bluuebunny/crossref_metadata_2025 huggingface dataset:
Fractures involving splitting of the humeral head
Authors: Chesser T. J. S. , Langdon I. J. , Ogilvie C. , Sarangi P. P. , Clarke A. M.
Published: February 2018

Splitting fractures of the humeral head are rare; part of the humeral head dislocates and the unfractured part remains attached to the shaft. We report eight cases in young patients. In five the diagnosis was made at presentation: three had minimal internal fixation using a superior subacromial approach, one had a closed reduction and one a primary prosthetic replacement. All five patients regained excellent function with no avascular necrosis at two years. In three the injury was initially unrecognised; two developed a painless bony ankylosis and one is awaiting hemiarthroplasty.

It is important to obtain the three trauma radiographic views to diagnose these unusual fractures reliably. CT delineates the configuration of the fracture. In young patients open reduction and internal fixation seems preferable to replacement of the humeral head, since we have shown that the head is potentially viable.
Necrotising fasciitis of a limb
Authors: Tang W. M. , Ho P. L. , Fung K. K. , Yuen K. Y. , Leong J. C. Y.
Published: February 2018

Between January 1992 and December 1998, we treated 24 patients with necrotising fasciitis of a limb. There were 15 men and nine women with a mean age of 59.8 years (5 to 86). The infection was usually confused with cellulitis. Exquisite pain and early systemic toxicity were the most consistent clinical features. Diabetes mellitus and hepatic cirrhosis were the most commonly associated medical diseases. One third of the patients died. Those with involvement of the limbs above the knee or elbow on admission had a significantly higher rate of mortality than those with distal lesions (Fisher’s exact test, p = 0.027). There was no correlation between mortality and advanced age (Student’s t-test, p = 0.22) or between amputation and survival (Fisher’s exact test, p = 0.39).
Endoscopic reconstruction of the anterior cruciate ligament with quadrupled hamstring tendons
Authors: Natsu-ume T. , Shino K. , Nakata K. , Nakamura N. , Toritsuka Y. , Mae T.
Published: February 2018

A total of 30 patients who underwent endoscopic reconstruction of the anterior cruciate ligament using quadrupled hamstring tendons, through a single drill hole in the femur, had MRI 24 to 28 months after operation. In 18 patients the scans revealed that both the anterior and posterior portions of the graft ran in parallel from the inside of the femoral to the tibial tunnel. In 12, the posterior bundle had moved anteriorly and the anterior bundle could not be identified at the anterodistal border of the femoral tunnel. The mean difference in the anterior laxity, when compared with the contralateral knee, was 2.0 ± 1.7 mm and 4.3 ± 2.8 mm for the two types, respectively. Damage to the anterior bundle may occur when using the endoscopic technique because of biomechanical disadvantages, including concentration of loading and repetitive bending stress in the anterior bundle at the opening of the femoral tunnel.
Function of the upper limb after surgery for obstetric brachial plexus palsy
Authors: Dumont C. E. , Forin V. , Asfazadourian H. , Romana C.
Published: February 2018

We reviewed a consecutive series of 33 infants who underwent surgery for obstetric brachial plexus palsy at a mean age of 4.7 months. Of these, 13 with an upper palsy and 20 with a total palsy were treated by nerve reconstruction. Ten were treated by muscle transfer to the shoulder or elbow, and 16 by tendon transfer to the hand. The mean postoperative follow-up was 4 years 8 months. Ten of the 13 children (70%) with an upper palsy regained useful shoulder function and 11 (75%) useful elbow function. Of the 20 children with a total palsy, four (20%) regained useful shoulder function and seven (35%) useful elbow function. Most patients with a total palsy had satisfactory sensation of the hand, but only those with some preoperative hand movement regained satisfactory grasp. The ability to incorporate the palsied arm and hand into a co-ordinated movement pattern correlated with the sensation and prehension of the hand, but not with shoulder and elbow function.
The effect of partial and full weight-bearing on venous return in the lower limb
Authors: Eisele R. , Weickert E. , Eren A. , Kinzl L.
Published: February 2018

We studied the effect of full and partial weight-bearing on venous peak velocity in the legs of 73 subjects. We used colourflow Duplex ultrasound to determine the minimal amount of weight-bearing required to produce the same venous peak velocity as full weight-bearing.

We found that the venous peak velocity remains the same in the femoral vein during partial weight-bearing (196 N and above). This is important for postoperative physiotherapy and thrombo-prophylaxis. The median peak velocity was 30 cm/s. This corresponds to an amplification factor of four in relation to the individual resting level (peak velocity).

In addition, we found that partial weight-bearing at 196 N can reliably be reproduced. The median value of partial weight-bearing after a three-day training programme was 206 N.
Reconstruction does not reduce tibial translation in the cruciate-deficient knee
Authors: Beard D. J. , Murray D. W. , Gill H. S. , Price A. J. , Rees J. L. , Alfaro-Adrián J. , Dodd C. A. F.
Published: February 2018

We have assessed the effectiveness of reconstruction of the anterior cruciate ligament (ACL) in reducing functional tibial translation (TT).

The gait of 11 ACL-deficient patients was studied using Vicon equipment before and after surgery. Measurements of the angle between the patellar tendon and the long axis of the tibia were obtained in order to calculate TT in the sagittal plane relative to the uninjured limb during standing and walking.

Before surgery, patients did not show abnormal TT on the injured side, but after surgery significant anterior TT was found in the operated limb for every parameter of gait.

