scholarly journals Subsidence of a metaphyseal-anchored press-fit stem after 4-year follow-up: an EBRA-FCA analysis

2021 ◽  
Author(s):  
Dietmar Dammerer ◽  
Philipp Blum ◽  
David Putzer ◽  
Dietmar Krappinger ◽  
Michael C. Liebensteiner ◽  
...  
Keyword(s):  
Migration Behavior ◽  
Press Fit ◽  
Age At Surgery ◽  
Radiological Measurements ◽  
Retrospective Study Design ◽  
Medical Histories ◽  
Migration Analysis ◽  
Stem Migration

Abstract Purpose Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analyse) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless metaphyseal-anchored press-fit stem after 4-year follow-up. Methods Applying a retrospective study design, we reviewed all consecutive patients who between 2012 and 2017 received a cementless Accolade II press-fit stem at our Department. We reviewed medical histories and performed radiological measurements using EBRA-FCA software. EBRA-FCA measurements and statistical investigations were performed by two independent investigators. Results A total of 102 stems in 91 patients (female 60; male 31) fulfilled our inclusion criteria. Mean age at surgery was 66.2 (range 24.3–92.6) years. EBRA migration analysis showed a mean subsidence of 1.4 mm (range 0.0–12.0) at final follow-up. The angle between stem and femur axis was 0.5° (range 0.0°–2.8°) after 48 months. No correlations between gender or Dorr types and subsidence were found (p > 0.05). A body mass index > 30 kg/m2 showed a significant increase in stem subsidence within the first 6 (p = 0.0258) and 12 months (p = 0.0466) postoperative. Conclusions Migration pattern of the metaphyseal-anchored stem and a low subsidence rate at final follow-up may predict a good long-term clinical result. Trial registration Number: 20181024-1875.

scholarly journals Two-year radiologic assessment of the Pinnacle cup—a migration analysis with EBRA

2020 ◽  
Author(s):  
Dietmar Dammerer ◽  
Alexander Ruzicka ◽  
Philipp Blum ◽  
David Putzer ◽  
Maximilian Liebsch ◽  
...  
Keyword(s):  
Term Outcome ◽  
Long Term Outcome ◽  
Press Fit ◽  
Age At Surgery ◽  
Registration Number ◽  
Cause Of Failure ◽  
Radiological Measurements ◽  
Medical Histories ◽  
Migration Analysis

Abstract Introduction The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by EBRA (Einzel-Bild-Roentgen-Analyse) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 1 milimeter (mm) within the first 2 years after surgery. In this study, we investigated the migration behaviour of an uncemented press-fit cup after 2 years follow-up. Materials and methods Applying a retrospective study design, we reviewed all consecutive patients who received an uncemented press-fit cup at our Department between 2013 and 2018. A total of 484 patients were identified. We reviewed medical histories and performed radiological measurements using EBRA-Cup software. EBRA measurements and statistical investigations were performed by two independent investigators. Results A total of 165 cups in 159 patients (female: 90; male: 69) met our inclusion criteria. Mean age at surgery was 66.7 (range 18.4–90.5) years. EBRA migration analysis showed a mean total migration of 0.7 mm (range 0.0–6.3) over our follow-up period of 2 years. Of the investigated cups, 53.2% showed less than 1 mm migration in the investigated follow-up period. Conclusion In conclusion, the Pinnacle cup used in our study provides low mean migration at final follow-up. Based on the assumption of secondary stabilization, good long-term outcome of the Pinnacle cup can be expected. Trial registration number and date of registration Number: 20181024-1875; Date: 2018-09-20

scholarly journals Migration characteristics of the Corail hydroxyapatite-coated femoral stem—a retrospective clinical evaluation and migration measurement with EBRA

2021 ◽  
Author(s):  
Dietmar Dammerer ◽  
Philipp Blum ◽  
David Putzer ◽  
Dietmar Krappinger ◽  
Christof Pabinger ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Femoral Stem ◽  
Migration Behavior ◽  
Press Fit ◽  
Long Term Result ◽  
Stem Type ◽  
Medical Histories ◽  
And Migration ◽  
Migration Analysis

