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Sample records for arthroplasty preliminary study

  1. Nubac Disc Arthroplasty: Preclinical Studies and Preliminary Safety and Efficacy Evaluations

    PubMed Central

    Songer, Matthew; Pimenta, Luis; Werner, Dieter; Reyes-Sanchez, Alejandro; Balsano, Massimo; Agrillo, Umberto; Coric, Domagoj; Davenport, Kenneth; Yuan, Hansen

    2007-01-01

    Background Disc arthroplasty is gaining popularity for treatment of low-back pain caused by degenerative disc disease (DDD). It can involve total disc replacement or partial disc or nucleus replacement (or augmentation). Compared with total disc replacement, nucleus replacement is less invasive, has less surgical risk, has faster postoperative recovery, and doesn't “burn bridges” should further surgery be required. However, nucleus replacement has a high risk of implant expulsion because the device is not fixed to the vertebrae. Nubac is the first polyetheretherketone (PEEK)-on-PEEK articulated disc arthroplasty device designed to optimally restore the lumbar anatomy and biomechanics. Methods ISO 10993 standards were used to evaluate the biocompatibility of the PEEK material. Chemical and thermal–mechanical tests and in vivo study assessed PEEK's biostability after exposure to high g irradiation and harsh oxidative conditions. Biomechanical tests to evaluate kinematic properties and anatomical restoration of the implanted lumbar motion segments and implant expulsion risk assessments were performed with a human cadaveric model. Because of the novelty of PEEK-on-PEEK as a self-mating articulating material, extensive wear tests were conducted with unidirectional and coupled motions. Static and fatigue strength also were tested. Animal study with a baboon model was conducted with gross, radiographic, biomechanical, and histological evaluations at 6 and 12 months postoperatively. Preliminary clinical data were collected through a prospective multicenter cohort study. Results PEEK demonstrated exceptional biocompatibility and biodurability. Nubac restored disc height and motion segment range of motion. The unique articulating design of the Nubac demonstrated low risk of implant expulsion in a human cadaveric model. Wear tests showed that the Nubac has minimal wear and compares favorably to other disc arthroplasty materials. The Nubac also had excellent static and

  2. “Remotion” Total Wrist Arthroplasty: Preliminary Results of a Prospective International Multicenter Study of 215 Cases

    PubMed Central

    Herzberg, Guillaume; Boeckstyns, Michel; Sorensen, Allan Ibsen; Axelsson, Peter; Kroener, Karsten; Liverneaux, Philippe; Obert, Laurent; Merser, Soren

    2012-01-01

    This study reports the current results of an international multicenter study of one last generation total wrist arthroplasty (TWA) (“ReMotion,” Small Bone Innovation, Morristown, PA). The two first authors (G.H. and M.B.) built a Web-based prospective database including clinical and radiological preoperative and postoperative reports of “ReMotion” TWA at regular intervals. The cases of 7 centers with more than 15 inclusions were considered for this article. A total of 215 wrists were included. In the rheumatoid arthritis (RA; 129 wrists) and nonrheumatoid arthritis (non-RA; 86 wrists) groups, there were respectively 5 and 6% complications requiring implant revision with a survival rate of 96 and 92%, respectively, at an average follow-up of 4 years. Within the whole series, only one dislocation was observed in one non-RA wrist. A total of 112 wrists (75 rheumatoid and 37 nonrheumatoid) had more than 2 years of follow-up (minimum: 2 years, maximum: 8 years). In rheumatoid and non-RA group, visual analog scale (VAS) pain score improved by 48 and 54 points, respectively, and QuickDASH score improved by 20 and 21 points, respectively, with no statistical differences. Average postoperative arc of wrist flexion–extension was 58 degrees in rheumatoid wrists (loss of 1 degree) compared with 63 degrees in non-RA wrists (loss of 9 degrees) with no statistical differences. Grip strength improved respectively by 40 and 19% in rheumatoid and non-RA groups (p = 0.033). Implant loosening was observed in 4% of the rheumatoid wrists and 3% of the non-RA wrists with no statistical differences. A Web-based TWA international registry was presented. Our results suggest that the use of the “ReMotion” TWA is feasible in the midterm both for rheumatoid and non-RA patients. This is a significant improvement compared with the previous generation TWA. The level of evidence for this study is IV. PMID:23904975

  3. Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

    PubMed Central

    Yang, Li-Li; Liu, Zu-De; Yuan, Wen

    2016-01-01

    Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P < 0.05), without statistically relevant differences between the 2 groups. The OSA and FSU angle increased significantly in both groups (P <0.05). Compared with Zero-P group, ROMs at the index levels were well maintained in the Discover group (P < 0.05). However, there were no statistical differences in the ROMs of adjacent levels between the 2 groups (P > 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the

  4. Two-Year Incidence and Predictors of Future Knee Arthroplasty in Persons with Symptomatic Knee Osteoarthritis: Preliminary Analysis of Longitudinal Data from the Osteoarthritis Initiative

    PubMed Central

    Kong, Xiangrong; Jiranek, William A.

    2009-01-01

    Objective There is little evidence to guide physicians when discussing future likelihood of knee arthroplasty with patients who have symptomatic knee osteoarthritis. Data from Osteoarthritis Initiative (OAI) was used to determine the incidence of and predictors for knee arthroplasty. Methods OAI data were collected on a sample of 778 persons aged 45 to 79 years with symptomatic knee osteoarthritis. An extensive set of measurements were obtained at baseline and persons were followed for 2 years to identify who underwent knee arthroplasty. Random forest analysis was used to identify optimal variables that discriminate among those who did and those who did not undergo knee arthroplasty. Results The two year incidence of knee arthroplasty in the cohort was 3.7% (95%CI, 2.6%, 5.3%). Because of the low number of knee arthroplasty procedures, the predictor analysis was preliminary in nature. The analysis identified several variables that could be used to assist in identifying patients at future risk for knee arthroplasty. Conclusion For persons at high risk of knee arthroplasty, the two year incidence of knee arthroplasty is very low. The most powerful predictors were those that accounted for disease severity and functional loss. These data could assist physicians in advising patients with knee osteoarthritis on future surgical care. PMID:19419874

  5. Pain and Function Recovery Trajectories following Revision Hip Arthroplasty: Short-Term Changes and Comparison with Primary Hip Arthroplasty in the ADAPT Cohort Study

    PubMed Central

    Whitehouse, Michael R.; Wylde, Vikki; Gooberman-Hill, Rachael; Blom, Ashley W.

    2016-01-01

    Background and Purpose Patients report similar or better pain and function before revision hip arthroplasty than before primary arthroplasty but worse results are reported after revision surgery than after primary surgery. The trajectory of post-operative recovery during the first months and any differences by type of surgery have received little attention. We explored the trajectories of change in pain and function after revision hip arthroplasty to 12-months post-operatively and compare them with those observed after primary hip arthroplasty. Methods This study is a prospective cohort study of patients undergoing primary (n = 80 with 92% for an indication of osteoarthritis) and revision (n = 43) hip arthroplasties. WOMAC pain and function scores and walking speed were collected pre-operatively, at 3 and 12-months post-operatively. Multilevel regression models were used to chart and compare the trajectories of change (0–3 months and 3–12 months) between types of surgery. Results The improvements in pain and function following revision arthroplasty occurred within the first 3-months with no evidence of further change beyond this initial period. While the pattern of recovery was similar to the one observed after primary arthroplasty, improvements in the first 3-months were smaller after revision compared to primary arthroplasty. Patients listed for revision surgery reported lower pre-operative pain levels but similar post-operative levels compared to those undergoing primary surgery. At 12-months post-operation patients who underwent a revision arthroplasty had not reached the same level of function achieved by those who underwent primary arthroplasty. Conclusion The post-operative improvements in pain and function are larger following primary hip arthroplasty than following revision hip arthroplasty. Irrespectively of surgery type, most of the improvements occur in the first three post-operative months. More research is required to identify whether the recovery

  6. RESULTS FROM BI-CONTACT® TOTAL ELBOW ARTHROPLASTY: MULTICENTER STUDY

    PubMed Central

    Benegas, Eduardo; Malavolta, Eduardo Angeli; Gracitelli, Mauro Emilio Conforto; de Sousa, Augusto Tadeu Barros; Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Ikemoto, Roberto Yukio; Murachovsky, Joel; Matsumoto, Marcelo Hide; Tamaoki, Marcel Jun Sugawara; Neto, Arnaldo Amado Ferreira

    2015-01-01

    Objective: To describe the initial experience of four orthopedic clinics from using Bi-Contact® total elbow arthroplasty (TEA), reporting the results and complications of the procedure. Methods: This was a retrospective study, through analysis on the medical records of patients who underwent primary TEA using a prosthesis model developed in conjunction with IOT-HCFMUSP. Forty-six elbows (45 patients) that were operated at four orthopedic clinics between 2000 and 2009 were evaluated. Results: The majority of the patients were female (74%), and the median age was 62.5 years. The diagnoses encountered were trauma sequelae (47.83%), rheumatoid arthritis (32.61%), primary osteoarthrosis (8.7%), acute fractures (6.52%) and heterotopic ossification (2.17%). The median length of follow-up was 2.08 years (0.25-9). The procedure significantly alleviated pain and improved range of motion. It was observed that at least one complication was present in 69.57% of the cases, and the main ones were infection (28.26%), need for revision (28.26%), intraoperative fracture (15.22%) and aseptic loosening (15.22%). Conclusion: Bi-Contact® TEA provided significant alleviation of pain and improvement of range of motion in the present series. The complication rate was high, and the most frequently observed complications were infection, aseptic loosening and intraoperative fracture. PMID:27027055

  7. SHOULDER ARTHROPLASTY RECORDS

    PubMed Central

    Filho, Geraldo Motta; Galvão, Marcus Vinicius; Monteiro, Martim; Cohen, Marcio; Brandão, Bruno

    2015-01-01

    The study's objective is to evaluate the characteristics and problems of patients who underwent shoulder arthroplasties between July 2004 and November 2006. Methodology: During the period of the study, 145 shoulder arthroplasties were performed. A prospective protocol was used for every patient; demographic, clinical and surgical procedure data were collected. All gathered data were included in the data base. The patients were divided in three major groups: fractures, degenerative diseases and trauma sequels. Information obtained from the data base was correlated in order to determine patients' epidemiologic, injuries, and surgical procedure profiles. Results: Of the 145 shoulder arthroplasties performed, 37% presented trauma sequels, 30% degenerative diseases, and 33% proximal humerus fracture. 12% of the cases required total arthroplasties and 88% partial arthroplasties. Five major complications were observed on early postoperative period. Conclusion: Shoulder arthroplasties have become a common procedure in orthopaedic practice. Surgical records are important in evidencing progressive evolution and in enabling future clinical outcomes evaluation. PMID:26998463

  8. Periacetabular bone mineral density changes after resurfacing hip arthroplasty versus conventional total hip arthroplasty. A randomized controlled DEXA study.

    PubMed

    Smolders, José M H; Pakvis, Dean F; Hendrickx, Baudewijn W; Verdonschot, Nico; van Susante, Job L C

    2013-08-01

    A randomized controlled trial was performed to evaluate acetabular bone mineral density (BMD) changes after hip resurfacing (RHA) versus an established conventional total hip arthroplasty (THA). A total of 71 patients were allocated randomly to receive either an RHA press-fit cobalt-chromium cup (n=38) or a THA with a threaded titanium cup and polyethylene-metal-inlay insert (n=33). The BMD in five separate periacetabular regions of interest (ROI) was prospectively quantified preoperative until 24 months. We conclude that, in contrast to our hypothesis, periacetabular BMD was better preserved after RHA than after placement of a conventional THA. Long term follow-up studies are necessary to see whether this benefit in bone preservation sustains over longer time periods and whether it is turned into clinical benefits at future revision surgery.

  9. Efficacy and safety of rivaroxaban thromboprophylaxis after arthroplasty of the hip or knee: retrospective cohort study

    PubMed Central

    Hua, A; Patel, S; Gibbons, C; Vizcaychipi, MP

    2016-01-01

    Introduction Venous thromboembolism (VTE) is a potentially fatal complication of hip arthroplasty and knee arthroplasty. The National Institute for Health and Care Excellence recommend rivaroxaban for VTE prevention. Amid concerns over bleeding complications, the modified thromboprophylaxis policy of Chelsea and Westminster Hospital (CWH; London, UK) advises enoxaparin given after surgery in the inpatient setting followed by rivaroxaban upon hospital discharge. This retrospective study investigated the efficacy and safety of rivaroxaban in this novel, modified venous-prophylaxis regimen in a surgical orthopaedic cohort at CWH. Methods A total of 479 patients who received modified thromboprophylaxis treatment at CWH after hip arthroplasty or knee arthroplasty between April 2013 and October 2014 formed the study cohort. Seven outcomes based on efficacy and safety while undergoing treatment with rivaroxaban were investigated: symptomatic deep-vein thrombosis (DVT), pulmonary embolism (PE), death, stroke, myocardial infarction (MI), major bleeding episodes (MBEs) and non-major bleeding episodes (NMBEs). Median follow-up was 369 days. Fisher’s exact and Mann–Whitney U-tests were adopted to identify associations with these outcomes. Results Prevalence of symptomatic PE, DVT, death, stroke and MI during treatment was zero. One (0.2%) MBE and nine (1.9%) NMBEs occurred. The MBE (a wound haematoma) required a return to theatre for aspiration. Off-treatment VTEs occurred in four (0.8%) patients after completion of a course of rivaroxaban, and were associated with known risk factors. Conclusions Rivaroxaban is an effective and safe anticoagulant for thromboprophylaxis after hip arthroplasty or knee arthroplasty if used in a modified regimen involving enoxaparin administered in the inpatient setting followed by rivaroxaban upon hospital discharge. PMID:27580310

  10. Comparative study of the quality of life between arthrodesis and total arthroplasty substitution of the ankle.

    PubMed

    Esparragoza, Luis; Vidal, Carlos; Vaquero, Javier

    2011-01-01

    Our goal was to compare the health status of patients with primary and secondary arthrosis of the ankle before and after arthrodesis or total substitution arthroplasty, and to determine the improvement in quality of life and whether there is any difference between these techniques. A prospective comparative study of clinical-functional evaluation was performed using the American Orthopaedic Foot & Ankle Society (AOFAS) scale and quality of life with the short form (SF)-36 questionnaire in patients who underwent arthrodesis (16 cases) or total substitution arthroplasty of the ankle (14 cases) after 2 years (mean, 25.2 months) of follow-up after surgery, in comparison with the baseline preoperative status. In this series of comparable patients, both techniques showed a statistically significant improvement with regard to the clinical evaluation and quality of life after 2 years of follow-up; the arthrodesis group increased from mean AOFAS values of 37.12 to 45.62 (P = .055) and mean SF-36 values of 32.96 to 46.25 (P = .008), whereas in the arthroplasty group the mean values of AOFAS increased from 33 to 62 (P = .024) and SF-36 from 33.62 to 59.84 (P = .001). Nevertheless, in all cases the improvement was statistically greater in patients who underwent arthroplasty than in those who underwent arthrodesis (P = .048 for AOFAS, and P = .026 for SF-36). In conclusion, arthrodesis and arthroplasty represent good options in the surgical treatment of ankle arthrosis, providing both a significant improvement in function and in the health perception and quality of life of the patient. New-generation total ankle substitution arthroplasty provides an improvement in the quality of life and perception of general health of the patient with arthrosis of this joint, when this technique is compared with surgical fusion.

  11. Analgesic drug consumption increases after knee arthroplasty: a pharmacoepidemiological study investigating postoperative pain.

    PubMed

    Fuzier, Régis; Serres, Isabelle; Bourrel, Robert; Palmaro, Aurore; Montastruc, Jean-Louis; Lapeyre-Mestre, Maryse

    2014-07-01

    Knee arthroplasty remains the gold standard in the treatment of severe osteoarthritis. Chronic postoperative pain has been reported with a prevalence ranging from 15% to 47%. The aim of this study was to compare analgesic drug consumption before and after surgery as an indicator of pain after knee surgery. A pharmacoepidemiological method comparing analgesics and antineuropathic issues 1 year before and 1 year after surgery was used. All patients who underwent knee arthroplasty in the Midi-Pyrenees region (2.5 million inhabitants) were identified through the Health Insurance System Database. Increase of drug issues (all analgesics, antineuropathic drugs, strong opioids) was calculated and compared between several periods surrounding the surgery (12 months, 2 months, and 10 months before and after the knee arthroplasty). A multivariate logistic regression model was used to identify factors associated with chronic postoperative pain. The study included 1939 patients. An increase in analgesic, antineuropathic, and opioid drug consumption was observed the year after the surgery in 47.3%, 8.6%, and 5.6% of patients, respectively. Multivariate analysis found a significant association between type of surgery (total knee vs unicompartmental arthroplasty) and analgesic consumption 1 year after surgery, and between preoperative pain and psychiatric vulnerability and increase in neuropathic drug dispensing. Conversely, older age was considered as a protective factor. This study revealed that an increase in the issue of different analgesic drugs is present in half of patients 1 year after knee arthroplasty. Several associated factors of drug consumption (preoperative pain, type of surgery, and psychiatric disorder) were identified.

  12. Total knee arthroplasty following tibial plateau fracture: a matched cohort study.

    PubMed

    Scott, C E H; Davidson, E; MacDonald, D J; White, T O; Keating, J F

    2015-04-01

    Radiological evidence of post-traumatic osteoarthritis (PTOA) after fracture of the tibial plateau is common but end-stage arthritis which requires total knee arthroplasty is much rarer. The aim of this study was to examine the indications for, and outcomes of, total knee arthroplasty after fracture of the tibial plateau and to compare this with an age and gender-matched cohort of TKAs carried out for primary osteoarthritis. Between 1997 and 2011, 31 consecutive patients (23 women, eight men) with a mean age of 65 years (40 to 89) underwent TKA at a mean of 24 months (2 to 124) after a fracture of the tibial plateau. Of these, 24 had undergone ORIF and seven had been treated non-operatively. Patients were assessed pre-operatively and at 6, 12 and > 60 months using the Short Form-12, Oxford Knee Score and a patient satisfaction score. Patients with instability or nonunion needed total knee arthroplasty earlier (14 and 13.3 months post-injury) than those with intra-articular malunion (50 months, p < 0.001). Primary cruciate-retaining implants were used in 27 (87%) patients. Complication rates were higher in the PTOA cohort and included wound complications (13% vs 1% p = 0.014) and persistent stiffness (10% vs 0%, p = 0.014). Two (6%) PTOA patients required revision total knee arthroplasty at 57 and 114 months. The mean Oxford knee score was worse pre-operatively in the cohort with primary osteoarthritis (18 vs 30, p < 0.001) but there were no significant differences in post-operative Oxford knee score or patient satisfaction (primary osteoarthritis 86%, PTOA 78%, p = 0.437). Total knee arthroplasty undertaken after fracture of the tibial plateau has a higher rate of complications than that undertaken for primary osteoarthritis, but patient-reported outcomes and satisfaction are comparable. Cite this article: Bone Joint J 2015;97-B:532-8.

  13. A resident survey study of orthopedic fellowship specialty decision making and views on arthroplasty as a career.

    PubMed

    Hariri, Sanaz; York, Sally C; O'Connor, Mary I; Parsley, Brian S; McCarthy, Joseph C

    2011-09-01

    A dramatic shortage of total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgeons has been projected because fewer residents enter arthroplasty fellowships, and the demand for THAs/TKAs is rising. The purposes of this study were to ascertain the future supply of THA/TKA surgeons, to identify the criteria residents use to choose their fellowship specialty, and to assess resident perceptions of an arthroplasty career. Four hundred ninety-eight post-graduate year 3 and above residents completed the online survey. Residents most highly prioritize intellectual factors and role models/mentors in determining their fellowship specialty. In the face of a looming patient access-to-care crisis, the data from this study support a policy of highlighting the intellectual challenges and satisfaction of THA/TKA as a career and encouraging mentorship early in a resident's training.

  14. Effect of patellar thickness on knee flexion in total knee arthroplasty: a biomechanical and experimental study.

    PubMed

    Abolghasemian, Mansour; Samiezadeh, Saeid; Sternheim, Amir; Bougherara, Habiba; Barnes, C Lowry; Backstein, David J

    2014-01-01

    A biomechanical computer-based model was developed to simulate the influence of patellar thickness on passive knee flexion after arthroplasty. Using the computer model of a single-radius, PCL-sacrificing knee prosthesis, a range of patella-implant composite thicknesses was simulated. The biomechanical model was then replicated using two cadaveric knees. A patellar-thickness range of 15 mm was applied to each of the knees. Knee flexion was found to decrease exponentially with increased patellar thickness in both the biomechanical and experimental studies. Importantly, this flexion loss followed an exponential pattern with higher patellar thicknesses in both studies. In order to avoid adverse biomechanical and functional consequences, it is recommended to restore patellar thickness to that of the native knee during total knee arthroplasty.

  15. Walking ability following knee arthroplasty: a prospective pilot study of factors affecting the maximal walking distance in 18 patients before and 6 months after total knee arthroplasty.

