scholarly journals Straight stem and threaded cup in patients under 60 years of age. 28.8-30.2 years of follow-up

2020 ◽  
Author(s):  
Lorenz Pisecky ◽  
Jakob Allerstorfer ◽  
Bernhard Schauer ◽  
Günter Hipmair ◽  
Rainer Hochgatterer ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Young Patients ◽  
Septic Loosening ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Straight Stem ◽  
Total Wear

Abstract Purpose: The aim of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup.Methods:Between 1986 and 1987, 75 hips of 75 patients (mean age: 53.35±6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. 44 patients had died over the last 30 years. The remaining 31 patients (mean age: 82.9±6.4years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out.Results: At a mean follow-up of 29.5 (28.8-30.2), 4 patients (5.3%) were lost to follow up.For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner, caused by wear. The average time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revison surgery were septic loosening (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), total wear of liner including cup (1 case).Conclusion: The combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-longterm follow up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.

scholarly journals Straight stem and threaded cup in patients under 60 years of age: 28.8–30.2 years of follow-up

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
L. Pisecky ◽  
J. Allerstorfer ◽  
B. Schauer ◽  
G. Hipmair ◽  
R. Hochgatterer ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Young Patients ◽  
Septic Loosening ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Straight Stem ◽  
Long Term Follow Up

Abstract Purpose The aim of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup. Methods Between 1986 and 1987, 75 hips of 75 patients (mean age, 53.35 ± 6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. Forty-four patients had died over the last 30 years. The remaining 31 patients (mean age, 82.9 ± 6.4 years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out. Results At a mean follow-up of 29.5 (28.8–30.2), 4 patients (5.3%) were lost to follow-up. For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner, caused by wear. The average time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revision surgery were septic loosening (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), and total wear of liner including cup (1 case). Conclusion The combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-long-term follow-up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.

scholarly journals Straight stem and threaded cup total hip arthroplasty systems in patients under 60 years of age: outdated or still a benchmark? A report on a cohort of 75 patients after 28.8-30.2 years of follow-up

2020 ◽  
Author(s):  
Lorenz Pisecky ◽  
Jakob Allerstorfer ◽  
Bernhard Schauer ◽  
Günter Hipmair ◽  
Rainer Hochgatterer ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Hip Arthroplasty ◽  
Aseptic Loosening ◽  
Hip Arthroplasty ◽  
Young Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Total Hip ◽  
Straight Stem

Abstract Purpose: The goal of this retrospective observational study of one cohort was to evaluate the long-term outcome in patients younger than 60 years after total hip arthroplasty using a straight uncemented stem and an uncemented threaded cup. Methods: Between 1986 and 1987, 75 hips of 75 patients (mean age: 53.35±6.17 years) were consecutively implanted with an Alloclassic Zweymüller/Alloclassic SL stem and an Alloclassic CSF cup. 44 patients had died over the last 30 years. The remaining 31 patients (mean age: 82.9±6.4years) were reinvited for follow-up examinations. Clinical and radiographic evaluations were carried out. Results: At a mean follow-up of 29.5 (28.8-30.2), 4 patients (5.3%) were lost to follow up. For the endpoint aseptic loosening (defined as the removal of stem or the cup for 2 cases), the overall survival rate is 97.3%. For the endpoint revision for any reason (22 patients), the survival rate is 70.6%. Eleven patients needed an exchange of head and liner due to wear. The mean time from implantation until change of head and liner was 21.44 years (SD 5.92). Other reasons for revisons were septic loosenings (3 cases), aseptic loosening of stem and cup (1 case), aseptic loosening of stem (1 case), periprosthetic calcification (2 cases), implant fracture (1 case), periprosthetic fracture (1 case), intraoperative fissure of stem (1 case), total wear of liner including cup (1 case). Conclusion: The combination of a straight stem (Alloclassic) and a screw cup (CSF) shows excellent results in young patients under the age of 60 at ultra-longterm follow up at 30 years. Revisions due to wear of the polyethylene liner are more likely than in the older patients.

Aortic Valve–Sparing Root Replacement (David I Procedure) in Adolescents: Long-Term Outcome

2019 ◽  
Author(s):  
Erik Beckmann ◽  
Andreas Martens ◽  
Heike Krueger ◽  
Wilhelm Korte ◽  
Tim Kaufeld ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Connective Tissue Diseases ◽  
Young Patients ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Initial Surgery ◽  
Valve Sparing

