scholarly journals The Relationship Between Arthroplasty Surgeons’ Experience Level and Optimal Cable Tensioning in the Fixation of Extended Trochanteric Osteotomy

2021 ◽  
Vol 12 ◽  
pp. 215145932110633
Author(s):  
Kerem Başarır ◽  
Mahmut Kalem ◽  
Ercan Şahin ◽  
Emre Anıl Özbek ◽  
Mustafa Onur Karaca ◽  
...  

Introduction In this study, our aim was to examine the relationship between the arthroplasty surgeons’ experience level and their aptitude to adjust the cable tension to the value recommended by the manufacturer when asked to provide fixation with cables in artificial bones that underwent extended trochanteric osteotomy (ETO). Materials and Methods A custom-made cable tensioning device with a microvoltmeter was used to measure the tension values in Newtons (N). An ETO was performed on 4 artificial femur bones. Surgeons at various levels of experience attending the IXth National Arthroplasty Congress were asked to fix the osteotomized fragment using 1.7-mm cables and the tensioning device. The participants’ demographic and experience data were investigated and recorded. The surgeons with different level of experience repeated the tensioning test 3 times and the average of these measurements were recorded. Results In 19 (35.2%) of the 54 participants, the force applied to the cable was found to be greater than the 490.33 N (50 kg) value recommended by the manufacturer. No statistically significant difference was determined between the surgeon’s years of experience, the number of cases, and the number of cables used and the tension applied over the recommended maximum value ( P = .475, P = .312, and P = .691, respectively). Conclusions No significant relationship was found between the arthroplasty surgeon’s level of experience and the adjustment of the cable with the correct tension level. For this reason, we believe that the use of tensioning devices with calibrated tension gauges by orthopedic surgeons would help in reducing the number of complications that may occur due to the cable.

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Gwang Chul Lee ◽  
Sang Hong Lee ◽  
Sin Wook Kang ◽  
Hyung Seok Park ◽  
Suenghwan Jo

Abstract Background Several methods using simple anteroposterior (AP) radiographs have been suggested for the measurement of anteversion of the cup component after total hip arthroplasty. Herein, we compared six widely used anteversion measurement methods using two different types of AP radiograph, the conventional pelvis AP and hip-centered AP radiographs, to identify the measurement method and the type of radiograph that would provide the highest accuracy and reliability. Methods We developed two custom-made bi-planar anteversion measurement models for the validation test. The models were designed for pelvis AP and hip-centered AP radiographs, respectively. The radiographs were acquired using the inclination angles of both models, changing from 10° to 70° at 10° increments. For each inclination angle, anteversion was changed from 0° to 30° at 5° increments. The measurements were obtained independently by two orthopedic surgeons blinded from each other’s measurements, using the methods of 1) Pradhan et al., 2) Lewinnek et al., 3) Widmer et al., 4) Liaw et al., 5) Hassan et al., and 6) Ackland et al. The measurements were repeated after 2 months. The accuracy, compared with that of the reference angle, and intra-observer and inter-observer reliabilities of each method were calculated. Results The highest accuracy was found when the method of Liaw et al. was used with hip-centered AP radiographs, which showed a difference of 1.37° ± 1.73 from the reference angle. Moreover, regardless of the type of radiograph, the methods by Pradhan et al., Lewinnek et al., and Liaw et al. showed excellent correlations with the reference anteversion. However, substantial differences were found when the methods by Widmer et al., Hassan et al., and Ackland et al. were used, regardless of the type of radiograph used. When anteversion was measured in an inclination between 30° and 50°, the method of Pradhan et al., when used with pelvis AP radiographs, showed the highest accuracy (1.23° ± 0.92°). We also found no significant difference in anteversions between the measurements made on pelvic and hip-centered AP radiographs. Both interobserver and intraobserver reliabilities were high for all the measurements tested. Conclusions The methods by Pradhan et al., Liaw et al., and Lewinnek et al. may provide relatively accurate anteversion measurements with high reliability, regardless of the type of radiograph.


