Outcomes of Total Hip Arthroplasty in Human Immunodeficiency Virus-Positive Patients.
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Outcomes of Total Hip Arthroplasty in Human Immunodeficiency Virus-Positive Patients.
J Arthroplasty. 2013 May 15;
Authors: Snir N, Wolfson TS, Schwarzkopf R, Swensen S, Alvarado CM, Hamula M, Dayan AJ
Abstract
Today, patients with human immunodeficiency virus (HIV) live long enough to develop chronic degenerative and HIV-associated joint disease. There is a growing population of patients infected with HIV who are candidates for total hip arthroplasty (THA). A total of 31 HIV-positive, non-hemophilic patients undergoing 41 THAs at our institution between 2000 and 2012 were identified. In-hospital medical complications were reported in 5 of 41 hips, all of which resolved prior to discharge. Deep infection developed in 1 of 41 hips and revision was required in 3 of 41 hips. These results suggest that low rates of complications and revision can be achieved in the HIV-positive, non-hemophilic population. We believe that with careful patient selection, THA may improve the quality of life in the HIV-positive population.
PMID: 23683515 [PubMed - as supplied by publisher]
Hip Osteonecrosis: Does Prior Hip Surgery Alter Outcomes Compared to an Initial Primary Total Hip Arthroplasty?
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Hip Osteonecrosis: Does Prior Hip Surgery Alter Outcomes Compared to an Initial Primary Total Hip Arthroplasty?
J Arthroplasty. 2013 May 15;
Authors: Issa K, Johnson AJ, Naziri Q, Khanuja HS, Delanois RE, Mont MA
Abstract
The purpose of this study was to assess the clinical and radiographic outcomes of total hip arthroplasty (THA) in patients who had osteonecrosis to see if prior hip preserving surgery affected outcomes. Implant survivorship, Harris hip scores, and radiographic outcomes were compared between 87 patients (92 hips) who had undergone prior hip preserving procedures and 105 patients (121 hips) who had only undergone THA. Patients were also sub-stratified into low- and high-risk groups for osteonecrosis. At a mean follow-up of 75 months, there were no significant differences in survivorship, clinical, and radiographic outcomes among the cohorts. Higher revision rates were associated with patients who were in the high-risk group. The authors believe that hip joint preserving procedures may not adversely affect the outcomes of later THA in patients with osteonecrosis.
PMID: 23683516 [PubMed - as supplied by publisher]
Comparison of Mechanical Stress and Change in Bone Mineral Density Between Two Types of Femoral Implant Using Finite Element Analysis.
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Comparison of Mechanical Stress and Change in Bone Mineral Density Between Two Types of Femoral Implant Using Finite Element Analysis.
J Arthroplasty. 2013 May 15;
Authors: Hirata Y, Inaba Y, Kobayashi N, Ike H, Fujimaki H, Saito T
Abstract
Stress shielding after total hip arthroplasty (THA) remains an unsolved issue. Various patterns of mechanical stress appear according to the type of femoral stem used. To compare differences in mechanical stress conditions between Zweymuller type and fit-and-fill type stems, finite element analysis (FEA) was performed. Differences in bone mineral density (BMD) changes in the femur were also compared. Maximum stress was confirmed in Gruen zone 4, whereas zone 1 had the minimum amount of stress with both types of implant. The Zweymuller stem group had less mechanical stress and lower BMD in zone 7 than the fit-and-fill stem group. In conclusion, differences in mechanical stress may be related to changes in BMD after THA.
PMID: 23683518 [PubMed - as supplied by publisher]
Characterisation of in vivo release of gentamicin from polymethyl methacrylate cement using a novel method.
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Characterisation of in vivo release of gentamicin from polymethyl methacrylate cement using a novel method.
Int Orthop. 2013 May 19;
Authors: Webb JC, Gbejuade H, Lovering A, Spencer R
Abstract
PURPOSE: The purpose of this study was to investigate the in vivo elution kinetics of gentamicin from bone cement by assessing antibiotic levels in the urine. METHODS: Urinary samples of 35 patients who had undergone primary total hip arthroplasty were collected post-operatively. Gentamicin concentrations were analysed using the fluorescence polarisation immunoassay technique. RESULTS: The mean duration of urinary gentamicin release in all cases was 43 days (range 13-95). There was still detectable gentamicin at the final collection in 20 % (7/35) of cases, and in these cases, the mean gentamicin release was 71 days. CONCLUSIONS: From the assessment of urinary gentamicin, we were able to demonstrate the biphasic gentamicin elution from bone cement. In addition, there were detectable concentrations of the antibiotic from the urinary samples for prolonged periods of up to two to six months. Our study indicates that the assessment of urinary antibiotics can offer a non-invasive method of monitoring the in vivo release kinetics of antibiotics from bone cement.
PMID: 23685878 [PubMed - as supplied by publisher]
Reply to: Comment on Langlois et al.: Charnley-Kerboull total hip arthroplasty combining zirconia on polyethylene. A minimum eight-year follow-up prospective study.