Introduction Aortic valve-sparing root replacement (David's procedure) is an especially appealing treatment option for young patients. Here, we present the short-, mid, and long-term outcomes of this operation in adolescent patients. Methods Between September 1994 and March 2014, 29 patients aged 6 to 21 years underwent the David-I procedure at our center. We conducted a retrospective study with follow-up. Results The mean age was 16.8 ± 3.4 years and 90% (n = 26) were male. Marfan's syndrome was present in 86% (n = 25) of cases. Ninety-seven percent (n = 28) of cases were performed electively, and one case (3%) was performed emergently for acute aortic dissection type A. There were no early perioperative deaths (0%). Follow-up, which was completed on 100% of patients, comprised a total of 394 patient years and a mean follow-up time of 13.6 ± 5.4 years. The estimates for survival at 1, 5, and 10 years after initial surgery were 100, 97, and 93%, respectively. During follow-up, there were four (14%) late deaths and five (17%) aortic valve-related reoperations. The 1-, 5-, and 10-year estimates for freedom from valve-related reoperation were 100, 86, and 83%, respectively. The perioperative mortality for these five reoperations was 0%. Discussion Aortic valve–sparing root replacement can be performed in adolescents with a very low perioperative risk. Long-term survival seems to be affected by connective tissue diseases.

NCOG-10. RADIATION THERAPY CAN BE SAFELY DEFERRED IN OLIGODENDROGLIOMAS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi153-vi154
Author(s):  
Alexis Demopoulos ◽  
Jonathan Knisely
Keyword(s):  
Radiation Therapy ◽  
Management Practice ◽  
Young Patients ◽  
Memory Loss ◽  
Progression Free Survival ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome

Abstract Deferring multimodal aggressive therapies in young patients to delay treatment-induced toxicity without jeopardizing long-term outcome would be of great benefit to our patients. After IRB approval, we retrospectively reviewed 80 confirmed IDH mutant and 1p19q codeleted oligodendrogliomas treated at one institution between 2005 and 2020. Median follow-up was 5 (range 1-26) years. All patients underwent maximal safe resection, followed by observation with routine imaging (n=28), chemotherapy alone (n=27), or radiation with chemotherapy (n=25) as initial upfront therapy. Median progression free survival was 36 (range 1-203), 54 (range 1-306), and 57 (range 4-281) months, respectively. Median overall survival was not reached, with 85% (67/80) alive, 8 on treatment and 59 stable off therapy. Among 35 patients who died or were followed for 10 years, median PFS was 12, 15, and 10 years for observation (n=9), chemotherapy (n=11) and chemoradiotherapy (n=15), with deaths or KPS below 50 in 3, 6, and 8, respectively. Three deaths in the observation group occurred 12, 12 and 17 years after diagnosis; one at 95 years old and another tumor-unrelated. Among 44 patients eventually receiving radiation, 15 suffered toxicity, including pathologically proven necrosis (n=6), cognitive decline with KPS< 50 (n=5), memory loss with KPS > 50 (n=3), and optic neuropathy (n=1). Myelosuppression from PCV was more pronounced after chemoradiation than in the upfront setting. Temozolomide after PCV chemotherapy was well tolerated. Long term follow-up of oligodendroglioma patients is challenging, but essential in determining late toxicities and treatment efficacy. Long-term results of European and North American multicenter cooperative group trials contradicted earlier publications reporting no benefit from early chemotherapy. Some management practice guidelines established a half-century ago persist (i.e., administer radiation therapy early), despite potentially crippling late effects. Deferring upfront radiation therapy is safe, less toxic, and equally efficacious in codeleted oligodendrogliomas.

Long-term outcome of breast cancer patients diagnosed ≤40 years according to breast cancer subtype in the absence of adjuvant systemic therapy: The PARADIGM initiative.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 535-535
Author(s):  
Gwen Dackus ◽  
Natalie D ter Hoeve ◽  
Mark Opdam ◽  
Willem Vreuls ◽  
Esther A Koop ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Systemic Treatment ◽  
Young Patients ◽  
Breast Cancer Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Adjuvant Systemic Treatment

535 Background: Young age at breast cancer diagnosis is considered a poor prognostic factor. As a result, many treatment guidelines advice adjuvant systemic treatment for young patients. Answering prognostic questions on young patients has therefore become a challenge. The PARADIGM (PAtients with bReast cAncer DIaGnosed preMenopausally) project aims to assess the long-term outcome of women diagnosed with breast cancer ≤40 years in the absence of adjuvant systemic therapy, using real world data from the nationwide Netherlands Cancer Registry (NCR) coupled with tissue biobanking. Methods: All women ≤40 years, diagnosed in the Netherlands between 1989-2000 with a primary invasive, histologically proven, TanyN0M0 breast cancer, without adjuvant systemic treatment were identified through the NCR. Back then N0 patients were considered low risk and did not receive adjuvant systemic treatment. Tissue specimens were revised by a team of dedicated breast pathologists. Cox regression was performed to estimate hazard ratios for recurrence-free (RFS) and overall survival (OS) according to immunohistochemical (IHC) subtype. Analyses were adjusted for grade, pathological T-stage, histological subtype and radiotherapy. Results: We included 2310 patients with a mean follow-up of 15.4 years (range 0-25 years). OS for the whole cohort was 68% and RFS 58.4% at 25 years. In total 740 deaths and 1043 recurrences were observed. Hormone receptor (HR)+/HER2+ patients had a significantly worse OS when compared to HR-HER2+ patients (adjusted Hazard Ratio 1.58; 95% confidence interval 1.05-2.38; p=0.029). No difference was observed between HR-HER2+ and the triple negative and HR+/HER2- subgroups at 25-years. RFS was similar for all IHC subtypes. Conclusions: In this large cohort of non-adjuvant systemically treated young breast cancer patients with long-term follow-up HR+/HER2+ patients have a significantly worse survival when compared to triple negative, HR-/HER2+ and HR+/HER2- patients. The latter three subtypes have similar OS at 25 years. Future molecular studies have been planned to distinguish the favorable from the unfavorable prognostic patients.

