Comparison of Femoral Head Translation following Eccentric Rotational Acetabular Osteotomy and Rotational Acetabular Osteotomy

2016 ◽  
Vol 27 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Tohru Irie ◽  
Daisuke Takahashi ◽  
Tsuyoshi Asano ◽  
Ryuta Arai ◽  
Takuya Konno ◽  
...  
Keyword(s):  
Femoral Head ◽  
Confidence Interval ◽  
Rotational Acetabular Osteotomy ◽  
Acetabular Roof ◽  
Significant Difference ◽  
The Mean ◽  
Radiological Methods ◽  
Roof Angle ◽  
Head Translation ◽  
Eccentric Rotational Acetabular Osteotomy

Purpose Eccentric rotational acetabular osteotomy (ERAO) is a modification of rotational acetabular osteotomy (RAO); it has been reported that ERAO allows the femoral head to translate medially and distally. However, no study has compared femoral head translation following RAO or ERAO. The purpose of this study was to compare immediate postoperative translation of the femoral head after RAO and ERAO in comparison with the pre-operative position by radiological methods. Methods Patients treated by RAO or ERAO between 2006 and 2014 were retrospectively evaluated. 19 hips (17 patients) were treated with RAO, and 25 hips (22 patients) were treated with ERAO. The acetabular roof angle and the location of the femoral head were measured on anteroposterior pelvic radiographs. Results The mean pre-operative acetabular roof angle was 20.9° in the RAO group and 22.0° in the ERAO group, showing no significant difference. The mean acetabular roof angle immediately postoperatively was −0.5° in the RAO group and −0.4° in the ERAO group, again showing no significant difference. The mean femoral head translation immediately postoperatively was 3.1 mm (95% confidence interval (CI), 1.5-4.7 mm) laterally and 3.0 mm (95% CI, 1.3-4.7 mm) proximally in the RAO group and 0.8 mm (95% CI, −0.7-2.3 mm) medially and 2.8 mm (95% CI, 1.5-4.1 mm) distally in the ERAO group; this difference was very highly significant (p≤0.001). Conclusions In contrast with RAO, ERAO resulted in significant femoral head translation both medially and distally immediately postoperatively.

scholarly journals Evaluating Endoscopic Ipsilateral Endonasal Corridor Approaches to the Anterolateral Wall of the Maxillary Sinus: A Computerized Tomography Study

2021 ◽  
Author(s):  
Navarat Vatcharayothin ◽  
Pornthep Kasemsiri ◽  
Sanguansak Thanaviratananich ◽  
Cattleya Thongrong
Keyword(s):  
Confidence Interval ◽  
Maxillary Sinus ◽  
Inferior Turbinate ◽  
Radial Access ◽  
Sinus Wall ◽  
Nasal Floor ◽  
Significant Difference ◽  
Anterolateral Wall ◽  
The Mean ◽  
Maxillary Sinuses

Abstract Introduction The endoscopic access to lesions in the anterolateral wall of the maxillary sinus is a challenging issue; therefore, the evaluation of access should be performed. Objective To assess the accessibility of three endoscopic ipsilateral endonasal corridors. Methods Three corridors were created in each of the 30 maxillary sinuses from 19 head cadavers. Accessing the anterolateral wall of the maxillary sinus was documented with a straight stereotactic navigator probe at the level of the nasal floor and of the axilla of the inferior turbinate. Results At level of the nasal floor, the prelacrimal approach, the modified endoscopic Denker approach, and the endoscopic Denker approach allowed mean radial access to the anterolateral maxillary sinus wall of 42.6 ± 7.3 (95% confidence interval [CI]: 39.9–45.3), 56.0 ± 6.1 (95%CI: 53.7–58.3), and 60.1 ± 6.2 (95%CI: 57.8–62.4), respectively. Furthermore, these approaches provided more lateral access to the maxillary sinus at the level of the axilla of the inferior turbinate, with mean radial access of 45.8 ± 6.9 (95%CI: 43.3–48.4) for the prelacrimal approach, 59.8 ± 4.7 (95% CI:58.1–61.6) for the modified endoscopic Denker approach, and 63.6 ± 5.5 (95%CI: 61.6–65.7) for the endoscopic Denker approach. The mean radial access in each corridor, either at the level of the nasal floor or the axilla of the inferior turbinate, showed a statistically significant difference in all comparison approaches (p < 0.05). Conclusions The prelacrimal approach provided a narrow radial access, which allows access to anteromedial lesions of the maxillary sinus, whereas the modified endoscopic Denker and the endoscopic Denker approaches provided more lateral radial access and improved operational feasibility on far anterolateral maxillary sinus lesions.

