Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Aims Highly polished stems with force-closed design have shown satisfactory clinical results despite being related to relatively high early migration. It has been suggested that the minimal thickness of cement mantles surrounding the femoral stem should be 2 mm to 4 mm to avoid aseptic loosening. The line-to-line cementing technique of the femoral stem, designed to achieve stem press-fit, challenges this opinion. We compared the migration of a highly polished stem with force-closed design by standard and line-to-line cementing to investigate whether differences in early migration of the stems occur in a clinical study. Methods In this single-blind, randomized controlled, clinical radiostereometric analysis (RSA) study, the migration pattern of the cemented Corail hip stem was compared between line-to-line and standard cementing in 48 arthroplasties. The primary outcome measure was femoral stem migration in terms of rotation and translation around and along with the X-, Y-, and Z- axes measured using model-based RSA at three, 12, and 24 months. A linear mixed-effects model was used for statistical analysis. Results Results from mixed model analyses revealed a lower mean retroversion for line-to-line (0.72° (95% confidence interval (CI) 0.38° to 1.07°; p < 0.001), but no significant differences in subsidence between the techniques (-0.15 mm (95% CI -0.53 to 0.227; p = 0.429) at 24 months. Radiolucent lines measuring < 2 mm wide were found in three and five arthroplasties cemented by the standard and line-to-line method, respectively. Conclusion The cemented Corail stem with a force-closed design seems to settle earlier and better with the line-to-line cementing method, although for subsidence the difference was not significant. However, the lower rate of migration into retroversion may reduce the wear and cement deformation, contributing to good long-term fixation and implant survival. Cite this article: Bone Joint J 2022;104-B(1):19–26.

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Biomechanical evaluation of the primary stability of three different types of femoral stem fixations for canine total hip replacement

10.21203/rs.3.rs-86655/v1 ◽

2020 ◽

Author(s):

Charles Saban ◽

Eric Viguier ◽

Mathieu Taroni ◽

Arnaud Baldinger ◽

Margaux Blondel ◽

...

Keyword(s):

Femoral Stem ◽

Primary Stability ◽

Longitudinal Axis ◽

Transverse Displacement ◽

Salvage Procedure ◽

Total Hip ◽

Press Fit ◽

Femoral Stems ◽

Mean Strain

Abstract Background: Total hip arthroplasty is the main salvage procedure performed for hip osteoarthritis in dogs. Two main types of femoral stems are available: cemented stems, which offer excellent primary stability but are subject to aseptic loosening in the long term, and cementless stems, which have good long-term outcomes but lack primary stability. The adjunction of a neutral rod through the neck of the cementless stem to the lateral cortex of the femur could offer better primary stability before osteointegration. The aim of this study was to compare the primary stability of three different femoral stems, cemented (cFS), press-fit cementless (pfFS), and rod-press-fit cementless stems (r-pfFS), by measuring their transverse displacement on cyclic assays and resistance to subsidence with unidirectional load compression parallel to the longitudinal axis of the femur.Results: The force-displacement and stress-strain curves were assessed. The work necessary for subsidence, strain to failure, and mean strain of the cyclic assays were calculated. No significant differences were observed in transverse displacement (p=0.263) or mean strain (p=0.244) during the cyclic tests or in work necessary for subsidence (p=0.079) or strain to failure (p=0.075). The cFS and r-pfFS were significantly more resistant to subsidence than was the pfFS (p<0,05). No significant differences were observed between the cFS and r-pfFS groups (p=0.48).Conclusions: Cementless femoral stems with transfixing rods offer significantly higher stability to compressive load parallel to the longitudinal axis of the femur than do standard cementless stems and a level of stability comparable to that of cemented stems. r-pfFSs may be valuable in limiting the subsidence and micro-motion of press-fit femoral stems and thus improving the state of osteointegration of the prosthesis during the short-term postoperative period.