Abstract Purpose Uncemented stem migration analysis by EBRA-FCA (Einzel-Bild-Roentgen Analyse, Femoral Component Analysis) has been seen to be a good predictive indicator for early implant failure. In this study, we investigated the migration behavior of a cementless press-fit stem after two years follow-up. Stem type and postoperative gap between collar and femur were evaluated as a risk factor. Methods Applying a retrospective study design, we reviewed all consecutive patients who between 2013 and 2017 received a cementless press-fit Corail stem (DePuy Orthopaedics Inc., Warsaw, IN, USA) at our Department. We reviewed medical histories and performed radiological measurements using EBRA-FCA software. Results A total of 109 stems in 105 patients (female: 60; male: 45) fulfilled our inclusion criteria. Mean age at surgery was 67.8 (range, 21.6–90.5) years. EBRA migration analysis showed a mean subsidence of 1.8 mm (range, 0.0–12.1) at final follow-up. At 18 months mean subsidence of collared stems was significantly lower than in the collarless group [1.3 mm (range, 0.0–7.6) vs. 3.2 mm (range, 0.5–10.7), p = 0.0104]. Collared stems resting on the femoral cut presented a tendency to less subsidence than did collared stems showing a postoperative gap between collar and femur (1.3 vs. 2.0 mm) without finding statistical significance (p > 0.05). Conclusions Low subsidence and the migration pattern of the cementless press-fit stem may predict a good long-term result. Collared stems investigated in our study provide good stability and are able to prevent significant subsidence. Trial registration number and date of registration: Number: 20181024-1875; Date: 2018-10-24

scholarly journals Good mid-term results with the trident peripheral self-locking cup: a clinical evaluation and migration measurement with EBRA

2020 ◽  
Author(s):  
Dietmar Dammerer ◽  
Philipp Blum ◽  
David Putzer ◽  
Andreas Tscholl ◽  
Michael C. Liebensteiner ◽  
...  
Keyword(s):  
Trial Registration ◽  
Inclusion Criteria ◽  
Acetabular Cup ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Press Fit ◽  
Medical Histories ◽  
Migration Analysis ◽  
Radiological Analysis

Abstract Introduction The most common cause of failure in total hip arthroplasty (THA) is aseptic loosening. Uncemented cup migration analysis by means of Einzel–Bild–Roentgen–Analyse (EBRA) has shown to be a good predictive indicator for early implant failure if the cup migrates more than 2 mm within 4 years after surgery. In this study, we performed a migration analysis of an uncemented peripheral self-locking (PSL) press-fit cup after 4 years follow-up. Materials and methods We retrospectively reviewed all patients who received a trident PSL press-fit cup at our department between 2004 and 2017. A total of 636 patients were identified. As inclusion criteria for radiological analysis, a minimum follow-up of 2 years was defined. We reviewed medical histories and performed radiological analysis using EBRA software. EBRA measurements and statistical investigations were performed by two independent investigators. Results A total of 149 cups in 146 patients (female 82; male 64) met our inclusion criteria. Mean age at surgery was 65 years (33–89). We found a significant improvement in the WOMAC score pre- to postoperative (p < 0.0001). EBRA migration analysis showed a mean total migration of 0.6 mm (0.0–8.2) over our follow-up period of 4 years. Of the investigated cups, 69.8% showed a migration rate smaller than 2 mm in the investigated follow-up. Conclusion The acetabular cup used in our study provides low migration at final follow-up. Therefore, a good long-term outcome can be expected for the PSL cup. Trial registration Trial registration number is 20181024-1875 and date of registration is 2018-10-24.

Long-term outcomes after corrective cartilaginous joint resection based on arthrographic findings of duplicated thumbs

2021 ◽  
Vol 46 (4) ◽  
pp. 367-372
Author(s):  
Kousuke Iba ◽  
Akira Saito ◽  
Megumi Hanaka ◽  
Toshihiko Yamashita
Keyword(s):  
Growth Period ◽  
Joint Space ◽  
Type Ii ◽  
Scoring Method ◽  
Joint Congruency ◽  
Thumb Duplication ◽  
Age At Surgery ◽  
Joint Connection

We report greater than 10-year outcomes in duplicated thumbs following corrective cartilaginous resection during the growth period. We have undertaken corrective resection of cartilaginous joint connections based on intraoperative arthrographic findings to reconstruct favourable alignment in six Wassel Type II and IV thumb duplication in six patients. The age at surgery was 13 months (range 10–15), and the average post-surgical follow-up was 134 months (range 120–160). We observed five excellent and one good outcome using the Japanese Society for Surgery of the Hand scoring method. Favourable joint congruency and alignment were preserved, and no growth plate arrest or joint space narrowing was present more than 10 years after surgery. We conclude that corrective resection of the cartilaginous joint based on intraoperative arthrographic findings has long-term reliability for duplicated thumbs, especially those of Wassel Type II and IV, which have a cartilaginous joint connection. Levels of evidence: IV

scholarly journals Tubularized proximally-incised plate in distal/midshaft hypospadias repair

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Antonio Marte ◽  
Lucia Pintozzi
Keyword(s):  
Perioperative Complications ◽  
Foley Catheter ◽  
Case Series ◽  
Functional Results ◽  
Inclusion Criteria ◽  
Urethral Plate ◽  
Age At Surgery ◽  
Long Term Follow Up

