Comparison of the long-term outcome of cemented Charnley low-friction arthroplasty with hybrid arthroplasty in patients with congenital hip disease

Aims To our knowledge, no study has compared the long-term results of cemented and hybrid total hip arthroplasty (THA) in patients with osteoarthritis (OA) secondary to congenital hip disease (CHD). This is a demanding procedure that may require special techniques and implants. Our aim was to compare the long-term outcome of cemented low-friction arthroplasty (LFA) and hybrid THA performed by one surgeon. Patients and Methods Between January 1989 and December 1997, 58 hips (44 patients; one man, 43 woman; mean age 56.6 years (25 to 77)) with OA secondary to CHD were treated with a cemented Charnley LFA (group A), and 55 hips (39 patients; two men, 37 women; mean age 49.1 years (27 to 70)) were treated with a hybrid THA (group B), by the senior author (GH). The clinical outcome and survivorship were compared. Results At all timepoints, group A hips had slightly better survivorship than those in group B without a statistically significant difference, except for the 24-year survival of acetabular components with revision for aseptic loosening as the endpoint, which was slightly worse. The survivorship was only significantly better in group A compared with group B when considering reoperation for any indication as the endpoint, 15 years postoperatively (74% vs 52%, p = 0.018). Conclusion We concluded that there was not a substantial difference at almost any time in the outcome of cemented Charnley LFAs compared with hybrid THAs when treating patients with OA of the hip secondary to CHD. We believe, however, that after improvements in the design of components used in hybrid THA, this could be the method of choice, as it is technically easier with a shorter operating time. Cite this article: Bone Joint J 2019;101-B:1050–1057.

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Persistent abnormal muscle response after microvascular decompression for hemifacial spasm

Scientific Reports ◽

10.1038/s41598-020-75742-x ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Li Xu ◽

Wu Xu ◽

Jing Wang ◽

Yulong Chong ◽

Weibang Liang ◽

...

Keyword(s):

Hemifacial Spasm ◽

Microvascular Decompression ◽

Duration Of Symptoms ◽

Long Term Outcome ◽

Muscle Response ◽

Abnormal Muscle Response ◽

Significant Difference ◽

Group A ◽

Group B

Abstract To explore the causes of persistent abnormal muscle response (AMR) after microvascular decompression (MVD) for hemifacial spasm (HFS) and the clinical outcomes of these patients. MVDs performed in Nanjing Drum Tower Hospital in 2017 were retrospectively studied, and 326 patients with HFS were classified into two groups based on whether AMR disappeared or persisted following MVD. The clinical features, treatment efficacy and postoperative complications were compared between the two groups. 305 patients with disappeared AMR after decompression were classified as Group A. In Group B, the 21 patients exhibited persistent AMR after successful MVD. The preoperative duration of symptoms in Group B was significantly longer than that in Group A (P < 0.001), and no significant difference was identified between the two groups in terms of gender, side, age and offending vessels (P > 0.05). The immediate postoperative cure rate of Group A (88.9%)was significantly higher than that in Group B (28.6%, P < 0.001), furthermore, the two groups were not different in the long-term outcome and the incidence of surgical complications (P > 0.05). The long preoperative duration of HFS patients may account for persistent AMR after successful decompression, and it is more likely for these patients to get delayed cured, the long-term outcomes showed no difference compared to those in patients with disappeared AMR after MVD.

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Uncomplicated moderate coronary artery dissections after balloon angioplasty: good outcome without stenting

Heart ◽

10.1136/hrt.86.2.193 ◽

2001 ◽

Vol 86 (2) ◽

pp. 193-198

Author(s):

M Albertal ◽

G Van Langenhove ◽

E Regar ◽

I P Kay ◽

D Foley ◽

...