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Reply to: Comment on Langlois et al.: Charnley-Kerboull total hip arthroplasty combining zirconia on polyethylene. A minimum eight-year follow-up prospective study.
Int Orthop. 2013 May 19;
Authors: Langlois J, Hamadouche M
Abstract
PMID: 23685879 [PubMed - as supplied by publisher]
An Integrated Health Care System’s Approach to Development of a Process to Collect Patient Functional Outcomes on Total Joint Replacement Procedures.
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An Integrated Health Care System's Approach to Development of a Process to Collect Patient Functional Outcomes on Total Joint Replacement Procedures.
Am J Med Qual. 2013 May 17;
Authors: Topel AM, Schini CA
Abstract
Health care organizations are challenged to find ways to measure not only process of care but also outcomes of care. Gundersen Health System's Orthopaedic Surgery Department in the La Crosse, Wisconsin area developed a process to collect outcomes of care for patients having hip or knee arthroplasty procedures and planned to use these data to determine impact on patients' lives. The Hip Osteoarthritis Outcomes Score and Knee Osteoarthritis Outcomes Score, adapted from the widely used Western Ontario and McMaster Universities Osteoarthritis Index, were collected preoperatively and at 1 year postoperatively. From these data, the health system determined that patients were experiencing significant improvement in 4 of 5 scales. Further recommendations include evaluating the impact of patients' age, sex, and preoperative body mass index on outcomes, as well as evaluating the impact of more patient involvement in goal setting on recovery time and functional outcomes.
PMID: 23687238 [PubMed - as supplied by publisher]
Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience.
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Intradural extramedullary benign spinal lesions radiosurgery. Medium- to long-term results from a single institution experience.
Acta Neurochir (Wien). 2013 May 18;
Authors: Marchetti M, De Martin E, Milanesi I, Fariselli L
Abstract
BACKGROUND: Surgery represents the first-choice treatment for spinal intradural tumours. On the other hand, whether it is most appropriate in the setting of recurrences, residual or multiple lesions remains an open question. Moreover, some patients are less than ideal candidates for surgery. In this study we report about our own radiosurgery experience in the treatment of benign intradural extramedullary tumours of the spine. METHODS: In our study we analyzed the outcomes for 18 patients (21 lesions) treated for benign intradural extramedullary lesions, with a minimum follow-up period of 32 months. The lesions included 11 meningiomas, 9 schwannomas and 1 neurofibroma. RESULTS: The mean follow-up was 43 months (32-73 months). The median tumour volume was 2 cc (0.2-17.7 cc). Eleven lesions underwent single-fraction treatment (mean prescribed dose ranging from 10 to 13 Gy). The others received a multisession radiosurgery treatment (4-6 fractions) with a mean prescription dose ranging from 18.5 to 25 Gy. The maximum dose to the spinal cord ranged from 9.2 to 26 Gy. During the follow-up period, none of the lesions showed radiological evidence of progression. Neurological status was preserved or improved and no permanent sequelae were observed. Significant and durable pain relief was observed. CONCLUSIONS: Although surgical excision remains the primary treatment option for most intradural tumours, radiosurgery offers a real alternative therapeutic modality, especially in case of recurrent and residual lesions or when surgery is contraindicated.
PMID: 23686634 [PubMed - as supplied by publisher]
Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.
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Knee joint passive stiffness and moment in sagittal and frontal planes markedly increase with compression.
Comput Methods Biomech Biomed Engin. 2013 May 20;
Authors: Marouane H, Shirazi-Adl A, Adouni M
Abstract
Knee joints are subject to large compression forces in daily activities. Due to artefact moments and instability under large compression loads, biomechanical studies impose additional constraints to circumvent the compression position-dependency in response. To quantify the effect of compression on passive knee moment resistance and stiffness, two validated finite element models of the tibiofemoral (TF) joint, one refined with depth-dependent fibril-reinforced cartilage and the other less refined with homogeneous isotropic cartilage, are used. The unconstrained TF joint response in sagittal and frontal planes is investigated at different flexion angles (0°, 15°, 30° and 45°) up to 1800 N compression preloads. The compression is applied at a novel joint mechanical balance point (MBP) identified as a point at which the compression does not cause any coupled rotations in sagittal and frontal planes. The MBP of the unconstrained joint is located at the lateral plateau in small compressions and shifts medially towards the inter-compartmental area at larger compression forces. The compression force substantially increases the joint moment-bearing capacities and instantaneous angular rigidities in both frontal and sagittal planes. The varus-valgus laxities diminish with compression preloads despite concomitant substantial reductions in collateral ligament forces. While the angular rigidity would enhance the joint stability, the augmented passive moment resistance under compression preloads plays a role in supporting external moments and should as such be considered in the knee joint musculoskeletal models.
PMID: 23682906 [PubMed - as supplied by publisher]
D5 Creation