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25<sup>th</sup> percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

scholarly journals Long-Term Bowel Function and Fate of the Ileal Pouch After Restorative Proctocolectomy in Patients With Crohn’s Disease: A Systematic Review With Meta-Analysis and Metaregression

2019 ◽  
Vol 14 (3) ◽  
pp. 418-427 ◽  
Author(s):  
Gianluca Pellino ◽  
Danilo Vinci ◽  
Giuseppe Signoriello ◽  
Christos Kontovounisios ◽  
Silvestro Canonico ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Ileal Pouch ◽  
Meta Analysis ◽  
Bowel Function ◽  
Age At Surgery ◽  
Secondary Endpoints ◽  
Grade Failure

Abstract Background and Aims Debate exists on whether ileal pouch anal anastomosis [IPAA] can be safely offered to patients diagnosed with Crohn’s disease [CD]. Our aim was to assess the outcome of IPAA for CD vs ulcerative colitis [UC]. Methods We used a PRISMA/MOOSE-compliant meta-analysis. Studies published between 1993 and 2018 were retrieved. Primary end points included complications. Secondary endpoints included functional outcome. The time of CD diagnosis was considered [intentional vs incidental IPAA]. Results Eleven studies comprising 6770 patients [CD = 352, UC = 6418] were included, with 44–120 months of follow-up. Pouch fistulae were more common in CD (CD vs UC; odds ratio (OR) 6.08; p = 0.0003, GRADE+++), as were strictures [OR 1.82; p = 0.02, GRADE+++] and failure [OR 5.27; p &lt; 0.0001, GRADE++++]. Compared with UC, postoperative CD diagnosis was associated with a much higher risk of fistulae [OR 6.23; p = 0.006, GRADE+++] and failure [OR 8.53; p &lt; 0.0001, GRADE++++] than intentional IPAA in CD [fistula: OR 4.17; p = 0.04, GRADE+++; failure: OR 2.48; p = 0.009, GRADE++++]. Age at surgery was positively associated with failure in CD [p = 0.007]. Obstruction was more common after intentional IPAA for CD. The risk of pouchitis did not differ between CD and UC [OR 1.07, p = 0.76, GRADE+++]. CD patients were at a higher risk of seepage [OR 2.27; p = 0.010, GRADE++]. Conclusions Patients with CD have 5-fold higher risk of failure, and a 2-fold risk of strictures after IPAA compared with UC. The risk is much higher if diagnosis is performed after IPAA. Function in those who retain the pouch seemed similar to that of patients with UC. CD does not increase the risk of pouchitis. IPAA could be offered to a selected population of CD patients after proper preoperative counselling. [PROSPERO registry 116811]

Long-Term Radiographic Changes in Stemless Press-Fit Total Shoulder Arthroplasty

2020 ◽  
Author(s):  
Sascha Beck ◽  
Theodor Patsalis ◽  
André Busch ◽  
Florian Dittrich ◽  
Alexander Wegner ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Proximal Humerus ◽  
Total Shoulder Arthroplasty ◽  
Stress Shielding ◽  
Shoulder Prosthesis ◽  
Mild Stress ◽  
Press Fit ◽  
Radiographic Changes

Abstract Introduction Stemmed humeral implants have represented the gold standard in total shoulder arthroplasty (TSA) for decades. Like many other joints, the latest trends in TSA designs aim at bone preservation. Current studies have demonstrated that native proximal humeral bone stresses are most closely mimicked by stemless implants. Nevertheless, there are concerns about the long-term performance of stemless designs. The aim of the present study was to evaluate the long-term radiographic changes at the proximal humerus in anatomical stemless press-fit TSA. Materials and Methods Between 2008 and 2010, 48 shoulders in 43 patients were resurfaced using an anatomic stemless shoulder prosthesis (TESS, Biomet). Thirty shoulders in twenty-five patients who were aged 65.7 ± 9.9 (34 to 82) years were available for clinical and radiographic review at a mean follow-up of 94.0 ± 8.9 (78 to 110) months. Results Radiographic changes of the proximal humerus due to stress shielding were found in 38.4% of the stemless TESS implants. Mild stress shielding accounted for 80% of the observed radiographic changes. Radiographs exhibited stable fixation of the stemless humeral press-fit implant at early and late follow-up. In contrast, radiolucent lines at the glenoid implant were found in 96.1% of the cases. Irrespective of the degree of radiographic changes, clinical scores (VAS, Quick-DASH, Constant score) significantly improved at follow-up. Conclusions The anatomic stemless press-fit implant seems to be favorable in terms of implant-related stress shielding. Clinical outcome was not affected by radiographic changes, demonstrating an 8-year clinical performance that seems to be comparable to conventional stemmed TSA.

