scores, patient-reported questionnaires and radiological documentation is rare. Methods for data documentation and transfer are paper form, electronic entry as well as scanning of the data using bar codes. The data are mostly being checked for their completeness and validity. Most registers offer results of the data evaluation to the treating orthopedists and

  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. 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

  19. 人工颈椎间盘与颈椎动态稳定器治疗颈椎病的早中期临床疗效和影像学分析%A comparison of cervical disc arthroplasty versus dynamic cervial implant in the treatment of cervical spondylopathy:a clinical and radiological study

    Institute of Scientific and Technical Information of China (English)

    关立; 陈小龙; 海涌; 刘玉增; 汪文龙; 于志毅

    2015-01-01

    ;两组患者术后6个月和末次随访与术前比较,差异均有统计学意义(P<0.01),但两组间术前及术后末次随访时差异无统计学意义(P>0.05);两组患者术前、术后6个月及末次随访时对比,手术节段椎间隙高度、手术节段和相邻节段椎间活动度差异无统计学意义(P>0.05)。Prodisc-C 组术后末次随访发现3例异位骨化,2例假体前移1 mm,DCI 组未出现异位骨化和假体移动。结论 Prodisc-C 人工颈椎间盘与 DCI 治疗颈椎病均能保留颈椎活动度,恢复和维持椎间隙高度和颈椎生理弧度,早中期疗效满意。%Objective To evaluate the clinical and radiological outcomes of cervical disc arthroplasty by Prodisc-C versus dynamic cervial implant ( DCI ) in the treatment of cervical spondylopathy.Methods All cervical spondylopathy cases undergoing cervical disc arthroplasty by Prodisc-C or dynamic cervial implant between February 2011 and February 2013 were analyzed retrospectively. There were 16 patients in anterior cervical disc arthroplasty group ( male 8, female 8 ). Age averaged 44 years ( range: 32-54 years ). There were 10 cases with cervical spondylotic myelopathy, and 6 cases with radicular spondylosis. In dynamic cervical implant group were 10 cases ( male 6, female 4 ). Age averaged 44.5 years ( range: 33-55 years ). There were 7 cases of cervical spondylotic myelopathy, and 3 cases of radicular spondylosis. Parameters as gender, age, operation time and blood loss of all the patients were analyzed. The patients were followed 1 month, 3 months, 6 months, 12 months and 24 months postoperatively. Neck disability index ( NDI ), Japanese Orthopaedic Association ( JOA ) Score and Visual Analogue Scale ( VAS ) were used to evaluate the clinical outcomes of the two groups. Anterioposterior and lateral X-ray, hyperextension and hyperflexion X-ray films before and after surgery were analyzed and cervical lordosis, the height of disc, range of motion

  20. Design of an Elastic Arthroplastic Disc Optimized under Different Loads

    Directory of Open Access Journals (Sweden)

    Azadeh Ghouchani

    2011-06-01

    Full Text Available Introduction: Due to limitations of current treatments for degenerative disc disease, arthroplastic methods to repair the diseased disc have been proposed. The artificial disc is a mobile implant for degenerative disc replacement that attempts to lessen the degeneration of the adjacent elements following interbody fusion procedures. Because the success of artificial disc replacement depends on maintenance or restoration of the mechanical function of the intervertebral disc, it is useful to study the initial mechanical performance of the disc after implantation in the spine.   Materials and Methods: A three-dimensional finite element model of the L3–L4 disc was analyzed. The model took into account the material nonlinearities and it imposed different loading conditions. In this study, we validated the model by comparison of its predictions with several sets of experimental data; we determined the optimal Young’s modulus as well as the Poissan ratios for the artificial disc under different loading conditions. Results: The artificial disc was subjected to three loading conditions: 1 compression, 2 bending and 3 torsion. In each case, optimum elastic parameters were determined. Then, by using the root mean square method, optimum parameters for all loading conditions (and therefore minimum error were calculated. Discussion and Conclusion: The results of this study suggest that a well-designed elastic arthroplastic disc preferably has Young’s modulus values of 18.63 MPa and 1.19 MPa for the annulus and nucleus sections, respectively. Elastic artificial disc with such properties can then achieve the goal of restoring the disc height and mechanical function of a normal disc under different loading conditions.

  1. Mid-term clinical outcome of Bryan artificial cervical disc replacement for cervical spondylosis and its effect on degeneration of adjacent discs%Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果及对邻近椎间盘退变的影响

    Institute of Scientific and Technical Information of China (English)

    王贝宇; 曾建成; 孔清泉; 刘浩; 丁琛; 胡韬; 石锐; 李涛; 洪瑛; 宋跃明; 刘立岷

    2011-01-01

    Objective To observe the clinical outcome of Bryan artificial cervical disc replacement for cervical spondylo-sis, and to investigate its effect on degeneration of adjacent discs in mid-term study. Methods From November 2004 to December 2007, 34 patients (38 discs) receiving Bryan artificial cervical disc replacement were included in this study. Clinical results were evaluated by SF-36 score, neck disability index (NDI) score, neck/arm pain visual anatague scale (VAS) scores and Odom' s scale. The data were collected before surgery and at 1 week ,3,6, 12, 24, 36, 48 and 60 months after surgery. Adjacent degeneration was assessed by scoring system of cervical disk degeneration based on neutral lateral radiographs before operation and 12, 24, 36, 48 and 60 months after surgery. Incidence of postoperative complications and reoper-ations were also recorded. Results The neurological symptoms of each patient were significantly alleviated in short term after operation. The postoperative SF-36 physical component score and SF-36 mental component score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of pre-operation. In 36 and 48 months after surgey, excellent and good outcomes were observed , though there were some cases with decreased outcomes; sound outcomes were achieved at the final follow-up in all cases. Mild degeneration of adjacent discs occurred after operation, but there was no severe degeneration at the final follow-up. There was no prosthesis subsidence or excursion, no heterotopic ossification or spontaneous fusion, and no reoperation. Conclusion Bryan artificial disc replacement has a sound clinical outcome in mid-term and can protect against acceleration of adjacent discs degeneration.%目的 观察Bryan人工颈椎椎间盘置换术治疗颈椎病的中期临床效果,研究该术对邻近椎间盘的影响.方法 2004年11月~2007年12月间,对34例颈椎间盘突出症患者共38个节段实施Bryan人工颈椎

  2. 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.

  3. 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 ...

  4. ADJACENT SEGMENT DEGENERATION AFTER CERVICAL ARTIFICIAL DISC REPLACEMENT AT EARLY MID-TERM FOLLOW-UP%人工颈椎间盘置换术后邻近节段退变情况的早中期随访

    Institute of Scientific and Technical Information of China (English)

    刘雅普; 夏虹; 艾福志; 石林; 隋文渊

    2012-01-01

    Objective To study the effectiveness of artificial disc replacement for cervical diseases and the adjacent segment degeneration. Methods Between January 2008 and October 2010, 39 cases of cervical spondylosis underwent cervical disc replacement. Of them, there were 20 males and 19 females with an average age of 45.7 years (range, 32-60 years) and an average disease duration of 30 months (range, 1 month to 10 years), including 26 cases of cervical myelopathy, 11 cases of nerve root cervical spondylosis, and 2 cases of mixed cervical spondylosis. Single level disc lesion was observed in 27 cases while bi-level lesion in 12 cases. Prestige disc prosthesis was used in 9 patients, Prodisc-C prosthesis in 4 patients, and Discover disc prosthesis in 26 patients. The neurological functional recovery was assessed after operation by Japanese Orthopaedic Association (JOA) score. The range of motion of replaced segment and adjacent segments was measured (Cobb angle), and Kellgren's X-ray assessment was used to evaluate the degree of adjacent segment degeneration. Results The operation was successfully performed in all cases, with primary healing of all the incisions. All patients were followed up from 12 to 36 months with an average of 23.1 months. JOA score was significantly improved at last follow-up when compared with preoperative score (P 0.05). According to the Kellgren's X-ray assessment, degeneration of the adjacent segments occurred in 5 cases at last follow-up, including 3 cases of degeneration from grade 0 to grade 1 or 2, 1 from grade 1 to grade 2, and 1 from grade 2 to grade 3, with a degeneration rate of 12.8%, but no significant difference was found in degeneration degree when compared with preoperative value (X2=1.793, P=0.406). No degeneration of adjacent segments occurred in 32 patients at 15 months after operation. Conclusion Artificial disc replacement has a good effectiveness in treating cervical spondylosis, which can maintain the range of motion of the

  5. Artificial Total Disc Replacement for Lumbar Degenerative Disc Disease: A Systematic Review%人工全椎间盘置换治疗退行性腰椎间盘疾病的系统评价

    Institute of Scientific and Technical Information of China (English)

    何祖胜; 白靖平; 锡林宝勒日; 金格勒; 吴泰相; 李静

    2005-01-01

    目的分析人工全椎间盘置换治疗退行性腰椎间盘疾病的疗效.方法计算机检索Cochrane图书馆(2004年第2期)中的临床对照试验资料库和Cochrane协作网背痛专业试验数据库、MEDLINE(1966~2004)、EMBASE(1980~2004)、中国生物医学文献光盘数据库(CBMdisk,2003),手工检索中文文献(截自2004年6月),并询问相关厂家以及研究者.由两名评价员独立提取资料,并按Cochrane协作网提供的方法对纳入文献进行质量评价和结果分析.结果共纳入3个RCT,包括152例患者.文献质量评价结果显示,3个RCT均可能存在选择性偏倚、实施偏倚和测量偏倚的高度可能性.其中两篇使用ProDisc-Ⅱ人工全椎间盘置换,1篇使用SB-Ⅲ人工全椎间盘置换.3个RCT均未提供详细的原始数据,因此不能进行Meta分析.人工全椎间盘置换组病人术后早期VAS疼痛评分(visual analog scale)和ODI功能评分(oswestry disability index)有改善,但术后6个月与融合组无差异.病人满意率,术后6个月人工全椎间盘置换组有优于融合组的趋势.短期随访显示,人工椎间盘能够保存受累节段的运动功能.两篇RCT报告了相关并发症.结论人工全椎间盘置换短期内能够重建退变节段的高度及生理运动功能,但缺乏长期的随访,尤其对于能否防止毗邻节段的退变缺乏证据.尚需更多设计严格的研究以增加证据的强度.

  6. M obi-C 颈椎人工间盘置换治疗单节段颈椎间盘突出症的效果%Effect of Mobi-C cervical artificial disc replacement in the treatment of single proplase of cervical intervertebral disc

    Institute of Scientific and Technical Information of China (English)

    柳达; 黄瑛; 李彬; 贾长青; 许晓军; 梁峰; 付勤

    2013-01-01

    Objective:To research the short-term effect of Mobi-C cervical artificial disc replacement (CADR) therapy in patients with single proplase of cervical intervertebral disc .Methods:Mobi-C artificial cervical disc was applied to treat 12 cases of single proplase of cervical intervertebral disc .The data about clinical observation , imaging evaluation and questionnaire were collected at preoperative , postoperative ( 1-2 days ) and the end follow-up.Results:The patients were followed up for 6 to 24 months,average 13 months.All the patients were satisfactory to the outcome , excellent in 10 cases and good in 2 cases according to Odom criterion .The pain in upper limb and neck were significantly relieved, the VAS score immediately decreased 5.8 points after operation(P<0.05), and 5.5 points at the last follow-up(P<0.05).NDI and SF-36 improved obviously,which meant the patient′s quality of life improved obviously .Degeneration at the adjacent segments was not found in addition to 3 patient with heterotopic ossification .Conclusions:Mobi-C CADR therapy reserving mobility of cervical spine has a good effect in the early stage , and can improve the quality of life of the patients .%目的:探讨Mobi-C颈椎人工间盘置换治疗单节段颈椎间盘突出症的近期效果。方法:对应用Mobi-C颈椎人工间盘置换治疗的12例单节段颈椎间盘突出症患者于术前、术后(1~2 d )及末次随访时进行全面的影像学和临床评价,并进行问卷调查。结果:本组病例随访6~24月,平均13个月。 Odom临床疗效评价优10例,良2例。患者的颈部及上肢疼痛明显缓解,VAS评分术后下降了5.8分(P<0.05),末次随访时下降了5.5分(P<0.05)。颈椎功能障碍指数(NDI)和SF-36生活质量量表评分明显改善,患者的生活质量明显提高。除3例患者发生异位骨化外,未发现相邻节段退变加速。结论:保留颈椎活动度的Mobi-C颈椎人工间

  7. Medium term efficacy analysis of bi-level BRYAN artificial cervical disc replacement for the treatment of cervical spondylosis%双节段BRYAN人工颈间盘置换的中期疗效分析

    Institute of Scientific and Technical Information of China (English)

    种涛; 俞兴; 贾育松; 李春根; 柳根哲; 毕连涌; 徐林

    2013-01-01

    [ Objective]To observe the clinical effect and imaging results of the treatment of adjacent segment cervical spon-dylosis in the adjacent bi - level BRYAN cervical disc replacement. [ Method] A retrospective studying was performed on 19 cases of cervical spondylosis receiving adjacent bi - level BRYAN artificial cervical disc replacement and were followed up from January 2006 to February 2009 in our hospital. Clinical outcome of surgery was evaluated by Japanese Orthopaedic Association score (JOA) , neck disability index(NDI) and visual analogue pain scale (VAS)for neck pain before surgery and at 1 week,3, 6,12,24,36 months after surgery respectively. The range of motion (ROM) of the surgical segments, the upper and lower adjacent segments, and C2-7 was assessed by cervical dynamic X - ray film before operation and 3 ,6,12,24,36 months after sugery. Operative adjacent segment degeneration was assessed by X - ray disc degeneration scoring system 12,24 and 36 months after surgery. [Result]The neurological symptoms of each patients were significantly improved. The postoperative JOA score , NDI scores, neck pain VAS scores were improved significantly at each follow - up time point compared with those of preoperation, difference was statistically significant (P 0. 05). ROM of the two operative segment increased significantly compared with the preoperative each time point after 3 - month follow - up (P 0. 05). To the last follow - up, the surgery had not led to adjacent segment disc degeneration exacerbated and no serious complications occurred. [ Conclusion ] The clinical result of BRYAN artificial cervical disc replacement in the treatment of adjacent bi - level cervical degenerative disc disease is good, not only reserving the kinematic characteristics of operative segment, adjacent segments , C2-7 segment but preventing of adjacent segment degeneration. No serious complication occurs during mediterm follow - up.%[目的]观察相邻双节段BRYAN人工颈椎间盘

  8. Artificial cervical disc replacement: range of motion of replacement segment and degeneration of adjacent segments%人工颈椎间盘置换:置换节段活动度及相邻节段退变分析

    Institute of Scientific and Technical Information of China (English)

    陈渲宇; 初冬; 伍骥; 郑超; 黄蓉蓉; 崔玉明; 尚咏; 范恒华; 虞攀峰; 赵旭红

    2015-01-01

    BACKGROUND:In recent years,artificial cervical disc replacement surgery as a new method for the treatment of cervical disease has gradualy been accepted and understood,but relevant complications have gradualy attracted attention.OBJECTIVE:To investigate the clinical outcomes of artificial cervical disc replacement in the treatment of cervical disease and the range of motion of the replacement segment.METHODS: A total of 25 patients with artificial cervical disc replacement in the treatment of cervical spondylosis,who were treated in the Department of Orthopedics,Air Force General Hospital of Chinese PLA from August 2006 to April 2012,were enroled in this study,including 15 males and 10 females,aged 31-76 years,averagely 51.04 years.There were 6 cases of double segments and 19 cases of single segment.They were folowed up for 24 to 93 months.Clinical results were assessed using the Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores.Imaging was used to observe range of motion,cervical curvature,heterotopic ossification,and degeneration of adjacent segments.RESULTS AND CONCLUSION:Neurological function in al patients was improved to different degrees.One case suffered from mild heterotopic ossification,but no clinical symptoms were found.No significant difference in range of motion of surgical segment,and range of motion of upper and lower adjacent segments was detected between pre-replacement and final folow-up results (P>0.05).No significant difference in range of motion of C2-C7 was found between pre-replacement and final folow-up results (P>0.05).Japanese Orthopaedic Association score,cervical dysfunction index and pain visual analog scale scores were significantly improved during final folow-up compared with pre-replacement (P<0.05).These results indicated that artificial cervical disc replacement in the treatment of cervical disease can achieve better clinical efficacy,can keep the range of motion of

  9. Clinical outcome of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis: A midterm follow-up%Bryan人工颈椎间盘置换治疗颈椎病的中期临床随访

    Institute of Scientific and Technical Information of China (English)

    丁琛; 孔清泉; 刘浩; 胡韬; 石锐; 李涛; 洪瑛; 宋跃明; 刘立岷; 曾建成

    2011-01-01

    BACKGROUND: Although the short-term clinical efficacy of Bryan artificial cervical disc replacement is generally acknowledged by most spinal surgeons, the midterm and long term clinical results and complications are still unclear.OBJECTIVE: To summarize midterm term clinical results of Bryan artificial cervical disc replacement for the treatment of cervical spondylosis.METHOD: From November 2004 to December 2007, 34 patients had Bryan cervical disc replacement in Department of Orthopedics, West China Hospital were selected, including 30 cases with single replacement and 4 cases with bi-level replacement. Clinical result was evaluated by SF-36 score, JOA score, and neck/arm pain VAS scores. And the data was collected before surgery and at 7 days, 3, 6, 12, 24, 36 and 48 months after surgery. Neutral lateral and dynamic cervical radiographs were made to measure the flexion-extension range of motion (ROM) of operative segment, adjacent segments and C2-7 segment, the intervertebral height of operative and adjacent segments, and the translation of operative level. The intraoperative and postoperative complications were recorded and analyzed.RESULTS AND CONCLUSION: The neurological symptoms of each patient were alleviated notably. The postoperative SF-36physical component score and SF-36 mental component score, JOA score, NDI score and neck/arm pain VAS scores were significantly improved compared with those of the preoperative (P < 0.05), but no statistical significance were noted between each time point after 3-month follow-up (P > 0.05). Each implanted prosthesis preserved the ROM>2° at each follow-up time point,and no heterotopic ossification or spontaneous fusion was found at the operative segment. At 48-month follow-up,flexion-extension ROM of operative segment and C2-7 segment slightly increased but showed no statistical significance compared with the preoperative counterparts (P > 0.05); ROM of upper and lower adjacent segments also showed no statistical

  10. Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效%Clinic Therapeutic Effect of Bryan Artificial Disc Single Level Replacement on Cervical Disc Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    石锐; 刘浩; 丁琛; 胡韬; 李涛; 龚全; 宋跃明; 洪瑛

    2011-01-01

    -up visiting at the expected time in the next two years after the operation. Patients' symptom scale, VAS for neck pain, VAS for arm pain, NDI were 2. 80 ±0. 42, 4. 62 ± 1. 84, 5. 01 ±1. 79, and 22. 60±4. 88, respectively before the operation and significantly decreased to 0. 20±0. 42, 1. 01±0. 56, 0. 82±0. 24, and 4. 30+1. 25, respectively at the end of the follow-up. All patients had good or higher score of the Odom score. The ymptoms were completely relieved in eight patients (38. 1%). The mean operation time was (110. 5±42. 6) minutes, the average blood loss was (166. 0±108. 8) mL. The normal motion of the artificial disc was observed. No cervical instability was observed. Two prosthesis migrated slightly. Conclusion Single segmental Bryan disc replacement is safe and effective on the cervical disc degeneration. The two-year follow-up reveales a satisfied clinical outcome.

  11. Herniated lumbar disc

    OpenAIRE

    Jordon, Jo; Konstantinou, Kika; O'Dowd, John

    2011-01-01

    Herniated lumbar disc is a displacement of disc material (nucleus pulposus or annulus fibrosis) beyond the intervertebral disc space. The highest prevalence is among people aged 30 to 50 years, with a male to female ratio of 2:1.

  12. Herniated Lumbar Disc

    Science.gov (United States)

    Herniated Lumbar Disc What is a herniated disc? Nonsurgical treatment Medication and pain management Surgery What can I expect after ... at and just below the waist. A herniated lumbar disc can press on the nerves in the spine ...

  13. Effect of psychological intervention on pain and early rehabilitation of the patients after total artificial hip arthroplasty%疼痛心理干预对人工髋关节置换术后早期康复效果的影响

    Institute of Scientific and Technical Information of China (English)

    帅红; 李安

    2012-01-01

    Objective:To investigate the effect of psychological intervention on pain and early rehabilitation of the patients after total artificial hip arthroplasty. Methods: 60 patients who underwent total artificial hip arthroplasty were randomly divided into the experimental and control groups ( 30 cases in each group ). The patients in the control group were given routine nursing care, health education and analgesic treatment and the patients in the experimental group were additionally given comprehensive psychological interventions, such as cognitive behavior therapy, relaxation and biofeedback therapy and supportive psychotherapy. The degree of postoperative pain and hip joint function were observed in the two groups. Results:The pain scores in the resting and active state respectively in 6,f2,24,48 and 72 hours after operation were lower in the experimental group than the control group ( P <0. 05 ) ;the active exercise times of flexion and rotation of the ankle of the affected limb 2 days after operation were many more in the experimental group than the control group ( P < 0. 01 ); Hams scores of the hip function 2 and 4 weeks after operation were higher in the experimental group than the control group ( P <0. 05 ). Conclusion:The comprehensive psychological intervention can effectively control the postoperative pain of patients and promote early rehabilitation of hip joint function after total artificial hip arthroplasty.%目的:探讨疼痛心理干预对人工髋关节置换术(THA)后早期康复效果的影响.方法:将60例THA患者随机分为实验组和对照组各30例,对照组给予常规护理、健康宣教及疼痛治疗,实验组在对照组基础上给予认知行为疗法、放松与生物反馈疗法、支持心理疗法等疼痛心理干预措施.观察两组术后疼痛程度及髋关节功能.结果:两组比较,实验组术后6、12、24、48、72 h静息及活动状态疼痛评分均低于对照组(P<0.05);实验组术后2 d平均每天完成

  14. Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty:a retrospective controlled study

    Institute of Scientific and Technical Information of China (English)

    SUN Yu; ZHAO Yan-bin; PAN Sheng-fa; ZHOU Fei-fei; CHEN Zhong-qiang; LIU Zhong-jun

    2012-01-01

    Background Cervical arthroplasty is indicated to preserve cervical motion and prevent accelerated adjacent segment degeneration.Whether accelerated adjacent segment degeneration is prevented in the long term is unclear.This trial compared adjacent segment degeneration in Bryan disc arthroplasty with that in anterior cervical decompression and fusion five years after the surgery.Methods We studied patients with single level degenerative cervical disc disease.The extent of adjacent segment degeneration was estimated from lateral X-rays.Results Twenty-six patients underwent single level Bryan disc arthroplasty and twenty-four patients underwent single level anterior cervical decompression and fusion.All patients were followed up for an average of sixty months.In the Bryan arthroplasty group,nine(17.6%)segments developed adjacent segment degeneration,which was significantly lower than that(60.4%)in the anterior cervical decompression and fusion group.Eleven segments in the Bryan arthroplasty group developed heterotopic ossification according to McAfee's classification and two segments had range of motion less than 2°.In the heterotopic ossification group,four(19.5%)segments developed adjacent segment degeneration,similar to the number in the non-heterotopic ossification group(16.7%).Adjacent segment degeneration rate was 50% in gradeⅣ?group but 11.8% in gradeⅡ?to Ⅲ.Conclusions Adjacent segment degeneration was accelerated after anterior cervical decompression and fusion.However,Bryan disc arthroplasty avoided accelerated adjacent segment degeneration by preserving motion.Patients with gradeⅣ?heterotopic ossification lost motion,and the rate of adjacent segment degeneration was higher than that in patients without heterotopic ossification.

  15. 人工腰椎间盘假体位置对活动度的影响%Effect of intervertebral position on range of motion after artificial lumbar total disc replacement and clinical management

    Institute of Scientific and Technical Information of China (English)

    刘艳成; 宁尚龙; 杨强; 夏群; 张继东; 徐宝山; 胡永成; 吉宁; 苗军; 白剑强; 韩岳

    2010-01-01

    Objective To discuss the effect of SB Charité lumbar artificial disc position on intervertebral range of motion(ROM)and clinical management.Methods Between 2004 and 2007, 30 discogenic low back pain patients confirmed by discography underwent 1/2-level total disc replacement (TDR)implantation with 32 prostheses.There were 12 males and 18 females with a mean age of 44 years old (range:28-55).All indexed levels were inserted between L4-S1 involving L4-5(n =9), L5S1(n = 19)and L4-S1(n =2).The clinical outcome was measured by Oswestry disability index(ODI)and visual analogue scale(VAS).Radiographic outcome measures included flexion/extension ROM, restoration of operative level intervertebral disc height, maintenance of disc height at the final follow-up.A technique previously described by McAfee was used to evaluate TDR position in three groups.Paired t test was used to compare the preoperative and postoperative ROM and clinical ODI, VAS scores.Results Twenty-eight patients were followed-up for 24-60 months with an average of 38 months.All the prostheses were solidly immobilized with the vertebral endplate.No disc prosthesis rupture, dislocation, subsidence or heterotopic ossification was observed.Preoperative ODI, VAS back pain and VAS leg pain scores were 70.34 ± 9.21, 7.46 ± 2.65,4.81 ± 2.75;and postoperative corresponding scores 7.65 ± 8.61, 0.68 ± 0.69, 0.35 ± 0.32respectively.The positions of disc prostheses were graded as Group Ⅰ , excellent, n = 17;Group Ⅱ,suboptimal, n = 6;Group Ⅲ, poor, n = 5.Preoperative mean intervertebral flexion/extension ROM (degree)of Group Ⅰ to Group Ⅲ were 9.75 ± 2.80, 10.30 ± 1.20 and 10.08 ± 2.43 respectively.The postoperative mean intervertebral flexion/extension ROM(degree): 6.68 ± 3.83, 4.22 ± 3.51 and 3.48 ± 3.56 respectively.Postoperatively all clinical outcome scores were lower than preoperative ones.Disc height was significantly restored.Mean intervertebral ROM decreased versus preoperative

  16. Preliminary clinical outcomes of traumatic cervical herniation by artificial cervical disc replacement%人工椎间盘置换治疗外伤性颈椎椎间盘突出症的初期临床疗效

    Institute of Scientific and Technical Information of China (English)

    欧云生; 刘显宏; 权正学; 唐可; 罗小辑; 蒋电明; 安洪

    2011-01-01

    Objective To observe the preliminary outcomes of traumatic cervical hemiation treated by artificial cervical disc replacement (ACDR). Methods Clinical data of 8 patients with traumatic cervical hemiation undergoing ACDR from April 2007 to February 2011 were studied retrospectively. All the patients were assessed by clinical observation and radiological studies preoperatively, in 3 and 6 months postoperatively, and at the end of follow-up. Clinical outcome was evaluated using Japanese Orthopaedic Association (JOA) score, neck disabiliy index (NDI) criteria, and visual analog scale (VAS). Functional spinal unit range of motion (ROM) was also measured in the reontgenographs at anteroposterior and lateral, bending and extending positions. Results All cases were followed up for 6-36 months (mean 15 months). The JOA, NDI, VAS ( neck pain and arm pain) and cervical unit ROM were all significantly improved after operation ( P <0.05). No neurological or vascular complication was found in these 8 cases. The disc height and stability of cervical vertebra were maintained in the reontgenographs taken at the final follow-up. One case was found having artificial cervical prosthesis antedisplacement 1 mm 42 d after operation, and the distance of antedisplacement was not increased at the final follow-up. There was no subsidence, loosening, excursion, or heterotopic ossification in the other 7 patients. Conclusion As long as indication is correctly chosen, satisfactory outcomes will be achieved for traumatic cervical hemiation by ACDR.%目的 观察人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗外伤性颈椎椎间盘突出症的初期临床疗效.方法 对8例行ACDR的外伤性颈椎椎间盘突出症患者的临床资料进行随访分析.临床疗效评价包括术前、术后3个月、术后6个月及末次随访时的日本骨科学会(Japanese Orthopaedic Association,JOA)评分、颈椎功能障碍指数( neck disabiliy index,NDI)评分

  17. Broken discs: warp propagation in accretion discs

    Science.gov (United States)

    Nixon, Christopher J.; King, Andrew R.

