Early Results of Total Cementless Hip Joint Arthroplasty with the Anatomical Stem

2021 ◽  
Vol 23 (3) ◽  
pp. 167-180
Author(s):  
Marek Drobniewski ◽  
Magdalena Krasińska ◽  
Marek Synder ◽  
Andrzej Borowski
Keyword(s):  
Hip Joint ◽  
Functional Results ◽  
Joint Arthroplasty ◽  
Acetabular Cup ◽  
Kaplan Meier ◽  
Early Results ◽  
Long Term Follow Up ◽  
The Mean ◽  
Joint Arthroplasties

Background. The aim of this study is to present the early results of hip joint arthroplasty with the EXCEPTION anatomical stem (BIOMET). Materials and methods. The study enrolled 173 patients (110 women and 63 men) who underwent a total of 190 hip joint arthroplasties with the EXCEPTION anatomical stem. The mean age of the patients at surgery was 58.2 years (range: 28-82 years). The mean follow-up period was 7.3 years (range: 5-10.1 years). Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) of the study group were poor in all patients. Mean post-operative improvement was 6.7 points. The outcomes were classified as excellent in 131 cases, good in 39, satisfactory in 13 and poor in 7 cases. Poor results were always associated with implant loosening. Heterotopic ossification was noted in 14 cases (7.4%). According to the Kaplan-Meier estimator, 5 years’ survival probability was 96.31% for the whole implant and 99.47% for the stem alone. Conclusions. 1. Our follow-up data (from a mean follow-up period of more than 7 years) indicate that the EXCEPTION anatomical stem affords excellent clinical and functional results. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Due to the relatively short duration of follow-up, there may be more cases of loosening (mainly of the acetabular cup) over time, requiring regular long-term follow-up.

Analysis of Outcomes of Total Cementless Hip Joint Arthroplasty in the Treatment of Advanced Hip Osteoarthritis Following Childhood Perthes’ Disease

2020 ◽  
Vol 22 (5) ◽  
pp. 333-342
Author(s):  
Marek Drobniewski ◽  
Magdalena Krasińska ◽  
Andrzej Grzegorzewski ◽  
Marek Synder ◽  
Andrzej Borowski
Keyword(s):  
Hip Joint ◽  
Hip Osteoarthritis ◽  
Joint Arthroplasty ◽  
Perthes Disease ◽  
Acetabular Cup ◽  
Kaplan Meier ◽  
Long Term Follow Up ◽  
The Mean ◽  
Joint Arthroplasties

Background. The aim of this study is to analyse the outcomes of total cementless hip joint arthroplasty in the treatment of advanced hip osteoarthritis following Perthes’ disease in childhood. Material and methods. The study enrolled 56 patients (15 women and 41 men) who underwent a total of 61 hip joint arthroplasties for coxarthrosis following Perthes’ disease. The mean age of the patients at surgery was 46.7 years (range 21-67 years). The mean follow-up period was 13.7 years. Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) of the study group were poor in all patients. Mean post-operative improvement was 6.7 points. The outcomes were classified as excellent in 25 cases, good in 16, satisfactory in 16 and poor in 9 cases. Poor results were always related to loosening of the acetabular cup. Heterotopic ossification was noted in 7 cases. According to the Kaplan-Meier estimator, 10 years’ survival probability was 85.24% for the whole implant and 100% for the stem. Conclusions. 1. Total cementless hip joint arthroplasty is an effective method in the treatment of advanced hip osteoarthritis following Perthes’ disease in childhood. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Due to the patients’ young age, there may be more cases of loosening over time, requiring regular long-term follow-up.

Analysis of the Results of Hip Arthroplasty with the Use of Khanuja Group 6 stems

2021 ◽  
Vol 23 (5) ◽  
pp. 361-374
Author(s):  
Marek Drobniewski ◽  
Magdalena Krasińska ◽  
Marek Synder ◽  
Andrzej Borowski
Keyword(s):  
Hip Joint ◽  
Hip Osteoarthritis ◽  
Functional Results ◽  
Joint Arthroplasty ◽  
Implantation Technique ◽  
Acetabular Cup ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
The Mean

