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Biomechanical analysis of tension band wiring （TBW） of transverse fractures of patella

Chinese Journal of Traumatology 2016年第5期19卷 255-258页

作者： Mohammed Ali jan kuiper Joby John Trauma and Orthopaedics North Cumbria NHS Trust UK The Robert Jones and Agnes Hunt Orthopaedics Hospital Oswestry UK University Hospitals of Nottinghamshire UK

Purpose： Tension band wiring is commonly used for fixation of simple transverse fractures. The popular configuration is parallel Kirschner wires （K-wires） and a stainless steel wire loop placed in a vertically oriented figure-of-8. Methods： We used a wooden model of a patella with a midway transverse fracture and compared four different types of fixation. The first construct had a vertical figure-of-8 with one twist of wire. The second contained a vertical figure-of-8 with two twists of wire. The third was a vertical figure-of-8 with two twists of wire placed at adjacent corners while the last one had a horizontal figure-of-8 with two twists of wire placed at adjacent corners, lnterfragmentary compression at the point of wire breakage was measured for each construct as well as permanent displacement on cyclic loading. Results： Placement of the figure-of-eight in a horizontal orientation with two wire twists at the corner improved interfragmentary compression by 63% （p 〈 0.05, Tukey post ]hoc test）. On cyclic loading, all the constructs with vertical figure-of-eight but none with a horizontal construct failed （p = 0.01; Fisher＇s exact test）. Permanent fracture displacement after cyclic loading was ,57% lower with horizontal figure- of-eight constructs （p 〈 0.05; t test）. Conclusion： Placing wire twists at the corner and a horizontal placement of figure-of-8 improves stability of the construct.

关键词： Patella transverse fractures Tension band wiring Biomechanical analysis

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Assessment of the effectiveness of weight-adjusted antibiotic administration,for reduced duration,in surgical prophylaxis of primary hip and knee arthroplasty

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World Journal of Orthopedics 2024年第2期15卷 170-179页

作者： Tosan Okoro Michael Wan Takura Darlington Mukabeta Ella Malev Marketa Gross Claudia Williams Muhammad Manjra jan Herman kuiper John Murnaghan Department of Arthroplasty Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestry SY107AGUnited Kingdom School of Medicine Keele UniversityStaffordshire ST55BGUnited Kingdom St Joseph’s Health Centre Unity Health TorontoToronto M6R 1B5Canada Department of Arthroplasty The Royal London HospitalBarts Health NHS TrustLondon E11BBUnited Kingdom Department of Arthroplasty Sunnybrook Holland Orthopaedic and Arthritis CentreToronto M4Y 1H1Canada Institute for Science and Technology in Medicine Keele UniversityStaffordshire ST51BGUnited Kingdom

BACKGROUND Prophylactic antibiotics have significantly led to a reduction in the risk of postoperative surgical site infections(SSI)in orthopaedic *** aim of using antibiotics for this purpose is to achieve serum and tissue drug levels that exceed,for the duration of the operation,the minimum inhibitory concentration of the likely organisms that are *** antibiotics reduce the rate of SSIs in lower limb arthroplasty from between 4%and 8%to between 1%and 3%.Controversy,however,still surrounds the optimal frequency and dosing of antibiotic *** To evaluate the impact of introduction of a weight-adjusted antibiotic prophylaxis regime,combined with a reduction in the duration of administration of post-operative antibiotics on SSI incidence during the 2 years following primary elective total hip and knee arthroplasty METHODS Following ethical approval,patients undergoing primary total hip arthroplasty(THA)/total knee arthroplasty(TKA)with the old regime(OR)of a preoperative dose[cefazolin 2 g intravenously(IV)],and two subsequent doses(2 h and 8 h),were compared to those after a change to a new regime(NR)of a weight-adjusted preoperative dose(cefazolin 2 g IV for patients120 kg)and a post-operative dose at 2 *** primary outcome in both groups was SSI rates during the 2 years *** A total of n=1273 operations(THA n=534,TKA n=739)were performed in n=1264 *** was no statistically significant difference in the rate of deep(OR 0.74%(5/675)vs NR 0.50%(3/598);fishers exact test P=0.72),nor superficial SSIs(OR 2.07%(14/675)vs NR 1.50%(9/598);chi-squared test P=0.44)at 2 years *** propensity score weighting and an interrupted time series analysis,there was also no difference in SSI rates between both groups[RR 0.88(95%CI 0.61 to 1.30)P=0.46].CONCLUSION A weight-adjusted regime,with a reduction in number of post-operative doses had no adverse impact on S

关键词： Antibiotics Weight-adjusted Hip and knee arthroplasty Surgical site infection

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髋关节表面置换术治疗类风湿性关节炎——基于国际注册资料11年随访结果的独立研究

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中国矫形外科杂志 2011年第23期19卷 1957-1957页

作者：肖军史占军 Tajeshwar S.Aulakh jan H.kuiper Josh Dixey James B.Richardson 南方医科大学南方医院骨病科广州510515

人工全髋置换术已被证明对于类风湿性关节炎患者具备满意的疗效。那么,髋关节表面置换术是否也能够获得同样的疗效？基于一项髋关节表面置换术的国际注册资料,47例年龄和性别匹配的髋关节类风湿关节炎患者和131例髋关节骨关节炎患者被... 详细信息

人工全髋置换术已被证明对于类风湿性关节炎患者具备满意的疗效。那么,髋关节表面置换术是否也能够获得同样的疗效？基于一项髋关节表面置换术的国际注册资料,47例年龄和性别匹配的髋关节类风湿关节炎患者和131例髋关节骨关节炎患者被纳入本研究。通过问卷调查,记录髋关节功能和假体翻修情况。应用Hierarchical回归、Cox回归和Kap-lan-Meier法进行统计学分析。