scholarly journals Two-Staged Implant-Based Breast Reconstruction: A Long-Term Outcome Study in a Young Population

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 481 ◽  
Author(s):  
Oscar J. Manrique ◽  
Ali Charafeddine ◽  
Amjed Abu-Ghname ◽  
Joseph Banuelos ◽  
Steven R. Jacobson ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Young Patients ◽  
Retrospective Chart Review ◽  
Roc Curves ◽  
Adjuvant Radiation ◽  
Obese Women ◽  
Term Outcome ◽  
Long Term Outcome

Background and objectives: Differences in patient anatomy and physiology exist between young and older patients undergoing breast reconstruction after mastectomy. Breast cancer has been described as being more aggressive, more likely to receive radiation, contralateral mastectomy, as well as bilateral reconstruction in young patients. Our purpose is to report long-term experience on two-staged implant-based breast reconstruction (IBR) in young females, with complication sub-analysis based on obesity and adjuvant radiation. Materials and Methods: Retrospective chart review of all consecutive young patients who underwent two-staged IBR at our institution, between 2000 and 2016, was performed. Patients between 15 and 40 years old with least 1-year follow-up were included. Univariate logistic regression models and receiver operating characteristic (ROC) curves were created. Results: Overall 594 breasts met our inclusion criteria. The mean age was 34 years, and the median follow-up was 29.6 months. Final IBR was achieved in 98% of breasts. Overall, 12% of breasts had complications, leading to explantations of 5% of the devices. Adjuvant radiation was followed by higher rates of total device explantations (p = 0.003), while obese patients had higher rates of total complications (p < 0.001). For each point increase in BMI, the odds of developing complications increased 8.1% (p < 0.001); the cutoff BMI to predict higher complications was 24.81 kg/m2. Conclusions: This population demonstrates high successful IBR completion and low explantation rates. These data suggest that obese women and those with planned adjuvant radiation deserve special counseling about their higher risk of complications.

Review of a 13-Year Single-Center Experience with Minimally Invasive Direct Coronary Artery Bypass as the Primary Surgical Treatment of Coronary Artery Disease

2012 ◽  
Vol 15 (2) ◽  
pp. 61 ◽  
Author(s):  
David M. Holzhey ◽  
Jan P. Cornely ◽  
Ardawan J. Rastan ◽  
Piroze Davierwala ◽  
Friedrich W. Mohr
Keyword(s):  
Coronary Artery ◽  
Survival Rate ◽  
Minimally Invasive ◽  
Artery Bypass ◽  
Postoperative Mortality ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome

<p><b>Background and Aim of the Study:</b> In this study, we review our experience with 1768 minimally invasive direct coronary artery bypass (MIDCAB) operations. The focus is on long-term outcome with more than 10 years of follow-up.</p><p><b>Methods:</b> All patients undergoing standard MIDCAB between 1996 and 2009 were included. For all 1768 patients, pre-, intra-, and postoperative data could be completed. Long-term follow-up information about health status, major adverse cardiac and cerebrovascular events (MACCE), and freedom from angina was collected annually via questionnaire or personal contact. Five-year follow-up is available for 1313 patients, and 10-year-follow-up is available for 748 patients. A multivariate Cox regression analysis was performed to determine risk factors for long-term outcome.</p><p><b>Results:</b> Mean age was 63.4 � 10.8 years, mean ejection fraction was 60.0% � 14.2%, and perioperative mortality risk calculated by logistic EuroSCORE was 3.8 � 6.2%. In 31 patients (1.75%) intraoperative conversion to sternotomy was necessary. Early postoperative mortality was 0.8% (15 patients); 0.4% (7 patients) had a perioperative stroke. Seven hundred twelve patients received routine postoperative angiogram, showing 95.5% early graft patency. Short-term target vessel reintervention was needed in 59 patients (3.3%) (11 percutaneous transluminal coronary angioplasty (PTCA)/stent, 48 re-operation). Kaplan-Meyer analysis revealed a 5-year survival rate of 88.3% (95% confidence interval [CI], 86.6% to 89.9%) and a 10-year-survival rate of 76.6% (95% CI, 73.5% to 78.7%). The freedom from MACCE and angina after 5 and 10 years was 85.3% (95% CI, 83.5% to 87.1%) and 70.9% (95% CI, 68.1% to 73.7%), respectively.</p><p><b>Conclusions:</b> MIDCAB is a safe operation with low postoperative mortality and morbidity. With excellent short-term and long-term results, it is a very good alternative compared to both percutaneous coronary intervention (PCI) and conventional surgery.</p>

