Dual mobility total hip arthroplasty (DM-THA) allows for very large femoral head size, which may be beneficial for hip range of motion (ROM). No clinical study has objectively compared ROM in patients with DM-THA and large (36-mm head) total hip arthroplasty (36-THA). The aim of this prospective case-control study is to test the hypotheses that DM-THA provides superior hip ROM compared to 36-THA by dynamic radiography, and that surgical approach (posterolateral [PL] versus modified anterolateral [AL]) has effect on post-operative hip ROM. Sixteen patients (11 males, 5 females) who had undergone DM-THA with a minimum follow up of one year were age, sex and body mass index (BMI) matched to twenty patients (12 males, 8 females) with 36-THA, all operated upon by the senior author. Maximum hip-trunk flexion, extension and total hip-trunk ROM was calculated on standing lateral digital radiographs of the lower lumbar spine, pelvis and hip, using commercially available software (TraumaCad®, BrainLab, Munich, Germany) from three upright positions; standing neutral, standing with maximum hip flexion and standing with maximum hip extension. Contributions to motion from lumbo-sacral spine (LSS) and pelvic tilt were calculated and subtracted from hip-trunk measurements to quantify true hip flexion, extension and total true hip ROM. Statistical analysis (SPSS software, Chicago, IL) was performed on all radiographic measurements to detect difference in ROM between DM-THA and 36-THA, and to detect difference in ROM between THAs performed through posterolateral (THA-PL) and anterolateral (THA-AL) approaches.Introduction:
Materials and Methods:
The aim of this study is to explore the effect of extracorporeal shock wave therapy (ESWT) in patients with chronic planter faciitis. In this prospective study 70 heels in 62 patients with chronic planter faciitis in whom conventional conservative treatment consisting of nonsteroidal anti-inflammatory drugs, heel cup, orthoses and/or shoe modifications, local steroid injections have failed, were treated with low energy ESWT. Patients were reviewed at 6, 12 and 24 weeks post treatment. At follow-up there was significant decrease in pain on the visual analog scale (VAS) (p=0.27), with significant improvement in pain score (p=0.009) and in functional score (p<
0.001). The comfortable walking distance has increased significantly. There were no reported side effects. This study indicates that in patients with chronic plantar fasciitis, the ESWT provide a good pain relief and a satisfactory clinical outcome.