Abnormal anterior TT occurring during activity does not seem to be reduced by reconstruction; rather, it increases. It may be that the increased translation results from relaxation of excess contraction of the hamstring muscles, since compensatory muscle activity no longer is required in a reconstructed knee. The reduction of TT may not be an appropriate objective in surgery on the ACL.
Effects of reconstruction of the anterior cruciate ligament on voluntary activation of quadriceps femoris
Authors: Urbach D. , Nebelung W. , Becker R. , Awiszus F.
Published: February 2018

The loss of full muscle activation contributes to weakness of the quadriceps muscle in patients with deficiency of the anterior cruciate ligament (ACL). We examined whether a deficit of voluntary activation (VA) of the quadriceps muscle can be reversed by reconstruction of the ACL and assessed its influence on muscle strength and clinical parameters.

We evaluated 12 male subjects with an isolated tear of the ACL and 12 matched control subjects before operation and two years after reconstruction of the ACL. Assessment included measurements of isometric knee-extension torque at maximal voluntary contraction (MVC force), knee stability tests, the International Knee Ligament Standard Evaluation Form and the Tegner activity score. A sensitive method of twitch interpolation was used to quantify the VA and to calculate true muscle force.

Before operation we found a deficit of VA on both the injured (mean ±SEM 74.9 ± 3.5%) and the uninjured side (74.6 ± 3.0%) in comparison with the control group (91 ± 0.9%). Two years after reconstruction of the ACL the VA improved significantly on both sides but remained less than that of the controls. Correlation analysis revealed an improvement of the VA in patients who returned to a higher level of activity. The deficit of true muscle force, however, persisted regardless of the clinical outcome and ligament stability.
Neurones in the dorsal root ganglia of T13, L1 and L2 innervate the dorsal portion of lower lumbar discs in rats
Authors: Ohtori S. , Takahashi K. , Yamagata M. , Sameda H. , Moriya H. , Chiba T. , Takahashi Y.
Published: February 2018

Based on a study using a retrograde neurotracer, we have previously found that the dorsal portion of the L5/6 disc in the rat is multisegmentally innervated by dorsal root ganglia (DRG) from the level of T13 to L6, and that sensory nerve fibres from DRG of T13, L1 and L2 pass through the paravertebral sympathetic trunks. In this study in newborn rats, we injected crystals of 1,1′-dioctadecyl-3,3,3′,3′-tetramethylinedocarbocyanine perchlorate (DiI) into the DRG of T13, L1 and L2 and showed DiI-labelled sensory nerve fibres in the dorsal portion of the discs from the level of T13/L1 to L5/6. Our results show that the dorsal portion of the lumbar discs is innervated by the DRG from levels T13 to L2.
A retrieval study of Capital hip prostheses with titanium alloy femoral stems
Authors: McGrath L. R. , Shardlow D. L. , Ingham E. , Andrews M. , Ivory J. , Stone M. H. , Fisher J.
Published: February 2018

We have examined 26 retrieved, failed titanium-alloy femoral stems. The clinical details, radiological appearances and the histology of the surrounding soft tissues in each patient were also investigated.

The stems were predominantly of the flanged design and had a characteristic pattern of wear. A review of the radiographs showed a series of changes, progressive with time. The first was lateral debonding with subsidence of the stem. This was followed by calcar resorption and fragmentation or fracture of the cement. Finally, osteolysis was seen, starting with a radiolucency at the cement-bone interface and progressing to endosteal cavitation.

Three histological appearances were noted: granulomatous, necrobiotic and necrotic. We suggest that an unknown factor, possibly related to the design of the stem, caused it to move early. After this, micromovement at the cement-stem interface led to the generation of particulate debris and fracture of the cement. A soft-tissue reaction to the debris resulted in osteolysis and failure of fixation of the prostheses.
Intervertebral discs which cause low back pain secrete high levels of proinflammatory mediators
Authors: Burke J. G. , Watson R. W. G. , McCormack D. , Dowling F. E. , Walsh M. G. , Fitzpatrick J. M.
Published: February 2018

Herniated intervertebral disc tissue has been shown to produce a number of proinflammatory mediators and cytokines, but there have been no similar studies using discs from patients with discogenic low back pain.

We have compared the levels of production of interleukin-6 (IL-6), interleukin-8 (IL-8) and prostaglandin E2 (PGE2) in disc tissue from patients undergoing discectomy for sciatica (63) with that from patients undergoing fusion for discogenic low back pain (20) using an enzyme-linked immunoabsorbent assay.

There was a statistically significant difference between levels of production of IL-6 and IL-8 in the sciatica and low back pain groups (p < 0.006 and p < 0.003, respectively).

The high levels of proinflammatory mediator found in disc tissue from patients undergoing fusion suggest that production of proinflammatory mediators within the nucleus pulposus may be a major factor in the genesis of a painful lumbar disc.
Cannulation of simple bone cysts
Authors: Tsuchiya H. , Abdel-Wanis M. E. , Uehara K. , Tomita K. , Takagi Y. , Yasutake H.
Published: February 2018

We describe a consecutive series of 26 patients with simple bone cysts who were treated by curettage, multiple drilling and continuous decompression by the insertion of either a cannulated screw or a pin. In the first 15 patients we used titanium cannulated screws (group 1) and in the next 11 a cannulated hydroxyapatite pin (group 2). Satisfactory healing was achieved in 12 patients in group 1 (80%) and in all in group 2. This technique seems to be a promising option for the treatment of simple bone cysts. The cannulated hydroxyapatite pin is recommended because of its higher success rate and the fact that it does not need to be removed.
Endotoxin contamination of particles produces misleading inflammatory cytokine responses from macrophages in vitro
Authors: Brooks R. A. , Wimhurst J. A. , Rushton N.
Published: February 2018

Particulate prosthetic materials are often studied by adding them to monocytic cells in vitro and measuring the release of cytokines as an indicator of their inflammatory potential. Endotoxin is known to be a contaminant of particle preparations and also stimulates the release of cytokines. It is usual to use a proprietary endotoxin test to avoid erroneous results.