    2012-04-01

    We simulate the viscous evolution of an accretion disc around a spinning black hole. In general, any such disc is misaligned, and warped by the Lense-Thirring effect. Unlike previous studies, we use effective viscosities constrained to be consistent with the internal fluid dynamics of the disc. We find that non-linear fluid effects, which reduce the effective viscosities in warped regions, can promote breaking of the disc into two distinct planes. This occurs when the Shakura & Sunyaev dimensionless viscosity parameter α is ≲0.3 and the initial angle of misalignment between the disc and hole is ≳45°. The break can be a long-lived feature, propagating outwards in the disc on the usual alignment time-scale, after which the disc is fully co-aligned or counter-aligned with the hole. Such a break in the disc may be significant in systems where we know the inclination of the outer accretion disc to the line of sight, such as some X-ray binaries: the inner disc, and so any jets, may be noticeably misaligned with respect to the orbital plane.

  18. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active ... bit. That’s just fluid to wash out any blood or bone wax or whatever, pieces of bone. ...

  19. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... piece of what we call -- it’s a medical plastic. It’s ultrahigh molecular weight polyethylene, and it’s a medical-grade plastic that’s really been made to sustain active compression ...

  20. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... welcome. Today we’re going to have the opportunity to watch Dr. William Beutler perform a total ... of the nerve. So that’s what Dr. Beutler’s job is right now, is to remove all this ...

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    Full Text Available ... cord. So it’s sometimes a little bit more work. Well, there’s the space for where that nerve ... end plate forms the socket. The implant components work together with the surrounding spinal structures to provide ...

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  10. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... Beutler is defining out, that’s the platysma muscle right there. He’ll divide that a little to ... catch on that a little bit different. But right now Dr. Beutler is exposing the spine. He’s ...

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  12. Artificial Cervical Disc Replacement Improves Mobility

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  14. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... have to mess with those today or any day. So can I have the nerve fork. I’ ... not to go to work for about ten days. I must say this patient here, he is ... that allow patients to go home the same day after these operations because they feel well right ...

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  17. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... Beutler planned the incision with the use of X-Ray, placing a marker external to the skin to ... he wants to do is confirm it with X-Ray so that there’s no confusion to take the ...

  18. Artificial Cervical Disc Replacement Improves Mobility

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    Full Text Available ... been utilized to perform anterior cervical discectomies and fusions. The fusion procedure has been the most common way to ... significant benefits over the previous procedure of the fusion, and that is, able to maintain motion of ...

  19. Comparison of short - term curative effects between artificial disc replacement and simple discectomy for treatment of degenerative disc disease%人工腰椎间盘置换术与单纯髓核摘除术治疗退行性腰椎间盘疾病的近期疗效比较

    Institute of Scientific and Technical Information of China (English)

    吴亮; 孙晓亮; 张雷; 吴国峰; 周剑; YveCartonne; Pascal Moussellard

    2011-01-01

    [ Objective] To evaluate the short - term curative effects of artificial disc replacement ( ADR) and simple dis-cectomy for treatment of degenerative disc disease. [Methods] Twelve ADR and 20 simple discectomy for the treatment of degenerative disc disease were preformed from May 2007 to May 2010. Seven males and 5 females with an average age of 40. 2 years underwent ADR Eleven males and 9 females with an average age of 38. 1 years underwent simple discectomy. The visual analogue scale (VAS), Oswestry Disability Index (ODI) , the range of motion ( ROM) of the involved lumbar segment, and inter-vertebral height of the two groups before and after operation were compared. [ Results ] The follow - up time averaged 20. 1 months (6 ~30 months) . The post - operative VAS and ODI of the two groups significantly improved (P 0. 05 ) . At 6 months after operation . The ROM of the two groups showed no significant difference (P > 0. 05 ) . But the ROM of the patients with ADR was more improved than patients with simple discectomy at the last follow - up ( P 0. 05) . [ Conclusion] Both ADR and simple discectomy can acquire satisfactory short - term curative effects for treatment of degenerative disc disease. Compared to simple discectomy, ADR showed more superiorities in improving ROM of the involved lumbar segment and restoring the intervertebral height%[目的]对人工腰椎间盘置换术和单纯髓核摘除术治疗退行性腰椎间盘疾病的近期临床疗效进行比较.[方法]2007年5月~2010年5月行人工腰椎间盘置换术治疗退行性腰椎间盘疾病12例,其中男性7例,女性5例;平均年龄40.2岁(28 ~54岁).同期行单纯髓核摘除术治疗退行性腰椎间盘疾病20例,其中男性11例,女性9例;平均年龄38.1岁(24 ~51岁).对两组病例手术前后的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腰椎活动度(ROM),以及椎间隙高度进行分析比较.[结果]随访时间平均20.1个月(6~30个月).术后

  20. Lumbar disc replacement in adolescents: An initial experience in two cases

    OpenAIRE

    Kasliwal, Manish K.; Harel Deutsch

    2012-01-01

    Management of painful lumbar disc degeneration is one of the most common conditions treated by spine surgeons. Several recent prospective multicenter trials have demonstrated the effectiveness of artificial lumbar disc replacement in treating discogenic lower back pain. Though data on the safety and effectiveness has gradually been accumulated in adults, there is a lack of published data on the effectiveness and feasibility of lumbar artificial disc replacement in adolescents. The authors sha...

  1. In vitro-analysis of kinematics and intradiscal pressures in cervical arthroplasty versus fusion – A biomechanical study in a sheep model with two semi-constrained prosthesis

    OpenAIRE

    Daentzer, Dorothea; Welke, Bastian; Hurschler, Christof; Husmann, Nathalie; Jansen, Christina; Flamme, Christian Heinrich; Richter, Berna Ida

    2015-01-01

    Background As an alternative technique to arthrodesis of the cervical spine, total disc replacement (TDR) has increasingly been used with the aim of restoration of the physiological function of the treated and adjacent motions segments. The purpose of this experimental study was to analyze the kinematics of the target level as well as of the adjacent segments, and to measure the pressures in the proximal and distal disc after arthrodesis as well as after arthroplasty with two different semi-c...

  2. Prodisc-C人工颈椎椎间盘置换的临床疗效观察和运动功能评估%Clinical efficiency and motor function assessment of Prodisc-C artificial cervical disc replacement

    Institute of Scientific and Technical Information of China (English)

    陈道森; 施荣茂; 周强; 罗飞; 代飞; 张劲松; 许建中

    2011-01-01

    目的 通过术后随访评价Prodisc-C人工颈椎椎间盘置换术(artificial cervical disc replacement,ACDR)治疗颈椎病的临床疗效及其对颈椎置换节段、邻近节段运动功能的影响.方法 回顾性分析2009年8月~2011年2月行Prodisc-C ACDR治疗20例颈椎病患者,其中脊髓型9例、神经根型8例、混合型3例,单椎间盘置换17例、双椎间盘置换3例.患者术前行CT、MRI检查明确诊断,术前和术后定期行疼痛视觉模拟量表(visual analogue scale,VAS)和日本骨科学会(Japanese Orthopaedic Association,JOA)及摄颈椎X线片.结果 13例患者获得6~18个月随访.患者术前颈肩背疼痛、上下肢麻木、肌力减弱等不适症状均明显改善.术后VAS及JOA评分均较术前明显改善,差异有统计学意义(P<0.01);置换节段椎间活动度( range of motion,ROM)在术后1、3、6个月显著增大,与术前相比差异有统计学意义(P<0.01);在末次随访时仍大于术前,差异有统计学意义(P<0.05);上下位邻近节段椎间隙高度和椎间ROM与术前相比,差异无统计学意义(P>0.05).所有病例未见假体松动、移位和异位骨化.结论 Prodisc-C ACDR短期随访疗效优良,置换节段ROM增大,邻近节段椎间隙高度和椎间ROM维持在正常水平,但远期疗效还有待进一步随访观察.%Objective To evaluate the clinical efficacy of artificial cervical disc replacement (ACDR) with Prodisc-C and its effects on the motor function of the replaced level and adjacent segments. Methods A total of 20 patients who received ACDR with Prodisc-C from April 2009 to February 2011 were retrospectively analyzed. There were 9 patients with myelopathy, 8 with radiculopa-thy, and the left 3 with both symptoms. There were 17 participators received single level replacement, and the other 3 had 2 levels replaced. All the patients received CT and MRI preoperatively for accurate diagnosis. Visual analogue scale ( VAS) scores for neck and arm

  3. Preliminary results of Activ C artificial disc replacement for cervical spondylosis%Activ C人工椎间盘置换术治疗颈椎病的早期疗效

    Institute of Scientific and Technical Information of China (English)

    赵耀; 刘屹林; 王利民; 谭洪宇; 王卫东; 廖文胜; 鲍恒

    2012-01-01

    目的:观察Activ C人工椎间盘置换术治疗颈椎病的早期临床疗效,分析其临床应用价值.方法:2009年11月~2011年3月在我院接受Activ C人工椎间盘置换术并获得随访的颈椎病患者共43例(45个节段),平均年龄48.3岁,其中男18例,女25例,脊髓型颈椎病22例,神经根型颈椎病16例,混合型颈椎病5例;单节段置换41例(C3/4 2例,C4/5 17例,C5/6 21例,C6/7 1例),双节段置换2例(C4/5和C5/6 1例,C5/6和C6/7 1例).采用日本骨科协会JOA评分、颈椎活动障碍指数(NDI)和疼痛视觉模拟评分(VAS)评价术后症状改善程度,比较手术前后的颈椎曲度、手术节段及邻近上下节段活动度变化,观察统计手术并发症情况.结果:术后随访8~24个月,平均13.8个月.患者的JOA评分、NDI、颈部VAS评分、上肢VAS评分分别由术前的8.2±0.7、35.3±4.7、6.8±1.1和6.5±1.2分显著改善至末次随访时的14.7±0.4、16.2±3.4、1.3±0.8和1.8±0.9分(P均<0.05).颈椎生理曲度术前为7.97°±4.49°,末次随访时为9.15°±3.85°,手术前后无明显差异(P>0.05).置换节段活动度较术前明显增加(P<0.01),邻近上下节段活动度手术前后差异无统计学意义(P>0.05).术后人工椎间盘活动良好,无塌陷或移位,随访期间未见邻近节段明显退变,2例分别在术后7个月和10个月时异位骨化形成.结论:Activ C人工椎间盘置换术可有效改善颈椎病患者的临床症状,维持颈椎的生理曲度和活动度,早期临床疗效满意.%Objectives: To investigate the early clinical effects of cervical Activ C artificial disc replacement. Methods: 43 patients(mean age 48.3 years; 18 males and 25 females) of cervical spondylosis with a total of 45 levels involved underwent anterior cervical decompression and Activ C implantation between November 2009 and March 2011. There were 22 cases of cervical spondylotic myelopathy, 16 cases of cervical spondy-lotic radiculopathy and 5 cases of mixed

  4. Finite element analysis of biomechanical performance of atlanto-axial bony structure following artificial atlanto-odontoid joint arthroplasty%人工寰齿关节置换后寰枢椎骨性结构生物力学性能的有限元分析

    Institute of Scientific and Technical Information of China (English)

    胡勇; 袁振山; 赵红勇; 张美超; 顾勇杰

    2013-01-01

    Objective To investigate the stress characteristics of atlanto-axial bony structure under conditions of anteflexion,posterior extension,lateral flexion,and rotation after artificial atlanto-odontoid joint arthroplasty using three-dimensional finite element method and to improve the orientation of artificial atlantoodontoid joint from perspective of stress.Methods A three-dimensional finite element model of prosthetic atlanto-odontoid joint arthroplasty was created from CT images of the artificial atlantoodontoid joint and cervical vertebrae using software Mimics,Freeform,and Ansys.Stress characteristics of the model dealt with proneness,posterior extension,lateral flexion,or rotation loads were observed.Biomechanical performance of the bony structure of the model was analyzed and the orientation in improving the prosthesis was discussed.Results Anteflexion loading produced a maximum stress of 0.138 ×l08 N/m2 at the junction of lateral mass and posterior arch of the atlas,and 0.201 × 108 N/m2 at axial nail hole,contact point of plates with the axis,and posterior arch of the axis.Posterior extension loading produced a maximum stress of 0.666 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.254 × 108 N/m2 at arch of the axis.Besides,stress concentration occurred at atlantoaxis nail hole.Right bending produced a maximum stress of 0.124 × 108 N/m2 at nail hole of right mass of atlas and 0.178 × 108 N/m2 at right contact point of the axis with plates.Right rotation produced a maximum stress of 0.847 × 107 N/m2 at junction of lateral mass and posterior arch of the atlas and 0.170 × 109 N/m2 at contact point of the axis with plates.The finite element model comprised 28 620 nodes and 107 441 units and provided good defining of the structural properties of artificial atlanto-odontoid joint arthroplasty.Under different loading conditions,the stress was mainly distributed in contact point of the vertebral body with plates,nail holes

  5. 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 ...

  6. 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 ...

  7. 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. ...

  8. Total disc replacement for chronic low back pain: background and a systematic review of the literature

    OpenAIRE

    de Kleuver, M.; F. Oner; W. Jacobs

    2002-01-01

    In this paper the rationale for total disc replacement is discussed, and the authors suggest seven requirements that should be met before the implantation of these devices can be accepted as regular procedures. In an attempt to answer the questions raised, a systematic literature search was performed. The search yielded no controlled trials and nine case series with a total of 564 arthroplasties in 411 patients. The devices used were SB Charité in eight and Acroflex in one study. The percenta...

  9. Operative Management of Lumbar Degenerative Disc Disease

    Science.gov (United States)

    Lee, Yu Chao; Osti, Orso Lorenzo

    2016-01-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  10. Operative Management of Lumbar Degenerative Disc Disease.

    Science.gov (United States)

    Lee, Yu Chao; Zotti, Mario Giuseppe Tedesco; Osti, Orso Lorenzo

    2016-08-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  11. 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

  12. 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

  13. 人工椎间盘置换术后脊柱节段运动范围及有关参数变化的相关评价%Correlated evaluation on the spinal segment motion scope and the alteration of the corre sponding parameters after artificial lumbar intervertebral disc replacement

    Institute of Scientific and Technical Information of China (English)

    徐义春; 刘尚礼; 黄东生; 沈慧勇; 李春海; 马若凡

    2004-01-01

    destroyed by physiological aging and pathological damages. The results may cause not only disc degenerative diseases, but also serial changes of spinal biomechanics because intervertebral discs are key structures in the spinal motion segment. So it is better to reconstruct the normal function of the destroyed disc, which not only can treat disc degenerative diseases but also restore its function partly.OBJECTIVE: To explore the motion scope and the alterations of the corresponding parameters of the corresponding spinal segment after artificial disc replacement(ADR) in patients with degenerative diseases of lumbar intervertebral disc.DESIGN: A before-after controlled study.SETTING: Department of Orthopaedics, the Third Affiliated Hospital and Department of Orthopaedics, the Second Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: The study was principally performed in the Department of Orthopaedics of the Second Affiliated Hospital of Sun Yat-sen University. Thirty-four patients diagnosed with degenerative diseases of lumbar intervertebral disc were selected for our study during February 1999 to June 2002. Artificial disc replacement was performed in 41 intervertebral discs. All patients completed the whole process of the study according to the postoperative requirement.METHODS: All the patients received ADR with SB Charite Ⅲ artificial lumbar intervertebral disc(AID) made by Link Company, Germany, made through an anterior extraperitoneal approach under endotracheal anaesthesia after pararectal incision, and relative evaluations as well.tor segment, motor scope of the intervertebral articulation, the height of inpostoperative clinical effectivenessRESULTS: Single segment replacement was performed in 2 cases of I3-44, 18cases of L4-5, and 7 cases of L6S1, and two-segment replacement was performed in 1 case of L3-4 combined with L4-5 and 6 cases of L4-5 combined with L6S1. All patients received postoperative follow-up for a period of 3 to 38 months(average of 18

  14. Double rupture disc experience

    International Nuclear Information System (INIS)

    Result of these observations, comparisons and evaluations can be summarized in the following list of concerns regarding the use of double rupture discs coupled to the liquid space of a steam generator that is subjected to a large leak sodium water reaction event. Single rupture disc show delayed collapse characteristics in LLTR Series I and double disc assemblies are presumed to be more complex with additional delay before opening to give pressure relief. Delayed failure increases pressures in the IHTS and must be adequately covered by design requirements. With CRBR design, the first disc may fail only partially reducing the loading on the second disc with the result that relief performance may not meet requirements

  15. 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

  16. 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

  17. 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...

  18. Applied anatomy of the sciatic nerve injury in the artificial total hip arthroplasty%人工全髋关节置换术中坐骨神经损伤的应用解剖学观察

    Institute of Scientific and Technical Information of China (English)

    杨景武; 史晓林

    2005-01-01

    背景:人工全髋关节置换术(THR)是近年来治疗老年人髋关节疾患的首选方法,按Harri's评分优良率为84%.该手术对坐骨神经损伤发生率国内报道为0.46%,国外报道为0.08%~9.70%.目的:通过解剖位置的分析探讨THR术中坐骨神经损伤的因素.设计:以人体解剖标本为研究对象,单一样本研究.单位:湖州师范学院医学院解剖实验室.对象:实验于2003-03/05在湖州师范学院医学院解剖实验室完成.正常人体成年骨盆标本56具,男27具,女29具.方法:对坐骨神经的来源及走行、坐骨神经与髋臼的关系进行测量分析,并对在THR术中拉钩及螺丝钉固定所致坐骨神经损伤,进行详尽测量分析. 主要观察指标:坐骨神经与髋臼的位置关系.结果:测出坐骨神经至髋臼底的距离左侧为(6.00±0.85)mm,右侧为(6.00±0.71)mm;坐骨神经至髋臼缘的距离左侧为(13.00±0.75)mm,右侧为(14.00±0.06)mm.坐骨神经在髋臼缘处周径左侧为(32.00±0.28)mm,右侧为(31.00±0.68)mm.髋臼底至坐骨大孔的距离为左侧为(29.00±0.36)mm,右侧为(29.00±0.24)mm.结论:确定拉钩及螺丝钉固定在1~3点及5~6点为安全区.在THR术中陈旧髋臼骨折脱位、拉钩的位置不当、螺钉固定髋臼位置不当均可导致医源因素损伤坐骨神经.%BACKGROUND: At present, the artificial total hip replacement(THR) is the first choice of the hip joint disease for the old, and the choiceness rate is 84% according to the Harri' s grade, and the therapeutic effect is content. The occurrence rate of the sciatic nerve injury in the THR is reported to be 0.46% in and 0. 08%-9.7% abroad.OBJECTIVE: To study the influencing factors of the sciatic nerve injury in the THR through the anatomical location analysis.DESIGN: Single sample study based on the human anatomical samples.SETTING: Human Anatomy Laboratory in the Medical Department of the Huzhou Normal University.PARTICIPANTS: The study was completed in the

  19. Optic disc oedema

    DEFF Research Database (Denmark)

    Nielsen, Marianne Kromann; Hamann, Steffen

    2014-01-01

    Optic disc oedema describes the nonspecific, localized swelling of the optic nerve head regardless of aetiology. Therefore, differentiating among the various aetiologies depends on a thorough history and knowledge of the clinical characteristics of the underlying conditions. Papilloedema strictly...... refers to optic disc oedema as a consequence of elevated intracranial pressure. It is usually a bilateral condition and visual function is preserved until late. Optic disc oedema caused by an anterior optic neuropathy is usually unilateral and accompanied by the loss of visual function....

  20. Curative effect evaluation and complication analysis of Bryan artificial cervical disc replacement%Bryan人工颈椎间盘置换术后疗效评价及并发症分析

    Institute of Scientific and Technical Information of China (English)

    蓝旭; 许建中; 刘雪梅; 葛宝丰

    2013-01-01

    To observe the curative effects and complications nf Bryan cervical disc replacement for cervical disc herniation. Methods:From Jannary 2005 to December 2008,39 patients with cervical disc herniation were treated with Bryan cervical disc replacement. There were 20 males and 19 females,with an average age of 47 years old (ranged ,35 to 59). Spinal compression symptom (20 cases) and nerve root symptom (19 eases) were main clinical symptoms. Single level disc was replaced in 35 cases and two-level replaced in 4 cases. Offset and activity of prosthesis, cervical physiological curvature, heterotopic ossification, prosthetic fusion were observed by dynamic X-ray. According to Odom's standard and JOA score, nerve function were evaluated;and depending on NDI standard,clinical symptom and daily function status were recorded. Results: All the patients were followed up from 16 to 36 months with an average of 24 months. Nerve function obviously improved and radiating pain of upper limb completely relieved. No patient with prosthetic anterior-posterior offset more than 2 mm was found. Prosthetic flexion and extention angle was(8.5±1.8)°,left and right flexion range respectively were (3.5±1.2)° and (3.3±1.5)°. Cervical physiological curvature improved obviously or recovered normally. Three cases occurred in heterotopic ossification and 2 cases occurred in prosthetic fusion. According to Odom's standard,25 cases got an excellent results,9 good,5 fair,the rate of excellent and good was 87.2%. JOA score increased from preoperative(8.26±1.32) to (15.71±1.89) at final follow-up and NDI decreased from preoperative (43.7±3.8) to (20.1±2.9) at final follow-up. Conclusion: Treatment of cervical disc herniation with Bryan cervical disc replacement can get the good curative effects,which can obtain good nerve functional recovery,cervical stability and activity. Nevertheless, the operation has typical complication such as heterotopic ossification and prosthetic fusion. Thus.it is

  1. 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 ...

  2. Radially truncated galactic discs

    CERN Document Server

    De Grijs, R; Wesson, K H; Grijs, Richard de; Kregel, Michiel; Wesson, Karen H.

    2000-01-01

    We present the first results of a systematic analysis of radially truncatedexponential discs for four galaxies of a sample of disc-dominated edge-onspiral galaxies. Edge-on galaxies are very useful for the study of truncatedgalactic discs, since we can follow their light distributions out to largerradii than in less highly inclined galaxies. The origin of these truncationsand their asymmetry and sharpness are helpful to better constrain theories ofgalaxy formation. In general, the discs of our sample galaxies are truncated at similar radiion either side of their centres. With the exception of the disc of ESO 416-G25,it appears that our sample galaxies are closely symmetric, in terms of both thesharpness of their disc truncations and the truncation length. However, thetruncations occur over a larger region and not as abruptly as found by van derKruit & Searle (KS1-4). We show that the truncated luminosity distributions of our sample galaxies,if also present in the mass distributions, comfortably meet the r...

  3. ANALYSIS OF MONOPOLE ANTENNA ON CIRCULAR DISC BY MODE MATCHING

    Institute of Scientific and Technical Information of China (English)

    Sun Baohua; Zhang Fushun; Liu Qizhong

    2001-01-01

    Mode matching is used for the analysis of monopole antenna on circular disc, which is achieved by developing a novel model consisting of two artificial ground planes above and bellow the monopole antenna. Using this model, the input impedance is computed and compared with measured data reported in literatures, and excellent agreement is observed.

  4. 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.

  5. 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.

  6. 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.

  7. Discover颈人工椎间盘置换术联合颈椎前路减压融合术治疗颈椎病的临床疗效%The clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    吴兴林

    2014-01-01

    Objective To explore the clinic effect of discover cervical artificial disc replacement combined with anterior cervical decompression and fusion in treatment of cervical spondylosis. Methods 96 patients were selected from our hospital,and the they were evenly divied into two group by random,experimental group patients were treated with discover cervical artificial disc replacement combined with anterior cervical decompression,the control group patients were treated with anterior cervical decompression and fusion.Compared and analyzed the two groups'cervical spine,the average hospital stay,postoperative cervical fixation time,normal activity recovery time and clinical effect after treatment. Results The experimental group's cervical average activity was (44.6±4.7) degree which was higher than control group,and the difference was significantly(P < 0.05);The experimental group was shorter than control group in average hospital stay,postoperative cervical fixation time,normal activity recovery time,and the difference was significantly(P < 0.05);Experimental group's total effective rate was 97.9% which was higher than the control group(87.5%),and the difference was significantly(P<0.05). Conclusion Discover cervical artificial disc replacement combined with anterior cervical decompression and fusion can reduce the average hospital stay,postoperative cervical fixation time,normal activity recovery time,can ensure the patients's cervical average activity to recover normal,and can improve the clinical effect.%目的:探讨分析Discover颈人工椎间盘置换术联合颈椎前路减压融合术的临床疗效。方法选择我院96例患者,将其随机均分为两组,实验组行Discover颈人工椎间盘置换术联和颈椎前路减压融合术治疗;对照组行颈椎前路减压融合术治疗,比较患者术后颈椎活动度、平均住院时间、术后颈椎固定时间、恢复正常活动时间以及患者临床疗效,并进行统计学分析。

  8. 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.

  9. 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

  10. Pseudoenhancement of intervertebral disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Araki, Y.; Ootani, M.; Furukawa, T.; Tsukaguchi, I. (Dept. of Radiology, Osaka Rosai Hospital (Japan)); Mitomo, M. (Dept. of Radiology, Osaka Univ. Medical School (Japan))

    1992-08-01

    Two patients with intervertebral disc herniation appeared to demonstrate abnormally diffuse and intense enhancement of the disc after intravenous administration of gadolinium-DTPA for MRI. Surgery disclosed a dilated epidural venous plexus in one and vascular granulation tissue in the other, associated with the herniated disc material. The mechanism of this 'pseudoenhancement' of the disc appears to be a partial volume effect of disc material and the adjacent veins or granulation tissue. Pseudoenhancement of a herniated disc should be included in the differential diagnosis of a diffusely enhancing epidural mass. (orig.).

  11. The vibration of rolling discs

    OpenAIRE

    Ferguson, Neil Stuart

    1988-01-01

    The study presented is a fundamental investigation into the vibration of a rolling disc and an analysis of the sound which is then produced by the disc response. In order to characterise the disc's behaviour the free and forced vibration of a thin disc is analysed with the additional conditions which occur in rolling. These conditions include the geometric boundary conditions, the effect of the in-plane load, the change due to rotation of the disc and the effect of contact on the disc which i...

  12. Design of the PROCON trial: a prospective, randomized multi – center study comparing cervical anterior discectomy without fusion, with fusion or with arthroplasty

    Directory of Open Access Journals (Sweden)

    Grotenhuis J André

    2006-11-01

    Full Text Available Abstract Background PROCON was designed to assess the clinical outcome, development of adjacent disc disease and costs of cervical anterior discectomy without fusion, with fusion using a stand alone cage and implantation of a Bryan's disc prosthesis. Description of rationale and design of PROCON trial and discussion of its strengths and limitations. Methods/Design Since proof justifying the use of implants or arthroplasty after cervical anterior discectomy is lacking, PROCON was designed. PROCON is a multicenter, randomized controlled trial comparing cervical anterior discectomy without fusion, with fusion with a stand alone cage or with implantation of a disc. The study population will be enrolled from patients with a single level cervical disc disease without myelopathic signs. Each treatment arm will need 90 patients. The patients will be followed for a minimum of five years, with visits scheduled at 6 weeks, 3 months, 12 months, and then yearly. At one year postoperatively, clinical outcome and self reported outcomes will be evaluated. At five years, the development of adjacent disc disease will be investigated. Discussion The results of this study will contribute to the discussion whether additional fusion or arthroplasty is needed and cost effective. Trial registration Current Controlled Trials ISRCTN41681847

  13. 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

  14. 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 ...

