scholarly journals Midterm Survivorship of an Uncemented Hydroxyapatite-Coated Titanium Femoral Component and Clinically Meaningful Outcomes in Patients Older Than 75 Years

2021 ◽  
Vol 10 (5) ◽  
pp. 1019
Author(s):  
Alexander Zimmerer ◽  
Luis Navas ◽  
Stefan Kinkel ◽  
Stefan Weiss ◽  
Matthias Hauschild ◽  
...  
Keyword(s):  
Survival Rate ◽  
Femoral Component ◽  
Survival Rates ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Rank Test ◽  
Kaplan Meier ◽  
Clinically Meaningful Outcomes ◽  
Modified Harris Hip Score

Purpose: It remains controversial whether cementless femoral components are safe in elderly patients. The aim of this study was (1) to determine the stem survival rate in patients >75 years of age who were treated with an uncemented femoral component and (2) to report clinically significant results on a mid-term follow-up. Methods: 107 total hip arthroplasties (THA) were retrospectively evaluated in 97 patients over 75 years of age (mean age 78 years, range 75–87) treated with an uncemented femoral stem. The minimum follow-up was five years (mean 6.4 years, range 5–8). Stem survival rates, clinically meaningful outcomes, and incidence of complications were evaluated. Results: Kaplan-Meier survival analysis, with the endpoint revision for any reason, showed a 6.4-year survival rate of 98% (95% CI, 95–99%; 63 hips at risk). The survival rates were comparable for male and female patients (log-rank test, p = 0.58). The modified Harris Hip Score (mHHS) improved from 42.2 (12 to 85) points to 81.1 (22 to 97) points (p < 0.0001). Mid-term minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) were 25, 84, and 70, respectively. Conclusion: An uncemented stem is a viable option in patients over 75 years with good clinical outcomes and survivorship. Periprosthetic fractures were not a relevant failure mechanism with the stem used.

scholarly journals Charnley femoral cemented stem with a permeable and resorbable cement restrictor and low-viscosity cement

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 39
Author(s):  
Jean-Louis Prudhon ◽  
Jacques H. Caton ◽  
Thierry Aslanian
Keyword(s):  
Survival Rate ◽  
Femoral Component ◽  
First Year ◽  
Low Friction ◽  
Low Viscosity ◽  
Kaplan Meier ◽  
Cemented Stem ◽  
Component Revision ◽  
Cement Restrictor

Introduction: In 1979, in his first book dealing with low-friction arthroplasty (LFA), Charnley highlighted the use of a cement restrictor. Breusch and Malchau described in 2005 the “second-generation cementing technique.” The main objective of this study was to report on the clinical survival of 100 cases of Charnley femoral component implanted in 2007 and 2008 using a permeable and resorbable cement restrictor and a low-viscosity antibiotic-loaded cement. The secondary objectives were to analyze the complications and side effects and the accuracy of the device positioning. Material and methods: This was a monocentric retrospective review of a prospectively compiled database. Diaphyseal restrictor was biodegradable and permeable to gas, blood, and fluids to avoid intramedullary over pression during cementation. The cement was a low-viscosity antibiotic-loaded cement. Among 3555 patients, we selected the first continuous 100 cases of patients where we implanted the device. Survival probability was computed according to Kaplan–Meier method. Results: Mean follow-up was 6.55 ± 2.6 (range 1–11). Considering femoral component revision as the endpoint, survival rate was 100%. No patients died intraoperatively, none in the first month and the first year after surgery. No early periprosthetic fractures have been reported. Discussion: As described initially by Charnley, the use of a cement restrictor was highly recommended through the different generations of cementing techniques. Hypotensive episodes and cardiac arrest have been reported during cement insertion. In our series, we did not deplore any adverse effect related to the cementation. Conclusion: Our study demonstrates a 100% survival rate of a cemented femoral component without adverse effects when using routinely a resorbable and permeable cement restrictor and a low-viscosity cement. Bone cement is still a fantastic ally for the surgeon and the patients.

