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https://www.readbyqxmd.com/read/28209401/the-effect-of-prophylactic-cerclage-wires-in-primary-total-hip-arthroplasty-a-biomechanical-study
#1
Andrew C Waligora, John R Owen, Jennifer S Wayne, Shane R Hess, Gregory J Golladay, William A Jiranek
BACKGROUND: Despite literature to support the use of various cerclage techniques to address intraoperative femoral fractures in total hip arthroplasty, there are limited data to support prophylactic cerclage wiring of the femur during cementless implant placement. This study aims to evaluate the effect of prophylactic calcar cerclage wires on the biomechanical parameters required to produce periprosthetic femoral fractures and on the morphology of these fracture patterns in stable cementless femoral implants...
January 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28208960/functional-outcome-of-conservatively-treated-bilateral-neck-of-femur-fracture-in-an-elderly-a-case-report
#2
Prateek Sunil Joshi
Bilateral Neck of Femur (NOF) fractures is relatively rare. Surgery, either osteosynthesis or hemireplacement arthroplasty, is the mainstay of treatment. Significant complications are known to occur in such cases. In this case report, we present the functional outcome of a conservatively treated bilateral NOF fracture at one year, in a 93-year-old man. Our patient, a 93-year-old gentleman, sustained right side NOF fracture in May 2014 and left side NOF fracture in May 2015, both after trivial fall. He did not give consent for surgery considering high operative risk...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205299/perioperative-hypothermia-during-hip-fracture-surgery-an-observational-study
#3
Usha Gurunathan, Christopher Stonell, Paul Fulbrook
RATIONALE: Elderly patients are at high risk of accidental perioperative hypothermia. The primary objective of this study was to measure the changes in body temperature and the incidence of hypothermia in elderly patients undergoing hip fracture surgery. METHODS: We conducted a prospective observational study on all adult patients undergoing surgery for fractured neck of femur between December 2013 and July 2014. We monitored their temperatures in different perioperative areas at multiple time points and also noted the warming methods used...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28203357/wrist-bone-mineral-density-utility-in-diagnosing-hip-osteoporosis-in-postmenopausal-women
#4
Bina Eftekhar-Sadat, Mostafa Ghavami, Vahideh Toopchizadeh, Masood Ghahvechi Akbari
BACKGROUND: Osteoporosis is a common bone disease that increases with age. Wrist bone mineral density (BMD) has significant correlation with other skeletal sites and it could be used as a diagnostic method for osteoporosis. The purpose of this study was to evaluate the role of wrist BMD in diagnosing osteoporosis in postmenopausal women. METHODS: In this cross-sectional study, 99 postmenopausal women with mean age of 57 ± 6.9 (range 50-76) years were evaluated...
December 2016: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28202082/bone-morphogenetic-proteins-and-myostatin-pathways-key-mediator-of-human-sarcopenia
#5
Manuel Scimeca, Eleonora Piccirilli, Francesca Mastrangeli, Cecilia Rao, Maurizio Feola, Augusto Orlandi, Elena Gasbarra, Elena Bonanno, Umberto Tarantino
BACKGROUND: Sarcopenia, osteoporosis and osteoarthritis are the most frequent musculoskeletal disorders affecting older people. The main aim of this study was to test the hypothesis that the balance between BMPs and myostatin pathways regulates the age-related muscle degeneration in OP and OA patients. To this end, we investigated the relationship among the expression of BMP-2/4-7, myostatin and phosphorylated Smads1-5-8 and the muscle quality, evaluated in term of fibers atrophy and satellite cells activity...
February 15, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28194709/high-survivorship-and-little-osteoarthritis-at-10-year-followup-in-scfe-patients-treated-with-a-modified-dunn-procedure
#6
Kai Ziebarth, Milan Milosevic, Till D Lerch, Simon D Steppacher, Theddy Slongo, Klaus A Siebenrock
BACKGROUND: The modified Dunn procedure has the potential to restore the anatomy in hips with slipped capital femoral epiphyses (SCFE) while protecting the blood supply to the femoral head and minimizing secondary impingement deformities. However, there is controversy about the risks associated with the procedure and mid- to long-term data on clinical outcomes, reoperations, and complications are sparse. QUESTIONS/PURPOSES: Among patients treated with a modified Dunn procedure for SCFE, we report on (1) hip pain and function as measured by the Merle d'Aubigné and Postel score, Drehmann sign, anterior impingement test, limp, and ROM; (2) the cumulative survivorship at minimum 10-year followup with endpoints of osteoarthritis (OA) progression (at least one Tönnis grade), subsequent THA, or a Merle d'Aubigné and Postel score < 15; (3) radiographic anatomy of the proximal femur measured by slip angle, α angle, Klein line, and sphericity index; and (4) the risk of subsequent surgery and complications...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28194386/femur-lengthening-with-monoplanar-external-fixator-associated-with-locked-intramedullary-nail
#7
Henrique Paradella Alvachian Fernandes, Danilo Gabriel do Nascimento Silva Barronovo, Fabio Lucas Rodrigues, Marcos Hono
