bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention of Venous Thromboembolic Events following Femoroacetabular Osteoplasty: Aspirin is Enough for Most
Authors: Tischler Eric H. , Ponzio Danielle Y. , Diaz-Ledezma Claudio , Parvizi Javad 
Published: April 2014

Background As hip-preservation surgery is performed in a particularly young and active group of patients, the knowledge accrued in the fields of hip arthroplasty and hip fracture care regarding postoperative thromboprophylaxis cannot be extrapolated to this patient population. Recommendations based on the evidence for each particular surgical procedure and population is desirable. For these reasons, the purpose of our study is to describe the rate of clinically relevant venous thromboembolism (VTE) and anticoagulation-related complications observed in patients undergoing hip-preservation surgery through mini-open femoracetabular osteoplasty (FAO) with a formal postoperative thromboprophylaxis protocol of aspirin dosing. Methods A prospective case series of 407 consecutive FAO procedures in 375 patients of mean age 34.5 ± 11.1 years (range 15–62 years) were followed six weeks postoperatively to document the presence of clinically relevant VTE as well as major bleeding events, as defined by the most recent American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. All patients were given aspirin 325 mg by mouth daily for two to four weeks. Results There was one case of distal DVT in a 31-year-old male with no specific risk factors. No cases of pulmonary embolism were observed. There were no major bleeding events or reoperations due to postsurgical haematoma. There were no deaths. The crude incidence of clinically relevant VTE was 1 per 407 procedures (0.25%). Conclusion Aspirin is a safe and effective modality to provide thromboprophylaxis in patients undergoing hip-preservation surgery. The rate of VTE that we observed is, thus far, the lowest in comparison to other published series of hip preservation surgery that specifically focused on this complication.
Risedronate does not Enhance Fixation or BMD in Revision Cups: Randomised Study with Three Years follow-up
Authors: Saari Tuuli M. , Digas Georgios , Kärrholm Johan N. 
Published: April 2014

Background Bisphosphonates may improve implant fixation by inhibition of bone resorption and stimulation of osteoblasts by up regulation of BMP-2. However, there are few clinical studies in this area. Questions/purpose Does treatment with oral bisphosphonates improve implant fixation and bone remodelling around the acetabular component after revision arthroplasty with or without use of morselised allograft? Patients and methods Fifty-three patients received university pharmacy blinded medication for three months: 5 mg risedronate or placebo one dosage and 1 g calcium carbonate and 800IE cholecalciferol per day. Forty-one patients were operated upon with revision of the cup. The revisions were performed with an uncemented (Trilogy, Zimmer, Warsaw, USA) or a cemented (Ogee, Depuy Int, England) cup. Radiostereometric analysis was obtained within one week after the operation, at three and six months, and after one, two and three years to study cup migration. Bone mineral density was measured postoperatively, at six months, one and two years, using DEXA. The presence and extension of radiolucent lines and graft remodelling were studied on conventional radiography. Results The risendronate group revealed less anterior-posterior rotation at 6 months. We found no significant differences in migration at three years, change in bone mineral density, or graft remodelling and radiolucent lines formation between groups. Conclusions We could not demonstrate any beneficial effects of oral administration of risedronate on the fixation, bone mineral density or bone remodelling of revision cups using various amount of bone graft.
Prospective Five-Year Subsidence Analysis of a Cementless Fully Hydroxyapatite-Coated Femoral Hip Arthroplasty Component
Authors: Clauss Martin , Van Der Straeten Catherine , Goossens Marc 
Published: April 2014