    PubMed

    Rosenberg, N; Nierenberg, G; Lenger, R; Soudry, M

    2007-12-01

    Functional assessment of patients before and after prosthetic knee arthroplasty is based on clinical examination, which is usually summarized in various knee scores. The present study proposes a different and more subject orientated assessment for functional grading of these patients by measuring their maximal distance of walking ability, which is not apparent from the conventional outcome scores. Eighteen consecutive patients with knee osteoarthritis were evaluated for their knee and knee functional scores (The Knee Society clinical rating system) and for the maximal distance of their walking ability before and 6 months after knee arthroplasty. Specially designed walking ability grading was used for evaluation of walking on walkway. The pre- and post-operative knee scores and maximal walking distance and grading were statistically compared. A significant improvement in the knee and functional scores following surgery was observed. But the maximal walking ability grades and distances did not change significantly following surgery, showing a high relation between pre- and post-operative values. The limitation in post-operative walking was due to the revealed additional health disabilities, not related to the affected knee. Therefore we suggest that pre-operative evaluation of walking abilities should be taken into consideration both for patients' selection and timing of surgery and also for matching of patients' expectation from outcome of prosthetic knee arthroplasty.

  16. In-home telerehabilitation for post-knee arthroplasty: a pilot study.

    PubMed

    Tousignant, Michel; Boissy, Patrick; Corriveau, Hélène; Moffet, Hélène; Cabana, Francois

    2009-01-01

    The purpose of this study was to investigate the efficacy of in-home telerehabilitation as an alternative to conventional rehabilitation services following knee arthroplasty. Five community-living elders who had knee arthroplasty were recruited prior to discharge from an acute care hospital. A pre/post-test design without a control group was used for this pilot study. Telerehabilitation sessions (16) were conducted by two trained physiotherapists from a service center to the patient's home using H264 videoconference CODECs (Tandberg 550 MXP) connected at 512 Kb\\s. Disability (range of motion, balance and lower body strength) and function (locomotor performance in walking and functional autonomy) were measured in face-to-face evaluations prior to and at the end of the treatments by a neutral evaluator. The satisfaction of the health care professional and patient was measured by questionnaire. Results are as follows. One participant was lost during follow-up. Clinical outcomes improved for all subjects and improvements were sustained two months post-discharge from in-home telerehabilitation. The satisfaction of the participants with in-home telerehabilitation services was very high. The satisfaction of the health care professionals with the technology and the communication experience during the therapy sessions was similar or slightly lower. In conclusion, telerehabilitation for post-knee arthroplasty is a realistic alternative for dispensing rehabilitation services for patients discharged from an acute care hospital.

  17. Persistent pain after total knee or hip arthroplasty: differential study of prevalence, nature, and impact

    PubMed Central

    Pinto, Patrícia R; McIntyre, Teresa; Ferrero, Ramón; Araújo-Soares, Vera; Almeida, Armando

    2013-01-01

    This study compares the incidence, nature, and impact of persistent post-surgical pain after total knee arthroplasty (TKA) and total hip arthroplasty (THA) and investigates differences between these procedures, with the focus on potential presurgical and post-surgical issues that could be related to the distinct persistent post-surgical pain outcomes between these two groups. A consecutive sample of 92 patients was assessed prospectively 24 hours before, 48 hours, and 4–6 months after surgery. The data show that TKA patients had a higher likelihood of developing persistent post-surgical pain, of reporting higher pain levels, and of using more neuropathic descriptors when classifying their pain. In addition, TKA patients more often reported interference from pain on functional domains, including general activity, walking ability, and normal work. Demographic factors, like gender and age, along with presurgical clinical factors like disease onset, existence of medical comorbidities, and other pain problems, may have contributed to these differences, whereas baseline psychologic factors and functionality levels did not seem to exert an influence. Heightened acute post-surgical pain experience among TKA patients could also be related to distinct outcomes for persistent post-surgical pain. Future prospective studies should therefore collect TKA and THA samples wherein patients are homogeneous for demographic and presurgical clinical issues. Overall, these findings contribute to a small but growing body of literature documenting persistent post-surgical pain after major arthroplasty, conducted in different countries and across different health care settings. PMID:24072977

  18. Comparative Study of Peripheral Rim Fixation Using Jumbo Cup in Revisional Hip Arthroplasty

    PubMed Central

    Jo, Woo-Lam; Im, Jin-Hyung; Kim, Seung-Chan; Kwon, Soon-Yong; Kim, Yong-Sik

    2017-01-01

    Purpose It is challenging procedure to revise acetabular component in acetabulum with severe bone defect or deformity. The jumbo cup is good option for revisional arthroplasty in large bone defect. The purpose of this study is to compare the prognosis of revisional total hip arthroplasty using jumbo cup with peripheral rim fixation and no rim fixation. Materials and Methods We included the patients who had performed acetabular revisional total hip arthroplasty from January 2002 to March 2015 in our institute. Total of 51 hips (51 patients) were included. The mean follow up period was 51 months (range, 12 to 154 months) and mean age was 60.7 years (range, 30 to 81 years). We divided into two groups (peripheral rim fixation group and no rim fixation group) by anteroposterior and lateral plain radiograph. We compared survival rate, hip center change and clinical outcomes between two groups. Results There were 37 patients in peripheral rim fixation group and 14 patients in no rim fixation group. There was one patient who had aseptic loosening necessary to re-revision in rim fixation group and 3 patients in no rim fixation group. And one patient had superficial infection in rim fixation group and one patient had periprosthetic fracture in no rim fixation group. Survival rate was higher in the peripheral rim fixation group (97.3%) than no rim fixation group (78.6%, P=0.028) Conclusion Based on our findings, peripheral rim fixation might be recommended to improve short-term outcome after revision total hip arthroplasty using jumbo cup. PMID:28316959

  19. Costs of internal fixation and arthroplasty for displaced femoral neck fractures: a randomized study of 68 patients.

    PubMed

    Rogmark, Cecilia; Carlsson, Ake; Johnell, Olof; Sembo, Ingemar

    2003-06-01

    We included in a prospective, randomized study 68 patients aged 70 years or older, with displaced cervical hip fractures. The patients were randomized to internal fixation with hook-pins (36) or primary arthroplasty (32) (total or hemiarthroplasty due to their prefracture status) and followed for 2 years. Patients with rheumatoid arthritis, mental confusion and/or residence in an institution were excluded. The postoperative stay in hospital, rehabilitation wards or nursing homes were recorded as well as complications and the costs of surgery. The aim of this study was to compare the accumulated costs of each method, during the first 2 years after the fracture. In the internal fixation group, 15/36 were considered failures, as compared to 1/32 in the arthroplasty group. As regards primary treatment of the fracture, the durations of surgery and hospital stay were shorter after internal fixation, but the total need for hospitalization/institutionalization was somewhat longer in these patients. The mean 2-year cost for a patient with internal fixation was USD 21,000 and of one with primary arthroplasty USD 15,000. We conclude that primary arthroplasty is a cost-efficient treatment. Considering the very much higher failure rate after internal fixation--leading to increased suffering for these patients--primary arthroplasty stands out as the best method for displaced fractures of the femoral neck.

  20. Dielectric cure monitoring: Preliminary studies

    NASA Technical Reports Server (NTRS)

    Goldberg, B. E.; Semmel, M. L.

    1984-01-01

    Preliminary studies have been conducted on two types of dielectric cure monitoring systems employing both epoxy resins and phenolic composites. An Audrey System was used for 23 cure monitoring runs with very limited success. Nine complete cure monitoring runs have been investigated using a Micromet System. Two additional measurements were performed to investigate the Micromet's sensitivity to water absorption in a post-cure carbon-phenolic material. While further work is needed to determine data significance, the Micromet system appears to show promise as a feedback control device during processing.

  1. Safety of desirudin in thrombosis prevention after total knee arthroplasty: the DESIR-ABLE study.

    PubMed

    Jove, Maurice; Maslanka, Marc; Minkowitz, Harold S; Jaffer, Amir K

    2014-01-01

    Desirudin, administered 30 minutes before total hip arthroplasty is superior to enoxaparin in preventing proximal deep vein thrombosis (DVT) and pulmonary embolism (PE) with similar bleeding. The purpose of this study was to determine the safety of desirudin in patients undergoing elective total knee arthroplasty (TKA) when the first dose of desirudin was administered the evening after surgery. This is a case series of patients undergoing TKA who received desirudin 15 mg every 12 hours subcutaneously for an average of 5 days with the first dose administered postoperatively. The primary endpoint was major bleeding; secondary endpoints included wound outcomes (oozing and infection) and new symptomatic DVT or PE. Desirudin has a favorable safety profile when administered postoperatively in patients undergoing TKA with no reports of major bleeding, wound ooze, or infection. No patients experienced symptomatic DVT, but 2 patients had PE detected by computed tomography after experiencing atypical symptoms. The safety profile of desirudin is improved when administered postoperatively. Bleeding and wound outcomes seem to occur less frequently than historical desirudin and enoxaparin controls.

  2. Cervical Total Disc Arthroplasty

    PubMed Central

    Basho, Rahul; Hood, Kenneth A.

    2012-01-01

    Symptomatic adjacent segment degeneration of the cervical spine remains problematic for patients and surgeons alike. Despite advances in surgical techniques and instrumentation, the solution remains elusive. Spurred by the success of total joint arthroplasty in hips and knees, surgeons and industry have turned to motion preservation devices in the cervical spine. By preserving motion at the diseased level, the hope is that adjacent segment degeneration can be prevented. Multiple cervical disc arthroplasty devices have come onto the market and completed Food and Drug Administration Investigational Device Exemption trials. Though some of the early results demonstrate equivalency of arthroplasty to fusion, compelling evidence of benefits in terms of symptomatic adjacent segment degeneration are lacking. In addition, non-industry-sponsored studies indicate that these devices are equivalent to fusion in terms of adjacent segment degeneration. Longer-term studies will eventually provide the definitive answer. PMID:24353955

  3. The Contribution of Reverse Shoulder Arthroplasty to Utilization of Primary Shoulder Arthroplasty

    PubMed Central

    Jain, Nitin B.; Yamaguchi, Ken

    2014-01-01

    Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty, and present age and sex stratified national rates of shoulder arthroplasty. We also assessed contemporary complication rates, mortality, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009–2011 to calculate estimates of shoulder arthroplasty and assessed trends using joinpoint regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (total anatomical, hemi, and reverse) increased significantly from 52,397 procedures (95% CI=47,093–57,701) in 2009 to 67,184 cases (95% CI=60,638–73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The diagnosis of concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75–84 year female sub-group (77; 95% CI=67–87). Revision cases were 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were secondary to mechanical complications/loosening while 18% were due to dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a three year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded as a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed. Level of evidence Epidemiology Study, Database Analysis PMID:25304043

  4. The clinical efficacy of using autologous platelet rich plasma in hip arthroplasty: A retrospective comparative study

    PubMed Central

    Safdar, Atif; Shaaban, Hamid; Tibayan, Restituto; Miller, Richard; Boairdo, Richard; Guron, Gunwant

    2015-01-01

    Background: Platelet rich plasma (PRP) is a blood derivative concentrate of platelets, fibrin and growth factors obtained through withdrawal and centrifugation of autologous blood and use for its inherent hemostatic and adhesive properties to promote wound healing. Hip arthroplasty is often associated with significant perioperative complications including blood loss necessitating blood transfusions, which can lead to multiple adverse reactions, infection transmission, and longer hospital stay. Materials and Methods: We conducted this retrospective comparative study to determine whether the use of PRP can reduce the bleeding complications in hip replacement surgeries and therefore decrease analgesic requirements and shorten the hospital stay. Results: Sixty patients had consecutive hip replacement surgeries. The study group (n=23) received PRP applications while the control group (n=37) were operated without PRP applications. Postoperative drop of hemoglobin, number of red blood cell (RBC) transfusions, analgesic requirements, and duration of hospital stay were recorded. There was no significant difference in the drop of hemoglobin preoperatively and postoperatively comparing study and control groups (P=0.75). There was no difference in transfusion requirements between the two groups (P=0.16) but there was trend toward less transfusion in the PRP-treated group. There were also no statistical differences in analgesic use (P=0.83) and lengths of hospitalization (P=0.68) between the two groups. Conclusion: We concluded that there is no clinical efficacy in using PRP in hip replacement surgeries. We recommend a larger prospective study be conducted to determine its clinical utility as an optimization strategy to improve outcome after hip arthroplasty PMID:25810634

  5. Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study.

    PubMed

    Lass, Richard; Kubista, Bernd; Olischar, Boris; Frantal, Sophie; Windhager, Reinhard; Giurea, Alexander

    2014-04-01

    In a prospective randomized study of two groups of 65 patients each, we compared the acetabular component position when using the imageless navigation system compared to the freehand conventional technique for cementless total hip arthroplasty. The position of the component was determined postoperatively on computed tomographic scans of the pelvis. There was no significant difference for postoperative mean inclination (P = 0.29), but a significant difference for mean postoperative acetabular component anteversion (P = 0.007), for mean deviation of the postoperative anteversion from the target position of 15° (P = 0.02) and for the outliers regarding inclination (P = 0.02) and anteversion (P < 0.05) between the computer-assisted and the freehand-placement group. Our results demonstrate the importance of imageless navigation for the accurate positioning of the acetabular component.

  6. Time trends in total ankle arthroplasty in the USA: a study of the National Inpatient Sample.

    PubMed

    Singh, Jasvinder A; Ramachandran, Rekha

    2016-01-01

    The objective of this study was to assess the time trends in utilization, clinical characteristics, and outcomes of patients undergoing total ankle arthroplasty (TAA) in the USA. We used the Nationwide Inpatient Sample (NIS) data from 1998 to 2010 to examine time trends in the utilization rates of TAA. We used the Cochran Armitage test for trend to assess time trends across the years and the analysis of variance (ANOVA), Wilcoxon test, or chi-squared test (as appropriate) to compare the first (1998-2000) and the last time periods (2009-2010). TAA utilization rate increased significant from 1998 to 2010: 0.13 to 0.84 per 100,000 overall, 0.14 to 0.88 per 100,000 in females, and from 0.11 to 0.81 per 100,000 in males (p < 0.0001 for each comparison for time trends). Compared to the 1998-2000 period, those undergoing TAA in 2009-2010 were older (41% fewer patients <50 years, p < 0.0001), less likely to have rheumatoid arthritis as the underlying diagnosis (55% fewer patients, p = 0.0001), more likely to have Deyo-Charlson index of 2 or more (197% more, p = 0.0010), and had a shorter length of stay at 2.5 days (17% reduction, p < 0.0001). Mortality was rare ranging from 0 to 0.6% and discharge to inpatient facility ranged 12.6-14.1%; we noted no significant time trends in either (p > 0.05). The utilization rate of TAA increased rapidly in the USA from 1998 to 2010, but post-arthroplasty mortality rate was stable. Underlying diagnosis and medical comorbidity changed over time and both can impact outcomes after TAA. Further studies should examine how the outcomes and complications of TAA have evolved over time.

  7. Blood Loss in the Minimally Invasive Posterior Approach to Total Hip Arthroplasty: A Comparative Study

    PubMed Central

    Vicente, Jose Ricardo Negreiros; Croci, Alberto Tesconi; de Camargo, Olavo Pire

    2008-01-01

    AIMS Our primary aim was to evaluate whether there is really less bleeding in patients for whom the minimally invasive posterior approach is used in comparison with the direct lateral approach for primary total hip arthroplasty. Our secondary aim was to evaluate the clinical functional results after six months as well as the postoperative radiographic result. METHODS In a comparative non-random prospective study, 76 adult patients underwent elective total hip arthroplasty using one of two approaches. The minimally invasive posterior approach (34 cases; mini-incision group) was compared with the standard direct lateral approach (42 cases; control group). RESULTS Lower total estimated bleeding (means of 1083.5 ml versus 1682.3 ml; p < 0.001) and lower intraoperative bleeding (means of 745.6 ml versus 1282.8 ml; p < 0.001) were found in the mini-incision group. There was, however, no difference in the volume of blood drained after the operation (means of 340 ml and 399 ml; p = 0.77). There was also a difference between the two groups regarding the need for allogenic transfusion (8.8% in the mini-incision group versus 28.6%, p = 0.02). We observed a better clinical result in the mini-incision group (p = 0.002) despite the lack of difference between the two groups in relation to the radiographic result. DISCUSSION Our results draw attention to the possibility that other authors may have underestimated blood losses when using minimally invasive approaches. CONCLUSION The minimally invasive approach gave rise to a positive final impression with regard to lower blood loss. PMID:18568245

  8. Patellar tracking during total knee arthroplasty: an in vitro feasibility study.

    PubMed

    Belvedere, C; Catani, F; Ensini, A; Moctezuma de la Barrera, J L; Leardini, A

    2007-08-01

    Abnormal patellar tracking results in patello-femoral (PF) joint disorders and frequently in failure of total knee arthroplasty (TKA). It is fundamental to assess this tracking intra-operatively, i.e. since the implantation of the femoral and tibial components. The aim of this study was to assess the feasibility of three-dimensional anatomical-based patellar tracking intra-operatively in standard TKA. A surgical navigation system was utilized to test the new technique in-vitro. An original tracking device and a reference frame were designed and an articular convention for the description of PF joint kinematics was adopted. Six fresh-frozen amputated legs were analyzed with the new technique. Landmark digitations were used to define anatomical reference frames for the femur, tibia, and patella. Five trials of passive flexion were performed with 100 N force on the quadriceps, before and after standard knee arthroplasty. Patellar flexion, tilt, rotation and shift were calculated in addition to standard tibio-femoral (TF) joint kinematics. An intra-specimen repeatable path of motion over repetitions and a coupled path of motion throughout the flexion-extension cycle were observed in all intact knees, both at the TF and PF joints. Replication of the original PF motion in the intact knee was not fully accomplished in the replaced knee. These results revealed the feasibility and the necessity of patellar tracking during TKA. By monitoring intra-operatively also the PF kinematics, the surgeon has a more complete prediction of the performance of the final implant and therefore a valuable support for the most critical surgical decisions.

  9. Malnutrition in Joint Arthroplasty: Prospective Study Indicates Risk of Unplanned ICU Admission

    PubMed Central

    Kamath, Atul F.; McAuliffe, Caitlin L.; Kosseim, Laura M.; Pio, Finnah; Hume, Eric

    2016-01-01

    Background: Malnutrition has been linked to poor outcomes after elective joint arthroplasty, but the risk of unplanned postoperative intensive care unit (ICU) admission in malnourished arthroplasty patients is unknown. Methods: 1098 patients were followed as part of a prospective risk stratification program at a tertiary, high-volume arthroplasty center. Chronic malnutrition was defined as preoperative albumin <3.5 g/dL. Results: The overall incidence of malnutrition was 16.9% (primary and revision arthroplasty patients). Average BMI was highest for patients in albumin category 3.0-3.5 (BMI 35.7). Preoperative albumin <3.0 and <3.5 g/dL translated to 15.4% and 3.8% rates of unplanned ICU admission, respectively, indicating nutritional status to be a factor in postoperative ICU admission. Conclusion: Patients with poor nutritional status must be counseled on the risks of adverse medical complications. PMID:27200389

  10. Evaluation of the effects of a physiotherapy program on quality of life in females after unilateral total knee arthroplasty: a prospective study

    PubMed Central

    Hudáková, Zuzana; Zięba, Halina Romualda; Lizis, Paweł; Dvořáková, Vlasta; Cetlová, Lada; Friediger, Teresa; Kobza, Wojciech

    2016-01-01

    [Purpose] Osteoarthritis is a chronic and degenerative joint disease and is considered to be one of the most common musculoskeletal disorders. This study evaluated the differences in the quality of life of females treated with supervised physiotherapy and a standardized home program after unilateral total knee arthroplasty. [Subjects and Methods] From January 2012 to May 2015, a total of 40 females were examined at the Central Military Hospital in Ruzomberk, Slovakia. Quality of life was assessed with the Short Form-36. Quality of life and intensity of pain after normal daily activity, according to the visual analog scale, were assessed before total knee arthroplasty, immediately after physiotherapy, 3 months after total knee arthroplasty, and 6 months after total knee arthroplasty. [Results] We found statistically significant improvement of the quality of life results and a decreased intensity of pain at each time point compared with before total knee arthroplasty. [Conclusions] The results of this study provide further evidence indicating that patients who undergo total knee arthroplasty for primary osteoarthritis of the knee can achieve a significant improvement in the quality of life by using supervised physiotherapy compared with a standardized home program. PMID:27313341

  11. Quality of life and functionality after total hip arthroplasty: a long-term follow-up study

    PubMed Central

    2011-01-01

    Background There is a lack of data on the long-term outcome of total hip arthroplasty procedures, as assessed by validated tools. Methods We conducted a follow-up study to evaluate the quality of life and functionality of 250 patients an average of 16 years (range: 11-23 years) after total hip arthroplasty using a validated assessment set including the SF-36 questionnaire, Harris Hip Score, WOMAC score, Functional Comorbidity Index, and a study specific questionnaire. Models of multiple stepwise linear and logistic regression analysis were constructed to evaluate the relationships between several explanatory variables and these functional outcomes. Results The SF-36 physical indexes of these patients compared negatively with the normative values but positively with the results obtained in untreated subjects with severe hip osteoarthritis. Similar results were detected for the Harris Hip Score and WOMAC score. There was a 96% rate of post-surgical satisfaction. Hip functionality and comorbidities were the most important determinants of physical measures on the SF-36. Conclusions Patients who had undergone total hip arthroplasty have impaired long-term self-reported physical quality of life and hip functionality but they still perform physically better than untreated patients with advanced hip osteoarthritis. However, the level of post-surgical satisfaction is high. PMID:21978244

  12. Is aggressive gap arthroplasty essential in the management of temporomandibular joint ankylosis?-a prospective clinical study of 15 cases.

