bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Tearscope-Plus versus Slit Lamp Measurements of Inferior Tear Meniscus Height in Normal Individuals
Authors: Fodor Eszter , Hagyó Krisztina , Resch Miklós , Somodi Dóra , Németh János 
Published: January 2018

Purpose To measure the lower tear meniscus height (LTMH) with image by Tearscope and using slit-lamp biomicroscopy with or without fluorescein staining. Methods The lower tear meniscus height was measured in 31 eyes of 31 healthy volunteers (mean age 31.29 years; SD 4.83) with Tearscope and slit lamp with and without fluorescein staining. The mean values of LTMH were measured with different methods and the repeatability of the measurements was statistically analyzed. Measurement of fluorescein tear film break up time (FBUT) and Schirmer test were also performed. Results The mean value of LTMH was 0.21 mm (SD 0.07) with Tearscope, 0.20 mm (SD 0.06) with slit lamp without fluorescein staining, and 0.23 mm (SD 0.07) with fluorescein staining. There was no significant difference among the mean values of LTMH with these 3 different measurement methods. Based on the random effect analysis of variance (p=0.05), the measurements were more repeatable with Tearscope-plus than with the other 2 methods. No correlation was found between the LTMH and the results of Schirmer test or FBUT. Conclusions The LTMH could be reliably measured with slit-lamp biomicroscopy without staining, but the measurements were more repeatable with Tearscope.
Deep Anterior Lamellar Keratoplasty with Intacs Explantation in Keratoconus
Authors: Titiyal Jeewan S. , Chawla Bhavna , Sharma Namrata 
Published: January 2018

Purpose To describe the surgical technique and clinical outcome of deep anterior lamellar keratoplasty (DALK) with Intacs explantation in patients with poor visual outcome after Intacs implantation for keratoconus correction. Methods TWO patients with bilateral keratoconus underwent Intacs segment implantation. Due to poor visual outcome and patient dissatisfaction, the Intacs segments were explanted and a big bubble-assisted DALK procedure was performed at the time of Intacs removal. Results DALK could be successfully completed in both cases. There were no postoperative complications. At 2 years follow-up, the grafts were clear in both patients, with a best spectacle-corrected visual acuity of 20/25. Conclusions A modified big bubble-assisted DALK procedure can be performed in keratoconic eyes requiring Intacs explantation and may provide a better alternative to a penetrating keratoplasty.
Comparison of the Transpalpebral Tonometer TGDc-01 with Goldmann Applanation Tonometry
Authors: Waisbourd Michael , Shemesh Gabi , Top Lea Baras , Lazar Moshe , Loewenstein Anat 
Published: January 2018

Purpose This study aimed to compare intraocular pressure (IOP) measurements obtained by the transpalpebral tonometer TGDc-01 and by the Goldmann applanation tonometer (GAT). Methods IOP was measured by the conventional GAT and the TGDc-01 tonometer. Central corneal thickness (CCI) was measured for all eyes. Results Sixty-seven consecutive patients (123 eyes) participated. The mean difference between the 2 techniques (TGDc-01-GAT) was −0.93 mmHg, SD=2.74 (p=0.0002, paired t-test), and 70% of the measurements were within ±2 mmHg. The correlation coefficient was 0.67 (p<0.0001). A subgroup analysis according to CCT was conducted. For CCT <520 μm, the mean IOP difference was 0.67 mmHg (p=0.13); r=0.75 (p<0.001). For CCT 520 μm-580 μm, the mean IOP difference was −1.08 mmHg (p=0.001); r=0.69 (p<0.0001). For CCT>580 μm, the mean IOP difference was −2.29 mmHg (p=0.0003); r=0.57 (p=0.003). Conclusions TGDC-01 may estimate IOP with a fair agreement to the Goldmann tonometer, although caution should be used for patients who require precise IOP measurements. TGDc-01 measured higher IOPs than Goldman tonometry for thinner corneas, a trend that was reversed for thicker corneas. This tonometer is a portable device, easy to use, does not require anesthetic drops, and may be suitable for IOP screening.
Familial Clustering of Diabetic Retinopathy in Chongqing, China, Type 2 Diabetic Patients
Authors: Zhang Xuedong , Gao Yan , Zhou Zhongqiang , Wang Jing , Zhou Qingyun , Li Qi 
Published: January 2018