Four different formulations of cement were found to be free from endotoxin using standard, gelclot tests but stimulated different levels of release of cytokines from macrophages. These differences were explained when a more sensitive, kinetic endotoxin assay showed that release correlated with minor contamination with endotoxin. In a repeat experiment using cement particles with low or undetectable levels of endotoxin by kinetic assay, differences in the ability of the formulations to stimulate the release of cytokines were not seen.

Endotoxin is adsorbed on to the surface of particles and it is this combination which stimulates increased release of cytokines. In both the above methods for determination of endotoxin, the water in which the particles had been soaked was examined rather than the particles directly. Further investigations showed that a kinetic assay directly on a particle suspension is the most sensitive method to measure contamination with endotoxin.
Revision of the Kotz type of tumour endoprosthesis for the lower limb
Authors: Mittermayer F. , Windhager R. , Dominkus M. , Krepler P. , Schwameis E. , Sluga M. , Kotz R. , Strasser G.
Published: February 2018

In 251 patients over a period of 15 years an uncemented Kotz modular femoral and tibial reconstruction mega prosthesis was implanted after resection of a malignant tumour of the lower limb. Twenty-one patients (8.4%) underwent revision for aseptic loosening, again using an uncemented prosthesis, and five of these required a further revision procedure. The median follow-up time from the first revision was 60 months (11 to 168) and after a second revision, 33 months (2 to 50). The probability of a patient avoiding aseptic loosening for ten years was 96% for a proximal femoral, 76% for a distal femoral and 85% for a proximal tibial implant.

At the time of follow-up all radiographs were assessed according to the International Symposium of Limb Salvage criteria. The first radiological signs of aseptic loosening were always seen at the most proximal or distal part of the anchorage stem at a mean of 12 months (4 to 23) after the first implantation. Using the Musculoskeletal Tumor Society score for evaluation, the clinical results showed a mean of 88% of normal function.
OSTEONECROSIS OF THE HUMERAL HEAD AFTER EXTRACORPOREAL SHOCK-WAVE LITHOTRIPSY
Authors: Durst H. B. , Blatter G. , Kuster M. S.
Published: February 2018

A 59-year-old woman with calcific tendinitis in her right shoulder underwent extracorporeal shock-wave lithotripsy. Three years and four months later she presented with osteonecrosis of the head of the right humerus. It is known that shock waves in patients with urological disorders can damage blood vessels. A possible reason for the development of osteonecrosis in this patient may have been damage to the blood supply of the head of the humerus.
Migration of the femoral stem after impaction bone grafting
Authors: van Doorn W. J. , ten Have B. L. E. F. , van Biezen F. C. , Hop W. C. J. , Ginai A. Z. , Verhaar J. A. N.
Published: February 2018

We report the initial results of an ongoing randomised, prospective study on migration of the Exeter and Elite Plus femoral stems after impaction allografting, as measured by radiostereometry.

Clinically, the impaction technique gave good results for both stems. The mean subsidence in the first year was 1.30 mm and 0.20 mm for the Exeter and the Elite Plus stems, respectively. In the second year, the Exeter stem continued to subside further by a mean of 0.42 mm, while the Elite Plus stem did not do so. Subsidence of the Exeter stem correlated with deficiency of bone stock as graded on the Gustilo and Pasternak scale. This correlation was not found for the Elite Plus stem. None of the other parameters which were studied predisposed to subsidence. There was no significant association between the amount of subsidence and the radiological appearance of the graft for either stem. Our findings do not support the theory that radial compression, due to subsidence of the Exeter stem, is the essential stimulus for remodelling in impaction allografting.
The effect of rotational malunion of the radius and the ulna on supination and pronation
Authors: Dumont C. E. , Thalmann R. , Macy J. C.
Published: February 2018

We have assessed the influence of isolated and combined rotational malunion of the radius and ulna on the rotation of the forearm. Osteotomies were made in both the radius and the ulna at the mid-diaphyseal level of five cadaver forearms and stabilised with intramedullary metal implants. Malunion about the axis of the respective forearm bone was produced at intervals of 10°. The ranges of pronation and supination were recorded by a potentiometer under computer control. We examined rotational malunions of 10° to 80° of either the radius or ulna alone and combined rotational malunions of 20° to 60° of both the radius and ulna.

Malunion of the ulna in supination had little effect on rotation of the forearm. Malunion of either the radius or of the ulna in pronation gave a moderate reduction of rotation of the forearm. By contrast, malunion of the radius in supination markedly reduced rotation of the forearm, especially with malunion greater than 60°. Combined rotational malunion produced contrasting results. A combination of rotational malunion of the radius and ulna in the same direction had an effect similar to that of an isolated malunion of the radius. A combination in the opposite direction gave the largest limitation of the range of movement. Clinically, rotational malunion may be isolated or part of a complex angular/rotational deformity and rotational malunion may lead to marked impairment of rotation of the forearm. A reproducible method for assessing rotational malunion is therefore needed.
Tissue-engineered cartilage and bone using stem cells from human infrapatellar fat pads
Authors: Dragoo J. L. , Samimi B. , Zhu M. , Hame S. L. , Thomas B. J. , Lieberman J. R. , Hedrick M. H. , Benhaim P.
Published: February 2018

Multipotential processed lipoaspirate (PLA) cells extracted from five human infrapatellar fat pads and embedded into fibrin glue nodules, were induced into the chondrogenic phenotype using chondrogenic media. The remaining cells were placed in osteogenic media and were transfected with an adenovirus carrying the cDNA for bone morphogenetic protein-2 (BMP-2). We evaluated the tissue-engineered cartilage and bone using in vitro techniques and by placing cells into the hind legs of five severe combined immunodeficient mice.

