Risk factors for loosening of cementless threaded femoral implants in canine total hip arthroplasty

2015 ◽  
Vol 28 (01) ◽  
pp. 48-53 ◽  
Author(s):  
Cimin Brown ◽  
K. Aoki ◽  
S. Franklin ◽  
K. Hayashi ◽  
K. A. Agnello
Keyword(s):  
Risk Factors ◽  
Clinical Signs ◽  
Significant Risk ◽  
Femoral Stem ◽  
Implant Loosening ◽  
Lateral Cortex ◽  
Total Hip ◽  
Stem Loosening ◽  
One Year ◽  
Post Implantation

SummaryObjective: To determine the incidence and potential risk factors of femoral implant loosening in the canine Helica® total hip replacement (THR) system.Method: Sixteen dogs with a Helica THR were included. Medical records were reviewed for signalment and size of implants. Stem angle, stem collar to lateral cortex distance, tip to cortex distance, stem collar to lateral cortex distance at a stem angle of 150°, lever arm distance, and the distance on the diaphysis measurements were calculated from the one year postoperative radiographs. Three ratios were determined from these measurements to take into account the size of the femur in relation to the size of the implant. Femoral implant loosening was identified by radiographic and clinical signs, and confirmed at the time of surgical explantation. Differences in the successful and fe-moral stem failure groups were compared using either a students t-test or a Mann Whitney test. Significance was set at p <0.003.Results: Six of the 16 dogs had loosening of the femoral prostheses within one year post-implantation. One dog had evidence of a septic cause for loosening. No significant risk factors could be identified in this group of dogs with Helica stem loosening.Clinical significance: Helica femoral stem loosening was a common complication within one year post-implantation in this group of dogs. No risk factors were identified to potentially decrease the incidence of loosening. Therefore, due to this unacceptably high complication rate, the authors do not recommend this model of the Helica THR.

scholarly journals Herpes Zoster in Solid Organ Transplantation: Incidence and Risk Factors

2021 ◽  
Vol 12 ◽  
Author(s):  
Marcia M. L. Kho ◽  
Stefan Roest ◽  
Dominique M. Bovée ◽  
Herold J. Metselaar ◽  
Rogier A. S. Hoek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Herpes Zoster ◽  
Multivariable Analysis ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Clinical Signs ◽  
Significant Risk ◽  
Solid Organ ◽  
Disseminated Disease ◽  
Cmv Prophylaxis

BackgroundStudies on herpes zoster (HZ) incidence in solid organ transplant (SOT) recipients report widely varying numbers. We investigated HZ incidence, severity, and risk factors in recipients of four different SOTs, with a follow-up time of 6–14 years.MethodsRecords of 1,033 transplant recipients after first heart (HTx: n = 211), lung (LuTx: n = 121), liver (LiTx: n = 258) and kidney (KTx: n = 443) transplantation between 2000 and 2014 were analyzed for VZV-PCR, clinical signs of HZ, and complications.ResultsHZ was diagnosed in 108 of 1,033 patients (10.5%): 36 HTx, 17 LuTx, 15 LiTx, and 40 KTx recipients. Overall HZ incidence rate after HTx (30.7 cases/1,000 person–years (PY)), LuTx (38.8 cases/1,000 PY), LiTx (22.7 cases/1,000 PY) and KTx (14.5 cases/1,000 PY) was significantly higher than in the general 50–70 year population. Multivariable analysis demonstrated age ≥50 years at transplantation (p = 0.038, RR 1.536), type of organ transplant (overall p = 0.002; LuTx p = 0.393; RR 1.314; LiTx p = 0.011, RR 0.444; KTx p = 0.034, RR 0.575), CMV prophylaxis (p = 0.043, RR 0.631) and type of anti-rejection therapy (overall p = 0.020; methylprednisolone p = 0.008, RR 0.475; r-ATG p = 0.64, RR1.194) as significant risk factors. Complications occurred in 33 of 108 (31%) patients (39% of HTx, 47% of LuTx, 20% of LiTx, 20% of KTx): post-herpetic neuralgia, disseminated disease, and cranial nerve involvement.ConclusionHZ incidence and severity in SOT recipients are most pronounced after heart and lung transplantation, in older patients, and when CMV prophylaxis is lacking.

scholarly journals Total hip arthroplasty and lumbar spine disorders: Plain co-existence or mutual influence?