Background. Total cementless hip joint arthroplasty is universally recognized as a method of treatment of ad­vanced hip osteoarthritis. Multifaceted research by a wide group of implant specialists has led to the development of special implants that fulfill their purpose even in the most severe deformities of the hip joint. The aim of the study is to present and analyse the results of hip joint arthroplasty with the Antega anatomical stem. Materials and methods. The study enrolled 533 patients (342 women and 191 men) who underwent a total of 595 hip joint arthroplasties with the Antega anatomical stem. The mean age of the patients at surgery was 56.2 years (range: 20-87 years). The mean follow-up period was 7.3 years (range: 5-15.5 years). Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) were poor in all patients. Mean post-operative improvement was 6.1 points. The outcomes were classified as excellent in 419 cases (70.4%), good in 102 cases (17.1%), satisfactory in 39 (6.6%) and poor in 34 cases. Poor results were usually associated with loosening of one of the prosthetic components. Heterotopic ossification was noted in 37 cases (6.2%). According to the Kaplan-Meier estimator, 10 years’ survival probability was 89.9% for the whole implant and 96.1% for the stem alone. Conclusions. 1. Our follow-up data (from a mean follow-up period of more than 10 years) indicate that the Antega anatomical stem affords excellent clinical and functional results. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Modification of the Antega stem implantation technique significantly reduces the risk of so-called unexplained thigh pain, which sometimes occurs following hip replacement surgery. 4. As only medium-term follow-up data are available, there may be more cases of loosening (mainly of the acetabular cup) over time, requiring regular long-term follow-up.

Obstetrical brachial plexus injuries: Late functional results of the Steindler procedure

2014 ◽  
Vol 39 (8) ◽  
pp. 868-875 ◽  
Author(s):  
A. Gilbert ◽  
S. Valbuena ◽  
C. Posso
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Elbow Flexion ◽  
Functional Results ◽  
Obstetrical Brachial Plexus Palsy ◽  
Long Term Follow Up ◽  
The Mean ◽  
Extensor Lag

We reviewed late functional results of a modified Steindler procedure in patients with obstetrical brachial plexus palsy and poor active elbow flexion. From 1982 to 2005, we reviewed final functional results and complications of 27 cases with flexion weakness of the elbow secondary to obstetrical brachial plexus injury, treated with a modified Steindler procedure. At the end of the follow-up, the mean active elbow flexion was 97° and the mean extensor lag was 10°. In the long-term follow-up, the modified Steindler procedure maintained good results in 67% of the cases in our series, and this percentage raised by 82% when the wrist extensor was present or restored before the Steindler procedure. There were poor results in 19% of the patients, but no major complications.

Pyrocarbon proximal interphalangeal joint arthroplasty: a medium to long term follow-up of a single surgeon series

2015 ◽  
Vol 40 (9) ◽  
pp. 952-956 ◽  
Author(s):  
P. A. Storey ◽  
M. Goddard ◽  
C. Clegg ◽  
M. E. Birks ◽  
S. H. Bostock
Keyword(s):  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Level Of Evidence ◽  
Visual Analogue Pain ◽  
Kaplan Meier ◽  
Long Term Follow Up ◽  
Post Traumatic ◽  
Joint Arthroplasties

We retrospectively reviewed a consecutive single surgeon series of 57 Ascension pyrocarbon proximal interphalangeal joint arthroplasties, with a mean follow-up of 7.1 years (range 2 years to 11 years 6 months). We assessed the ranges of motion, deformity, stability and pain of the operated joints, grip strength of the hand and patient satisfaction. Of the cases, 44 were for osteoarthritis, five for rheumatoid arthritis and eight for post-traumatic arthritis. The median post-operative active arc of motion was from 0° to 60°. The median post-operative visual analogue pain score was 0.3 out of ten. Thirty six of the joints had no complications; 14 had minor complications (squeak, slight swan neck); three required early reoperation (joint release, flexor tenodesis); and five required implant removal. A total of 69% of our patients would have the same operation if they had to make the decision again. The Kaplan-Meier survival method estimates the mean implant survival to be 10.7 years (95% confidence intervals 9.96–11.37 years). All five failures occurred during the first 2 years. Level of evidence 4 (Case-series).