2019 ◽  
Author(s):  
Gwang Chul Lee ◽  
Sang Hong Lee ◽  
Sin Wook Kang ◽  
Hyung Suk Park ◽  
Suenghwan Jo

Abstract Introduction Several methods have been suggested to measure anteversion of the cup component after total hip arthroplasty using simple anteroposterior (AP) radiographs. Herein, we compared six widely used anteversion measurement methods using two different AP radiographs (conventional pelvis AP vs. hip-centered AP) in order to identify the measurement method and radiograph that provide the highest accuracy and reliability. Methods We developed two custom-made bi-planar anteversion measurement models for the validation. Each model was designed for pelvis AP and hip-centered AP radiographs. The radiographs were acquired with both models’ inclination angle changing from 10° to 70° at 10° increments, and for each inclination angles, anteversion was changed from 0° to 30° at 5° increments. The measurements were obtained independently by two orthopedic surgeons blinded from each other using 6 methods: 1) Pradhan et al., 2) Lewinnek et al., 3) Widmer et al., 4) Liaw et al., 5) Hassan et al., and 6) Ackland et al. The measurements were repeated after 2 months. The accuracy, compared to the reference angle, and intra- and inter-observer reliabilities of each method were calculated. Results The highest accuracy was found when Liaw et al.’s method was used in hip-centered AP radiographs, which showed a difference of 1.37° ± 1.73 from the reference. Moreover, regardless of the type of the radiograph, the methods by Pradhan et al., Lewinnek et al., and Liaw et al. showed excellent correlations with the reference anteversion. However, substantial differences were found when the methods by Widmer et al., Hassan et al., and Ackland et al. were utilized, regardless of the type of radiograph used. When the anteversion was measured in the inclination between 30° and 50°, Pradhan et al.’s method in pelvis AP radiographs showed the highest accuracy (1.23° ± 0.92°). We also found no significant difference when the measured anteversions were compared between pelvis AP and hip-centered AP radiographs. Both inter- and intra-observer reliabilities were high for all measurements tested. Conclusions The methods by Pradhan et al., Liaw et al., and Lewinnek et al. may provide relatively accurate anteversion measurements with high reliability, regardless of the type of radiograph.


2019 ◽  
Author(s):  
Gwang Chul Lee ◽  
Sang Hong Lee ◽  
Sin Wook Kang ◽  
Hyung Suk Park ◽  
Suenghwan Jo

Abstract Background Several methods using simple anteroposterior (AP) radiographs have been suggested for the measurement of anteversion of the cup component after total hip arthroplasty. Herein, we compared six widely used anteversion measurement methods using two different types of AP radiograph, the conventional pelvis AP and hip-centered AP radiographs, to identify the measurement method and the type of radiograph that would provide the highest accuracy and reliability. Methods We developed two custom-made bi-planar anteversion measurement models for the validation test. The models were designed for pelvis AP and hip-centered AP radiographs, respectively. The radiographs were acquired using the inclination angles of both models, changing from 10° to 70° at 10° increments. For each inclination angle, anteversion was changed from 0° to 30° at 5° increments. The measurements were obtained independently by two orthopedic surgeons blinded from each other’s measurements, using the methods of 1) Pradhan et al., 2) Lewinnek et al., 3) Widmer et al., 4) Liaw et al., 5) Hassan et al., and 6) Ackland et al. The measurements were repeated after 2 months. The accuracy, compared with that of the reference angle, and intra-observer and inter-observer reliabilities of each method were calculated. Results The highest accuracy was found when the method of Liaw et al. was used with hip-centered AP radiographs, which showed a difference of 1.37° ± 1.73 from the reference angle. Moreover, regardless of the type of radiograph, the methods by Pradhan et al., Lewinnek et al., and Liaw et al. showed excellent correlations with the reference anteversion. However, substantial differences were found when the methods by Widmer et al., Hassan et al., and Ackland et al. were used, regardless of the type of radiograph used. We also found no significant difference in anteversions between the measurements made on pelvic and hip-centered AP radiographs. Both interobserver and intraobserver reliabilities were high for all the measurements tested. Conclusions The methods by Pradhan et al., Liaw et al., and Lewinnek et al. may provide relatively accurate anteversion measurements with high reliability, regardless of the type of radiograph.


2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.