After six weeks, radiological and histological analysis indicated that the PLA cells induced into the chondrogenic phenotype had the histological appearance of hyaline cartilage. Cells transfected with the BMP-2 gene media produced abundant bone, which was beginning to establish a marrow cavity. Tissue-engineered cartilage and bone from infrapatellar fat pads may prove to be useful for the treatment of osteochondral defects.
Development and testing of a reduced WOMAC function scale
Authors: Whitehouse S. L. , Lingard E. A. , Katz J. N. , Learmonth I. D.
Published: February 2018

We used prospective data from 862 total knee and 716 total hip replacements three years after surgery in order to derive and validate a reduced Western Ontario and McMasters University Osteoarthritis Index (WOMAC) function scale. The reduced scale was derived using the advice of clinical experts as well as analysis of data. The scale was tested for validity, reliability and responsiveness.

Items which were retained included: ascending stairs, rising from sitting, walking on the flat, getting in or out of a car, putting on socks, rising from bed, and sitting.

The reduced and full scales had comparable, moderate correlations with other measures of function, confirming convergent validity. Cronbach’s alpha was high (α > 0.85) with the reduced scale confirming reliability. Responsiveness was greater for the reduced scale (full = 1.4, reduced = 1.6).

This reduced version of the WOMAC function scale provides a practical, valid, reliable and responsive alternative to the full function scale for use after total joint replacement. Further work is needed to demonstrate its wider applicability.
Secondary resurfacing of the patella for persistent anterior knee pain after primary knee arthroplasty
Authors: Muoneke H. E. , Khan A. M. , Giannikas K. A. , Hägglund E. , Dunningham T. H.
Published: February 2018

Out of a total of 623 patients who, over a ten-year period, underwent primary total knee replacement (TKR) without patellar resurfacing, 20 underwent secondary resurfacing for chronic anterior knee pain.

They were evaluated pre- and postoperatively using the clinical and radiological American Knee Society score. The mean follow-up was 36.1 months (12 to 104). The mean knee score improved from 46.7 to 62.2 points and the mean functional score from 44.7 to 52.2 points. Only 44.4% of the patients, however, reported some improvement; the remainder reported no change or deterioration. The radiographic alignment of the TKR did not influence the outcome of secondary resurfacing of the patella. Complications were noted in six of the 20 patients including fracture and instability of the patella and loss of movement.

Anterior knee pain after TKR remains difficult to manage. Secondary resurfacing of the patella is not advocated in all patients since it may increase patient dissatisfaction and hasten revision.
Ultrasonographic screening for developmental dysplasia of the hip in infants
Authors: Roovers E. A. , Boere-Boonekamp M. M. , Geertsma T. S. A. , Zielhuis G. A. , Kerkhoff A. H. M.
Published: February 2018

We studied the reproducibility of ultrasonographic screening examination of the hip when read by diagnostic radiographers. In order to determine interobserver variability, 200 ultrasonograms were classified according to Graf’s method by five observers (four radiographers and one radiologist). The kappa values for interobserver variability indicated moderate agreement (kappa 0.47) for the exact Graf classification and substantial agreement (kappa 0.65) for the classification of normal (type I) versus abnormal (type IIa-IV). Agreement was significantly different for normal, immature and abnormal hips. Comparison of the findings in our interobserver study with existing information based on other examinations and treatment revealed that only a small number of infants with mildly dysplastic hips would have been typed as normal by some observers as a result of observer variability. In conclusion, the interobserver agreement on the ultrasound assessment of the hip was good enough for screening purposes. Observer variability did not result in any severe cases being missed.
Levels of metal ions after small- and large-diameter metal-on-metal hip arthroplasty
Authors: Clarke M. T. , Lee P. T. H. , Arora A. , Villar R. N.
Published: February 2018

Metal-on-metal (MOM) bearings for hip arthroplasty are increasing in popularity. Concern remains, however, regarding the potential toxicological effects of the metal ions which these bearings release.

The serum levels of cobalt and chromium in 22 patients who had undergone MOM resurfacing arthroplasty were compared with a matched group of 22 patients who had undergone 28 mm MOM total hip arthroplasty (THA).

At a median of 16 months (7 to 56) after resurfacing arthroplasty, we found the median serum levels of cobalt and chromium to be 38 nmol/l (14 to 44) and 53 nmol/l (23 to 165) respectively. These were significantly greater than the levels after 28 mm MOM THA which were 22 nmol/l (15 to 87, p = 0.021) and 19 nmol/l (2 to 58, p < 0.001) respectively.