    PubMed

    Babu, Lokesh; Jain, Manoj Kumar; Ramesh, C; Vinayaka, N

    2013-09-01

    The purpose of this three-year, prospective, follow-up study was to evaluate whether aggressive gap arthroplasty is essential in the management of ankylosis of the temporomandibular joint (TMJ). Fifteen patients were treated by the creation of a minimal gap of 5-8mm and insertion of an interpositional gap arthroplasty using the temporalis fascia. Eleven patients had unilateral coronoidectomy and 4 bilateral coronoidectomy based on Kaban's protocol. Preoperative assessment included recording of history, clinical and radiological examinations, personal variables, the aetiology of the ankylosis, the side affected, and any other relevant findings. Patients were assessed postoperatively by a surgeon unaware of the treatment given for a minimum of 3 years, which included measurement of the maximal incisal opening, presence of facial nerve paralysis, recurrence, and any other relevant findings. Of the 15 patients (17 joints), 12 had unilateral and three had bilateral involvement, with trauma being the most common cause. The patients were aged between 7 and 29 years (mean (SD) age 20 (8) years). Preoperative maximal incisal opening was 0-2mm in 8 cases and 2-9mm in 9. Postoperatively adequate mouth opening of 30-40mm was achieved in all cases, with no recurrence or relevant malocclusion during 3-year follow up. However, patients will be followed up for 10 years. Aggressive gap arthroplasty is not essential in the management of ankylosis of the TMJ. Minimal gap interpositional arthroplasty with complete removal of the mediolateral ankylotic mass is a feasible and effective method of preventing recurrence.

  13. Alpine Skiing With total knee ArthroPlasty (ASWAP): study design and intervention.

    PubMed

    Kösters, A; Pötzelsberger, B; Dela, F; Dorn, U; Hofstaedter, T; Fink, C; Müller, E

    2015-08-01

    The aim of this study was to monitor the long-term effects of skiing on health-related parameters and implant related factors like loosening and wear in patients with total knee arthroplasty. This paper describes the overall study design, general demographics, and physiological demand of the intervention phase. A control group design consisting of an intervention group (n = 14; age: 70.4 ± 4.5 years) and a control group (n = 17; age: 71.5 ± 5.1 years) was utilized in this study. Parameters of interest were measured during pre-, post-, and retention test sessions. During the 12 weeks of intervention, an average of 25.5 days of guided skiing was conducted by each patient. Daily heart rate (HR) profiles and global positioning system data throughout the ski day were recorded. The intervention group completed an average of 3393 vertical meters of downhill skiing, with a total skiing distance of 33.6 km/day. Average skiing speed was 8.2 m/s. In the skiing phase, the average physiological load was 75.9 ± 6.6% of HRmax . Further effects of the 12-week skiing intervention on the tested parameters will be reported in the following papers of this supplementum.

  14. Patellofemoral arthroplasty.

    PubMed

    Lonner, Jess H

    2007-08-01

    Patellofemoral arthroplasty can be an effective intermediate treatment for the patient with isolated arthritis of the anterior compartment of the knee. In the absence of patellar malalignment, results are optimized when an implant with sound geometric features is used, the prosthesis is appropriately aligned, and the soft tissues are balanced. Although previous prosthesis designs resulted in a relatively high prevalence of failure because of patellofemoral maltracking, patellofemoral catching, and anterior knee pain, newer prosthesis designs show promise in reducing the prevalence of patellofemoral dysfunction. Progressive tibiofemoral cartilage degeneration is another so-called failure mechanism; such progressive degeneration underscores the importance of restricting the procedure to patients who do not have tibiofemoral chondromalacia. Because long-term failure as a result of tibiofemoral degeneration may occur in approximately 25% of patients, patellofemoral arthroplasty may be considered an intermediate procedure for select patients with patellofemoral arthritis.

  15. Temperature-Controlled Continuous Cold Flow Device after Total Knee Arthroplasty: A Randomized Controlled Trial Study.

    PubMed

    Ruffilli, Alberto; Castagnini, Francesco; Traina, Francesco; Corneti, Isabella; Fenga, Domenico; Giannini, Sandro; Faldini, Cesare

    2016-11-30

    Total knee arthroplasty (TKA) is a widely accepted and successful procedure for end-stage arthritis. Nevertheless, fast-track may be compromised by many factors, such as pain, edema, and blood loss. Cryotherapy has been advocated as a safe and effective strategy to improve the postoperative results, acting on pain, edema, and blood loss. This study is a prospective randomized controlled study, involving 50 patients after primary TKA. A power analysis was performed preoperatively. Twenty-four patients were addressed to a postoperative treatment with a continuous cold flow device (Hilotherm, Hilotherm GmbH, Germany). Twenty-six patients represented the control group, treated with crushed ice packs. All the patients shared the same analgesic strategy and the same rehabilitation protocol. Pain, analgesic consumption, active knee range of motion, drain output, transfusion requirement, and total blood loss were evaluated at different follow-ups (postoperative first, third, and seventh days). The two groups were homogenous for preoperative and intraoperative features. The groups showed no statistically significant differences in all the evaluated parameters. A modest reduction of knee volume was evident after 7 days from surgery (trend). No differences in blood loss were noticed. Continuous cold flow device in the acute postoperative setting after TKA did not show superiority in reducing edema, pain, and blood loss, compared with traditional icing regimen. Thus, due to the costs, it should be reserved to selected cases.

  16. Return to work after total hip and knee arthroplasty: results from a clinical study.

    PubMed

    Tilbury, C; Leichtenberg, C S; Tordoir, R L; Holtslag, M J; Verdegaal, S H M; Kroon, H M; Nelissen, R G H H; Vliet Vlieland, T P M

    2015-12-01

    The aim of this study was to measure return to work and duration until return to work in patients undergoing total hip or knee arthroplasty (THA or TKA). This prospective study included patients under 65 years of age, undergoing THA or TKA, who provided information on their work status preoperatively (paid work yes/no and working hours) and 1 year thereafter (paid work yes/no, working hours and time until return to work). Seventy-one THA and 64 TKA patients had a paid job preoperatively. The employment rates 1 year postoperatively were 64/71 (90 %) after THA and 53/64 (83 %) after TKA. Of those who returned to work, 9/64 (14 %) of THA patients and 10/53 (19 %) of TKA patients worked less hours than preoperatively [mean decrease of 16 (SD 11.5) and 14 (SD 13.0) hours, respectively]. The mean time to return to work was 12.5 (SD 7.6) and 12.9 (SD 8.0) weeks in THA and TKA, respectively. The majority of working patients who underwent THA or TKA returned to work, after approximately 12 weeks. A considerable proportion of the patients returning to work worked less hours than preoperatively. More research into patients who do not return or decrease their working hours is needed.

  17. Stance time variability during stair stepping before and after total knee arthroplasty: a pilot study

    PubMed Central

    Smith, Jessica W.; Marcus, Robin L.; Tracy, Brian L.; Foreman, K. Bo; Christensen, Jesse C.; LaStayo, Paul C.

    2015-01-01

    The main objectives of this pilot study were to: 1) investigate stance time variability (STV) during stair stepping in older adults with osteoarthritis (OA) before and after total knee arthroplasty (TKA), and compare to an age- and sex-matched group of healthy controls with native knees and 2) evaluate the relationship between quadriceps strength and STV during stair stepping before and after TKA. A prospective, observational, pilot study was carried out on 13 individuals (15% male, mean age 62.71 ± 6.84 years) before and after TKA using an instrumented stairway, patient-reported outcomes, timed stair stepping test, and quadriceps strength measures. At 6-months post-operatively, STV during stair descent was significantly greater in the TKA-GROUP compared to the CONTROL-GROUP, but was not significantly different at 12-months compared to controls. There were no significant differences in STV for stair ascent between the pre- and post-operative visits, or compared to controls. There was a trend toward significance for the relationship between quadriceps strength and STV during stair ascent (P=0.059) and descent (P=0.073). Variability during stair stepping may provide an important, short-term rehabilitation target for individuals following TKA and may represent another parameter to predict declines in functional mobility. PMID:26590484

  18. An analytical approach to study the intraoperative fractures of femoral shaft during total hip arthroplasty.

    PubMed

    Malekmotiei, Leila; Farahmand, Farzam; Shodja, Hossein M; Samadi-Dooki, Aref

    2013-04-01

    An analytical approach which is popular in micromechanical studies has been extended to the solution for the interference fit problem of the femoral stem in cementless total hip arthroplasty (THA). The multiple inhomogeneity problem of THA in transverse plane, including an elliptical stem, a cortical wall, and a cancellous layer interface, was formulated using the equivalent inclusion method (EIM) to obtain the induced interference elastic fields. Results indicated a maximum interference fit of about 210 μm before bone fracture, predicted based on the Drucker-Prager criterion for a partially reamed section. The cancellous layer had a significant effect on reducing the hoop stresses in the cortical wall; the maximum press fit increased to as high as 480 μm for a 2 mm thick cancellous. The increase of the thickness and the mechanical quality, i.e., stiffness and strength, of the cortical wall also increased the maximum interference fit before fracture significantly. No considerable effect was found for the implant material on the maximum allowable interference fit. It was concluded that while larger interference fits could be adapted for younger patients, care must be taken when dealing with the elderly and those suffering from osteoporosis. A conservative reaming procedure is beneficial for such patients; however, in order to ensure sufficient primary stability without risking bone fracture, a preoperative analysis might be necessary.

  19. Total knee arthroplasty kinematics may be assessed using computer modeling: a feasibility study.

    PubMed

    Mihalko, William M; Williams, John L

    2012-10-01

    The next generational leap in computer navigation will hopefully aid surgeons in personalizing surgical techniques to patients' individual anatomical variables to optimize outcomes. To effectively use the information obtained in the operating room, a multitude of kinematic variables must be conveyed to the orthopedic surgeon in a usable and coherent manner. This study used an intraoperative navigation system to record passive knee kinematics after a total knee arthroplastyperformed. The clinical measures were taken via research software with the ability to record kinematic data in 10-second intervals. The data from 10 consecutive clinical cases were averaged, and the translation (anterior/posterior) and rotation (internal/external) were recorded and compared from 0° to 100° of flexion to allow for comparison with the previously recorded computer model. Model and clinical curves compared favorably, with less than 1° rotational and 1.5-mm differences, on average. The comparison of information and analyses were reviewed to indicate how they might be interpreted in the operating room for future use during surgery to allow a more personalized approach to improving functional outcomes after total knee arthroplasty.

  20. Cadaveric validation of a finite element modeling approach for studying scapular notching in reverse shoulder arthroplasty.

    PubMed

    Permeswaran, Vijay N; Goetz, Jessica E; Rudert, M James; Hettrich, Carolyn M; Anderson, Donald D

    2016-09-06

    Cadaveric experiments were undertaken to validate a finite element (FE) modeling approach for studying impingement-related scapular notching in reverse shoulder arthroplasty (RSA). The specific focus of the validation was contact at the site of impingement between the humeral polyethylene component and the inferior aspect of the scapula during an adduction motion. Lateralization of the RSA center of rotation was varied because it has been advocated clinically to reduce impingement and presumably decrease the risk of scapular notching. Tekscan sensors were utilized to directly measure contact stress at the impingement site, and FE was used to compute contact stresses. Favorable agreement was seen between physically measured and FE-computed impingement site location (within one sensing element of the Tekscan sensor) and contact loads (mean absolute difference of 14.9%). Contact stresses and contact areas were difficult to compare directly due to the disparate spatial resolutions of the Tekscan sensor and the FE model. FE-computed contact at the impingement site was highly focal, with a total contact area comparable to the area of an individual Tekscan sensing element. The good agreement between the physically measured and FE-computed contact data (i.e., contact load and location) support the use of FE modeling as a tool for computationally testing the efficacy of changing various surgical variables associated with RSA.

  1. Reverse shoulder arthroplasty.

    PubMed

    Smithers, Christopher J; Young, Allan A; Walch, Gilles

    2011-12-01

    The reverse shoulder arthroplasty emerged as a potential solution for those patients who could not be managed effectively with a conventional total shoulder arthroplasty. Grammont revolutionized the design by medializing and distalizing the center of rotation and utilizing a large convex glenoid surface and concave humeral component with a neck-shaft angle of 155°. This design has been highly successful in cuff deficient shoulders, and indications continue to broaden. Many mid-term studies have improved upon the early encouraging results. Long-term studies are starting to emerge, demonstrating good survivorship, but progressive functional and radiographic deterioration continue to be concerning. Careful patient selection and attention to appropriate technique are required to reduce the current high rate of complications. New prosthesis designs are continuing to develop to address some of these limitations.

  2. Survey Criteria for Fibromyalgia Independently Predict Increased Postoperative Opioid Consumption after Lower Extremity Joint Arthroplasty: A Prospective, Observational Cohort Study

    PubMed Central

    Brummett, Chad M.; Janda, Allison M.; Schueller, Christa M.; Tsodikov, Alex; Morris, Michelle; Williams, David A.; Clauw, Daniel J.

    2013-01-01

    Background Variance in pain following total knee and hip arthroplasty may be due to a number of procedural and peripheral factors but also, in some individuals, to aberrant central pain processing as is described in conditions like fibromyalgia. To test this hypothesis, we conducted a prospective, observational cohort study of patients undergoing lower extremity joint arthroplasty. Methods 519 patients were preoperatively phenotyped using validated self-reported pain questionnaires, psychological measures, and health information. In addition to assessing factors previously found to be associated with poor outcomes in arthroplasty, participants also completed the American College of Rheumatology survey criteria for fibromyalgia. Previous studies have suggested that rather than being “present” or “absent,” features of fibromyalgia as measured by this instrument, occur over a wide continuum. Postoperative pain control was assessed by total postoperative opioid consumption. Results Preoperatively, patients with higher fibromyalgia survey scores were younger, more likely to be female, taking more opioids, reported higher pain severity, and had a more negative psychological profile. In the multivariate analysis, the fibromyalgia survey score, younger age, preoperative opioid use, knee (vs. hip), pain severity at baseline, and the anesthetic technique were all predictive of increased postoperative opioid consumption. Conclusions Using the survey criteria for fibromyalgia distinct phenotypic differences were found, and the measure was independently predictive of opioid consumption. This self-report measure may provide an additional simple means of predicting postoperative pain outcomes and analgesic requirements. Future studies are needed to determine whether tailored therapies can improve postoperative pain control in this population. PMID:24343289

  3. Effects of adenosine triphosphate (ATP) on early recovery after total knee arthroplasty (TKA): a randomized, double-blind, controlled study.

    PubMed

    Long, Gong; Zhang, Guo Qiang

    2014-12-01

    Functional exercise after total knee arthroplasty (TKA) is necessary. However, it may be a difficult and painful process for the patient. Desirable methods of relieving the patient's pain are worth exploring. Oral supplement of adenosine triphosphate (ATP) is a potential option. In the present study, we decide to investigate whether short-term administration of ATP benefits patients undergoing TKA. A total of 244 subjects were randomized to receive 120mg ATP or placebo each day for 4weeks. Significant differences in quadriceps strength, pain scores at postoperative days 7, 14, 21, and 28 and total opioid consumption were detected. It follows that oral supplement of ATP could benefit patients recovering from TKA.

  4. A Smart Tool for Intraoperative Leg Length Targeting in Total Hip Arthroplasty: A Retrospective Cohort Study

    PubMed Central

    Grosso, Paul; Snider, Matthew; Muir, Jeffrey M.

    2016-01-01

    Background: Leg length discrepancies following total hip arthroplasty (THA) may necessitate subsequent interventions, from heel lifts to revision surgery. Current intraoperative methods of determining leg length are either inaccurate or expensive and invasive. Objective: The objective of the current study was to investigate the ability of a novel, intraoperative smart tool (Intellijoint HIP®, Intellijoint Surgical®, Inc., Waterloo, ON) to provide accurate, real-time leg length measurements during THA. Methods: We retrospectively reviewed the medical records of 25 patients who underwent THA utilizing the Intellijoint HIP smart tool between February and August 2014. Intraoperative leg length data was compared with radiographic leg length calculations. Two observers blinded to the Intellijoint HIP findings independently assessed all post-procedure radiographs. Results: The mean difference between smart tool and radiographic measurements was 1.3 mm [CI: -0.1, 2.7]. 88% (22/25) of intraoperative measurements were within 5 mm of radiographic measurements; 100% (25/25) were within 10 mm. A Bland-Altman analysis showed excellent agreement, with 96% (24/25) of measurements within the statistical limit for acceptable agreement, and 84% (21/25) within the clinically acceptable range (± 5 mm). Removal of the first 13 procedures (surgeon training) decreased the mean difference between methods to 0.6 mm [-0.6, 1.9]. All post-training procedures were associated with a difference of <5 mm. There were no reported adverse events related to the use of the smart tool. Conclusion: The Intellijoint HIP smart tool is a safe and accurate tool for providing intraoperative measurements of leg length in real-time. PMID:27843511

  5. A comprehensive joint replacement program for total knee arthroplasty: a descriptive study

    PubMed Central

    Cook, Jon R; Warren, Meghan; Ganley, Kathleen J; Prefontaine, Paul; Wylie, Jack W

    2008-01-01

    Background Total knee arthroplasty (TKA) is a commonly performed surgical procedure in the US. It is important to have a comprehensive inpatient TKA program which maximizes outcomes while minimizing adverse events. The purpose of this study was to describe a TKA program – the Joint Replacement Program (JRP) – and report post-surgical outcomes. Methods 74 candidates for a primary TKA were enrolled in the JRP. The JRP was designed to minimize complications and optimize patient-centered outcomes using a team approach including the patient, patient's family, and a multidisciplinary team of health professionals. The JRP consisted of a pre-operative class, standard pathways for medical care, comprehensive peri-operative pain management, aggressive physical therapy (PT), and proactive discharge planning. Measures included functional tests, knee range of motion (ROM), and medical record abstraction of patient demographics, length of stay, discharge disposition, and complications over a 6-month follow-up period. Results All patients achieved medical criteria for hospital discharge. The patients achieved the knee flexion ROM goal of 90° (91.7 ± 5.4°), but did not achieve the knee extension ROM goal of 0° (2.4 ± 2.6°). The length of hospital stay was two days for 53% of the patients, with 39% and 7% discharged in three and four days, respectively. All but three patients were discharged home with functional independence. 68% of these received outpatient physical therapy compared with 32% who received home physical therapy immediately after discharge. Two patients (< 3%) had medical complications during the inpatient hospital stay, and 9 patients (12%) had complications during the 6-month follow-up period. Conclusion The comprehensive JRP for TKA was associated with satisfactory clinical outcomes, short lengths of stay, a high percentage of patients discharged home with outpatient PT, and minimal complications. This JRP may represent an efficient, effective and safe

  6. Assessment of isometricity before and after total knee arthroplasty: a cadaver study.

    PubMed

    Kuster, Markus S; Jeffcote, Benjamin O; Schirm, Andreas C; Jacob, Hilaire; Nicholls, Rochelle L

    2009-10-01

    Total knee arthroplasty (TKA) relies on soft tissue to regulate joint stability after surgery. In practice, the exact balance of the gaps can be difficult to measure, and various methods including intra-operative spreaders or distraction devices have been proposed. While individual ligament strain patterns have been measured, no data exist on the isometricity of the soft tissue envelope as a whole. In this study, a novel device was developed and validated to compare isometricity in the entire soft tissue envelope for both the intact and TKA knee. A spring-loaded rod was inserted in six cadaver knee joints between the tibial shaft and the tibial plateau or tibial tray after removing a 7 mm slice of bone. The displacement of the rod during passive flexion represented variation in tissue tension around the joint. The rod position in the intact knee remained within 1 mm of its initial position between 15 degrees and 135 degrees of flexion, and within 2 mm (+/-1.2 mm) throughout the entire range of motion (0-150 degrees). After insertion of a mobile-bearing TKA, the rod was displaced a mean of 6 mm at 150 degrees (p<0.001). The results were validated using a force transducer implanted in the tibial baseplate of the TKA, which showed increased tibiofemoral force in the parts of the flexion range where the rod was most displaced. The force measurements were highly correlated with the displacement pattern of the spring-loaded rod (r=-0.338; p=0.006). A simple device has been validated to measure isometricity in the soft tissue envelope around the knee joint. Isometricity measurements may be used in the future to improve implantation techniques during TKA surgery.

  7. Preoperative prediction of potentially preventable morbidity after fast-track hip and knee arthroplasty: a detailed descriptive cohort study

    PubMed Central

    Petersen, Morten Aa; Kehlet, Henrik

    2016-01-01

    Objectives Construction of a simple preoperative risk score for patients in high risk of potentially preventable ‘medical’ complications. Secondary objectives were to construct simple preoperative risk scores for ‘severe medical’, ‘surgical’ and ‘total’ potentially preventable complications. Design Prospective observational study. Setting Elective primary unilateral total hip and knee arthroplasty with prospectively collected preoperative patient characteristics; similar standardised fast-track protocols; evaluation of complications through discharge and medical records; and complete 90 days follow-up through nationwide databases. Participants 8373 consecutive unselected total hip arthroplasty (THA) and knee arthroplasty from January 2010 to November 2012. Results There were 557 procedures (6.4%) followed by potentially preventable complications resulting in hospitalisation >4 days or readmission. Of 22 preoperative characteristics, 7 were associated with 379 (4.2%) potentially preventable ‘medical’ complications. Patients with ≥2 of the following, age ≥80 years, anticoagulant therapy, pulmonary disease, pharmacologically treated psychiatric disorder, anaemia and walking aids, composed 19.1% of the procedures; 55.7% constituted potentially preventable ‘medical’ complications that were mainly falls, mobilisation issues, pneumonias and cardiac arrhythmias. The number needed to be treated for a hypothetical intervention leading to 25% reduction in potentially preventable ‘medical’ complications was 34. THA, use of walking aids and cardiac disease were associated with 189 (2.2%) ‘surgical’ complications, but no clinically relevant preoperative prediction was possible. Conclusions Preoperative identification of patients at high risk of preventable ‘medical’, but not ‘surgical’, complications is statistically possible. However, clinical relevance is limited. Future risk indices should differ between ‘medical’ and

  8. Preliminary study for the OFFELO

    SciTech Connect

    Hao, Y.; Litvinenko, V.N.