  15. Artificial intelligence

    CERN Document Server

    Hunt, Earl B

    1975-01-01

    Artificial Intelligence provides information pertinent to the fundamental aspects of artificial intelligence. This book presents the basic mathematical and computational approaches to problems in the artificial intelligence field.Organized into four parts encompassing 16 chapters, this book begins with an overview of the various fields of artificial intelligence. This text then attempts to connect artificial intelligence problems to some of the notions of computability and abstract computing devices. Other chapters consider the general notion of computability, with focus on the interaction bet

  16. 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

  17. Composition of Airy disc

    Institute of Scientific and Technical Information of China (English)

    Guoquan Zhou; Xiuxiang Chu; Jun Zheng

    2008-01-01

    The description of a plane wave diffracted by a circular aperture is directly started from the Maxwell's equations. Based on the vector angular spectrum representation of Maxwell's equations, the diffracted plane wave is decomposed into the TE and TM terms. The analytical TE and TM terms in the far field are presented by stationary phase. As the TE and TM terms are orthogonal to each other in the far field, their sum constitutes the so-called Airy disc pattern. Therefore, this research reveals the composition of Airy disc, which is beneficial to deepen and enhance the recognition of the classical diffraction problem.

  18. Innervation of ''painful'' lumbar discs

    NARCIS (Netherlands)

    Coppes, MH; Marani, E; Thomeer, RTWM; Groen, GJ

    1997-01-01

    Study Design. The authors investigated the innervation of discographically confirmed degenerated and ''painful'' human intervertebral discs. Objective. To determine the type and distribution patterns of nerve fibers present in degenerated human intervertebral discs. Summary of Background Data. The i

  19. The growth of planets by pebble accretion in evolving protoplanetary discs

    CERN Document Server

    Bitsch, Bertram; Johansen, Anders

    2015-01-01

    The formation of planets depends on the underlying protoplanetary disc structure, which influences both the accretion and migration rates of embedded planets. The disc itself evolves on time-scales of several Myr during which both temperature and density profiles change as matter accretes onto the central star. Here we use a detailed model of an evolving disc to determine the growth of planets by pebble accretion and their migration through the disc. Cores that reach their pebble isolation mass accrete gas to finally form giant planets with extensive gas envelopes, while planets that do not reach pebble isolation mass are stranded as ice giants and ice planets containing only minor amounts of gas in their envelopes. Unlike earlier population synthesis models, our model works without any artificial reductions in migration speed and for protoplanetary discs with gas and dust column densities similar to those inferred from observations. We find that in our nominal disc model the emergence of planetary embryos pr...

  20. 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

  1. 人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病%Artificial Disc Replacement Combined with Anterior Cervical Decompression and Autograft Bone Fusion for the Treatment of Multi-segment Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    廖维峰; 肖晟; 黄象望; 刘向阳; 张毅; 向铁城

    2014-01-01

    [目的]探讨人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病的临床疗效。[方法]湖南省人民医院2008年2月至2012年6月收治的12例多节段颈椎病手术病例,均行人工椎间盘置换加颈前路椎体次全切减压植骨融合术,随访时间为12~18个月,平均随访15.5个月,均摄术前、术后及末次随访时的颈椎正侧位及颈椎过伸过屈位X线片及磁共振检查,观察植骨融合、内固定及人工椎间盘的情况,以JO A评分评价神经功能改善情况。[结果]所有病例内置物无松动、移位,植骨融合时间在3~6个月,平均4.9个月。置换间隙活动度术后1年时为12.5°±5.0°,与术前(12.3°±4.9°)比较无统计学差异(P>0.05)。术前JOA 评分平均为9.3分,术后6个月时平均为16.1分,平均改善率为91.2%。[结论]人工椎间盘置换加颈前路椎体次全切减压植骨融合术治疗多节段颈椎病近期疗效满意,是治疗多节段颈椎病的一种可行方法。%[Objective]To explore the clinical efficacy of cervical artificial disc replacement combined with anterior cervical decompression and autograft bone fusion for the treatment of multi -segment cervical spon-dylosis .[Methods]Twelve patients with multi- segment cervical spondylosis operated in Hunan provincial people's hospital from Feb .2008 to June 2012 underwent cervical artificial disc replacement combined with an-terior cervical decompression and autograft bone fusion .The follow up time was 12~18 months(average 15 .5 months) .Cervical MRI and X-ray films of cervical normal lateral position ,hyperextension and hyperflexion position were performed before and after operation and at the last time of follow up .Bone fusion ,internal fixa-tion and artificial disc were observed .JOA score was used to evaluate the improvement of neurological func-tion .[Results]No loosening and displacement of

  2. How do accretion discs break?

    Science.gov (United States)

    Dogan, Suzan

    2016-07-01

    Accretion discs are common in binary systems, and they are often found to be misaligned with respect to the binary orbit. The gravitational torque from a companion induces nodal precession in misaligned disc orbits. In this study, we first calculate whether this precession is strong enough to overcome the internal disc torques communicating angular momentum. We compare the disc precession torque with the disc viscous torque to determine whether the disc should warp or break. For typical parameters precession wins: the disc breaks into distinct planes that precess effectively independently. To check our analytical findings, we perform 3D hydrodynamical numerical simulations using the PHANTOM smoothed particle hydrodynamics code, and confirm that disc breaking is widespread and enhances accretion on to the central object. For some inclinations, the disc goes through strong Kozai cycles. Disc breaking promotes markedly enhanced and variable accretion and potentially produces high-energy particles or radiation through shocks. This would have significant implications for all binary systems: e.g. accretion outbursts in X-ray binaries and fuelling supermassive black hole (SMBH) binaries. The behaviour we have discussed in this work is relevant to a variety of astrophysical systems, for example X-ray binaries, where the disc plane may be tilted by radiation warping, SMBH binaries, where accretion of misaligned gas can create effectively random inclinations and protostellar binaries, where a disc may be misaligned by a variety of effects such as binary capture/exchange, accretion after binary formation.

  3. Spontaneously disappearing lumbar disc protrusion

    OpenAIRE

    Ushewokunze, Shungu; Abbas, Naeem; Dardis, Ronan; Killeen, Ian

    2008-01-01

    Spontaneous disappearance of a herniated lumbar disc is known to occur. This case study describes a 45-year-old patient whose symptoms of lumbar radiculopathy resolved and follow-up imaging showed complete disappearance of the disc prolapse. This phenomenon strengthens the role of conservative treatment in the management of lumbar disc protrusions.

  4. 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.

  5. 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...

  6. 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

  7. Tracing Planets in Circumstellar Discs

    Directory of Open Access Journals (Sweden)

    Uribe Ana L.

    2013-04-01

    Full Text Available Planets are assumed to form in circumstellar discs around young stellar objects. The additional gravitational potential of a planet perturbs the disc and leads to characteristic structures, i.e. spiral waves and gaps, in the disc density profile. We perform a large-scale parameter study on the observability of these planet-induced structures in circumstellar discs in the (submm wavelength range for the Atacama Large (SubMillimeter Array (ALMA. On the basis of hydrodynamical and magneto-hydrodynamical simulations of star-disc-planet models we calculate the disc temperature structure and (submm images of these systems. These are used to derive simulated ALMA maps. Because appropriate objects are frequent in the Taurus-Auriga region, we focus on a distance of 140 pc and a declination of ≈ 20°. The explored range of star-disc-planet configurations consists of six hydrodynamical simulations (including magnetic fields and different planet masses, nine disc sizes with outer radii ranging from 9 AU to 225 AU, 15 total disc masses in the range between 2.67·10-7 M⊙ and 4.10·10-2 M⊙, six different central stars and two different grain size distributions, resulting in 10 000 disc models. At almost all scales and in particular down to a scale of a few AU, ALMA is able to trace disc structures induced by planet-disc interaction or the influence of magnetic fields in the wavelength range between 0.4...2.0 mm. In most cases, the optimum angular resolution is limited by the sensitivity of ALMA. However, within the range of typical masses of protoplane tary discs (0.1 M⊙...0.001 M⊙ the disc mass has a minor impact on the observability. At the distance of 140 pc it is possible to resolve discs down to 2.67·10-6 M⊙ and trace gaps in discs with 2.67·10-4 M⊙ with a signal-to-noise ratio greater than three. In general, it is more likely to trace planet-induced gaps in magneto-hydrodynamical disc models, because gaps are wider in the presence of

  8. Evolution of Protoplanetary Discs with Magnetically Driven Disc Winds

    CERN Document Server

    Suzuki, Takeru K; Morbidelli, Alessandro; Crida, Aurélien; Guillot, Tristan

    2016-01-01

    Aims: We investigate the evolution of protoplanetary discs (PPDs hereafter) with magnetically driven disc winds and viscous heating. Methods: We consider an initially massive disc with ~0.1 Msun to track the evolution from the early stage of PPDs. We solve the time evolution of surface density and temperature by taking into account viscous heating and the loss of the mass and the angular momentum by the disc winds within the framework of a standard alpha model for accretion discs. Our model parameters, turbulent viscosity, disc wind mass loss, and disc wind torque, which are adopted from local magnetohydrodynamical simulations and constrained by the global energetics of the gravitational accretion, largely depends on the physical condition of PPDs, particularly on the evolution of the vertical magnetic flux in weakly ionized PPDs. Results: Although there are still uncertainties concerning the evolution of the vertical magnetic flux remaining, surface densities show a large variety, depending on the combinatio...

  9. Artificial Limbs

    Science.gov (United States)

    ... you are missing an arm or leg, an artificial limb can sometimes replace it. The device, which ... activities such as walking, eating, or dressing. Some artificial limbs let you function nearly as well as ...

  10. Vibration analysis of atomising discs

    Energy Technology Data Exchange (ETDEWEB)

    Deng, H; Ouyang, H, E-mail: H.Ouyang@liverpool.ac.u [Department of Engineering, University of Liverpool, Liverpool L69 3GH (United Kingdom)

    2009-08-01

    The centrifugal atomisation of metallic melts using a spinning disc is an important process for powder production and spray deposition. In the manufacturing process the high-temperature melt flows down to the surface of the atomising disc spinning at very high speed. It is observed that there is a hydraulic jump of the melt flow prior to atomisation. In this paper, the dynamic model of the atomising disc as a spinning Kirchhoff plate with this hydraulic jump is established. The flowing melt is modelled as moving mass and weight force in the radial direction. Using a Galerkin method, it is found that the vibration properties of the atomising disc vary with the disc clamping ratio. The amplitude of the vibration is largely raised when the clamping ratio is smaller than the critical jump radius ratio. It is also found that the disc vibration is non-stationary before becoming steady and the amplitude decreases with increasing disc speed.

  11. Discs in misaligned binary systems

    CERN Document Server

    Rawiraswattana, Krisada; Goodwin, Simon P

    2016-01-01

    We perform SPH simulations to study precession and changes in alignment between the circumprimary disc and the binary orbit in misaligned binary systems. We find that the precession process can be described by the rigid-disc approximation, where the disc is considered as a rigid body interacting with the binary companion only gravitationally. Precession also causes change in alignment between the rotational axis of the disc and the spin axis of the primary star. This type of alignment is of great important for explaining the origin of spin-orbit misaligned planetary systems. However, we find that the rigid-disc approximation fails to describe changes in alignment between the disc and the binary orbit. This is because the alignment process is a consequence of interactions that involve the fluidity of the disc, such as the tidal interaction and the encounter interaction. Furthermore, simulation results show that there are not only alignment processes, which bring the components towards alignment, but also anti-...

  12. [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

  13. The Mobi-C cervical disc for one-level and two-level cervical disc replacement: a review of the literature

    Directory of Open Access Journals (Sweden)

    Alvin MD

    2014-11-01

    Full Text Available Matthew D Alvin,1,2 Thomas E Mroz1,3,41Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland, OH, USA; 2Case Western Reserve University School of Medicine, Cleveland, OH, USA; 3Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA; 4Department of Neurological Surgery, Cleveland Clinic, Cleveland, OH, USABackground: Cervical disc arthroplasty (CDA is a novel motion-preserving procedure that is an alternative to fusion. The Mobi-C disc prosthesis, one of many Food and Drug Administration (FDA-approved devices for CDA, is the only FDA-approved prosthesis for two-level CDA. Hence, it may allow for improved outcomes compared with multilevel fusion procedures.Purpose: To critically assess the available literature on CDA with the Mobi-C prosthesis, with a focus on two-level CDA.Methods: All clinical articles involving the Mobi-C disc prosthesis for CDA through September 1, 2014 were identified on Medline. Any paper that presented Mobi-C CDA clinical results was included. Study design, sample size, length of follow-up, use of statistical analysis, quality of life outcome scores, conflict of interest, and complications were recorded.Results: Fifteen studies were included that investigated Mobi-C CDA, only one of which was a level Ib randomized control trial. All studies included showed non-inferiority of one-level Mobi-C CDA to one-level anterior cervical discectomy and fusion (ACDF. Only one study analyzed outcomes of one-level versus two-level Mobi-C CDA, and only one study analyzed two-level Mobi-C CDA versus two-level ACDF. In comparison with other cervical disc prostheses, the Mobi-C prosthesis is associated with higher rates of heterotopic ossification (HO. Studies with conflicts of interest reported lower rates of HO. Adjacent segment degeneration or disease, along with other complications, were not assessed in most studies.Conclusion: One-level Mobi-C CDA is non-inferior, but not superior, to one-level ACDF for patients

  14. 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.

  15. 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.

  16. 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.

  17. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. PMID:24412045

  18. Apsidal precession, disc breaking and viscosity in warped discs

    CERN Document Server

    Nealon, Rebecca; Price, Daniel J; King, Andrew

    2015-01-01

    We demonstrate the importance of general relativistic apsidal precession in warped black hole accretion discs by comparing three - dimensional smoothed particle hydrodynamic simulations in which this effect is first neglected, and then included. If apsidal precession is neglected, we confirm the results of an earlier magnetohydrodynamic simulation which made this assumption, showing that at least in this case the $\\alpha$ viscosity model produces very similar results to those of simulations where angular momentum transport is due to the magnetorotational instability. Including apsidal precession significantly changes the predicted disc evolution. For moderately inclined discs thick enough that tilt is transported by bending waves, we find a disc tilt which is nonzero at the inner disc edge and oscillates with radius, consistent with published analytic results. For larger inclinations we find disc breaking.

  19. Disc-planet interactions in sub-keplerian discs

    OpenAIRE

    Paardekooper, S.-J.

    2009-01-01

    One class of protoplanetary disc models, the X-wind model, predicts strongly subkeplerian orbital gas velocities, a configuration that can be sustained by magnetic tension. We investigate disc-planet interactions in these subkeplerian discs, focusing on orbital migration for low-mass planets and gap formation for high-mass planets. We use linear calculations and nonlinear hydrodynamical simulations to measure the torque and look at gap formation. In both cases, the subkeplerian nature of the ...

  20. 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...

  1. Heat distribution in disc brake

    Science.gov (United States)

    Klimenda, Frantisek; Soukup, Josef; Kampo, Jan

    2016-06-01

    This article is deals by the thermal analysis of the disc brake with floating caliper. The issue is solved by numerically. The half 2D model is used for solution in program ADINA 8.8. Two brake discs without the ventilation are solved. One disc is made from cast iron and the second is made from stainless steel. Both materials are an isotropic. By acting the pressure force on the brake pads will be pressing the pads to the brake disc. Speed will be reduced (slowing down). On the contact surface generates the heat, which the disc and pads heats. In the next part of article is comparison the maximum temperature at the time of braking. The temperatures of both materials for brake disc (gray cast iron, stainless steel) are compares. The heat flux during braking for the both materials is shown.

  2. Edge-on thick discs

    Science.gov (United States)

    Kasparova, A.; Katkov, I.; Chilingarian, I.; Silchenko, O.; Moiseev, A.; Borisov, S.

    2016-06-01

    Although thick stellar discs are detected in nearly all edge-on disc galaxies, their formation scenarios still remain a matter of debate. Due to observational difficulties, there is a lack of information about their stellar populations. Using the Russian 6-m telescope BTA we collected deep spectra of thick discs in three edge-on early-type disc galaxies located in different environments: NGC4111 in a dense group, NGC4710 in the Virgo cluster, and NGC5422 in a sparse group. We see intermediate age (4 ‑ 5 Gyr) metal rich ([Fe/H] ~ ‑0.2 ‑ 0.0 dex) stellar populations in NGC4111 and NGC4710. On the other hand, NGC5422 does not harbour young stars, its only disc is thick and old (10 Gyr) and its α-element abundance suggests a long formation epoch implying its formation at high redshift. Our results prove the diversity of thick disc formation scenarios.

  3. Pathophysiology of Degenerative Disc Disease

    OpenAIRE

    Choi, Yong-Soo

    2009-01-01

    The intervertebral disc is characterized by a tension-resisting annulus fibrosus and a compression-resisting nucleus pulposus composed largely of proteoglycan. The most important function of the annulus and nucleus is to provide mechanical stability to the disc. Degenerative disc disease in the lumbar spine is a serious health problem. Although the three joint complex model of the degenerative process is widely accepted, the etiological basis of this degeneration is poorly understood. With th...

  4. Postero-Lateral Disc Prosthesis Combined With a Unilateral Facet Replacement Device Maintains Quantity and Quality of Motion at a Single Lumbar Level

    OpenAIRE

    Nayak, Aniruddh N.; Doarn, Michael C.; Gaskins, Roger B.; James, Chris R.; Cabezas, Andres F.; Castellvi, Antonio E.; Santoni, Brandon G.

    2014-01-01

    Background Mechanically replacing one or more pain generating articulations in the functional spinal unit (FSU) may be a motion preservation alternative to arthrodesis at the affected level. Baseline biomechanical data elucidating the quantity and quality of motion in such arthroplasty constructs is non-existent. Purpose The purpose of the study was to quantify the motion-preserving effect of a posterior total disc replacement (PDR) combined with a unilateral facet replacement (FR) system at ...

  5. Numbered nasal discs for waterfowl

    Science.gov (United States)

    Bartonek, J.C.; Dane, C.W.

    1964-01-01

    Numbered nasal discs were successfully used in studies requiring large numbers of individually marked waterfowl. The procedure for constructing these discs is outlined. Blue-winged teal (Anas discors) with 5/8-inch discs, and canvasback (Aythya valisineria) and redhead (A. americana) with 3/4-inch discs can be individually identified up to 50 and 80 yards, respectively, with a gunstock-mounted, 20-power spotting scope. The particular value of these markers is their durability, the number of combinations possible, and the apparent absence of behavioral or mortality influence among such species as the blue-winged teal.

  6. Evaluation of Near/Far Field and Directivity of Ultrasonic Transducer for Turbine Rotor Disc

    International Nuclear Information System (INIS)

    Near/far field length and directivity of transducers were investigated for the improvement and evaluation of the detectability of flaws in a disc. The reference block is fabricated for the disc of stage 6 in Yonggwang unit 1. The near/far field and directivity of an ultrasonic transducer with the center frequency of 5MHz were calculated for the inspection of the disc. These values showed good agreements with the experimental results. In the system composed of a wedge and a disc, those are evaluated theoretically and experimentally for the specimen with the artificial flaws of the size 2mm and 4mm and an ultrasonic transducer with the center frequency 5MHz and diameter 0.5 inch. The detectability of keyway-flaw and detectable region for inspection were evaluated by using both tangential 45 .deg. and 90 .deg. transducers located at the distance of 53mm and 75mm from the disc hub, respectively

  7. Development of an Ultrasonic Inspection Technique for LP Turbine Rotor Disc

    International Nuclear Information System (INIS)

    Turbine rotor disc consists of disc, bore, keyway, hub, and rim in which the typical defects are located. And these part of disc has very complicated geometry, therefore proper transducer selection, wedge design, fabrication, classification and evaluation of the signal identification are required. In this research, test block with the artificial flaws at keyway and boresurface parts have been used in order to establish the ultrasonic inspection technique for flaw detectability on disc. The analysis of the signals from the test blocks was performed. The wedges were designed according to the curvature from the discs. All the ultrasonic signals were collected and identified for evaluation. The ultrasonic inspection technique for the flaw-detection was established from this research. And it is proved that the result of this research can be applicable in the field inspection

  8. Two-level total disc replacement with Mobi-C(r over 3-years

    Directory of Open Access Journals (Sweden)

    Reginald Davis

    2014-01-01

    Full Text Available Objective: To evaluate the safety and effectiveness of two-level total disc replacement (TDR using a Mobi-C(r Cervical Artificial Disc at the 36 month follow-up. Methods: a Prospective, randomized, controlled, multicenter clinical trial of an artificial cervical disc (Mobi-C(r Cervical Artificial Disc was conducted under the Investigational Device Exemptions (IDE and the U.S. Food & Drug Administration (FDA regulations. A total of 339 patients with degenerative disc disease were enrolled to receive either two-level treatment with TDR, or a two-level anterior cervical discectomy and fusion (ACDF as control. The 234 TDR patients and 105 ACDF patients were followed up at regular time points for three years after surgery. Results: At 36 months, both groups demonstrated an improvement in clinical outcome measures and a comparable safety profile. NDI scores, SF-12 PCS scores, patient satisfaction, and overall success indicated greater statistically significant improvement from baseline for the TDR group, in comparison to the ACDF group. The TDR patients experienced lower subsequent surgery rates and a lower rate of adjacent segment degeneration. On average, the TDR patients maintained segmental range of motion through 36 months with no device failure. Conclusion: Results at three-years support TDR as a safe, effective and statistically superior alternative to ACDF for the treatment of degenerative disc disease at two contiguous cervical levels.

  9. 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

  10. 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

  11. 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...

  12. 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

  13. 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...

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. Artificial blood

    Directory of Open Access Journals (Sweden)

    Sarkar Suman

    2008-01-01

    Full Text Available Artificial blood is a product made to act as a substitute for red blood cells. While true blood serves many different functions, artificial blood is designed for the sole purpose of transporting oxygen and carbon dioxide throughout the body. Depending on the type of artificial blood, it can be produced in different ways using synthetic production, chemical isolation, or recombinant biochemical technology. Development of the first blood substitutes dates back to the early 1600s, and the search for the ideal blood substitute continues. Various manufacturers have products in clinical trials; however, no truly safe and effective artificial blood product is currently marketed. It is anticipated that when an artificial blood product is available, it will have annual sales of over $7.6 billion in the United States alone.

  19. Chemonucleolysis of lumbar disc herniation

    International Nuclear Information System (INIS)

    Chemonucleolysis is an advantageous alternative to surgical treatment of lumbar disc herniation. To achieve the best results the indications must be strictly observed and the procedure itself must be technically perfect. In these circumstances a rapid, non-invasive and less expensive treatment of lumbar disc herniation is possible. (orig.)

  20. 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

  1. On disc-planet interactions in sub-keplerian discs

    CERN Document Server

    Paardekooper, S -J

    2009-01-01

    One class of protoplanetary disc models, the X-wind model, predicts strongly subkeplerian orbital gas velocities, a configuration which can be sustained by magnetic tension. We investigate disc-planet interactions in these subkeplerian discs, focusing on orbital migration for low-mass planets and gap formation for high-mass planets. We use linear calculations and non-linear hydrodynamical simulations to measure the torque and look at gap formation. In both cases, the subkeplerian nature of the disc is treated as a fixed external constraint. We show that, depending on the degree to which the disc is subkeplerian, the torque on low-mass planets varies between the usual Type I torque and the one-sided outer Lindblad torque, which is also negative but an order of magnitude larger. In strongly subkeplerian discs, corotation effects can be ignored, making migration fast and inward. Gap formation near the planet's orbit is more difficult in such discs, since there are no resonances close to the planet accommodating ...

  2. Artificial urushi.

    Science.gov (United States)

    Kobayashi, S; Uyama, H; Ikeda, R

    2001-11-19

    A new concept for the design and laccase-catalyzed preparation of "artificial urushi" from new urushiol analogues is described. The curing proceeded under mild reaction conditions to produce the very hard cross-linked film (artificial urushi) with a high gloss surface. A new cross-linkable polyphenol was synthesized by oxidative polymerization of cardanol, a phenol derivative from cashew-nut-shell liquid, by enzyme-related catalysts. The polyphenol was readily cured to produce the film (also artificial urushi) showing excellent dynamic viscoelasticity. PMID:11763444

  3. Artificial intelligence

    CERN Document Server

    Ennals, J R

    1987-01-01

    Artificial Intelligence: State of the Art Report is a two-part report consisting of the invited papers and the analysis. The editor first gives an introduction to the invited papers before presenting each paper and the analysis, and then concludes with the list of references related to the study. The invited papers explore the various aspects of artificial intelligence. The analysis part assesses the major advances in artificial intelligence and provides a balanced analysis of the state of the art in this field. The Bibliography compiles the most important published material on the subject of

  4. Coevolution of Binaries and Gaseous Discs

    CERN Document Server

    Fleming, David P

    2016-01-01

    The recent discoveries of circumbinary planets by $\\it Kepler$ raise questions for contemporary planet formation models. Understanding how these planets form requires characterizing their formation environment, the circumbinary protoplanetary disc, and how the disc and binary interact and change as a result. The central binary excites resonances in the surrounding protoplanetary disc that drive evolution in both the binary orbital elements and in the disc. To probe how these interactions impact binary eccentricity and disc structure evolution, N-body smooth particle hydrodynamics (SPH) simulations of gaseous protoplanetary discs surrounding binaries based on Kepler 38 were run for $10^4$ binary periods for several initial binary eccentricities. We find that nearly circular binaries weakly couple to the disc via a parametric instability and excite disc eccentricity growth. Eccentric binaries strongly couple to the disc causing eccentricity growth for both the disc and binary. Discs around sufficiently eccentri...

  5. Artificial Reefs

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — An artificial reef is a human-made underwater structure, typically built to promote marine life in areas with a generally featureless bottom, control erosion, block...

  6. Peripheral Disc Margin Shape and Internal Disc Derangement: Imaging Correlation in Significantly Painful Discs Identified at Provocation Lumbar Discography

    OpenAIRE

    Bartynski, W.S.; Rothfus, W.E.

    2012-01-01

    Annular margin shape is used to characterize lumbar disc abnormality on CT/MR imaging studies. Abnormal discs also have internal derangement including annular degeneration and radial defects. The purpose of this study was to evaluate potential correlation between disc-margin shape and annular internal derangement on post-discogram CT in significantly painful discs encountered at provocation lumbar discography (PLD).

  7. Discs in misaligned binary systems

    Science.gov (United States)

    Rawiraswattana, Krisada; Hubber, David A.; Goodwin, Simon P.

    2016-08-01

    We perform SPH simulations to study precession and changes in alignment between the circumprimary disc and the binary orbit in misaligned binary systems. We find that the precession process can be described by the rigid-disc approximation, where the disc is considered as a rigid body interacting with the binary companion only gravitationally. Precession also causes change in alignment between the rotational axis of the disc and the spin axis of the primary star. This type of alignment is of great important for explaining the origin of spin-orbit misaligned planetary systems. However, we find that the rigid-disc approximation fails to describe changes in alignment between the disc and the binary orbit. This is because the alignment process is a consequence of interactions that involve the fluidity of the disc, such as the tidal interaction and the encounter interaction. Furthermore, simulation results show that there are not only alignment processes, which bring the components towards alignment, but also anti-alignment processes, which tend to misalign the components. The alignment process dominates in systems with misalignment angle near 90°, while the anti-alignment process dominates in systems with the misalignment angle near 0° or 180°. This means that highly misaligned systems will become more aligned but slightly misaligned systems will become more misaligned.

  8. 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....

  9. 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.

  10. 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.