Keyword(s):

Adverse Events ◽

Balloon Angioplasty ◽

Major Adverse Cardiac Events ◽

Cardiac Events ◽

Term Outcome ◽

Long Term Outcome ◽

Adverse Cardiac Events ◽

Group A ◽

Group B

OBJECTIVETo study the relation between moderate coronary dissections, coronary flow velocity reserve (CFVR), and long term outcome.METHODS523 patients undergoing balloon angioplasty and sequential intracoronary Doppler measurements were examined as part of the DEBATE II trial (Doppler endpoints balloon angioplasty trial Europe). After successful balloon angioplasty, patients were randomised to stenting or no further treatment. Dissections were graded at the core laboratory by two observers and divided into four categories: none, mild (type A-B), moderate (type C), severe (types D to F). Patients with severe dissections (n = 128) or without available reference vessel CFVR (n = 139) were excluded. The remaining 256 patients were divided into two groups according to the presence (group A, n = 45) or absence (group B, n = 211) of moderate dissection.RESULTSFollowing balloon angioplasty, there was no difference in CFVR between the two groups. At 12 months follow up, a higher rate of major adverse cardiac events was observed overall in group A than in group B (10 (22%)v 23 (11%), p = 0.041). However, the risk of major adverse events was similar in the subgroups receiving balloon angioplasty (group A, 6 (19%) v group B, 16 (16%), NS). Among group A patients, the adverse events risk was greater in those randomised to stenting (odds ratios 6.603v 1.197, p = 0.046), whereas there was no difference in risk if the group was analysed according to whether the CFVR was < 2.5 or ⩾ 2.5 after balloon angioplasty.CONCLUSIONSModerate dissections left untreated result in no increased risk of major adverse cardiac events. Additional stenting does not improve the long term outcome.

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BT-7 Long-term outcome and late adverse effects of intracranial primary germ cell tumor

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab159.105 ◽

2021 ◽

Vol 3 (Supplement_6) ◽

pp. vi27-vi27

Author(s):

Mitsuto Hanihara ◽

Tomoyuki Kawataki ◽

Ryu Saito ◽

Masakazu Ogiwara ◽

Hiroyuki Kinouchi

Keyword(s):

Physical Activity ◽

Radiation Therapy ◽

Germ Cell ◽

Late Complications ◽

Cell Tumor ◽

Term Outcome ◽

Long Term Outcome ◽

Group A ◽

Group B

Abstract Background: Current standard of care for intracranial germ cell tumor (IGCT) have favorable cure rates. However, long-term treatment-related adverse event data are limited. The present study examined the long-term outcome of IGCT.Methods: The data from 27 patients with IGCT treated at our institutes from 1993 to 2020 were retrospectively analyzed. The patients were divided into two groups: group A; who received whole-ventricle RT (30 Gy) or focal RT (40-50Gy) from 1993 to 2012, group B; who received whole-ventricle RT (23.4 Gy) from 2013 to 2020. Complications and physical-activity level after treatment were retrospectively analyzed.Results: Pathological diagnosis was germinoma in all cases, and chemotherapy was CARE in 19 cases and ICE in 2 cases. Radiation therapy was performed in 15 cases in group A and 6 cases in group B. The follow-up period was 8–19 years (mean 11.3 years) in group A and 0.4–7 years (mean 3.6 years) in group B. Radiological cure was obtained in all cases, there was no recurrence. Hypopituitarism requiring hormone replacement therapy was observed in 53% of patients in group A and 50% of patients in group B. Late complications were cerebral hemorrhage from venous malformation (4 years after treatment), symptomatic cerebral atrophy in 2 cases (3 years / 6 years after treatment), radiation induced malignant glioma (19 years after treatment) in group A. The rate of good physical-activity was 71% of group A and 100% of group B.Discussion/Conclusions: CARE + whole-ventricle radiation therapy is appropriate as a standard treatment for ICGT. Late complications are directly linked to poor quality of life and may be radiation dose dependent. Optimize radiation therapy to further improve outcomes is required.

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SP1.2.5Robot-assisted Colorectal Surgery: Short-term Outcome of First 70 cases at Different Time-intervals along the Learning Curve

British Journal of Surgery ◽

10.1093/bjs/znab361.016 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Sandeep Singh ◽

William Rea ◽

Shaun Nai ◽

Tamas Sollei ◽

Neil Kukreja ◽

...

