PATELLOFEMORAL ARTHROPLASTY CHANGES THE TROCHLEAR GROOVE ANGLE

2017 ◽  
Vol 17 (04) ◽  
pp. 1750068
Author(s):  
F. J. WIESNER ◽  
P. J. ERASMUS ◽  
K. J. CHO ◽  
J. H. MÜLLER
Keyword(s):  
The Other ◽  
Trochlear Groove ◽  
Failure Rates ◽  
Patellofemoral Arthritis ◽  
Patellofemoral Arthroplasty ◽  
Early Failure ◽  
Patellar Maltracking

High early failure rates occur in the treatment of isolated symptomatic patellofemoral arthritis with commercially available patellofemoral arthroplasty (PFA) prostheses. We postulate that PFA changes the trochlear groove angle, thereby causing patellar maltracking, catching and pain. We examined the extent of this change in trochlear groove angle by virtually implanting five commercially available patellofemoral prostheses into two 3D reconstructed knees, one with a normal and the other with a dysplastic trochlea. The axial and coronal trochlear groove angles were measured pre- and post PFA for the five different prostheses in both the normal and the dysplastic knee. Post PFA, the trochlear groove angle changed from the original in both the axial and coronal planes for all the prostheses in both the normal and the dysplastic knee. The trochlear groove change is dependent on the design of the specific prosthesis. To avoid excessive changes post PFA, both the wide variation of changes between different generic PFA prostheses, as well as the wide variation in patient femoral anatomy should be considered.

scholarly journals Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-Trochlear Groove Distance

2021 ◽  
Author(s):  
Conglei Dong ◽  
Chao Zhao ◽  
Ming Li ◽  
Huijun Kang ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellofemoral Joint ◽  
Tibial Tuberosity ◽  
Tibial Tubercle ◽  
Trochlear Groove ◽  
Patellofemoral Arthritis ◽  
Patellofemoral Arthroplasty ◽  
Group I ◽  
Tibial Tubercle Transfer ◽  
Group Ii

Abstract BackgroundThe objective of present study was to investigate the operative effect of patellofemoral arthroplasty combined with the tibial tubercle transfer for isolated patellofemoral arthritis patients with an increased tibial tuberosity-trochlear groove distance (>20mm). MethodsA prospective study was performed between November 2012 and December 2017. Finally, thirty-six cases, with a mean age of 61.1 ± 7.3 years, were admitted to our study. A total of 17 patients underwent patellofemoral arthroplasty combined with tibial tubercle transfer, and 19 patients underwent patellofemoral arthroplasty only. All eligible patients had CT scans preoperatively and at 12 months follow-up, to assess the stability of the patellofemoral joint on axial slices. In addition, the demographic and clinical features of all the patients were asked. Knee balance was assessed with the single leg stance test and timed get up and go, and functionality was evaluated with stair climbing test and the Western Ontario and McMaster Universities Osteoarthritis Index score. (P>0.05) ResultsPreoperatively, the data regarding the knee balance and functionality were not significantly different between the two Groups (P>0.05). Many measurements showed significant differences between the two groups at the last follow-up. Significant differences were seen in well-known measurements such as the SLST (Group I, 28.9 s (SD 7.5); Group II, 20.3 s (SD 5.9); p < 0.001), TGUG (Group I, 13.4 s (SD 3.2); Group II, 16.8 s (SD 3.1); p < 0.001), and SCT (Group I, 18.6 s (SD 6.8); Group II, 24.5 s (SD 8.7); p < 0.001). Additionally, the median WOMAC score was improved from 62.7 (SD 11.2) preoperatively to 25.7 (SD 8.2) one year postoperatively in Group I and from 64.1 (SD 10.7) to 36.2 (SD 9.7) in Group II, which were also significantly different between the groups. ConclusionsFor such special IPA patients with an increased TT-TG (>20mm), the combined operation of PFA combined with TTT can better restore the involutional relationship of patellofemoral joint and further improve the balance and function of knee joint.

scholarly journals Good Operative Effects of Patellofemoral Arthroplasty Combined With the Tibial Tubercle Transfer for Isolated Patellofemoral Arthritis Patients With an Increased Tibial Tuberosity-trochlear Groove Distance

2021 ◽  
Author(s):  
Conglei Dong ◽  
Chao Zhao ◽  
Ming Li ◽  
Huijun Kang ◽  
Kang Piao ◽  
...  
Keyword(s):  
Patellofemoral Joint ◽  
Tibial Tuberosity ◽  
Tibial Tubercle ◽  
Trochlear Groove ◽  
Patellofemoral Arthritis ◽  
Patellofemoral Arthroplasty ◽  
Group I ◽  
Tibial Tubercle Transfer ◽  
Group Ii