Author(s):  
Ma. Dulce C. Guillena

Gonado-somatic index and fecundity are tools for measuring the sexual maturity and ability of animals to reproduce.  This study investigates the reproduction of Trichiurus lepturus. Specifically, this aimed to determine the sex ratio, the GSI, the relationship between fecundity and total length, fecundity and total weight, fecundity and ovary weight. The Descriptive Method of research was used.  Percentage and chi-square was utilized in determining the percentage of occurrence and sex ratio respectively.   Pearson r Product Moment Coefficient of Correlation was used to determine the relationships of the parameters. The study revealed that females outnumbered males and the sex ratio for different month showed significant difference.  Spawning season was observed to occur in November and December as revealed in its GSI values and it synchronized with the full and new moon phases.  Fecundity is positively correlated with body weight, body size, and ovary weight where ovary weight is observed to be the best index for fecundity.  The results of this study could be used further for formal stock assessment of cutlassfish fishery.


Agrometeoros ◽  
2018 ◽  
Vol 26 (1) ◽  
Author(s):  
Ronaldo Matzenauer ◽  
Bernadete Radin ◽  
Alberto Cargnelutti Filho

O objetivo deste trabalho foi avaliar a relação entre o fenômeno El Niño Oscilação Sul - ENOS e o rendimento de grãos de soja e de milho no Rio Grande do Sul e verificar a hipótese de que os eventos El Niño são favoráveis e os eventos La Niña são prejudiciais ao rendimento de grãos das culturas. Foram utilizados dados de rendimento de grãos dos anos agrícolas de 1974/75 a 2016/17, e relacionados com as ocorrências de eventos ENOS. Foram analisados os dados de rendimento observados na colheita e os dados estimados com a remoção da tendência tecnológica. Os resultados mostraram que não houve diferença significativa do rendimento médio de grãos de soja e de milho na comparação entre os eventos ENOS. Palavras-chave: El Niño, La Niña, safras agrícolas. Abstract – The objective of this work was to evaluate the relationship between the El Niño Southern Oscillation (ENSO) phenomenon with the grain yield of soybean and maize in Rio Grande do Sul state, Brazil and to verify the hypothesis that the El Niño events are favorable and the La Niña events are harmful to the culture’s grain yields. Were used data from the agricultural years of 1974/75 to 2016/17, and related to the occurrence of ENOS events. We analyzed income data observed at harvest and estimated data with technological tendency was removed. The results showed that there was no significant difference in the average yield of soybeans and corn in the comparison between events.


2019 ◽  
Author(s):  
Siddharth Garg

Objective: The aim of this paper was to examine the relationship between income, subjective wellbeing, and culture among people from a higher socio-economic class across the world. Rationale: Ed Diener proposed the law of diminishing marginal utility as an explanation for differences in subjective wellbeing among different income groups across different countries (Diener, Ng, & Tov, Balance in life and declining marginal utility of diverse resources, 2009). Thus, people with higher incomes would experience less subjective wellbeing due to income, and culture should emerge as a significant predictor. Method: Data from this study came from another study (https://siddharthgargblog.wordpress.com/2019/07/14/love-for-money/). I used an online survey to collect data on annual income in US dollars, subjective wellbeing (WHO-5), and country of residence (Indicator of Culture). 96 responses (Indians = 24, Foreigners = 72) were entered in IBM SPSS and a regression analysis was conducted. The raw dataset used in this study can be found at https://doi.org/10.6084/m9.figshare.8869040.v1Results: ANOVA showed a significant difference (p < 0.05) between Indians and foreigners on levels of subjective wellbeing. Linear regression shows the regression coefficient of culture to be significant (Beta = -.254, p = .014) but the regression coefficient of income was not found to be significant. The overall model was found to explain 8.2% of the variance in wellbeing.Conclusion: The sample of this study is too small to make any kind of generalization; it does lend a little bit of support to the idea of diminishing marginal utility of income on subjective wellbeing and provides a rationale for further research.


2015 ◽  
Vol 72 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Marko Igic ◽  
Nebojsa Krunic ◽  
Ljiljana Aleksov ◽  
Milena Kostic ◽  
Aleksandra Igic ◽  
...  