Early subsidence >1.5 mm is considered to be a predictive factor for later aseptic loosening of the femoral component following total hip arthroplasty (THA). The aim of this study was to assess five-year subsidence rates of the cementless hydroxyapatite-coated twinSys® stem (Mathys Ltd., Bettlach, Switzerland). This prospective single-surgeon series examined consecutive patients receiving a twinSys® stem at Maria Middelares Hospital, Belgium. Patients aged >85 years or unable to come to follow-up were excluded. Subsidence was assessed using Ein Bild Roentgen Analyse – Femoral Component Analysis (EBRA-FCA). Additional clinical and radiographic assessments were performed. Follow-ups were prospectively scheduled at two, five, 12, 24, and 60 months. In total, 218 THA (211 patients) were included. At five years, mean subsidence was 0.66 mm (95% CI: 0.43-0.90). Of the 211 patients, 95.2% had an excellent or good Harris Hip Score. There were few radiological changes. Kaplan-Meier analysis indicated five-year stem survival to be 98.4% (95% CI: 97.6-100%). Subsidence levels of the twinSys® femoral stem throughout the five years of follow-up were substantially lower than the 1.5 mm level predictive of aseptic loosening. This was reflected in the high five-year survival rate.
The influence of triple pelvic osteotomy on birth canal size
Authors: Schwarz Ondřej , Chomiak Jiří , Dungl Pavel , Burian Michal 
Published: April 2014

Introduction The aim of this study was to investigate the influence of triple pelvic osteotomy on the internal pelvic dimensions and thus on the potential for normal vaginal delivery. Methods Data were acquired by processing fixed anatomical specimens of 19 female pelves with maintained sacrotuberous and sacrospinous ligaments after unilateral and bilateral osteotomy, respectively. The specimens were measured and x-ray images and photographs were taken. Results The dimensions in the plane of the pelvic inlet and the plane of the greatest pelvic dimension after unilateral osteotomy increased in 51%, remained unchanged in 34% and in 15% of cases they decreased. The most critical locations for the passage of fetus decreased in average from 0.016 cm in distantia interspinalis in the plane of the least pelvic dimension to 0.695 cm in distantia intertuberositas in the plane of the pelvic outlet. After bilateral osteotomy are decreases more significant from 0.226 cm (2.05%) to 1.00 cm (9.51%). Decreases we observed in the monitored dimensions were not so big in comparison to other published studies. Conclusion Results of this study confirm our hypothesis that unilateral triple pelvic osteotomy does not significantly narrow the bony birth canal and so it does not impede the ability to deliver per vias naturales in female patients with this surgical procedure in anamnesis. After bilateral triple osteotomy we would rather recommend Caesarean section.
A seven- to 14-year follow-up study of bipolar hip arthroplasty in the treatment of osteonecrosis of the femoral head
Authors: Gągała Jacek , Tarczyńska Marta , Gaweda Krzysztof 
Published: April 2014

Introduction Bipolar hip arthroplasty (BHA) in the treatment of Ficat stage III osteonecrosis of the femoral head (ONFH) has theoretical advantages over total hip replacement (THR) in that it preserves the natural acetabulum and uses an implant that allows better stability and larger range of movement. The purpose of this study was to evaluate the clinical and radiological outcomes of BHA with uncemented ingrowth stems in the treatment of ONFH. Material and methods Thirty-nine hips in 34 patients (two women and 32 men) with a mean age at the time of surgery of 45.31 years (range 30–66 years) operated between 1998 and 2005 were examined in a retrospective evaluation. Mean follow-up was 9.5 years (range 3–14 years). Patients were evaluated with the Harris hip score (HHS). Kaplan-Meier survivorship was calculated to examine the revision rate. Radiographic analysis included evaluation of bipolar head migration, radiolucent lines around the stem and osteolysis in the acetabulum and the femur. Results Evaluation of clinical results revealed an increase in HHS from 28 points preoperatively to 88.6 points at the most recent follow-up. Radiographic evaluation showed bipolar head migration in 3 hips (7.7%). Survival rate of BHA, with revision THR defined as the endpoint, was 92.31% at ten years (CI 95%). All implanted uncemented stems were stable without any radiographic signs of loosening or osteolysis. Conclusions The results of the present study show that implantation of BHA with uncemented ingrowth stem in Ficat stage III is still justified.
Regional variability in the rates of total hip replacement in Spain
Authors: Padilla-Eguiluz Norma G. , García-Rey Eduardo , Cordero-Ampuero Jose , Gómez-Barrena Enrique 
Published: April 2014

