Stem loosening more common with ITH than Lubinus prosthesis: A 5-year clinical and radiographic follow-up of 142 patients

This paper presents the case of a female patient who underwent eleven revision surgeries after primary hip arthroplasty due to infection and loosening of the stem and acetabulum. We decided that in order to save the limb, it was necessary to use a total femur prosthesis. Three years’ follow-up showed that the patient was satisfied with the outcome of the surgery.

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Cementless Primary or Revision Stem in the First-time Revision Hip Arthroplasty for Aseptic Stem Loosening? A Retrospective Comparative Study.

10.21203/rs.3.rs-812388/v1 ◽

2021 ◽

Author(s):

Fu-Yuan Pai ◽

Te-Feng Arthur Chou ◽

Hsuan-Hsiao Ma ◽

Wei-Lin Chang ◽

Shang-Wen Tsai ◽

...

Keyword(s):

Hip Arthroplasty ◽

Harris Hip Score ◽

Secondary Outcome ◽

Implant Survival ◽

Revision Stem ◽

Stem Loosening ◽

Revision Tha ◽

Primary Stem ◽

First Time

Abstract IntroductionThe use of primary or revision stem during the first-time revision total hip arthroplasty(THA) procedure for aseptic stem loosening remains controversial. The aim of this study was to compare the outcome of patients that underwent revision THA with a primary or revision stem.Materials and MethodsWe retrospectively reviewed 78 patients that received first-time revision THA for aseptic stem loosening using primary(N=28) or revision stems(N=50). The bone defects were classified as Paprosky type I or II. The mean follow-up duration was 72.3±34.7 months. The primary outcome domains included surgical complications and implant failures. The secondary outcome domains included medical complications, 30-day and 90-day readmission, and Harris hip score (HHS).ResultsThe use of revision stem was associated with higher incidence of patient having complications (60.0% vs. 32.1%, p=0.018), including intraoperative femur fracture (28.0% vs. 7.1%, p=0.029) and greater trochanter fracture (16.0% vs. 0%, p=0.045), compared with the use of primary stem. The implant survival was comparable in both groups. HHS at the final follow-up was similar.ConclusionWith a lower risk of surgical complication and similar mid-term implant survival, cementless primary stem might be a better alternative to revision stem in the first-time revision THA for aseptic stem loosening.

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Inadvertent, intraoperative, non- to minimally displaced periprosthetic humeral shaft fractures in RTSA do not affect the clinical and radiographic short-term outcome

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-03930-z ◽

2021 ◽

Author(s):

Anita Hasler ◽

Philipp Kriechling ◽

Caroline Passaplan ◽

Karl Wieser

Keyword(s):

Clinical Outcome ◽

External Rotation ◽

Constant Score ◽

Humeral Fractures ◽

Shoulder Prosthesis ◽

Radiographic Outcome ◽

Press Fit ◽

Stem Loosening ◽

Patient Consent

Abstract Introduction Little information is available on the clinical and radiographic outcome of intraoperative, non- to minimally displaced humeral fractures that occur during implantation of a stemmed, reverse shoulder prosthesis but are only recognized on routine postoperative radiographs. The goal of this study is to report the clinical and radiographic outcome for this rarely reported fracture type. Materials and methods 39 conservatively treated non- to minimally displaced intraoperative periprosthetic humeral fractures after stemmed RTSA were detected from our radiographic database between 1.1.2006 and 31.1.2018. Exclusion criteria were lack of patient consent, preoperative humeral fracture, and revision arthroplasties. Clinical (absolute and relative Constant score, the Subjective Shoulder Value) and radiographic (conventional radiographs) assessment was performed preoperatively, at 6 weeks (only radiographically) and at latest follow-up with a minimum follow-up of 2 years. Results 35 patient’s with a mean age of 72 years (range 32–88, SD ± 11 years) and a mean follow-up of 53 months (range 24–124, SD ± 31) were included in the study. At latest follow-up, all clinical outcome parameters except external rotation improved significantly. A complication rate of 17% (n:6) was recorded. At 6 weeks after the index surgery, none of the radiographs showed a fracture displacement or a sintering of the stem. At latest follow-up, all fractures were healed and no stem loosening was observed in any of the shoulders. Conclusions Non- to minimally displaced intraoperative periprosthetic humeral fractures in RTSA have an incidence of about 5% in this series of mainly uncemented press-fit stems. They generally heal without any further treatment and are not associated with stem loosening or compromise the clinical outcome after primary RTSA. Except slight restriction in the postoperative rehabilitation protocol, no further attention or action is needed.