    2010-08-23

    X-ray Optics-Free FEL Oscillator (OFFELO) has potential of becoming a choice for next generation light sources. Using electron beam for the feedback allows OFFELO to be completely tunable and to combine the peak power of high-gain SASE FELs with extremely narrow bandwidth of the oscillator. While the high-gain X-ray FELs has been studied in depth and has been successfully demonstrated, two other concepts (the transport and the feed-back) involved in OFFELO still need detail studies. In this short paper we focus on the simulation of the feedback process and the evolution of FEL spectrum in X-ray OFFELO. In our initial studies of OFFELO studied the saturation of the system and also its evolution using Genesis 2.0 code with a homemade wrapping code. While and lattice design from the modulator to the radiator, in order to minimize the feedback information loss in transporting the beam.

  9. Implementing a benchmarking and feedback concept decreases postoperative pain after total knee arthroplasty: A prospective study including 256 patients

    PubMed Central

    Benditz, A.; Drescher, J.; Greimel, F.; Zeman, F.; Grifka, J.; Meißner, W.; Völlner, F.

    2016-01-01

    Perioperative pain reduction, particularly during the first two days, is highly important for patients after total knee arthroplasty (TKA). Problems are not only caused by medical issues but by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent benchmarking. All patients included into the study had undergone total knee arthroplasty. Outcome parameters were analyzed by means of a questionnaire on the first postoperative day. A multidisciplinary team implemented a regular procedure of data analyzes and external benchmarking by participating in a nationwide quality improvement project. At the beginning of the study, our hospital ranked 16th in terms of activity-related pain and 9th in patient satisfaction among 47 anonymized hospitals participating in the benchmarking project. At the end of the study, we had improved to 1st activity-related pain and to 2nd in patient satisfaction. Although benchmarking started and finished with the same standardized pain management concept, results were initially pure. Beside pharmacological treatment, interdisciplinary teamwork and benchmarking with direct feedback mechanisms are also very important for decreasing postoperative pain and for increasing patient satisfaction after TKA. PMID:27917911

  10. Preliminary design study of lunar housing configurations

    NASA Technical Reports Server (NTRS)

    Reynolds, K. H.

    1992-01-01

    A preliminary design study assesses various configurations for habitation of the lunar surface. The study assumes an initial 4-man habitation module expandable to a 48-man concept. Through the numerous coupling combinations of identical modules, five basic configuration types are identified. A design model presents each configuration in light of certain issues. The issues include circulation, internal and external spatial characteristics, functional organizations, and future growth potential. The study discusses the attributes, potentials, and unique requirements of each configuration.

  11. I-ONE therapy in patients undergoing total knee arthroplasty: a prospective, randomized and controlled study

    PubMed Central

    2012-01-01

    Background Total knee arthroplasty (TKA) is often associated with a severe local inflammatory reaction which, unless controlled, leads to persistent pain up to one year after surgery. Standard and accelerated rehabilitation protocols are currently being implemented after TKA, but no consensus exists regarding the long-term effects. Biophysical stimulation with pulsed electromagnetic fields (PEMFs) has been demonstrated to exert an anti-inflammatory effect, to promote early functional recovery and to maintain a positive long-term effect in patients undergoing joint arthroscopy. The aim of this study was to evaluate whether PEMFs can be used to limit the pain and enhance patient recovery after TKA. Methods A prospective, randomized, controlled study in 30 patients undergoing TKA was conducted. Patients were randomized into experimental PEMFs or a control group. Patients in the experimental group were instructed to use I-ONE stimulator 4hours/day for 60days. Postoperatively, all patients received the same rehabilitation program. Treatment outcome was assessed using the Knee Society Score, SF-36 Health-Survey and VAS. Patients were evaluated pre-operatively and one, two, six and 12 months after TKA. Joint swelling and Non Steroidal Anti Inflammatory Drug (NSAID) consumption were recorded. Comparisons between the two groups were carried out using a two-tail heteroschedastic Student’s t-test. Analysis of variance for each individual subject during the study was performed using ANOVA for multiple comparisons, applied on each group, and a Dunnet post hoc test. A p value < 0.05 was considered statistically significant. Results Pre-operatively, no differences were observed between groups in terms of age, sex, weight, height, Knee-Score, VAS, SF-36 and joint swelling, with the exception of the Functional Score. The Knee-Score, SF-36 and VAS demonstrated significantly positive outcomes in the I-ONE stimulated group compared with the controls at follow-ups. In the I

  12. Risk Factors for Moderate and Severe Persistent Pain in Patients Undergoing Total Knee and Hip Arthroplasty: A Prospective Predictive Study

    PubMed Central

    Pinto, Patrícia R.; McIntyre, Teresa; Ferrero, Ramón; Almeida, Armando; Araújo-Soares, Vera

    2013-01-01

    Persistent post-surgical pain (PPSP) is a major clinical problem with significant individual, social and health care costs. The aim of this study was to examine the joint role of demographic, clinical and psychological risk factors in the development of moderate and severe PPSP after Total Knee and Hip Arthroplasty (TKA and THA, respectively). This was a prospective study wherein a consecutive sample of 92 patients were assessed 24 hours before (T1), 48 hours after (T2) and 4–6 months (T3) after surgery. Hierarchical logistic regression analyses were performed to identify predictors of moderate and severe levels of PPSP. Four to six months after TKA and THA, 54 patients (58.7%) reported none or mild pain (Numerical Rating Scale: NRS ≤3), whereas 38 (41.3%) reported moderate to severe pain (NRS >3). In the final multivariate hierarchical logistic regression analyses, illness representations concerning the condition leading to surgery (osteoarthritis), such as a chronic timeline perception of the disease, emerged as a significant predictor of PPSP. Additionally, post-surgical anxiety also showed a predictive role in the development of PPSP. Pre-surgical pain was the most significant clinical predictive factor and, as expected, undergoing TKA was associated with greater odds of PPSP development than THA. The findings on PPSP predictors after major joint arthroplasties can guide clinical practice in terms of considering cognitive and emotional factors, together with clinical factors, in planning acute pain management before and after surgery. PMID:24058502

  13. Microcurrent skin patches for postoperative pain control in total knee arthroplasty: a pilot study.

    PubMed

    El-Husseini, T; El-Kawy, S; Shalaby, H; El-Sebai, M

    2007-04-01

    Pain control following painful orthopaedic procedures such as total knee arthroplasty (TKA) is an ongoing challenge, as current pain management techniques often result in under-medication and/or complications. In a study designed to test the effect of the micro-current skin patch (MCT) on pain relief in patients following TKA, we followed 24 patients, randomly divided into two groups, one group receiving MCT plus tramadol hydrochloride (tramadol) for pain relief and a control group receiving only tramadol, for 10 days postoperatively. Tramadol was given intramuscularly in increment doses of 100 mg, as needed, for the duration of the study period. Pain was assessed daily using a visual analogue score (VAS). Other parameters, including the effect of MCT on the dose of tramadol needed for pain relief, the degree of wound healing measured at the end of the follow-up period, category of the wound 10 days postoperatively (1, 2 or 3) and total drain fluid volume, were also assessed. During the 10-day postoperative period there was a progressive decrease in pain in patients of both groups, however the patients of the MCT group showed a consistently lower VAS throughout the observation period, most markedly on those follow-up days with the highest pain scores in patients of the control group. This effect was monitored on the basis of the average dose of tramadol administered per day: 200.0+/-7.0 mg/day in the control group and 63.3+/-15.8 mg/day in the MCT group. Wound healing was better with the application of the MCT patch: grade 1 wounds were observed in 50% of the patients of the MCT group as compared to 8.3% in control group. The total drain volume was lower in patients of the MCT group compared to the controls (1020.8+/-211.6 and 1170.8+/-243.5 ml, respectively). None of the patients indicated that they wished to discontinue MCT therapy. This pilot study shows that MCT therapy led to better pain control with a markedly lower need for tramadol as compared to the

  14. A prospective randomised study of periprosthetic femoral bone remodeling using four different bearings in hybrid total hip arthroplasty.

    PubMed

    Zerahn, Bo; Borgwardt, Lotte; Ribel-Madsen, Søren; Borgwardt, Arne

    2011-01-01

    We performed a study to assess whether different bearing materials have an impact on femoral bone remodeling within the first four years after a hybrid total hip arthroplasty. 205 of 300 patients were available for 4 years follow-up after being randomly allocated to four prosthetic combinations: A: Zirconia ceramic head, polyethylene cup; B: Cobalt-Chrome-Molybdenum head and cup; C: Zirconia ceramic head, polyethylene moulded on the Titanium shell of the Asian cup; D: Alumina head and cup. Bone mineral density (BMD) was measured with Dual-Energy X-ray Absorptiometry in seven Gruen zones adjacent to the femoral implant. Scans were performed within one week after surgery and four years postoperatively. Clinical outcomes were monitored using the Oxford Hip Score (OHS). A high proportion of patients from group D were excluded due to re-operations (19 patients). BMD decreased significantly in all Gruen zones with the largest declines in group D. BMD changes in Gruen zones 1, 2, 3, 6, and 7 correlated with height, and body weight. Advanced age was associated with an increase in bone loss in Gruen zones 1, 2, 3, 6, and 7. A large stem size was associated with a decline in BMD in Gruen zones 1, 6, and 7.Bone remodeling after total hip arthroplasty may depend on the composition of bearing materials, but age, height, weight, and stem size are also related to changes in BMD.

  15. Cementless total hip arthroplasty in patients with ankylosing spondylitis: A retrospective observational study.

    PubMed

    Xu, Jun; Zeng, Min; Xie, Jie; Wen, Ting; Hu, Yihe

    2017-01-01

    Controversies on the surgical protocols and efficacies of total hip arthroplasty (THA) in ankylosing spondylitis (AS) still exist. The aim of this study was to retrospectively analyze the perioperative managements and their outcomes related to performing THA on patients with AS.Data of 54 AS patients who underwent 81 THAs between 2008 and 2014 were retrospectively analyzed. Clinical and imaging data were collected preoperatively, postoperatively, and during the follow-up period for surgical efficacy.Using posterolateral approach, cementless prostheses were selected in all cases. Mean follow-up period was 3.6 years (range, 2-8 years). Inclinations and anteversions of acetabular cups were 36.3°±4.5° (range, 30°-50°) and 12.3°±4.9° (range, 0°-25°) respectively. Mean visual analog scale (VAS) score decreased from 6.7 ± 2.1 (range, 4-10) preoperatively to 1.5 ± 1.0 (range, 0-4) at final follow-up, and mean Harris hip score (HHS) improved from 31.2 ± 11.6 (range, 15-45) to 86.1 ± 4.3 (range, 80-95) (P < 0.05). Postoperative range of motion (ROM) in flexion was improved from 6.7°±13.5° (range, 0°-50°) preoperatively to 82.5°±6.4° (range, 70°-100°) at final follow-up, and ROM in extension was improved from 1.8°±5.7°(range, 0°-15°) to 15.4°±2.6° (range, 10°-20°) (P < 0.05). Heterotopic ossification (HO) was documented in 9 hips (11.1%). Signs of stable fibrous ingrowth and bone ingrowth were detected in 52 and 29 hips, respectively. Sciatic never injury was occurred in 3 cases, and treated conservatively. There were no signs of periprosthetic fractures, dislocation, or prosthesis loosening.Surgical efficacies of THA for AS patients with severe hip involvement are satisfactory.

  16. Preliminary summary of the ETF conceptual studies

    NASA Technical Reports Server (NTRS)

    Seikel, G. R.; Bercaw, R. W.; Pearson, C. V.; Owens, W. R.

    1978-01-01

    Power plant studies have shown the attractiveness of MHD topped steam power plants for baseload utility applications. To realize these advantages, a three-phase development program was initiated. In the first phase, the engineering data and experience were developed for the design and construction of a pilot plant, the Engineering Test Facility (ETF). Results of the ETF studies are reviewed. These three parallel independent studies were conducted by industrial teams led by the AVCO Everett Research Laboratory, the General Electric Corporation, and the Westinghouse Corporation. A preliminary analysis and the status of the critical evaluation of these results are presented.

  17. Tendon interposition arthroplasty versus arthrodesis for the treatment of trapeziometacarpal arthritis: a retrospective comparative follow-up study.

    PubMed

    Mureau, M A; Rademaker, R P; Verhaar, J A; Hovius, S E

    2001-09-01

    Long-term subjective and objective outcomes of 24 tendon interposition arthroplasties in 17 patients and 32 trapeziometacarpal (TMC) arthrodeses in 26 patients were compared retrospectively in a standardized manner. Tendon interposition arthroplasty led to complications less often (27%) than TMC arthrodesis (39%). Patients in the tendon interposition arthroplasty group reported significantly less pain, less temperature intolerance, and better thumb mobility and were more satisfied with pain symptoms than patients in the arthrodesis group. Patients undergoing tendon interposition arthroplasty had better thumb opposition, interphalangeal joint mobility, and radial and palmar TMC joint range of motion. No statistically significant differences were found in tip pinch, key pinch, and grip strength between the 2 groups. Proximal first metacarpal collapse occurred in the tendon interposition patients without affecting subjective or objective outcome. Seven of 25 patients with TMC arthrodesis had pseudarthrosis. Tendon interposition arthroplasty seems to be preferable to TMC joint arthrodesis for the treatment of TMC arthritis.

  18. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    PubMed

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction.

  19. Total shoulder arthroplasty outcome for treatment of osteoarthritis: a multicenter study using a contemporary implant.

    PubMed

    Wright, Thomas W; Flurin, Pierre-Henri; Crosby, Lynn; Struk, Aimee M; Zuckerman, Joseph D

    2015-11-01

    In this article, we present clinical results of primary total shoulder arthroplasty for osteoarthritis using an implant that provides dual eccentricity and variable neck and version angles for reconstruction of proximal humeral anatomy. Two hundred one patients with symptomatic osteoarthritis underwent 218 total shoulder arthroplasties with a fourth-generation anatomical shoulder and a replicator plate at 4 centers between August 1, 2006, and December 31, 2010. Fourth-generation implants allow for varying humeral neck and version angles and have dual eccentricity so as to be consistently able to cover the humeral head cut. At a mean follow-up of 3 years (minimum, 2 years), there was an 81% follow-up rate. At final follow-up, 3 objective measures were significantly (P < .05) improved over preoperative levels: average active elevation (preoperative, 92°; postoperative, 137°), active external rotation (pre, 15°; post, 42°), and active internal rotation (pre, S3; post, L2). The functional outcome scores that were significantly (P < .05) improved at final follow-up were Constant normalized (pre, 39; post, 79), Shoulder Pain and Disability Index (pre, 86; post, 20), Simple Shoulder Test (pre, 3.3; post, 10), UCLA Shoulder Rating Scale (pre, 13; post, 31), and American Shoulder and Elbow Surgeons Shoulder Assessment (pre, 33; post, 85). Complications were noted in 11% of the shoulders. The most common complications were rotator cuff failure (13, 6%) and infection (5, 2%).

  20. Intra-articular bupivacaine reduces postoperative pain and meperidine use after total hip arthroplasty: a randomized, double-blind study.

    PubMed

    Chen, Dave W; Hu, Chih-Chien; Chang, Yu-Han; Lee, Mel S; Chang, Chee-Jen; Hsieh, Pang-Hsin

    2014-12-01

    One hundred patients receiving unilateral total hip arthroplasty (THA) were randomized to receive an intra-articular injection of 300mg bupivacaine or normal saline after completion of surgery. Pain scores of the bupivacaine group were significantly lower than those of the control group the first 12hours postoperatively (all, P<0.001). A significantly lower dose of meperidine was used in the study group than in the control group the first 24hours postoperatively (median, 25 vs. 45mg, P<0.001). Nineteen patients in the study group required meperidine the first day after surgery, as compared to 45 patients in the control group. We conclude that intra-articular injection of bupivacaine after THA reduces pain and meperidine use in the first 12hours after surgery.

  1. Quantifying Gait Quality in Patients with Large-Head and Conventional Total Hip Arthroplasty--A Prospective Cohort Study.

    PubMed

    Jensen, Carsten; Penny, Jeannette Ø; Nielsen, Dennis B; Overgaard, Søren; Holsgaard-Larsen, Anders

    2015-12-01

    We used the Gait Deviation Index (GDI) as method to compare preoperative to postoperative gait changes after uncemented 50 mm (median) large-head and 28/32 mm total hip arthroplasty (THA). We also identified predictors of improvements in GDI. Gait analysis and patient-reported (WOMAC) data were recorded in 35 patients before, 2 and 6-months after treatment. Twenty age-matched adults provided normative gait data. Contrary to our hypothesis, patients who received large-head THA had less improvement in GDI compared with patients who received 28/32 mm THA. The preoperative GDI score was identified as a predictor of postoperative GDI improvement, while WOMAC, age, gender and walking speed were not. This study provides useful information for clinicians and rehabilitation specialists about gait improvement that can be expected after THA.

  2. Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations.

    PubMed

    Benoni, G; Fredin, H; Knebel, R; Nilsson, P

    2001-10-01

    We performed a randomized, double-blind study on the effect of tranexamic acid on blood loss and blood transfusions in 40 primary total hip arthroplasties. Tranexamic acid, 10 mg/kg body weight, or placebo, was given intravenously just before the operation. Blood loss during the operation and postoperatively into the drains was recorded, as also were blood hemoglobin concentrations. Ultrasound examination 1 week postoperatively was done to estimate the blood loss due to remaining hematomas. Total (operation + drain) blood loss was 0.76 (95 CI 0.63-0.89) L in the tranexamic acid group as compared to 1.0 (CI 0.81-1.2) L in the placebo group (p = 0.03). The number of blood transfusions during the day of operation was 2 vs. 10 (p = 0.07) and the total number during the hospital stay was 5 vs. 13 (p = 0.2). 1 patient in each group had a pulmonary embolism.

  3. Relationship between joint gap difference and range of motion in total knee arthroplasty: a prospective randomised study between different platforms.

    PubMed

    Higuchi, Hiroshi; Hatayama, Kazuhisa; Shimizu, Masaki; Kobayashi, Atsushi; Kobayashi, Tsutomu; Takagishi, Kenji

    2009-08-01

    The objective of this study was to investigate the range of motion (ROM) of the knee before and four years after total knee arthroplasty (TKA) with a mobile or fixed type of platform and to prospectively evaluate whether there was a difference in ligament balance between the platform types. The subjects were 68 patients involving 76 joints. The mobile type was used in 31 joints and fixed type in 45 joints by employing a prospective randomised method. The passive maximum ROM was measured using a goniometer before and four years after surgery. Also, the intraoperative knee ligament balance was measured. The postoperative extension ROM was significantly improved after TKA using a mobile bearing type compared with that employing a fixed bearing type. In TKA using the former, the intraoperative gap difference was not related to the postoperative flexion angle of the knee. However, they were related in TKA using a fixed bearing type, with a positive correlation regarding the flexion gap.

  4. Evaluation of Distal Femoral Rotational Alignment with Spiral CT Scan before Total Knee Arthroplasty (A Study in Iranian population)

    PubMed Central

    Jabalameli, Mahmoud; Moradi, Amin; Bagherifard, Abolfazl; Radi, Mehran; Mokhtari, Tahmineh

    2016-01-01

    Background: Evaluating the landmarks for rotation of the distal femur is a challenge for orthopedic surgeons. Although the posterior femoral condyle axis is a good landmark for surgeons, the surgical transepicondylar axis may be a better option with the help of preoperative CT scanning. The purpose of this study was to ascertain relationships among the axes’ guiding distal femur rotational alignment in preoperative CT scans of Iranian patients who were candidates for total knee arthroplasty and the effects of age, gender, and knee alignment on these relationships. Methods: One hundred and eight cases who were admitted to two university hospitals for total knee arthroplasty were included in this study. The rotation of the distal femur was evaluated using single axial CT images through the femoral epicondyle. Four lines were drawn digitally in this view: anatomical and surgical transepicondylar axes, posterior condylar axis and the Whiteside anteroposterior line. The alignment of the extremity was evaluated in the standing alignment view. Then the angles were measured along these lines and their relationship was evaluated. Results: The mean angle between the anatomical transepicondylar axis and posterior condylar axis and between the surgical transepicondylar axis and posterior condylar axis were 5.9 ± 1.6 degrees and 1.6±1.7 degrees respectively. The mean angle between the Whiteside’s anteroposterior line and the line perpendicular to the posterior condylar axis was 3.7±2.1 degrees. Significant differences existed between the two genders in these relationships. No significant correlation between the age of patients and angles of the distal femur was detected. The anatomical surgical transepicondylar axis was in 4.3 degrees external rotation in relation to the surgical transepicondylar axis. Conclusion: Preoperative CT scanning can help accurately determine rotational landmarks of the distal femur. If one of the reference axes cannot be determined, other

  5. Transition from nerve blocks to periarticular injections and emerging techniques in total joint arthroplasty.

    PubMed

    Springer, Bryan D

    2014-10-01

    The emergence of procedure-specific multimodal pain management regimens that provide effective control of postoperative pain, while markedly reducing the amount of opioid medication required, has been one of the most important advances in hip and knee replacement in recent years. When peripheral nerve blockade first became widely available for inclusion in multimodal regimens, it was viewed as a revolution in the management of postoperative pain. This approach, however, is costly and has some important limitations, including an increased incidence of falls. For many patients, peripheral nerve blocks can now be replaced by a periarticular injection with EXPAREL® (bupivacaine liposome injectable suspension), an extended-release anesthetic infiltrated by the surgeon as part of a multimodal pain regimen. EXPAREL® offers some important clinical and administrative benefits over nerve blocks. Preliminary data from a pilot study comparing the relative effectiveness of EXPAREL® versus sciatic nerve blockade has shown a noticeable reduction in average pain scores at rest with EXPAREL® following both hip and knee arthroplasty, as well as a reduction in the 6- to 12-hour pain score following hip arthroplasty. There was also a significant reduction in opioid use with EXPAREL®, as well as a $411 reduction in the cost of total knee arthroplasty and a $348 reduction in the cost of total hip arthroplasty.