Primary Total Hip Arthroplasty Using a Grit-Blasted, Press-Fit Femoral Prosthesis. Long-Term Results with Survivorship Analysis

2002 ◽  
Vol 12 (2) ◽  
pp. 55-72 ◽  
Author(s):  
G. Grappiolo ◽  
J.D. Blaha ◽  
T.A. Gruen ◽  
G. Burastero ◽  
L. Spotorno
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Component ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Femoral Prosthesis ◽  
Periprosthetic Osteolysis ◽  
Press Fit ◽  
Primary Total Hip Arthroplasty

Background This report presents the initial experience with the use of a grit-blasted, press-fit femoral prosthesis. Methods The first 300 consecutive primary total hip arthroplasty procedures using a collarless, three-dimensional tapered, straight, titanium alloy stem with a grit-blasted surface (performed in 299 patients) were evaluated with independent clinical and radiographic follow-up examinations up to sixteen years. Eight different types of acetabular components, including a cementless all-polyethylene socket in 80 percent of the cases, were used. Radiographic evaluation, performed by an independent observer using a zonal analysis method, included assessment of component migration, Engh's implant-bone femoral fixation score, implant-bone demarcations, and periprosthetic osteolysis. The average duration of long-term radiographic follow-up was 12.6 years (range; 10 to 16 years). Results At last examination only five hips were lost to follow-up and 69 patients were deceased. The overall mechanical failure rate (i.e. unstable with or without revision) of the femoral component was 2 percent. The femoral revision rate was 7 percent (two hips for aseptic loosening, five hips for septic loosening, and twelve hips with osseointegrated stems for severe progressive femoral osteolysis) and the acetabular revision rate was 27 percent (revised for either socket migration or progressive peri-acetabular osteolysis or both). Survivorship, based on any revision (femoral or acetabular) was 89 percent at ten years and 62 percent at fourteen years; survivorship of the femoral component was 95 percent at ten years and 90 percent at fourteen years. The incidence of femoral periprosthetic osteolysis, by radiographic examination at ten years or more was 47 percent, including 12 hips (5 percent) with distal endosteal osteolysis. Femoral implant-bone fixation was stable, bone-ongrowth in 97 percent; stable, fibrous-fixation in 1 percent, and unstable, fibrous-fixation in 2 percent of the cases. Conclusions The grit-blasted, press-fit, collarless, tapered femoral component continued to perform well clinically and radiographically up to sixteen years of follow-up despite the challenging environment of periprosthetic osteolysis associated with the acetabular component design. The high incidence of failure among the cementless all-polyethylene sockets was not unexpected and the use of this acetabular implant was discontinued in 1985. While considered a “first-generation” cementless stem, this implant is still in use virtually without design modifications. This study demonstrates the durability of the results of the grit-blasted femoral component and indicates that such an implant offers a viable alternative for fixation without bone cement.

scholarly journals Epidemiology of interdigital infections of toe web spaces in Shanghai, China: Etiology, risk factors, and therapeutic approaches

2020 ◽  
Author(s):  
Qian Yu ◽  
Wei Li ◽  
Siyue Kan ◽  
Xiaoping Liu ◽  
Hong Yang ◽  
...  
Keyword(s):  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Therapeutic Effects ◽  
Recurrence Rates ◽  
Cross Sectional ◽  
Long Term Follow Up ◽  
Medical Histories ◽  
Pathogenic Agents

Abstract Background Interdigital infections are frequently misdiagnosed as tinea pedis and remain intractable to treatments because of high recurrence rates and potential complications. We aimed to understand the epidemiology of interdigital infections in Shanghai, China. Methods We conducted a cross-sectional study at Shanghai Dermatology Hospital from January 2019 to December 2019, enrolling 57 patients with acute interdigital inflammation. Patients received antibiotic therapy and underwent long-term follow-up. Clinical features and medical histories, including blood, bacterial, and mycologic examination results, cultures and drug susceptibility test results, and follow-up data were analyzed for pathogenic agents. Results We found Pseudomonas aeruginosa (40.35%), Staphylococcus aureus (36.84%), and other bacteria (22.8%). Compared to other bacteria, P. aeruginosa interdigital infection were more inclined to co-infect with fungal agents. Further, P. aeruginosa interdigital infections were frequently seen in the spring and autumn and in patients aged 60–69 years. However, interdigital infections caused by S. aureus occurred more frequently in the summer and in patients aged 31–40 years. We found that levofloxacin had excellent therapeutic effects. Conclusion Our findings may inform treatment and diagnostic guidelines and, subsequently, help reduce the rate of recurrence and improve patient outcomes following interdigital infections.

Long-term follow-up evaluation of a prototype press-fit knee prosthesis

1991 ◽  
Vol 6 (2) ◽  
pp. 115-118
Author(s):  
Eugene E. Berg ◽  
Jonathan J. Paley
Keyword(s):  
Knee Prosthesis ◽  
Press Fit ◽  
Long Term Follow Up
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