  11. Sizes of protoplanetary discs after star-disc encounters

    CERN Document Server

    Breslau, Andreas; Vincke, Kirsten; Pfalzner, Susanne

    2014-01-01

    Most stars do not form in isolation, but as part of a star cluster or association. These young stars are initially surrounded by protoplanetary discs. In these cluster environments tidal interactions with other cluster members can alter the disc properties. Besides the disc frequency, its mass, angular momentum, and energy, in particular the disc's size is prone to being changed by a passing star. So far the change in disc size was only investigated for a small number of very specific encounters. Several studies investigated the effect of the cluster environment on the sizes of planetary systems, like our own solar system, based on a generalisation of information from this limited sample. We performed numerical simulations covering the wide parameter space typical for young star clusters, to test the validity of this approach. Here the sizes of discs after encounters are presented, based on a size definition which is comparable to that one used in observational studies. We find that, except for encounters bet...

  12. 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.

  13. 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. ...

  14. 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...

  15. Intervertebral disc (IVD): Structure, degeneration, repair and regeneration

    Energy Technology Data Exchange (ETDEWEB)

    Whatley, Benjamin R.; Wen Xuejun, E-mail: xjwen@clemson.edu

    2012-02-01

    Low back pain affects a large portion of the population, resulting in high care costs for therapy and treatment. One primary cause of low back pain is the degeneration of the intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. Exact causes of degeneration are unknown, but it is thought that natural aging, and both biological and genetic factors may play a significant role in the degenerative process. Conventional methods to alleviate low back pain include spinal fusion and artificial disc replacement. Traditional treatments through spinal fusion may eliminate pain yet do not restore disc function and lead to further degeneration of adjacent levels by altering disc biomechanics and natural kinematics. Recently, artificial IVD replacements have started to gain interest, with two IVD implants currently approved in the United States. Although these implants facilitate the preservation of motions and disc space height, they are unable to sustain compressive forces due to their lack of elasticity. In addition, the implants may produce wear debris that can cause osteolysis and other deleterious effects. As an alternative to these conventional approaches, tissue engineered IVD constructs offer the advantage of biointegration while preserving the essential attributes of natural motion and disc space restoration. There is a great need for the development of tissue engineered scaffolds that simulate the natural 3D morphology and microenvironment of the targeted tissue. Scaffolds should facilitate biological transport to satisfy nutrition and waste removal requirements within the IVD. The discrete tissue architectures of the nucleus pulposus (NP) and annulus fibrosus (AF) have posed great challenges to IVD tissue engineering. Current attempts have not been able to satisfy the biological functions and/or mechanical properties of native tissue. Therefore, these current scaffolds are far from satisfactory. This review highlights the

  16. Intervertebral disc (IVD): Structure, degeneration, repair and regeneration

    International Nuclear Information System (INIS)

    Low back pain affects a large portion of the population, resulting in high care costs for therapy and treatment. One primary cause of low back pain is the degeneration of the intervertebral disc (IVD) resulting in the compression of the spinal nerves and adjacent vertebrae. Exact causes of degeneration are unknown, but it is thought that natural aging, and both biological and genetic factors may play a significant role in the degenerative process. Conventional methods to alleviate low back pain include spinal fusion and artificial disc replacement. Traditional treatments through spinal fusion may eliminate pain yet do not restore disc function and lead to further degeneration of adjacent levels by altering disc biomechanics and natural kinematics. Recently, artificial IVD replacements have started to gain interest, with two IVD implants currently approved in the United States. Although these implants facilitate the preservation of motions and disc space height, they are unable to sustain compressive forces due to their lack of elasticity. In addition, the implants may produce wear debris that can cause osteolysis and other deleterious effects. As an alternative to these conventional approaches, tissue engineered IVD constructs offer the advantage of biointegration while preserving the essential attributes of natural motion and disc space restoration. There is a great need for the development of tissue engineered scaffolds that simulate the natural 3D morphology and microenvironment of the targeted tissue. Scaffolds should facilitate biological transport to satisfy nutrition and waste removal requirements within the IVD. The discrete tissue architectures of the nucleus pulposus (NP) and annulus fibrosus (AF) have posed great challenges to IVD tissue engineering. Current attempts have not been able to satisfy the biological functions and/or mechanical properties of native tissue. Therefore, these current scaffolds are far from satisfactory. This review highlights the

  17. The Comparison between Cervical Artificial Disc Arthroplasty and Anterior Cervical Decompression and Fusion on the Influence of the Adjacent Segments Degeneration%颈椎间盘置换术与颈椎前路减压融合术对邻近节段退变情况影响的比较

    Institute of Scientific and Technical Information of China (English)

    王鲲鹏; 邱玉金; 王玉凤; 刘守勇; 吴磊磊

    2013-01-01

    Objective To compare CADR with ACDF on the influence of the adjacent segments degenera-tion.Methods From February 2008 to October 2010,a total of 62 cases of cervical spondylosis was retrospectively re-viewed.All the patients were divided into CADR group and ACDF group ,depending on different surgical methods .The symptoms and neurological function were evaluated by the cervical Japanese Orthopaedic Association ( JOA) Scores and neck disability index ( NDI ) .The Cobb angle of C 2~7 and the mobility of adjacent segments were valuated the cervical range of mobility and degeneration .Results Compared with the preoperation , the last follow-up neurological function significantly improved ,the difference was statistically significant ( P0 .05 ) .At last follow-up Cobb angle of C 2~7 and the mobility of adjacent upper and lower segments in CADR group were similar to the preoperative ,there was no significant difference statistically (P>0.05).And there was significant difference statistically in ACDF group and between the groups ( P<0.05) .Conclusion CADR is less influ-ential on the adjacent segments degeneration postoperative .%目的:比较分析颈椎间盘置换术( CADR )与颈椎前路减压融合术( ACDF )对邻近节段退变情况的影响。方法回顾性分析2008年2月~2011年10月手术治疗的62名患者,根据术式不同,分为CADR组与ACDF组。采用颈椎JOA、NDI评分评价症状及神经功能,C2~7 Cobb角和手术相邻节段活动度评价颈椎活动范围及退变情况。结果与术前比较,末次随访时两组患者神经功能明显改善,组内差异有显著性(P<0.05),但组间比较差异无显著性(P>0.05)。与术前相比,末次随访时CADR组C2~7 Cobb角和手术相邻上、下节段活动度相近,差异无显著性(P>0.05);ACDF组内比较与两组间末次随访时比较C2~7 Cobb角和手术相邻上、下节段活动度,差异有显著性( P<0.05)。结论 CADR术后对邻近节段的退变影响较ACDF小。

  18. 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...

  19. Debris disc formation induced by planetary growth

    CERN Document Server

    Kobayashi, Hiroshi

    2014-01-01

    Several hundred stars older than 10 million years have been observed to have infrared excesses. These observations are explained by dust grains formed by the collisional fragmentation of hidden planetesimals. Such dusty planetesimal discs are known as debris discs. In a dynamically cold planetesimal disc, collisional coagulation of planetesimals produces planetary embryos which then stir the surrounding leftover planetesimals. Thus, the collisional fragmentation of planetesimals that results from planet formation forms a debris disc. We aim to determine the properties of the underlying planetesimals in debris discs by numerically modelling the coagulation and fragmentation of planetesimal populations. The brightness and temporal evolution of debris discs depend on the radial distribution of planetesimal discs, the location of their inner and outer edges, their total mass, and the size of planetesimals in the disc. We find that a radially narrow planetesimal disc is most likely to result in a debris disc that ...

  20. Eclipse mapping of accretion discs

    CERN Document Server

    Baptista, R

    2000-01-01

    The eclipse mapping method is an inversion technique that makes use of the information contained in eclipse light curves to probe the structure, the spectrum and the time evolution of accretion discs. In this review I present the basics of the method and discuss its different implementations. I summarize the most important results obtained to date and discuss how they have helped to improve our understanding of accretion physics, from testing the theoretical radial brightness temperature distribution and measuring mass accretion rates to showing the evolution of the structure of a dwarf novae disc through its outburst cycle, from isolating the spectrum of a disc wind to revealing the geometry of disc spiral shocks. I end with an outline of the future prospects.

  1. Face-on accretion onto a protoplanetary disc

    Science.gov (United States)

    Wijnen, T. P. G.; Pols, O. R.; Pelupessy, F. I.; Portegies Zwart, S.

    2016-10-01

    Context. Stars are generally born in clustered stellar environments, which can affect their subsequent evolution. An example of this environmental influence can be found in globular clusters (GCs) harbouring multiple stellar populations. An evolutionary scenario in which a second (and possibly higher order) population is formed by the accretion of chemically enriched material onto the low-mass stars in the initial GC population has been suggested to explain the multiple stellar populations. The idea, dubbed early disc accretion, is that the low-mass, pre-main-sequence stars sweep up gas expelled by the more massive stars of the same generation into their protoplanetary disc as they move through the cluster core. The same process could also occur, to a lesser extent, in embedded stellar systems that are less dense. Aims: Using assumptions that represent the (dynamical) conditions in a typical GC, we investigate whether a low-mass star of 0.4 M⊙ surrounded by a protoplanetary disc can accrete a sufficient amount of enriched material to account for the observed abundances in so-called second generation GC stars. In particular, we focus on the gas-loading rate onto the disc and star, as well as on the lifetime and stability of the disc. Methods: We perform simulations at multiple resolutions with two different smoothed particle hydrodynamics codes and compare the results. Each code uses a different implementation of the artificial viscosity. Results: We find that the gas-loading rate is about a factor of two smaller than the rate based on geometric arguments, because the effective cross-section of the disc is smaller than its surface area. Furthermore, the loading rate is consistent for both codes, irrespective of resolution. Although the disc gains mass in the high-resolution runs, it loses angular momentum on a timescale of 104 yr. Two effects determine the loss of (specific) angular momentum in our simulations: (1) continuous ram pressure stripping and (2

  2. Cervical Disc Disease: Biomechanical Aspects

    OpenAIRE

    Kolstad, Frode

    2011-01-01

    Degenerative disc disease in the cervical spine may cause significant pain and disability. Patients present themselves with neck pain, radiculopathy, and/or myelopathy. When the symptoms do not improve with conservative treatment, surgical treatment is considered. The goal of surgical treatment is to decompress nervous structures and to restore the normal anatomical conditions of disc height, alignment, and stability.The present thesis concerns four studies involving the treatment of cervical...

  3. Corticosteroids in Lumbar Disc Surgery

    OpenAIRE

    Lundin, Anders

    2005-01-01

    In a prospective randomised double-blind study eighty patients with MRI verified lumbar disc herniation and corresponding clinical findings underwent microscopic disc removal. The patients were peroperatively given systemic and local corticosteroids or placebo, and followed for 2 years. The hospital stay and time to return to full-time work was significantly shorter in the treatment group. Pain measured as worst pain during the last week was also lower in the corticosteroid group. The results...

  4. Percutaneous diode laser disc nucleoplasty

    Science.gov (United States)

    Menchetti, P. P.; Longo, Leonardo

    2004-09-01

    The treatment of herniated disc disease (HNP) over the years involved different miniinvasive surgical options. The classical microsurgical approach has been substituted over the years both by endoscopic approach in which is possible to practice via endoscopy a laser thermo-discoplasty, both by percutaneous laser disc nucleoplasty. In the last ten years, the percutaneous laser disc nucleoplasty have been done worldwide in more than 40000 cases of HNP. Because water is the major component of the intervertebral disc, and in HNP pain is caused by the disc protrusion pressing against the nerve root, a 980 nm Diode laser introduced via a 22G needle under X-ray guidance and local anesthesia, vaporizes a small amount of nucleous polposus with a disc shrinkage and a relief of pressure on nerve root. Most patients get off the table pain free and are back to work in 5 to 7 days. Material and method: to date, 130 patients (155 cases) suffering for relevant symptoms therapy-resistant 6 months on average before consulting our department, have been treated. Eightyfour (72%) males and 46 (28%) females had a percutaneous laser disc nucleoplasty. The average age of patients operated was 48 years (22 - 69). The level of disc removal was L3/L4 in 12 cases, L4/L5 in 87 cases and L5/S1 in 56 cases. Two different levels were treated at the same time in 25 patients. Results: the success rate at a minimum follow-up of 6 months was 88% with a complication rate of 0.5%.

  5. 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...

  6. Disc piezoelectric ceramic transformers.

    Science.gov (United States)

    Erhart, Jirií; Půlpán, Petr; Doleček, Roman; Psota, Pavel; Lédl, Vít

    2013-08-01

    In this contribution, we present our study on disc-shaped and homogeneously poled piezoelectric ceramic transformers working in planar-extensional vibration modes. Transformers are designed with electrodes divided into wedge, axisymmetrical ring-dot, moonie, smile, or yin-yang segments. Transformation ratio, efficiency, and input and output impedances were measured for low-power signals. Transformer efficiency and transformation ratio were measured as a function of frequency and impedance load in the secondary circuit. Optimum impedance for the maximum efficiency has been found. Maximum efficiency and no-load transformation ratio can reach almost 100% and 52 for the fundamental resonance of ring-dot transformers and 98% and 67 for the second resonance of 2-segment wedge transformers. Maximum efficiency was reached at optimum impedance, which is in the range from 500 Ω to 10 kΩ, depending on the electrode pattern and size. Fundamental vibration mode and its overtones were further studied using frequency-modulated digital holographic interferometry and by the finite element method. Complementary information has been obtained by the infrared camera visualization of surface temperature profiles at higher driving power.

  7. Artificial intelligence

    International Nuclear Information System (INIS)

    A vivid example of the growing need for frontier physics experiments to make use of frontier technology is in the field of artificial intelligence and related themes. This was reflected in the second international workshop on 'Software Engineering, Artificial Intelligence and Expert Systems in High Energy and Nuclear Physics' which took place from 13-18 January at France Telecom's Agelonde site at La Londe des Maures, Provence. It was the second in a series, the first having been held at Lyon in 1990

  8. Artificial Intelligence

    CERN Document Server

    Warwick, Kevin

    2011-01-01

    if AI is outside your field, or you know something of the subject and would like to know more then Artificial Intelligence: The Basics is a brilliant primer.' - Nick Smith, Engineering and Technology Magazine November 2011 Artificial Intelligence: The Basics is a concise and cutting-edge introduction to the fast moving world of AI. The author Kevin Warwick, a pioneer in the field, examines issues of what it means to be man or machine and looks at advances in robotics which have blurred the boundaries. Topics covered include: how intelligence can be defined whether machines can 'think' sensory

  9. 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

  10. Artificial sweeteners

    DEFF Research Database (Denmark)

    Raben, Anne Birgitte; Richelsen, Bjørn

    2012-01-01

    Artificial sweeteners can be a helpful tool to reduce energy intake and body weight and thereby risk for diabetes and cardiovascular diseases (CVD). Considering the prevailing diabesity (obesity and diabetes) epidemic, this can, therefore, be an important alternative to natural, calorie-containin...

  11. Artificial treatment of 35 cases of unilateral total knee arthroplasty,genu varus combination of flexion contracture deformity clinical a-nalysis%人工全膝关节置换术治疗35例单侧膝内翻合并屈曲挛缩畸形临床分析

    Institute of Scientific and Technical Information of China (English)

    王晖; 马超; 秦泗通; 王涛; 许永; 那健

    2015-01-01

    目的:探讨人工全膝关节置换术治疗单侧膝内翻合并屈曲挛缩畸形的临床效果,为临床治疗提供依据。方法选择2009年6月至2014年6月收治的35例单侧膝内翻合并屈曲挛缩畸形的患者为研究对象,应用人工全膝关节置换术进行治疗,对比分析治疗前后患者的膝关节股胫角、屈曲挛缩度、膝关节屈伸活动度与膝关节 HSS 评分的变化,同时进行随访,评估患者恢复一年后,下肢力线的恢复情况以及双下肢等长情况。结果经过手术的治疗及12个月的恢复,手术后患者膝关节股胫角、屈曲挛缩度和膝关节屈伸活动度分别为(18.0±5.8)°、(19.7±1.2)°和(42.2±17.5)°,与手术前相比较,[(168.9±2.6)°、(1.3±0.5)°和(147.3±22.7)°],患者的膝关节股胫角和膝关节屈伸活动度均大幅提高,屈曲挛缩度大幅降低,差异具有统计学意义( P ﹤0.05)。经过手术的治疗及12个月的恢复,患者的膝关节 HSS 临床评分和功能评分分别为(88.3±5.1)和(19.3±1.3)分,同术前相比[(31.2±10.1)分、(14.3±1.1)分],均大幅提高,差异有统计学意义( P ﹤0.05)。术后随访发现,患者并无下肢不等长、术后跛行和严重感染情况等并发症的发生。结论人工全膝关节置换术治疗单侧膝内翻合并屈曲挛缩畸形临床效果显著,患者术后膝关节股胫角、屈曲挛缩和膝关节 HSS 评分有显著改善,有效提高了患者的生存质量,值得在临床推广应用。%Objective The present study evaluated the clinic effect of total knee arthroplasty in the treatment of unilateral knee versus with flexion contracture,thus providing the basis for clinic treatment. Methods The patients,who endure the unilateral knee versus with flexion contracture,were enrolled in the present study,and the sample included 35 cases. The study was carried on form June 2009 to June

  12. A Heavy Baryonic Galactic Disc

    CERN Document Server

    Davies, Jonathan

    2012-01-01

    We investigate the possibility that the observed rotation of galaxies can be accounted for by invoking a massive baryonic disc with no need for non-baryonic dark matter or a massive halo. There are 5 primary reasons for suggesting this: 1. there are well known disc surface mass density distributions that naturally produce the observed rotation curves of galaxies. 2. there are a number of rotation curve `puzzles' that cannot be explained by a massive dark matter halo i.e. the success of maximum disc fitting, HI gas scaling to the observed rotation, the disc/halo conspiracy and the interpretation of the Tully-Fisher relation. 3. recent 21cm observations show an almost constant HI surface density and a distinct `cut-off' or edge to galactic discs. We explain this constant surface density in terms of either an optical depth effect or the onset of molecular gas formation and hence the possibility of considerably more gas existing in galaxies. We suggest that the HI cut-off does indeed mark the edge of the galactic...

  13. Tidally-induced warps in protostellar discs

    OpenAIRE

    Terquem, C.; Papaloizou, J.; Nelson, R.(University of California, Davis, Davis, USA)

    1998-01-01

    We review results on the dynamics of warped gaseous discs. We consider tidal perturbation of a Keplerian disc by a companion star orbiting in a plane inclined to the disc. The perturbation induces the precession of the disc, and thus of any jet it could drive. In some conditions the precession rate is uniform, and as a result the disc settles into a warp mode. The tidal torque also leads to the truncation of the disc, to the evolution of the inclination angle (not necessarily towards alignmen...

  14. 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

  15. 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.)

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. 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

  1. Black hole accretion disc impacts

    Science.gov (United States)

    Pihajoki, P.

    2016-04-01

    We present an analytic model for computing the luminosity and spectral evolution of flares caused by a supermassive black hole impacting the accretion disc of another supermassive black hole. Our model includes photon diffusion, emission from optically thin regions and relativistic corrections to the observed spectrum and time-scales. We test the observability of the impact scenario with a simulated population of quasars hosting supermassive black hole binaries. The results indicate that for a moderate binary mass ratio of 0.3, and impact distances of 100 primary Schwarzschild radii, the accretion disc impacts can be expected to equal or exceed the host quasar in brightness at observed wavelength λ = 510 nm up to z = 0.6. We conclude that accretion disc impacts may function as an independent probe for supermassive black hole binaries. We release the code used for computing the model light curves to the community.

  2. Black hole accretion disc impacts

    CERN Document Server

    Pihajoki, Pauli

    2015-01-01

    We present an analytic model for computing the luminosity and spectral evolution of flares caused by a supermassive black hole impacting the accretion disc of another supermassive black hole. Our model includes photon diffusion, emission from optically thin regions and relativistic corrections to the observed spectrum and time-scales. We test the observability of the impact scenario with a simulated population of quasars hosting supermassive black hole binaries. The results indicate that for a moderate binary mass ratio of 0.3, and impact distances of 100 primary Schwarzschild radii, the accretion disc impacts can be expected to equal or exceed the host quasar in brightness at observed wavelength {\\lambda} = 510 nm up to z = 0.6. We conclude that accretion disc impacts may function as an independent probe for supermassive black hole binaries. We release the code used for computing the model light curves to the community.

  3. Laser engineering of spine discs

    Science.gov (United States)

    Sobol, E.; Zakharkina, O.; Baskov, A.; Shekhter, A.; Borschenko, I.; Guller, A.; Baskov, V.; Omelchenko, A.; Sviridov, A.

    2009-04-01

    The laser engineering of intervertebral discs is one of the branch of medical physics aimed at the development of minimally invasive laser medical techniques based on the effect of the controlled (time- and space-modulated) laser radiation on the structure and the field of mechanical stress of biological tissues. A new method for the laser engineering of the intervertebral discs and the differences of this approach from the existing physical methods of medical treatment are considered. The newly formed tissues of animals and humans are hystologically studied. Possible regeneration processes are discussed. A control system that provides for the treatment efficiency and safety is developed. The new laser medical equipment that is designed for the laser engineering of intervertebral discs is described, and the corresponding results of the clinical application are presented.

  4. Artificial Intelligence.

    Science.gov (United States)

    Lawrence, David R; Palacios-González, César; Harris, John

    2016-04-01

    It seems natural to think that the same prudential and ethical reasons for mutual respect and tolerance that one has vis-à-vis other human persons would hold toward newly encountered paradigmatic but nonhuman biological persons. One also tends to think that they would have similar reasons for treating we humans as creatures that count morally in our own right. This line of thought transcends biological boundaries-namely, with regard to artificially (super)intelligent persons-but is this a safe assumption? The issue concerns ultimate moral significance: the significance possessed by human persons, persons from other planets, and hypothetical nonorganic persons in the form of artificial intelligence (AI). This article investigates why our possible relations to AI persons could be more complicated than they first might appear, given that they might possess a radically different nature to us, to the point that civilized or peaceful coexistence in a determinate geographical space could be impossible to achieve.

  5. Artificial intelligence

    OpenAIRE

    Duda, Antonín

    2009-01-01

    Abstract : Issue of this work is to acquaint the reader with the history of artificial inteligence, esspecialy branch of chess computing. Main attention is given to progress from fifties to the present. The work also deals with fighting chess programs against each other, and against human opponents. The greatest attention is focused on 1997 and duel Garry Kasparov against chess program Deep Blue. The work is divided into chapters according to chronological order.

  6. Disc size regulation in the brood cell building behavior of leaf-cutter bee, Megachile tsurugensis

    Science.gov (United States)

    Kim, Jong-Yoon

    2007-12-01

    The leaf-cutter bee, Megachile tsurugensis, builds a brood cell in a preexisting tunnel with leaf discs that she cuts in decreasing sizes and assembles them like a Russian matryoshka doll. By experimentally manipulating the brood cell, it was investigated how she regulates the size of leaf discs that fit in the brood cell’s internal volume. When the internal volume was artificially increased by removing a bulk of leaf discs, she decreased the leaf disc size, although increasing it would have made the leaf disc more fitting in the increased internal volume. As a reverse manipulation, when the internal volume was decreased by inserting a group of inner layers of preassembled leaf discs to a brood cell, she decreased the leaf disc size, so that the leaf disc could fit in the decreased internal volume. These results suggest that she uses at least two different mechanisms to regulate the disc size: the use of some internal memory about the degree of building work accomplished in the first and of sensory feedback of dimensional information at the construction site in the second manipulation, respectively. It was concluded that a stigmergic mechanism, an immediate sensory feedback from the brood cell changed by the building work, alone cannot explain the details of the bee’s behavior particularly with respect to her initial response to the first manipulation. For a more complete explanation of the behavior exhibited by the solitary bee, two additional behavioral elements, reinforcement of building activity and processing of dimensional information, were discussed along with stigmergy.

  7. Artificial vision.

    Science.gov (United States)

    Zarbin, M; Montemagno, C; Leary, J; Ritch, R

    2011-09-01

    A number treatment options are emerging for patients with retinal degenerative disease, including gene therapy, trophic factor therapy, visual cycle inhibitors (e.g., for patients with Stargardt disease and allied conditions), and cell transplantation. A radically different approach, which will augment but not replace these options, is termed neural prosthetics ("artificial vision"). Although rewiring of inner retinal circuits and inner retinal neuronal degeneration occur in association with photoreceptor degeneration in retinitis pigmentosa (RP), it is possible to create visually useful percepts by stimulating retinal ganglion cells electrically. This fact has lead to the development of techniques to induce photosensitivity in cells that are not light sensitive normally as well as to the development of the bionic retina. Advances in artificial vision continue at a robust pace. These advances are based on the use of molecular engineering and nanotechnology to render cells light-sensitive, to target ion channels to the appropriate cell type (e.g., bipolar cell) and/or cell region (e.g., dendritic tree vs. soma), and on sophisticated image processing algorithms that take advantage of our knowledge of signal processing in the retina. Combined with advances in gene therapy, pathway-based therapy, and cell-based therapy, "artificial vision" technologies create a powerful armamentarium with which ophthalmologists will be able to treat blindness in patients who have a variety of degenerative retinal diseases.

  8. Vertebral osteomyelitis without disc involvement

    Energy Technology Data Exchange (ETDEWEB)

    Kamani, I.; Syed, I.; Saifuddin, A. E-mail: asaifuddin@aol.com; Green, R.; MacSweeney, F

    2004-10-01

    Vertebral osteomyelitis is most commonly due to pyogenic or granulomatous infection and typically results in the combined involvement of the intervertebral disc and adjacent vertebral bodies. Non-infective causes include the related conditions of chronic recurrent multifocal osteomyelitis (CRMO) and SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. Occasionally, these conditions may present purely within the vertebral body, resulting in various combinations of vertebral marrow oedema and sclerosis, destructive lesions of the vertebral body and pathological vertebral collapse, thus mimicking neoplastic disease. This review illustrates the imaging features of vertebral osteomyelitis without disc involvement, with emphasis on magnetic resonance imaging (MRI) findings.

  9. Dead discs, unstable discs and the stars they surround

    Directory of Open Access Journals (Sweden)

    D’Angelo Caroline

    2014-01-01

    Full Text Available Strong stellar magnetic fields significantly alter the behaviour of surrounding accretion discs. Recent work has demonstrated that at low accretion rates a large amount of mass can remain confined in the disc, contrary to the standard assumption that the magnetic field will expel the disc in an outflow (the “propeller regime”. These “dead discs” often become unstable, causing cycles of accretion onto the central star. Here I present the main predictions of this model, and argue that it provides a good explanation for the peculiar behaviour seen in several accreting sources with strong magnetic fields. I will focus in particular on three accreting millisecond X-ray pulsars: SAX J1808.4-3658, NGC 6440 X-2 and IGR J00291+5934. These sources all show low-frequency quasi-periodic oscillations consistent with a variable accretion rate, as well as unusual outburst patterns that suggest gas is confined in the inner disc regions during quiescence.

  10. Wear Performance of UHMWPE and Reinforced UHMWPE Composites in Arthroplasty Applications: A Review

    Directory of Open Access Journals (Sweden)

    Juan C. Baena

    2015-05-01

    Full Text Available As the gold standard material for artificial joints, ultra-high-molecular-weight polyethylene (UHMWPE generates wear debris when the material is used in arthroplasty applications. Due to the adverse reactions of UHMWPE wear debris with surrounding tissues, the life time of UHMWPE joints is often limited to 15–20 years. To improve the wear resistance and performance of the material, various attempts have been made in the past decades. This paper reviews existing improvements made to enhance its mechanical properties and wear resistance. They include using gamma irradiation to promote the cross-linked structure and to improve the wear resistance, blending vitamin E to protect the UHMWPE, filler incorporation to improve the mechanical and wear performance, and surface texturing to improve the lubrication condition and to reduce wear. Limitations of existing work and future studies are also identified.