  6. A Population-Based Study of Trends in the Use of Total Hip and Total Knee Arthroplasty, 1969-2008

    PubMed Central

    Singh, Jasvinder A.; Vessely, Michael B.; Harmsen, W. Scott; Schleck, Cathy D.; Melton, L. Joseph; Kurland, Robert L.; Berry, Daniel J.

    2010-01-01

    OBJECTIVE: To study the rates of use of total hip arthroplasty (THA) and total knee arthroplasty (TKA) during the past 4 decades. METHODS: The Rochester Epidemiology Project was used to identify all Olmsted County, Minnesota, residents who underwent THA or TKA from January 1, 1969, through December 31, 2008. We used a population-based approach because few data are available on long-term trends in the use of THA and TKA in the United States. Rates of use were determined by age- and sex-specific person-years at risk. Poisson regression was used to assess temporal trends by sex and age group. RESULTS: The age- and sex-adjusted use of THA increased from 50.2 (95% confidence interval [CI], 40.5-59.8) per 100,000 person-years in 1969-1972 to 145.5 (95% CI, 134.2-156.9) in 2005-2008, whereas TKA increased markedly from 31.2 (95% CI, 25.3-37.1) per 100,000 person-years in 1971-1976 to 220.9 (95% CI, 206.7-235.0) in 2005-2008. For both procedures, use was greater among females, and the rate generally increased with age. CONCLUSION: In this community, TKA and THA use rates have increased steadily since the introduction of the procedures and continue to increase for all age groups. On the basis of these population-based data, the probable need for TKA and THA exceeds current federal agency projections. PMID:20823375

  7. Influence of offset stem couplers in femoral revision knee arthroplasty: a radiographic study.

    PubMed

    Brilhault, Jean M; Ries, Michael D

    2012-03-01

    We questioned whether the use of offset femoral stem would result in modifying the posterior femoral condylar offset (PFCO) in revision knee arthroplasty (RTKA). We measured both PFCO and stem alignment on lateral radiographs of two cohorts: 91 knees with straight stems and 35 knees with offset coupled stems. A higher PCOR was observed in knees with an offset stem compared to knees with straight stem. Knees with an offset stem had a better alignment within the intramedullary canal. Our conclusion is that the use of a modular offset coupler with femoral stem in RTKA compared to a modular straight stem both increases the posterior condylar offset and improves alignment of the stem within the intramedullary canal.

  8. A preliminary neutron crystallographic study of thaumatin

    SciTech Connect

    Teixeira, Susana C. M.; Blakeley, Matthew P.; Leal, Ricardo M. F.; Mitchell, Edward P.; Forsyth, V. Trevor

    2008-05-01

    Preliminary neutron crystallographic data from the sweet protein thaumatin have been recorded using the LADI-III diffractometer at the Institut Laue Langevin (ILL). The results illustrate the feasibility of a full neutron structural analysis aimed at further understanding the molecular basis of the perception of sweet taste. Such an analysis will exploit the use of perdeuterated thaumatin. A preliminary neutron crystallographic study of the sweet protein thaumatin is presented. Large hydrogenated crystals were prepared in deuterated crystallization buffer using the gel-acupuncture method. Data were collected to a resolution of 2 Å on the LADI-III diffractometer at the Institut Laue Langevin (ILL). The results demonstrate the feasibility of a full neutron crystallographic analysis of this structure aimed at providing relevant information on the location of H atoms, the distribution of charge on the protein surface and localized water in the structure. This information will be of interest for understanding the specificity of thaumatin–receptor interactions and will contribute to further understanding of the molecular mechanisms underlying the perception of taste.

  9. Cervical disc arthroplasty: Pros and cons

    PubMed Central

    Moatz, Bradley; Tortolani, P. Justin

    2012-01-01

    Background: Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. Methods: This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Results: Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Conclusion: Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing. PMID:22905327

  10. Outcomes Study of the TM Reverse Shoulder System Used in Primary or Revision Reverse Total Shoulder Arthroplasty

    ClinicalTrials.gov

    2017-01-10

    Osteoarthritis; Rheumatoid Arthritis; Post-traumatic Arthritis; Ununited Humeral Head Fracture; Irreducible 3-and 4-part Proximal Humeral Fractures; Avascular Necrosis; Gross Rotator Cuff Deficiency; Failed Total Shoulder Arthroplasty (Both Glenoid and Humeral Components Require Revision

  11. A computer controlled pulsatile pump: preliminary study.

    PubMed

    Zwarts, M S; Topaz, S R; Jones, D N; Kolff, W J

    1996-12-01

    A Stepper Motor Driven Reciprocating Pump (SDRP) can replace roller pumps and rotary pumps for cardio pulmonary bypass, hemodialysis and regional perfusion. The blood pumping ventricles are basically the same as ventricles used for air driven artificial hearts and ventricular assist devices. The electric stepper motor uses a flexible linkage belt to produce a reciprocating movement, which pushes a hard sphere into the diaphragm of the blood ventricles. The SDRP generates pulsatile flow and has a small priming volume. The preset power level of the motor driver limits the maximum potential outflow pressure, so the driver acts as a safety device. A double pump can be made by connecting two fluid pumping chambers to opposing sides of the motor base. Each pump generates pulsatile flow. Pressure and flow studies with water were undertaken. Preliminary blood studies showed low hemolysis, even when circulating a small amount of blood up to 16 hours.

  12. Porous tantalum tibial component prevents periprosthetic loss of bone mineral density after total knee arthroplasty for five years-a matched cohort study.

    PubMed

    Minoda, Yukihide; Kobayashi, Akio; Ikebuchi, Mitsuhiko; Iwaki, Hiroyoshi; Inori, Fumiaki; Nakamura, Hiroaki

    2013-12-01

    In 21 knees receiving porous tantalum tibial component and 21 knees receiving a cemented cobalt-chromium tibial component, dual x-ray absorptiometry scans were performed for five years post-operatively. The postoperative decrease in the bone mineral density in the lateral aspect of the tibia was significantly less in knees with porous tantalum tibial components (11.6%) than in knees with cemented cobalt-chromium tibial components (29.6%) at five years (p < 0.05). No prosthetic migration or periprosthetic fracture was detected in either group. The present study is one of the studies with the longest follow-up period on bone mineral density after total knee arthroplasty. Porous tantalum tibial component has a favorable effect on the bone mineral density of the proximal tibia after total knee arthroplasty up to five years.

  13. Return to sports after shoulder arthroplasty.

    PubMed

    Johnson, Christine C; Johnson, Daniel J; Liu, Joseph N; Dines, Joshua S; Dines, David M; Gulotta, Lawrence V; Garcia, Grant H

    2016-09-18

    Many patients prioritize the ability to return to sports following shoulder replacement surgeries, including total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty (HA). While activity levels after hip and knee replacements have been well-established in the literature, studies on this topic in the field of shoulder arthroplasty are relatively limited. A review of the literature regarding athletic activity after shoulder arthroplasty was performed using the PubMed database. All studies relevant to shoulder arthroplasty and return to sport were included. The majority of patients returned to their prior level of activity within six months following TSA, RTSA, and shoulder HA. Noncontact, low demand activities are permitted by most surgeons postoperatively and generally have higher return rates than contact sports or high-demand activities. In some series, patients reported an improvement in their ability to participate in sports following the arthroplasty procedure. The rates of return to sports following TSA (75%-100%) are slightly higher than those reported for HA (67%-76%) and RTSA (75%-85%). Patients undergoing TSA, RTSA, and shoulder HA should be counseled that there is a high probability that they will be able to return to their preoperative activity level within six months postoperatively. TSA has been associated with higher rates of return to sports than RTSA and HA, although this may reflect differences in patient population or surgical indication.

  14. Return to sports after shoulder arthroplasty

    PubMed Central

    Johnson, Christine C; Johnson, Daniel J; Liu, Joseph N; Dines, Joshua S; Dines, David M; Gulotta, Lawrence V; Garcia, Grant H

    2016-01-01

    Many patients prioritize the ability to return to sports following shoulder replacement surgeries, including total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty (HA). While activity levels after hip and knee replacements have been well-established in the literature, studies on this topic in the field of shoulder arthroplasty are relatively limited. A review of the literature regarding athletic activity after shoulder arthroplasty was performed using the PubMed database. All studies relevant to shoulder arthroplasty and return to sport were included. The majority of patients returned to their prior level of activity within six months following TSA, RTSA, and shoulder HA. Noncontact, low demand activities are permitted by most surgeons postoperatively and generally have higher return rates than contact sports or high-demand activities. In some series, patients reported an improvement in their ability to participate in sports following the arthroplasty procedure. The rates of return to sports following TSA (75%-100%) are slightly higher than those reported for HA (67%-76%) and RTSA (75%-85%). Patients undergoing TSA, RTSA, and shoulder HA should be counseled that there is a high probability that they will be able to return to their preoperative activity level within six months postoperatively. TSA has been associated with higher rates of return to sports than RTSA and HA, although this may reflect differences in patient population or surgical indication. PMID:27672564

  15. Emerging Indications for Reverse Shoulder Arthroplasty.

    PubMed

    Urch, Ekaterina; Dines, Joshua S; Dines, David M

    2016-01-01

    Historically, reverse shoulder arthroplasty was reserved for older, low-demand patients in whom rotator cuff arthropathy was diagnosed. Other common indications included sequelae of previously treated proximal humerus fractures, failed anatomic total shoulder arthroplasty, tumor resection, and rheumatoid arthritis in the elderly population. Unpredictable implant durability and high complication rates have limited the use of reverse shoulder arthroplasty to a narrow group of patients. Over the past decade, however, research has led to an improved understanding of the biomechanics behind reverse shoulder prostheses, which has improved implant design and surgical techniques. Consequently, orthopaedic surgeons have slowly begun to expand the indications for reverse shoulder arthroplasty to include a wider spectrum of shoulder pathologies. Recent studies have shown promising results for patients who undergo reverse shoulder arthroplasty for the treatment of acute proximal humerus fractures, massive rotator cuff tears without arthropathy, primary osteoarthritis, and chronic anterior dislocation, as well as for younger patients who have rheumatoid arthritis. These data suggest that, with judicious patient selection, reverse shoulder arthroplasty can be an excellent treatment option for a growing patient cohort.

  16. The Kaiser Permanente Shoulder Arthroplasty Registry

    PubMed Central

    Ake, Christopher F; Burke, Mary F; Singh, Anshuman; Yian, Edward H; Paxton, Elizabeth W; Navarro, Ronald A

    2015-01-01

    Background and purpose Shoulder arthroplasty is being performed in the United States with increasing frequency. We describe the medium-term findings from a large integrated healthcare system shoulder arthroplasty registry. Patients and methods Shoulder arthroplasty cases registered between January 2005 and June 2013 were included for analysis. The registry included patient characteristics, surgical information, implant data, attrition, and patient outcomes such as surgical site infections, venous thromboembolism, and revision procedures. Results During the study period, 6,336 primary cases were registered. Median follow-up time for all primaries was 3.3 years; 461 cases were lost to follow-up by ending of health plan membership. Primary cases were predominantly female (56%) and white (81%), with an average age of 70 years. The most common reason for surgery was osteoarthritis in 60% of cases, followed by acute fracture (17%) and rotator cuff tear arthropathy (15%). In elective shoulder arthroplasty procedures, 200 all-cause revisions (4%) were reported, with glenoid wear being the most common reason. Interpretation Most arthroplasties were elective procedures: over half performed for osteoarthritis. Glenoid wear was the most common reason for revision of primary shoulder arthroplasty in elective cases. PMID:25727949

  17. Three-dimensional component alignment and functional outcome in computer-navigated total knee arthroplasty: a prospective, randomized study comparing two navigation systems.

    PubMed

    Harvie, Paul; Sloan, Karen; Beaver, Richard J

    2011-12-01

    Computer navigation in total knee arthroplasty produces better component alignment than conventional techniques. Different navigation systems exist. We undertook a prospective, randomized study comparing 2 navigations systems (Stryker Full Navigation and Stryker Articular Surface Mounted [ASM] navigation systems). Three-dimensional component alignment (Perth computed tomographic knee protocol) and function at 1 year (Knee Society Scores) were assessed. Forty patients participated (20 fully navigated and 20 ASM-navigated total knee arthroplasties). Cohorts were well matched according to sex, age, and body mass index. No statistically significant difference was seen in any parameter of 3-dimensional component alignment or function between cohorts. Operative time for the ASM cohort was significantly less than the fully navigated cohort (P = .001). Both systems performed equally well, and therefore, surgeon preference should determine which system is used.

  18. Impact of Melatonin on Sleep and Pain After Total Knee Arthroplasty Under Regional Anesthesia With Sedation: A Double-Blind, Randomized, Placebo-Controlled Pilot Study.

    PubMed

    Kirksey, Meghan A; Yoo, Daniel; Danninger, Thomas; Stundner, Ottokar; Ma, Yan; Memtsoudis, Stavros G

    2015-12-01

    This pilot study explores sleep disruption after total knee arthroplasty and the impact of melatonin on sleep and postoperative pain. Sleep time was decreased on the last preoperative night and first two postoperative nights. Sleep efficiency was decreased on all three postoperative nights. Compared to placebo, melatonin increased sleep efficiency by 4.4% (mean; 95% CI -1.6, 10.4; P=0.150) and sleep time by 29 min (mean; 95% CI -2.0, 60.4; P=0.067). Melatonin appeared to have no effect on subjective sleep quality or daytime sleepiness, pain at rest or pain with standardized activity. In conclusion, sleep quality is impaired after total knee arthroplasty and exogenous melatonin does not appear to improve postoperative sleep or pain to a significant degree.

  19. Impromptu Speaking and Interpretation Studies: A Preliminary Study

    ERIC Educational Resources Information Center

    Heinz, Michael

    2013-01-01

    The purpose of this preliminary study was to look at forensics-based competition events and determine what, if any, impact they could have on the language learning and public speaking skills of interpreters in training. This paper details the nature of the impromptu and extemporaneous speaking events in forensics competitions and introduces a…

  20. The acetabulum: A prospective study of three-phase bone and indium white blood cell scintigraphy following porous-coated hip arthroplasty

    SciTech Connect

    Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Anderson, J.H.; Callaghan, J.J. )

    1990-03-01

    Although few studies address the use of three-phase bone scanning (TPBS) and indium-111-labeled white blood cell scintigraphy ({sup 111}In-WBC) in hip arthroplasty utilizing a porous-coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen with the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous-coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and {sup 111I}n-WBC at approximately 7 days, and 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the acetabulum. All 25 prostheses (144 of 144 scans) demonstrated increased uptake on the bone-phase images. Although this activity decreased with time, 76% had persistent uptake at 24 mo. Twenty-three of 25 prostheses (126 of 140 scans) showed increased uptake on {sup 111}In-WBC scintigraphy, invariably decreasing with time, but with 37% having significant uptake at 24 mo. Scintigraphic patterns in the uncomplicated porous-coated hip arthroplasty patient appear to differ from patterns described in cemented prostheses.

  1. [Total knee arthroplasty - GPs' views in Germany: a questionnaire-based study].

    PubMed

    Rau, C; Zimmermann-Stenzel, M; Parsch, D

    2008-04-01

    To assess general knowledge and individual views of general practitioners (GPs) on total knee arthroplasty (TKA), we conducted a questionnaire-based survey involving 170 GPs in Germany. Eighty-one GPs returned the questionnaire. They treat a mean of 10.6+/-8.3 patients with TKA. General knowledge can be estimated as good. Compared with the data in the literature, GPs assessed the rate of satisfied patients as lower and the risk for revision surgery as higher. The mean risk of potential complications (infection, instability, persistent pain) in association with TKA was estimated correctly. Seventy-eight percent of GPs consider an allergic reaction to the implant or bone cement as problematic. The number of cases per year, personal experience with the surgeon, and - less important - local accessibility are important factors for GPs when recommending an operating centre to a patient.A broad spectrum of individual responses indicates the need to improve the information transfer between orthopaedic surgeons and referring GPs.

  2. A clinical study of the rotational alignment of the femoral component in total knee arthroplasty

    PubMed Central

    Ding, Liangjia; Liu, Xiaomin; Liu, Changlu; Liu, Yingli

    2015-01-01

    [Purpose] The reasons for femorotibial rotational malalignment after total knee arthroplasty (TKA) were analyzed to provide evidence for clinical knee joint surgery and to reduce complications. [Subjects and Methods] Ninety knees of 60 patients were selected and randomly divided into two groups (n=30). For one group, rotational alignment of the femoral component was determined by the transepicondylar axis and TKA was performed. For the other group, rotational alignment of the femoral component was conducted through 3° external rotation of the posterior femoral condyles. Knee joint specimens were operated with TKA and various biomechanical indices were measured. [Results] The femoral epicondylar axis was a constant, reliable reference for femoral component rotational alignment. When the femoral component was rotated by 0° versus the epicondylar axis, the peak contact pressure on the patellofemoral joint was optimal. When the femoral component was arranged in parallel with Whiteside’s line, the peak contact pressure on the patellofemoral joint varied largely. The patellofemoral contact areas of the two groups were similar. [Conclusion] Axial rotational alignment of the femoral component influenced the contact pressure of patellofemoral joints in TKA more significantly than external rotation of the femoral condyles. It is more reliable to use the femoral epicondylar axis as the reference for the rotational alignment of the femoral component. PMID:26311929

  3. Assessment of radiolucent lines in cemented shoulder hemi-arthroplasties: study of concordance and reproducibility.

    PubMed

    Torrens, Carlos; Martínez-Díaz, Santos; Ruiz, Aina; Gines, Alberto; Cáceres, Enrique

    2009-02-01

    We report on the concordance and reproducibility of the evaluation of radiolucent lines in the humeral component of shoulder arthroplasty. Thirty-two shoulder prostheses were assessed independently, on two occasions, by five observers. The level of inter- and intra-observer agreement was calculated using the kappa statistic. Intra-observer agreement: the overall kappa values ranged from 0 to 0.6, meaning poor, fair and moderate agreement levels. Inter-observer agreement: when the anteroposterior (AP) views were analysed, the values obtained for the bone-cement interface ranged from 0.290 to 0.539, meaning a poor-to-moderate agreement. For the cement-implant interface, the values ranged from 0.064 to 0.684, meaning a poor-to-good agreement. When radiolucent lines of the humeral component were analysed, inter-observer agreement proved to be as low as that obtained when total hip or knee components were analysed. Intra-observer agreement showed better results.

  4. The association between use of serotonergic antidepressants and perioperative bleeding during total hip arthroplasty--a cohort study.

    PubMed

    Dall, Michael; Primdahl, Annie; Damborg, Frank; Nymark, Tine; Hallas, Jesper

    2014-09-01

    In vitro studies have shown that selective serotonin reuptake inhibitors inhibit platelet aggregation. It is well documented that SSRIs cause serious gastrointestinal bleeding, but studies on other bleeding manifestations have been equivocal. Our objective was to determine a possible association between use of serotonergic antidepressants (SA) and perioperative bleeding during hip replacements. We conducted a retrospective study between 1 January 2007 and 30 June 2012 among patients that underwent a primary unilateral uncemented total hip arthroplasty (THA). Information was collected on the observed blood loss and the need for blood transfusions among this group. We compared the blood loss between users of SA, users of non-serotonergic antidepressants (NSA) and non-users, while adjusting for potential confounders using multivariate linear regression. We indentified 1318 patients that underwent a THA in the study period. The average volume of surgical bleeding was 350 ml. The adjusted incremental blood loss associated with use of SA and NSA was 93, 95% confidence interval (38-147) ml and -50 (-125 to 25) ml compared with non-use. Only 48 subjects (3.6%) had transfusions. Use of SA was associated with an increased blood loss compared with non-users. The hypothesis that SA impairs haemostasis is supported by these results.