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Nils Wirries ◽  
Michael Schwarze ◽  
Dorothea Daentzer ◽  
Michael Skutek
Keyword(s):  
Lumbar Spine ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Mutual Influence ◽  
Negative Impact ◽  
Clinical Signs ◽  
Clinical Results ◽  
Total Hip ◽  
One Year ◽  
Spine Disorders

Lumbar spine disorders (LSD) might influence the outcome after total hip arthroplasty (THA). Despite a known common prevalence of LSD and degenerative hip disorders, this study investigates their mutual influence in case of co-existence with the purpose to advance surgeons planning and patient’s prognosis. Patients with and without LSD were compared before and at the one-year postoperative examination. For clinical evaluation the WOMAC was assessed. The radiological analysis focused on cup anteversion and inclination. The total group included 203 consecutive patients. The overall incidence of LSD was 51.0%. Patients with LSD were on average 4.3 years older and had a 1.8 higher BMI than non-LSD patients (P<0.05). The cup positioning and the clinical results were comparable between both groups before and at the last time of follow up (P>0.05). No hip dislocations nor clinical signs of impingement were seen.We can conclude that there is a high degree of co-existence of LSD and hip disorders. However, a strong negative impact of LSD to clinical or radiologic results could not be confirmed in our study.

scholarly journals Determining Risk Factors for the Development of Temporomandibular Disorders during Orthodontic Treatment

2020 ◽  
Vol 10 (22) ◽  
pp. 8216
Author(s):  
Alessandro Ugolini ◽  
Federico Garbarino ◽  
Luca Di Vece ◽  
Francesca Silvestrini-Biavati ◽  
Valentina Lanteri
Keyword(s):  
Risk Factors ◽  
Temporomandibular Disorders ◽  
Orthodontic Treatment ◽  
Complex Disease ◽  
Myofascial Pain ◽  
Significant Risk ◽  
Female Gender ◽  
Structured Interview ◽  
Disc Displacement ◽  
One Year

Temporomandibular disorders (TMD) represent a complex disease with a multifactorial etiology. Despite several studies on the subject, a causal relationship between orthodontic treatment and different forms of TMD has not been established. The aim of this study was to analyze the effect of orthodontic treatment on two aspects of TMD: myofascial pain and disc displacement. This retrospective cohort study followed 224 orthodontic adult patients at three points in time: before treatment (T0), immediately after treatment (T1), and one year after treatment (T2). Disc displacement and myofascial pain were evaluated through a clinical assessment and with a semi-structured interview, along with headache, neck, and shoulder pain parameters and behavioral and somatic accompanying symptoms. Multivariate logistic regression was used to identify risk factors that could influence the development of TMD in these patients. There was a non-significant increase in disc displacement during orthodontic treatment, which mostly resolved after completion of treatment. Myofascial pain scores worsened during treatment, but improved when compared with the baseline once treatment was complete (T0 = 51.3%, T1 = 64.6%, T2 = 44.9%). Female gender (aOR = 1.9, CI 95%, 1.23–2.36), the presence of somatic symptoms (aOR = 3.6, CI 95%, 2.01–5.84), and symptoms of anxiety or depression (aOR = 2.2, CI 95%, 1.14–4.51) were significant risk factors associated with the development of TMD. There is a low and not significant risk of TMD development during orthodontic treatment. When TMD occurred, they resolved within 1 year of the end of treatment.

Serious Symptomatic Thromboembolic Complications in Patients Undergoing Total Hip Replacement - A Prospective Study.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 630-630
Author(s):  
Camilla Ryge ◽  
Michael Rud Lassen ◽  
Soeren Solgaard ◽  
Stig Sonne-Holm
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Total Hip Replacement ◽  
Logistic Regression Analysis ◽  
Hip Replacement ◽  
Significant Risk ◽  
Vascular Events ◽  
Total Hip ◽  
Vein Thrombosis