The role of economic resources, distribution of providers, and demography may explain part of the variability found in hip arthroplasty in international surveys. We aimed to investigate the influence of ageing index, health budget, and density of orthopaedic surgeons in the regional variability of the primary and revision THR rate in Spain, where regions decide on the allocation of their health budget. Inpatient database of hip procedures for years 1997 to 2011 was obtained from the Spanish Ministry of Health, segregated for each of the 17 regional health services in Spain. Crude and adjusted rates (direct method with total Spanish population per year) were calculated and used as dependent variables. Ageing index, Health Expenditure of Gross Domestic Product (GDP), and number of orthopaedic surgeons per region were used as independent variables. Negative binomial regression analysis model and Poisson regression were calculated to estimate the risk contribution of the ecological variables. A total of 425,914 hip procedures, with 367,489 primary (mean crude rate = 124 × 105 inhabitants/year) and 58,425 revision hips (21 × 105 inhabitants/year) were included in the analysis. Regional variability was higher than expected in THR in Spain, despite a universal coverage health system in which equity may be challenged in the administration of hip arthroplasty. This was found particularly for primary THR. When hip replacement rates were adjusted for sex and age, the regional ageing index, the density of orthopaedic surgeons and the regional health budget could only partially explain risk ratio changes.
Salter innominate osteotomy in the treatment of late presentation Perthes disease
Authors: Yavuz Umut , Demir Bilal , Yildirim Timur , Beng Kubilay , Karakas Eyup Salahattin 
Published: April 2014

Purpose The aim of this study was to evaluate the clinical and radiological results of patients presenting older than eight years and treated with Salter osteotomy for Perthes disease. Method Seventeen patients (18 hips) with late presentation of Perthes disease treated with Salter osteotomy. Sixteen males were identified. The average age of patients was 8.8 years (range 8-12). Preoperation radiographs were analysed for lateral pillar staging, centre-periphery (CP) angle, Sharp acetabular index, acetabular depth index, acetabular covering percentage and Cross-over sign. Final follow-up radiograph were classified using modified Stulberg grade. Results The average follow-up of the patients was 78 months (range 40-104). During the surgery, seven hips were found to be lateral pillar grade B, three hips grade B/C and 8 hips grade C. In the final examination, 10 hips were evaluated as good (Stulberg 1 or 2), seven as medium (Stulberg 3) and one as bad (Stulberg 4). There was shortening in four patients who were all either Stulberg stage 3 or 4. A meaningful difference was detected between the pre-operation and post-operation radiographic values, regardless of the surgical staging. However, no statistical difference was found between the patients in Stulberg stage 3 or 4 and stage 1 or 2 for radiographic variables. Conclusion Salter osteotomy can be used to treat older patients with lateral pillar stage B, B/C and C at presentation.
Single tranexamic acid dose to reduce perioperative morbidity in primary total hip replacement: a randomised clinical trial
Authors: Hourlier Hervé , Fennema Peter 
Published: April 2014

Introduction Although prophylactic tranexamic acid (TXA) is a safe, low-cost option to reduce bleeding in patients undergoing total hip replacement (THR), its optimal dose and duration is unknown. We compared the safety and effectiveness of TXA given as either a single injection or continuous infusion in THR patients, hypothesising that a second TXA dose would not offer any clinical advantages over the single injection. Materials and methods One hundred and sixty-four patients undergoing unilateral THR were randomised. Exclusion criteria were history of thromboembolic events (TE), epilepsy, thrombophilia, and severe chronic renal failure. Patients received either a single dose of 30 mg/kg TXA on induction of surgery (one shot [OS] group), or a loading dose of 10 mg/kg TXA followed two hours later by a continuous infusion of 2 mg/kg per hour for 20 hours (one day [OD] group). The primary outcome was blood loss (BL) calculated from haematocrit levels. Secondary outcomes were mortality and TE events within 90 days postoperatively. Results All patients completed treatment, with none lost to follow-up. Mean BL was 1107 ± 508 ml in Group OS and 1047 ± 442 ml in Group OD (p = 0.43). No patients were transfused prior to Day 10 postoperatively. At final follow-up, no patients had died, and there were no occurrences of major TE. Conclusion The 30 mg/kg TXA single shot was as safe as continuous infusion. As it is also less cumbersome, we recommend it as part of routine care in THR patients.
Comparison of mechanoreceptor quantities in hip joints of developmental dysplasia of the hip patients with normal hips
Authors: Desteli Engin Eren , Gülman Ali Birol , Imren Yunus , Kaymaz Figen 
Published: April 2014