  11. Current status of the application of antibiotic-loaded bone cements in primary arthroplasty%初次关节置换中抗生素骨水泥的应用现状

    Institute of Scientific and Technical Information of China (English)

    王晓楠; 王金成

    2013-01-01

    Infection is considered to be a serious complication of artificial arthroplasty. Accordingly, infection control becomes a research focus in recent years. In order to reduce its incidence, many doctors use antibiotic-loaded bone cements in primary arthroplasty, especially in those special cases, such as surgery with a long period, or with a high risk of pollution, revision surgery, and for patients with idiopathic or acquired immunodeficiency, patients with rheumatoid diseases or systemic lupus erythematosus, patients treated with radiotherapy or chemotherapy, obese patients, diabetic patients, especially patients with poor glucose control, and patients with previous joint infection or malignancy. However, there exists such problems as higher costs and a single kind of antibiotics in use. At the same time, the release time of antibiotics in bone cements is limited, which determines that the infection is mainly prevented in the introduced pathway after artificial arthroplasty. So it is uncertain whether all types of bacteria entering the human body through the introduced pathway can be included by the antibacterial spectrum of antibiotics in bone cements, and further experiments and studies are needed for doctors to verify the results. In this article, we reviewed the application of antibiotic-loaded bone cements in primary arthroplasty for reference.

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. [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

  17. Spontaneous regression of an intraspinal disc cyst

    Energy Technology Data Exchange (ETDEWEB)

    Demaerel, P.; Eerens, I.; Wilms, G. [University Hospital, Leuven (Belgium). Dept. of Radiology; Goffin, J. [Dept. of Neurosurgery, University Hospitals, Leuven (Belgium)

    2001-11-01

    We present a patient with a so-called disc cyst. Its location in the ventrolateral epidural space and its communication with the herniated disc are clearly shown. The disc cyst developed rapidly and regressed spontaneously. This observation, which has not been reported until now, appears to support focal degeneration with cyst formation as the pathogenesis. (orig.)

  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. Electromagnetic Levitation of a Disc

    Science.gov (United States)

    Valle, R.; Neves, F.; de Andrade, R., Jr.; Stephan, R. M.

    2012-01-01

    This paper presents a teaching experiment that explores the levitation of a disc of ferromagnetic material in the presence of the magnetic field produced by a single electromagnet. In comparison to the classical experiment of the levitation of a sphere, the main advantage of the proposed laboratory bench is that the uniform magnetic field…

  4. Intervertebral disc degeneration in dogs

    NARCIS (Netherlands)

    Bergknut, Niklas

    2011-01-01

    Back pain is common in both dogs and humans, and is often associated with intervertebral disc (IVD) degeneration. The IVDs are essential structures of the spine and degeneration can ultimately result in diseases such as IVD herniation or spinal instability. In order to design new treatments halting

  5. 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...

  6. 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.

  7. 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...

  8. 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...

  9. 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 ...

  10. 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...

  11. 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 ...

  12. 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...

  13. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level

    OpenAIRE

    Tayfun Hakan; Serkan Gürcan

    2016-01-01

    Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain ...

  14. Lumbar Disc Degenerative Disease: Disc Degeneration Symptoms and Magnetic Resonance Image Findings

    OpenAIRE

    Saleem, Shafaq; Aslam, Hafiz Muhammad; Rehmani, Muhammad Asim Khan; Raees, Aisha; Alvi, Arsalan Ahmad; Ashraf, Junaid

    2013-01-01

    Study Design Cross sectional and observational. Purpose To evaluate the different aspects of lumbar disc degenerative disc disease and relate them with magnetic resonance image (MRI) findings and symptoms. Overview of Literature Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. It may present as disc herniation, lumbar spinal stenosis, facet joint arthropathy or any combination. Presenting symptoms of lumbar disc degeneration ...

  15. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  16. 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

  17. MR imaging findings of a sequestered disc in the lumbar spine: a comparison with an extruded disc

    Energy Technology Data Exchange (ETDEWEB)

    Sim, Su Youn; Park, Ji Seon; Ryu, Kyung Nam [Kyung Hee University Medical Center, Seoul (Korea, Republic of); Jin, Wook [Kyung Hee University East-west Neo Medical Center, Seoul (Korea, Republic of)

    2007-10-15

    To compare the MR findings of a sequestered disc with an extruded disc. MR images of 28 patients with a sequestered disc and 18 patients with an extruded disc were retrospectively reviewed. Patients with sequestered discs were divided into two groups whether definite separation from the parent disc was or was not seen. In the latter group (definite separation not seen) and the extruded disc group of patients, the signal intensities of the herniated discs were compared with the signal intensities of the parent discs and were evaluated on T1-and T2-weighted images. We also assessed the presence of a notch within the herniated disc. In the sequestered disc group of patients (28 discs), only 5 discs (18%) showed obvious separation from the parent disc. Among the remaining 23 discs with indefinite separation, the notch was visible in 14 discs (61%) and 9 discs (39%) had no notch. In the extruded disc group (18 discs), the notch was visible in 2 (11%) discs and the difference between the two groups was statistically significant ({rho} 0.0002). The signal intensities of the herniated discs on T1-weighted images were isointense in both the sequestered and extruded discs. The difference of incidence of high signal intensities on T2-weighted images was not statistically significant ({rho} = 0.125). It is necessary to consider the possibility of the presence of a sequestered disc when a herniated disc material shows a notch.

  18. Therapeutic Effect of Artificial Total Hip Arthroplasty for the Treatment of the Hip Lesions in the Patients with Ankylosing Spondylitis%人工全髋关节置换术治疗强直性脊柱炎髋关节病变的临床疗效

    Institute of Scientific and Technical Information of China (English)

    刘亮; 张星火; 于振山; 张亚奎; 赵峰; 刘喜波

    2012-01-01

    目的 观察人工全髋关节置换治疗强直性脊柱炎髋关节病变的手术方法和临床效果.方法 对2001年3月至2009年6月26例(31髋)强直性脊柱炎髋关节病变患者行人工全髋关节置换并随访,置换前患者日常活动均明显受限或者严重疼痛,Harris评分平均(43.2±5.8)分,髋关节活动度平均51.8°±9.7°.记录术后末次随访的Harris评分,X线检查结果,观察假体有无松动、脱位及异位骨化. 结果 所有病例得到随访,平均随访24.9(8 ~125)个月.末次随访患者均疼痛消失,步态正常.Harris评分平均(82.4±4.7)分;髋关节活动度平均148.6°±7.4°;髋关节Harris评分及关节活动度均显著高于置换前(P<0.05).2髋出现异位骨化,为Brooker分级Ⅰ、Ⅲ级.无脱位、骨折及假体松动下沉,无患者进行翻修. 结论 人工全髋关节置换是治疗强直性脊柱炎晚期髋关节病变的有效方法,可以恢复关节功能,缓解关节疼痛并改善患者生活质量.%Objective To investigate the operative methods and clinical outcomes of total hip arthroplas-ty (THA) in the treatment of patients with hip lesions due to ankylosing spondylitis (AS). Methods From March 2001 to June 2009, 26 patients (31 hips) with AS received THA. All the hips were severe pain and an-kylosed in average 51. 8° ± 9. 7° of flexion. Preoperative Harris hip score was (43. 2 ±5.8) points. Radio-graphic examination and last Harris score were performed completely at the last time of follow-up. Results All the patients were followed up for average 24.9(8 ~ 125) month. Postoperatively.all patient get pain free and normal gait. According to Brooker system, 2 hips appeared heterotopic ossification, one was of Brookers Class I and the other Class III. No loosening or subsidence occurred in all patients. Harris hip score at final follow-up was (82.4±4.7) points (P <0.05), range of motion of hip were average 148. 6° ±7.4°(P <0. 05). Conclusion THA is effective

  19. Accretion and plasma outflow from dissipationless discs

    OpenAIRE

    Bogovalov, Sergei; Kelner, Stanislav

    2008-01-01

    We consider an extreme case of disc accretion onto a gravitating centre when the viscosity in the disc is negligible. The angular momentum and the rotational energy of the accreted matter is carried out by a magnetized wind outflowing from the disc. The outflow of matter from the disc occurs due to the Blandford & Payne(1982) centrifugal mechanism. The disc is assumed to be cold. Accretion and outflow are connected by the conservation of the energy, mass and the angular momentum. The basic pr...

  20. On the warping of Be star discs

    OpenAIRE

    Porter, John M.

    1998-01-01

    The theory of radiatively-induced warps in accretion discs is applied to the discs of Be stars. It is found that these discs may develop warps in their inner regions, although once the warp amplitude is large enough then the interaction between the disc and fast radiatively-driven wind will determine its evolution. The warping is shown to be more important for later than earlier B stars. Although the interaction of the fast-wind with the disc will limit the amplitude of the warp, it cannot dr...

  1. 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...

  2. Three-level cervical disc herniation

    Directory of Open Access Journals (Sweden)

    St. Iencean Andrei

    2015-09-01

    Full Text Available Multilevel cervical degenerative disc disease is well known in the cervical spine pathology, with radicular syndromes or cervical myelopathy. One or two level cervical herniated disc is common in adult and multilevel cervical degenerative disc herniation is common in the elderly, with spinal stenosis, and have the same cause: the gradual degeneration of the disc. We report the case of a patient with two level cervical disc herniation (C4 – C5 and C5 – C6 treated by anterior cervical microdiscectomy both levels and fusion at C5 – C6; after five years the patient returned with left C7 radiculopathy and MRI provided the image of a left C6 – C7 disc herniation, he underwent an anterior microsurgical discectomy with rapid relief of symptoms. Three-level cervical herniated disc are rare in adults, and the anterior microdiscectomy with or without fusion solve this pathology.

  3. Determination of the intervertebral disc space from CT images of the lumbar spine

    Science.gov (United States)

    Korez, Robert; Å tern, Darko; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2014-03-01

    Degenerative changes of the intervertebral disc are among the most common causes of low back pain, where for individuals with significant symptoms surgery may be needed. One of the interventions is the total disc replacement surgery, where the degenerated disc is replaced by an artificial implant. For designing implants with good bone contact and continuous force distribution, the morphology of the intervertebral disc space and vertebral body endplates is of considerable importance. In this study we propose a method for the determination of the intervertebral disc space from three-dimensional (3D) computed tomography (CT) images of the lumbar spine. The first step of the proposed method is the construction of a model of vertebral bodies in the lumbar spine. For this purpose, a chain of five elliptical cylinders is initialized in the 3D image and then deformed to resemble vertebral bodies by introducing 25 shape parameters. The parameters are obtained by aligning the chain to the vertebral bodies in the CT image according to image intensity and appearance information. The determination of the intervertebral disc space is finally achieved by finding the planes that fit the endplates of the obtained parametric 3D models, and placing points in the space between the planes of adjacent vertebrae that enable surface reconstruction of the intervertebral disc space. The morphometric analysis of images from 20 subjects yielded 11:3 +/- 2:6, 12:1 +/- 2:4, 12:8 +/- 2:0 and 12:9 +/- 2:7 cm3 in terms of L1-L2, L2-L3, L3-L4 and L4-L5 intervertebral disc space volume, respectively.

  4. The growth of planets by pebble accretion in evolving protoplanetary discs

    Science.gov (United States)

    Bitsch, Bertram; Lambrechts, Michiel; Johansen, Anders

    2015-10-01

    The formation of planets depends on the underlying protoplanetary disc structure, which in turn influences both the accretion and migration rates of embedded planets. The disc itself evolves on time scales of several Myr, during which both temperature and density profiles change as matter accretes onto the central star. Here we used a detailed model of an evolving disc to determine the growth of planets by pebble accretion and their migration through the disc. Cores that reach their pebble isolation mass accrete gas to finally form giant planets with extensive gas envelopes, while planets that do not reach pebble isolation mass are stranded as ice giants and ice planets containing only minor amounts of gas in their envelopes. Unlike earlier population synthesis models, our model works without any artificial reductions in migration speed and for protoplanetary discs with gas and dust column densities similar to those inferred from observations. We find that in our nominal disc model, the emergence of planetary embryos preferably should occur after approximately 2 Myr in order to not exclusively form gas giants, but also ice giants and smaller planets. The high pebble accretion rates ensure that critical core masses for gas accretion can be reached at all orbital distances. Gas giant planets nevertheless experience significant reduction in semi-major axes by migration. Considering instead planetesimal accretion for planetary growth, we show that formation time scales are too long to compete with the migration time scales and the dissipation time of the protoplanetary disc. All in all, we find that pebble accretion overcomes many of the challenges in the formation of ice and gas giants in evolving protoplanetary discs. Appendices are available in electronic form at http://www.aanda.org

  5. 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.

  6. 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

  7. 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...

  8. 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...

  9. 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

  10. 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

  11. Grain charging in protoplanetary discs

    OpenAIRE

    Ilgner, Martin

    2011-01-01

    Recent work identified a growth barrier for dust coagulation that originates in the electric repulsion between colliding particles. Depending on its charge state, dust material may have the potential to control key processes towards planet formation such as MHD (magnetohydrodynamic) turbulence and grain growth which are coupled in a two-way process. We quantify the grain charging at different stages of disc evolution and differentiate between two very extreme cases: compact spherical grains a...

  12. Reoperations Following Cervical Disc Replacement

    OpenAIRE

    Skovrlj, Branko; Lee, Dong-Ho; Caridi, John Michael; Cho, Samuel Kang-Wook

    2015-01-01

    Cervical disc replacement (CDR) has emerged as an alternative surgical option to cervical arthrodesis. With increasing numbers of patients and longer follow-ups, complications related to the device and/or aging spine are growing, leaving us with a new challenge in the management and surgical revision of CDR. The purpose of this study is to review the current literature regarding reoperations following CDR and to discuss about the approaches and solutions for the current and future potential c...

  13. The dispersal of protoplanetary discs

    Directory of Open Access Journals (Sweden)

    Ercolano Barbara

    2013-04-01

    Full Text Available Protoplanetary discs are a natural consequence of the star formation process and as such are ubiquitous around low-mass stars. They are fundamental to planet formation as they hold the reservoir of material from which planets form. Their evolution and final dispersal and the timescales that regulate these process are therefore of particular interest. In this contribution I will review the observational evidence for the dispersal of discs being dominated by two timescales and for the final dispersal to occur quickly and from the inside out. I will discuss the current theoretical models, including X-ray photoevaporation, showing that the latter provides a natural explanation to the observed behaviour and review supporting and contrasting evidence. I will finally introduce a new mechanism based on the interaction between planet formation and photoevaporation that may explain a particular class of transition discs with large inner holes and high accretion rates that are problematic for photoevaporation models and planet formation models alone.

  14. The Aerodynamics of a Flying Sports Disc

    Science.gov (United States)

    Potts, Jonathan R.; Crowther, William J.

    2001-11-01

    The flying sports disc is a spin-stabilised axi-symmetric wing of quite remarkable design. A typical disc has an approximate elliptical cross-section and hollowed out under-side cavity, such as the Frisbee(TM) disc. An experimental study of flying disc aerodynamics, including both spinning and non-spinning tests, has been carried out in the wind tunnel. Load measurements, pressure data and flow visualisation techniques have enabled an explanation of the flow physics and provided data for free-flight simulations. A computer simulation that predicts free-flight trajectories from a given set of initial conditions was used to investigate the dynamics of a flying disc. This includes a six-degree of freedom mathematical model of disc flight mechanics, with aerodynamic coefficients derived from experimental data. A flying sports disc generates lift through forward velocity just like a conventional wing. The lift contributed by spin is insignificant and does not provide nearly enough down force to support hover. Without spin, the disc tumbles ground-ward under the influence of an unstable aerodynamic pitching moment. From a backhand throw however, spin is naturally given to the disc. The unchanged pitching moment now results in roll, due to gyroscopic precession, stabilising the disc in free-flight.

  15. Artificial Economy

    Directory of Open Access Journals (Sweden)

    Alexandru JIVAN

    2011-08-01

    Full Text Available This paper proposes to eliminate, a routine in the economic thinking, claimed to be responsible for the negative essence of economic developments, from the point of view, of the ecological implications (employment in the planetary ecosystem. The methodological foundations start from the natural origins of the functionality of the human economic society according to the originary physiocrat liberalism, and from specific natural characteristics of the humankind. This paper begins with a comment-analysis of the difference between natural and artificial within the economy, and then explains some of the most serious diversions from the natural essence of economic liberalism. It shall be explained the original (heterodox interpretation of the Classical political economy (economics, by making calls to the Romanian economic thinking from aggravating past century. Highlighting the destructive impact of the economy - which, under the invoked doctrines, we call unnatural - allows an intuitive presentation of a logical extension of Marshall's market price, based on previous research. Besides the doctrinal arguments presented, the economic realities inventoried along the way (major deficiencies and effects, determined demonstrate the validity of the hypothesis of the unnatural character and therefore necessarily to be corrected, of the concept and of the mechanisms of the current economy.The results of this paper consist of original heterodox methodspresented, intuitive or developed that can be found conclusively within the key proposals for education and regulation.

  16. 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

  17. 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.

  18. 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

  19. 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

  20. 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.

  1. Do We Need Biomarkers for Disc Degeneration?

    Directory of Open Access Journals (Sweden)

    Helen E. Gruber

    2006-01-01

    Full Text Available Disc degeneration plays a major role in this country's medical, social and economic structure. The life-time prevalence of low back pain, which has disc degeneration as its cause, is about 80% in the general population. It is a primary cause of disability and estimated costs related to low back disorders exceed $100 billion per year in the U.S. alone. Biomarkers are becoming increasingly important as indicators of the presence of disease, and in evaluating outcomes during clinical treatment. Cell-based biologic therapies which are currently being developed to treat disc degeneration are going to be most efficacious when applied to the early stages of disc disease. In this article we ask: 1 Whether there are existing biomarkers which could play a role in detecting early stages of disc degeneration, and 2 Highlight exciting potentials in future biomarker screening for disc degeneration.

  2. Alteration of blue pigment in artificial iris in ocular prosthesis: effect of paint, drying method and artificial aging.

    Science.gov (United States)

    Goiato, Marcelo Coelho; Fernandes, Aline Úrsula Rocha; dos Santos, Daniela Micheline; Hadadd, Marcela Filié; Moreno, Amália; Pesqueira, Aldiéris Alves

    2011-02-01

    The artificial iris is the structure responsible for the dissimulation and aesthetics of ocular prosthesis. The objective of the present study was to evaluate the color stability of artificial iris of microwaveable polymerized ocular prosthesis, as a function of paint type, drying method and accelerated aging. A total of 40 discs of microwaveable polymerized acrylic resin were fabricated, and divided according to the blue paint type (n = 5): hydrosoluble acrylic, nitrocellulose automotive, hydrosoluble gouache and oil paints. Paints where dried either at natural or at infrared light bulb method. Each specimen was constituted of one disc in colorless acrylic resin and another colored with a basic sclera pigment. Painting was performed in one surface of one of the discs. The specimens were submitted to an artificial aging chamber under ultraviolet light, during 1008 h. A reflective spectrophotometer was used to evaluate color changes. Data were evaluated by 3-way repeated-measures ANOVA and the Tukey HSD test (α = 0.05). All paints suffered color alteration. The oil paint presented the highest color resistance to artificial aging regardless of drying method. PMID:21081281

  3. 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...

  4. Debris disc formation induced by planetary growth

    OpenAIRE

    Kobayashi, Hiroshi; Loehne, Torsten

    2014-01-01

    Several hundred stars older than 10 million years have been observed to have infrared excesses. These observations are explained by dust grains formed by the collisional fragmentation of hidden planetesimals. Such dusty planetesimal discs are known as debris discs. In a dynamically cold planetesimal disc, collisional coagulation of planetesimals produces planetary embryos which then stir the surrounding leftover planetesimals. Thus, the collisional fragmentation of planetesimals that results ...

  5. CFD design analysis of ventilated disc brakes

    OpenAIRE

    Pulugundla, Gautam

    2008-01-01

    This thesis reports the numerical investigation of the automotive ventilated disc brake rotor. Disc brakes operate on the principle of friction by converting kinetic energy into heat energy. The main objective of a disc brake rotor is to store this heat energy and dissipate it as soon as possible. This work is carried out in a area where there is very limited understanding. Commercial CFD code FLUENT was used for carrying out the simulations with the rotor rotating in still ...

  6. DSC Study of Collagen in Disc Disease

    OpenAIRE

    S. Skrzyński; Sionkowska, A.; A. Marciniak

    2010-01-01

    Differential scanning calorimetry (DSC) has been used to estimate the effect of disc disease on the collagen helix-coil transition and morphology for tissue extracted from patients during surgical operation. Forty discs were obtained from patients with degenerative disc disease undergoing surgery for low back pain. The patients were in the age between 20 and 70 years old. The specimens were kept wet during DSC experiment. The data allow the comparison between thermal stability of collagen ti...

  7. Stability and Evolution of Galactic Discs

    OpenAIRE

    Sellwood, J. A.

    1999-01-01

    In this review, I discuss just three aspects of the stability and evolution of galactic discs. (1) I first review our understanding of the bar instability and how it can be controlled. Disc galaxies in which the orbital speed does not decrease much towards the centre have no difficulty avoiding bars, even when dark matter makes an insignificant contribution to the inner part of the rotation curve. (2) I then briefly discuss interactions between disturbances in the discs of galaxies and the sp...

  8. Propeller outflows from an MRI disc

    OpenAIRE

    Lii, Patrick S.; Romanova, Marina M.; Ustyugova, Galina V.; Koldoba, Alexander V.; Lovelace, Richard V. E.

    2013-01-01

    We present the results of axisymmetric simulations of MRI-driven accretion onto a rapidly rotating, magnetized star accreting in the propeller regime. The stellar magnetosphere corotates with the star, forming a centrifugal barrier at the disc-magnetosphere boundary which inhibits matter accretion onto the star. Instead, the disc matter accumulates at the disc-magnetosphere interface and slowly diffuses into the inner magnetosphere where it picks up angular momentum and is quickly ejected fro...

  9. Computed tomography in the diagnosis of the lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Iwakura, Yuichiro (Yatsushiro General Hospital, Kumamoto (Japan)); Hayashi, Yasuo; Suzuki, Mutsuaki; Uemura, Mitsuharu; Fukuda, Kazuyuki; Koito, Hirofumi

    1984-06-01

    In this study, effectiveness of computed tomography (CT) in diagnosing lumbar disc herniation was evaluated. Twenty CT examinations which were interpreted as positive for a herniated disc, and were comfirmed by myelography, were reviewed. In 19 patients, CT demonstrated posterior protrusion of the disc but in one normal disc. Three typical cases were described. This study suggests that CT accurately demonstrates lumbar disc herniation.

  10. Artificial neural networks in neurosurgery.

    Science.gov (United States)

    Azimi, Parisa; Mohammadi, Hasan Reza; Benzel, Edward C; Shahzadi, Sohrab; Azhari, Shirzad; Montazeri, Ali

    2015-03-01

    Artificial neural networks (ANNs) effectively analyze non-linear data sets. The aimed was A review of the relevant published articles that focused on the application of ANNs as a tool for assisting clinical decision-making in neurosurgery. A literature review of all full publications in English biomedical journals (1993-2013) was undertaken. The strategy included a combination of key words 'artificial neural networks', 'prognostic', 'brain', 'tumor tracking', 'head', 'tumor', 'spine', 'classification' and 'back pain' in the title and abstract of the manuscripts using the PubMed search engine. The major findings are summarized, with a focus on the application of ANNs for diagnostic and prognostic purposes. Finally, the future of ANNs in neurosurgery is explored. A total of 1093 citations were identified and screened. In all, 57 citations were found to be relevant. Of these, 50 articles were eligible for inclusion in this review. The synthesis of the data showed several applications of ANN in neurosurgery, including: (1) diagnosis and assessment of disease progression in low back pain, brain tumours and primary epilepsy; (2) enhancing clinically relevant information extraction from radiographic images, intracranial pressure processing, low back pain and real-time tumour tracking; (3) outcome prediction in epilepsy, brain metastases, lumbar spinal stenosis, lumbar disc herniation, childhood hydrocephalus, trauma mortality, and the occurrence of symptomatic cerebral vasospasm in patients with aneurysmal subarachnoid haemorrhage; (4) the use in the biomechanical assessments of spinal disease. ANNs can be effectively employed for diagnosis, prognosis and outcome prediction in neurosurgery.

  11. Long-term outcome after implantation of prosthetic disc nucleus device (PDN) in lumbar disc disease

    OpenAIRE

    Selviaridis, P; Foroglou, N; Tsitlakidis, A; Hatzisotiriou, A; Magras, I; Patsalas, I

    2010-01-01

    Background: The prosthetic disc nucleus (PDN) device offers an adjunct treatment for patients with degenerative disc disease and herniation, who necessitate surgical intervention, avoiding total-disc replacement or fusion. This prospective, clinical study aimed to gauge the long-term effectiveness of microdiscectomy followed by PDN implantation in relieving pain and improving functional status in patients with symptomatic degenerative lumbar disc disease and herniation.

  12. Accretion Discs Show Their True Colours

    Science.gov (United States)

    2008-07-01

    Quasars are the brilliant cores of remote galaxies, at the hearts of which lie supermassive black holes that can generate enough power to outshine the Sun a trillion times. These mighty power sources are fuelled by interstellar gas, thought to be sucked into the hole from a surrounding 'accretion disc'. A paper in this week's issue of the journal Nature, partly based on observations collected with ESO's Very Large Telescope, verifies a long-standing prediction about the intensely luminous radiation emitted by these accretion discs. Uncovering the disc ESO PR Photo 21/08 Uncovering the inner disc "Astronomers were puzzled by the fact that the best models of these discs couldn't quite be reconciled with some of the observations, in particular, with the fact that these discs did not appear as blue as they should be," explains lead-author Makoto Kishimoto. Such a discrepancy could be the signal that there was something very wrong with the models. With his colleagues, he investigated this discrepancy by studying the polarised light from six quasars. This enabled them to demonstrate that the disc spectrum is as blue as predicted. "The crucial observational difficulty here has been that the disc is surrounded by a much larger torus containing hot dust, whose light partly outshines that of the disc," says Kishimoto. "Because the light coming from the disc is scattered in the disc vicinity and thus polarised, by observing only polarised light from the quasars, one can uncover the buried light from the disc." In a similar way that a fisherman would wear polarised sunglasses to help get rid of the glare from the water surface and allow him to see more clearly under the water, the filter on the telescope allowed the astronomers to see beyond surrounding clouds of dust and gas to the blue colour of the disc in infrared light. The observations were done with the FORS and ISAAC instruments on one of the 8.2-m Unit Telescopes of ESO's Very Large Telescope, located in the Atacama

  13. Computed tomography in lumbar herniated disc

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Chul Soon; Chang, Kee Hyun; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-09-15

    197 spine CTs were performed from 29th , March 1982 to 7th March, 1984. Among them, 39 patients preoperatively diagnosed as herniated nucleus pulposus or bulging disc with CT and myelography were operated. 43 disc spaces of disc disease are analysed in true positive and false negative cases. Finally the accuracy, sensitivity and specificity of spine CT and myelography are calculated. The results are as follows: 1. The CT findings of disc diseases are in order of frequency, asymmetrical obliteration of epidural fat (82%) , ventral indentation or compression on dural sac (72%), focal protrusion of disc (64%), root changes - obliteration, displacement, compression, non-filling of metrizamide - (54%), diffuse disc bulging (36%), disc at body level (31%), disc calcifications (26%), disc vacuum (10%) and other associated findings - spinal stenosis, foraminal stenosis, ligament flavum thickening, facet joint hypertrophy (26%). 2. Sensitivities of spine CT and myelography are 95% and 94%, specificities are 67%, 50% and overall accuracies 93%, 87%, respectively. 3. Therefore, it is recommended that the spine CT be used as a primary diagnostic method and the myelography as a secondary complementary study when the CT gives no conclusive findings.