Course and long-term outcome of ’refractory’ secretory otitis media

2005 ◽  
Vol 119 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Marie Ryding ◽  
Peter White ◽  
Olof Kalm
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Young Patients ◽  
Secretory Otitis Media ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ventilation Tubes ◽  
One Year

Objective: The course and the long-term outcome of ’refractory’ secretory otitis media (SOM), defined as continuous SOM for more than 6 years, were studied in 52 young patients. They had during childhood been treated for bilateral SOM on average for 12 years (range 6 to 26 years). The mean interval between resolution of SOM and examination was 7 years.Methods: At follow up the patients’ medical records were scrutinized with regards to transmyringeal ventilation tubes, adenoidectomy, sequelae and complications, and a questionnaire was filled in to document other diseases.Results: The onset of SOM showed two peaks, one at the age of one year and one at the age of 3.5 years. Patients whose onset of SOM was related to an episode of acute otitis media (AOM) were younger at SOM onset than those who had no such relation. Otorrhoea and AOM episodes were more frequent during the SOM periods, with blocked or expelled tubes, than during periods with patent tubes. Cholesteatoma were seen in 3 per cent and perforations in 5 per cent of patients.Conclusions: Extremely long-standing SOM does not necessarily result in myringeal perforation or cholesteatoma to a greater extent than that seen in patients with shorter durations of SOM. However, at follow up one-third of the patients reported hearing impairment and a majority felt discomfort when flying or diving.

scholarly journals P147 Progression to biologic treatment in very early onset inflammatory bowel disease patients- a long term follow up retrospective study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S229-S230
Author(s):  
A Eindor ◽  
L Meleady ◽  
K Jacobson
Keyword(s):  
Young Patients ◽  
Biologic Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disease Characteristics ◽  
Kaplan Meier ◽  
Inflammatory Bowel ◽  
Disease Location

Abstract Background Very early onset inflammatory bowel disease (VEOIBD) prevalence has been increasing over the last decades. These young patients have been known to have special disease characteristics and disease location. Although it is known that only a low percentage of these patients require biologic treatment after diagnosis, there is only scarce evidence about their long- term outcome and biologic requirements. We aimed to assess the long term outcome of VEOIBD patients and the time of progression to biologic treatment. Methods We retrospectively reviewed IBD patients diagnosed under 6 years of age, between January 2005 and December 2019, from the British Columbia (BC) Pediatric IBD database. Demographic data, disease characteristics and symptoms at diagnosis were documented. The disease location and severity were documented according to the Paris classification. Data collected retrospectively until the last appointment recorded in the electronic medical records included whether the patient received biologic treatment at the time of follow up, the time to intiation of the treatment, the type of biologic treatment and response. Kaplan meier curves were used to asses the number of years to progression to biologic treatment and the parameters influencing it. Results 89 patients under the age of 6 were diagnosed with IBD during the study period. 3 patients failed to meet inclusion criteria and were excluded. Median age at diagnosis was 3.8 (IQR 2.6–5.1). 45.3% of patients had Crohn’s disease (CD) and 62.8% were males. Median time of follow up was 6.39 (IQR 3.71–10.55). 68.1% of the ulcerative colitis (UC) patients had pancolitis and 48.7% of CD patients had ileocolonic disease. 39.5% of patients were started on biologic treatment and 7.1% underwent surgery. Kaplan Meier curves demonstrated that patients diagnosed in the years 2012 -2019 had shorter duration of progression to biologics than those diagnosed 2005–2011 (p=0.0047). In patients with CD those with perianal or stricturing disease progressed faster to biologic treatment (p=0.024,p=0.038, respectively) and in UC patients those with high severity of disease (p=0.017). 63.6% of patients were reported to be on clinical remission on the biologic treatment. Conclusion Although VEOIBD patients have more extensive diseas, they require less biologic treatment than previously reported in older patients. Factors influencing shorter duration of progression to biologics were the severity of disease and behaviour and not disease location. Patients diagnosed more recently had shorter duration to biologic treatment which might reflect physicians perception on using biologic treatment in these young patients rather than disease severity.

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

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
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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