关键词：类风湿性关节炎患者髋关节表面置换术国际注册随访结果人工全髋置换术 Cox回归治疗髋关节功能

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Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts

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World Journal of Orthopedics 2014年第5期5卷 667-676页

作者： Jesse WP kuiper Robin Tjeenk Willink Dirk jan F Moojen Michel PJ van den Bekerom Sascha Colen Center for Orthopaedic Research Alkmaar Medical Center Alkmaar 1815 JD Alkmaar The Netherlands Department of Surgery Spaarne Hospital2134 TM Hoofddorp The Netherlands Department of Orthopaedic Surgery University Hospitals Leuven Department of Orthopaedic Surgery and Traumatology Onze Lieve Vrouwe Gasthuis 1091 AC Amsterdam The Netherlands Department of Orthopedic Surgery and Traumatology Sint Bonifatius Hospital

Periprosthetic joint infection(PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively(4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one ormore positive culture results. Debridement, antibiotics and implant retention(DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus(aureus or coagulase nega

关键词： Arthroplasty Prosthesis Infection Periprosthetic joint infection Retention Debridement antibiotics and implant retention Debridement Acute

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Leukocyte ABCA1 is atheroprotective in absence of ApoAI

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中国病理生理杂志 2012年第11期 2009-2009页

作者： Laura CALPE-BERDIEL Josep JULVE Joan Carles ESCOL-GIL Amanda FOKS Ronald J.VAN DER SLUIS Johan kuiper Francisco BLANCO-VACA Theo J.C.VAN BERKEL jan-Albert KUIVENHOVEN Miranda VAN ECK Department of Pathophysiology School of Biology and Basic Medical SciencesSoochow UniversitySuzhou 215123China IIB Sant Pau and CIBER de Diabetes y Enfermedades Metabólicas Asociadas CIBERDEMBarcelonaSpain 3. Division of BiopharmaceuticsLeiden/Amsterdam Center for Drug ResearchGorlaeus LaboratoriesLeiden UniversityLeidenNetherlands Departament de Bioquímicali Biologia Molecular Universitat Autònoma de BarcelonaBarcelonaSpain Department of Vascular Medicine Academic Medical CenterUniversity of AmsterdamAmsterdamNetherlands

AIM:ABC-transporter A1(ABCA1)facilitates cellular cholesterol efflux to lipid-free/poor apolipoproteins,including apolipoprotein AI(ApoAI).The aim of the present study was to investigate the importance of ApoAI for AB... 详细信息

关键词： Leukocyte ABCA1 is atheroprotective in absence of ApoAI

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自适应辅助通气的潮气量决定因素：一项多中心观察研究

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麻醉与镇痛 2010年第1期6卷 92-98页

作者： Dave A. Dongelmans Denise P. Veelo Alexander Bindels jan M. Binnekade Kees Koppenol Matty Koopmans Joke C. Korevaar Michael A. kuiper Marcus J. Schultz 杨婷(译) 姚尚龙(校) Department of Intensive Care Medidne University of Amsterdam Amsterdam The Netherlands Department of Anesthesiology Academic Medical Center University of Amsterdam Amsterdam The Netherlands Department of Intensive Care Medicine Catharina Hospital Eindhoven Eindhoven The Netherlands Department of Intensive Care Medi- cine Medical Centre Leeuwarden Leeuwarden The Netherlands Department of Clinical Epidemiology and Biostatistics Academic Medical Center University of Amsterdam Amsterdam The Netherlands HERMES Critical Care Group Amsterdam The Netherlands Laboratory for Experimental Intensive Care and Anesthesiology( L. E. I. C. A) Academic Medical Center University of Amsterdam Amsterdam The Netherlands 不详

引言在本研究中，我们在心胸外科手术后患者中观察了自适应辅助通气（adaptive support ventilation，ASV）。我们明确了在这种微处理器控制机械通气模式下的潮气量（tidal volumes，VT）和潮气量的影响因素。方法这是一项在荷兰的三家... 详细信息

引言在本研究中，我们在心胸外科手术后患者中观察了自适应辅助通气（adaptive support ventilation，ASV）。我们明确了在这种微处理器控制机械通气模式下的潮气量（tidal volumes，VT）和潮气量的影响因素。方法这是一项在荷兰的三家加强监护病房进行的为期5个多月的前瞻性、多中心观察研究。机械通气的数据在患者来到加强监护病房后的稳定状态下收集。结果数据来自心胸外科术后的连续346例患者：其中262例患者采用自适应辅助通气模式，84例患者采用压力控制机械通气模式。在ASV模式下，每实际公斤体重（ABW）的VT（mean±SD）为7．1±1．6ml，每理想公斤体重（IBW）的、VT为8.3±1.5ml。而在恰当设定体重（SBW）（如，理想体重IBW）的患者，VT为8．1±1．4ml／kg。在压力控制机械通气模式下，VT为7．3±1．4ml／kgIBW（P〈0．001vsASV）。多变量logistic回归分析表明ASV模式的VT仅依赖于两个参数：呼吸频率和设定体重的正确性。结论ASV模式的VT依赖于两个参数：呼吸频率和设定体重的正确性。第一个因素并没有重要的临床意义，因为呼吸频率是由微处理器自动选择的。第二个因素在临床上非常重要，因为这是受操作者影响的唯一因素。我们的数据表明了在ASV模式下设定正确体重的重要性。在ASV模式下，绝大多数患者的VT〉8ml／kg IBW。未来还需要进行随机临床试验来将ASV和其他通气模式进行比较。

关键词：辅助通气潮气量自适应多中心 logistic回归分析机械通气模式微处理器控制理想体重

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