Background/Aim. The vertical dimension of occlusion is a very important parameter for proper reconstruction of the relationship between the jaws. The literature describes many methods for its finding, from the simple, easily applicable clinically, to quite complicated, with the use of one or more devices for determination. The aim of this study was to examine the possibility of determining the vertical dimension of occlusion using the vocals ?O? and ?E? with the control of values o btained by applying cognitive functions. Methods. This investigation was performed with the two groups of patients. The first group consisted of 50 females and 50 males, aged 18 to 30 years. In this group the distance between the reference points (on top of the nose and chin) was measured in the position of the mandible in the vertical dimension of occlusion, the vertical dimension at rest and the pronunciation of the words ?OLO? and ?ELE?. Checking the correctness of the particular value for the word ?OLO? was also performed by the phonetic method with the application of cognitive exercises when the patients counted from 89 to 80. The obtained difference in the average values i n determining the vertical dimension of occlusion and the ?OLO? and ?ELE? in the first group was used as the reference for determining the vertical dimension of occlusion in the second group of patients. The second group comprised of 31 edentulous persons (14 females and 17 males), aged from 54 to 85 years who had been made a complete denture. Results. The average value obtained for the vertical dimension of rest for the entire sample was 2.16 mm, for the word ?OLO? for the entire sample was 5.51 mm and for the word ?ELE? for the entire sample was 7.47 mm. There was no statistically significant difference between the genders for the value of the vertical dimension at rest, ?ELE? and ?OLO?. There was a statistically significant difference between the values f or the vertical dimension at rest, ?OLO? and ?ELE? for both genders. There was a statistically significant correlation between the value for the vertical dimension at rest, ?OLO? and ?ELE?, for both groups of subjects. Conclusion. Determining the vertical dimension of occlusion requires 5.5 mm subtraction from the position of the mandible in pronunciation of the word ?OLO? or 7.5 mm in pronunciation of the word ?ELE?.


2021 ◽  
pp. 1-8
Author(s):  
Mustafa Avcu ◽  
Mehmet Metin ◽  
Raşit Kılıç ◽  
Muhammed Alpaslan

Background: In this study, optic coherence tomography (OCT) examination was performed to check whether there was any interaction between ophthalmic axonal structures in unilateral tinnitus patients, and the relationship between optic nerve thickness and cochlear nerve thickness was evaluated. Objective: The aim of the study was to evaluate the relatioship between hearing loss, tinnitus, and nerve thicknesses. Study Design: Prospective study. Setting: Tertiary referral university hospital. Patients: The study included 88 patients with unilateral tinnitus, for which no organic cause could be found in physical examination, psychiatric evaluation, or with imaging methods. Study groups were formed of the tinnitus side and control groups were formed of the healthy side as follows: Group 1 (Non-tinnitus side normal hearing values – n = 30), Group 2 (non-tinnitus side minimal hearing loss – n = 27), Group 3 (non-tinnitus side moderate hearing loss – n = 31), Group 4 (tinnitus side normal hearing values – n = 25), Group 5 (tinnitus side minimal hearing loss – n = 25), and Group 6 (tinnitus side moderate hearing loss – n = 38). Intervention: Retinal nerve fiber layer (RNFL) thickness was evaluated with OCT, and the cochlear nerve cross-sectional area was evaluated with MRI. Main Outcome Measures: RNFL measurements were taken with OCT from the subfoveal area (RNFL-SF) and 1.5 mm temporal to the fovea (RNFL-T µm) and nasal (RNFL-N µm) sectors. On MRI, 3 measurements were taken along the nerve from the cerebellopontine angle as far as the internal auditory canal, and the mean value of these 3 measurements was calculated. Results: When the groups were evaluated in respect of cochlear nerve thickness, a significant difference was seen between Group 1 and both the groups with hearing loss and the tinnitus groups. In the subgroup analysis, a statistically significant difference was determined between Group 1 and Groups 3, 4, 5, and 6 (p = 0.013, p = 0.003, p < 0.001, and p < 0.001, respectively). When the groups were evaluated in respect of the RNFL-SF (µm), RNFL-T (µm), and RNFL-N (µm) values, the differences were determined to be statistically significant (p < 0.001 for all). In the correlation analysis, a negative correlation was determined between hearing loss and cochlear nerve diameter (r: −0.184, p = 0.014), and RNFL-N (r: −0.272, p < 0.001) and between tinnitus and cochlear nerve diameter (r: −0.536, p < 0.001), and RNFL-T (r: −0.222, p < 0.009). Conclusion: The study results clearly showed a relationship between cochlear nerve fiber thickness and hearing loss and the severity of tinnitus in cases with unilateral tinnitus and that there could be neurodegenerative factors in the disease etiology. A similar relationship seen with the RNFL supports the study hypothesis.


2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.


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