Since the upper limit for normal patients without implants is typically 5 nmol/l, both groups had significantly raised levels of metal ions. MOM bearings of large diameter, however, result in a greater systemic exposure of cobalt and chromium ions than bearings of small diameter. This may be of relevance for potential long-term side-effects. It is not known to what extent this difference is due to corrosion of the surfaces of the component or of the wear particles produced.
Conversion of biarticular to monoarticular muscles as a component of multilevel surgery in spastic diplegia
Authors: Metaxiotis D. , Wolf S. , Doederlein L.
Published: February 2018

We treated 20 children (40 limbs) with diplegic cerebral palsy who could walk by multilevel soft tissue operative procedures including conversion of the biarticular semitendinosus and gastrocnemius to monoarticular muscles. The mean age at surgery was 11.5 years (5.6 to 17.0). All patients underwent clinical and radiological examination and three-dimensional instrumented gait analysis before and at a mean of 3.1 years (2.0 to 4.5) after surgery.

The passive range of movement at the ankle, knee and hip showed improvement at follow-up. Kinematic parameters indicated a reduced pelvic range of movement and improvement of extension of the knee in single stance after operation (p < 0.0001). However, postoperative back-kneeing was detected in five of the 40 limbs. The kinetic studies showed that the power of the hamstrings and plantar flexors of the ankle was maintained while the maximum knee extensor moment during stance was reduced. The elimination of knee flexor activity of semitendinosus and gastrocnemius combined with transfer of distal rectus femoris led to an improvement in gait as confirmed by gait analysis.
The prognosis following acute primary glenohumeral dislocation
Authors: te Slaa R. L. , Wijffels M. P. J. M. , Brand R. , Marti R. K.
Published: February 2018

We have studied 105 patients with 107 acute, primary, dislocations of the glenohumeral joint seen between January 1, 1991 and July 1, 1994. The mean time of follow-up was 71 months (46 to 91). In 34% the injury occurred during a sports activity and in 28% at home. The bias toward sport was even greater in patients less than 40 years of age, and in men. In patients older than 40 years of age, and in women, the dislocation occurred more often at home.

The overall probability of recurrence within four years was 26%. Age was the most significant prognostic factor in recurrence which took place in 64% of patients less than 20 years of age and in 6% of those older than 40 years. Statistically, there was no difference between the rates of recurrence in patients who were active in sport and those who were not. The mean Rowe score for the whole group was 87 (15 to 100). Associated fractures were found in 20 patients (19%) and nerve injuries in 22 (21%). None of those in whom a fracture of the greater tuberosity was seen subsequently suffered a recurrent dislocation.

At follow-up we found that 36 patients (34%) had not returned to their former employment but in only 2% was this owing to the injured shoulder.
Concomitant tumour resistance in patients with osteosarcoma
Authors: Kaya M. , Wada T. , Nagoya S. , Kawaguchi S. , Isu K. , Yamashita T.
Published: February 2018

Concomitant tumour resistance (CTR) is a unique phenomenon in which animals harbouring large primary tumours are resistant to the growth of smaller metastatic tumours by systemic angiogenic suppression. To examine this clinically, in ten patients with osteosarcoma, we investigated the effects of removal of the primary tumour on the development of pulmonary metastases, the systemic angiogenesis-inducing ability and the serum levels of several angiogenesis modulators.

We found that removal of the primary tumour significantly elevated systemic angiogenesis-inducing ability in five patients who had post-operative recurrence of the tumour. Post-operative elevation of the angiogenesis-induced ability was suppressed by the addition of an angiogenic inhibitor, endostatin. Also, primary removal of the tumour decreased the serum levels of vascular endothelial growth factor and endostatin.

These findings suggest, for the first time, the presence of CTR in patients with osteosarcoma for whom postoperative antiangiogenic therapy may be used to prevent the post-operative progression of micrometastases.
Arthroscopic debridement in the treatment of the infected total knee replacement
Authors: Dixon P. , Parish E. N. , Cross M. J.
Published: February 2018

Infection is a potentially disastrous complication of total knee replacement (TKR). Retention of the prosthesis has been associated with high rates of persistent infection. Our study shows that in selected situations, arthroscopic debridement may allow retention of the prosthesis and eradication of the infection. However, the prosthesis must be stable, the surgical technique must be meticulous and specific antibiotics must be taken for a lengthy period. Arthroscopic debridement should be considered as an alternative to an open technique, or revision, for the infected TKR.
Wear debris from hip or knee replacements causes chromosomal damage in human cells in tissue culture
Authors: Daley B. , Doherty A. T. , Fairman B. , Case C. P.
Published: February 2018

Wear debris was extracted from 21 worn hip and knee replacements. Its mutagenic effects were tested on human cells in tissue culture using the micronucleus assay and fluorescent in situ hybridisation.

The extracted wear debris increased the level of micronuclei in a linear dose-dependent manner but with a tenfold difference between samples. The concentration of titanium +/− vanadium and aluminium within the wear debris was linearly related both to the level of centromere-positive micronuclei in tissue culture, indicating an aneuploid event, and to the level of aneuploidy in vivo in peripheral blood lymphocytes. The concentration of cobalt and chromium +/− nickel and molybdenum in the wear debris correlated with the total index of micronuclei in tissue culture, both centromere-positive and centromere-negative i.e. both chromosomal breakage and aneuploidy events.

The results show that wear debris can damage chromosomes in a dose-dependent manner which is specific to the type of metal. The results from studies in vitro correlate with those in vivo and suggest that the wear debris from a worn implant is at least partly responsible for the chromosomal damage which is seen in vivo.
The effect of extracorporeal shock waves on a rat model of injury to tendo Achillis
Authors: Orhan Z. , Ozturan K. , Guven A. , Cam K.
Published: February 2018

The effects of extracorporeal shock waves (ESWT) on tendon healing were assessed by observing histological and biomechanical parameters in a rat model of injury to the tendo Achillis. The injury was created by inserting an 18-G needle through tendo Achillis in 48 adult Wistar albino rats. The animals were divided into three groups. The first group received radiation only after the operation. The second received no shock waves and the third had 500 15 KV shocks on the second post-operative day. All the rats were killed on the 21st day after surgery.

