Lundingsunesen7590

The abduction angle and the distance from rotation center to the ischial tuberosity line were significantly different between the two sides in the traditional group.

Application of the 3D printing template for THA with DDH can facilitate the surgical procedure and create an ideal artificial acetabulum placement.

Application of the 3D printing template for THA with DDH can facilitate the surgical procedure and create an ideal artificial acetabulum placement.

With the development of 4th generation ceramic bearing, the large ceramic head is available for ceramic-on-ceramic total hip arthroplasty (THA). This retrospective study aimed to compare the outcomes of ceramic-on-ceramic THA with 4th generation 36mm head to those with 3rd generation 28mm head using propensity score matching.

We retrospectively reviewed the results of 133 ceramic-on-ceramic THAs with 4th generation 36mm ceramic head in 129 patients and 133 ceramic-on-ceramic THAs identified from 405 ceramic-on-ceramic THAs with 3rd generation 28mm head by propensity score matching. There were 83 males and 50 females in both groups with a mean age of 55years. compound 3k in vivo There was no significant difference in other demographic features except for follow-up period (4.2years in the 36mm group and 6.4years in the 28mm group,

 < 0.001). Clinical and radiological results and occurrence of complication were compared between the two groups.

Harris Hip Score was increased significantly from 46.4 to 92.1 in the 36mm group and from 46.7 to 93.6 in the 28mm group. No loosening or osteolysis was observed in the 36mm group. link2 However, one hip showed radiologic sign of loosening in the 28mm group. As for complication, postoperative dislocation was more frequent in the 28mm group (6 in the 28mm group vs. 0 in the 36mm group,

 = 0.03). Otherwise, there was no significant difference in other results including inguinal pain, squeaking or ceramic fracture.

Ceramic-on-ceramic THA with 4th generation 36mm head significantly reduced postoperative dislocation rate without increasing the rate of inguinal pain, squeaking, or ceramic fracture compared to that with 3rd generation 28mm head.

Ceramic-on-ceramic THA with 4th generation 36 mm head significantly reduced postoperative dislocation rate without increasing the rate of inguinal pain, squeaking, or ceramic fracture compared to that with 3rd generation 28 mm head.

During the last century, total hip arthroplasties have become more popular. They have had a huge impact on the quality of life, pain, range of motion, social interaction, and psychological well-being. link3 A number of studies have emphasized the importance of using templates to choose the appropriate implant size when planning the surgery. Our aim is to use MediCad

software to analyze the ability of the digital template system MediCad

to predict the size of the implant needed in total hip arthroplasties.

An arthroplasty preoperative plan was created according to the MediCad

software guidelines, on anteroposterior hip X-ray by one junior resident, one senior resident, and three experienced hip surgeons.

The median size accuracy was 0.7 (range 0.27-0.87) for the cup, 0.73 (range 0.36-0.83) for the stem, and 0.28 (range -0.14-0.69) for the neck. Interobserver reliability was good (kappa > 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.

 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.

Uncemented total hip arthroplasty (THA) with large size femoral heads have shown greater advantage with good stability, range of motion and decreased dislocation rate in ankylosing spondylitis (AS). Meticulous planning is needed to address the unique surgical challenges in such patients with fused hip and spinal deformity.

Thirty fivefused hip joints in twenty-five AS patients who underwent uncemented THA (April 2014 to December 2016) were included in our prospective study and were followed up for a minimum period of 36months. Pain relief, functional improvement and patient satisfaction were statistically assessed using "Visual Analogue Score" (VAS), "Harris Hip Score" (HHS) and "AJRI 10-Point Satisfaction Score" (A10PSS), respectively.

The overall mean preoperative VAS improved from 6.9 ± 1.5 to 1.5 ± 1, HHS improved from 50.0 ± 12 to 88.4 ± 7.8 and A10PSS improved from 2.2 ± 1.2 to 7.6 ± 0.8. Our study results were significant with zero dislocation and good functional score in comparison to the other available studies in literature. First subdivision study in AS patients with bilateral THA performed better than unilateral THA. Second subdivision study showed no significant statistical difference in terms of VAS, HHS, A10PSS and dislocation rate in relation to femoral head size between 32mm, 36mm and 40mm.

Uncemented THA with large size femoral head equal or greater than 32mm provides better stability and good functional outcome with less dislocation rate in comparison to older studies of literature with femoral head size less than 32mm.

A Level II study. (Data collected from the ongoing prospective study) (https//www.spine.org/Documents/LevelsofEvidenceFinal.pdf).

A Level II study. (Data collected from the ongoing prospective study) (https//www.spine.org/Documents/LevelsofEvidenceFinal.pdf).

The present study aimed to evaluate the effect of a longer interval between the first and second stages of infected total knee arthroplasty (TKA) revision on the clinical and functional outcome.