The Distribution of Yin-Deficient Symptoms and Their Relationship on Survival Rate in Cancer Patients with Yin-Deficiency

2008 ◽  
Vol 36 (04) ◽  
pp. 655-663 ◽  
Author(s):  
Shu-Chuan Lin ◽  
Ming-Feng Chen ◽  
Tsai-Chung Li ◽  
Yu-Ho Hsieh ◽  
Shwu-Jiuan Liu
Keyword(s):  
Survival Rate ◽  
Cancer Patients ◽  
Survival Rates ◽  
Rank Test ◽  
Yin Deficiency ◽  
Rate Analysis ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Product Limit ◽  
Cumulative Probabilities

Yin-Deficiency (YD), representing a status of the human body under lack of nutrition and fluid in traditional Chinese medicine, is commonly seen in late stage of cancer patients. It is not known whether the severity of YD related symptoms/signs can predict the survival rate of cancer patients. This study evaluated the distribution of Yin-deficiency symptoms/signs (YDS) in cancer patients with YD, and investigated whether the severity of YDS can predict the survival rate of cancer patients with YD. From 5 January 2007 to 5 May 2007, we selected 43 cancer patients with diagnosis of YD from hospitalized patients and outpatients. The severity of YD was evaluated by a questionnaire. We further estimated the cumulative probabilities of the survival rates over 4 months since the start of study by the Kaplan-Meier product-limit method, and compared the differences among groups with various severities in each symptom/sign with the use of the log-rank test. The results revealed that, the 3 most common YDS were sleeplessness with annoyance, less or non-coated tongue with or without redness and dry mouth. In the survival rate analysis, only 2 parameters, rapidly small pulse (p = 0.002) and less-or non-coated tongue with paleness (p = 0.017), were found to be related to the decrease of cancer patients with YD. This suggests that, both rapidly small pulse and less-or non-coated tongue without redness may be used as predictors for the estimation of survival rate in cancer patients with YD.

scholarly journals Determination of Affected Factor on Survival Rates In Referral Gastric Cancer Patients to Imam Khomeini Clinic in Hamadan Province from 2004-2017

2020 ◽  
Author(s):  
Fatemeh Gohari-Ensaf ◽  
Zeinab Berangi ◽  
Mohamad Abbasi ◽  
Ghodratollah Roshanaei
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Screening Program ◽  
Survival Rates ◽  
Tumor Stage ◽  
Rank Test ◽  
Significance Level ◽  
Kaplan Meier ◽  
One Year ◽  
Gastric Cancer Patients

Introduction: Gastric cancer is the fourth most common cancer and the second leading cause of death in the world. Despite the recent advances in controlling and treating the disease, the survival rate of this cancer is relatively low. Various factors can affect the survival of the patients with gastric cancer. The aim of this study was to determine the survival rates and the effective factors in the patients with gastric cancer. Methods: The study population included all the patients diagnosed with gastric cancer in Hamadan Province who were referred to Hamadan Imam Khomeini Specialized Clinic between 2004 to 2017. Patients were followed up by periodical referrals and/or telephone contact. The survival rate of the patients was calculated using Kaplan-Meier method and effective survival factors with Cox proportional regression. Data were analyzed using SPSS 23 software at a significance level of 0.05. Results: Out of the 350 patients with gastric cancer, 74.3% were male and 25.7% were female. One-year, three-year and five-year survival rates were 67%, 36% and 27%, respectively. The log -rank test showed that age, type of tumor, stage of disease, type of Surgery and metastasis of the disease were effective on the survival of patients. In Cox's multivariate analysis, the only age variables at the time of diagnosis and chemotherapy were survival variables. (P<0.05). Conclusion: The results of this study showed that age variable is a strong factor in survival, so it is essential to diagnose the disease at the early age and early stages of the disease using a screening program.

