Radiostereometric Analysis (RSA) is an imaging method that is increasingly being utilized for monitoring fixation of orthopaedic implants in randomized clinical trials. Extensive RSA research has been conducted over the last 35+ years using standard clinical x-ray acquisition modalities that irradiate screen/film media or Computed Radiography (CR) plates. The precision of RSA can depend on a number of factors including modality image quality. This study assesses the precision of RSA with a novel Digital Radiography (DR) system compared to a CR imaging system using different imaging techniques. Additionally, the study assesses the precision of locating beads embedded in a modified spine pedicle screw.Introduction
Objective
Despite being matched by age, gender and modified Charnley classification, there were significant differences in post-operative functional scores. The revision TKR group’s mean WOMAC score was 73 (SD 17), compared to the primary group’s mean score of 84 (SD 14), p=0.002. Similarly, the revision group’s mean SF-12 PCS score was 35 (SD 8) compared to the primary group’s superior score of 44 (SD 10), p<
0.0001. There was no differences detected in post-operative SF-12 mental component scores; 49 (SD 12) for the revision group compared to 53 (SD 10) for the primary group, p=0.11.
The purpose of the present study was to investigate the role of E2 on the responsiveness of the AIS cells to the melatonin, to determine the expression of estrogens receptors (ERα and ERβ) in AIS tissues and to clarify the impact of estrogen receptor gene polymorphisms in the pathogenesis of AIS.
Supported by the Fondation Yves Cotrel, Institut de France
The twelve matte and twelve polished surfaces of hemi-arthroplasties were contaminated with Tremendous suffering is associated with infection following total joint arthroplasty. To reduce infection risk, some surgeons use pulse irrigation prior to wound closure. This practice is based on the assumption that pulse irrigation will more effectively remove adherent bacteria. However, there has been no study of the effectiveness of pulse irrigation in clearing bacteria from prosthetic surfaces. The hypothesis of this study is that pulse irrigation is more effective than bulb irrigation in removing intra-operative bacterial contaminants from prosthetic surfaces. The matte and polished surfaces of hemiarthroplasties were studied separately. Each surface was contaminated with Twelve matte and twelve polished surfaces were examined using both irrigation types with corresponding non-irrigation reference values. Results are expressed as the percentage of contaminant bacteria recovered. The matte finish groups showed median values of 1.46 and 2.88x10−2 while the polished finish groups showed 1.49x10−3 and 2.83x10−6 with bulb and pulse irrigation, respectively. The difference between irrigation types is significant ( Pulse irrigation was more effective than bulb irrigation in removing contaminant bacteria from the prosthetic surfaces studied.
Allogenic blood transfusions are frequent sequellae of hip and knee arthroplasty with potentially deleterious consequences. A prospective collection of a comprehensive data set of 1,185 knee and 1,064 hip arthroplasty patients including primary and revision surgeries was completed with analysis of allogenic and predonated blood usage, blood salvage systems and costs. The most effective strategy in reducing allogenic blood transfusion is the use of a blood salvage system. The most expensive strategy is the use of blood salvage systems with predonation. The least expensive and least effective strategy is no predonation of blood and no blood salvaging system. The purpose of this study is to evaluate the usage, effectiveness and cost of blood salvage technologies in total hip and knee arthroplasty. The most effective strategy in reducing allogenic blood transfusion is the use of a blood salvage system. The most expensive strategy is the use of blood salvage systems with predonation. The least expensive and least effective strategy is no predonation of blood and no blood salvaging system. More than half of the predo-nated blood collected was never used. Blood loss in total hip and knee arthroplasty can have significant deleterious physiologic effects on patients. There are potential health risks with allogenic blood transfusion as well as patient anxiety toward allogenic transfusion. Recent advances in blood management provide additional options that need further evaluation. The lowest cost strategy was no predonation and no blood salvage system at an average of $30 per patient, but with a 14% incidence of allogenic transfusion. Pre-donation alone had a cost of $330 with a 12% transfusion rate. Predonated blood was wasted in 60% of knee arthroplasties and 48% of hip arthroplasties. The Consta Vac and OrthoPAT blood salvage systems had a cost of $110 and $365 with 5% and 7% transfusion rate, respectively. A prospective collection of a two-year comprehensive data set of 1,185 knee and 1,064 hip arthroplasty patients including both primary and revision surgeries was completed. Analysis of blood counts, allogenic and predonated blood usage, blood salvage systems, length of stay, demographics and costs were performed.