scholarly journals Confidence interval approach for evaluating bias in laboratory methods

1988 ◽  
Vol 10 (3) ◽  
pp. 144-146 ◽  
Author(s):  
K. F. Yee
Keyword(s):  
Confidence Interval ◽  
Statistical Tests ◽  
Laboratory Methods ◽  
Mean Values ◽  
Practical Concern ◽  
Alternative Approach ◽  
Interval Approach ◽  
Significant Difference ◽  
The Mean

A statistically significant difference in mean values between two laboratory quantitation methods is interpreted as a bias. Sometimes such a difference is so minute that it does not constitute any practical concern. An alternative approach is to test statistically whether the two methods are close enough, not for equality. This is to look at the confidence interval of the mean method difference and does not entail any additional statistical tests.

scholarly journals Assessment of decrease in renal function associated with hypothyroidism

2021 ◽  
Vol 12 (1) ◽  
pp. 275-286
Author(s):  
Ayesha Ammar ◽  
Kahkashan Bashir Mir ◽  
Sadaf Batool ◽  
Noreen Marwat ◽  
Maryam Saeed ◽  
...  
Keyword(s):  
Renal Function ◽  
Confidence Interval ◽  
Creatinine Clearance ◽  
Confidence Intervals ◽  
Standard Error ◽  
Radioactive Iodine ◽  
T Test ◽  
Euthyroid State ◽  
Significant Difference ◽  
The Mean

Objective: Study was aimed to see the effects of hypothyroidism on GFR as a renal function. Material and methods: Total of Fifty-eight patients were included in the study. Out of those forty-eight patients were female and the rest were male. Out of fifty eight patients, fifty three patients were of thyroid cancer in which hypothyroidism was due to discontinuation of thyroxine before the administration of radioactive iodine for Differentiated thyroid cancer.Moreover, remaining five patients were post radioactive iodine treatment (for hyperthyroidism) hypothyroid. All of the patients were above eighteen years of age with TSH value > 30µIU/ml. Pregnant and lactating females were excluded.Renal function tests (urea/creatinine, creatinine clearance) and serum electrolytes followed by Tc-99m-DTPA renal scan for GFR assessment (GATES’ method) were carried out in all subjects twice during the study, One study during hypothyroid state (TSH > 30 µIU/ml) and other during euthyroid state (TSH between 0.4 to 4µ IU/ml). The results of Student’s t-test showed significant difference in renal functions (Urea, creatinine, creatinine clearance, GFR values) in euthyroid state and hypothyroid state (p-value <0.05). RESULTS: In case of creatinine the paired t test reveal the mean 1.014±0.428, with standard error of 0.669 within 95% confidence interval, for creatinine clearance 80.11±14.12 with standard error of 1.94 within 95% confidence intervals, for urea the mean 28±12.13 with standard error of 1.607 within 95% confidence intervals and for GFR for individual kidney is 38.056±8.56 with standard error of 1.3717 within 95% confidence interval. There was no difference in the outcome of the 2 groups. Conclusion: Hypothyroidism impairs renal function to a significant level and hence needs to be prevented and corrected as early as possible.

scholarly journals Femoral Head Diameters and Sex Differentiation in the Northern Zone (Rajshahi) of Bangladesh