Abstract Purpose: The objective of present study was to investigate the operative effect of patellofemoral arthroplasty combined with the tibial tubercle transfer for isolated patellofemoral arthritis patients with an increased tibial tuberosity-trochlear groove distance (>20mm).Methods: A prospective study was performed between November 2012 and December 2017. Finally, thirty-six cases, with a mean age of 61.1 ± 7.3 years, were admitted to our study. A total of 17 patients underwent patellofemoral arthroplasty combined with tibial tubercle transfer, and 19 patients underwent patellofemoral arthroplasty only. All eligible patients had CT scans preoperatively and at 12 months follow-up, to assess the stability of the patellofemoral joint on axial slices. In addition, the demographic and clinical features of all the patients were asked. Knee balance was assessed with the single leg stance test and timed get up and go, and functionality was evaluated with stair climbing test and the Western Ontario and McMaster Universities Osteoarthritis Index score. (P>0.05)Results: Preoperatively, the data regarding the knee balance and functionality were not significantly different between the two Groups (P>0.05). Many measurements showed significant differences between the two groups at the last follow-up. Significant differences were seen in well-known measurements such as the SLST (Group I, 28.9 s (SD 7.5); Group II, 20.3 s (SD 5.9); p < 0.001), TGUG (Group I, 13.4 s (SD 3.2); Group II, 16.8 s (SD 3.1); p < 0.001), and SCT (Group I, 18.6 s (SD 6.8); Group II, 24.5 s (SD 8.7); p < 0.001). Additionally, the median WOMAC score was improved from 62.7 (SD 11.2) preoperatively to 25.7 (SD 8.2) one year postoperatively in Group I and from 64.1 (SD 10.7) to 36.2 (SD 9.7) in Group II, which were also significantly different between the groups.Conclusion: For such special IPA patients with an increased TT-TG (>20mm), the combined operation of PFA combined with TTT can better restore the involutional relationship of patellofemoral joint and further improve the balance and function of knee joint.

scholarly journals Paper # 106: The Low Contact Stress Patellofemoral Arthroplasty – High Early Failure Rate

2011 ◽  
Vol 27 (10) ◽  
pp. e138-e139
Author(s):  
Paul M. Sutton ◽  
Bambos Charalambous ◽  
Simon Mills ◽  
Zain Abiddin Z ◽  
Shaun Rogers ◽  
...  
Keyword(s):  
Failure Rate ◽  
Contact Stress ◽  
Patellofemoral Arthroplasty ◽  
Early Failure ◽  
Low Contact Stress

Comparison of postal and non-postal post-vasectomy semen sample submission strategies on compliance and failures: an 11-year analysis of the audit database of the Association of Surgeons in Primary Care of the UK

2021 ◽  
pp. bmjsrh-2021-201064
Author(s):  
Melanie Atkinson ◽  
Gareth James ◽  
Katie Bond ◽  
Zoe Harcombe ◽  
Michel Labrecque
Keyword(s):  
Primary Care ◽  
Semen Analysis ◽  
Failure Detection ◽  
Semen Sample ◽  
Failure Rates ◽  
Early Failure ◽  
Detection Rates ◽  
Late Failure ◽  
The Difference ◽  
The Uk

BackgroundVasectomy occlusive success is defined by the recommendation of ‘clearance’ to stop other contraception, and is elicited by post-vasectomy semen analysis (PVSA). We evaluated how the choice of either a postal or non-postal PVSA submission strategy was associated with compliance to PVSA and effectiveness of vasectomy.MethodsWe studied vasectomies performed in the UK from 2008 to 2019, reported in annual audits by Association of Surgeons in Primary Care members. We calculated the difference between the two strategies for compliance with PVSA, and early and late vasectomy failure. We determined compliance by adding the numbers of men with early failure and those given clearance. We performed stratified analyses by the number of test guidance for clearance (one-test/two-test) and the study period (2008–2013/2014–2019).ResultsAmong 58 900 vasectomised men, 32 708 (56%) and 26 192 (44%) were advised submission by postal and non-postal strategies, respectively. Compliance with postal (79.5%) was significantly greater than with non-postal strategy (59.1%), the difference being 20.4% (95% CI 19.7% to 21.2%). In compliant patients, overall early failure detection was lower with postal (0.73%) than with non-postal (0.94%) strategy (−0.22%, 95% CI −0.41% to −0.04%), but this difference was neither clinically nor statistically significant with one-test guidance in 2014–2019. There was no difference in late failure rates.ConclusionsPostal strategy significantly increased compliance to PVSA with similar failure detection rates. This resulted in more individuals receiving clearance or early failure because of the greater percentage of postal samples submitted. Postal strategy warrants inclusion in any future guidelines as a reliable and convenient option.

