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Prosthetic Impingement in Total Hip Arthroplasty—The Trigger for Adverse Wear

Open Journal of Orthopedics 2020年第12期10卷 321-358页

作者： Ian C. Clarke Jean Yves Lazennec Evert Johannes Smith Thomas K. Donaldson Department of Orthopaedics Loma Linda University Medical Center Loma Linda CA USA Department of Orthopaedics La Pitié-Salpêtrière University Hospital Paris France spire bristol hospital Bristol UK

Development of total hip arthroplasty (THA) now spans more than 5 decades encompassing combinations of metal-on-metal (MOM), ceramic-on-metal (COM), metal-on-plastic (MOP), ceramic-on-plastic (COM), and ceramic-on-ceramic (COC). In every arena of extensive technical development, there exists a data set that when viewed in isolation seemed of little import, but when assembled in-toto may produce a generational shift in perception. Our review focused on two such THA events. Firstly, COC retrieval studies (1999-2001) noted habitual wear patterns on heads and peripheral wear stripes, along with femoral-neck impingement, and ceramic surfaces stained gray by metal debris. These COC data indicated THA risks included, 1) cup edge-loading (E/L) on heads producing “stripe wear”, 2) component impingement releasing metal particles resulting in 3) tissues contaminated by metal debris. A corresponding MOM impingement-debris mechanism was only perceived by Howie (2005) in a McKee-Farrar retrieval study. Our anticipation at LLUMC was that MOM retrievals would provide superior wear details to those seen on COC retrievals. We noted stripe wear in the polar zone of CoCr heads and basal stripes in the non-wear areas. The basal-polar stripe combinations were found in all MOM retrievals. Basal-polar stripe combinations followed cup-rim profiles in our LLUMC simulations of prosthetic impingement. LPUH videos demonstrat

关键词： Ceramic on Ceramic Edge-Loading Impingement Metal Debris Metal on Metal Metal on Polyethylene Resurfacing Arthroplasty Retrieval Stripe Wear Subluxation Total Hip Arthroplasty 3rd-Body Wear

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Bilateral Long Bone Fractures in a Patient with Sarcoid: A Case Report

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Open Journal of Orthopedics 2013年第1期3卷 49-52页

作者： Denosshan Sri George Tamvakopoulos Rosie Guy Adrian Butler-Manuel QEII hospital Welwyn Garden City UK 2spire Sussex hospital Hastings UK. QEII hospital Welwyn Garden City United Kingdom 2spire Sussex hospital United Kingdom. spire Sussex hospital Hastings UK.

Although there have been many reports of small bone and vertebral involvement in sarcoidosis, long bone pathology is rare. We report a case of almost identical bilateral fractures of the proximal femoral diaphysis during separated in time through a low-energy mode of injury, and explore the difficulties encountered when seeking radiological and tissue diagnosis.

关键词： Sarcoidosis Osseous Sarcoidosis Bilateral Long Bone Fractures Alendronate Pathological Fractures

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Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures?A cross-sectional survey of United Kingdom surgeons

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World Journal of Orthopedics 2023年第4期14卷 248-259页

作者： Amber Berry Linzy Houchen-Wolloff Natalie Crane David Townshend Robert Clayton Jitendra Mangwani Department of Physiotherapy Spire HospitalLeicester LE22FFUnited Kingdom Department of Physiotherapy University Hospitals of Leicester NHS TrustLeicester LE39QPUnited Kingdom Department of Orthopaedics Northumbria Healthcare NHS Foundation TrustNorth Sheilds NE298NHUnited Kingdom Department of Orthopaedics Victoria HospitalKirkcaldy KY25AHUnited Kingdom Academic Team of Musculoskeletal Surgery University Hospitals of Leicester NHS TrustLeicester LE54PWUnited Kingdom

BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as *** could have significant benefits for patients and the health *** there are theoretical concerns about post-operative complications and patient satisfaction due to *** To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom(UK).METHODS An online survey(19 questions)was sent to UK foot and ankle surgeons via the British Orthopaedic Foot&Ankle Society membership list in August *** foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge,with day surgery as the intended treatment *** 132 people responded to the survey invitation with 80%working in Acute NHS *** 45%of respondents perform less than 100 day-case surgeries per year for these procedures.78%felt that there was scope to perform more procedures as day-case at their ***-operative pain(34%)and patient satisfaction(10%)was not highly measured within their *** of adequate physiotherapy input pre/post-operatively(23%)and lack of out of hours support(21%)were the top perceived barriers to performing more major foot and ankle procedures as *** There is consensus among UK surgeons to do more major foot/ankle procedures as *** of hours support and physiotherapy input pre/post-op were perceived as the main *** theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those *** is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of *** a local level,the provision of physiotherapy and out of hours support should be explored at sites where this is a percei

关键词： Day-case Foot Ankle Physiotherapy Survey

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Surface Treated Catheters for Vascular Access—Useful?

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Open Journal of Nephrology 2013年第3期3卷 152-160页

作者： Rolf Bambauer Ralf Schiel Carolin Bambauer Reinhard Latza Inselklinik Heringsdorf GmbH Seeheilbad Heringsdorf Germany Institute for Blood Purification Homburg Germany Laboratorium of Medicine St. Ingbert Germany Main hospital Darmstadt Darmstadt Germany

Background: Catheter-related infections (CRI), thrombosis, and stenosis are among the most frequent complications associated with catheters which are inserted in vessels as vascular access. These problems are usually related to the handling of the staff, the catheter materials, and the surface properties of the catheter. To mitigate such complications surface treatment process of the outer surface, such as ion beam assisted deposition is investigated in a retrospective study from 1992 to 2007, to prove if the surface treatment of the catheters is a sufficient solution. Methods: This study (1992-2007) evaluated silver coated and non-coated implanted large-bore catheters used for extracorporeal detoxification. In 159 patients, 54 patients received a silver coated catheter (Spi-Argent, spire Corporation, Bedford, MA, USA) and 105 patients, an untreated catheter served as controls. The catheters were inserted into the internal jugular or subclavian veins. After removal, the catheters were cultured for bacterial colonization using standard microbiologic assays. They were also examined using a scanning electron microscope (SEM). Results: The silver coated catheters showed a tendency towards longer in situ time. The microbiologic examinations of the catheter tips were in both catheter types high positive, but not significant. Conclusion: The silver coated catheters showed no significant reduction in infection rate by evaluation of all collected data in this retrospective study. There was no association between both catheters in significantly reducing patient discomfort. Other surface treatments which include the outer and inner surface are necessary. New developed catheter materials such as the microdomain structured inner and outer surface, as an example, are considered more biocompatible because they mimic the structure of natural biological surface.

关键词： Surface Treated Large Bore Catheters Hemodialysis Apheresis Ion Been Assisted Deposition (IBAD) Microdomain-Structered Surface (PUR-SMA Coated Catheter)

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