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Primary stability of a proximally coated and tapered stem

The Bone & Joint Journal ◽

10.1302/0301-620x.103b4.bjj-2020-1648.r1 ◽

2021 ◽

Vol 103-B (4) ◽

pp. 644-649

Author(s):

Joseph Alsousou ◽

Emeka Oragu ◽

Alexander Martin ◽

Louise Strickland ◽

Simon Newman ◽

...

Keyword(s):

Femoral Stem ◽

Primary Stability ◽

Mineral Density ◽

Term Outcome ◽

Long Term Outcome ◽

Early Migration ◽

Initial Stability ◽

Tapered Stem ◽

Five Dimension

Aims The aim of this prospective cohort study was to evaluate the early migration of the TriFit cementless proximally coated tapered femoral stem using radiostereometric analysis (RSA). Methods A total of 21 patients (eight men and 13 women) undergoing primary total hip arthroplasty (THA) for osteoarthritis of the hip were recruited in this study and followed up for two years. Two patients were lost to follow-up. All patients received a TriFit stem and Trinity Cup with a vitamin E-infused highly cross-linked ultra-high molecular weight polyethylene liner. Radiographs for RSA were taken postoperatively and then at three, 12, and 24 months. Oxford Hip Score (OHS), EuroQol five-dimension questionnaire (EQ-5D), and adverse events were reported. Results At two years, the mean subsidence of the head and tip for the TriFit stem was 0.38 mm (SD 0.32) and 0.52 mm (SD 0.36), respectively. The total migration of the head and tip was 0.55 mm (SD 0.32) and 0.71 mm (SD 0.38), respectively. There were no statistically significant differences between the three to 12 months' migration (p = 0.105) and 12 to 24 months' migration (p = 0.694). The OHS and EQ-5D showed significant improvements at two years. Conclusion The results of this study suggest that the TriFit femoral stem achieves initial stability and is likely to be stable in the mid and long term. A long-term outcome study is required to assess late mechanisms of failure and the effects of bone mineral density (BMD) related changes. Cite this article: Bone Joint J 2021;103-B(4):644–649.

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Six-year clinical outcomes of implant-supported acrylic vs. ceramic superstructures according to the All-on-4 treatment concept for the rehabilitation of the edentulous maxilla

Odontology ◽

10.1007/s10266-021-00605-4 ◽

2021 ◽

Author(s):

Mustafa Ayna ◽

Fatih Karayürek ◽

Søren Jepsen ◽

Marie Emmert ◽

Yahya Acil ◽

...

Keyword(s):

Bone Loss ◽

Clinical Outcomes ◽

Acrylic Resin ◽

Clinical Results ◽

Marginal Bone Loss ◽

Bleeding On Probing ◽

Related Quality ◽

Health Related ◽

The Difference

AbstractThe aim of the current study was to document the long-term clinical results of the use of two prosthetic techniques for the rehabilitation of completely edentulous maxillae according to the “All-on-Four” concept: Fixed, screw-retained prosthesis mounted on a chrome-molybdenum framework with (1) metal-ceramic veneers and (2) Acrylic prosthesis with acrylic resin prosthetic teeth. A total of 34 patients were assigned to subgroups according to their own preference of the superstructure type (ceramics [n: 17] or acrylic resin [n: 17]). Prosthetic complications, marginal bone loss, plaque accumulation, bleeding on probing, bite force and oral-health-related quality of life were assessed over a period of 6 years. Marginal bone loss around implants of the ceramic group remained well within the limits for ‘success’, as defined by the 2007 Pisa consensus over the time (1.43 ± 0.35 mm). However, marginal bone loss was significantly more pronounced around the implants in the acrylic group (2.15 ± 0.30) and the difference between two groups was statistically significant (p: 0.00). Bleeding on probing and plaque accumulation showed also positive correlation with marginal bone loss. Both acrylic and ceramic suprastructures appeared to be equivalent after 6 years; however, ceramic suprastructures revealed superior clinical results in terms of bone loss and plaque accumulation. Current study determines the long-term clinical outcomes of different prosthetic management alternatives in All-on-Four and aids to increase dental professionals’ ability to meet the patients’ expectations.