Allogenic blood transfusions are frequent sequellae of hip and knee arthroplasty with potentially deleterious consequences. A prospective collection of a comprehensive data set of 1,185 knee and 1,064 hip arthroplasty patients including primary and revision surgeries was completed with analysis of allogenic and predonated blood usage, blood salvage systems and costs. The most effective strategy in reducing allogenic blood transfusion is the use of a blood salvage system. The most expensive strategy is the use of blood salvage systems with predonation. The least expensive and least effective strategy is no predonation of blood and no blood salvaging system. The purpose of this study is to evaluate the usage, effectiveness and cost of blood salvage technologies in total hip and knee arthroplasty. The most effective strategy in reducing allogenic blood transfusion is the use of a blood salvage system. The most expensive strategy is the use of blood salvage systems with predonation. The least expensive and least effective strategy is no predonation of blood and no blood salvaging system. More than half of the predonated blood collected was never used. Blood loss in total hip and knee arthroplasty can have significant deleterious physiologic effects on patients. There are potential health risks with allogenic blood transfusion as well as patient anxiety toward allogenic transfusion. Recent advances in blood management provide additional options that need further evaluation. The lowest cost strategy was no predonation and no blood salvage system at an average of $30 per patient, but with a 14% incidence of allogenic transfusion. Pre-donation alone had a cost of $330 with a 12% transfusion rate. Predonated blood was wasted in 60% of knee arthroplasties and 48% of hip arthroplasties. The Consta Vac and OrthoPAT blood salvage systems had a cost of $110 and $365 with 5% and 7% transfusion rate, respectively. A prospective collection of a two-year comprehensive data set of 1,185 knee and 1,064 hip arthroplasty patients including both primary and revision surgeries was completed. Analysis of blood counts, allogenic and predonated blood usage, blood salvage systems, length of stay, demographics and costs were performed.
Surgical treatment of recurrent dislocation after total hip arthroplasty (THA) is challenging with often disappointing results. The influence of the posterior hip capsule is important, and restoration of its function is a major goal of treatment. We describe our experience using an Achilles tendon allograft as a checkrein to limit hip internal rotation and to prevent posterior instability. Twenty unstable THAs were treated using this technique, eliminating instability in fifteen. At an average follow-up of 3.6 years, Achilles tendon allograft augmentation has proven a useful adjunct for the treatment of recurrent posterior dislocation after THA in selected patients. The purpose of this study is to review our results with a novel treatment for recurrent dislocation after total hip arthroplasty (THA) using an Achilles tendon allograft as a checkrein to prevent instability. Achilles tendon allograft augmentation has proved to be a useful adjunct for the treatment of recurrent posterior dislocation after THA in selected patients. Surgical treatment of recurrent dislocation after total hip arthroplasty (THA) is challenging with often disappointing results. Among possible causes of dislocation, the influence of the static soft tissue restraint provided by the hip capsule is important, and restoration of its integrity and function is a major goal of treatment. We describe a new technique in which an Achilles tendon allograft is employed as a checkrein to limit hip internal rotation and to prevent posterior instability. Twenty unstable THAs with recurrent instability were treated using this technique, eliminating instability in fifteen at an average follow-up of 3.6 (0.5 to 6.6) years. Prospective data was collected and reviewed on the first twenty patients with recurrent THA instability stabilized with an Achilles tendon allograft. Head and liner exchanges accompanied the allograft. Use of a constrained cup was considered a failure. Instability was successfully controlled in 75% of patients with use of the Achilles allograft. The technique is an important addition to the treatment arsenal of this difficult problem.