OBJECTIVE: This study aimed to demonstrate that the lengthening technique of an external fixator associated with locked intramedullary nail is an efficient method that decreases the duration of the external fixation and improves the rehabilitation period. METHODS: From January of 2005 to May of 2014, 31 patients with mean lower limb discrepancy of 5.31 cm were treated. The etiologies of the deformity were femur fracture sequelae, infection, hip development dysplasia, polio, and congenital short femur...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28178228/imaging-evaluation-of-the-safe-region-for-distal-locking-screw-of-proximal-femoral-nail-anti-rotation-in-patients-with-proximal-femoral-fracture
#8
Jinpeng Gong, Pengcheng Liu, Ming Cai
BACKGROUND Proximal femoral nail anti-rotation (PFNA) is a standard femoral intertrochanteric fracture operation. Iatrogenic vascular injury, although uncommon, is a reported complication of PFNA surgery as well as a complication of hip fracture surgery. This study aimed to compare the safety and best use of the distal locking screw in 170 mm PFNA and 240 mm PFNA devices, and to determine the safe region for placement of the distal locking screw in PFNA surgery. MATERIAL AND METHODS A retrospective analysis of 100 patients with 170 mm PFNA and 80 patients with 240 mm PFNA were retrospectively analyzed...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28176673/surgical-hip-dislocation-in-treatment-of-slipped-capital-femoral-epiphysis
#9
Mohammed Elmarghany, Tarek M Abd El-Ghaffar, Mahmoud Seddik, Ahmed Akar, Yousef Gad, Eissa Ragheb, Alessandro Aprato, Alessandro Massè
BACKGROUND: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666-679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI) [Leunig M, Slongo T, Ganz R (2008) Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis...
2017: SICOT-J
https://www.readbyqxmd.com/read/28176355/strain-shielding-inspired-re-design-of-proximal-femoral-stems-for-total-hip-arthroplasty
#10
Myriam Cilla, Sara Checa, Georg N Duda
A large number of hip prosthesis with different designs have been developed. However, the influence of hip implant design changes on the strains induced in the bone remains unclear. The purpose of this study is to better understand the mechanics of short stem total hip arthroplasty. Specifically, it investigates whether strain shielding can be avoided by changing implant shape and/or material properties. It is hypothesized that the re-design of existing implant designs can result in further reduction of strain shielding and thus keep bone loss minimal following total hip replacement...
February 8, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28175978/skeletal-effects-of-vitamin-d-deficiency-among-patients-with-primary-hyperparathyroidism
#11
J H Lee, J H Kim, A R Hong, S W Kim, C S Shin
: Little is known about the association between vitamin D deficiency and the skeletal phenotypes in primary hyperparathyroidism (PHPT) patients. A low 25-hydroxyvitamin D level was associated with a low bone mineral density and deteriorated hip geometry in women with PHPT in an Asian population where vitamin D deficiency is prevalent. INTRODUCTION: Few studies have examined the effect of vitamin D deficiency on the bone health of primary hyperparathyroidism (PHPT) patients...
February 7, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28169450/quantitating-the-effect-of-prosthesis-design-on-femoral-remodeling-using-high-resolution-region-free-densitometric-analysis-dxa-rfa
#12
Mohsen Farzi, Richard M Morris, Jeannette Penny, Lang Yang, Jose M Pozo, Søren Overgaard, Alejandro F Frangi, J Mark Wilkinson
Dual energy X-ray absorptiometry (DXA) is the reference standard method used to study bone mineral density (BMD) after total hip arthroplasty (THA). However, the subtle, spatially-complex changes in bone mass due to strain-adaptive bone remodeling relevant to different prosthesis designs are not readily resolved using conventional DXA analysis. DXA region free analysis (DXA RFA) is a novel computational image analysis technique that provides a high-resolution quantitation of periprosthetic BMD. Here we applied the technique to quantitate the magnitude and areal size of periprosthetic BMD changes using scans acquired during two previous randomized clinical trials (2004 to 2009); one comparing three cemented prosthesis design geometries, and the other comparing a hip resurfacing versus a conventional cementless prosthesis...
February 7, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28168640/3d-computer-graphical-anatomy-study-of-the-femur-a-basis-for-a-new-nail-design
#13
Beat Schmutz, Stanley Kmiec, Martin E Wullschleger, Martin Altmann, Michael Schuetz
BACKGROUND: Current intramedullary nails with a radius of curvature (ROC) of 1500-2000 mm sometimes cause distal anterior cortical encroachment. Furthermore, clinical data indicate that the proximal nail end is too long for some Asian patients. The objective of our study was to develop a comprehensive 3D measurement protocol that measures both the anatomy of the canal and the proximal region. The protocol was used to obtain measurements from Caucasian and Asian (Japanese and Thai) specimens...
February 6, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28168080/the-femoral-neck-mechanoresponse-to-hip-extensors-exercise-a-case-study
#14
Saulo Martelli, Hossein Mokhtarzadeh, Peter Pivonka, Peter R Ebeling
Physical activity is recommended to prevent age-related bone loss. However, the proximal femur mechanoresponse is variable, possibly because of a muscle-dependant mechanoresponse. We compared the proximal femur response with the femoral strain pattern generated by the hip extensor muscles. A healthy participant underwent a six-month unilateral training of the hip extensor muscles using a resistance weight regularly adjusted to the 80% of the one-repetition maximum weight. DXA-based measurements of the areal Bone Mineral Density (aBMD) in the exercise leg were adjusted for changes in the control leg...