  14. The quiescent phase of galactic disc growth

    Science.gov (United States)

    Aumer, Michael; Binney, James; Schönrich, Ralph

    2016-07-01

    We perform a series of controlled N-body simulations of growing disc galaxies within non-growing, live dark matter haloes of varying mass and concentration. Our initial conditions include either a low-mass disc or a compact bulge. New stellar particles are continuously added on near-circular orbits to the existing disc, so spiral structure is continuously excited. To study the effect of combined spiral and giant molecular cloud (GMC) heating on the discs, we introduce massive, short-lived particles that sample a GMC mass function. An isothermal gas component is introduced for a subset of the models. We perform a resolution study and vary parameters governing the GMC population, the histories of star formation and radial scale growth. Models with GMCs and standard values for the disc mass and halo density provide the right level of self-gravity to explain the age-velocity dispersion relation of the solar neighbourhood (Snhd). GMC heating generates remarkably exponential vertical profiles with scaleheights that are radially constant and agree with observations of galactic thin discs. GMCs are also capable of significantly delaying bar formation. The amount of spiral-induced radial migration agrees with what is required for the metallicity distribution of the Snhd. However, in our standard models, the outward-migrating populations are not hot enough vertically to create thick discs. Thick discs can form in models with high baryon fractions, but the corresponding bars are too long, the young stellar populations too hot and the discs flare considerably.

  15. Evolution of linear warps in accretion discs and applications to protoplanetary discs in binaries

    CERN Document Server

    Foucart, Francois

    2014-01-01

    The existence of warped accretion discs is expected in a wide variety of astrophysical systems, including circumstellar discs in binaries and discs around binary protostars. A common feature of these discs is that they are perturbed by a misaligned external potential. In this paper, we study the long-term evolution of the disc warp and precession in the case of thick discs (with the dimensionless thickness $H/r$ larger than the viscosity parameter $\\alpha$) in which bending waves can propagate. For small warps, such discs undergo approximately rigid-body precession with a coherent global frequency. We derive the analytical expressions for the warp/twist profiles of the disc and the alignment timescale for a variety of disc models/parameters. Applying our results to circumbinary discs, we find that these discs align with the orbital plane of the binary on a timescale comparable to the global precession time of the disc, and typically much smaller than its viscous timescale. The development of parametric instab...

  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. Follow-up Study on the Motion Range after Treatment of Degenerative Disc Disease with the Bryan Cervical Disc Prosthesis

    Institute of Scientific and Technical Information of China (English)

    YANG Shuhua; HU Yong; ZHAO Jijun; HE Xianfeng; LIU Yong; XU Weihua; DU Jingyuan; FU Dehao

    2007-01-01

    This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs, improving the patients' ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion. From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up for 2 to 8 months (with a mean of 5.2 months). Of them 5 had cervical spondylotic myelopathy and 7 had cervical disc herniation. The patients included 7 males and 5 females, with their age ranging from 35 to 62 y and a mean of 50.3 y. Single-level replacements were performed in 10 cases and 2 cases received two-level replacement. Operation time of the single-level surgery averaged 130±50 min and the time of two-level surgery was 165±53 min on average (from skin incision to skin suturing).Neurological or vascular complications during or after surgery was not observed. Japanese Orthopedic Association scores (JOA scores) increased from 8.6 to 15.8 on average. There was no prothesis subsidence or excursion. Replaced segments were stable and the range of motion was partially restored, being 4.68° (3.6°-6.1°) in flexion and extension position and 3.51° (2.5°-4.6°) 3.42° (2.6°-4.3°) in left and right bending position. No obvious loss of physiological curvature was noted. CT or MRI follow-up showed that excursion was less than 1.5 mm) in 2 of 14 levels and between 1.5 mm and 3 mm) in 1 of 14 levels. No ossification in the replaced levels was observed. It is concluded that satisfactory short-term results were achieved in the 12 cases of artificial disc replacements. Different from anterior cervical discectomy and fusion, the replacement could achieve quick functional recovery and did not lead to the movement limitation of cervical vertebrae. At least a 5-years follow-up was needed to assess the long-term effect of the prosthesis on its neighboring segments.

  5. 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

  6. 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

  7. 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.

  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. Unusual disc herniation in a dog: a case history report

    International Nuclear Information System (INIS)

    Unusual disc herniation was identified in a dog. Disc herniation was considered unusual because of its displacement into the vertebral endplate of the adjoining vertebra. Unusual disc herniation in this dog was compared with Schmorl's node in humans

  12. Changes in disc herniation after CT-guided Percutaneous Laser Disc Decompression (PLDD): MR findings

    Science.gov (United States)

    Brat, Hugues G.; Bouziane, Tarik; Lambert, Jean; Divano, Luisa

    2004-09-01

    The aim of Percutaneous Laser Disc Decompression (PLDD) is to vaporize a small portion of the nucleus pulposus. Clinical efficacy of this technique is largely proven. However, time-evolution of intervertebral disc and its hernia after PLDD is not known. This study analyses changes in disc herniation and its native intervertebral disc at a mean follow-up of 7.5 months after PLDD in asymptomatic patients. Main observations at MRI are appearance of a high signal on T2WI in the hernia in 59%, shrinking of the hernia in 66% and overall stability of disc height.

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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.

  19. 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

  20. Methodology for optic disc localization

    Directory of Open Access Journals (Sweden)

    Marcos A. Leiva-Vasconcellos

    2014-04-01

    Full Text Available The use of digital images in many areas of society is an activity that has reached a remarkable growth in recent years mainly due to the great development that has occurred in technology around the world. These images have a great use in many branches of medicine because they facilitate the diagnosis by specialists and thus help patients to be diagnosed long before symptoms of the disease begin to manifest. For Ophthalmology, one of the most used images are the digital retinography, If it is used properly will allow the occurrence of eye diseases such as glaucoma and diabetic retinopathy. One of the main elements shown on retinal images are the optic disc, the location and detection is of vital importance for working with different parts of the structure o f the eye. This paper proposes two techniques for locating the optic disc in retinal images based on the combination of multiple filters and applying logical operators. To test the algorithms diaretDB0v11 and DRIVE database were used , as a result of the tests are correctly located the 99.091 % of the images from both repo sitories, and were successfully detected 85 % and 87.143 % of images of DRIVE database and diaretDB0v11 respectively.

  1. The inner cavity of the circumnuclear disc

    Science.gov (United States)

    Blank, M.; Morris, M. R.; Frank, A.; Carroll-Nellenback, J. J.; Duschl, W. J.

    2016-06-01

    The circumnuclear disc (CND) orbiting the Galaxy's central black hole is a reservoir of material that can ultimately provide energy through accretion, or form stars in the presence of the black hole, as evidenced by the stellar cluster that is presently located at the CND's centre. In this paper, we report the results of a computational study of the dynamics of the CND. The results lead us to question two paradigms that are prevalent in previous research on the Galactic Centre. The first is that the disc's inner cavity is maintained by the interaction of the central stellar cluster's strong winds with the disc's inner rim, and secondly, that the presence of unstable clumps in the disc implies that the CND is a transient feature. Our simulations show that, in the absence of a magnetic field, the interaction of the wind with the inner disc rim actually leads to a filling of the inner cavity within a few orbital time-scales, contrary to previous expectations. However, including the effects of magnetic fields stabilizes the inner disc rim against rapid inward migration. Furthermore, this interaction causes instabilities that continuously create clumps that are individually unstable against tidal shearing. Thus the occurrence of such unstable clumps does not necessarily mean that the disc is itself a transient phenomenon. The next steps in this investigation are to explore the effect of the magnetorotational instability on the disc evolution and to test whether the results presented here persist for longer time-scales than those considered here.

  2. Genetic association studies in lumbar disc degeneration

    DEFF Research Database (Denmark)

    Eskola, Pasi J; Lemmelä, Susanna; Kjaer, Per;

    2012-01-01

    Low back pain is associated with lumbar disc degeneration, which is mainly due to genetic predisposition. The objective of this study was to perform a systematic review to evaluate genetic association studies in lumbar disc degeneration as defined on magnetic resonance imaging (MRI) in humans....

  3. Computing Decoupled Residuals for Compact Disc Players

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Stoustrup, Jakob; Andersen, Palle;

    2006-01-01

    a pair of residuals generated by Compact Disc Player. However, these residuals depend on the performance of position servos in the Compact Disc Player. In other publications of the same authors a pair of decoupled residuals is derived. However, the computation of these alternative residuals has been...

  4. Modeling quasar accretion disc temperature profiles

    CERN Document Server

    Hall, Patrick B; Chajet, L S; Weiss, E; Nixon, C J

    2013-01-01

    Microlensing observations indicate that quasar accretion discs have half-light radii larger than expected from standard theoretical predictions based on quasar fluxes or black hole masses. Blackburne and colleagues have also found a very weak wavelength dependence of these half-light radii. We consider disc temperature profile models that might match these observations. Nixon and colleagues have suggested that misaligned accretion discs around spinning black holes will be disrupted at radii small enough for the Lense-Thirring torque to overcome the disc's viscous torque. Gas in precessing annuli torn off a disc will spread radially and intersect with the remaining disc, heating the disc at potentially large radii. However, if the intersection occurs at an angle of more than a degree or so, highly supersonic collisions will shock-heat the gas to a Compton temperature of T~10^7 K, and the spectral energy distributions (SEDs) of discs with such shock-heated regions are poor fits to observations of quasar SEDs. T...

  5. Feature Based Control of Compact Disc Players

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh

    Two servo control loops are used to keep the Optical Pick-up Unit focused and radially on the information track of the Compact Disc. These control servos have problems handling surface faults on the Compact Disc. In this Ph.D thesis a method is proposed to improve the handling of these surface...

  6. The maximum rotation of a galactic disc

    NARCIS (Netherlands)

    Bottema, R

    1997-01-01

    The observed stellar velocity dispersions of galactic discs show that the maximum rotation of a disc is on average 63% of the observed maximum rotation. This criterion can, however, not be applied to small or low surface brightness (LSB) galaxies because such systems show, in general, a continuously

  7. Forbidden calcium lines as disc tracers

    CERN Document Server

    Aret, Anna

    2015-01-01

    Forbidden emission lines are particularly valuable disc tracers, because their profiles reflect the kinematics within their formation region. Here we present a short excerpt from the results of a spectroscopic survey of evolved massive stars surrounded by high-density discs.

  8. Thin, thick and dark discs in LCDM

    CERN Document Server

    Read, J I; Agertz, O; Debattista, Victor P

    2008-01-01

    In a LCDM cosmology, the Milky Way accretes satellites into the stellar disc. We use cosmological simulations to assess the frequency of near disc plane and higher inclination accretion events, and collisionless simulations of satellite mergers to quantify the final state of the accreted material and the effect on the thin disc. On average, a Milky Way-sized galaxy has 1.5 subhalos with vmax>80km/s; 5 with vmax>60km/s; and 13 with vmax>40km/s merge at redshift z>1. A third of these merge at an impact angle 20 degrees) are twice as likely as low inclination ones. These lead to structures that closely resemble the recently discovered inner/outer stellar halos. They also do more damage to the Milky Way stellar disc creating a more pronounced flare, and warp; both long-lived and consistent with current observations. The most massive mergers (vmax > 80km/s) heat t he thin disc enough to produce a thick disc. These heated thin disc stars are essential for obtaining a thick disc as massive as that seen in the Milky ...

  9. 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

  10. Simulations of the Galactic Centre Stellar Discs In a Warped Disc Origin Scenario

    International Nuclear Information System (INIS)

    The Galactic Center (GC) hosts a population of young stars some of which seem to form a system of mutually inclined warped discs. While the presence of young stars in the close vicinity of the massive black hole is already problematic, their orbital configuration makes the situation even more puzzling. We present a possible warped disc origin scenario for these stars, which assumes an initially flat accretion disc which develops a warp through Pringle instability, or Bardeen-Petterson Effect. By working out the critical radii and the time scales involved, we argue that disc warping is plausible for GC parameters. We construct time evolution models for such discs considering the discs' self-gravity, and the torques exerted by the surrounding old star cluster. Our simulations suggest that the best agreement for a purely self-gravitating model is obtained for a disc-to-black hole mass ratio of Md/Mbh ∼ 0.001.

  11. Simulations of the Galactic Centre Stellar Discs In a Warped Disc Origin Scenario

    Science.gov (United States)

    Ulubay-Siddiki, A.; Bartko, H.

    2012-07-01

    The Galactic Center (GC) hosts a population of young stars some of which seem to form a system of mutually inclined warped discs. While the presence of young stars in the close vicinity of the massive black hole is already problematic, their orbital configuration makes the situation even more puzzling. We present a possible warped disc origin scenario for these stars, which assumes an initially flat accretion disc which develops a warp through Pringle instability, or Bardeen-Petterson Effect. By working out the critical radii and the time scales involved, we argue that disc warping is plausible for GC parameters. We construct time evolution models for such discs considering the discs' self-gravity, and the torques exerted by the surrounding old star cluster. Our simulations suggest that the best agreement for a purely self-gravitating model is obtained for a disc-to-black hole mass ratio of Md/Mbh ~ 0.001.

  12. About detection of precessing circumpulsar discs

    Science.gov (United States)

    Grimani, Catia

    2016-08-01

    Detections of circumpulsar discs and planetary systems through electromagnetic observations appear quite rare. In the case of PSR 1931+24 and B0656+14, the hypothesis of a precessing disc penetrating the pulsar light cylinder is found consistent with radio and gamma observations from these stars. Disc self-occultation and precession may affect electromagnetic measurements. We investigate here under which conditions gravitational waves generated by circumpulsar disc precession may be detected by the proposed second-generation space interferometers DECI-hertz Interferometer Gravitational Wave Observatory and Big Bang Observer. The characteristics of circumpulsar detectable precessing discs are estimated as a function of distance from the Solar system. Speculations on detection rates are presented.

  13. Strongly magnetized accretion discs require poloidal flux

    CERN Document Server

    Salvesen, Greg; Simon, Jacob B; Begelman, Mitchell C

    2016-01-01

    Motivated by indirect observational evidence for strongly magnetized accretion discs around black holes, and the novel theoretical properties of such solutions, we investigate how a strong magnetization state can develop and persist. To this end, we perform local simulations of accretion discs with an initially purely toroidal magnetic field of equipartition strength. We demonstrate that discs with zero net vertical magnetic flux and realistic boundary conditions cannot sustain a strong toroidal field. However, a magnetic pressure-dominated disc can form from an initial configuration with a sufficient amount of net vertical flux and realistic boundary conditions. Our results suggest that poloidal flux is a necessary prerequisite for the sustainability of strongly magnetized accretion discs.

  14. Lumbar disc cyst with contralateral radiculopathy

    Directory of Open Access Journals (Sweden)

    Kishore Tourani

    2012-08-01

    Full Text Available Disc cysts are uncommon intraspinal cystic lesions located in the ventrolateral epidural space. They communicate with the nucleus pulposus of the intervertebral disc and cause symptoms by radicular compression. We report a unique case of lumbar disc cyst that was associated with disc herniation and contralateral radiculopathy. A 22 year old male presented with one month history of back-ache radiating to the left leg. Magnetic Resonance Imaging (MRI showed L3-L4 disc herniation with annular tear and cystic lesion in the extradural space anterior to the thecal sac on right side, which increased in size over a period of 3 weeks. L3 laminectomy and bilateral discectomy and cyst excision was done with partial improvement of patients symptoms.

  15. Lumbar Epidural Varix Mimicking Disc Herniation

    Science.gov (United States)

    Bursalı, Adem; Guvenal, Ahmet Burak; Yaman, Onur

    2016-01-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4–5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method. PMID:27446525

  16. The formation of planets by disc fragmentation

    Directory of Open Access Journals (Sweden)

    Stamatellos Dimitris

    2013-04-01

    Full Text Available I discuss the role that disc fragmentation plays in the formation of gas giant and terrestrial planets, and how this relates to the formation of brown dwarfs and low-mass stars, and ultimately to the process of star formation. Protostellar discs may fragment, if they are massive enough and can cool fast enough, but most of the objects that form by fragmentation are brown dwarfs. It may be possible that planets also form, if the mass growth of a proto-fragment is stopped (e.g. if this fragment is ejected from the disc, or suppressed and even reversed (e.g by tidal stripping. I will discuss if it is possible to distinguish whether a planet has formed by disc fragmentation or core accretion, and mention of a few examples of observed exoplanets that are suggestive of formation by disc fragmentation.

  17. Propeller outflows from an MRI disc

    CERN Document Server

    Lii, Patrick S; Ustyugova, Galina V; Koldoba, Alexander V; Lovelace, Richard V E

    2013-01-01

    We present the results of axisymmetric simulations of MRI-driven accretion onto a rapidly rotating, magnetized star accreting in the propeller regime. The stellar magnetosphere corotates with the star, forming a centrifugal barrier at the disc-magnetosphere boundary which inhibits matter accretion onto the star. Instead, the disc matter accumulates at the disc-magnetosphere interface and slowly diffuses into the inner magnetosphere where it picks up angular momentum and is quickly ejected from the system as an outflow. Due to the interaction of the matter with the magnetosphere, this wind is discontinuous and is launched as discrete plasmoids. If the ejection rate is lower than the disc accretion rate, the matter accumulates at the disc-magnetosphere boundary faster than it can be ejected. In this case, accretion onto the star proceeds through the episodic accretion instability in which episodes of matter accumulation are followed by simultaneous accretion and ejection. During the accretion phase of this inst...

  18. Lumbar Epidural Varix Mimicking Disc Herniation.

    Science.gov (United States)

    Bursalı, Adem; Akyoldas, Goktug; Guvenal, Ahmet Burak; Yaman, Onur

    2016-07-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method.

  19. Lumbar Epidural Varix Mimicking Disc Herniation.

    Science.gov (United States)

    Bursalı, Adem; Akyoldas, Goktug; Guvenal, Ahmet Burak; Yaman, Onur

    2016-07-01

    Lumbar radiculopathy is generally caused by such well-recognized entity as lumbar disc herniation in neurosurgical practice; however rare pathologies such as thrombosed epidural varix may mimic them by causing radicular symptoms. In this case report, we present a 26-year-old man with the complaint of back and right leg pain who was operated for right L4-5 disc herniation. The lesion interpreted as an extruded disc herniation preoperatively was found to be a thrombosed epidural varix compressing the nerve root preoperatively. The nerve root was decompressed by shrinking the lesion with bipolar thermocoagulation and excision. The patient's complaints disappeared in the postoperative period. Thrombosed lumbar epidural varices may mimic lumbar disc herniations both radiologically and clinically. Therefore, must be kept in mind in the differential diagnosis of lumbar disc herniations. Microsurgical techniques are mandatory for the treatment of these pathologies and decompression with thermocoagulation and excision is an efficient method. PMID:27446525

  20. Magnetic resonance imaging of intervertebral disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Hiroshi; Noguchi, Masao (Kitakyushu City Yahata Hospital, Fukuoka (Japan)); Kira, Hideaki; Fujiki, Hiroshi; Shimokawa, Isao; Hinoue, Kaichi

    1993-02-01

    The aim of this study was to correlate the degree of lumbar intervertebral disc degeneration with findings of magnetic resonance imaging (MRI). Seventeen autopsied (from 7 patients) and 21 surgical (from 20 patients) intervertebral discs were used as specimens for histopathological examination. In addition, 21 intervertebral discs were examined on T2-weighted images. Histopathological findings from both autopsied and surgical specimens were well correlated with MRI findings. In particular, T2-weighted images reflected increased collagen fibers and rupture within the fibrous ring accurately. However, when severely degenerated intervertebral discs and hernia protruding the posterior longitudinal ligament existed, histological findings were not concordant well with T2-weighted images. Morphological appearances of autopsy specimens, divided into four on T2-weighted images, were well consistent with histological degeneration. This morphological classification, as shown on T2-weighted images, could also be used in the evaluation of intervertebral disc degeneration. (N.K.).

  1. Strongly magnetized accretion discs require poloidal flux

    Science.gov (United States)

    Salvesen, Greg; Armitage, Philip J.; Simon, Jacob B.; Begelman, Mitchell C.

    2016-08-01

    Motivated by indirect observational evidence for strongly magnetized accretion discs around black holes, and the novel theoretical properties of such solutions, we investigate how a strong magnetization state can develop and persist. To this end, we perform local simulations of accretion discs with an initially purely toroidal magnetic field of equipartition strength. We demonstrate that discs with zero net vertical magnetic flux and realistic boundary conditions cannot sustain a strong toroidal field. However, a magnetic pressure-dominated disc can form from an initial configuration with a sufficient amount of net vertical flux and realistic boundary conditions. Our results suggest that poloidal flux is a necessary prerequisite for the sustainability of strongly magnetized accretion discs.

  2. Spine imaging after lumbar disc replacement: pitfalls and current recommendations

    Directory of Open Access Journals (Sweden)

    Sandén Bengt

    2009-07-01

    Full Text Available Abstract Background Most lumbar artificial discs are still composed of stainless steel alloys, which prevents adequate postoperative diagnostic imaging of the operated region when using magnetic resonance imaging (MRI. Thus patients with postoperative radicular symptoms or claudication after stainless steel implants often require alternative diagnostic procedures. Methods Possible complications of lumbar total disc replacement (TDR are reviewed from the available literature and imaging recommendations given with regard to implant type. Two illustrative cases are presented in figures. Results Access-related complications, infections, implant wear, loosening or fracture, polyethylene inlay dislodgement, facet joint hypertrophy, central stenosis, and ankylosis of the operated segment can be visualised both in titanium and stainless steel implants, but require different imaging modalities due to magnetic artifacts in MRI. Conclusion Alternative radiographic procedures should be considered when evaluating patients following TDR. Postoperative complications following lumbar TDR including spinal stenosis causing radiculopathy and implant loosening can be visualised by myelography and radionucleotide techniques as an adjunct to plain film radiographs. Even in the presence of massive stainless steel TDR implants lumbar radicular stenosis and implant loosening can be visualised if myelography and radionuclide techniques are applied.

  3. 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 ...

  4. 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...

  5. 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.

  6. 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...

  7. 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 ...

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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...

  14. Generation of highly inclined protoplanetary discs through single stellar flybys

    CERN Document Server

    Xiang-Gruess, Meng

    2015-01-01

    We study the three-dimensional evolution of a viscous protoplanetary disc which is perturbed by a passing star on a parabolic orbit. The aim is to test whether a single stellar flyby is capable to excite significant disc inclinations which would favour the formation of so-called misaligned planets. We use smoothed particle hydrodynamics to study inclination, disc mass and angular momentum changes of the disc for passing stars with different masses. We explore different orbital configurations for the perturber's orbit to find the parameter spaces which allow significant disc inclination generation. Prograde inclined parabolic orbits are most destructive leading to significant disc mass and angular momentum loss. In the remaining disc, the final disc inclination is only below $20^\\circ$. This is due to the removal of disc particles which have experienced the strongest perturbing effects. Retrograde inclined parabolic orbits are less destructive and can generate disc inclinations up to $60^\\circ$. The final disc...

  15. 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

  16. Gravitoturbulence in magnetised protostellar discs

    CERN Document Server

    Riols, A

    2016-01-01

    Gravitational instability (GI) features in several aspects of protostellar disk evolution, most notably in angular momentum transport, fragmentation, and the outbursts exemplified by FU Ori and EX Lupi systems. The outer regions of protostellar discs may also be coupled to magnetic fields, which could then modify the development of GI. To understand the basic elements of their interaction, we perform local 2D ideal and resistive MHD simulations with an imposed toroidal field. In the regime of moderate plasma beta, we find that the system supports a hot gravito-turbulent state, characterised by considerable magnetic energy and stress and a surprisingly large Toomre parameter $Q~10$. This result has potential implications for disk structure, vertical thickness, ionisation, etc. Our simulations also reveal the existence of long-lived and dense `magnetic islands' or plasmoids. Lastly, we find that the presence of a magnetic field has little impact on the fragmentation criterion of the disk. Though our focus is on...

  17. 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.

  18. 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

  19. 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

  20. The properties of discs around planets and brown dwarfs as evidence for disc fragmentation

    CERN Document Server

    Stamatellos, Dimitris

    2015-01-01

    Direct imaging searches have revealed many very low-mass objects, including a small number of planetary mass objects, as wide-orbit companions to young stars. The formation mechanism of these objects remains uncertain. In this paper we present the predictions of the disc fragmentation model regarding the properties of the discs around such low-mass objects. We find that the discs around objects that have formed by fragmentation in discs hosted by Sun-like stars (referred to as 'parent' discs and 'parent' stars) are more massive than expected from the ${M}_{\\rm disc}-M_*$ relation (which is derived for stars with masses $M_*>0.2 {\\rm M}_{\\odot}$). Accordingly, the accretion rates onto these objects are also higher than expected from the $\\dot{M}_*-M_*$ relation. Moreover there is no significant correlation between the mass of the brown dwarf or planet with the mass of its disc nor with the accretion rate from the disc onto it. The discs around objects that form by disc fragmentation have larger than expected m...

  1. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level.

    Science.gov (United States)

    Hakan, Tayfun; Gürcan, Serkan

    2016-01-01

    Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc herniation caudally immigrating at L4-5 level three years ago. He refused the surgical intervention that was offered and was treated conservatively at that time. He had no neurological deficit and a history of spontaneous regression of the extruded lumbar disc; so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-inflammatory drugs, and analgesics, was advised. In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at adjacent/different level may occur. Furthermore, it is important to know which herniated disk should be removed and which should be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome. PMID:27429818

  2. Spontaneous Regression of Herniated Lumbar Disc with New Disc Protrusion in the Adjacent Level

    Directory of Open Access Journals (Sweden)

    Tayfun Hakan

    2016-01-01

    Full Text Available Spontaneous regression of herniated lumbar discs was reported occasionally. The mechanisms proposed for regression of disc herniation are still incomplete. This paper describes and discusses a case of spontaneous regression of herniated lumbar discs with a new disc protrusion in the adjacent level. A 41-year-old man was admitted with radiating pain and numbness in the left lower extremity with a left posterolateral disc extrusion at L5-S1 level. He was admitted to hospital with low back pain due to disc herniation caudally immigrating at L4-5 level three years ago. He refused the surgical intervention that was offered and was treated conservatively at that time. He had no neurological deficit and a history of spontaneous regression of the extruded lumbar disc; so, a conservative therapy, including bed rest, physical therapy, nonsteroidal anti-inflammatory drugs, and analgesics, was advised. In conclusion, herniated lumbar disc fragments may regress spontaneously. Reports are prone to advise conservative treatment for extruded or sequestrated lumbar disc herniations. However, these patients should be followed up closely; new herniation at adjacent/different level may occur. Furthermore, it is important to know which herniated disk should be removed and which should be treated conservatively, because disc herniation may cause serious complications as muscle weakness and cauda equine syndrome.