Impact of dental implant length on early failure rates: a meta-analysis of observational studies

2011 ◽  
Vol 38 (9) ◽  
pp. 856-863 ◽  
Author(s):  
Bernhard Pommer ◽  
Sophie Frantal ◽  
Jürgen Willer ◽  
Martin Posch ◽  
Georg Watzek ◽  
...  
Keyword(s):  
Dental Implant ◽  
Observational Studies ◽  
Meta Analysis ◽  
Failure Rates ◽  
Early Failure ◽  
Implant Length

scholarly journals Best Vascular Access in the Elderly: Time for Innovation?

2018 ◽  
Vol 47 (1-3) ◽  
pp. 236-239 ◽  
Author(s):  
Arif Asif ◽  
Mohamed M. Bakr ◽  
Michael Levitt ◽  
Tushar Vachharajani
Keyword(s):  
Arteriovenous Fistula ◽  
Ulnar Artery ◽  
The Elderly ◽  
Dialysis Access ◽  
Failure Rates ◽  
Early Failure ◽  
Upper Arm ◽  
Arteriovenous Access ◽  
Surgical Manipulation ◽  
Innovative Techniques

Background: Conflicting data continue to surround the optimal dialysis access for the elderly. Many propose that catheters are the best option for this population; others emphasize the creation of an arteriovenous fistula. Summary: While an arteriovenous access is the best available access, it has a high early failure rate, particularly in the elderly. However, significant differences exist in forearm (men ≥65 years ~70%; women ≥65 years ~80%) versus upper arm (men ≥65 years ~40%; women ≥65 years ~38%) fistula failure rates in the elderly, with upper arm having much lower failure rates. Two percutaneous innovative techniques that successfully establish fistulas at the upper arm using proximal radial/ulnar ­artery as the inflow have been recently introduced. These procedures have been successfully performed in the elderly. Importantly, these techniques bypass the open surgical exploration and as such avoid the surgical manipulation of the juxta-anastomotic region (a common cause for the development of juxta-anastomotic stenosis and early fistula failure). Key Message: This article discusses the arteriovenous fistula creation in the elderly, highlights the factors necessary for successful fistula creation, and describes the 2 innovative techniques that can be used to provide a robust platform for successful fistula creation in this population.

Optimization of Anastomotic Geometry for Vascular Access Fistula

2015 ◽  
Author(s):  
Guangyu Bao ◽  
Xiaomin Chen ◽  
Ramesh K. Agarwal
Keyword(s):  
Genetic Algorithm ◽  
Turbulent Flows ◽  
Vascular Access ◽  
Term Treatment ◽  
Optimization Process ◽  
Failure Rates ◽  
Early Failure ◽  
Long Term Treatment ◽  
Computational Fluid Dynamics Cfd ◽  
Single Objective

Arteriovenous fistula (AVF) is one type of vascular access which is a surgically created vein used to remove and return blood during hemodialysis [1]. It is a long-term treatment for kidney failure. Although clinical treatment and technology have both achieved great improvements in recent years, the vascular access for hemodialysis still has significant early failure rates after the insertion of AVF in patients [2]. Studies have shown that stenosis in the vascular access circuit is the single major cause for access morbidity. Majority of efforts to understand the mechanisms of stenosis formation, and its prevention and management have largely focused on understanding and managing this complication based on the pathophysiology, tissue histology and molecular biology; however these efforts have not resulted in significant progress to date. We believe that the major impact in this area will come from continued and accurate understanding of the hemodynamics, and by development of techniques of intervention to modulate factors such as flow rates, pressures and compliance of the circuit. The goal of this paper is to study anastomotic models of AV access using Computational Fluid Dynamics (CFD) and optimize them to minimize the wall shear stress (WSS). In order to achieve this goal, the commercial CFD software FLUENT [3] is employed in conjunction with a single objective genetic algorithm [4]. Computations for two types of AVF currently in use in clinical practice are performed. AVF with 25° angle/3–4mm diameter and 90° angle/3–5mm diameter are selected to conduct the optimization. A single-objective genetic algorithm is employed in the optimization process and a k-kl-ω turbulence model is employed in CFD simulations; this model can accurately compute transitional/turbulent flows. In order to optimize for the same flow conditions, a fixed boundary condition is used during the optimization process. Computations for 16 to 20 generations of the selected AVFs are obtained from the genetic algorithm solver. The maximum WSS in the two AVFs considered are 6997.8 and 7750 dynes/cm2; however, the maximum WSS in the shape-optimized AVFs are reduced to 3511.2 and 4293.9 dynes/cm2 respectively, which have decreased by 49.82% and 44.59% respectively. Thus, the probability of the formation of stenosis in AVFs and early failure rates of vascular access are reduced by using the optimized AVFs.