  5. Posterior cruciate ligament balancing in total knee arthroplasty: a numerical study with a dynamic force controlled knee model

    PubMed Central

    2014-01-01

    Background Adequate soft tissue balancing is a key factor for a successful result after total knee arthroplasty (TKA). Posterior cruciate ligament (PCL) is the primary restraint to posterior translation of the tibia after cruciate retaining TKA and is also responsible for the amount of joint compression. However, it is complex to quantify the amount of ligament release with its effects on load bearing and kinematics in TKA and limited both in vivo and in vitro. The goal of this study was to create a dynamic and deformable finite element model of a full leg and analyze a stepwise release of the PCL regarding knee kinematics, pressure distribution and ligament stresses. Methods A dynamic finite element model was developed in Ansys V14.0 based on boundary conditions of an existing knee rig. A cruciate retraining knee prosthesis was virtually implanted. Ligament and muscle structures were simulated with modified spring elements. Linear elastic materials were defined for femoral component, inlay and patella cartilage. A restart algorithm was developed and implemented into the finite element simulation to hold the ground reaction force constant by adapting quadriceps force. After simulating the unreleased PCL model, two models were developed and calculated with the same boundary conditions with a 50% and 75% release of the PCL stiffness. Results From the beginning of the simulation to approximately 35° of flexion, tibia moves posterior related to the femur and with higher flexion anteriorly. Anterior translation of the tibia ranged from 5.8 mm for unreleased PCL to 3.7 mm for 75% PCL release (4.9 mm 50% release). A decrease of maximum von Mises equivalent stress on the inlay was given with PCL release, especially in higher flexion angles from 11.1 MPa for unreleased PCL to 8.9 MPa for 50% release of the PCL and 7.8 MPa for 75% release. Conclusions Our study showed that dynamic FEM is an effective method for simulation of PCL balancing in knee arthroplasty. A tight

  6. Can Total Wrist Arthroplasty Be an Option for Treatment of Highly Comminuted Distal Radius Fracture in Selected Patients? Preliminary Experience with Two Cases

    PubMed Central

    Schmidt, Ingo

    2015-01-01

    We present two case reports of successful primary shortening of the forearm and total wrist arthroplasty (TWA) using the new angle-stable Maestro Wrist Reconstructive System (WRS) for treatment of highly comminuted distal radius fracture in selected autonomous patients. In a 56-year-old male patient with adequate bone stock, insertion of the noncemented Maestro WRS was combined with ulnar shortening osteotomy. In an 84-year-old female patient with poor osteoporotic bone stock, insertion of the radial cemented Maestro WRS was combined with ulnar head resection. Both patients could resume their work without additional surgery after TWA. At the 1-year follow-up, there were no changes in position of either implant without signs of loosening, no impingement, and no instability of the distal radioulnar joint or the distal ulna stump. All clinical parameters (DASH score, pain through VAS, and grip strength) were satisfactory. Both patients reported that they would have the same procedure again. Further experience is needed to validate this concept. PMID:26491587

  7. Preliminary design study for an atomospheric science facility

    NASA Technical Reports Server (NTRS)

    Hutchison, R.

    1972-01-01

    The activities and results of the Atmospheric Science Facility preliminary design study are reported. The objectives of the study were to define the scientific goals, to determine the range of experiment types, and to develop the preliminary instrument design requirements for a reusable, general purpose, optical research facility for investigating the earth's atmosphere from a space shuttle orbital vehicle.

  8. Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study

    PubMed Central

    Aneja, Vikas; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

    2016-01-01

    Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ ankylosis. The aim of this series was to evaluate the effectiveness of the temporomyofacial flap in the treatment of TMJ ankylosis as an interpositional gap arthroplasty. A total of 10 cases with unilateral TMJ ankylosis were treated by interpositional gap arthroplasty by pedicled temporalis myofacial flap and evaluated with a follow-up of 6 months to 5 years (Mean 3.3 years) for the functional stability of TMJ. All the patients were successfully treated. There were no signs of recurrence in any patients up to last follow up visit. The result showed that temporalis myofascial flap is a preferable choice for inter-positional gap arthroplasty which proves its versatility as an inter-positional material. PMID:27891496

  9. Early outcomes of staged bilateral reverse total shoulder arthroplasty: a case-control study.

    PubMed

    Wiater, B P; Boone, C R; Koueiter, D M; Wiater, J M

    2013-09-01

    Some surgeons are reluctant to perform a reverse total shoulder arthroplasty (RTSA) on both shoulders because of concerns regarding difficulty with activities of daily living post-operatively as a result of limited rotation of the shoulders. Nevertheless, we hypothesised that outcomes and patient satisfaction following bilateral RTSA would be comparable to those following unilateral RTSA. A single-surgeon RTSA registry was reviewed for patients who underwent bilateral staged RTSA with a minimum follow-up of two years. A unilateral RTSA matched control was selected for each shoulder in those patients undergoing bilateral procedures. The Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Values (SSV), visual analogue scale (VAS) for pain, range of movement and strength were measured pre- and post-operatively. The mean CMS, ASES, SSV, VAS scores, strength and active forward elevation were significantly improved (all p < 0.01) following each operation in those undergoing bilateral procedures. The mean active external rotation (p = 0.63 and p = 0.19) and internal rotation (p = 0.77 and p = 0.24) were not significantly improved. The improvement in the mean ASES score after the first RTSA was greater than the improvement in its control group (p = 0.0039). The improvement in the mean CMS, ASES scores and active forward elevation was significantly less after the second RTSA than in its control group (p = 0.0244, p = 0.0183, and p = 0.0280, respectively). Pain relief and function significantly improved after each RTSA in those undergoing a bilateral procedure. Bilateral RTSA is thus a reasonable form of treatment for patients with severe bilateral rotator cuff deficiency, although inferior results may be seen after the second procedure compared with the first.

  10. Total hip arthroplasty.

    PubMed Central

    Siopack, J S; Jergesen, H E

    1995-01-01

    Total hip arthroplasty, or surgical replacement of the hip joint with an artificial prosthesis, is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. In this review we briefly summarize the evolution of total hip arthroplasty, the design and development of prosthetic hip components, and the current clinical indications for this procedure. The possible complications of total hip arthroplasty, its clinical performance over time, and future directions in hip replacement surgery are also discussed. Images PMID:7725707

  11. Sports Activity after Low-contact-stress Total Knee Arthroplasty – A long term follow-up study

    PubMed Central

    Vielgut, Ines; Leitner, Lukas; Kastner, Norbert; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

    2016-01-01

    The purpose of this study was to provide comprehensive long-term data about sports activity levels in patients following total knee arthroplasty (TKA) and to determine the impact of pre-operative function, pain and specific performed sports on the results. 236 patients who have undergone TKA for severe osteoarthritis of the knee were asked to provide specific information regarding exercised types of sports before surgery and after at least 10 years following TKA. Pre- and postoperative function and pain were evaluated by the use of Tegner-, WOMAC- and VAS Score. After a mean of 14.9 years, a significant improvement regarding pain and function was observed. Pre-operative Tegner- and WOMAC scores revealed significant positive correlations with the post-operative Tegner-Score. Accordingly, a high percentage of patients (70.9%) stayed actively involved in sports. Nevertheless, the number of performing patients has decreased according to the sports impact. 71.3% continued practising low-impact-, 43.7% intermediate-impact sports whereas only 16.4% kept performing high impact sports. We conclude that TKA is highly effective in long-time pain reduction as well as improvement of function. Additionally, we found considerable sports activities preserved in the investigated series. However, sports activities in particular, seem to decrease according to the impact of sports. PMID:27090945

  12. Clinical Study of 3D Imaging and 3D Printing Technique for Patient-Specific Instrumentation in Total Knee Arthroplasty.

    PubMed

    Qiu, Bing; Liu, Fei; Tang, Bensen; Deng, Biyong; Liu, Fang; Zhu, Weimin; Zhen, Dong; Xue, Mingyuan; Zhang, Mingjiao

    2017-01-25

    Patient-specific instrumentation (PSI) was designed to improve the accuracy of preoperative planning and postoperative prosthesis positioning in total knee arthroplasty (TKA). However, better understanding needs to be achieved due to the subtle nature of the PSI systems. In this study, 3D printing technique based on the image data of computed tomography (CT) has been utilized for optimal controlling of the surgical parameters. Two groups of TKA cases have been randomly selected as PSI group and control group with no significant difference of age and sex (p > 0.05). The PSI group is treated with 3D printed cutting guides whereas the control group is treated with conventional instrumentation (CI). By evaluating the proximal osteotomy amount, distal osteotomy amount, valgus angle, external rotation angle, and tibial posterior slope angle of patients, it can be found that the preoperative quantitative assessment and intraoperative changes can be controlled with PSI whereas CI is relied on experience. In terms of postoperative parameters, such as hip-knee-ankle (HKA), frontal femoral component (FFC), frontal tibial component (FTC), and lateral tibial component (LTC) angles, there is a significant improvement in achieving the desired implant position (p < 0.05). Assigned from the morphology of patients' knees, the PSI represents the convergence of congruent designs with current personalized treatment tools. The PSI can achieve less extremity alignment and greater accuracy of prosthesis implantation compared against control method, which indicates potential for optimal HKA, FFC, and FTC angles.

  13. Prognostic Factors in Arthroplasty in the Rheumatoid Shoulder

    PubMed Central

    Nagels, Jochem; Rozing, Maarten P.

    2010-01-01

    Total shoulder arthroplasty is commonly considered a good option for treatment of the rheumatoid shoulder. However, when the rotator cuff and glenoid bone stock are not preserved, the clinical outcome of arthroplasty in the rheumatoid patients remains unclear. Aim of the study is to explore the prognostic value of multiple preoperative and peroperative variables in total shoulder arthroplasty and shoulder hemiarthroplasty in rheumatoid patients. Clinical Hospital for Special Surgery Shoulder score was determined at different time points over a mean period of 6.5 years in 66 rheumatoid patients with total shoulder arthroplasty and 75 rheumatoid patients with shoulder hemiarthroplasty. Moreover, radiographic analysis was performed to assess the progression of humeral head migration and glenoid loosening. Advanced age and erosions or cysts at the AC joint at time of surgery were associated with a lower postoperative Clinical Hospital for Special Surgery Shoulder score. In total shoulder arthroplasty, status of the rotator cuff and its repair at surgery were predictive of postoperative improvement. Progression of proximal migration during the period after surgery was associated with a lower clinical score over time. However, in hemiarthroplasty, no relation was observed between the progression of proximal or medial migration during follow-up and the clinical score over time. Status of the AC joint and age at the time of surgery should be taken into account when considering shoulder arthroplasty in rheumatoid patients. Total shoulder arthroplasty in combination with good cuff repair yields comparable clinical results as total shoulder arthroplasty when the cuff is intact. PMID:21423883

  14. Reverse-total shoulder arthroplasty cost-effectiveness: A quality-adjusted life years comparison with total hip arthroplasty

    PubMed Central

    Bachman, Daniel; Nyland, John; Krupp, Ryan

    2016-01-01

    AIM: To compare reverse-total shoulder arthroplasty (RSA) cost-effectiveness with total hip arthroplasty cost-effectiveness. METHODS: This study used a stochastic model and decision-making algorithm to compare the cost-effectiveness of RSA and total hip arthroplasty. Fifteen patients underwent pre-operative, and 3, 6, and 12 mo post-operative clinical examinations and Short Form-36 Health Survey completion. Short form-36 Health Survey subscale scores were converted to EuroQual Group Five Dimension Health Outcome scores and compared with historical data from age-matched patients who had undergone total hip arthroplasty. Quality-adjusted life year (QALY) improvements based on life expectancies were calculated. RESULTS: The cost/QALY was $3900 for total hip arthroplasty and $11100 for RSA. After adjusting the model to only include shoulder-specific physical function subscale items, the RSA QALY improved to 2.8 years, and its cost/QALY decreased to $8100. CONCLUSION: Based on industry accepted standards, cost/QALY estimates supported both RSA and total hip arthroplasty cost-effectiveness. Although total hip arthroplasty remains the quality of life improvement “gold standard” among arthroplasty procedures, cost/QALY estimates identified in this study support the growing use of RSA to improve patient quality of life. PMID:26925384

  15. The evaluation of the failed shoulder arthroplasty.

    PubMed

    Wiater, Brett P; Moravek, James E; Wiater, J Michael

    2014-05-01

    As the incidence of shoulder arthroplasty continues to rise, the orthopedic shoulder surgeon will be increasingly faced with the difficult problem of evaluating a failed shoulder arthroplasty. The patient is usually dissatisfied with the outcome of the previous arthroplasty as a result of pain, but may complain of poor function due to limited range of motion or instability. A thorough and systematic approach is necessary so that the most appropriate treatment pathway can be initiated. A comprehensive history and physical examination are the first steps in the evaluation. Diagnostic studies are numerous and include laboratory values, plain radiography, computed tomography, ultrasound imaging, joint aspiration, nuclear scans, and electromyography. Common causes of early pain after shoulder arthroplasty include technical issues related to the surgery, such as malposition or improper sizing of the prosthesis, periprosthetic infection, neurologic injury, and complex regional pain syndrome. Pain presenting after a symptom-free interval may be related to chronic periprosthetic infection, component wear and loosening, glenoid erosion, rotator cuff degeneration, and fracture. Poor range of motion may result from inadequate postoperative rehabilitation, implant-related factors, and heterotopic ossification. Instability is generally caused by rotator cuff deficiency and implant-related factors. Unfortunately, determining the cause of a failed shoulder arthroplasty can be difficult, and in many situations, the source of pain and disability is multifactorial.

  16. 33. Historic American Buildings Survey COPY OF PRELIMINARY STUDY FOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. Historic American Buildings Survey COPY OF PRELIMINARY STUDY FOR HEALY BUILDING, c. 1876 (COURTESY OF THE COMMISSION OF FINE ARTS) - Georgetown University, Healy Building, Thirty-seventh & O Streets, Northwest, Washington, District of Columbia, DC

  17. Physical performance tests, self-reported outcomes, and accidental falls before and after total knee arthroplasty: an exploratory study.

    PubMed

    Swinkels, Annette; Allain, Theresa J

    2013-08-01

    This longitudinal, observational study explored the relationship between physical performance tests, self-reported outcomes, and accidental falling, before and after total knee arthroplasty (TKA). Thirty-seven patients were randomly selected from a larger study of falling before and after surgery conducted at a UK National Health Service Orthopaedic Unit. Physical performance tests were the Berg Balance Score (BBS), Timed Up and Go (TUG), and Hand Grip Strength (HGS). Self-reported outcomes incorporated the Western Ontario and McMaster's Osteoarthritis Index (WOMAC), Activities Balance Confidence Scale (ABC-UK), Geriatric Depression Scale (GDS), and accidental falls. Paired pre- and postoperative data were available on 22 patients. A total of 22.7% patients fell before and after TKA. Postoperative improvement in BBS and TUG was found in 41% and 50% of patients, respectively, HGS did not change. BBS showed a consistent moderate-to-strong association with other physical tests both before and after surgery; TUG (rs -0.76; rs -0.90), maximal HGS (r 0.49; r 0.48), and self-report measures; ABC-UK (r 0.52; r 0.74), WOMAC stiffness (r -0.53; r -0.48), and WOMAC function (r -0.56; r -0.45). Although self-report questionnaires are an efficient, cost-effective approach to outcome assessment in TKA, there is a growing case for inclusion of physical performance tests. The Berg Balance Score may be a useful addition to outcome assessment in patients with TKA.

  18. RAPID KNEE-EXTENSIONS TO INCREASE QUADRICEPS MUSCLE ACTIVITY IN PATIENTS WITH TOTAL KNEE ARTHROPLASTY: A RANDOMIZED CROSS-OVER STUDY

    PubMed Central

    Wilquin, Lousia; Jakobsen, Thomas Linding; Holsgaard-Larsen, Anders; Bandholm, Thomas

    2017-01-01

    Background Inhibition of the quadriceps muscle and reduced knee-extension strength is common shortly following total knee arthroplasty (weeks to months), due to reduced voluntary activation of the quadriceps muscle. In healthy subjects, strength training with heavy loads is known to increase agonist muscle activity, especially if the exercise is conducted using rapid muscle contractions. Purpose The purpose of this study was to examine if patients with total knee arthroplasty could perform rapid knee-extensions using a 10 RM load four to eight weeks after surgery, and the degree to which rapid knee-extensions were associated with greater voluntary quadriceps muscle activity during an experimental strength training session, compared to that elicited using slow knee-extensions. Study Design A randomized cross-over study. Methods Twenty-four patients (age 66.5) 4-8 weeks post total knee arthroplasty randomly performed one set of five rapid, and one set of five slow knee-extensions with the operated leg, using a load of their 10 repetition maximum, while surface electromyography recordings were obtained from the vastus medialis and lateralis of the quadriceps muscle. Results Data from 23 of the 24 included patients were analyzed. Muscle activity was significantly higher during rapid knee-extensions (120.2% [10th-90th percentile: 98.3-149.1]) compared to slow knee-extensions (106.0% [88.8-140.8]) for the vastus lateralis (p<0.01), but not for the vastus medialis (120.8% [90.4-134.0]) and (121.8% [93.0-133.0]) (p = 0.17), respectively. Slow and rapid knee-extensions were performed at a median angular velocity of 19.7 degrees/sec (13.7-24.4) and 51.4 degrees/sec (28.9-63.1), respectively Conclusion Four to eight weeks after their total knee arthroplasty, the patients in the present study were able to conduct rapid knee-extensions according to the experimental protocol with an approximately doubled angular velocity compared to slow knee-extensions. This was associated with

  19. Factors for Assessing the Effectiveness of Early Rehabilitation after Minimally Invasive Total Knee Arthroplasty: A Prospective Cohort Study

    PubMed Central

    Amano, Tetsuya; Tamari, Kotaro; Tanaka, Shigeharu; Uchida, Shigehiro; Ito, Hideyuki; Morikawa, Shinya; Kawamura, Kenji

    2016-01-01

    The effectiveness of current rehabilitation programs is supported by high-level evidence from the results of randomized controlled trials, but an increasing number of patients are not discharged from the hospital because of the schedule of the critical path (CP). The present study aimed to determine which factors can be used to assess the effectiveness of early rehabilitation. We enrolled 123 patients with medial knee osteoarthritis (OA) who had undergone unilateral minimally invasive total knee arthroplasty for the first time. The following factors were assessed preoperatively: the maximum isometric muscle strength of the knee extensors and flexors, maximum knee and hip joint angle, pain, 5-m maximum walking speed, sex, age, body mass index, exercise habits, Kellgren-Lawrence grade, femorotibial angle, failure side (bilateral or unilateral knee OA), and functional independence measure. We re-evaluated physical function (i.e., muscle strength, joint angle, and pain) and motor function (5-m maximum walking speed) 14 days postoperatively. Changes in physical function, motor function (5-m maximum walking speed), and number of days to independent walking were used as explanatory variables. The postoperative duration of hospitalization (in days) was used as the dependent variable in multivariate analyses. These analyses were adjusted for sex, age, body mass index, exercise habits, Kellgren-Lawrence grade, femorotibial angle, failure side, and functional independence measure. The duration of hospitalization was significantly affected by the number of days to independent walking (p < 0.001, β = 0.507) and a change in the 5-m maximum walking speed (p = 0.016, β = -0.262). Multiple regression analysis showed that the radiographic knee grade (p = 0.029, β = 0.239) was a significant confounding factor. Independent walking and walking speed recovery were considered to reduce the duration of hospitalization. Therefore, these indices can be used to assess the effectiveness of

  20. Dermabond efficacy in total joint arthroplasty wounds.

    PubMed

    Miller, Adam G; Swank, Michael L

    2010-10-01

    The goals of wound closure are a low infection rate and timely healing. Total joint arthroplasty (TJA) requires mobile recovery, and, therefore, a high-tension wound care environment. We conducted a study to compare the efficacy of high-viscosity Dermabond (Ethicon, Somerville, New Jersey) and the efficacy of surgical staples in healing high-tension, mobile surgical sites of TJA. Of 236 total knee arthroplasties and 223 total hip arthroplasties (459 surgeries total), 250 were performed with Dermabond and 209 with staples. According to χ2 analysis, case and control infection rates were equivalent. Signs of acute inflammation (redness, drainage, dehiscence) also were statistically equivalent. Absence of staples accounted for a significant decrease in tape blisters and skin abscesses. Dermabond is superior to staples in high-tension wound care.

  1. More than 95% completeness of reported procedures in the population-based Dutch Arthroplasty Register

    PubMed Central

    van Steenbergen, Liza N; Spooren, Anneke; van Rooden, Stephanie M; van Oosterhout, Frank J; Morrenhof, Jan W; Nelissen, Rob G H H

    2015-01-01

    Background and purpose A complete and correct national arthroplasty register is indispensable for the quality of arthroplasty outcome studies. We evaluated the coverage, completeness, and validity of the Dutch Arthroplasty Register (LROI) for hip and knee arthroplasty. Patients and methods The LROI is a nationwide population-based registry with information on joint arthroplasties in the Netherlands. Completeness of entered procedures was validated in 2 ways: (1) by comparison with the number of reimbursements for arthroplasty surgeries (Vektis database), and (2) by comparison with data from hospital information systems (HISs). The validity was examined by conducting checks on missing or incorrectly coded values in the LROI. Results The LROI contains over 300,000 hip and knee arthroplasties performed since 2007. Coverage of all Dutch hospitals (n = 100) was reached in 2012. Completeness of registered procedures was 98% for hip arthroplasty and 96% for knee arthroplasty in 2012, based on Vektis data. Based on comparison with data from the HIS, completeness of registered procedures was 97% for primary total hip arthroplasty and 96% for primary knee arthroplasty in 2013. Completeness of revision arthroplasty was 88% for hips and 90% for knees in 2013. The proportion of missing or incorrectly coded values of variables was generally less than 0.5%, except for encrypted personal identity numbers (17% of which were missing) and ASA scores (10% of which were missing). Interpretation The LROI now contains over 300,000 hip and knee arthroplasty procedures, with coverage of all hospitals. It has a good level of completeness (i.e. more than 95% for primary hip and knee arthroplasty procedures in 2012 and 2013) and the database has high validity. PMID:25758646

  2. Revision of failed humeral head resurfacing arthroplasty

    PubMed Central

    Streubel, Philipp N.; Simone, Juan P.; Cofield, Robert H.; Sperling, John W.