1970 ◽  
Vol 18 (2) ◽  
pp. 84-88
Author(s):  
Akhtari Afroze ◽  
M Durrul Huda
Keyword(s):  
Femoral Head ◽  
Sex Differentiation ◽  
Sex Identification ◽  
Statistical Significant Difference ◽  
Significant Difference ◽  
Northern Zone ◽  
The Mean ◽  
The Right ◽  
Present Area

This study was aimed to find out the variations of the femoral head diameters in relation to sex in Bangladeshi people. The study was based on 123 paired human femurs (radiological view) of which 52 were male and 71were female. It was observed that the mean vertical and transverse diameters of the head of the male femur were significantly greater than that of female (P<0.001).No statistical significant difference was present between the measurement of the right and left side of the same sixth identification points that were derived from the vertical and transverse diameters of the head of the femur were higher in males than in females. The results showed that diameters of the femoral head as well as the identification points that are derived from them are of use in sex identification. The present study is of value to the forensic experts, orthopaedicians and prosthetists as it gives the idea about the dimensions of the femoral head in the present area.   doi: 10.3329/taj.v18i2.3172 TAJ 2005; 18(2): 84-88

scholarly journals Elimination of the Femoral Neck in Measuring Femoral Version Allows for Less Variance in Interobserver Reliability

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1363
Author(s):  
Radomir Dimovski ◽  
Robert Teitge ◽  
Nicholas Bolz ◽  
Patrick Schafer ◽  
Vamsy Bobba ◽  
...  
Keyword(s):  
Femoral Head ◽  
Lower Bound ◽  
Confidence Interval ◽  
Upper Bound ◽  
Interobserver Reliability ◽  
Femoral Shaft ◽  
Lesser Trochanter ◽  
Femoral Version ◽  
Significant Difference ◽  
Head Neck

Background and Objectives: Producing consistent measures of femoral version amongst observers are necessary to allow for an assessment of version for possible corrective procedures. The purpose of this study was to compare two computed tomography (CT)-based techniques for the reliability of measuring femoral version amongst observers. Materials and Methods: Review was performed for 15 patients post-femoral nailing for comminuted (Winquist III and IV) femoral shaft fractures where CT scanograms were obtained. Two CT-based techniques were utilized to measure femoral version by five observers. Results: The mean femoral version, when utilizing a proximal line drawn down the center of the femoral head-neck through CT, was 9.50 ± 4.82°, while the method utilizing the head and shaft at lesser trochanter centers produced a mean version of 18.73 ± 2.69°. A significant difference was noted between these two (p ≤ 0.001). The method of measuring in the center of the femoral head and neck produced an intraclass correlation coefficient (ICC) of 0.960 with a 95% confidence interval lower bound of 0.909 and upper bound of 0.982. For the method assessing version via the center of the head and shaft at the lesser trochanter region, the ICC was 0.993 with a 95% confidence interval lower bound of 0.987 and an upper bound of 0.996. Conclusions: The method of measuring version proximally through a CT image of the femoral head–neck versus overlaying the femoral head with the femoral shaft at the most prominent aspect of the lesser trochanter produces differing version measurements by roughly 10° while yielding an almost perfect interobserver reliability in the new technique. Both techniques result in significantly high interobserver reliability.

scholarly journals The Effects of Including Aerobic Exercise in the Treatment Protocol of Concussions: A Systemic Review and Meta-analysis

2019 ◽  
Vol 7 (4) ◽  
pp. 33
Author(s):  
Sofie De Wandel ◽  
Tracey Sulak ◽  
Darryn S. Willoughby
Keyword(s):  
Physical Activity ◽  
Confidence Interval ◽  
Aerobic Exercise ◽  
Children And Adolescents ◽  
Effect Size ◽  
Meta Analysis ◽  
Risk Difference ◽  
Systemic Review ◽  
Significant Difference ◽  
The Mean