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Reduced Impact of Endovascular Thrombectomy on Disability in Real-World Practice, Relative to Randomized Controlled Trial Evidence in Australia

Frontiers in Neurology ◽

10.3389/fneur.2020.593238 ◽

2020 ◽

Vol 11 ◽

Author(s):

Lan Gao ◽

Elise Tan ◽

Marj Moodie ◽

Mark Parsons ◽

Neil J. Spratt ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Years Of Life Lost ◽

Endovascular Thrombectomy ◽

Survival Gain ◽

Randomized Controlled ◽

Significant Survival ◽

Life Years ◽

The Difference

Background and Aims: Disability-adjusted life years (DALYs) are an important measure of the global burden of disease that informs patient outcomes and policy decision-making. Our study aimed to compare the DALYs saved by endovascular thrombectomy (EVT) in the Australasian-based EXTEND-IA trial vs. clinical registry data from EVT in Australian routine clinical practice.Methods: The 3-month modified Rankin scale (mRS) outcome and treatment status of consecutively enrolled Australian patients with large vessel occlusion (LVO) stroke were taken from the International Stroke Perfusion Imaging Registry (INSPIRE). DALYs were calculated as the summation of years of life lost (YLL) due to premature death and years lived with a disability (YLD). A generalized linear model (GLM) with gamma family and log link was used to compare the difference in DALYs for patients receiving/not receiving EVT while controlling for key covariates. Ordered logit regression model was utilized to compare the difference in functional outcome at 3 months between the treatment groups. Cox regression analysis was undertaken to compare the difference in survival over an 18-year time horizon. Estimated long-term DALYs saved based on the EXTEND-IA randomized controlled trial (RCT) results were used as the comparator.Results: INSPIRE patients who received EVT treatment only achieved nominally better functional outcomes than the non-EVT group (p = 0.181) at 3 months. There was no significant survival gain from EVT over the first 3 months of stroke in both INSPIRE and EXTEND-IA patients. However, measured against no EVT in the long-term, EVT in INSPIRE was associated with no significant survival gain [hazard ratio (HR): 0.92, 95% confidence interval (CI): 0.78–1.08, p = 0.287] compared with the survival benefit extrapolated from the EXTEND-IA trial (HR: 0.42, 95% CI: 0.22–0.82, p = 0.01]. Offering EVT to patients with LVO stroke was also associated with fewer DALYs lost (11.04, 95% CI: 10.45–11.62) than those not receiving EVT in INSPIRE (12.13, 95% CI: 11.75–12.51), a reduction of −1.09 DALY (95% CI: −1.76 to −0.43, p = 0.002). The absolute magnitude of the treatment effect was lower than that seen in EXTEND-IA (−2.72 DALY reduction in EVT vs non-EVT patients).Conclusions: EVT for the treatment of LVO in a registry of routine care was associated with significantly lower DALYs lost than medical care alone, but the saved DALYs are less than those reported in clinical trials, as there were major differences in the baseline characteristics of the patients.

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Health-related quality of life of young adults with Turner syndrome following a long-term randomized controlled trial of recombinant human growth hormone

Yearbook of Endocrinology ◽

10.1016/j.yend.2011.08.002 ◽

2012 ◽

Vol 2012 ◽

pp. 322-323

Author(s):

E. Eugster

Keyword(s):

Quality Of Life ◽

Controlled Trial ◽

Recombinant Human Growth Hormone ◽

Human Growth ◽

Health Related Quality ◽

Randomized Controlled ◽

Related Quality ◽

Health Related

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Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽

10.1024/0301-1526.31.1.36 ◽

2002 ◽

Vol 31 (1) ◽

pp. 36-42 ◽

Cited By ~ 3

Author(s):

. Bucek ◽

Hudak ◽

Schnürer ◽

Ahmadi ◽

Wolfram ◽

...