scholarly journals Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Engin Çarkçı ◽  
Ayse Esin Polat ◽  
Yusuf Öztürkmen ◽  
Tolga Tüzüner
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Survival Rates ◽  
Femoral Stem ◽  
Long Term Results ◽  
Harris Hip Score ◽  
Acetabular Cup ◽  
Total Hip ◽  
Kaplan Meier

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem. Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator. Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively. Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival. doi: https://doi.org/10.12669/pjms.37.1.3089 How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Survival of Patients With Testicular Cancer in Lithuania During 1999–2002

Medicina ◽  
2011 ◽  
Vol 47 (1) ◽  
pp. 8 ◽  
Author(s):  
Agnius Juška ◽  
Albertas Ulys ◽  
Laura Kairevičė ◽  
Giedrė Smailytė ◽  
Edgaras Stankevičius ◽  
...  
Keyword(s):  
Survival Rate ◽  
Testicular Cancer ◽  
Cancer Patients ◽  
Cancer Registry ◽  
Survival Rates ◽  
Tumor Stage ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Younger Age

The aim of this study was to evaluate the survival of patients with testicular cancer in Lithuania during 1998–2002 and factors that influenced the survival.Material and methods. The survival rates of testicular cancer patients were evaluated using the data of the Lithuanian Cancer Registry for 1998–2002. The survival was evaluated using the Kaplan-Meier method and log-rank test in order to compare the survival rates. The observed survival rates were calculated.Results. The 5-year observed survival rate in Lithuania was 71.2% (95% CI, 64.4%–77.5%). The survival of testicular cancer patients depended on age at the time of diagnosis, histology of tumor, stage and extent of disease.Conclusions. The survival of patients with testicular cancer in Lithuania was substantially lower than in other European countries. The better survival was associated with younger age and lesser extent of metastases.

scholarly journals Short uncemented femoral component for hip revision: prognosis and risk factors associated with failure

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zeming Liu ◽  
Bo Liu ◽  
Bingshi Zhang ◽  
Wenhui Ma ◽  
Tao Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survival Rate ◽  
Femoral Component ◽  
Revision Surgery ◽  
Femoral Fracture ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Categorical Variables ◽  
Periprosthetic Femoral Fracture ◽  
Significant Difference

Abstract Background The application of short femoral stems is partially restricted in revision surgery. This study will demonstrate the therapeutic effect and unsuitable situation for short stem revision. Methods Demographic characteristics of all patients were recorded in detail (Table 1). Anteroposterior view radiographic examinations of proximal femur are necessary before and after the operation for patients. The primary outcome of interest was the survival rate of the femoral stem at the final follow-up. Risk factors for failure were also investigated. The secondary outcomes of interest included the Harris hip score, excellent to good rate and incidence of complications. The Mann–Whitney U test was performed for comparisons between continuous variables. The chi-square test was performed for comparisons between categorical variables. Cox regression analysis was used to assess the association between potential risk factors and the failure of revision surgery. Results A total of 381 patients with short stems were retrospectively reviewed. There were 188 males and 193 females. The average age and body mass index before revision surgery were 58.85 ± 13.46 years and 23.72 ± 3.40 kg/m2, respectively. The mid-term survival rate of the short femoral component was 94.23%. The prognosis and complications of patients between the two groups were compared. There was no significant difference between the two groups in the Harris score, complication incidence or survival rate of the femoral component. The strongest risk factor in this study was intraoperative periprosthetic femoral fracture during revision surgery (HR = 5.477, 95% CI = 2.156–13.913). Conclusion Three risk factors for failure were identified: ageing, osteoporosis and intraoperative periprosthetic femoral fracture during revision surgery. Therefore, a short femoral stem should be implanted in patients with these risk factors with additional caution.

scholarly journals Clinical outcomes and survival rate of cementless modular distal fixation femoral stem for revision hip arthroplasty: A minimum 6-year follow-up

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901881224 ◽  
Author(s):  
Joon Soon Kang ◽  
Yeop Na ◽  
Bong Seong Ko ◽  
Yoon Sang Jeon
Keyword(s):  
Survival Rate ◽  
Hip Arthroplasty ◽  
Periprosthetic Fracture ◽  
Femoral Stem ◽  
Revision Hip Arthroplasty ◽  
Harris Hip Score ◽  
The Mean ◽  
Distal Fixation