Purpose To investigate whether there is familial aggregation of diabetic retinopathy (DR) among type 2 diabetes mellitus (T2DM) patients in Chongqing, the municipality in southwest China. Methods From December 2004 to December 2006, 167 T2DM families with at least 2 diabetic siblings were investigated. In all 414 subjects, the sibling with the longest duration of diabetes was defined as the proband. The occurrence of retinopathy was compared between the siblings of probands with and without retinopathy. DR risk factors of the siblings of probands were studied by multiple logistic regression analysis. Results DR was diagnosed in 7.1% of the siblings of the probands without DR and in 29.7% of the siblings of the probands with DR. The difference reached statistical significance in probands with DR and probands without DR (p<0.0001). Nonesterified fatty acid (NEFA) was a risk factor for DR (odds ratio = 2.108, 95% confidence interval 1.077–4.127). It appeared that regardless of probands with DR, siblings with history of smoking had less risk for developing DR than those with no history of smoking. Conclusions Familial clustering of DR existed in the patients with T2DM in Chongqing, China. In DR siblings, NEFA is a risk factor of DR, while smoking may reduce DR occurrence.
Ex-PRESS Miniature Glaucoma Device in Vitrectomized Eyes
Authors: Vetrugno Michele , Ferren Paolo , Sborgia Carlo 
Published: January 2018

Purpose To evaluate the clinical efficacy and safety of the Ex-PRESS miniature glaucoma device placed under scleral flap for the treatment of ocular hypertension in eyes that underwent vitreoretinal surgery. Methods Vitrectomized patients who required glaucoma surgery for persistent ocular hypertension were included. The Ex-PRESS miniature glaucoma device was implanted under scleral flap. Postsurgical clinical outcomes and intraocular pressure (IOP) was monitored for 6 months after surgery. Results At 6 months, all the patients had an IOP lower than 18 mmHg, 3 of them without topical therapy. Conclusions The use of the Ex-PRESS implant under scleral flap in eyes that underwent vitreoretinal surgery was effective for lowering IOP
Bilateral Uveitis with Hypopyon as a Presenting Symptom of Metastatic Peritoneal Carcinomatosis
Authors: Iannetti Ludovico , Corsi Cinzia , Iafrate Franco , Sammartino Paolo , Di Giorgio Angelo , Pezzi Paola Pivetti 
Published: January 2018

Purpose To report the association between bilateral uveitis with hypopyon and metastatic peritoneal carcinomatosis. Methods A 76-year-old woman presented bilateral diffuse uveitis with hypopyon. She was in good health. She reported breast cancer history 20 years before with no recurrence of tumor at periodic examinations. Results The patient had visual acuity of count fingers in both eyes, hypopyon, and vitritis with no chorioretinal lesions. After 1 week of steroids, visual acuity and intraocular inflammation improved significantly. Given the late age at uveitis onset, clinical picture of uveitis, and breast cancer history, we suspected associated malignancy. Total body computed tomography revealed peritoneal carcinomatosis, which was removed 1 month later. After 12 months, visual acuity was 0.8 bilaterally and bilateral uveitis resolved completely. Conclusions Excluding a masquerade syndrome and a paraneoplastic syndrome on the basis of clinical features, uveitis represents an immune response to the concurrent tumor. The good response to steroid therapy is in accordance with this hypothesis. This is the first case of uveitis with hypopyon as presenting symptom of a metastatic peritoneal carcinomatosis developing 20 years after the removal of primitive breast cancer.
Calcification of a Rayner Centerflex 570H hydrophilic Acrylic Intraocular Lens following Vitrectomy for Retinal Detachment: A Clinicopathologic Report
Authors: Purbrick Robert M.J. , Stavrakas Panagiotis , Porooshani Hamid , Patel Chetan K. , Ferguson David J.P. 
Published: January 2018