Keyword(s):

Success Rate ◽

Clinical Stage ◽

Ankle Brachial Index ◽

Clinical Situation ◽

Clinical Results ◽

Transluminal Angioplasty ◽

Term Outcome ◽

Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

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Relationship between total plasma homocysteine and the risk of aneurysms – a meta-analysis

VASA ◽

10.1024/0301-1526/a000891 ◽

2020 ◽

pp. 1-6

Author(s):

Hanji Zhang ◽

Dexin Yin ◽

Yue Zhao ◽

Yezhou Li ◽

Dejiang Yao ◽

...

Keyword(s):

Large Scale ◽

Meta Analysis ◽

Single Species ◽

Total Plasma ◽

Control Groups ◽

Randomized Controlled ◽

Randomized Controlled Studies ◽

The Difference ◽

The Relationship ◽

Healthy Participants

Summary: Our meta-analysis focused on the relationship between homocysteine (Hcy) level and the incidence of aneurysms and looked at the relationship between smoking, hypertension and aneurysms. A systematic literature search of Pubmed, Web of Science, and Embase databases (up to March 31, 2020) resulted in the identification of 19 studies, including 2,629 aneurysm patients and 6,497 healthy participants. Combined analysis of the included studies showed that number of smoking, hypertension and hyperhomocysteinemia (HHcy) in aneurysm patients was higher than that in the control groups, and the total plasma Hcy level in aneurysm patients was also higher. These findings suggest that smoking, hypertension and HHcy may be risk factors for the development and progression of aneurysms. Although the heterogeneity of meta-analysis was significant, it was found that the heterogeneity might come from the difference between race and disease species through subgroup analysis. Large-scale randomized controlled studies of single species and single disease species are needed in the future to supplement the accuracy of the results.

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Reduction in hypoglycemia with the predictive low-glucose management system: a long-term randomized controlled trial in adolescents with T1DM

Yearbook of Paediatric Endocrinology ◽

10.1530/ey.15.10.6 ◽

2018 ◽

Cited By ~ 1

Author(s):

Abraham MB ◽

Nicholas JA ◽

Smith GJ ◽

Fairchild JM ◽

King BR ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Management System ◽

Controlled Trial ◽

Randomized Controlled ◽

System A ◽

Low Glucose ◽

Glucose Management

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A Problem of Long - Term Digital Preservation: Difference in Humanities and Natural Sciences

Bibliotheca Lituana ◽

10.15388/bibllita.2014.3.15570 ◽

2014 ◽

Vol 3 ◽

pp. 183-195

Author(s):

Elena Macevičiūtė

Keyword(s):

Social Sciences ◽

Digital Preservation ◽

Dynamic Activity ◽

Private Companies ◽

Time Line ◽

Digital Documents ◽

Whole Process ◽

The Difference ◽

Technological Science

The article deals with the requirements and needs for long-term digital preservation in different areas of scholarly work. The concept of long-term digital preservation is introduced by comparing it to digitization and archiving concepts and defined with the emphasis on dynamic activity within a certain time line. The structure of digital preservation is presented with regard to the elements of the activity as understood in Activity Theory. The life-cycle of digitization processes forms the basis of the main processing of preserved data in preservation archival system.The author draws on the differences between humanities and social sciences on one hand and natural and technological science on the other. The empirical data characterizing the needs for digital preservation within different areas of scholarship are presented and show the difference in approaches to long-term digital preservation, as well as differences in selecting the items and implementing the projects of digital preservation. Institutions and organizations can also develop different understanding of preservation requirements for digital documents and other objects.The final part of the paper is devoted to some general problems pertaining to the longterm digital preservation with the emphasis of the responsibility for the whole process of safe-guarding the cultural and scholarly heritage for the re-use of the posterior generations. It is suggested that the longevity of the libraries in comparison with much shorter life-span of private companies strengthens the claim of memory institutions to playing the central role in the long-term digital preservation.

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