Keyword(s):

Colorectal Surgery ◽

Learning Curve ◽

Operating Time ◽

Total Duration ◽

Time Intervals ◽

Term Outcome ◽

Female Ratio ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Aim To analyse the evolution of robot-assisted colorectal surgery (RACS). Methods All the patients who underwent RACS between June 2018 and December 2020 were selected. Study period was divided into 3 intervals along the learning curve; group A represents the 1st 10 months, group B 2nd 10 and group C last 11. Results Over the 31-month study period, 70 RACS were performed. Male to female ratio was 4:3, with mean age of 66 years and BMI 28.7. ASA score was reported as 1-2 in 65% patients and 35% as 3. Indication was malignancy for 89% patients and the remainder benign pathology. High or low anterior resection performed were 72%, right hemicolectomies 21%, Hartmann’s 3%, abdominoperineal resections 3%, and left hemicolectomy 1%. RACS performed in group A was 20 compared to 19 in B and 31 C. Type of RACS performed, BMI, ASA, complications, anastomotic leaks, R0 resections and harvested lymph nodes were unrelated to selected time-intervals along learning curve. Mean total duration of procedure dropped down to 247 minutes in group C from 375 in group A (p = <0.001). No significant difference in mean length of stay and readmission rate was observed in 3 groups (p = 0.7, p = 0.59). Conclusion The study demonstrates that introduction of this new surgical technique is safe even in the early phase of adoption with no significant difference in pre-and post-operative morbidities. Significant difference in time taken for surgery was observed with reduction of 88 minutes in average operating time between the start and end of the study.

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Management of fresh odontoid fractures using posterior C1–2 fixation without fusion: a long-term clinical follow-up study

Journal of Neurosurgery Spine ◽

10.3171/2021.9.spine21822 ◽

2021 ◽

pp. 1-11

Keyword(s):

Scale Score ◽

Neck Disability Index ◽

Implant Removal ◽

Odontoid Fractures ◽

Significant Difference ◽

Flexion Extension ◽

Group A ◽

Group B

OBJECTIVE Posterior C1–2 fixation without fusion makes it possible to restore atlantoaxial motion after removing the implant, and it has been used as an alternative technique for odontoid fractures; however, the long-term efficacy of this technique remains uncertain. The purpose of the present study was to explore the long-term follow-up outcomes of patients with odontoid fractures who underwent posterior C1–2 fixation without fusion. METHODS A retrospective study was performed on 62 patients with type II/III fresh odontoid fractures who underwent posterior C1–2 fixation without fusion and were followed up for more than 5 years. The patients were divided into group A (23 patients with implant removal) and group B (39 patients without implant removal) based on whether they underwent a second surgery to remove the implant. The clinical outcomes were recorded and compared between the two groups. In group A, the range of motion (ROM) of C1–2 was calculated, and correlation analysis was performed to explore the factors that influence the ROM of C1–2. RESULTS A solid fracture fusion was found in all patients. At the final follow-up, no significant difference was found in visual analog scale score or American Spinal Injury Association Impairment Scale score between the two groups (p > 0.05), but patients in group A had a lower Neck Disability Index score and milder neck stiffness than did patients in group B (p < 0.05). In group A, 87.0% (20/23) of the patients had atlantoodontoid joint osteoarthritis at the final follow-up. In group A, the C1–2 ROM in rotation was 6.1° ± 4.5° at the final follow-up, whereas the C1–2 ROM in flexion-extension was 1.8° ± 1.2°. A negative correlation was found between the C1–2 ROM in rotation and the severity of tissue injury in the atlantoaxial region (r = –0.403, p = 0.024) and the degeneration of the atlantoodontoid joint (r = –0.586, p = 0.001). CONCLUSIONS Posterior C1–2 fixation without fusion can be used effectively for the management of fresh odontoid fractures. The removal of the implant can further improve the clinical efficacy, but satisfactory atlantoaxial motion cannot be maintained for a long time after implant removal. A surgeon should reconsider the contribution of posterior C1–2 fixation without fusion and secondary implant removal in preserving atlantoaxial mobility for patients with fresh odontoid fractures.