    2016-01-01

    Purpose: The purpose of this study is to assess the outcomes of a consecutive series of patients who underwent revision surgery after humeral head resurfacing (HHR). Our joint registry was queried for all patients who underwent revision arthroplasty for failed HHR at our institution from 2005 to 2010. Eleven consecutive patients (average age 54 years; range 38-69 years) that underwent revision of 11 resurfacing arthroplasties were identified. The primary indication for resurfacing had been osteoarthritis in six, glenoid dysplasia in two, a chondral lesion in two, and postinstability arthropathy in one patient. The indication for revision was pain in 10 and infection in one patient. Seven patients had undergone an average of 1.9 surgeries prior to resurfacing (range 1-3). Materials and Methods: All patients were revised to stemmed arthroplasties, including one hemiarthroplasty, two reverse, and eight anatomic total shoulder arthroplasties at a mean 33 months after primary resurfacing (range 10-131 months). A deltopectoral approach was used in seven patients; four patients required an anteromedial approach due to severe scarring. Subscapularis attenuation was found in four cases, two of which required reverse total shoulder arthroplasty. Bone grafting was required in one glenoid and three humeri. Results: At a mean follow-up of 3.5 years (range 1.6-6.9 years), modified Neer score was rated as satisfactory in five patients and unsatisfactory in six. Abduction and external rotation improved from 73° to 88° (P = 0.32) and from 23° to 32° (P = 0.28) respectively. Reoperation was required in two patients, including one hematoma and one revision for instability. Conclusion: Outcomes of revision of HHR arthroplasty in this cohort did not improve upon those reported for revision of stemmed humeral implants. A comparative study would be required to allow for definitive conclusions to be made. PMID:26980986

  3. Preliminary Biomechanical Study of Different Acetabular Reinforcement Devices for Acetabular Reconstruction

    PubMed Central

    Tai, Ching-Lung; Lee, Po-Yi; Hsieh, Pang-Hsing

    2015-01-01

    Background Acetabular reinforcement devices (ARDs) are frequently used as load-sharing devices to allow allograft incorporation in revision hip arthroplasty with massive acetabular bone loss. The key to a successful reconstruction is robust fixation of the device to the host acetabulum. Interlocking fixation is expected to improve the initial stability of the postoperative construct. However, all commercially available ARDs are designed with non-locking fixation. This study investigates the efficacy of standard ARDs modified with locking screw mechanisms for improving stability in acetabular reconstruction. Methods Three types of ARDs were examined to evaluate the postoperative compression and angular stability: i) standard commercial ARDs, ii) standard ARDs modified with monoaxial and iii) standard ARDs modified with polyaxial locking screw mechanisms. All ARDs were implanted into osteomized synthetic pelvis with pelvic discontinuity. Axial compression and torsion tests were then performed using a servohydraulic material testing machine that measured load (angle) versus displacement (torque). Initial stability was compared among the groups. Results Equipping ARDs with interlocking mechanisms effectively improved the initial stability at the device/bone interface compared to standard non-locked ARDs. In both compression and torsion experiments, the monoaxial interlocking construct demonstrated the highest construct stiffness (672.6 ± 84.1 N/mm in compression and 13.3 ± 1.0 N·m/degree in torsion), whereas the non-locked construct had the lowest construct stiffness (381.4 ± 117.2 N/mm in compression and 6.9 ± 2.1 N·m/degree in torsion) (P < 0.05). Conclusions Our study demonstrates the potential benefit of adding a locking mechanism to an ARD. Polyaxial ARDs provide the surgeon with more flexibility in placing the screws at the cost of reduced mechanical performance. This in vitro study provides a preliminary evaluation of biomechanical performance for ARDs

  4. Preliminary design studies of an advanced general aviation aircraft

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Preliminary design studies are presented for an advanced general aviation aircraft. Advanced guidance and display concepts, laminar flow, smart structures, fuselage and wing structural design and manufacturing, and preliminary configuration design are discussed. This project was conducted as a graduate level design class under the auspices of the KU/NASA/USRA Advanced Design Program in Aeronautics. The results obtained during the fall semester of 1990 (Phase 1) and the spring semester of 1991 (Phase 2) are presented.

  5. Medial unicondylar knee arthroplasty: technical pearls

    PubMed Central

    BONIFORTI, FILIPPO

    2015-01-01

    Unicondylar knee arthroplasty implantation is extremely demanding as the prosthesis needs to be integrated in the natural anatomy of the knee. It ensures the integrity of the natural knee kinematic. Some studies and registries data have shown lower success rate in comparison with total knee arthroplasty, and patient-related factors may have an impact on outcome. While, better results have been published by high volume centres. The indications for surgery should be reconsidered critically, even if medial osteoarthritis of the knee remains the most common. This article sets out the diagnostic, and surgical steps in order to fine tuning the unicompartmental replacement of the knee. PMID:26605256

  6. Demonstration of saw blade accuracy and excursion: a cadaveric comparison study of blade types used in total knee arthroplasty.

    PubMed

    Wetzel, Robert J; Shah, Ritesh R; Puri, Lalit

    2013-06-01

    In total knee arthroplasty, outcomes partly depend on accurate osteotomies and integrity of stabilizing structures. We compared accuracy and excursion between a conventional and an oscillating tip saw blade. Two sets of osteotomies were made on cadaveric knees. Bi-planar accuracy was compared using computer navigation, and excursion was compared using methylene blue. Wilcoxon-Mann-Whitney testing demonstrated no significant difference in blade accuracy (p=0.35). Blades were within 0.5 degrees of neutral coronally and 2.0 degrees sagittally. The oscillating tip blade demonstrated less dye markings on the surrounding tissues. Accurate osteotomies and soft tissue protection are critical to successful arthroplasties. Although comparative accuracy was equal, the oscillating tip blade exhibited less excursion displaying potential for less iatrogenic soft tissue injuries leading to catastrophic failure.

  7. Past, present, and future of cervical arthroplasty.

    PubMed

    Hyun Oh, Chang; Hwan Yoon, Seung

    2013-01-01

    Cervical arthroplasty was developed in an attempt to maintain cervical motion and potentially to avoid or minimize adjacent-segment degeneration. If cervical arthroplasty is successful, the long-term results of surgery for cervical disc disease should improve. However, problems associated with cervical arthroplasty have been reported: these include kyphosis, heterotopic ossification-induced motion limitation, no motion preservation even at the index level, and a higher revision rate in a limited number of cases compared with anterior cervical discectomy and fusion (ACDF). In addition, for degenerative cervical disc disorders, the risk of developing adjacent segment degeneration more than 2 years after surgery is reportedly similar for ACDF and cervical arthroplasty. Cervical disc arthroplasty is an emerging motion-sparing technology and is currently undergoing evaluation in many countries as an alternative to arthrodesis for the treatment of cervical radiculopathy and myelopathy. The decision whether to use arthrodesis or arthroplasty is a difficult one. The achievement of good prosthetic performance demands exacting implantation techniques to ensure correct placement. This fact underlines the increasing importance of special instrumentation and surgical skills that involve an understanding of prosthetic lubrication, wear, and biologic effects and familiarity with currently available information regarding kinematics, basic science, testing, and early clinical results. Fortunately, a number of devices are at the late preclinical study stage or at the early clinical trial stage, and results in many cases are promising. In the near future, it is likely that new designs will be produced to replace spinal discs totally or partially in a pathologic entity-specific manner.

  8. Malnutrition and Total Joint Arthroplasty

    PubMed Central

    Ellsworth, Bridget; Kamath, Atul F.

    2016-01-01

    Malnutrition is prevalent in patients undergoing elective total joint arthroplasty (TJA). Malnutrition has been shown to be an independent risk factor for multiple postsurgical complications following TJA in addition to increasing postoperative mortality. In the current healthcare environment, it is important to recognize and correct modifiable risk factors preoperatively to minimize perioperative complications and improve patient outcomes. Recently, multiple studies have been published focusing on the association between malnutrition and perioperative complications following TJA. The findings of these studies are summarized in this review. Further research is required to determine if optimization of nutritional status preoperatively influence surgical outcomes in the elective TJA patient. PMID:27376151

  9. Preliminary design study. Shuttle modular scanning spectroradiometer

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Fundamental concepts on which to base a detailed design for a Shuttle Modular Scanning Spectroradiometer were developed, and a preliminary design is presented. The recommended design features modularity and flexibility. It includes a 75-cm f/1.7-telescope assembly in an all-reflective Schmidt configuration, a solid state scan system (pushbroom) with high resolution over a 15 deg field of view, and ten detector channels covering the spectral range from 0.45 to 12.5 micrometers. It uses charge transfer device techniques to accommodate a large number of detector elements for earth observation measurements. Methods for in-flight radiometric calibration, for image motion compensation, and for data processing are described. Recommendations for ground support equipment are included, and interfaces with the shuttle orbiter vehicle are illustrated.

  10. Three-phase bone scan and indium white blood cell scintigraphy following porous coated hip arthroplasty: A prospective study of the prosthetic tip

    SciTech Connect

    Oswald, S.G.; Van Nostrand, D.; Savory, C.G.; Callaghan, J.J. )

    1989-08-01

    Although few reports address the use of three-phase bone scanning (TPBS) and {sup 111}In-labeled white blood cell (In-WBC) scintigraphy in hip arthroplasty utilizing a porous coated prosthesis, the literature suggests that scintigraphic patterns in the uncomplicated patient may differ from that seen in the cemented prosthesis. In an attempt to determine the scintigraphic natural history, 25 uncomplicated porous coated hip arthroplasties in 21 patients were prospectively studied with serial TPBS and In-WBC at approximately 7 days, and at 3, 6, 12, 18, and 24 mo postoperatively. This report deals with findings related to the prosthetic tip. Only one of 136 flow studies were abnormal and only two of 136 blood-pool images demonstrated focally increased activity. All 25 prostheses (120 of 143 scans) demonstrated increased uptake on the bone phase images. The area about the tip was divided into three segments; increased uptake at 24 mo was noted in the medial, distal, and lateral segments in 16%, 72%, and 56% of prostheses, respectively. Twenty of 25 prostheses (82 of 142 scans) showed uptake on In-WBC scintigraphy, being noted in 48% of prostheses at 24 mo. We conclude that scintigraphic patterns in the uncomplicated patient with a porous coated prosthesis appear to differ from patterns described in cemented prostheses.

  11. One-Day vs Two-Day Epidural Analgesia for Total Knee Arthroplasty (TKA): A Retrospective Cohort Study

    PubMed Central

    Corbett, Kelly L; Reichmann, William M; Katz, Jeffrey N; Beagan, Carolyn; Corsello, Paul; Ghazinouri, Roya; Dang, Bachyen; Mikulinsky, Regina; Losina, Elena; Wright, John

    2010-01-01

    Introduction: Over 500,000 total knee arthroplasties (TKAs) are performed annually in the US, yet postoperative pain management varies widely. In patients managed with epidural analgesia, the epidural catheter is generally removed on the second postoperative day. We compared in-hospital outcomes associated with removing the epidural catheter on postoperative day 1 (POD1-group) vs on postoperative day 2 (POD2-group) among patients undergoing TKA. Methods: We identified 89 patients who had TKA performed by a single surgeon from January through July 2007, and who were managed with epidural analgesia. This study took advantage of a change of policy from removing the epidural on the second postoperative day prior to March 2007 (n = 34) to removing the epidural on the first postoperative day thereafter (n = 55). Data were obtained by medical record review and analyzed with bivariate and multivariate techniques. Outcomes included knee range of motion (ROM), pain (0-10 scale), distance walked, narcotic usage, and length of stay. Results: The mean patient age was 68 ± 10 years. We did not identify clinically important differences in preoperative characteristics across groups. Patients in the POD1- group had a shorter length of stay (median of 3 vs 4 days in the POD2-group, p<0.001). The POD1-group also walked a greater distance on the second postoperative day (mean of 38 feet vs 9 feet in the POD2-group, p < 0.002). We did not observe a difference between the two groups with respect to change in passive ROM, pain on the second postoperative day, or narcotic usage. The POD1-group had more restricted continuous passive motion settings on the second postoperative day than the POD2-group (50° vs 65°, p = 0.031), and the POD1-group had somewhat worse passive range of motion at discharge (e.g. passive flexion 82o vs 76o in the POD2- group, p = 0.078). Conclusion: The balance between a shorter hospital stay and earlier walking achievement with the POD1-strategy-- vs better ROM

  12. [Resurfacing arthroplasty of the hip].

    PubMed

    Knecht, A; Witzleb, W-C; Günther, K-P

    2005-01-01

    Currently, an increase in resurfacing arthroplasty in the treatment of hip osteoarthritis--especially in young adults--can be observed. New bearing technologies (mainly metal-on-metal surfaces) show better tribologic results than historical designs (e.g. the Wagner cup). At present, it is unclear whether these modifications and a definitively low dislocation rate--due to the large head diameter--can be supported by further good clinical results. The quantity as well as the quality of the available investigations prevents a definite opinion at the moment. Appropriate clinical studies with documented radiographic follow-up are necessary to compare the outcome of these new implants with standard techniques.

  13. The Danish Hip Arthroplasty Register

    PubMed Central

    Gundtoft, Per Hviid; Varnum, Claus; Pedersen, Alma Becic; Overgaard, Søren

    2016-01-01

    Aim of database The aim of the Danish Hip Arthroplasty Register (DHR) is to continuously monitor and improve the quality of treatment of primary and revision total hip arthroplasty (THA) in Denmark. Study population The DHR is a Danish nationwide arthroplasty register established in January 1995. All Danish orthopedic departments – both public and private – report to the register, and registration is compulsory. Main variables The main variables in the register include civil registration number, indication for primary and revision surgery, operation date and side, and postoperative complications. Completeness of primary and revision surgery is evaluated annually and validation of a number of variables has been carried out. Descriptive data A total of 139,525 primary THAs and 22,118 revisions have been registered in the DHR between January 1, 1995 and December 31, 2014. Since 1995, completeness of procedure registration has been high, being 97.8% and 92.0% in 2014 for primary THAs and revisions, respectively. Several risk factors, such as comorbidity, age, specific primary diagnosis and fixation types for failure of primary THAs, and postoperative complications, have been identified through the DHR. Approximately 9,000 primary THAs and 1,500 revisions are reported to the register annually. Conclusion The DHR is important for monitoring and improvement of treatment with THA and is a valuable tool for research in THA surgery due to the high quality of prospective collected data with long-term follow-up and high completeness. The register can be used for population-based epidemiology studies of THA surgery and can be linked to a range of other national databases. PMID:27822092

  14. Frequent Dental Scaling Is Associated with a Reduced Risk of Periprosthetic Infection following Total Knee Arthroplasty: A Nationwide Population-Based Nested Case-Control Study

    PubMed Central

    Tai, Ta-Wei; Lin, Tzu-Chieh; Ho, Chia-Jung; Kao Yang, Yea-Huei; Yang, Chyun-Yu

    2016-01-01

    Oral bacteremia has been presumed to be an important risk factor for total knee arthroplasty (TKA) infection. We aimed to investigate whether dental scaling could reduce the risk of TKA infection. A nested case-control study was conducted to compare 1,291 TKA patients who underwent resection arthroplasty for infected TKA and 5,004 matched controls without infection in the TKA cohort of Taiwan’s National Health Insurance Research Database (NHIRD). The frequency of dental scaling was analyzed. Multiple conditional logistic regression was used to assess the frequency of dental scaling and the risk of TKA infection. The percentage of patients who received dental scaling was higher in the control group than in the TKA infection group. The risk for TKA infection was 20% lower for patients who received dental scaling at least once within a 3-year period than for patients who never received dental scaling. Moreover, the risk of TKA infection was reduced by 31% among patients who underwent more frequent dental scaling (5–6 times within 3 years). Frequent and regular dental scaling is associated with a reduced risk of TKA infection. PMID:27336912

  15. Frequent Dental Scaling Is Associated with a Reduced Risk of Periprosthetic Infection following Total Knee Arthroplasty: A Nationwide Population-Based Nested Case-Control Study.

    PubMed

    Tai, Ta-Wei; Lin, Tzu-Chieh; Ho, Chia-Jung; Kao Yang, Yea-Huei; Yang, Chyun-Yu

    2016-01-01

    Oral bacteremia has been presumed to be an important risk factor for total knee arthroplasty (TKA) infection. We aimed to investigate whether dental scaling could reduce the risk of TKA infection. A nested case-control study was conducted to compare 1,291 TKA patients who underwent resection arthroplasty for infected TKA and 5,004 matched controls without infection in the TKA cohort of Taiwan's National Health Insurance Research Database (NHIRD). The frequency of dental scaling was analyzed. Multiple conditional logistic regression was used to assess the frequency of dental scaling and the risk of TKA infection. The percentage of patients who received dental scaling was higher in the control group than in the TKA infection group. The risk for TKA infection was 20% lower for patients who received dental scaling at least once within a 3-year period than for patients who never received dental scaling. Moreover, the risk of TKA infection was reduced by 31% among patients who underwent more frequent dental scaling (5-6 times within 3 years). Frequent and regular dental scaling is associated with a reduced risk of TKA infection.

  16. Cervical disk arthroplasty versus ACDF for preoperative reducible kyphosis.

    PubMed

    Chen, Yu; Wang, Xinwei; Lu, Xuhua; Yang, Haisong; Chen, Deyu

    2013-07-01

    Cervical total disk arthroplasty has proven to be an effective and safe alternative for anterior cervical diskectomy and fusion (ACDF) for the treatment of cervical disk degenerative disease. However, whether and when cervical disk arthroplasty is indicated for preoperative cervical spine kyphosis is unclear. In the authors' clinical experiences, preoperative kyphosis can generally be divided into reducible and irreducible forms according to the results of dynamic flexion-extension lateral radiographs. Reducible kyphosis is mostly related to local disk prolapse, clinical symptoms, and musculature weakness, but irreducible kyphosis is always associated with significant cervical degeneration or congenital bone malformation. In this study, 32 patients with preoperative reducible kyphosis were randomized in a 1:1 ratio to either single-level total cervical arthroplasty with the Discover cervical disk prosthesis (DePuy Spine, Raynham, Massachusetts) (arthroplasty group) or single-level ACDF with a polyetheretherketone cage and plate (ACDF group). No significant differences existed in clinical and radiological results at 2-year follow-up between the arthroplasty and ACDF groups. The global and functional spinal unit angles of the arthroplasty group were significantly lower than those of the ACDF group 6 months postoperatively, which was consistent with the result of the comparison in Neck Disability Index score. However, the sagittal alignment of the overall cervical spine and the treated segment and the Neck Disability Index score significantly improved after 6 months in the arthroplasty group but not in the ACDF group. Therefore, preoperative reducible kyphosis is not a contraindication for cervical total disk arthroplasty. However, neck strength-building exercises should be emphasized for the postoperative rehabilitation after cervical total disk arthroplasty.

  17. Knee Pain during Strength Training Shortly following Fast-Track Total Knee Arthroplasty: A Cross-Sectional Study

    PubMed Central

    Bandholm, Thomas; Thorborg, Kristian; Lunn, Troels Haxholdt; Kehlet, Henrik; Jakobsen, Thomas Linding

    2014-01-01

    Background Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA). It is unknown how these exercise variables influence knee pain after TKA. Objective To investigate the effect of loading and contraction failure on knee pain during strength training, shortly following TKA. Design Cross-sectional study. Setting Consecutive sample of patients from the Copenhagen area, Denmark, receiving a TKA, between November 2012 and April 2013. Participants Seventeen patients, no more than 3 weeks after their TKA. Main outcome measures: In a randomized order, the patients performed 1 set of 4 standardized knee extensions, using relative loads of 8, 14, and 20 repetition maximum (RM), and ended with 1 single set to contraction failure (14 RM load). The individual loadings (kilograms) were determined during a familiarization session >72 hours prior. The patients rated their knee pain during each repetition, using a numerical rating scale (0–10). Results Two patients were lost to follow up. Knee pain increased with increasing load (20 RM: 3.1±2.0 points, 14 RM: 3.5±1.8 points, 8 RM: 4.3±2.5 points, P = 0.006), and repetitions to contraction failure (10% failure: 3.2±1.9 points, 100% failure: 5.4±1.6 points, P<0.001). Resting knee pain 60 seconds after the final repetition (2.7±2.4 points) was not different from that recorded before strength training (2.7±1.8 points, P = 0.88). Conclusion Both loading and repetitions performed to contraction failure during knee- extension strength-training, increased post-operative knee pain during strength training implemented shortly following TKA. However, only the increase in pain during repetitions to contraction failure exceeded that defined as clinically relevant, and was very short-lived. Trial Registration

  18. Preliminary design studies of an advanced general aviation aircraft

    NASA Technical Reports Server (NTRS)

    Barrett, Ron; Demoss, Shane; Dirkzwager, AB; Evans, Darryl; Gomer, Charles; Keiter, Jerry; Knipp, Darren; Seier, Glen; Smith, Steve; Wenninger, ED

    1991-01-01

    The preliminary design results are presented of the advanced aircraft design project. The goal was to take a revolutionary look into the design of a general aviation aircraft. Phase 1 of the project included the preliminary design of two configurations, a pusher, and a tractor. Phase 2 included the selection of only one configuration for further study. The pusher configuration was selected on the basis of performance characteristics, cabin noise, natural laminar flow, and system layouts. The design was then iterated to achieve higher levels of performance.

  19. Preliminary Design Study of a Hybrid Airship for Flight Research

    NASA Technical Reports Server (NTRS)

    Browning, R. G. E.

    1981-01-01

    The feasibility of using components from four small helicopters and an airship envelope as the basis for a quad-rotor research aircraft was studied. Preliminary investigations included a review of candidate hardware and various combinations of rotor craft/airship configurations. A selected vehicle was analyzed to assess its structural and performance characteristics.

  20. Preliminary simulation studies related to the Cerro Prieto Field

    SciTech Connect

    Lippmann, M.J.; Bodvarsson, G.S.; Witherspoon, P.A.; Rivera, J.R.