Background of Study: More research studies are being completed advocating for the use of exercise as an intervention and form of treatment for concussions. However, exercise can include many forms of physical activity, intensities, and durations. This systemic review and meta-analysis focused on the use of aerobic exercise, such as cycling or walking, as an intervention and form of treatment for children and young adults suffering from a concussion. Objective: The purpose of this systematic review and meta-analysis was to determine if the addition of aerobic exercise to an individual concussion treatment makes a significant difference when compared to treatments using flexibility as a form of physical activity or traditional methods of treatment following guidelines from the 2016 Berlin Consensus Statement on Concussion in Sport. Method: The search conducted for articles generated 472 studies. Out of these, 5 studies were selected based from the inclusion criteria. Results: Aerobic exercise was shown to significantly decrease the absolute risk difference for the development of prolonged post-concussion symptoms in children and adolescents with concussions when compared to those who reported no physical activity. The mean risk difference for the independent variable (IV) was -0.12 with a 95% confidence interval was reported to be -0.17 to -0.07 and an effect size of Z = 4.94 (P < 0.00001). Aerobic exercise was also shown to have an effect on the change in post-concussion symptom scale scores. The mean IV difference was 8.7 with a 95% confidence interval of 2.05 to 14.35 and an effect size of Z=3.02 (p=0.003). Conclusion: In conclusion, while there is evidence that aerobic exercise is beneficial for children and adolescents with a concussion, more studies need to be completed focusing on this age group and the effects of aerobic exercise on concussion recovery.

scholarly journals The Diagnostic Value of SPECT/CT in Predicting the Occurrence of Osteonecrosis following Femoral Neck Fracture : a prospective cohort study

2020 ◽  
Author(s):  
Jae Youn Yoon ◽  
Soong Joon Lee ◽  
Kang Sup Yoon ◽  
Pil Whan Yoon
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
Uptake Ratio ◽  
Significant Difference ◽  
Neck Fracture ◽  
The Mean

Abstract Backgrounds One of the most significant complications after a femoral neck fracture is osteonecrosis of the femoral head (ONFH). The concomitant use of single-photon emission computed tomography (SPECT) with computed tomography (CT) increases the sensitivity for detecting the anatomic location and severity of ONFH. In this study, we evaluated the diagnostic value of SPECT/CT for the occurrence of ONFH by quantifying the perfusion status of the femoral head. Methods A total of 30 patients who had multiple pinnings for femur neck fractures were included in this study. We classified the perfusion status into three groups: normal perfusion, decreased perfusion, and avascular groups, and compared the occurrence of femoral head necrosis between them. For quantitative analysis, we evaluated the uptake ratio of both femur heads (head-to-head uptake ratio). If the patient’s contralateral hip was incomparable, we measured the uptake ratio from the superior dome of the ipsilateral acetabulum (head-to-acetabulum uptake ratio). Results Twenty-four patients out of 30 achieved bone union, whereas the others developed ONFH. When the population was divided into intact and defective perfusion groups on scintigraphy, the sensitivity, specificity, and accuracy of the test were 83.3%, 75.0%, and 76.7%, respectively. The mean head-to-head uptake ratio value with a 95% confidence interval (CI) was 1.10 (95% CI: 0.85 – 1.36). In the osteonecrosis group, the mean value of the head-to-head uptake ratio was 0.33 (95% CI: 0.28 – 0.38). In contrast, the ratio was 1.30 (95% CI: 1.03 – 1.57) in the non-osteonecrosis group, demonstrating a significant difference in the uptake ratio ( P < 0.001). When the cutoff value of the uptake ratio was set to 0.5, both the sensitivity and specificity were 100%. There was also a significant difference in the head-to-acetabulum uptake ratio between the two groups ( P < 0.001). Conclusions SPECT/CT was useful in evaluating the perfusion status of the femoral head, showing high accuracy in predicting the occurrence of avascular necrosis. To demonstrate the reliability and validity of SPECT/CT, further prospective studies on a larger scale are warranted.