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Early Aneurysm Surgery and Preventive Therapy with Intravenously Administered Nimodipine: A Multicenter, Double-Blind, Dose-Comparison Study

Neurosurgery ◽

10.1227/00006123-199003000-00013 ◽

1990 ◽

Vol 26 (3) ◽

pp. 458-464 ◽

Cited By ~ 42

Author(s):

Joachim M. Gilsbach ◽

Hans J. Reulen ◽

Bengt Ljunggren ◽

Lennart Brandt ◽

Hans v. Holst ◽

...

Keyword(s):

Preventive Therapy ◽

Neurological Dysfunction ◽

Comparison Study ◽

Double Blind ◽

Term Outcome ◽

Long Term Outcome ◽

Dose Comparison ◽

Significant Difference ◽

Low Incidence

Abstract A European, multicenter. prospective, randomized. double-blind, dose-comparison study on preventive therapy with intravenously administered nimodipine was performed to evaluate the efficacy and tolerability of two different doses: 2 and 3 mg/h. Two hundred four patients fulfilled the criteria for enrollment in the study; surgery within 72 hours after the last subarachnoid hemorrhage, and age between 16 and 72 years. All patients who had Hunt and Hess grades of I to III were operated upon: patients who had poor Hunt and Hess grades (IV-V) were operated on according to the surgeon's choice. This treatment regimen was associated with a low incidence of delayed neurological dysfunction with no significant difference between the two dosage groups: three patients (1.5%) remained severely disabled and two (1%) moderately disabled due to vasospasm with or without additional complications. Among the patients with Hunt and Hess grades of IV or V. the long-term outcome was favorable (good-fair) for 40% and unfavorable for 60%. Among the patients with grades of I to III, the long-term outcome was favorable for 89% and unfavorable for 11%.

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Frictional Characteristics of the Newer Low-friction Elastomeric Ligatures

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1137 ◽

2016 ◽

Vol 6 (1) ◽

pp. 19-23

Author(s):

Amol Mhatre ◽

VK Ravindranath ◽

Sachin Doshi ◽

Girish Karandikar ◽

PS Vivek

Keyword(s):

Testing Machine ◽

Frictional Resistance ◽

Minimal Amount ◽

New Delhi ◽

Low Friction ◽

Significant Difference ◽

Group A ◽

Group B ◽

New Generation

ABSTRACT Aim The aim of this in vitro study was to investigate the efficiency of the new generation of elastomeric ligatures with innovative designs (SlideTM and AlastiKTM Easy-to-Tie) in reducing frictional resistance (FR) during sliding mechanics as compared with conventional ligatures. Materials and Methods Sixty ligature samples divided into four groups were used for the study. Group A: QuiK-StiK™ (3M Unitek, Monrovia, CA, USA), Group B: AlastiK™ Easy-to-Tie (3M Unitek, Monrovia, CA, USA), Group C: Slide™ (Leone, Firenze, Italy), and Group D: SS ligatures 0.010” (Libral Traders, New Delhi, India). Universal Testing Machine, Instron was used for measuring FR at the bracket-wire interface. Results There was statistically significant difference in FR among all the four groups of ligatures tested (p < 0.001). Slide ligatures produced the least amount of FR followed by SS ligatures, Easy-to-Tie, and QuiK-StiK in the increasing order of the FR values registered. Conclusion SlideTM ligatures may represent a valid alternative to passive self-ligating brackets when minimal amount of friction is desired. Angulation introduced into the elastomeric ligatures reduces the friction in comparison to conventional elastomeric ligatures. How to cite this article Vivek PS, Ravindranath VK, Karandikar G, Doshi S, Mhatre A, Sonawane M. Frictional Characteristics of the Newer Low-friction Elastomeric Ligatures. J Contemp Dent 2016;6(1):19-23.