  3. Disc nucleus fortification for lumbar degenerative disc disease: a biomechanical study.

    Science.gov (United States)

    Dupré, Derrick A; Cook, Daniel J; Brad Bellotte, J; Oh, Michael Y; Whiting, Donald; Cheng, Boyle C

    2016-05-01

    OBJECTIVE Spinal stability is attributed in part to osteoligamentous structures, including the vertebral body, facets, intervertebral discs, and posterior elements. The materials in this study provide an opportunity to augment the degenerated nucleus without removing native disc material, a procedure introduced here as "fortification." The objective of this study was to determine the effect of nucleus fortification on lumbar disc biomechanics. METHODS The authors performed in vitro analysis of human cadaveric functional spinal units (FSUs), along with characterization and quantification of movement of the units using biomechanical data in intact, disc-only, and fortified specimens. The units underwent removal of all posterior elements and annulus and were fortified by injecting a biogel into the nucleus pulposus. Each specimen was subjected to load testing, range of motion (ROM) quantification, and disc bulge measurements. Optoelectric tracking was used to quantify disc bulge. These criteria were assessed in the intact, disc-only, and fortified treatments. RESULTS Disc-only FSUs resulted in increased ROM when compared with intact and fortified conditions. Fortification of the FSU resulted in partial restoration of normal ROM in the treatment groups. Analysis of hysteresis loops showed more linear response in the fortified groups when compared with the intact and disc-only groups. CONCLUSIONS Disc nucleus fortification increases linearity and decreases ROM. PMID:26771371

  4. Chemical separation of disc components using RAVE

    CERN Document Server

    Wojno, Jennifer; Steinmetz, Matthias; McMillan, Paul J; Matijevič, Gal; Binney, James; Wyse, Rosemary F G; Boeche, Corrado; Just, Andreas; Grebel, Eva K; Siebert, Arnaud; Bienaymé, Olivier; Gibson, Brad K; Zwitter, Tomaž; Bland-Hawthorn, Joss; Navarro, Julio F; Parker, Quentin A; Reid, Warren; Seabroke, George; Watson, Fred

    2016-01-01

    We present evidence from the RAdial Velocity Experiment (RAVE) survey of chemically separated, kinematically distinct disc components in the solar neighbourhood. We apply probabilistic chemical selection criteria to separate our sample into $\\alpha$-low (`thin disc') and $\\alpha$-high (`thick disc') components. Using newly derived distances, which will be utilized in the upcoming RAVE DR5, we explore the kinematic trends as a function of metallicity for each of the disc components. For our thin disc stars, we find a negative trend in the mean rotational velocity ($V_{\\mathrm{\\phi}}$) as a function of iron abundance ([Fe/H]). We measure a positive trend in $\\partial V_{\\mathrm{\\phi}}$/$\\partial$[Fe/H] for the thick disc, consistent with results from high-resolution surveys. We also find differences between the chemical thin and thick discs in all three components of velocity dispersion. We discuss the implications of an $\\alpha$-low, metal-rich population originating from the inner Galaxy, where the orbits of ...

  5. Stem cells sources for intervertebral disc regeneration.

    Science.gov (United States)

    Vadalà, Gianluca; Russo, Fabrizio; Ambrosio, Luca; Loppini, Mattia; Denaro, Vincenzo

    2016-05-26

    Intervertebral disc regeneration field is rapidly growing since disc disorders represent a major health problem in industrialized countries with very few possible treatments. Indeed, current available therapies are symptomatic, and surgical procedures consist in disc removal and spinal fusion, which is not immune to regardable concerns about possible comorbidities, cost-effectiveness, secondary risks and long-lasting outcomes. This review paper aims to share recent advances in stem cell therapy for the treatment of intervertebral disc degeneration. In literature the potential use of different adult stem cells for intervertebral disc regeneration has already been reported. Bone marrow mesenchymal stromal/stem cells, adipose tissue derived stem cells, synovial stem cells, muscle-derived stem cells, olfactory neural stem cells, induced pluripotent stem cells, hematopoietic stem cells, disc stem cells, and embryonic stem cells have been studied for this purpose either in vitro or in vivo. Moreover, several engineered carriers (e.g., hydrogels), characterized by full biocompatibility and prompt biodegradation, have been designed and combined with different stem cell types in order to optimize the local and controlled delivery of cellular substrates in situ. The paper overviews the literature discussing the current status of our knowledge of the different stem cells types used as a cell-based therapy for disc regeneration. PMID:27247704

  6. Optically-thick accretion discs with advection

    Institute of Scientific and Technical Information of China (English)

    陈林红; 吴枚; 尚仁成

    2002-01-01

    The structures of optically-thick accretion discs with radial advection have been investigated by the iteration and integration algorithms. The advective cooling term changes mostly the inner part of disc solution, and even results in an optically-thick advection-dominated accretion flow (ADAF). Three distinct branches-the outer Shakura-Sunyaev disc (SSD), the inner ADAF and the middle transition layer-are found for a super-Eddington disc. The SSD-ADAF transition radius can be estimated as 18(M/ME)RG where RG is the Schwarzschild radius, M is the mass accretion rate and ME is the Eddington accretion rate. SSD solutions calculated with the iteration and integration methods are identical, while ADAF solutions obtained by these two methods differ greatly. Detailed algorithms and their differences have been analysed. The iteration algorithm is not self-consistent, since it implies that the dimensionless advection factor ξ is invariant, but in the inner ADAF region the variation of ξ is not negligible. The integration algorithm is always effective for the whole region of an optically-thick disc if the accretion rate is no smaller than 10-4ME. For optically-thin discs, the validity of these two algorithms is different. We suggest that the integration method be employed to calculate the global solution of a disc model without assuming ξ to be a constant. We also discuss its application to the emergent continuum spectrum in order to explain observational facts.

  7. Structure of radiation dominated gravitoturbulent quasar discs

    CERN Document Server

    Shadmehri, Mohsen; Dib, Sami

    2016-01-01

    Self-gravitating accretion discs in a gravitoturbulent state, including radiation and gas pressures, are studied using a set of new analytical solutions. While the Toomre parameter of the disc remains close to its critical value for the onset of gravitational instability, the dimensionless stress parameter is uniquely determined from the thermal energy reservoir of the disc and its cooling rate. Our solutions are applicable to the accretion discs with dynamically important radiation pressure like in the quasars discs. We show that physical quantities of a gravitoturbulent disc in the presence of radiation are significantly modified compared to solutions with only gas pressure. We show that the dimensionless stress parameter is an increasing function of the radial distance so that its steepness strongly depends on the accretion rate. In a disc without radiation its slope is 4.5, however, we show that in the presence of radiation, it varies between 2 and 4.5 depending on the accretion rate and the central mass....

  8. Have proto-planetary discs formed planets?

    CERN Document Server

    Greaves, J S

    2010-01-01

    It has recently been noted that many discs around T Tauri stars appear to comprise only a few Jupiter-masses of gas and dust. Using millimetre surveys of discs within six local star-formation regions, we confirm this result, and find that only a few percent of young stars have enough circumstellar material to build gas giant planets, in standard core accretion models. Since the frequency of observed exo-planets is greater than this, there is a `missing mass' problem. As alternatives to simply adjusting the conversion of dust-flux to disc mass, we investigate three other classes of solution. Migration of planets could hypothetically sweep up the disc mass reservoir more efficiently, but trends in multi-planet systems do not support such a model, and theoretical models suggest that the gas accretion timescale is too short for migration to sweep the disc. Enhanced inner-disc mass reservoirs are possible, agreeing with predictions of disc evolution through self-gravity, but not adding to millimetre dust-flux as t...

  9. Stem cells sources for intervertebral disc regeneration.

    Science.gov (United States)

    Vadalà, Gianluca; Russo, Fabrizio; Ambrosio, Luca; Loppini, Mattia; Denaro, Vincenzo

    2016-05-26

    Intervertebral disc regeneration field is rapidly growing since disc disorders represent a major health problem in industrialized countries with very few possible treatments. Indeed, current available therapies are symptomatic, and surgical procedures consist in disc removal and spinal fusion, which is not immune to regardable concerns about possible comorbidities, cost-effectiveness, secondary risks and long-lasting outcomes. This review paper aims to share recent advances in stem cell therapy for the treatment of intervertebral disc degeneration. In literature the potential use of different adult stem cells for intervertebral disc regeneration has already been reported. Bone marrow mesenchymal stromal/stem cells, adipose tissue derived stem cells, synovial stem cells, muscle-derived stem cells, olfactory neural stem cells, induced pluripotent stem cells, hematopoietic stem cells, disc stem cells, and embryonic stem cells have been studied for this purpose either in vitro or in vivo. Moreover, several engineered carriers (e.g., hydrogels), characterized by full biocompatibility and prompt biodegradation, have been designed and combined with different stem cell types in order to optimize the local and controlled delivery of cellular substrates in situ. The paper overviews the literature discussing the current status of our knowledge of the different stem cells types used as a cell-based therapy for disc regeneration.

  10. Endoscopic anterior decompression in cervical disc disease

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2014-01-01

    Full Text Available Background: Although microscopic anterior cervical discectomy with or without fusion are common surgical procedures for treatment of cervical herniated discs, loss of disc height, pseudarthrosis, and adjacent disc degeneration are some of the problems associated with it. This study is aimed to evaluate results of endoscopic microforaminotomy in cervical disc diseases. Materials and Methods: A prospective study of 50 patients of mono segmental soft or hard disc causing myeloradiculopathy was undertaken. A visual analogue scale (VAS for neck and arm pain and functional outcomes using the Nurick grading system were assessed. There were 28, 12, 8, and 2 patients at C5-6, C6-7, C4-5, and C3-4 levels disc diseases, respectively. Patients with two or more level disc, instabilities, disc extending more than half vertebral body height, and previous operation at the same segment were excluded. Results: Age ranged from 21 to 67 years. Average postoperative reduction in disc height, operating time, and blood loss was 1.1 mm, 110 minutes, and 30 ml, respectively. Average pre-operative VAS score for arm pain and Nurick grading was 7.6 and 2.7, which improved to 1.9 and 0.82, respectively. All patients improved; 1, 2, 3 grade improvement was seen in 10, 27, and 10 patients, respectively. There was no significant complication or any mortality. Conclusion: Although longer follow up of large number of patients is required, endoscopic microforaminotomy is a safe and an effective alternative to microscopic anterior discectomy with or without fusion.

  11. 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

  12. Trends in Artificial Intelligence.

    Science.gov (United States)

    Hayes, Patrick

    1978-01-01

    Discusses the foundations of artificial intelligence as a science and the types of answers that may be given to the question, "What is intelligence?" The paradigms of artificial intelligence and general systems theory are compared. (Author/VT)

  13. The role of cryopreservation in the biomechanical properties of the intervertebral disc

    Directory of Open Access Journals (Sweden)

    SKL Lam

    2011-12-01

    Full Text Available Implantation of intervertebral disc (IVD allograft or tissue engineered disc constructs in the spine has emerged as an alternative to artificial disc replacement for the treatment of severe degenerative disc disease (DDD. Establishment of a bank of cryopreserved IVD allografts enables size matching and facilitates logistics for effective clinical management. However, the biomechanical properties of cryopreserved IVDs have not been previously reported. This study aimed to assess if cryopreservation with different concentrations of cryopreservant agents (CPA would affect the dynamic viscoelastic properties of the IVD. Whole porcine lumbar IVDs (n = 40 were harvested and processed using various concentrations of CPA, 0 % CPA, 10 % CPA and 20 % CPA. The discs were cryopreserved using a stepwise freezing protocol and stored in liquid nitrogen. After four weeks of storage, the cryopreserved IVDs were quickly thawed at 37 °C for dynamic viscoelastic testing. The apparent modulus, elastic modulus (G’, viscous modulus (G” and loss modulus (G”/G’ were calculated and compared to a fresh control group. Cryopreserved IVD without cryopreservants was significantly stiffer than the control. In the dynamic viscoelastic testing, cryopreservation with the use of CPA was able to preserve both G’ and G” of an IVD. No significant differences were found between fresh IVD and IVD cryopreserved with 10 % CPA or 20 % CPA. This study demonstrated that CPAs at an optimal concentration could preserve the mechanical properties of the IVD allograft and can provide further credence for the application of long-term storage of IVD allografts for disc transplantation or tissue engineered construct applications.

  14. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  15. 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...

  16. 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.

  17. 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...

  18. A lumbar disc surgery predictive score card.

    Science.gov (United States)

    Finneson, B E

    1978-06-01

    A lumbar disc surgery predictive score card or questionnaire has been developed to assess potential candidates for excision of a herniated lumbar disc who have not previously undergone lumbar spine surgery. It is not designed to encompass patients who are being considered for other types of lumbar spine surgery, such as decompressive laminectomy or fusion. In an effort to make the "score card" usable by almost all physicians who are involved in lumbar disc surgery, only studies which have broad acceptance and are generally employed are included. Studies which have less widespread use such as electromyogram, discogram, venogram, special psychologic studies (MMPI, pain drawings) have been purposely excluded.

  19. Spectroscopic Parameters of Lumbar Intervertebral Disc Material

    Science.gov (United States)

    Terbetas, G.; Kozlovskaja, A.; Varanius, D.; Graziene, V.; Vaitkus, J.; Vaitkuviene, A.

    2009-06-01

    There are numerous methods of investigating intervertebral disc. Visualization methods are widely used in clinical practice. Histological, imunohistochemical and biochemical methods are more used in scientific research. We propose that a new spectroscopic investigation would be useful in determining intervertebral disc material, especially when no histological specimens are available. Purpose: to determine spectroscopic parameters of intervertebral disc material; to determine emission spectra common for all intervertebral discs; to create a background for further spectroscopic investigation where no histological specimen will be available. Material and Methods: 20 patients, 68 frozen sections of 20 μm thickness from operatively removed intervertebral disc hernia were excited by Nd:YAG microlaser STA-01-TH third harmonic 355 nm light throw 0, 1 mm fiber. Spectrophotometer OceanOptics USB2000 was used for spectra collection. Mathematical analysis of spectra was performed by ORIGIN multiple Gaussian peaks analysis. Results: In each specimen of disc hernia were found distinct maximal spectral peaks of 4 types supporting the histological evaluation of mixture content of the hernia. Fluorescence in the spectral regions 370-700 nm was detected in the disc hernias. The main spectral component was at 494 nm and the contribution of the components with the peak wavelength values at 388 nm, 412 nm and 435±5 nm were varying in the different groups of samples. In comparison to average spectrum of all cases, there are 4 groups of different spectral signatures in the region 400-500 nm in the patient groups, supporting a clinical data on different clinical features of the patients. Discussion and Conclusion: besides the classical open discectomy, new minimally invasive techniques of treating intervertebral disc emerge (PLDD). Intervertebral disc in these techniques is assessed by needle, no histological specimen is taken. Spectroscopic investigation via fiber optics through the

  20. [Lumbar disc herniation and andrological diseases].

    Science.gov (United States)

    Jin, Bao-fang

    2015-10-01

    Lumbar disc herniation is a common male disease. In the past, More academic attention was directed to its relationship with lumbago and leg pain than to its association with andrological diseases. Studies show that central lumber intervertebral disc herniation may cause cauda equina injury and result in premature ejaculation, erectile dysfunction, chronic pelvic pain syndrome, priapism, and emission. This article presents an overview on the correlation between central lumbar intervertebral disc herniation and andrological diseases, focusing on the aspects of etiology, pathology, and clinical progress, hoping to invite more attention from andrological and osteological clinicians. PMID:26665671

  1. Artificial Inteligence and Law

    OpenAIRE

    Fuková, Kateřina

    2012-01-01

    Submitted diploma work Artificial Intelligence and Law deals with the rule of law and its position in the process of new advanced technologies in computer cybernetics and further scientific disciplines related with artificial intelligence and its creation. The first part of the work introduces the history of the first imagines about artificial intelligence and concerns with its birth. This chapter presents main theoretical knowledge and hypotheses defined artificial intelligence and progre...

  2. Investigation of the coatings applied onto brake discs on disc-brake pad pair

    Directory of Open Access Journals (Sweden)

    I. Kiliçaslan

    2009-07-01

    Full Text Available While braking, according to the severity of it, thermal, metallurgical, constructive and tribological occurrences emerge on the brake disc-pad interface. In this study, NiCr was sprayed as bonding layer onto the discs, one ofwhich was coated with Al2O3-TiO2 by plasma spray and the other was coated with NiCr-Cr3C2 by High Velocity Oxygen Fuel (HVOF. In addition, the discs were tested with inertia dynamometer according to SAE’s J2522 testing procedure. The measurements showed that although the pads of the coated discs were exposed to higher braking temperatures, friction coefficient of the disc coated with NiCr- Cr3C2 was obtained 6 % higher compared to the original disc.

  3. 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...

  4. Hybrid Surgery Versus Anterior Cervical Discectomy and Fusion in Multilevel Cervical Disc Diseases: A Meta-Analysis.

    Science.gov (United States)

    Zhang, Jianfeng; Meng, Fanxin; Ding, Yan; Li, Jie; Han, Jian; Zhang, Xintao; Dong, Wei

    2016-05-01

    To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases.Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF.To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched. Studies were included when they compared HS with ACDF and reported at least one of the following outcomes: functionality, neck pain, arm pain, cervical range of motion (ROM), quality of life, and incidence of complications. No language restrictions were used. Two authors independently assessed the methodological quality of included studies and extracted the relevant data.Seven clinical controlled trials were included in this study. Two trials were prospective and the other 5 were retrospective. The results of the meta-analysis indicated that HS achieved better recovery of NDI score (P = 0.038) and similar recovery of VAS score (P = 0.058) compared with ACDF at 2 years follow-up. Moreover, the total cervical ROM (C2-C7) after HS was preserved significantly more than the cervical ROM after ACDF (P = 0.000) at 2 years follow-up. Notably, the compensatory increase of the ROM of superior and inferior adjacent segments was significant in ACDF groups at 2-year follow-up (P multilevel cervical spondylosis to preserve cervical ROM and reduce the risk of adjacent disc degeneration. Nonetheless, more well-designed studies with large groups of patients are required to provide further evidence for the benefit and reliability of HS for the treatment of cervical disk diseases.

  5. Magnetic resonance imaging of artificial lumbar disks: safety and metal artifacts

    Institute of Scientific and Technical Information of China (English)

    YANG Chang-wei; LIU Liu; WANG Jian; DONG Ai-sheng; LU Jian-ping; HE Shi-sheng; LI Ming

    2009-01-01

    Background This study was to investigate the safety of two types of commercially available lumbar artificial discs (CHARITE and PRODISC -L) during a magnetic resonance imaging (MRI) procedure in a 1.5-Tesla MR system, and to evaluate the size of metal artifacts on the MR image for different sequences.Methods A 1.5-Tesla clinical MR imaging system was used. The degree of deflection of the endplates of two artificial discs was evaluated by an angle-measurement instrument at the portals of the MRI scanner. The heating effect of the radio frequency (RF) magnetic field was evaluated by using "worst-case" imaging sequences on a human cadaver implanted with an artificial lumbar disc at the L5/S1 intervertebral disc location. The temperatures of the tissue adjacent to the implant, and of the L4/L5 intervertebral disc (used as a control) were measured, respectively, using a digital probe thermometer before and after the MRI scan sequence. A rectangular water phantom was designed to evaluate the metal artifacts of these two artificial discs under different MR imaging sequences.Results The maximal deflection angle of the endplate of the implants under a static MR field was 7.5 and 6.0 degrees, for the CHARITE and PRODISC -L, respectively. The difference between temperature rise of tissue adjacent to the two types of artificial discs and the temperature rise of the L4/L5 control location was 0.4 and 0.6℃, respectively. The size of metal artifacts on images of TSE (T1/T2-weighted), STIR and Turbo Dark Fluid sequences were relatively less than those of TSE fat saturation, Flash and SE (T1-weighted) sequences.Conclusions The CHARITE and the PRODISC -L artificial disc do not present an additional hazard or risk to a patient undergoing an MRI procedure using a scanner operating with a static magnetic field of 1.5T or lower. Image artifacts from the implants may present problems if the anatomical region of interest is in or near the area where these implants are located (e

  6. Transradicular lumbar disc herniation: An extreme variant of intraradicular disc herniation

    OpenAIRE

    Kasliwal, Manish K.; Shimer, Adam L

    2015-01-01

    Intradural or intraradicular lumbar disc herniation (IDH) is a relatively rare condition often diagnosed intraoperatively. We encountered an extreme variant of IDH - a transradicular herniation as the disc material extruded through the lumbar nerve root through a split essentially transecting the nerve root. While failure to recognize intradural and intraradicular disc herniation can lead to failed back surgery, the variant described in the present case could lead to iatrogenic injury and com...

  7. Archival-grade optical disc design and international standards

    Science.gov (United States)

    Fujii, Toru; Kojyo, Shinichi; Endo, Akihisa; Kodaira, Takuo; Mori, Fumi; Shimizu, Atsuo

    2015-09-01

    Optical discs currently on the market exhibit large variations in life span among discs, making them unsuitable for certain business applications. To assess and potentially mitigate this problem, we performed accelerated degradation testing under standard ISO conditions, determined the probable disc failure mechanisms, and identified the essential criteria necessary for a stable disc composition. With these criteria as necessary conditions, we analyzed the physical and chemical changes that occur in the disc components, on the basis of which we determined technological measures to reduce these degradation processes. By applying these measures to disc fabrication, we were able to develop highly stable optical discs.

  8. Axial T2* mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Hoppe, Sven; Quirbach, Sebastian; Krause, Fabian G.; Benneker, Lorin M. [Inselspital, Berne University Hospital, Department of Orthopaedic Surgery, Berne (Switzerland); Mamisch, Tallal C. [Inselspital, Berne University Hospital, Department of Radiology, Berne (Switzerland); Werlen, Stefan [Clinic Sonnenhof, Department of Radiology, Berne (Switzerland)

    2012-09-15

    To demonstrate the potential benefits of biochemical axial T2* mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting. Ninety-three patients suffering from lumbar spine problems were examined using standard MRI protocols including an axial T2* mapping protocol. All discs were classified morphologically and grouped as ''healthy'' or ''abnormal''. Differences between groups were analysed regarding to the specific T2* pattern at different regions of interest (ROIs). Healthy intervertebral discs revealed a distinct cross-sectional T2* value profile: T2* values were significantly lower in the annulus fibrosus compared with the nucleus pulposus (P = 0.01). In abnormal IVDs, T2* values were significantly lower, especially towards the centre of the disc representing the expected decreased water content of the nucleus (P = 0.01). In herniated discs, ROIs within the nucleus pulposus and ROIs covering the annulus fibrosus showed decreased T2* values. Axial T2* mapping is effective to detect early stages of degenerative disc disease. There is a potential benefit of axial T2* mapping as a diagnostic tool, allowing the quantitative assessment of intervertebral disc degeneration. circle Axial T2* mapping effective in detecting early degenerative disc disease. (orig.)

  9. Transradicular lumbar disc herniation: An extreme variant of intraradicular disc herniation

    Directory of Open Access Journals (Sweden)

    Manish K Kasliwal

    2015-01-01

    Full Text Available Intradural or intraradicular lumbar disc herniation (IDH is a relatively rare condition often diagnosed intraoperatively. We encountered an extreme variant of IDH - a transradicular herniation as the disc material extruded through the lumbar nerve root through a split essentially transecting the nerve root. While failure to recognize intradural and intraradicular disc herniation can lead to failed back surgery, the variant described in the present case could lead to iatrogenic injury and complication if not recognized. A unique case of transradicular lumbar disc herniation in a 25-year-old patient is presented with the depiction of intraoperative images supplementing the text.

  10. Treatment of lumbar disc herniation by percutaneous laser disc decompression (PLDD) and modified PLDD

    Science.gov (United States)

    Chi, Xiao fei; Li, Hong zhi; Wu, Ru zhou; Sui, Yun xian

    2005-07-01

    Objective: To study the micro-invasive operative method and to compare the effect of treatment of PLDD and modified PLDD for Lumbar Disc Herniation. Method: Vaporized part of the nucleus pulposus in single or multiple point after acupuncture into lumbar disc, to reach the purpose of the decompression of the lumbar disc. Result: Among the 19 cases of the regular PLDD group, the excellent and good rate was 63.2%, and among the 40 cases of the modified PLDD group, the excellent and good rate was 82.5%. Conclusion: The modified PLDD has good effect on the treatment for lumbar disc herniation.

  11. Appearance of Keplerian discs orbiting Kerr superspinars

    CERN Document Server

    Stuchlik, Zdenek; 10.1088/0264-9381/27/21/215017

    2011-01-01

    We study optical phenomena related to appearance of Keplerian accretion discs orbiting Kerr superspinars predicted by the string theory. The superspinar exterior is described by the standard Kerr naked singularity geometry breaking the black hole limit on the internal angular momentum (spin). We construct local photon escape cones for a variety of orbiting sources that enable to determine the superspinars silhouette in the case of distant observers. We show that the superspinar silhouette depends strongly on the assumed edge where the external Kerr spacetime is joined to the internal spacetime governed by the string theory and significantly differs from the black hole silhouette. The appearance of the accretion disc is strongly dependent on the value of the superspinar spin in both their shape and frequency shift profile. Apparent extension of the disc grows significantly with growing spin, while the frequency shift grows with descending spin. This behavior differs substantially from appearance of discs orbit...

  12. CFD Analysis Of Straight Ventilated Disc Brake

    Directory of Open Access Journals (Sweden)

    Nikhil K

    2016-05-01

    Full Text Available Brakes are the key pieces of a vehicle that plays an active role in safety and performance of the system. The study of aerodynamic cooling of a disc brake in real working condition of vehicle is important in present situations. Brake discs get very hot quickly, so it should be dissipated properly through different modes of heat transfer. Contributions of these heat transfer modes are different in different type of problems. The cooling transfer rates are different in vane surface and frictional surface of a disc brake. Also the temperature varies in each small interval of braking time. So a transient problem simulation is important to study the cooling of a disc brake when a vehicle decelerates from a particular speed. ANSYS CFX tool is used for the simulation of this transient problem.

  13. Eclipse Mapping: Astrotomography of Accretion Discs

    CERN Document Server

    Baptista, Raymundo

    2015-01-01

    The Eclipse Mapping Method is an indirect imaging technique that transforms the shape of the eclipse light curve into a map of the surface brightness distribution of the occulted regions. Three decades of application of this technique to the investigation of the structure, the spectrum and the time evolution of accretion discs around white dwarfs in cataclysmic variables have enriched our understanding of these accretion devices with a wealth of details such as (but not limited to) moving heating/cooling waves during outbursts in dwarf novae, tidally-induced spiral shocks of emitting gas with sub-Keplerian velocities, elliptical precessing discs associated to superhumps, and measurements of the radial run of the disc viscosity through the mapping of the disc flickering sources. This chapter reviews the principles of the method, discusses its performance, limitations, useful error propagation procedures, as well as highlights a selection of applications aimed at showing the possible scientific problems that ha...

  14. Modeling and Thermal Analysis of Disc

    Directory of Open Access Journals (Sweden)

    Brake Praveena S

    2014-10-01

    Full Text Available The disc brake is a device used for slowing or stopping the rotation of the vehicle. Number of times using the brake for vehicle leads to heat generation during braking event, such that disc brake undergoes breakage due to high Temperature. Disc brake model is done by CATIA and analysis is done by using ANSYS workbench. The main purpose of this project is to study the Thermal analysis of the Materials for the Aluminum, Grey Cast Iron, HSS M42, and HSS M2. A comparison between the four materials for the Thermal values and material properties obtained from the Thermal analysis low thermal gradient material is preferred. Hence best suitable design, low thermal gradient material Grey cast iron is preferred for the Disc Brakes for better performance.

  15. Magnetic Field Amplification via Protostellar Disc Dynamos

    CERN Document Server

    Dyda, Sergei; Ustyugova, Galina V; Koldoba, Alexander V; Wasserman, Ira

    2015-01-01

    We model the generation of a magnetic field in a protostellar disc using an \\alpha-dynamo and perform axisymmetric magnetohydrodynamics (MHD) simulations of a T Tauri star. We find that for small values of the dimensionless dynamo parameter $\\alpha_d$ the poloidal field grows exponentially at a rate ${\\sigma} \\propto {\\Omega}_K \\sqrt{\\alpha_d}$ , before saturating to a value $\\propto \\sqrt{\\alpha_d}$ . The dynamo excites dipole and octupole modes, but quadrupole modes are suppressed, because of the symmetries of the seed field. Initial seed fields too weak to launch MHD outflows are found to grow sufficiently to launch winds with observationally relevant mass fluxes of order $10^{-9} M_{\\odot}/\\rm{yr}$ for T Tauri stars. For large values of $\\alpha_d$ magnetic loops are generated over the entire disc. These quickly come to dominate the disc dynamics and cause the disc to break up due to the magnetic pressure.