Surface replacement trapeziometacarpal joint arthroplasty – early results

2009 ◽  
Vol 34 (6) ◽  
pp. 748-757 ◽  
Author(s):  
A. PENDSE ◽  
A. NISAR ◽  
S. Z. SHAH ◽  
A. BHOSALE ◽  
J. V. FREEMAN ◽  
...  
Keyword(s):  
Joint Arthroplasty ◽  
Dash Score ◽  
Surface Replacement ◽  
Trapeziometacarpal Joint ◽  
Early Results ◽  
Asymptomatic Patients ◽  
The Mean ◽  
Quick Dash ◽  
Tendon Interposition

This study reviews the results of Surface Replacement Trapeziometacarpal (SR TMC, Avanta®, San Diego, CA) total joint arthroplasty. Fifty patients (62 joints) were included in the study. Forty-three patients (54 joints) were seen at final follow up. Seven patients (eight joints) were interviewed over the phone. Seven patients were revised to trapeziectomy and ligament reconstruction with tendon interposition, five for aseptic loosening and two for dislocation. At final follow up, the mean Quick DASH score was 30.4 and the Sollerman Score was 77.3. Radiological review of the surviving 55 joints showed subsidence of four trapezial components in asymptomatic patients. Cumulative survival rate was 91% at 3 years. Eighty-five percent of the patients were satisfied with the outcome of their treatment.

scholarly journals Complications in Hip Arthroplasty

2011 ◽  
Vol 18 (3) ◽  
pp. 59-63 ◽  
Author(s):  
Aleksandr Borisovich Slobodskoy ◽  
E Yu Osintsev ◽  
A G Lezhnev ◽  
A B Slobodskoi ◽  
E Yu Osintsev ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Joint ◽  
Hip Replacement ◽  
Joint Arthroplasty ◽  
Total Hip ◽  
Inflammatory Processes ◽  
History Of ◽  
Revision Total Hip Replacement ◽  
Joint Arthroplasties

Experience in follow up of 1399 patients after 1603 hip joint arthroplasties is presented. Bilateral operations were performed in 102 patients. In 111 patients revision total hip replacement was performed. Age of patients ranged from 18 to 94 years. Different complications were present in 4,3% of cases: pyo-inflammatory - in 1,37%, implant head dislocation - 1,93%, periprosthetic fractures - 0,19%, postoperative neuritis - 0,49% and pulmonary thrombosis - in 0,31% of cases. Elderly and senile patients, severe concomitant pathology (diabetes mellitus, rheumatoid arthritis and other systemic diseases), acute proximal femur injury, earlier operated dysplastic coxarthrosis, revision and complicated total hip replacement, history of pyo-inflammatory processes in the zone of hip joint are to be considered as risk factors to complication development. Scale for complications prognosis in hip joint arthroplasty is presented.

Incidence, management and outcome of raised intraocular pressure in childhood-onset uveitis at a tertiary referral centre

2018 ◽  
Vol 103 (6) ◽  
pp. 748-752 ◽  
Author(s):  
Shi Zhuan Tan ◽  
Kenneth Yau ◽  
Laura R Steeples ◽  
Jane Ashworth ◽  
Cecilia Fenerty ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Glaucoma Surgery ◽  
Median Number ◽  
Final Visit ◽  
Tertiary Referral Centre ◽  
Kaplan Meier ◽  
Long Term Follow Up ◽  
The Mean ◽  
Pre Treatment

Background/aimsTo investigate the incidence, management and outcome of uveitis and raised intraocular pressure (IOP) in children treated at the Manchester Uveitis Clinic (MUC).MethodsThis was a retrospective, observational study of patients who presented with uveitis under the age of 16 to the MUC from July 2002 to June 2016.ResultsA total of 320 children were included in the study. Out of these, 55 (17.2%) patients (75 eyes) were found to have raised IOP requiring treatment. The mean age at diagnosis of uveitis and at first recorded raised IOP was 8.2±4.3 and 10.8±3.6 years, respectively. The pre-treatment IOP was 32.3±6.6 mm Hg and the IOP at the final visit was 15.5±3.7 mm Hg (median follow-up period, 43.7 months) on a median number of 0 medications. Twenty-eight eyes (37.3%) required glaucoma drainage surgery, and eight eyes (12.5%) had cyclodiode laser before this. Kaplan-Meier analysis showed that 11.5% of eyes required glaucoma surgery at 1 year after diagnosis of raised IOP, increasing to 50.0% by 5 years. The best-corrected visual acuity at diagnosis of uveitis was 0.26±0.42 logMAR, which remained stable at 0.28±0.65 logMAR at final follow-up visit. Four eyes (5.3%) from four patients fulfilled the definition of blindness by the WHO criteria. The mean cup:disc ratio at final follow-up was 0.4.ConclusionOur cohort of children with raised IOP appeared to have a good outcome overall through aggressive medical and surgical management. Regular long-term follow-up is recommended, and early surgical intervention in eyes with uncontrolled IOP can prevent loss of vision.