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The Impact of Visual Aids on the Retention of English Word Stress Patterns

International Journal of Applied Linguistics & English Literature ◽

10.7575/aiac.ijalel.v.7n.2p.225 ◽

2018 ◽

Vol 7 (2) ◽

pp. 225 ◽

Cited By ~ 1

Author(s):

Farid Ghaemi ◽

Fahimeh Rafi

Keyword(s):

English Word ◽

Placement Test ◽

Visual Aids ◽

Word Stress ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Impact ◽

Stress Patterns

The present study aimed at comparing the effectiveness of three different techniques on learners’ long term memorization of English word stress patterns. After administering a quick placement test, 67 Iranian EFL elementary learners at language institutes were selected to participate in the study. Then they were divided into three groups. Before starting the instruction, a pretest was conducted to classify the participants’ abilities on word stress patterns. Then the new techniques were used to teach English word stress patterns. In all three groups, words were printed largely on a piece of paper and the syllables were clearly specified by dots. In group ‘A’, pronunciation and stress pattern of new words were taught aurally through the repetition of the words. In group ‘B’, all the procedure was exactly similar to that of group ‘A’, the only difference was that the stressed syllables were printed in bold. In group ‘C’, all the procedure was exactly similar to that of group ‘B’, except that the stressed syllables were not only printed in bold, but also introduced by teacher’s hand gesture. After two weeks, a delayed posttest was conducted to check long term memorization of the word stress patterns. The results of the study indicated that there was a significant difference between pretest and delayed posttest in all three groups. But the most meaningful difference belonged to group ‘C’. That is, the participants in the third group (gesture group) outperformed those in the other groups. Finally, some implications and suggestions provided for further research.

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Hypospadias: clinical approach, surgical technique and long-term outcome

BMC Pediatrics ◽

10.1186/s12887-021-02941-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Pier Luca Ceccarelli ◽

Laura Lucaccioni ◽

Francesca Poluzzi ◽

Anastasia Bianchini ◽

Diego Biondini ◽

...

Keyword(s):

Functional Outcome ◽

Surgical Repair ◽

Adult Life ◽

Clinical Approach ◽

Term Outcome ◽

Long Term Outcome ◽

Initial Surgery ◽

Significant Difference ◽

Corrective Procedures

Abstract Background Hypospadias is one of the most common congenital abnormalities in male newborn. There is no universal approach to hypospadias surgical repair, with more than 300 corrective procedures described in current literature. The reoperation rate within 6–12 months of the initial surgery is most frequently used as an outcome measure. These short-term outcomes may not reflect those encountered in adolescence and adult life. This study aims to identify the long-term cosmetic, functional and psychosexual outcomes. Methods Medical records of boys who had undergone surgical repair of hypospadias by a single surgical team led by the same surgeon at a single centre between August 2001 and December 2017 were reviewed. Families were contacted by telephone and invited to participate. Surgical outcome was assessed by combination of clinical examination, a life-related interview and 3 validated questionnaires (the Penile Perception Score-PPS, the Hypospadias Objective Score Evaluation-HOSE, the International Index of Erectile Function-5-IIEF5). Outcomes were compared according to age, severity of hypospadias, and respondent (child, parent and surgeon). Results 187 children and their families agreed to participate in the study. 46 patients (24.6%) presented at least one complication after the repair, with a median elapsed time of 11.5 months (6.5–22.5). Longitudinal differences in surgical corrective procedures (p < 0.01), clinical approach (p < 0.01), hospitalisation after surgery (p < 0.01) were found. Cosmetic data from the PPS were similar among children and parents, with no significant differences in child’s age or the type of hypospadias: 83% of children and 87% of parents were satisfied with the cosmetic result. A significant difference in functional outcome related to the type of hypospadias was reflected responses to HOSE amongst all groups of respondents: children (p < 0.001), parents (p=0.02) and surgeon (p < 0.01). The child’s HOSE total score was consistently lower than the surgeon (p < 0.01). The HOSE satisfaction rate on functional outcome was 89% for child and 92% for parent respondents. Conclusion Surgeons and clinicians should be cognizant of the long-term outcomes following hypospadias surgical repair and this should be reflected in a demand for a standardised approach to repair and follow-up.

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