Background Joint mechanoreceptors are afferent neural elements involved in pain sensation and tactile sense. Questions/purposes We aimed to detect the free nerve endings (FNE) and other types of mechanoreceptors and to compare their quantities in human hip joint capsule (HJC) and ligamentum capitis femoris (LCF) of babies with developmantal dysplasia of hip (DDH) and intrauterine ex foetuses (control group) to find out whether there is an increase in the amount of mechanoreceptors in hip joint due to the occured anatomical chages. Patients and methods We took 15 LCF and HJC biopsies from 15 patients undergoing hip surgery for DDH, and 15 HJC and LCFs from intrauterine ex fetuses. Total of 60 specimens were investigated. The mean age of the babies was 10.3 months (6-18 months) at the time of surgery. Full thickness 1 × 1 cm HJC and LCF portions were taken as biopsy specimens. An immunohistochemical technique was performed for neurogenic protein S-100 and examined under light microscopy. Results FNEs were detected in all four different tissues (type IVa). Other types of mechanoreceptors (Type I-II and III) were not detected in any of the specimens. The positive rates of FNE staining in the control group were % 2.60 ± 1.24 for the LCF and % 2.67 ± 1.11 for the HJC respectively and FNE staining in the DDH group were found to be % 2.67 ± 1.11 for the LCF and % 2.73 ± 1.16 for the HJC. We did not find a statistically significant difference in number of FNEs between the specimens of the DDH group and the control group (p>0.05), also there was no statistically significant difference in number of FNEs between the HJC and LCF within each group (p>0.05). Conclusion Our results suggest that the number of FNEs does not increase in HJC and LCF of DDH patients even though LCF hypertrophy and capsular elongation occurs.
Proximal femoral reconstruction after aseptic loosening following proximal femoral replacement for Ewing sarcoma: a case report with one-year follow-up
Authors: Schoof Benjamin , Jakobs Oliver , Gehrke Thorsten , Gebauer Matthias 
Published: April 2014

We report the case of a 30-year-old patient initially treated for a proximal femoral Ewing's sarcoma when 12 years old. Index treatment comprised tumour resection and total hip arthroplasty. Two years later revision for aseptic loosening was performed. Subsequently, six further surgical revisons were performed for varying causes. At the age of 23 years the proximal femur was resected and a proximal femoral endoprosthesis implanted. Eighteen years after initial diagnosis the patient presented with recurrent aseptc loosening. Both the proximal femur and acetabulum were reconstructed. For acetabular reconstruction a structural allograft and a tantalum cup were utilised. Reconstruction of the femur utilsed extensive wire mesh and circlage wiring with impaction bone allograft into which a femoral stem was implanted. At one-year follow-up the patient was pain free, had no evidence of infection with satisfactory radiographs and no evidence of implant loosening. This is the first case reporting an extended proximal femoral reconstruction with a wire mesh in combination with impaction bone grafting in an aseptic loosened proximal femoral replacement following Ewing's Sarcoma.
Use of Calcium-containing Endodontic Sealers as Apical Barrier in Fluid-contaminated Wide-open Apices
Authors: Prati Carlo , Siboni Francesco , Polimeni Antonella , Bossu' Maurizio , Gandolfi Maria Giovanna 
Published: April 2014