This study included a total of 56 patients who underwent two-stage revision TKA with a dynamic spacer with a minimum of 2years of follow-up. Patients were categorized into two groups according to time with the spacer < 3months (Group 1, 31 patients) or > 3months (Group 2, 25 patients). Clinical outcome and quality of life were assessed by knee range of motion (ROM), Knee Society Score for Knee (KSS-K), Knee Society Score for Function (KSS-F) and Short Form 36 (SF-36).

The mean follow-up period was 48 ± 19.1months (range, 24-84months). The KSS-K, KSS-F, and ROM values were significantly higher in Group 1 than in Group 2 (

 < 0.05). The SF-36 scores for general health, physical function, and bodily pain were significantly higher in Group 1 (

 < 0.05). Re-infection occurred in 10 patients (17.8%). Time with spacer was not associated with re-infection development (Group 1,

 = 6, 19% vs. Group 2,

 = 4, 16%;

 > 0.05).

Increased duration with a spacer is associated with poorer clinical and functional outcomes as well as higher treatment costs in two-stage revision knee arthroplasty. Surgeons can attempt to reduce the time patients spend in a spacer to obtain better postoperative functional outcomes, as well as a better quality of life.

3.

3.

Pain control after total knee replacement (TKR) is of primary importance to joint replacement surgeons to achieve good functional outcome post-surgery. This becomes even more challenging when these major procedures are done in immunocompromised patients like rheumatoid arthritis. Good peri-operative analgesia facilitates early rehabilitation, improves patient satisfaction, and reduces the hospital stay. The adverse effects caused by epidural analgesia or parenteral opioids can be avoided by replacing it with an analgesic cocktail locally. Our prospective study was to evaluate the benefits of a periarticular cocktail injection which was given in rheumatoid patients undergoing bilateral TKR in single sitting with respect to pain and knee motion recovery.

Sixty-four rheumatoid arthritis patients undergoing simultaneous primary total knee replacement were included in the study. A total of 128 knees were randomized either to receive a periarticular intra-operative injection containing ropivacaine, fentanyl, clrative analgesia and also improves patient satisfaction, with no apparent risks, following total knee arthroplasty in rheumatoid arthritis.

Periarticular cocktail injection significantly reduces the requirements for post-operative analgesia and also improves patient satisfaction, with no apparent risks, following total knee arthroplasty in rheumatoid arthritis.

Tranexamic acid (TXA) has shown to reduce perioperative blood loss after bilateral total knee arthroplasty (TKA). But dosage and schedule of administration are not clear in literature. This study was aimed to compare prospectively blood loss and transfusion requirement in bilateral TKA with 3-dose regimen versus a single intra-operative dose of intravenous TXA.

This prospective non-randomised controlled trial included 25 patients undergoing bilateral simultaneous TKA who received three doses of 1 g intravenous TXA (group 1). First dose was given prior to deflation of the tourniquet, followed by two more doses 6 h apart. The control group included 25 matched patients (group 2) receiving a single dose of 1 g intravenous TXA just prior to deflation of the tourniquet.

Mean drop in haemoglobin was less in group 1 as compared to group 2, but this difference was not statistically significant (2.51 vs 2.93g/dL,

 = 0.210). Similarly mean drop in haematocrit was more in group 2 as compared to group 1, though it was not statistically significant (9.34 vs. 9.18,

 = 0.868). The need for blood transfusions was more in group 2 compared to group 1, but this difference was not statistically significant (

 = 0.601). Higher frequency of ecchymosis around the surgical site was noted in group 2 as compared to group 1, for which prophylactic low-molecular-weight heparin had to be stopped post-operatively, but this difference was not statistically significant (

 = 0.065).

The study has failed to show any significant beneficial effect of three doses of TXA in TKA as compared to a single dose. Though a trend towards reduction in mean haemoglobin drop and decreased need for stopping LMWH in post-operative period was seen, the results were not statistically significant.

II, prospective non-randomised controlled trial.

II, prospective non-randomised controlled trial.

Hip hemiarthroplasty (HA) is a standard surgical procedure for elderly patients with displaced fracture of the femoral neck, where dislocation is a possible complication. This study is a systematic review on the risk factors of implant dislocation in patients with femoral neck fracture following hip hemiarthroplasty (HA), and evaluates the methodological quality of the included studies.

Studies on risk factor assessment of dislocation following hip HA were sourced from EMBASE, Ovid, PubMed and ScienceDirect databases. The quality of included studies was evaluated using an improved quality evaluation method combined with a best-evidence synthesis method.

A total of 130,127 patients were involved in 17 observational studies included in this systematic review, with a dislocation rate that ranged between 0.76 and 12.2% (overall incidence was 4-5% by meta-analysis). According to the applied quality evaluation criteria, eight studies were considered to be of high quality, six to be of medium quality, and three to be of low quality.