scholarly journals The Diagnostic Value of SPECT/CT in Predicting the Occurrence of Osteonecrosis Following Femoral Neck Fracture: a Prospective Cohort Study

2020 ◽  
Author(s):  
Jae Youn Yoon ◽  
Soong Joon Lee ◽  
Kang Sup Yoon ◽  
Pil Whan Yoon
Keyword(s):  
Computed Tomography ◽  
Femoral Head ◽  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Diagnostic Value ◽  
Emission Computed Tomography ◽  
Uptake Ratio ◽  
Significant Difference ◽  
Neck Fracture ◽  
The Mean

Abstract BackgroundsOne of the most significant complications after a femoral neck fracture is osteonecrosis of the femoral head (ONFH). The concomitant use of single-photon emission computed tomography (SPECT) with computed tomography (CT) increases the sensitivity for detecting the anatomic location and severity of ONFH. In this study, we evaluated the diagnostic value of SPECT/CT for the occurrence of ONFH by quantifying the perfusion status of the femoral head.MethodsA total of 30 patients who had multiple pinnings for femur neck fractures were included in this study. We classified the perfusion status into three groups: normal perfusion, decreased perfusion, and avascular groups, and compared the occurrence of femoral head necrosis between them. For quantitative analysis, we evaluated the uptake ratio of both femur heads (head-to-head uptake ratio). If the patient’s contralateral hip was incomparable, we measured the uptake ratio from the superior dome of the ipsilateral acetabulum (head-to-acetabulum uptake ratio).ResultsTwenty-four patients out of 30 achieved bone union, whereas the others developed ONFH. When the population was divided into intact and defective perfusion groups on scintigraphy, the sensitivity, specificity, and accuracy of the test were 83.3%, 75.0%, and 76.7%, respectively. The mean head-to-head uptake ratio value with a 95% confidence interval (CI) was 1.10 (95% CI: 0.85–1.36). In the osteonecrosis group, the mean value of the head-to-head uptake ratio was 0.33 (95% CI: 0.28–0.38). In contrast, the ratio was 1.30 (95% CI: 1.03–1.57) in the non-osteonecrosis group, demonstrating a significant difference in the uptake ratio (P < 0.001). When the cutoff value of the uptake ratio was set to 0.5, both the sensitivity and specificity were 100%. There was also a significant difference in the head-to-acetabulum uptake ratio between the two groups (P < 0.001).ConclusionsSPECT/CT was useful in evaluating the perfusion status of the femoral head, showing high accuracy in predicting the occurrence of avascular necrosis. To demonstrate the reliability and validity of SPECT/CT, further prospective studies on a larger scale are warranted.

Urinary Cell-Free DNA as a Potential Tumor Marker for Bladder Cancer

2007 ◽  
Vol 22 (4) ◽  
pp. 287-294 ◽  
Author(s):  
H.W. Chang ◽  
K.H. Tsui ◽  
L.C. Shen ◽  
H.W. Huang ◽  
S.N. Wang ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Confidence Interval ◽  
Tumor Marker ◽  
Cancer Patients ◽  
Cancer Detection ◽  
Screening Tool ◽  
Roc Curves ◽  
Urine Creatinine ◽  
Significant Difference ◽  
The Mean