P 004 - Patellofemoral arthroplasty improves gait in isolated patellofemoral arthritis, a prospective cohort gait analysis study

2018 ◽  
Vol 65 ◽  
pp. 241-242
Author(s):  
A. Choudhury ◽  
R. Lambkin ◽  
E. Auvinet ◽  
F. Iranpour ◽  
D. Tennent ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Prospective Cohort ◽  
Patellofemoral Arthritis ◽  
Patellofemoral Arthroplasty ◽  
Analysis Study

scholarly journals Patellofemoral Arthroplasty: A Systematic Review of the Literature

2012 ◽  
Vol 6 (1) ◽  
pp. 340-347 ◽  
Author(s):  
Payam Tarassoli ◽  
Shahid Punwar ◽  
Wasim Khan ◽  
David Johnstone
Keyword(s):  
Patellofemoral Joint ◽  
Degenerative Change ◽  
Surgical Techniques ◽  
The Other ◽  
Patellofemoral Osteoarthritis ◽  
Review Of The Literature ◽  
Patellofemoral Arthroplasty ◽  
Joint Replacements ◽  
Total Knee ◽  
Anterior Knee

Identification and management of patients with isolated patellofemoral osteoarthritis are challenging. Many of these patients present at a young age and it is important to distinguish degenerative change in the patellofemoral articulation from the other various causes of anterior knee pain. Once the diagnosis of isolated patellofemoral arthrosis has been made non-operative and conservative surgical techniques should be exhausted fully before prosthetic arthroplasty is considered. This review focuses on the use of arthroplasty for isolated patellofemoral arthrosis, in particular comparing the use of total knee against selective patellofemoral joint replacements.

scholarly journals A-142 Examining the Impact of the Recent New Dot Counting Test Cut-Off Score in Bilingualism and Traumatic Brain Injury Survivors

2020 ◽  
Vol 35 (6) ◽  
pp. 935-935
Author(s):  
Graub N ◽  
Lopez-Hernandez D ◽  
Litvin P ◽  
Rugh-Fraser R ◽  
Rad H ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
First Language ◽  
The Other ◽  
Group Differences ◽  
Failure Rates ◽  
Language Groups ◽  
English Second Language ◽  
Chi Squared ◽  
The Impact

Abstract Objective McCaul et al. (2018) recently revised the Dot Counting Test (DCT) cut-off score from ≥17 to 13.80; we evaluated the new cut-off in monolingual and bilingual traumatic brain injury survivors (TBIS) and healthy comparison participants (HCP). Method The sample consisted of 43 acute TBI [ATBI; 23 English monolinguals (EM); 11 English first language bilinguals (EFLB); and 9 English second language bilinguals (ESLB)]; 30 chronic TBI (CTBI; 13 EM; 9 EFLB; 8 ESLB), and 56 HCP (23 EM; 11 EFLB; 22 ESLB). Results An ANCOVA, controlling for age and education, revealed an interaction where ATBI-EFLB had higher E-scores than the other groups and the CTBI-EFLB had lower E-scores than the other groups. Both the conventional and proposed new cut-off (PNC) scores had different failure rates in ATBI (conventional cut-off: 9%; PNC: 28%), CTBI (conventional cut-off: 10%; PNC: 20%), and HCP (conventional cut-off: 11%; PNC: 13%). For language groups, EM (conventional cut-off: 14%; PNC: 22%), EFLB (conventional cut-off: 10%; PNC: 26%), and ESLB (conventional cut-off: 5%; PNC: 10%) demonstrated different failure rates across cut-off scores. Group differences were found with McCaul et al. (2018) cut-off, but not the conventional cut-off score. Also, chi-squared analysis revealed ATBI EFLB and EM had greater failure rates than ATBI ESLB. Conclusion Unfortunately, the new DCT cut-off score resulted in greater failure rates in TBIS. Furthermore, ATBI EM and EFLB were impacted more by the new cut offs than ATBI ESLB who learned English later in life, although the reason for this finding is unclear and requires additional study.

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