Purpose The case of a 71-year-old man who complained of progressive, unilateral visual blurring following vitrectomy for retinal detachment due to opacification of his Rayner Centerflex 570H intraocular lens (IOL) implant is reported. Intraocular lens exchange was carried out and the explanted lens analyzed. The same model lens in his fellow eye has remained clear. Methods Clinicopathologic case report. Results Scanning electron microscopy and energy-dispersive x-ray analysis confirmed the presence of hydroxyapatite deposits within the anterior surface of the IOL. Conclusions To our knowledge, this is the first clinicopathologic case report of calcification of this model IOL in an adult patient. The sequence of events, unilaterality and pathologic findings suggest secondary calcification, which could have been related to severe postoperative inflammation and associated blood-aqueous barrier breakdown.
The Modified Tonnis Triple Pelvic Osteotomy in the Young Adult - Early Results
Authors: De Roeck N. , Hashemi-Nejad A. 
Published: January 2018

Acetabular dysplasia may present as previously undiagnosed or as a sequel to treated DDH in a young adult, with a natural history of subsequent development of early osteoarthritis. Patients with acetabular dysplasia, a normal neck shaft angle, no significant leg length inequality and who demonstrate congruency at arthrogram are considered suitable for realignment pelvic osteotomy. We report the results of 15 young adults who underwent a modified Tonnis triple osteotomy with a mean 22-month follow-up. The modification was that the ischial osteotomy was performed through a groin incision. The only common complication was the requirement of catheterisation post-operatively (60%). There were no infections. There was one delayed union but no non-unions. One patient developed a deep vein thrombosis. All patients reported an improvement in their symptoms and level of activity, with a mean post-operative Harris hip score of 92. All showed an improved centre-edge angle of 28° (mean increase of 18°) and acetabular angle of 37° (mean decrease of 13°). The early results of this procedure show it to be a safe and useful option to delay the natural history of early osteoarthritis in the young adult.
Radiographic evaluation of the hip rotation centre after total joint replacement in hip dysplasia
Authors: D'angelo F. , Molina M. , Giudici M. , Cherubino P. 
Published: January 2018

A retrospective study was conducted to correlate the clinical result of joint replacement in dysplastic hips with the obtained modifications of the rotation centre. Sixty primary total hip arthroplasties were performed on 46 patients suffering from hip dysplasia at our institution. The radiographic evaluation of the hip rotation centre was performed using the method proposed by Pierchon. The clinical assessment was by Harris Hip Score. Our results revealed that it was possible to modify the position of the pathological rotational centre with a statistically significant difference (p<0.05) for both coordinates. The general clinical evaluation relates well to the radiological evaluation as the average HHS increased to 92.683 (p<0.05). The data from our study are in accordance with the most recent literature and confirm the importance of a suitable biomechanical position of the hip rotation centre in a distal and medial sense.
Metal-on-Metal Joint Arthroplasty: Potential Lifetime Longevity
Authors: Dunstan E. , Sanghrajka A.P. , Whittingham-Jones P. , Tilley S. , Blunn G. , Cannon S.R. , Briggs T.W.R. 
Published: January 2018

We have studied a historical group of patients who underwent metal-on-metal hip arthroplasty more than 30 years ago. Those retaining their original metal-on-metal articulation (average follow-up 33 years) had an average Harris Hip Score of 75 (range 53–93) and an average Musculoskeletal Tumour Outcome Score of 75 (range 63–90). Those that have been revised (at an average of 22 years) maintain good functional outcome. The original implant is still in situ in five of the 11 survivors (follow-up 26–38 years). Retrieval analysis using a Mitutoya form tracer and an electron microscope demonstrated the self-polishing capacity of the metal-on-metal articulation. The surface roughness (Ra) of the worn articulating surface (Ra 0.05 mm) was smoother than that of the original unworn surface (Ra 0.32 mm). We believe our case series highlights the potential longevity of metal-on-metal articulation.
Revision Hip Surgery Using the Cls Expansion Shell
Authors: Rozkydal Z. , Janícek P. , Havlícek V. , Deduch J. 
Published: January 2018