Abstract Purpose: To describe the rate and time of onset of serious thromboembolic (TE) complications within the first 90 postoperative days in an unselected population of THR patients. Secondary to analyse the data base for possible risk factors of TE. Material and method: Five hundred (430 primary THR and 70 revision THR) consecutive patients undergoing THR in Frederiksborg County, Denmark from January 2004 until May 2005 participated. The patients were interviewed the day before surgery for medical history. On the 5th postoperative day and at a telephone interview 90 days postoperatively patients were asked about signs and symptoms of acute myocardial infarction (AMI), pulmonary embolism (PE), deep vein thrombosis (DVT), transitory cerebral ischemia (TCI)/stroke, retinal vein thrombosis (RVT) and other cardio vascular events. All events were validated in hospital and/or the general practitioners files, using international criteria. All patients except 1 had chemical thromboprophylaxis during hospitalization. No patients had extended thromboprophylaxis after discharge. 498 patients had 90 days follow-up. Two patients withdrew their consent. Results: 24 patients (4.8%) experienced at least one serious TE complication during the first 90 days after the operation. Two (0.4%) patients died in relation to the operation (no autopsy was performed). Five patients (1.0%) had PE. One patient (0.2%) had AMI, 10 (2.0%) had DVT, two (0.4%) had RVT and four (0.8%) had TCI. Two patients experienced two events - one had AMI and later on a TCI, another had PE and TCI on the same day. Nine patients had their first event during the first five postoperative days - 15 patients had their first event after the 5th postoperative day. The only significant risk factor found in a backward logistic regression analysis including interaction (test for confounder/bias) was the length of the operation P=0.003 OR= 1.016 (1.005–1.026). This study has not been able to show any significant correlation between age, gender, co-morbidities, preoperative hemoglobin value ore platelet count, high ASA-score, kind of anesthesia, indication for operation or use of cement or interactions between the above in the logistic regression analysis, but individually all these factors were significant risk factors in the introductory bivariate analysis. Discussion: This study shows that venous and arterial thrombotic complications persist to be a major contribution to postoperative morbidity and mortality after elective total hip replacement, despite of rigorous early mobilization and optimized regimens of prevention of thromboembolism. After this study has been performed ACCP has recommended extend prophylaxis by LMWH, pentasaccharide or warfarin up to 4–5 weeks after total hip replacement. Further research to identify patients at risk is warranted to optimize risk/benefit of total hip replacement and prevention of venous and arterial thromboembolism. The majority of events occurred after discharge calling for improvement of the post-discharge period to reduce the risk of serious thromboembolism.

scholarly journals Evaluation of Risk Factors Influencing Instability after Total Hip Replacement

2020 ◽  
Author(s):  
Nikhil Deo ◽  
Gajanan Pisulkar ◽  
Suvarn Gupta ◽  
Kiran Saoji
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Hip Replacement ◽  
Significant Risk ◽  
Hip Dislocation ◽  
Significant Risk Factor ◽  
Harris Hip Score ◽  
Total Hip ◽  
Factors Influencing ◽  
Dislocation Group

Introduction: Total hip arthroplasty has been successful in relieving pain arising from hip joint diseases and maintains functional stability of hip joint. Instability can be rephrased as subluxation or dislocation of femoral head from the acetabulum. The study has been undertaken to find out causes related to instability after Total Hip Replacement (THR). Aim: To evaluate preoperative, intraoperative and postoperative risk factors influencing instability after THR. Materials and Methods: This retrospective study was carried out from June 2013 to June 2019. Preoperative, postoperative and six months follow-up data was recorded in the questionnaire. A total of eight patients were included in the group having postoperative dislocation and 122 patients were in normal THR group. Clinical outcome was measured using Harris Hip score. Data analysis was done by using Statistical Package for the Social Sciences (SPSS) software version 17.0 and parametric tests like paired t-test, Analysis of Variance (ANOVA) were used. Results: Majority of the patients in the study were in the age group of 31-40 years and 41-50 years (27.69% each) with total mean age of 41.14±12.40 years. About 77.69% were male and 22.31% were female. Mean Harris hip score of the total population was 74.73±5.35. Dislocation post THR was observed in 8 (6.15%) and all these patients were males. Six (75%) patients in hip dislocation group were chronic alcoholics while 41 (33.61%) in non-dislocation group were alcoholics and incidence of dislocation and alcoholism was statistically significant. Capsulectomy was done in 50% patients of hip dislocation group and 16.39% of non-dislocation group thus capsulectomy appears as a significant risk factor for postoperative hip dislocation. Conclusion: The incidence of hip instability after THR was 6.15%. Alcohol addiction was identified as a statistically significant independent preoperative risk factor. It was observed that capsulectomy was a significant risk factor for hip dislocation.

scholarly journals Risk factors for one-year all-cause mortality in elderly multimorbid medical in-patients.