Histopathological analysis showed an increase in the number of capillaries and less formation of adhesions in the study group compared with the control group (p = 0.03). A significantly greater force was required to rupture the tendon in the study group (p = 0.028). Our findings suggest a basis for clinical trials using ESWT.
The hydroxyapatite-coated JRI-Furlong hip
Authors: Robertson A. , Lavalette D. , Morgan S. , Angus P. D.
Published: February 2018

We present the clinical and radiographic outcome of 68 consecutive primary total hip replacements performed in 54 patients under the age of 55 years using a hydroxyapatite-coated femoral component and threaded cup with a modular ceramic head (JRI-Furlong). We reviewed 62 (91%) hips at a median follow-up of 8.8 years (5 to 13.8) after implantation; six (9%) were lost to follow-up. At review there had been four (6%) revisions but only one for aseptic loosening (acetabulum). Radiographic review of the remaining hips did not identify any evidence of femoral or acetabular loosening. The median Harris and Merle d’Aubigné and Postel hip scores were 95.9 (42.7 to 100) and 17 (3 to 18) respectively. The JRI-Furlong hip gives promising functional and radiographic results in young patients in the medium term.
Severity of hip dysplasia and loosening of the socket in cemented total hip replacement
Authors: Chougle A. , Hemmady M. V. , Hodgkinson J. P.
Published: February 2018

We have assessed the long-term results of 292 cemented total hip replacements which were performed for developmental dysplasia of the hip in 206 patients. The mean age of the patients at operation was 42.6 years (15.9 to 79.5) and most (202) were women. The severity of dysplasia was graded according to both the Crowe and the Hartofilakidis classifications. A 22.25-mm Charnley head was always used and the acetabular components were inserted with cement into the true acetabulum. Bone grafting of the acetabulum, using the patient’s own femoral head, was performed on 48 occasions.

At a mean follow-up of 15.7 years (2.2 to 31.2) the overall survival of the acetabular component was 78%. The main cause of revision was aseptic loosening (88.3%). The rate of survival at 20 years based on the Hartofilakidis classification was 76% in the dysplastic, 55% in the low-dislocation and 12% in the high-dislocation groups and on the Crowe classification, 72.7% for group I, 70.7% for group II, 36.7% for group III and 15.6% for group IV. There was no statistical correlation between bone grafting of the acetabulum and survival of the acetabular component. This study has shown a higher rate of failure of the acetabular component with increasing severity of hip dysplasia.
Spine–hip relations in patients with hip osteoarthritis
Authors: Rivière Charles , Lazic Stefan , Dagneaux Louis , Van Der Straeten Catherine , Cobb Justin , Muirhead-Allwood Sarah
Published: February 2018

Patients with hip osteoarthritis often have an abnormal spine-hip relation (SHR), meaning the presence of a clinically deleterious spine-hip and/or hip-spine syndrome. Definition of the individual SHR is ideally done using the EOS® imaging system or, if not available, with conventional lumbopelvic lateral radiographs. By pre-operatively screening patients with abnormal SHR, it is possible to refine total hip replacement (THR) surgical planning, which may improve outcomes. An important component of the concept of kinematically aligned total hip arthroplasty (KA THA) consists of defining the optimal acetabular cup design and orientation based on the assessment of an individual’s SHR, and use of the transverse acetabular ligament to adjust the cup positioning. The Bordeaux classification might advance the understanding of SHR and hopefully help improve THR outcomes.

Cite this article: EFORT Open Rev 2018;3:39-44. DOI: 10.1302/2058-5241.3.170020
Análisis multivariado para segmentación de clientes basada en RFM
Authors: Cuadros López Álvaro Julio , Gonzales Caicedo Caterine , Jiménez Oviedo Paola Cristina
Published: February 2018

Contexto: Para construir una gestión exitosa de relaciones con los clientes, las empresas deben comenzar con la identificación del verdadero valor de los clientes ya que esto proporciona información básica para implementar estrategias de marketing más dirigidas y personalizadas. El análisis RFM, un método clásico de análisis, permite mediante tres parámetros de evaluación, analizar el comportamiento de los clientes y establecer segmentos. La adición de un nuevo parámetro en la metodología tradicional es una oportunidad para refinar los posibles resultados de una segmentación de clientes, pues no sólo proporciona un nuevo elemento de evaluación para identificar los clientes más valiosos, sino que permite diferenciar y conocer aún mejor a los clientes.Método: La propuesta metodológica que se incluye en este artículo permite establecer segmentos de clientes utilizando un método RFM extendido con nuevas variables, seleccionadas mediante análisis multivariados.Resultados: La propuesta fue aplicada en una empresa en la que se probaron variables, como ganancia, porcentaje de ganancia y días de vencimiento de facturación, y se logró establecer una segmentación de clientes más detallada que el RFM clásico. Conclusiones: El análisis RFM es un método de amplio uso en la industria por su fácil comprensión y aplicabilidad. Este método puede ser mejorado con el uso de procedimientos estadísticos y nuevas variables, lo que permitirá contar con información más profunda sobre el comportamiento de los clientes y facilitará el diseño de estrategias específicas de marketing.
Multicapas VN/TiN, CrN/TiN y MnN/TiN, nuevos materiales para recubrimientos duros: un estudio AB initio
Authors: Casiano Jimenez Gladys Rocío , Escobar Elizalde Isabel , Espitia Rico Miguel
Published: February 2018