The aim of our study is to assess the outcomes using the uncemented CLS expansion shell in revision hip surgery for aseptic loosening of the acetabular component. Between 1991 and 2000 we used the CLS expansion shell in revision hip surgery in 215 patients (230 hips). We were able to evaluate 196 patients (211 hips) with failed acetabular components. The male/female ratio was 82/114 and the mean age of the patients was 63 years (range 38–71). The main reason for revision was aseptic loosening of the PE cup (184 patients). There were 79 hips with Paprosky defect of the acetabulum type I, 62 hips with type 2A, 57 hips with type 2B and 13 hips with type 2C in the study. The mean follow-up was 8.5 years (range 5–14). Plain radiographs using an AP view of the pelvis and AP and lateral views of the affected hip were taken immediately after surgery and at the latest follow-up. Clinical outcomes were determined using the Merlé dAubigné and Postel score and the Harris Hip score. The mean preoperative Merle dAubigné score was 7.8 points (range 6.9 to 9.9); at the latest follow-up it was 14.9 points (range: 12.5 to 15.9). The mean preoperative Harris Hip score was 38.6 points (range: 32 to 59); at the latest follow-up it was 82.5 points (range: 38 to 95). Osteointegration of the CLS expansion shell was present in 149 hips (70.6%) at the latest follow-up. There were 31 complications (15%) requiring a second revision. Clinical survivorship of the CLS expansion shell was 90% at five years and 84% at 8.5 years after revision surgery. Radiological survivorship was 78% at five years and 70% at 8.5 years after revision surgery. The CLS expansion shell offers a viable alternative for revision hip surgery with lower bone quality, insufficient bone at the bottom and cavitary defects of the acetabulum.
Outcome of Bilateral Hip Hemiarthroplasty for Displaced Fracture of the Hip
Authors: Nogales M.A. , Vega G.T. , Quiles M. , Roa C. , Perez S. , Porcel T. , Campos T. 
Published: January 2018

Our aim was to evaluate the outcome in patients with bilateral non-simultaneous hip fracture treated with hemiarthroplasty at our institution between 1997 and 2003. We looked for any important modification factor that could change the devastating functional and social results. Twenty-two patients with a mean age of 79 at the initial fracture and 82 at the subsequent fracture were evaluated; all were Garden grade III-IV. The second fracture happened a mean of 28 months after the first one. The outcome measurement was the incidence of hip pain, recovery of pre-injury level of ambulation and activities of daily living at a minimum follow-up of one year. Following the first hemiarthroplasty patients deteriorated in their walking capacity and other activities of daily life, and this happened to an even greater extent after the second operation. With respect to walking ability (measured in metres) we concluded that it improved if a modular hemiarthroplasty was used after both fractures (p<0.05) and that worse functional outcomes were observed when different kinds of hemiarthroplasties were used in the same patient.
Bone Preservation with a Conservative Metaphyseal Loading Implant
Authors: Santori N. , Albanese C.V. , Learmonth I.D. , Santori F.S. 
Published: January 2018

Proximal load transfer and the absence of distal fixation of the stem are crucial to obtain the best behaviour of the femoral bone after total hip replacement. In this study, dual energy X-ray absorptiometry (DEXA) was employed to understand and compare the bone density changes and thus the re-distribution of mechanical forces in two different extra short stems. Two cohorts of ten patients were included in this retrospective study. Both implants are custom-made and present a well defined lateral flare. The first model is fully coated and presents a short stem (Group A), the second is an unstemmed metaphyseal implant with a polished tip (Group B). DEXA scans were obtained in all patients at the two-year follow-up. A higher BMD was detected in ROIs 1, 2, 4, 5 in Group B confirming a preservation of the proximal bone mass and thus indirectly a more proximal load transfer. The results obtained confirm the importance of the geometry of the implant on proximal bone density. Loading both medial and lateral proximal femoral flares and the complete absence of the diaphyseal portion of the stem provide the optimal bone remodelling of the femur after total hip replacement.
Tribology Considerations for Hip Joint Articulations in Relation to the “New Orthopaedic Patient”
Authors: Rieker C.B. 
Published: January 2018

The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the “New Orthopaedic Patient”. As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.
Factors Affecting the Cement Penetration of a Hip Resurfacing Implant: An in Vitro Study
Authors: Howald R. , Kesteris U. , Klabunde R. , Krevolin J. 
Published: January 2018