2020 ◽  
Author(s):  
Marte Sofie Wang-Hansen ◽  
Hege Kersten ◽  
Torgeir Bruun Wyller
Keyword(s):  
Risk Factors ◽  
Body Mass ◽  
Rating Scale ◽  
Handgrip Strength ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Care Plans ◽  
All Cause Mortality ◽  
One Year

Abstract Background Due to expansion of longevity, the proportion of elderly people with multimorbidity is increasing. Our aim was to identify risk factors for all-cause mortality in elderly multimorbid medical in-patients one year after acute hospitalization. Information regarding risk factors is important to support targeted care plans after discharge. Methods Prospective cohort study of patients acutely admitted to a medical department in a Norwegian regional hospital. Eligible patients were community-dwelling, received home care services before hospitalization, were aged 75+, and suffered from two or more chronic conditions. Inclusion period was 1. April – 31. October 2012. Candidate variables were number of daily prescribed drugs, Cumulative Illness Rating Scale for Geriatrics score, delirium, body mass index (BMI), handgrip strength, Barthel Activities of Daily Living Index score, and the laboratory analyses haemoglobin (Hgb), sodium (Na) and estimated glomerular filtration rate (eGFR). Results We included 227 patients; mean age 86 years, 59% women, 71% lived alone. During the year after hospitalization, 39% died. In the adjusted cox proportional hazards regression analysis, significant and independent risk factors were BMI (hazard ratio (HR) 0.93, 95% confidence interval (CI) 0.88-0.98 per kg/m 2 ), Hgb (HR 0.87, 95% CI 0.76-0.98 per g/100 mL), Na (HR 0.94, 95% CI 0.90-0.99 per mmol/L) and eGFR < 60 mL/min/1.73 m 2 (HR 1.82, 95% CI 1.07-3.08). Conclusions In this cohort of multimorbid elderly internal medicine patients, low body mass, hyponatremia, impaired renal function and anaemia were identified as independent and significant risk factors for one-year mortality.

Ten-Year Survival of Optical Penetrating Keratoplasty and Risk Factors for Graft Failure in Thai Patients

2020 ◽  
Vol 103 (9) ◽  
pp. 883-890
Keyword(s):  
Risk Factors ◽  
Graft Survival ◽  
Graft Failure ◽  
Penetrating Keratoplasty ◽  
Significant Risk ◽  
Visual Outcome ◽  
Successful Outcome ◽  
Bullous Keratopathy ◽  
One Year

Objective: To determine long-term graft survival and identify risk factors for secondary graft failure of optical penetrating keratoplasty (PK) in Thai patients. Materials and Methods: A Retrospective study of patients that underwent optical PK at Siriraj Hospital between January 2002 and December 2005 was done. Results: Of 131 eyes, primary graft failure was found in two eyes (1.5%) thus, 129 eyes were recruited. The three most common surgical indications were pseudophakic or aphakic bullous keratopathy (33.3%), corneal scars (post-trauma, post-infection) (20.9%), and regrafts (16.3%). Mean follow-up period was 93.2 months (1 to 183 months). One-year, 2-year, 5-year, and 10-year graft survival rates were 84.5%, 73.2%, 50.2%, and 24.7%, respectively. The leading cause of graft failure was irreversible allograft rejection (62.5%). Most (56.0%) of the first graft rejection happened within one year post-operatively. Graft survival was lower in eyes with regrafts, history of glaucoma, deep corneal vascularization, peripheral anterior synechiae, and occurrence of one or more rejection episodes. Multivariate regression analysis demonstrated that peripheral anterior synechiae and occurrence of one or more rejection episodes were the significant independent risk factors for graft failure. Considering patients with the clear grafts at the last follow-up, the final best-corrected visual acuity was 6/36 or better in 66.7% eyes and 6/18 or better in 31.6% eyes. Comparing to pre-operative vision, patients with the clear grafts at the last follow-up had improved visual outcome in most eyes (82.5%). Conclusion: Ten-year survival and visual outcome of optical PK showed successful outcome, however, the survival rate decreased over time. The significant risk factors for graft failure should be cautiously evaluated before surgery. Keywords: Corneal graft survival, Keratoplasty outcome, Optical penetrating keratoplasty

scholarly journals Anticorpos anti-toxoplasma gondii em gatos domiciliados no Município de Rio Branco, Acre, Brasil