Purpose The sealing of wide-open apex roots is still a challenge and requires the use of apical barrier techniques. The aim was to evaluate ex vivo the sealing and the apical morphology of 3 commercial calcium oxide (CaO)-containing sealers - namely, 2 zinc oxide-based (CRCS and Sealapex) and a calcium silicate MTA-based (TechBiosealer Endo) - placed in wet root canals with artificial wide-open apices. Methods Thirty human single-rooted teeth were shaped with Protaper and an artificial open apex (diameter size 110) was created. Each root was inserted in a custom-designed support containing simulated body fluid (Hank's balanced salt solution, HBSS) at the bottom simulating the presence of periapical fluid in the canal. Each sealer (TechBiosealer Endo, CRCS, Sealapex) was compacted to the apical 5 mm and the filled roots stored in HBSS at 37°C. The sealing was evaluated as micro-infiltrated fluid since 24 hours up to 6 months using a high-precision digital fluid flow meter. The sealers were also studied for setting time in HBSS, calcium releasing (statistical analysis by 2-way ANOVA followed by Student-Newman-Keuls test, P<0.05) and surface morpho-chemistry by environmental scanning electron microscope with energy dispersive X-ray (ESEM-EDX) and optical microscopy (OM) analysis. Results All sealers showed a stable seal. TechBiosealer Endo maintained a better seal than the other materials (P<0.05) and ESEM-EDX and OM analyses showed the presence of apatite deposits. Conclusions The clinical use of hydraulic hydrophilic MTA-based sealers can be recommended to stop/reduce the fluid flow rate through the apex. The artificial apical barrier in wet wide apices is a suitable technique able to seal wet root canals.
Interfacial Sliding Properties of Bone Screw Materials and Their Effect on Screw Fixation Strength
Authors: Koistinen Arto P. , Korhonen Hannu , Kröger Heikki , Lappalainen Reijo 
Published: April 2014

Background This study examined the effect of interfacial sliding and test material properties on the fixation strength and insertional properties of self-tapping bone screws. Various substitute materials (polyacetal [POM], poly(methyl methacrylate) [PMMA] and E-glass-filled Epoxy [Sawbones®]) for human bone were evaluated, and the results were compared with the findings for cadaver bone. Methods Initial coefficient of friction (CoF) of the screw material stainless steel AISI316 was tested using a pin-on-disk apparatus, and the screws were exposed to pullout tests after insertion torque tests. The effect of a smooth diamond-like carbon (DLC) coating was studied by applying the coating on both CoF test balls and bone screws. Results Mechanical properties of test blocks strongly correlated to both pullout strength and insertion torque of the screws: for noncoated 2.7-mm screws, tensile strength correlated to pullout strength and insertion torque, with Pearson correlation coefficients r=0.977 and r=0.738, respectively. In contrast, CoF correlated strongly to screw insertion torque but not to pullout strength in bone substitute materials (for noncoated 2.7-mm screws, r=0.652 and r=0.248, respectively). There were no significant differences in CoF using noncoated and DLC-coated screw materials against bone substitutes. Conclusions Proper materials for in vitro testing help in evaluating the biomechanics of the implants in advance. However, choosing the material needs attention, as their ability to model human bone depends on test type.
Maternal and infant Bordetella pertussis infection
Authors: Narkevičiūtė Irena , Kavaliūnaitė Ema , Janušaitienė Rūta 
Published: April 2014

Background. Pertussis continues to be a public health concern around the world because of increasing morbidity among vaccinated children and adults, severe disease forms in infants and late diagnosis. It is frequently believed that pertussis is exclusively a “childhood disease”, but there have been increasing reports of B. pertussis infection among adolescents and adults, although the peak incidence and the highest mortality occur among infants.
Case presentation. 7-week-old infant illness started with a dry cough, on the 8th day of her illness it became paroxysmal. The infant’s recurrent apnea episodes started on the day 12 of the illness, she started vomiting and developed severe respiratory failure. The patient required intubation and ventilation and stayed in PICU for 9 days. Blood showed lymphocytic leukocytosis. Pertussis diagnosis was confirmed by specific IgM antibody seroconversion. Disease to her 30-year-old mother began with catarrhal symptoms, later her paroxysmal coughing became accompanied by vomiting. Atypical bacterial bronchitis was suspected. Rigorous epidemiological history and detection of pertussis antibodies have helped to the confirmation of the pertussis diagnosis. The clinical course of B. pertussis infection in the infant was severe, and the mother’s course was mild.
Conclusions. Our presented clinical case of the infant and her mother’s B. pertussis infection illustrates the complex diagnostic difficulties in diagnosing pertussis, requiring laboratory confirmation, analysis of epidemiological data and appropriate evaluation. Pertussis to the infant and the mother occurred with the typical three stages: catarrhal, paroxysmal and convalescente. The infant underwent a severe form of the disease, but the outcome was good. Understanding the source of pertussis may provide new approaches to preventing pertussis in the most vulnerable infants.