Purpose: Revision hip arthroplasty is a very challenging procedure. Use of a modular distal fixation stem is one of the available options for revision arthroplasty in patients with proximal femoral bone deficiency. The purpose of this study was to evaluate mid- to long-term outcomes of cementless modular distal fixation femoral stem implantation in revision hip surgery. Methods: Clinical and radiological findings, complications, and stem survival rate were analyzed for 46 patients (48 hips) who underwent revision hip arthroplasty using a cementless modular distal fixation femoral stem. The mean patient age was 58.8 years (range 31–82 years) and the mean follow-up period was 95 months (72–122 months). The preoperative diagnoses were aseptic loosening (36 hips), infection (4 hips), ceramic fracture (4 hips), and femoral periprosthetic fracture (4 hips). Results: The mean Harris hip score improved from 56.6 preoperatively to 88.2 postoperatively at the last follow-up. All hips showed stable osteointegration and firm fixation. Complications involved four hips (8.3%); there was one case each of periprosthetic fracture, delayed union of osteotomy site, femoral perforation, and infection. One stem re-revision was performed for deep infection of the femoral side. The Kaplan–Meier survival rate was 97.6% at the final follow-up. Conclusion: Revision hip arthroplasty using a cementless modular distal fixation femoral stem showed satisfactory initial firm fixation and mid- to long-term survival rate. Complications can be minimized by careful surgical planning and meticulous procedure.

scholarly journals Copy Number Analysis Reveal Genetic Risks of Penile Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Yongbo Yu ◽  
Chengwen Gao ◽  
Yuanbin Chen ◽  
Meilan Wang ◽  
Jianfeng Zhang ◽  
...  
Keyword(s):  
Survival Rate ◽  
Copy Number ◽  
Penile Cancer ◽  
Survival Rates ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Functional Roles ◽  
Kaplan Meier ◽  
Genome Analysis Toolkit ◽  
Penile Squamous Cell Carcinoma

ObjectivesTo evaluate copy number alterations (CNAs) in genes associated with penile cancer (PeC) and determine their correlation and prognostic ability with PeC.MethodsWhole-exome sequencing was performed for tumor tissue and matched normal DNA of 35 patients diagnosed with penile squamous cell carcinoma from 2011 to 2016. Somatic CNAs were detected using the Genome Analysis Toolkit (GATK). Retrospective clinical data were collected and analyzed. All the data were statistically analyzed using SPSS 16.0 software. The cancer-specific survival rates were estimated by Kaplan-Meier curves and compared with the log-rank test.ResultsCNAs in the MYCN gene was detected in 19 (amplification: 54.29%) patients. Other CNAs gene targets were FAK (amplification: 45.72%, deletion: 8.57%), TP53 (amplification: 2.86%, deletion: 51.43%), TRKA (amplification: 34.29%, deletion: 2.86%), p75NTR (amplification: 5.71%, deletion: 42.86%), Miz-1 (amplification: 14.29%, deletion: 20.00%), Max (amplification: 17.14%, deletion: 2.86%), Bmi1 (amplification:14.29%, deletion: 48.57%), and MDM2 (amplification: 5.71%, deletion: 45.72%). The CNAs in MYCN and FAK correlated significantly with patient prognosis (P&lt;0.05). The 3-year Recurrence-free survival rate was 87.10% among patients followed up. The 5-year survival rate of patients with MYCN amplification was 69.2%, compared to 94.4% in the non-amplification group. The 5-year survival rate of patients with FAK amplification was 65.6%, compared to 94.7% in the non-amplification group. The PPI network showed that TP53 and MYCN might play meaningful functional roles in PeC.ConclusionMYCN and FAK amplification and TP53 deletion were apparent in PeC. MYCN and TP53 were hub genes in PeC. MYCN and FAK amplification was also detected and analyzed, and the findings indicated that these two genes are predictors of poor prognosis in PeC.