Contexto: En este trabajo se realizó un estudio ab initio de las propiedades estructurales y electrónicas de las multicapas VN/TiN, CrN/TiN y MnN/TiN en la estructura cloruro de sodio (NaCl).Metodología: Los cálculos computacionales se ejecutaron con el código Quantum ESPRESSO, utilizando el método del pseudopotencial.Resultados: Los resultados de las propiedades estructurales revelan que el módulo de volumen de las multicapas VN/TiN, CrN/TiN y MnN/TiN es mayor que el de los compuestos binarios TiN, VN, CrN y MnN. Además, los resultados de la densidad de estados muestran que las multicapas poseen un comportamiento ferromagnético determinado por los estados híbridos V-3d, Cr-3d, Mn-3d y los estados N-2p y Ti-3d que atraviesan el nivel de Fermi.Conclusiones: Las multicapas poseen mayor dureza que los compuestos binarios individuales. Por otro lado, estas multicapas pueden ser potencialmente usadas en recubrimientos duros, en dispositivos que deban funcionar a altas temperaturas y a altas potencias.
Performa Peningkatan Lemak Dan Asam Lemak Linoleat Dari Daphnia Sp. Dengan Menggunakan Fermentasi Kotoran Burung Puyuh, Roti Afkir, Dan Ampas Tahu
Authors: Anwar Syaiful , Hutabarat Johannes , Herawati Vivi Endar
Published: February 2018

Daphnia sp. was natural feed which could adequate the needs of fish fry growth. Fats and fatty acids was main factor which very influenced the success of reproduction and live for hatched larva fish. Fats had important role as the main source. The lack of essencial fatty acid could impact the decrease of fish growth and reproduction. The purpose of this research were to found out the best treatments and the effect of fermented quail feces, bread waste, and tofu waste towards the growth, and increased fats and linoleic fatty acid from Daphnia sp..             The methods of this research was used experimental method and complete randomize design with 4 treatments and 3 repetitions, with density of 100 ind./litre. The treatments which used on this research were treatment A (50% bread waste, 50% tofu waste, and 0% quail feces), treatment B (25% bread waste, 50% tofu waste, and 25% quail feces), treatment C (50% bread waste, 25% tofu waste, and 25% quail feces), and treatment C (25% bread waste, 25% tofu waste, and 50% quail feces) with total combination amount of 200 grams/litre. The data that observed were population of Daphnia sp., fatty acid value, and linoleic fatty acid value.The result of this research showed that Daphnia sp. growth population was valued 502,22 ind/ml – 1949,44 ind/ml, whereas the increasing of fat value from 6,26% became 8,15% and linoleic fatty acid from 0,91% become 6,14%. Acording to the research result could be concluded that the additition of fermented quail feces, and tofu waste gave differences towards the growth, with the fat value increased of Daphnia sp. was 1,89% and linoleic fatty acid was 5,23% and the best treatment for growth and linoleic fatty acid value was the treatment C (50% bread waste, 25% tofu waste, and 25% quail feces) and treatment A (50% bread waste, 50% tofu waste, and 0% quail feces) for the fat value of Daphnia sp. Keyword: Daphnia sp.; Fats; Linoleic Fatty Acid; Fermentation
KOMPOSISI PENYUSUN TERUMBU KARANG TEPI (FRINGING REEF) DI PULAU MANDANGIN KABUPATEN SAMPANG, MADURA The Composition of Fringing Reef Formation in Pulau Mandangin, Sampang Province, Madura
Authors: Guntur Guntur , Arifin Samsul , Luthfi Oktiyas Muzaky
Published: February 2018

ABSTRAK   Terumbu karang tepi di Pulau Mandangin tersusun substrat biotik dan abiotik dengan kedalaman tidak lebih dari 40 m. Pulau Mandangin adalah pulau kecil yang memiliki komposisi substrat dasar seperti terumbu karang dan perairannya yaitu zona leeward dan zona windward. Zona leeward adalah sisi yang membelakangi arah datangnya angin, sedangkan zona windward adalah sisi yang menghadap arah datangnya angin. Tujuan dari penelitian ini adalah untuk mengetahui komposisi penyusun terumbu karang tepi (fringing reef) dan mengetahui perbedaan komposisi penyusun terumbu karang tepi (fringing reef) antara zona leeward dan zona windward di Pulau Mandangin. Metode yang digunakan adalah Line Intercept Transect (LIT) secara vertikal, LIT dimulai dari surut terendah sampai daerah reef slope dan dilakukan pencatatan semua jenis substrat yang dibawah garis transek. Hasil penelitian menunjukkan zona fringing reef yang mengelilingi Pulau Mandangin tersusun atas substrat rubble, sand, alga, rock, dead coral, dead coral with algae, sponge, coral massive dan coral submassive. Zona leeward lebih bervariasi dari zona windward dalam susunan fringing reef. Hal ini karena angin yang terjadi di zona windward lebih besar dari zona leeward, sehingga substrat di zona windward hanya rubble dan sand.   Kata kunci: Fringing reef, zona windward, zona leeward, substrat, Pulau Mandangin     ABSTRACT  Fringing reef in Mandangin Island comprises of biotic and abiotic substrates in depth not more than 40 m. Mandangin Island is a small island with base substrate composition mostly involving coral reef. The waters include leeward and windward zones. Leeward zone is paralleling with wind incoming direction, whereas windward zone is facing on wind incoming direction. The objective of research is to understand the composition that constitutes fringing reef and to recognize different constitutive composition of fringing reef at leeward zone and windward zone in Mandangin Island. Method of research is Line Intercept Transect (LIT) that is applied vertically. LIT starts from the lowest ebb toward the reef slope zone, and it involves registering all substrate types below transect line. Result of research indicates that fringing zone surrounding Mandangin Island consists of various substrates such as rubble, sand, alga, rock, dead coral, dead coral with algae, sponge, coral massive and coral sub-massive. Leeward zone is more diversified in fringing reef composition than windward zone. It is evident because wind occurrence at windward zone is higher than at leeward zone, and thus, substrates at windward zone include only rubble and sand. Keywords: Fringing reef, windward zone, leeward zone, substrates, Mandangin Island
EFISIENSI ALOKATIF FAKTOR PRODUKSI PADA USAHA PERIKANAN TANGKAP DI KOTA BENGKULU: KASUS PADA ALAT TANGKAP GILLNET Allocative Efficiency of Production Inputs in Capture Fishery Business in Bengkulu City: Case Study of Fishing Vessel with Gillnet Fishing
Authors: Sukiyono Ketut , Romdhon M. Mustopa
Published: February 2018