The objective was to assess the possibility of measuring urine creatinine (UCr)-adjusted urinary cell-free (ucf) DNA concentration as a noninvasive screening tool for bladder cancer. Using PicoGreen-based detection, the ucf-DNA/UCr concentration was quantified in urine supernatant specimens from 46 bladder cancer patients and 98 controls and compared to 400-bp real-time PCR-based detection, which detected the amplification of 400-bp β-actin (named 400-bp ucf-DNA/UCr). The mean concentrations for both PicoGreen and 400-bp ucf-DNA (ng/mL)/UCr (mg/dL) were significantly higher in bladder cancer patients than in controls: 15.28 vs 6.68 (p<0.001, t-test) and 14.98 vs 1.07 (p<0.001), respectively. Among different stages and grades, no significant difference was found between these two methods. The areas under the ROC curves of PicoGreen and 400-bp ucf-DNA/UCr were 0.571 (95% confidence interval, 0.451–0.692) and 0.805 (95% confidence interval, 0.713–0.896), respectively. In 400-bp ucf-DNA/UCr, the best sensitivity and specificity were 86.1% and 72.0% at the cutoff value of 0.0645. These data indicated that 400-bp ucf-DNA/UCr is more reliable for bladder cancer detection than PicoGreen. In conclusion, our results suggest that ucf-DNA/UCr can be used as a potential tumor marker for bladder cancer, especially for detecting longer DNA fragments.

scholarly journals Effect of Osteonecrosis Intervention Rod Versus Core Decompression Using Multiple Small Drill Holes on Early Stages of Necrosis of the Femoral Head: A Prospective Study on a Series of 60 Patients with a Minimum 1-Year-Follow-Up

2015 ◽  
Vol 9 (1) ◽  
pp. 179-184 ◽  
Author(s):  
Haixiong Miao ◽  
Dongping Ye ◽  
Weiguo Liang ◽  
Yicun Yao
Keyword(s):  
Femoral Head ◽  
Core Decompression ◽  
Alternative Methods ◽  
Early Stages ◽  
Significant Difference ◽  
Harris Score ◽  
The Mean ◽  
Drill Holes ◽  
Partial Weight

Introduction: The conventional CD used 10 mm drill holes associated with a lack of structural support. Thus, alternative methods such as a tantalum implant, small drill holes, and biological treatment were developed to prevent deterioration of the joint. The treatment of CD by multiple 3.2 mm drill holes could reduce the femoral neck fracture and partial weight bearing was allowed. This study was aimed to evaluate the effect of osteonecrosis intervention rod versus core decompression using multiple small drill holes on early stages of necrosis of the femoral head. Method: From January 2011 to January 2012, 60 patients undergoing surgery for osteonecrosis with core decompression were randomly assigned into 2 groups based on the type of core decompression used: (1) a total of 30 osteonecrosis patients (with 16 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with a porous tantalum rod insertion. The diameter of the drill hole for the intervention rod was 10mm.(2) a total of 30 osteonecrosis patients (with 14 hips on Steinburg stageⅠ,20 hips on Steinburg stageⅡ) were treated with core decompression using five drill holes on the lateral femur, the diameter of the hole was 3.2 mm. The average age of the patient was 32.6 years (20-45 years) and the average time of follow-up was 25.6 months (12- 28 months) in the rod implanted group. The average age of the patient was 35.2 years (22- 43 years) and the average time of follow-up was 26.3 months (12-28 months) in the small drill holes group. Results: The average of surgical time was 40 min, and the mean volume of blood loss was 30 ml in both surgical groups. The average of Harris score was improved from 56.2 ± 7.1 preoperative to 80.2 ± 11.4 at the last follow-up in the rod implanted group (p < 0.05). The mean Harris score was improved from 53.8 ± 6.6 preoperative to 79.7 ± 13.2 at the last follow-up in the small drill holes group (p<0. 05). No significant difference was observed in Harris score between the two groups. At the last follow-up, 28 of 36 hips were at the same radiographic stages as pre-operation, and 8 deteriorated in the rod implanted group. 26 of 34 hips were at the same radiographic stage as pre-operation, and 8 deteriorated in the small drill holes group. No significant difference was observed in radiographic stage between the two groups. There was no favourable result on the outcome of a tantalum intervention implant compared to multiple small drill holes. Discussion: CD via multiple small drill holes would allow similar postoperative load-bearing and seems to result in similar or even better clinical outcome without the prolonged implantation of an expensive tantalum implant. A tantalum rod intervention and core decompression using multiple small drill holes were effective on the stage I hips rather than stage II hips.

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