Hybrid Endovascular Repair of Thoracoabdominal Aorta: Early Results

2014 ◽  
Vol 17 (3) ◽  
pp. 146
Author(s):  
Osman Tansel Darcin ◽  
Mehmet Kalender ◽  
Ayse Gul Kunt ◽  
Okay Guven Karaca ◽  
Ata Niyazi Ecevit ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Therapeutic Option ◽  
Complete Recovery ◽  
Aortic Aneurysms ◽  
Thoracoabdominal Aorta ◽  
Mortality And Morbidity ◽  
Early Results ◽  
The Mean ◽  
Procedural Success

<p><b>Background:</b> Thoracoabdominal aortic aneurysms (TAAA) present a significant clinical challenge, as they are complex and require invasive surgery. In an attempt to prevent considerably high mortality and morbidity in open repair, hybrid endovascular repair has been developed by many authors. In this study, we evaluated the early-term results obtained from this procedure.</p><p><b>Methods:</b> From November 2010 to February 2013, we performed thoracoabdominal hybrid aortic repair in 18 patients. The mean age was 68 years (12 men, 6 women). All of the patients had significant comorbidities. Follow-up computed tomography (CT) scans were performed at 1 week, 3 months, 6 months, and annually thereafter.</p><p><b>Results:</b> All patients were operated on in a staged procedure and stent graft deployment was achieved. Procedural success was achieved in all cases. All patients were discharged with complete recovery. No endoleaks weres detected in further CT examination.</p><p><b>Conclusion:</b> Our results suggests that hybrid debranching and endovascular repair of extensive thoracoabdominal aneurysms represents a suitable therapeutic option to reduce the morbidity and mortality of TAAA repair, particularly in those typically considered at high risk for standard repair.</p>

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

Atrial fibrillation associated with increased risk of venous thromboembolism

2015 ◽  
Vol 113 (01) ◽  
pp. 185-192 ◽  
Author(s):  
Chun-Cheng Wang ◽  
Cheng-Li Lin ◽  
Guei-Jane Wang ◽  
Chiz-Tzung Chang ◽  
Fung-Chang Sung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Venous Thromboembolism ◽  
Incidence Rates ◽  
Vein Thrombosis ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Deep Vein

SummaryWhether atrial fibrillation (AF) is associated with an increased risk of venous thromboembolism (VTE) remains controversial. From Longitudinal Health Insurance Database 2000 (LHID2000), we identified 11,458 patients newly diagnosed with AF. The comparison group comprised 45,637 patients without AF. Both cohorts were followed up to measure the incidence of deep-vein thrombosis (DVT) and pulmonary embolism (PE). Univariable and multivariable competing-risks regression model and Kaplan-Meier analyses with the use of Aelon-Johansen estimator were used to measure the differences of cumulative incidences of DVT and PE, respectively. The overall incidence rates (per 1,000 person-years) of DVT and PE between the AF group and non-AF groups were 2.69 vs 1.12 (crude hazard ratio [HR] = 1.92; 95 % confidence interval [CI] = 1.54-2.39), 1.55 vs 0.46 (crude HR = 2.68; 95 % CI = 1.97-3.64), respectively. The baseline demographics indicated that the members of the AF group demonstrated a significantly older age and higher proportions of comorbidities than non-AF group. After adjusting for age, sex, and comorbidities, the risks of DVT and PE remained significantly elevated in the AF group compared with the non-AF group (adjusted HR = 1.74; 95 %CI = 1.36-2.24, adjusted HR = 2.18; 95 %CI = 1.51-3.15, respectively). The Kaplan-Meier curve with the use of Aelon-Johansen estimator indicated that the cumulative incidences of DVT and PE were both more significantly elevated in the AF group than in the non-AF group after a long-term follow-up period (p<0.01). In conclusion, the presence of AF is associated with increased risk of VTE after a long-term follow-up period.

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