2017: Journal of Osteoporosis
https://www.readbyqxmd.com/read/28167748/does-achieving-the-best-practice-tariff-improve-outcomes-in-hip-fracture-patients-an-observational-cohort-study
#15
B Oakley, J Nightingale, C G Moran, I K Moppett
OBJECTIVES: To determine if the introduction of the best practice tariff (BPT) has improved survival of the elderly hip fracture population, or if achieving BPT results in improved survival for an individual. SETTING: A single university-affiliated teaching hospital. PARTICIPANTS: 2541 patients aged over 60 admitted with a neck of femur fracture between 2008 and 2010 and from 2012 to 2014 were included, to create two cohorts of patients, before and after the introduction of BPT...
February 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28165597/increase-in-safe-zone-area-of-the-acetabular-cup-using-dual-mobility-cups-in-tha
#16
Takaaki Ohmori, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Hiroyuki Tsuchiya
BACKGROUND: Dual mobility cup (DMC) inserts reduce the risk of dislocation after total hip arthroplasty (THA). No available research has clearly delineated stability advantages of DMC inserts in primary and revision THA. We investigated: (i) the degree of change in the safe zone of the cup when a DMC insert is used compared to a fixed insert; (ii) the method of selecting candidates for a DMC insert without changing the position of the acetabular (cup) component during revision THA in frequent dislocation cases caused by implant impingement...
January 30, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28165592/selection-of-a-surgical-approach-for-total-hip-arthroplasty-according-to-the-depth-to-the-surgical-site
#17
Takaaki Ohmori, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Hiroyuki Tsuchiya
BACKGROUND: The surgical depths of approaches for total hip arthroplasty (THA) have not been reported previously. In this study, we investigate the relationships between the distances to the centre of the femoral head in different approaches and body mass index (BMI). METHODS: The study included patients with normal hip joints who presented to our hospital. We used the pelvic coordinate system relative to the anterior pelvic plane and the femur coordinate system relative to the posterior condylar plane...
February 4, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28164068/fracture-diaphyseal-femur-in-a-case-of-ipsilateral-excision-arthroplasty-of-hip-report-of-two-cases-with-description-of-an-unusual-injury-pattern-mechanism-and-clinical-decision-making-in-management
#18
Kunal Shah, Tushar Ubale, Rahematullah Abdul, Vaibhav Kasodekar, Ashish Assudani, Kiran Makwana
INTRODUCTION: Although fracture diaphyseal femur is commonly seen in orthopedic practice, its association with ipsilateral resection arthroplasty of hip/pseudarthrosis of neck is rare. The technique of excision arthroplasty has undergone modification with emphasis on preserving as much bone as possible. However, it is not always possible to preserve bone while removing the earlier prosthesis and cement. This often leads to extensive proximal bone loss. Associated ipsilateral fracture femur presents a unique scenario...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28164053/long-term-bisphosphonate-therapy-induced-periprosthetic-femoral-stress-fracture-in-a-sliding-hip-screw-implant-a-unique-case-report
#19
Mark R Adams, Conor Dunn, Michael S Sirkin, Mark C Reilly
INTRODUCTION: Long-term bisphosphonate therapy for osteoporosis is associated with an increased risk of low-to-no energy atypical subtrochanteric and femoral shaft fractures with characteristic radiologic findings. There are few reports of patients with long-term bisphosphonate-induced periprosthetic fractures, all of them had a hip arthroplasty prosthesis. In this report, we present a unique case of a 90-year-old Caucasian female on long-term bisphosphonate therapy with a sliding hip screw implant who sustained a periprosthetic fracture of the femoral shaft at the distal aspect of the plate...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28161119/monthly-oral-ibandronate-reduces-bone-loss-in-korean-women-with-rheumatoid-arthritis-and-osteopenia-receiving-long-term-glucocorticoids-a-48-week-double-blinded-randomized-placebo-controlled-investigator-initiated-trial
#20
Kichul Shin, Sung-Hwan Park, Won Park, Han Joo Baek, Yun Jong Lee, Seong Wook Kang, Jung-Yoon Choe, Wan-Hee Yoo, Yong-Beom Park, Jung-Soo Song, Seung-Geun Lee, Bin Yoo, Dae-Hyun Yoo, Yeong Wook Song
PURPOSE: Our aim was to investigate the efficacy of monthly oral ibandronate in Korean women with rheumatoid arthritis and reduced bone mineral density (BMD) receiving long-term glucocorticoids. METHODS: Patients (n = 167 women) were randomly assigned (1:1) to receive ibandronate 150 mg or placebo every 4 weeks. Patients had taken glucocorticoid (equivalent of daily prednisolone ≥5 mg) for 3 or more consecutive months before enrollment, and had a lumbar spine 1 to 4 (L1-L4) T-score of < -1...
February 1, 2017: Clinical Therapeutics
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