An understanding of how the cementing technique influences cement penetration is important for surgeons to plan and conduct hip resurfacing procedures. Therefore the aim of this study is to determine the influence of the following parameters on cement penetration: use of pulse lavage, type of cement, and the standing period of the cement. Nine fresh frozen paired whole cadaver femora were used to investigate cement penetration. The femora were divided into three paired groups: (A) compared the use of pulse lavage to no pulse lavage, (B) compared two low viscosity bone cements SULCEM-3 (Zimmer GmbH, Switzerland) and Surgical Simplex (Stryker Orthopaedics, USA), and (C) compared bone cement viscosities using standing times of 1.5 min. and 3 min. The Durom Hip Resurfacing implant (Zimmer GmbH, Switzerland) was used in all groups. A single slice was taken out of the center of each head. Cement penetration ratio (penetration area divided by the bone area enclosed by implant) and mean cement penetration depth were measured. Cement penetration is increased using pulse lavage, and has the tendency to increase with increasing the cement standing time from 1.5 to 3 min. No difference in cement penetration was found when different cement brands of comparable viscosity were used.
A District General Hospital'S Experience of Hip Resurfacing
Authors: McANDREW A.R. , Khaleel A. , Bloomfield M.D. , Aweid A. 
Published: January 2018

In our unit 180 consecutive hip resurfacing procedures have been performed. All patients had a posterior approach to the hip joint, followed by standard resurfacing using metal-on-metal components. The patients were evaluated radiographically and clinically preoperatively and postoperatively. The mean age of patients was 56 years (range 25–75). There was a statistically significant improvement between the preoperative Harris Hip Score and those at the latest follow-up. There were four fractures of the femoral neck; one was intra-operative and was converted to total joint arthroplasty. Three further fractures occurred: two were revised and one was treated non-operatively There were no cases of dislocation or deep infection. The short- and medium-term results that have been achieved in this district general hospital are comparable to those that have been achieved in the originator's institution.
A Review of Ceramic Bearing Materials in Total Joint Arthroplasty
Authors: Bal B.S. , Garino J. , Ries M. , Rahaman M.N. 
Published: January 2018

Bearings made of ceramics have ultra-low wear properties that make them suitable for total hip arthroplasty (THA) and total knee arthroplasty (TKA). When compared to cobalt chrome (CoCr)-on-polyethylene (PE) articulations, ceramics offer drastic reductions in bearing wear rates. Lower wear rates result in fewer wear particles produced by the articulating surfaces. In theory, this should reduce the risk of periprosthetic osteolysis and premature implant loosening, thereby contributing to the longevity of total joints. In addition to ceramics, other alternative bearing couples, such as highly cross-linked PE (XLPE) and metal-on-metal also offer less wear than CoCr-on-PE articulations in total joint arthroplasty. Alumina and zirconia ceramics are familiar to orthopaedic surgeons since both materials have been used in total joints for several decades. While not new in Europe, alumina-on-alumina ceramic total hips have only recently become available for widespread use in the United States from various orthopaedic implant manufacturers. As the search for the ideal total joint bearing material continues, composite materials of existing ceramics, metal-on-ceramic articulations, and new ceramic technologies will offer more choices to the arthroplasty surgeon. The objective of this paper is to present an overview of material properties, clinical applications, evolution, and limitations of ceramic materials that are of interest to the arthroplasty surgeon.
Z-Lengthening of the Iliotibial Band to Treat Recalcitrant Cases of Trochanteric Bursitis
Authors: Chirputkar K. , Weir P. , Gray A. 
Published: January 2018

Greater trochanteric bursitis is a relatively common presentation at hip clinics. It presents with pain around the greater trochanter. Diagnosis is usually made on clinical grounds when other hip and spinal pathologies are ruled out and there is tenderness present over the trochanteric region. Rheumatoid arthritis (1), athletic injury (2), total hip arthroplasty (3) and idiopathic disease (4) are some of the known causes of trochanteric bursitis. Treatment is mainly non-operative and expectant; however various operative interventions have been described in the literature. We present a series of 16 patients who had recalcitrant trochanteric bursitis following failed non-operative treatment and were treated with bursectomy and Z-lengthening of the iliotibial band. All 14 patients who answered the questionnaire were happy with the outcome of operation and 13/14 patients would undergo a similar procedure again. To the best of our knowledge, this is the only series in the literature describing this particular procedure for treatment of trochanteric bursitis.