ABSTRAK   Penelitian ini ditujukan untuk mengeksaminasi faktor yang mempengaruhi volume ikan hasil tangkapan dan menganalisa efisiensi alokatif input produksi.  Penelitian ini dilakukan di Kota Bengkulumeliputi survai pada 60 nelayan perikanan tangkap dengan alat tangkap jaring insang (Gillnet).  Fungsi produksi Cobb-Douglass digunakan utnuk menentukan faktor yang mempengaruhi volume ikan tangkapan dan efisiensi alokatif. Faktor produksi yang dimasukan dalam model adalah ukuran kapal, lama melaut, ukuran mesin kapal, jumlah ABK, dan biaya operasional melaut.  Hasil penelitian menunjukkan bahwa lama melaut dan jumlah ABK merupakan faktor penting yang mempengaruhi jumlah hasil tangkapan, sementara faktor yang lain tidak.  Lama melaut dan jumlah ABK tidak efisien sehingga penggunaan dua faktor ini harus ditingkatkan untuk mencapai efisiensi alokatif.   Kata kunci: Efisensi alokatif, Perikanan tangkapa, Gillnet     ABSTRACT  This research was aimed at examining factors that have an effect on the volume of catches fishes, and analyzing an allocative efficiency of input productions.  This research was conducted in Bengkulu City involving survey on 60 fishermen of fishing vessel with Gillnetfishing gears.  The production function of Cobb Douglass used to determine factors affected the volume of catches fishes and allocative efficiency.  Production factors were included in the model involving fishing vessel size, length of fishing day, vessel machine power, number of vessel crews, and operational costs. The research showed that length of fishing day and number of fishing vessel crews are an important factors affected the volume of catches fishes, while others are not. The use of length of fishing and the vessel crews were an inefficient.  Therefore, the use of these two factors should be increased to gain an allocative efficiency. Keywords: Allocative efficiency, Capture fishery, Gillnet
POLA GERAKAN STADIA UMUR KEPITING BAKAU (Scylla serrata) DALAM MERESPON MAKANAN YANG BERBEDA (SKALA LABORATORIUM) The Model Movement of Mud Crab’s Life Stage (Scylla serrata) in Responds to Different Food (Laboratory Scale)
Authors: Supadminingsih Fahresa Nugraheni , Fitri Aristi Dian Purnama , Asriyanto Asriyanto
Published: February 2018

ABSTRAK Kepiting bakau merupakan salah satu jenis crustacea yang daur hidupnya memiliki beberapa tahapan tingkatan umur berdasarkan lebar karapas. Habitat kepiting bakau terdapat di perairan estuari hingga laut dengan kebiasaan hidup yang berbeda, terutama dalam mencari makanan dan habitat tiap stadia. Penelitian ini bertujuan untuk mengetahui pola tingkah laku kepiting bakau pada stadia umur yang berbeda terhadap makanan. Materi penelitian adalah  kelompok umur kepiting muda (lebar karapas 8 cm) dan dewasa (lebar karapas 11 cm) serta jenis makanan berupa makanan kepala ayam, ikan petek dan keong mas yang ketiganya dalam keadaan segar. Metode penelitian menggunakan eksperimen skala laboratorium dengan 2 variabel umur dan makanan dengan 6 perlakuan secara deskriptif. Hasil penelitian mengindikasikan terdapat 2 pola gerakan pola tingkah laku dimana kepiting dewasa memberikan respon langsung, sedangkan kepiting muda menunjukkan respon tidak langsung terhadap makanan. Kata kunci: Tingkah Laku, Makanan, Pola Gerakan, Umur, Kepiting Bakau  ABSTRACT The Mud Crab’s  is one of crustaceans species that their life circle have some stage based on carapas length. The Mud crab’s live in differences behavior between  estuarine trought deep sea, mostly in the feeding behavior in the different life stage. The purpose of this study is to know the model movement between life stage factor towards food factor. The materials used  in this research are sub-adult (carapace width 8 cm) and adult (carapce 11 cm) mud crab and the types of  fresh food in the form of chicken’s head, leiognathus fish, and golden snail. The methods used in this reasearch are  experimental laboratory  with two variables: the types of bait and life stage with six treatments. The result shows that the adult crab’s  movement give the direct responses, but the subadult crab give  the indirect responses to the food. Keywords: Fish behaviour, food, model Movement, Life stage, Mud crab