scholarly journals 12-Month Self-Ligating Bracket Failure Rate with a Self-Etching Primer

2008 ◽  
Vol 78 (6) ◽  
pp. 1095-1100 ◽  
Author(s):  
Selma Elekdag-Turk ◽  
Fethiye Cakmak ◽  
Devrim Isci ◽  
Tamer Turk
Keyword(s):  
Survival Rate ◽  
Clinical Performance ◽  
Survival Rates ◽  
Rank Test ◽  
Dental Arch ◽  
Bond Failure ◽  
Lower Survival Rate ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Significant Difference

Abstract Objective: To compare the clinical performance of a self-etching primer (SEP) with a conventional two-step etch and primer method (CM). Materials and Methods: Study subjects were 39 patients with a mean age of 15 years 7 months. Six hundred and eighty-eight brackets were bonded by one operator with a split-mouth design, using Transbond Plus Self-Etching Primer or a conventional two-step etch and primer (Transbond XT). The survival rate of the brackets was estimated by the Kaplan-Meier analysis. Bracket survival distributions with respect to bonding procedure, dental arch, type of tooth (incisor, canine, and premolar) and patients' gender were compared using the log-rank test. Bond failure interface was determined using the Adhesive Remnant Index (ARI). Results: The bond failure rates of SEP and CM were 4.7% and 1.7%, respectively. A significant difference was found between the bonding procedures using the log-rank test (P &lt; .05). Furthermore, canine and premolar teeth displayed a lower survival rate than incisor teeth (P &lt; .05). Survival rates did not show significant differences between the upper and lower dental arches and patients' gender (P &gt; .05). No significant difference was observed for ARI scores (P &gt; .05). Conclusion: These findings indicate that the SEP (Transbond Plus) can be effectively used to bond orthodontic brackets.

scholarly journals Risk Factor Analysis of Intravesical Recurrence After Laparoscopic Nephroureterectomy for Upper Tract Urothelial Carcinoma

2021 ◽  
Author(s):  
Masato Yanagi ◽  
Tsutomu Hamasaki ◽  
JunJun Akatsuka ◽  
Yuki Endo ◽  
Hayato Takeda ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Survival Rates ◽  
Urine Cytology ◽  
Rank Test ◽  
Free Survival ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Positive Urine ◽  
Laparoscopic Nephroureterectomy

Abstract Background: One of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after laparoscopic nephroureterectomy (LNU) for UTUC.Methods: Clinicopathological and surgical information were collected from the medical records of 73 patients treated with LNU for non-metastatic UTUC, without a history of or concomitant bladder cancer. The association between IVR after LNU and clinicopathological and surgery-related factors, including preoperative urine cytology and pneumoperitoneum time, was analyzed using Cox proportional hazards regression models and the Kaplan–Meier method with log-rank test.Results: During the median follow-up time of 39.1 months, 18 (24.7%) patients had subsequent IVR after LNU. The 3- and 5-year IVR-free survival rates were 76.5% and 74.3%, respectively. In the multivariate Cox regression analysis, positive preoperative urine cytology (hazard ratio [HR]: 3.55; 95% confidence interval [CI]: 1.326–11.327; p=0.011) and prolonged pneumoperitoneum time of ≥ 210 min (HR: 3.40; 95% CI: 1.271–10.692; p=0.014) were independent prognostic factors for IVR-free survival. In patients with positive urine cytology, the Kaplan–Meier method with log-rank test revealed that the 3-year and 5-years IVR free survival rates were 46.3% and 39.7%, respectively, in patients with a prolonged pneumoperitoneum time of ≥ 210 min, which was significantly lower than that in their counterparts (76% and 76%, respectively, p=0.041).Conclusions: In UTUC patients with positive urine cytology, the occurrence of IVR is highly probable when the pneumoperitoneum time of LNU is prolonged (≥ 210 min). Strict follow-up after LNU is highly recommended for these patients.

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