Riisemahmoud0132

Sv, while the lowest average effective dose was found for the 5-y age group, about 0.06 mSv. The mean effective dose for all investigated patients in the five age categories was about 0.08 mSv. Variations in effective doses for the same age group and x-ray examination among involved hospitals are remarkable.

Patients with systemic lupus erythematosus (SLE) are typically treated with total hip arthroplasty (THA) because of osteonecrosis of the femoral head (ONFH). This study evaluated the outcome of THA in this patient group.

From January 2004 to January 2017, we retrospectively studied 92 THAs for patients with SLE and 92 THAs for age- and sex-matched patients suffering from ONFH due to nonrheumatic etiologies Both groups were treated with cementless THA and followed up for an average of 50.9 ± 30.6 months. Their surgical outcomes and complications were evaluated and compared.

No significant difference existed in age, sex, weight, height, follow-up time, and Ficat staging between the groups. All patients with SLE were in inactive or stably active disease conditions. For all patients, the Harris hip score (HHS) (from 52.6 to 92.8; P < 0.001), Physical Component Summary Scale score (PCS) (from 29.4 to 49.3; P < 0.001), and Mmental Component Summary Scale score (MCS) (from 50.5 to 55.5; P < 0.001) of disease condition resulted in comparable postoperative HHS and MCS scores, a lower PCS score, and shorter term postoperative complications compared with patients with ONFH resulting from nonrheumatic diseases. Dactinomycin Patients with SLE had a higher risk for postoperative complications. It is generally safe and effective to perform THA in patients with inactive or stably active SLE. However, they still have an increased risk of short-term complications.

In the setting of pathologic fractures or impending fractures of the femur, intramedullary nailing or hemiarthroplasty are the common surgical procedures indicated. Traditional teaching has stressed the importance of protecting the entire femur, and thus, it is common for these fractures to be treated with long nails or stems. Recent literature has begun to investigate whether this school of thought is valid and may challenge the perceived need for protection of the entire femur. The purpose of our study was to determine the incidence of ipsilateral distal femoral metastases after the treatment of proximal femoral metastases.

A retrospective chart review was performed that identified 66 patients who presented with completed or impending pathologic fractures of the proximal femur who then underwent either intramedullary nailing or hemiarthroplasty for surgical stabilization. Plain radiographs, in conjunction with CT, MRI, or positron emission tomography-CT when available, were used to determine whether there was disease progression and/or distal metastasis in the femur.

There was one patient (1.5%) in this series who developed distal femoral metastasis after hemiarthroplasty from metastatic breast carcinoma. There were three patients (4.54%) with local progression of the disease. No patient required further intervention, and there were no cases of hardware failure or periprosthetic fracture after prophylactic fixation.

Our findings show that there is an extremely low likelihood of developing distal femoral metastases when isolated proximal femoral metastases are present and thus protecting the entire femur may not be necessary in this clinical scenario.

IV, therapeutic study.

IV, therapeutic study.Biomechanical function, specifically implantation technique and immediate surgical fixation, of orthopaedic implants is the primary consideration during the development of orthopaedic implants. Biologic and material characteristics are additional factors to include in the design process because of the direct impact on short- and long-term implant performance. The body's initial interaction with implant materials can affect protein- and cell-based function, thereby either promoting or impeding osseointegration. An understanding and inclusion of the biologic response, material surface morphology, and material surface chemistry in implant design is crucial because these factors ultimately determine implant function and patient outcomes. Highlighting the biologic- and material-related advantages and inadequacies of current and potential implant materials as well as applications may guide further research and development of implant materials and designs.

Children with Legg-Calvé-Perthes disease (LCPD) are classically described as small, thin, high-energy children presenting with a painless limp. Epidemiologic studies have historically been retrospective and regional in nature. The purpose of this study was to determine the demographic and clinical features of children presenting in the early stages of LCPD in an international, multicenter cohort.

Children (6 to 10 years) in the early stages of LCPD (modified Waldenström stage I to IIa) were enrolled in a prospective, multicenter study. Demographic and clinical data at presentation were analyzed. Body mass index percentiles were determined using country-specific growth charts for children in the United States and India, two countries with largest enrollment. Statistical analyses included t-tests and chi-square.

A total of 209 children (86% males; mean age 7.9 ± 1.2 years) from 25 centers (six countries) were included. Eight-four percent of children presented with pain with or without a limp. Average pain score at presentation was 3 ± 2 (range 0 to 9), and 63% of children (n = 105) used pain medications. Of these children 65% required medication more than once per week. Thirty percent of children missed school due to pain in the past month, and of those, 74% missed at least 1 day per week. Twenty-nine percent of children from the United States and 20% of children from India were overweight or obese. Nineteen percent reported household smoking.

This prospective study provides a new international multicenter representation of early LCPD. The frequency of pain and missed school highlights the substantial morbidity and potential social cost and burden for children and families. The prevalence of being overweight/obese in our LCPD cohort was comparable to rates within the pediatric cohort as a whole, and fewer children have a history of smoke exposure than in previous reports.

Level II, prospective comparative study.

Level II, prospective comparative study.