  16. 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

  17. [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

  18. Activ C cervical disc replacement for myelopathy

    Directory of Open Access Journals (Sweden)

    L McGonagle

    2011-01-01

    Full Text Available Background: Cervical disc replacement is becoming an increasingly popular treatment option for cervical myelopathy. It retains motion at the affected segment, unlike anterior cervical discectomy and fusion. The aim of this study is to assess the outcomes of a series of patients who underwent Activ C disc replacement for cervical myelopathy. Materials and Methods: A series of patients at the above Trust with clinical and radiological evidence of cervical myelopathy who were suitable for cervical disc replacement from 2007 to 2009 were included. Implants were inserted by one of two consultant surgeons {IMS, MO′M}. Patients were assessed preoperatively and at six, 12 and 24 months, postoperatively, with a visual analogue score (VAS for neck and arm pain severity and frequency, the Neck Disability Index questionnaire (NDI and the Centre for Epidemiologic Studies Depression questionnaire (CES-D. Results: Ten patients underwent surgery between May 2007 and July 2009, 6 women, and 4 men. Average age was 54 years (40-64. Disc levels replaced were: four at C4-5; eight at C5-6; seven at C6-7. Three patients had one disc replaced, five patients had two discs replaced, and two patients had three discs replaced. The VAS for neck pain improved from 5.9 pre-operatively to 1.4-24 months postoperatively and the VAS arm pain improved from 5.4 to 2.6. The NDI improved from 51% preoperatively to 26.8% at 24 months postoperatively. The CES-D showed a slight increase from 19.5 preoperatively to 21.7 at 24 months, postoperatively. Conclusion: Cervical decompression and disc replacement improves pain and function in patients with cervical myelopathy. This benefit is maintained at 24 months post op, with no cases requiring revision.

  19. Mach disc formation in cylindrical recovery systems

    International Nuclear Information System (INIS)

    Cylindrical recovery systems have been used to shock-load polymers to pressures exceeding 50 GPa. In order to determine the pressures generated in these recovery systems the formation of the Mach disc on axis and its approach to steady state was monitored. The relation of the Mach disc diameter to the lateral dimension of the high explosive used to compress the polymer samples was also investigated

  20. Low back pain and degenerative disc disease

    OpenAIRE

    Jandrić Slavica; Antić Branislav

    2006-01-01

    Introduction. Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged men and women equally. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Pathophysiology. Degenerative cascade, described by Kirkaldy-Willis, is the widely accept...

  1. Mach disc formation in cylindrical recovery systems

    Energy Technology Data Exchange (ETDEWEB)

    Morris, C.E.; McQueen, R.G.; Marsh, S.P.

    1983-01-01

    Cylindrical recovery systems have been used to shock-load polymers to pressures exceeding 50 GPa. In order to determine the pressures generated in these recovery systems the formation of the Mach disc on axis and its approach to steady state was monitored. The relation of the Mach disc diameter to the lateral dimension of the high explosive used to compress the polymer samples was also investigated.

  2. Chemonucleolysis as Treatment for Herniated Lumbar Disc

    OpenAIRE

    Alexander, David I.

    1986-01-01

    Herniated disc, while not the most common cause of low back pain, is the most common reason for surgery to relieve back pain. An alternative to surgery when sciatic pain is the result of disc herniation is chemonucleolysis with chymopapain. Since this enzyme is effective only in very specific circumstances, proper patient selection is crucial. Five criteria for selection are presented, emphasizing that since chemonucleolysis is not conservative treatment, it should be reserved for patients wh...

  3. Do We Need Biomarkers for Disc Degeneration?

    OpenAIRE

    Gruber, Helen E.; Edward N. Hanley, Jr.

    2007-01-01

    Disc degeneration plays a major role in this country's medical, social and economic structure. The life-time prevalence of low back pain, which has disc degeneration as its cause, is about 80% in the general population. It is a primary cause of disability and estimated costs related to low back disorders exceed $100 billion per year in the U.S. alone. Biomarkers are becoming increasingly important as indicators of the presence of disease, and in evaluating outcomes during clinical treatment. ...

  4. Influence of degenerative changes of intervertebral disc

    OpenAIRE

    Wang, Yi; Chen, Hai-Bin; Zhang, Ling; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs) and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principle...

  5. Spontaneous Regression of a Large Lumbar Disc Extrusion

    OpenAIRE

    Ryu, Sung-Joo; Kim, In Soo

    2010-01-01

    Although the spontaneous disappearance or decrease in size of a herniated disc is well known, that of a large extruded disc has rarely been reported. This paper reports a case of a spontaneous regression of a large lumbar disc extrusion. The disc regressed spontaneously with clinical improvement and was documented on a follow up MRI study 6 months later. The literature is reviewed and the possible mechanisms of spontaneous disc regression are discussed.

  6. MOND predictions of "halo" phenomenology in disc galaxies

    OpenAIRE

    Milgrom, Mordehai; Sanders, Robert H.

    2004-01-01

    We examine two corollaries of MOND pertaining to the properties of the equivalent dark-matter halo. MOND predicts for pure exponential discs a tight relation involving the halo and disc scale lengths and the mean acceleration in the disc, which we find to test favorably against the Verheijen sample of Ursa Major galaxies. A correlation between halo and disc length scales is also apparent when the "maximum disc" contribution is assumed, but we demonstrate that this follows from the more genera...

  7. Density waves in debris discs and galactic nuclei

    OpenAIRE

    Jalali, Mir Abbas; Tremaine, Scott

    2011-01-01

    We study the linear perturbations of collisionless near-Keplerian discs. Such systems are models for debris discs around stars and the stellar discs surrounding supermassive black holes at the centres of galaxies. Using a finite-element method, we solve the linearized collisionless Boltzmann equation and Poisson's equation for a wide range of disc masses and rms orbital eccentricities to obtain the eigenfrequencies and shapes of normal modes. We find that these discs can support large-scale `...

  8. 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

  9. CT findings of calcified herniated lumbar disc

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyo Kun; Lee, Jun Hyung [Chang Dong Armed Forces Evacuation Hospital, Seoul (Korea, Republic of)

    1987-12-15

    Computed tomography (CT) of 10 calcified herniated lumber discs among 46 operated cases were analysed at the aspects of incidence, location, shape, etc. The results are as follows: 1. The incidence of calcification is 22% (10/46). 2. Among 10 cases, 3 cases are at the level of L4-5 disc space and 7 cases are at the level of L5-S1 disc space. 3. Central herniation (8 cases) are more common than posterolateral herniation (2 cases). 4. Linear or band-like calcifications in the periphery of herniated disc (annulus fibrosus type) are 6 cases and dense patchy calcification in the central portion of herniated disc (nucleus pulposus type) are 4 cases. 5. Two cases (50%) of 4 cases with nucleus pulposus type calcification were found to be ruptured at operation, but none of 6 annulus fibrous calcification types showed rupture. 6. Because more wide operation field and invasive exploration were required in calcified cases than non-calcified cases, it is suggested to evaluate the presence, location, and type of calcification in herniated disc in detail.

  10. Rapid radiative clearing of protoplanetary discs

    CERN Document Server

    Haworth, Thomas J; Owen, James E

    2015-01-01

    The lack of observed transition discs with inner gas holes of radii greater than ~50AU implies that protoplanetary discs dispersed from the inside out must remove gas from the outer regions rapidly. We investigate the role of photoevaporation in the final clearing of gas from low mass discs with inner holes. In particular, we study the so-called "thermal sweeping" mechanism which results in rapid clearing of the disc. Thermal sweeping was originally thought to arise when the radial and vertical pressure scale lengths at the X-ray heated inner edge of the disc match. We demonstrate that this criterion is not fundamental. Rather, thermal sweeping occurs when the pressure maximum at the inner edge of the dust heated disc falls below the maximum possible pressure of X-ray heated gas (which depends on the local X-ray flux). We derive new critical peak volume and surface density estimates for rapid radiative clearing which, in general, result in rapid dispersal happening less readily than in previous estimates. Thi...

  11. Magnetic white dwarfs with debris discs

    CERN Document Server

    Külebi, Baybars; Lorén-Aguilar, Pablo; Isern, Jordi; García-Berro, Enrique

    2013-01-01

    It has long been accepted that a possible mechanism for explaining the existence of magnetic white dwarfs is the merger of a binary white dwarf system, as there are viable mechanisms for producing sustainable magnetic fields within the merger product. However, the lack of rapid rotators in the magnetic white dwarf population has been always considered a problematic issue of this scenario. Smoothed Particle Hydrodynamics simulations show that in mergers in which the two white dwarfs have different masses a disc around the central compact object is formed. If the central object is magnetized it can interact with the disc through its magnetosphere. The torque applied by the disc changes the spin of the star, whereas the transferred angular momentum from the star to the disc determines the properties of the disc. In this work we build a model for the disc evolution under the effect of magnetic accretion, and for the angular momentum evolution of the star, which can be compared with the observations. Our model pre...

  12. Testing protoplanetary disc dispersal with radio emission

    CERN Document Server

    Owen, James E; Ercolano, Barbara

    2013-01-01

    We consider continuum free-free radio emission from the upper atmosphere of protoplanetary discs as a probe of the ionized luminosity impinging upon the disc. Making use of previously computed hydrodynamic models of disc photoevaporation within the framework of EUV and X-ray irradiation, we use radiative transfer post-processing techniques to predict the expected free-free emission from protoplanetary discs. In general, the free-free luminosity scales roughly linearly with ionizing luminosity in both EUV and X-ray driven scenarios, where the emission dominates over the dust tail of the disc and is partial optically thin at cm wavelengths. We perform a test observation of GM Aur at 14-18 Ghz and detect an excess of radio emission above the dust tail to a very high level of confidence. The observed flux density and spectral index are consistent with free-free emission from the ionized disc in either the EUV or X-ray driven scenario. Finally, we suggest a possible route to testing the EUV and X-ray driven disper...

  13. The Diversity of Thick Galactic Discs

    CERN Document Server

    Kasparova, Anastasia V; Chilingarian, Igor V; Silchenko, Olga K; Moiseev, Alexey V; Borisov, Svyatoslav B

    2016-01-01

    Although thick stellar discs are detected in nearly all edge-on disc galaxies, their formation scenarios still remain a matter of debate. Due to observational difficulties, there is a lack of information about their stellar populations. Using the Russian 6-m telescope BTA we collected deep spectra of thick discs in three edge-on S0-a disc galaxies located in different environments: NGC4111 in a dense group, NGC4710 in the Virgo cluster, and NGC5422 in a sparse group. We see intermediate age (4-5 Gyr) metal rich ([Fe/H] $\\sim$ -0.2 - 0.0 dex) stellar populations in NGC4111 and NGC4710. On the other hand, NGC5422 does not harbour young stars, its disc is thick and old (10 Gyr), without evidence for a second component, and its $\\alpha$-element abundance suggests a 1.5-2 Gyr long formation epoch implying its formation at high redshift. Our results suggest the diversity of thick disc formation scenarios.

  14. Proteomic signature of the murine intervertebral disc.

    Directory of Open Access Journals (Sweden)

    Matthew R McCann

    Full Text Available Low back pain is the most common musculoskeletal problem and the single most common cause of disability, often attributed to degeneration of the intervertebral disc. Lack of effective treatment is directly related to our limited understanding of the pathways responsible for maintaining disc health. While transcriptional analysis has permitted initial insights into the biology of the intervertebral disc, complete proteomic characterization is required. We therefore employed liquid chromatography electrospray ionization tandem mass spectrometry (LC-ESI-MS/MS protein/peptide separation and mass spectrometric analyses to characterize the protein content of intervertebral discs from skeletally mature wild-type mice. A total of 1360 proteins were identified and categorized using PANTHER. Identified proteins were primarily intracellular/plasma membrane (35%, organelle (30%, macromolecular complex (10%, extracellular region (9%. Molecular function categorization resulted in three distinct categories: catalytic activity (33%, binding (molecule interactions (29%, and structural activity (13%. To validate our list, we confirmed the presence of 14 of 20 previously identified IVD-associated markers, including matrix proteins, transcriptional regulators, and secreted proteins. Immunohistochemical analysis confirmed distinct localization patterns of select protein with the intervertebral disc. Characterization of the protein composition of healthy intervertebral disc tissue is an important first step in identifying cellular processes and pathways disrupted during aging or disease progression.

  15. The diversity of thick galactic discs

    Science.gov (United States)

    Kasparova, Anastasia V.; Katkov, Ivan Yu.; Chilingarian, Igor V.; Silchenko, Olga K.; Moiseev, Alexey V.; Borisov, Svyatoslav B.

    2016-07-01

    Although thick stellar discs are detected in nearly all edge-on disc galaxies, their formation scenarios still remain a matter of debate. Due to observational difficulties, there is a lack of information about their stellar populations. Using the Russian 6-m telescope BTA we collected deep spectra of thick discs in three edge-on S0-a disc galaxies located in different environments: NGC 4111 in a dense group, NGC 4710 in the Virgo cluster, and NGC 5422 in a sparse group. We see intermediate age (4-5 Gyr) metal rich ([Fe/H] ˜- 0.2…0.0 dex) stellar populations in NGC 4111 and NGC 4710. On the other hand, NGC 5422 does not harbour young stars, its disc is thick and old (10 Gyr), without evidence for a second component, and its α-element abundance suggests a 1.5-2 Gyr long formation epoch implying its formation at high redshift. Our results suggest the diversity of thick disc formation scenarios.

  16. Clumpy Disc and Bulge Formation

    CERN Document Server

    Perez, J; Tissera, P; Michel-Dansac, L

    2013-01-01

    We present a set of hydrodynamical/Nbody controlled simulations of isolated gas rich galaxies that self-consistently include SN feedback and a detailed chemical evolution model, both tested in cosmological simulations. The initial conditions are motivated by the observed star forming galaxies at z ~ 2-3. We find that the presence of a multiphase interstellar media in our models promotes the growth of disc instability favouring the formation of clumps which in general, are not easily disrupted on timescales compared to the migration time. We show that stellar clumps migrate towards the central region and contribute to form a classical-like bulge with a Sersic index, n > 2. Our physically-motivated Supernova feedback has a mild influence on clump survival and evolution, partially limiting the mass growth of clumps as the energy released per Supernova event is increased, with the consequent flattening of the bulge profile. This regulation does not prevent the building of a classical-like bulge even for the most ...

  17. Circumplanetary disc or circumplanetary envelope?

    Science.gov (United States)

    Szulágyi, J.; Masset, F.; Lega, E.; Crida, A.; Morbidelli, A.; Guillot, T.

    2016-08-01

    We present three-dimensional simulations with nested meshes of the dynamics of the gas around a Jupiter mass planet with the JUPITER and FARGOCA codes. We implemented a radiative transfer module into the JUPITER code to account for realistic heating and cooling of the gas. We focus on the circumplanetary gas flow, determining its characteristics at very high resolution (80 per cent of Jupiter's diameter). In our nominal simulation where the temperature evolves freely by the radiative module and reaches 13000 K at the planet, a circumplanetary envelope was formed filling the entire Roche lobe. Because of our equation of state is simplified and probably overestimates the temperature, we also performed simulations with limited maximal temperatures in the planet region (1000, 1500, and 2000 K). In these fixed temperature cases circumplanetary discs (CPDs) were formed. This suggests that the capability to form a CPD is not simply linked to the mass of the planet and its ability to open a gap. Instead, the gas temperature at the planet's location, which depends on its accretion history, plays also fundamental role. The CPDs in the simulations are hot and cooling very slowly, they have very steep temperature and density profiles, and are strongly sub-Keplerian. Moreover, the CPDs are fed by a strong vertical influx, which shocks on the CPD surfaces creating a hot and luminous shock-front. In contrast, the pressure supported circumplanetary envelope is characterized by internal convection and almost stalled rotation.

  18. Wear of polyethylene cups in total hip arthroplasty: a parametric mathematical model.

    Science.gov (United States)

    Pietrabissa, R; Raimondi, M; Di Martino, E

    1998-04-01

    This paper presents a parametric mathematical model of the head-cup wear coupling in total hip arthroplasty (THA). The model evaluates the dependence of acetabular volumetric wear upon the characteristic parameters of patient and hip prosthesis. Archard's law is assumed to calculate the wear coupling behaviour. The wear factor is taken from pin-on-disc wear tests as a function of materials and finishing of the articular joint. The forces acting on the hip joint are taken from experimental data found in the literature whilst the load distribution is calculated under the hypotheses of perfectly rigid ideal wear coupling. The sliding distance is obtained by combining the three elementary displacements -- due to rotations around the three axes -- at the generic bearing surface location. The simulations show that the polymeric wear volume per step cycle decreases ranging from fast walking speeds to low running speeds, it increases linearly with patient body weight and with femoral head diameter, it decreases slightly for positive variations of the socket inclination angle and it increases exponentially with femoral head roughness. The volumetric wear rate per year calculated for a standard reference patient is 5.8 mm3. The relevant iso-wear maps show a marginal pattern with the maximum located near the cup superior borderline. At the instant of peak load, the iso-stress maps show a paracentral pattern with the maximum superior to the cup polar point, and the iso-sliding distance maps show a marginal pattern with two maxima located near the cup's superior and inferior borderlines. PMID:9690490

  19. Dynamic, six-axis stiffness matrix characteristics of the intact intervertebral disc and a disc replacement.

    Science.gov (United States)

    Holsgrove, Timothy P; Gill, Harinderjit S; Miles, Anthony W; Gheduzzi, Sabina

    2015-11-01

    Thorough pre-testing is critical in assessing the likely in vivo performance of spinal devices prior to clinical use. However, there is a lack of data available concerning the dynamic testing of lumbar (porcine model) total disc replacements in all six axes under preload conditions. The aim of this study was to provide new data comparing porcine lumbar spinal specimen stiffness between the intact state and after the implantation of an unconstrained total disc replacement, in 6 degrees of freedom. The dynamic, stiffness matrix testing of six porcine lumbar isolated disc specimens was completed using triangle waves at a test frequency of 0.1 Hz. An axial preload of 500 N was applied during all testing. Specimens were tested both in the intact condition and after the implantation of the total disc replacement. Sixteen key stiffness terms were identified for the comparison of the intact and total disc replacement specimens, comprising the 6 principal stiffness terms and 10 key off-axis stiffness terms. The total disc replacement specimens were significantly different to the intact specimens in 12 of these key terms including all six principal stiffness terms. The implantation of the total disc replacement resulted in a mean reduction in the principal stiffness terms of 100%, 91%, and 98% in lateral bending, flexion-extension, and axial rotation, respectively. The novel findings of this study have demonstrated that the unconstrained, low-friction total disc replacement does not replicate the stiffness of the intact specimens. It is likely that other low-friction total disc replacements would produce similar results due to stiffness being actively minimised as part of the design of low-friction devices, without the introduction of stiffening elements or mechanisms to more accurately replicate the mechanical properties of the natural intervertebral disc. This study has demonstrated, for the first time, a method for the quantitative comparative mechanical function

  20. 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...

  1. 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...

  2. 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

  3. 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).

  4. 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

  5. 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

  6. A Simulation Model of Focus and Radial Servos in Compact Disc Players with Disc Surface Defects

    DEFF Research Database (Denmark)

    Odgaard, Peter Fogh; Stoustrup, Jakob; Andersen, Palle;

    2004-01-01

    Compact Disc players have been on the market in more than two decades.As a consequence most of the control servo problems have been solved. A large remaining problem to solve is the handling of Compact Discs with severe surface defects like scratches and fingerprints. This paper introduces a method...

  7. 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.

  8. 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....

  9. 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.

  10. 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...

  11. 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.

  12. 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...

  13. 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...

  14. 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 ...

  15. 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...

  16. Cervical disc hernia operations through posterior laminoforaminotomy

    Directory of Open Access Journals (Sweden)

    Coskun Yolas

    2016-01-01

    Full Text Available Objective: The most common used technique for posterolateral cervical disc herniations is anterior approach. However, posterior cervical laminotoforaminomy can provide excellent results in appropriately selected patients with foraminal stenosis in either soft disc prolapse or cervical spondylosis. The purpose of this study was to present the clinical outcomes following posterior laminoforaminotomy in patients with radiculopathy. Materials and Methods: We retrospectively evaluated 35 patients diagnosed with posterolateral cervical disc herniation and cervical spondylosis with foraminal stenosis causing radiculopathy operated by the posterior cervical keyhole laminoforaminotomy between the years 2010 and 2015. Results: The file records and the radiographic images of the 35 patients were assessed retrospectively. The mean age was 46.4 years (range: 34-66 years. Of the patients, 19 were males and 16 were females. In all of the patients, the neurologic deficit observed was radiculopathy. The posterolaterally localized disc herniations and the osteophytic structures were on the left side in 18 cases and on the right in 17 cases. In 10 of the patients, the disc level was at C5-6, in 18 at C6-7, in 2 at C3-4, in 2 at C4-5, in 1 at C7-T1, in 1 patient at both C5-6 and C6-7, and in 1 at both C4-5 and C5-6. In 14 of these 35 patients, both osteophytic structures and protruded disc herniation were present. Intervertebral foramen stenosis was present in all of the patients with osteophytes. Postoperatively, in 31 patients the complaints were relieved completely and four patients had complaints of neck pain and paresthesia radiating to the arm (the success of operation was 88.5%. On control examinations, there was no finding of instability or cervical kyphosis. Conclusion: Posterior cervical laminoforaminotomy is an alternative appropriate choice in both cervical soft disc herniations and cervical stenosis.

  17. Structures induced by companions in galactic discs

    Science.gov (United States)

    Kyziropoulos, P. E.; Efthymiopoulos, C.; Gravvanis, G. A.; Patsis, P. A.

    2016-09-01

    Using N-body simulations we study the structures induced on a galactic disc by repeated flybys of a companion in decaying eccentric orbit around the disc. Our system is composed by a stellar disc, bulge and live dark matter halo, and we study the system's dynamical response to a sequence of a companion's flybys, when we vary i) the disc's temperature (parameterized by Toomre's Q-parameter) and ii) the companion's mass and initial orbit. We use a new 3D Cartesian grid code: MAIN (Mesh-adaptive Approximate Inverse N-body solver). The main features of MAIN are reviewed, with emphasis on the use of a new Symmetric Factored Approximate Sparse Inverse (SFASI) matrix in conjunction with the multigrid method that allows the efficient solution of Poisson's equation in three space variables. We find that: i) companions need to be assigned initial masses in a rather narrow window of values in order to produce significant and more long-standing non-axisymmetric structures (bars and spirals) in the main galaxy's disc by the repeated flyby mechanism. ii) a crucial phenomenon is the antagonism between companion-excited and self-excited modes on the disc. Values of Q > 1.5 are needed in order to allow for the growth of the companion-excited modes to prevail over the the growth of the disc's self-excited modes. iii) We give evidence that the companion-induced spiral structure is best represented by a density wave with pattern speed nearly constant in a region extending from the ILR to a radius close to, but inside, corotation.

  18. Stem cell horizons in intervertebral disc degeneration

    Directory of Open Access Journals (Sweden)

    Joseph Ciacci

    2009-01-01

    Full Text Available Joseph Ciacci1, Allen Ho1,2, Christopher P Ames3, Rahul Jandial41Division of Neurosurgery, University of California, San Diego, La Jolla, California, USA; 2Del E Webb Neurosciences, Aging and Stem Cell Research Center, The Burnham Institute for Medical Research, La Jolla, California, USA; 3Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; 4Division of Neurosurgery, Department of Surgery, City of Hope Cancer Center, Duarte, CA, USAAbstract: Intervertebral disc degeneration remains a pervasive and intractable disease arising from a combination of aging and stress on the back and spine. The growing field of regenerative medicine brings the promise of stem cells in the treatment of disc disease. Scientists and physicians hope to employ stem cells not only to stop, but also reverse degeneration. However, there are many important outstanding issues, including the hostile avascular, apoptotic physiological environment of the intervertebral disc, and the difficulty of obtaining mesenchymal stem cells, and directing them towards chondrocytic differentiation and integration within the nucleus pulposus of the disc. Given the recent advances in minimally invasive spine surgery, and developing body of work on stem cell manipulation and transplantation, stem cells are uniquely poised to bring about large-scale improvements in treatment and outcomes for degenerative disc disease. In this review we will first discuss the cellular and molecular factors influencing degeneration, and then examine the efficacy and difficulties of stem cell transplantation.Keywords: intervertebral disc degeneration, stem cells, disc disease, mesenchymal stem cells, stem cell transplantation

  19. A rolling-gliding wear simulator for the investigation of tribological material pairings for application in total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    Denkena Berend

    2010-06-01

    Full Text Available Abstract Background Material wear testing is an important technique in the development and evaluation of materials for use in implant for total knee arthroplasty. Since a knee joint induces a complex rolling-gliding movement, standardised material wear testing devices such as Pin-on-Disc or Ring-on-Disc testers are suitable to only a limited extent because they generate pure gliding motion only. Methods A rolling-gliding wear simulator was thus designed, constructed and implemented, which simulates and reproduces the rolling-gliding movement and loading of the knee joint on specimens of simplified geometry. The technical concept was to run a base-plate, representing the tibia plateau, against a pivoted cylindrical counter-body, representing one femur condyle under an axial load. A rolling movement occurs as a result of the friction and pure gliding is induced by limiting the rotation of the cylindrical counter-body. The set up also enables simplified specimens handling and removal for gravimetrical wear measurements. Long-term wear tests and gravimetrical wear measurements were carried out on the well known material pairings: cobalt chrome-polyethylene, ceramic-polyethylene and ceramic-ceramic, over three million motion cycles to allow material comparisons to be made. Results The observed differences in wear rates between cobalt-chrome on polyethylene and ceramic on polyethylene pairings were similar to the differences of published data for existing material-pairings. Test results on ceramic-ceramic pairings of different frontal-plane geometry and surface roughness displayed low wear rates and no fracture failures. Conclusions The presented set up is able to simulate the rolling-gliding movement of the knee joint, is easy to use, and requires a minimum of user intervention or monitoring. It is suitable for long-term testing, and therefore a useful tool for the investigation of new and promising materials which are of interest for application in

  20. 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

  1. 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

  2. [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

  3. 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)

  4. 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.

  5. 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

  6. 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....

  7. 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)....

  8. 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...

  9. 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...

  10. 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...

  11. 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...

  12. 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)....

  13. 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

  14. 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

  15. 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...

  16. 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...

  17. Anticipatory Artificial Autopoiesis

    OpenAIRE

    DuBois, Daniel; Holmberg, Stig C.

    2010-01-01

    In examining relationships between autopoiesis and anticipation in artificial life (Alife) systems it is demonstrated that anticipation may increase efficiency and viability in artificial autopoietic living systems. This paper, firstly, gives a review of the Varela et al [1974] automata algorithm of an autopoietic living cell. Some problems in this algorithm must be corrected. Secondly, a new and original anticipatory artificial autopoiesis algorithm for automata is presented. ...

  18. Inteligencia artificial en vehiculo

    OpenAIRE

    Amador Díaz, Pedro

    2012-01-01

    Desarrollo de un robot seguidor de líneas, en el que se implementan diversas soluciones de las áreas de sistemas embebidos e inteligencia artificial. Desenvolupament d'un robot seguidor de línies, en el qual s'implementen diverses solucions de les àrees de sistemes encastats i intel·ligència artificial. Follower robot development of lines, in which various solutions are implemented in the areas of artificial intelligence embedded systems.

  19. Artificial cognition architectures

    CERN Document Server

    Crowder, James A; Friess, Shelli A

    2013-01-01

    The goal of this book is to establish the foundation, principles, theory, and concepts that are the backbone of real, autonomous Artificial Intelligence. Presented here are some basic human intelligence concepts framed for Artificial Intelligence systems. These include concepts like Metacognition and Metamemory, along with architectural constructs for Artificial Intelligence versions of human brain functions like the prefrontal cortex. Also presented are possible hardware and software architectures that lend themselves to learning, reasoning, and self-evolution

  20. 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