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Early Femoral Loosening of the Titanium 3M Capital Cemented Hip: A Lesson Relearned

Hip International ◽

10.1177/112070000201200103 ◽

2002 ◽

Vol 12 (1) ◽

pp. 17-22 ◽

Cited By ~ 3

Author(s):

A.R. Harvey ◽

I.W. Barlow ◽

N.M.P. Clarke

Keyword(s):

Hip Replacement ◽

Operative Technique ◽

Femoral Stem ◽

Cementing Technique ◽

Radiological Criteria ◽

Stem Loosening ◽

Capital Cases ◽

Hip Replacements ◽

Early Failures

A 4-year follow-up study is presented comparing 3M Capital cemented hip replacements with Charnley low friction arthroplasty controls. The mean radiological follow-up in the Capital and Charnley groups was 47 months (25 to 61) and 47 months (23 to 66) respectively. All cases were performed by the same surgical team over the same period (April 1991-October 1993). The operative technique including femoral preparation and cementing technique was identical in each group. Charnley broaches were used for femoral preparation in both groups and Charnley cups were used in all cases. In all of the 3M Capital cases cobalt-chrome femoral heads were used. There was no case selection for either group. Six of the 21 Capital femoral components were deemed to be loose on radiological criteria. None of the Charnley hips was loose. This represents an unacceptably high incidence of radiological femoral stem loosening in the Capital hip replacement. A previous uncontrolled study has attributed early failures to deficient femoral preparation and/or cementing technique. We suggest that early femoral stem loosening in the Capital hip occurs despite satisfactory operative technique in contrast with the results using the Charnley total hip replacement.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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Brief summary of Kleť photographic search programme for minor planets

International Astronomical Union Colloquium ◽

10.1017/s0252921100031419 ◽

1999 ◽

Vol 173 ◽

pp. 189-192

Author(s):

J. Tichá ◽

M. Tichý ◽

Z. Moravec

Keyword(s):

Ccd Camera ◽

Minor Planet ◽

Minor Planets ◽

Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

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Intranuclear Crystals in Regenerating Canine Kidneys

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100072502 ◽

1973 ◽

Vol 31 ◽

pp. 412-413

Author(s):

D.G. Osborne ◽

L.J. McCormack ◽

M.O. Magnusson ◽

W.S. Kiser

Keyword(s):

Epithelial Cell ◽

Epithelial Cells ◽

Tubular Epithelial Cell ◽

Tubular Epithelial Cells ◽

Cell Nuclei ◽

Crystalline Structures ◽

Small Crystals ◽

Membrane Bound

During a project in which regenerative changes were studied in autotransplanted canine kidneys, intranuclear crystals were seen in a small number of tubular epithelial cells. These crystalline structures were seen in the control specimens and also in regenerating specimens; the main differences being in size and number of them. The control specimens showed a few tubular epithelial cell nuclei almost completely occupied by large crystals that were not membrane bound. Subsequent follow-up biopsies of the same kidneys contained similar intranuclear crystals but of a much smaller size. Some of these nuclei contained several small crystals. The small crystals occurred at one week following transplantation and were seen even four weeks following transplantation. As time passed, the small crystals appeared to fuse to form larger crystals.

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Electron Microscopy of Human Gallstones

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100065523 ◽

1971 ◽

Vol 29 ◽

pp. 296-297

Author(s):

C. Wolpers ◽

R. Blaschke

Keyword(s):

Electron Microscopy ◽

Room Temperature ◽

Bile Pigment ◽

X Ray Diffraction ◽

Triclinic Crystal System ◽

X Ray ◽

Follow Up Study ◽

Infra Red ◽

Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

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Articulatory Intervention for the Visually Impaired

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1003.139 ◽

1979 ◽

Vol 10 (3) ◽

pp. 139-144

Author(s):

Cheri L. Florance ◽

Judith O’Keefe

Keyword(s):

High School ◽

High School Students ◽

Behavior Change ◽

Visually Impaired ◽

School Students ◽

Handicapped Children ◽

Paired Stimuli ◽

Visually Handicapped ◽

Parent Program

A modification of the Paired-Stimuli Parent Program (Florance, 1977) was adapted for the treatment of articulatory errors of visually handicapped children. Blind high school students served as clinical aides. A discussion of treatment methodology, and the results of administrating the program to 32 children, including a two-year follow-up evaluation to measure permanence of behavior change, is presented.

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