2015 ◽  
Vol 36 (6) ◽  
pp. 3757 ◽  
Author(s):  
Soraia Figueiredo de Souza ◽  
Luciana Dos Santos Medeiros ◽  
Adriane De Souza Belfort ◽  
Andrey Luiz Lopes Cordeiro ◽  
Michelle Federle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Toxoplasma Gondii ◽  
Significant Risk ◽  
Igg Antibodies ◽  
Domestic Cats ◽  
Chi Square ◽  
Significance Level ◽  
Chi Square Test ◽  
One Year ◽  
Toxoplasma Gondii Infection

Blood samples were collected from 89 cats to assess the prevalence of IgG antibodies against Toxoplasma gondii by indirect immunofluorescence (IIF) and the possible risk factors associated with feline Toxoplasma gondii infection. An epidemiological questionnaire was developed and implemented for owners of domestic cats domiciled in Rio Branco, Acre. The results were statistically evaluated with the odds ratio and chi-square tests, considering the significance level of 5%. Of 89 animals’ samples, 22 had antibodies against Toxoplasma gondii. Among the 22 reactive animals, 15 (68.19%) were female, 15 (68.19%) were less than one year old and 20 (90%) were cross breed. Concerning risk factors, there was no difference (p > 0.05) between the variables evaluated by the chi-square test. Moreover, 16 (72%) cats were fed a mixed diet, 20 (90%) of the cats had hunting habits, 18 (81%) had contact with animals of another species, 11 (50%) had access to the street, and 22 (95%) lived in homes that had areas of grass or dirt. In conclusion, the prevalence of anti-Toxoplasma gondii in domestic cats was 22.7%, and there were no significant risk factors for feline toxoplasmosis in the municipality of Rio Branco, Acre.

scholarly journals Dose-volumetric Predictors for Thyroid Dysfunction after 3D Conformal Radiotherapy: An Observational, Prospective Study

2020 ◽  
pp. 1-12
Author(s):  
M. Al-Jamal ◽  
A. Abd Elnaby ◽  
A. El-Badrawy ◽  
H. M. H. R. Elkalla ◽  
R. Omar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Statistical Significance ◽  
Significant Risk ◽  
Conformal Radiotherapy ◽  
Significant Risk Factor ◽  
University Hospital ◽  
Radiation Induced ◽  
One Year ◽  
Positive Results

Aim: This study was conducted to assess the dose-volumetric threshold of radiation induced hypothyroidism (RIHT) in patients receiving radiotherapy (RT) to the neck. Study Design: This is a prospective cohort observational study. Place and Duration of the Study: The study was conducted at Mansoura University Hospital, Mansoura, Egypt, between April 2016 until March 2019. Methods: We have completed 2 years of follow up to 50 patients with different malignancies who were treated by radiotherapy to the neck. Baseline assessment of the thyroid clinically and radiologically was done prior to the start of radiotherapy. Periodic testing of the cohort through the follow up period was done by clinical examination, measurement of TSH, fT4 and thyroid ultrasonography. Results: the incidence of RIHT was 26%. No statistical significance for the clinical risk factors. The dose-volumetric risk factors were studied and showed positive results. A mean dose of 5185 cGy was found a significant risk factor. Also, V40 ≥ 89%, V45 ≥ 63.5%, V50 ≥ 22.5% were found to be the cutoff predictors for the threshold radiation dose to induce hypothyroidism. Also decreasing the size of the gland by ≥0.7 cm3, fT4 value by ≥ 3.5 pmol/L and TSH by ≥ 0.75 uIU/L after one year from the end of EBRT is the cutoff value for prediction of occurrence of RIHT within the 2nd year of follow up. Conclusion: RIHT is a considerable late adverse effect for patients receiving RT to the neck. Mean dose, V40, V45 and V50 were found significantly related to RIHT. Mean dose of ≥ 5185 cGy, V40 ≥ 89%, V45 ≥ 63.5%, V50≥ 22.5% were proven to be the dose-volumetric threshold.

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