    1980-01-01

    Results of preliminary numerical simulations of the behavior of the Cerro Prieto field are discussed. The purpose of these studies is to examine: (1) the effect of using conventional isothermal methods of well test data analysis for geothermal systems, and (2) the influence of recharge from over under underlying aquifers on the temperature of a producing geothermal reservoir. 8 refs.

  1. National Day Care Study: Preliminary Findings and Their Implications.

    ERIC Educational Resources Information Center

    Travers, Jeffrey; And Others

    This interim report on the National Day Care Study (NDCS) presents preliminary findings of the 4-year research program designed to answer major policy questions about federal funding of center-based preschool day care. Major NDCS objectives have been to determine the impact of variations in staff-child ratio, group size, and staff size and…

  2. PTSD and Impaired Eye Expression Recognition: A Preliminary Study

    ERIC Educational Resources Information Center

    Schmidt, Jakob Zeuthen; Zachariae, Robert

    2009-01-01

    This preliminary study examined whether posttraumatic stress disorder (PTSD) was related to difficulties in identifying the mental states of others in a group of refugees. Sixteen Bosnian refugees, referred to treatment in an outpatient treatment center for survivors of torture and war-related trauma in Denmark (CETT), were compared to 16 non-PTSD…

  3. Alcohol consumption and the risk of postoperative mortality and morbidity after primary hip or knee arthroplasty – A register-based cohort study

    PubMed Central

    Rotevatn, Torill A.; Bøggild, Henrik; Olesen, Christinna R.; Torp-Pedersen, Christian; Mortensen, Rikke N.; Jensen, Per F.; Overgaard, Charlotte

    2017-01-01

    Objective To investigate the implications of low and moderate preoperative alcohol consumption on postoperative mortality and morbidity after primary hip and knee arthroplasty. Methods A total of 30,799 patients who underwent primary hip or knee arthroplasty between January 1st, 2005 and October 8th, 2011 with information on preoperative alcohol consumption (0 grams of pure alcohol/week, >0–168 g/week, >168–252 g/week, and >252 g/week) were identified through the Danish Anesthesia Database. The 90-day and 1-year risks of mortality (primary outcomes), 1-year risk of prosthetic infection, and 30-day risks of cardiovascular disease and deep venous thrombosis (secondary outcomes) were estimated by Cox regression analysis. Results We identified 285 (0.9%) deaths within the first 90 days and 694 (2.3%) within the first year. Within the first 30 days, 209 (0.7%) and 270 (0.9%) patients had acquired cardiovascular disease and deep venous thrombosis, respectively, and 514 (1.7%) patients developed prosthetic infection within the first year. The adjusted mortality models yielded hazard ratios of 0.55 (95% confidence interval [CI] 0.41 to 0.74) at 90 days and 0.61 (95% CI 0.51 to 0.73) at 1 year for the group consuming >0–168 g/week when compared to abstainers. Adjusted hazard ratios showed that the group consuming >0–168 g/week had a 0.91 (95% CI 0.75 to 1.11) risk of prosthetic infection, 0.68 (95% CI 0.50 to 0.92) risk of cardiovascular disease and 0.88 (95% CI 0.67 to 1.15) risk of deep venous thrombosis when compared to abstainers. Conclusions This study demonstrates that low-to-moderate alcohol consumption prior to primary hip or knee arthroplasty is associated with lower risks of mortality at both 90 days and 1 year after surgery and of cardiovascular disease after 30 days. More research from longitudinal studies is needed to identify specific causal relations and explanations. PMID:28306737

  4. Cervical disc arthroplasty with PRESTIGE LP disc versus anterior cervical discectomy and fusion: a prospective, multicenter investigational device exemption study.

    PubMed

    Gornet, Matthew F; Burkus, J Kenneth; Shaffrey, Mark E; Argires, Perry J; Nian, Hui; Harrell, Frank E

    2015-07-31

    OBJECT This study compared the safety and efficacy of treatment with the PRESTIGE LP cervical disc versus a historical control anterior cervical discectomy and fusion (ACDF). METHODS Prospectively collected PRESTIGE LP data from 20 investigational sites were compared with data from 265 historical control ACDF patients in the initial PRESTIGE Cervical Disc IDE study. The 280 investigational patients with single-level cervical disc disease with radiculopathy and/or myelopathy underwent arthroplasty with a low-profile artificial disc. Key safety/efficacy outcomes included Neck Disability Index (NDI), Neck and Arm Pain Numerical Rating Scale scores, 36-Item Short Form Health Survey (SF-36) score, work status, disc height, range of motion, adverse events (AEs), additional surgeries, and neurological status. Clinical and radiographic evaluations were completed preoperatively, intraoperatively, and at 1.5, 3, 6, 12, and 24 months postoperatively. Predefined Bayesian statistical methods with noninformative priors were used, along with the propensity score technique for controlling confounding factors. Analysis by independent statisticians confirmed initial statistical findings. RESULTS The investigational and control groups were mostly similar demographically. There was no significant difference in blood loss (51.0 ml [investigational] vs 57.1 ml [control]) or hospital stay (0.98 days [investigational] vs 0.95 days [control]). The investigational group had a significantly longer operative time (1.49 hours vs 1.38 hours); 95% Bayesian credible interval of the difference was 0.01-0.21 hours. Significant improvements versus preoperative in NDI, neck/arm pain, SF-36, and neurological status were achieved by 1.5 months in both groups and were sustained at 24 months. Patient follow-up at 24 months was 97.1% for the investigational group and 84.0% for the control group. The mean NDI score improvements versus preoperative exceeded 30 points in both groups at 12 and 24 months. SF

  5. Preliminary toxicological study of ferric acetyl acetonate

    SciTech Connect

    London, J.E.; Smith, D.M.

    1983-01-01

    The calculated acute oral LD/sub 50//sup 30/ (lethal does for 50% of the animals occuring with 30 days after compound administration) values for ferric acetyl acetonate were 584 mg/kg in mice and 995 mg/kg in rats. According to classical guidelines, this compound would be considered slightly toxic in both species. Skin application studies in the rabbit demonstrated the compound to be irritating. The eye irritation study disclosed the compound to be a severe irritant causing permanent damage to the cornea (inflammation and scarring resulting in blindness). The sensitization study in the guinea pig did not show ferric acetyl acetonate to be deleterious in this regard.

  6. Decision Support Systems: A Preliminary Study,

    DTIC Science & Technology

    1977-09-01

    goal for data management research is an integrated data system -12- _ _...__ _ _ ... ’ . ENGLISH LOGIC FORMAL DATA LISP OR SUBSET (KOWALSKI LANG FOR...studies are indicated to determine if cannonical forms can be used to make vector operations out of operations like COND (from LISP ). Studies of the...W.W., Boyer, Robert S., and Henneman , William H., (1972), "Computer Proofs of Limits Theorems", A.I. Jour., 3, pp. 27-60. 12. Bledsoe, W.W. and

  7. Recovery of Posture Stability at Different Foot Placements in Patients Who Underwent Minimally Invasive Total Hip Arthroplasty: A One-Year Follow-Up Study

    PubMed Central

    Chang, Chun-Ju; Lin, Na-Ling; Lee, Mel S.; Chern, Jen-Suh

    2015-01-01

    To understand the progression of recovery in postural stability and physical functioning after patients received the minimally invasive total hip arthroplasty (MTHA), we monitor the pain level, functional capacity, and postural stability before and after operation within one year. In total of 23 subjects in our study, we found out that MTHA was effective in relieving pain in first 2 weeks and restoring the hip joint integrity, but the postural stability was influenced especially in tandem stand in both anterior-posterior and medial-lateral directions. The recovery of postural stability and functional capacity in one year duration fluctuated and no consistent improvement tendency was found. We suggested clinicians designing postsurgery rehabilitation program for consistent and progressive long-term recovery of postural stability and fall prevention to optimize surgical results and prevent undesired postoperative consequences. PMID:26583110

  8. The Patient's Perception Does Not Differ Following Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Simultaneous Bilateral Randomized Study.

    PubMed

    Koh, In Jun; Kim, Min Woo; Kim, Man Soo; Jang, Sung Won; Park, Dong Chul; In, Yong

    2016-01-01

    This simultaneous bilateral randomized study investigated whether patients would perceive the difference between the subvastus approach (SVA) and the medial parapatellar approach (MPA) after total knee arthroplasty (TKA). In 50 patients scheduled to undergo same-day bilateral TKA, one knee was randomly assigned to SVA and the other to MPA. Patient-reported measures (pain, Western Ontario McMaster University Osteoarthritis Index score, and side preference) and physician-assessed measures (isokinetic muscle strength, range of motion, and Knee Society score) were compared. No differences were observed in the patient-reported measures and physician-assessed measures, with the exception of greater quadriceps strength at postoperative 1 week in knees that underwent SVA. Patients receiving contemporary perioperative management after same-day bilateral TKA do not perceive any difference between knees that underwent SVA or MPA.

  9. Traumatic Migration of the Bryan Cervical Disc Arthroplasty.

    PubMed

    Wagner, Scott C; Kang, Daniel G; Helgeson, Melvin D

    2016-02-01

    Study Design Case study. Objective To describe a case of dislodgment and migration of the Bryan Cervical Disc (Medtronic Sofamor Danek, Memphis, Tennessee, United States) arthroplasty more than 6 months after implantation secondary to low-energy trauma. Methods The inpatient, outpatient, and radiographic medical records of a patient with traumatic migration of the Bryan Cervical Disc arthroplasty were reviewed. The authors have no relevant disclosures to report. Results A 36-year-old man with chronic left upper extremity radiculopathy underwent uncomplicated Bryan Cervical Disc arthroplasty at C5-C6, with complete resolution of his symptoms. Approximately 6 months after his index procedure, he sustained low-energy trauma to the posterior cervical spine, after being struck by a book falling from a shelf. The injury forced his neck into flexion, and though he did not have recurrence of his radiculopathy symptoms, radiographs demonstrated anterior migration of the arthroplasty device. He underwent revision to anterior cervical diskectomy and fusion. Conclusions Although extremely rare, it is imperative that surgeons consider the potential for failure of osseous integration in patients undergoing cervical disk arthroplasty, even beyond 3 to 6 months postoperatively. This concern is especially relevant to press-fit or milled devices like the Bryan Cervical Disc arthroplasty, which lack direct fixation into adjacent vertebral bodies. We are considering modification of our postoperative protocol to improve protection of the device after implantation, even beyond 3 months postoperatively.

  10. Traumatic Migration of the Bryan Cervical Disc Arthroplasty

    PubMed Central

    Wagner, Scott C.; Kang, Daniel G.; Helgeson, Melvin D.

    2015-01-01

    Study Design Case study. Objective To describe a case of dislodgment and migration of the Bryan Cervical Disc (Medtronic Sofamor Danek, Memphis, Tennessee, United States) arthroplasty more than 6 months after implantation secondary to low-energy trauma. Methods The inpatient, outpatient, and radiographic medical records of a patient with traumatic migration of the Bryan Cervical Disc arthroplasty were reviewed. The authors have no relevant disclosures to report. Results A 36-year-old man with chronic left upper extremity radiculopathy underwent uncomplicated Bryan Cervical Disc arthroplasty at C5–C6, with complete resolution of his symptoms. Approximately 6 months after his index procedure, he sustained low-energy trauma to the posterior cervical spine, after being struck by a book falling from a shelf. The injury forced his neck into flexion, and though he did not have recurrence of his radiculopathy symptoms, radiographs demonstrated anterior migration of the arthroplasty device. He underwent revision to anterior cervical diskectomy and fusion. Conclusions Although extremely rare, it is imperative that surgeons consider the potential for failure of osseous integration in patients undergoing cervical disk arthroplasty, even beyond 3 to 6 months postoperatively. This concern is especially relevant to press-fit or milled devices like the Bryan Cervical Disc arthroplasty, which lack direct fixation into adjacent vertebral bodies. We are considering modification of our postoperative protocol to improve protection of the device after implantation, even beyond 3 months postoperatively. PMID:26835211

  11. Risk factors for persistent and new chronic opioid use in patients undergoing total hip arthroplasty: a retrospective cohort study

    PubMed Central

    Inacio, Maria C S; Hansen, Craig; Pratt, Nicole L; Graves, Stephen E; Roughead, Elizabeth E

    2016-01-01

    Objectives To determine chronic opioid use pre-THA (total hip arthroplasty) and post-THA, and risk factors for persistent or new chronic opioid use post-THA. Design Retrospective cohort study. Setting Australian Government Department of Veterans' Affairs health claims database. Participants 9525 patients who had an elective unilateral THA between 1/01/2001 and 12/31/2012. Primary outcome measure Chronic opioid use. Defined as 90 days of continuous opioid use or 120 days of non-continuous use. Results Pre-THA, 6.2% (n=593) of patients were chronic users, while 5.2% (n=492) were post-THA. Among the 492 postoperative chronic users, 302 (61%) were chronic users pre-THA and post-THA and 190 (39%) became new chronic users after surgery. Risk factors for persistent chronic use were younger age (OR=0.96, 95% CI 0.93 to 0.99/1-year increment), back pain (OR=1.99, 95% CI 1.20 to 3.23), diabetes (OR=3.52, 95% CI 1.05 to 11.8), hypnotics use (OR=2.52, 95% CI 1.48 to 4.30) and higher pre-THA opioid exposure (compared with opioid use for 94–157 days, 157–224 days (OR=3.75, 95% CI 2.28 to 6.18), 225+ days (OR=5.18, 95% CI 2.92 to 9.19). Risk factors for new chronic opioid use post-THA were being a woman (OR=1.40, 95% CI 1.00 to 1.96), back pain (OR=3.90, 95% CI 2.85 to 5.33), depression (OR=1.70, 95% CI 1.20 to 2.41), gastric acid disease (OR=1.62, 95% CI 1.16 to 2.25), migraine (OR=5.11, 95% CI 1.08 to 24.18), liver disease (OR=4.33, 95% CI 1.08 to 17.35), weight loss (OR=2.60, 95% CI 1.06 to 6.39), dementia (OR=2.19, 95% CI 1.04 to 4.61), hyperlipidaemia (OR=1.38, 95% CI 1.00 to 1.91), hypnotics (OR=1.56, 95% CI 1.13 to 2.16) and antineuropathic pain medication use (OR=3.11, 95% CI 2.05 to 4.72). Conclusions Patients undergoing THA are exposed to opioids for long periods of time, putting them at high risk of harm related to opioid use. We identified groups at risk of chronic opioid use, including younger patients and women, as well as modifiable risk factors of

  12. Engineering Technology Education Study. Preliminary Report.

    ERIC Educational Resources Information Center

    American Society for Engineering Education, Washington, DC.

    This is the half-way report of a 2-year study of engineering technology education that began in August 1969. The various sections include: (1) the history, traditions and transitions of engineering technology education; (2) abstracts of 4 important reports of technology education since 1960; (3) recent trends in the field; (4) goals, objectives,…

  13. Preliminary Study of Child's Second Language Acquisition.

    ERIC Educational Resources Information Center

    Yumoto, Kazuko

    1984-01-01

    A naturalistic study looked at the acquisition of English by two Japanese boys, aged 4 and 8 years, during a 2.5-year stay in the United States. Data were collected through observation and transcription of spontaneous speech in daily life. Analysis included a variety of features of language use and of the acquisition process, including attitudes…

  14. Preliminary shuttle structural dynamics modeling design study

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The design and development of a structural dynamics model of the space shuttle are discussed. The model provides for early study of structural dynamics problems, permits evaluation of the accuracy of the structural and hydroelastic analysis methods used on test vehicles, and provides for efficiently evaluating potential cost savings in structural dynamic testing techniques. The discussion is developed around the modes in which major input forces and responses occur and the significant structural details in these modes.

  15. Hybrid cervical disc arthroplasty.

    PubMed

    Tu, Tsung-Hsi; Wu, Jau-Ching; Cheng, Henrich; Mummaneni, Praveen V

    2017-01-01

    For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level. The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3-4 and bulging disc at C5-6. After nonoperative treatment failed, she underwent a single-level ACDF at C3-4 and single-level arthroplasty at C5-6, which successfully relieved her symptoms. No intervention was performed at the normal intervening C4-5 segment. By using ACDF combined with arthroplasty, the authors have avoided a 3-level fusion for this patient and maintained the range of motion of 2 disc levels. The video can be found here: https://youtu.be/OrxcPUBvqLk .

  16. Preliminary study of possible ORELA replacement options

    SciTech Connect

    Olsen, D.K.; Martin, J.A.; Horen, D.J.

    1984-06-01

    Based on two conceptual design studies performed by the LANL Accelerator Technology Division, the possibilities in terms of accelerator systems for replacing ORELA with a more intense Maxwellian-type continuous-energy neutron source are summarized and discussed. The neutron intensities from ORELA are compared with those from existing or potential accelerator systems used for cross-section and condensed-matter studies. The best replacement options seem to involve a spallation source from 200- to 400-MeV protons on an ORELA-like target. Pulsing and intensity desiderata with such a source are discussed which correspond to a spectrum-averaged 100-fold improved figure of merit over ORELA for TOF measurements with only a tenfold increased source strength. Existing accelerator designs seem to be inadequate for such a source. Consequently, two conceptual designs were developed for this study by the LANL Accelerator Technology Division. The first conceptual design is for a 200-MeV large linac capable of accelerating 1.3 A during a macropulse; this linac standing alone could serve as an ORELA replacement source. The second conceptual design is for a much smaller 250-MeV PIGMI linac with a 28-mA macropulse current which feeds a proton accumulator ring and bunch-compressor transport line. This linac-ring-compressor (LIRIC) option would give a more cost-effective neutron source for cross-section measurements, whereas the large linac, or a modified version of it, would give a much simpler system more suitable for expansion. In particular, both conceptual designs would incorporate the present ORELA building and would provide approximately 100-fold improved neutron sources over ORELA for cross-section measurements. The total estimated cost of the LIRIC system would be $43M (1984), whereas the cost of the large linac would be about a factor of two more. 55 references, 11 figures, 19 tables.

  17. Preliminary design study of a baseline MIUS

    NASA Technical Reports Server (NTRS)

    Wolfer, B. M.; Shields, V. E.; Rippey, J. O.; Roberts, H. L.; Wadle, R. C.; Wallin, S. P.; Gill, W. L.; White, E. H.; Monzingo, R.

    1977-01-01

    Results of a conceptual design study to establish a baseline design for a modular integrated utility system (MIUS) are presented. The system concept developed a basis for evaluating possible projects to demonstrate an MIUS. For the baseline study, climate conditions for the Washington, D.C., area were used. The baseline design is for a high density apartment complex of 496 dwelling units with a planned full occupancy of approximately 1200 residents. Environmental considerations and regulations for the MIUS installation are discussed. Detailed cost data for the baseline MIUS are given together with those for design and operating variations under climate conditions typified by Las Vegas, Nevada, Houston, Texas, and Minneapolis, Minnesota. In addition, results of an investigation of size variation effects, for 300 and 1000 unit apartment complexes, are presented. Only conceptual aspects of the design are discussed. Results regarding energy savings and costs are intended only as trend information and for use in relative comparisons. Alternate heating, ventilation, and air conditioning concepts are considered in the appendix.

  18. MIS unicondylar knee arthroplasty: surgical approach and early results.

    PubMed

    Gesell, Mark W; Tria, Alfred J

    2004-11-01

    Unicondylar arthroplasty of the knee has seen a resurgence of interest in the United States. The principles of unicondylar arthroplasty of the knee are different from those for total knee arthroplasty, allowing replacement of only the affected joint compartment with less bone loss. Minimally invasive surgery allows for less soft tissue dissection with the potential for less morbidity. The key question is: will the changes associated with the minimally invasive surgery procedure improve the clinical results of the standard unicondylar arthroplasty of the knee or will the changes make the procedure too difficult and lead to an increasing failure rate? This study reviews the surgical technique and presents the 2 to 4 year results of the minimally invasive unicondylar arthroplasty of the knee 47 knees in 41 patients. The average range of motion increased from 121 degrees -132 degrees . The Knee Society pain score improved from 45-80 and the function score improved from 47-78. Only one knee has been revised. With proper patient selection, minimally invasive unicondylar arthroplasty of the knee allows for results that are at least equal to those of the standard open procedure at 2 to 4 years after the surgery.

  19. Total knee arthroplasty in patients with prior ipsilateral hip fusion.

    PubMed

    Romness, D W; Morrey, B F

    1992-03-01

    Sixteen total knee arthroplasties performed between 1977 and 1985 in 13 patients with prior ipsilateral hip arthrodesis or ankylosis were studied to determine the preferred sequence and long-term follow-up of procedures in this clinical setting. Twelve of 16 underwent fusion takedown and total hip arthroplasty prior to knee replacement. The average age at total knee arthroplasty was 52.7 years and the average time from hip fusion to total knee arthroplasty was 36.3 years. Mean follow-up after total knee arthroplasty was 5.5 years (range, 2.3 to 10 years). The Hospital for Special Surgery knee score increased from a mean of 31.8 preoperatively to 72.2 after surgery. In patients who had conversion of the hip fusion prior to knee replacement, knee scores were 28 before and 72.5 after both procedures. Patients who retained their hip fusion had mean scores of 43.5 and 72.1, respectively. None of the knees has been removed and 14 of 16 had no pain at last follow-up. One had mild pain and one had moderate pain attributed to pes anserine bursitis. Although the numbers are small, this experience reveals that takedown of the fusion with total hip arthroplasty is an effective technique before performing the knee replacement. Though successful in some instances, the experience is too small to show that if hip fusion is in good position, knee replacement without fusion takedown is acceptable.

  20. Preliminary systems design study assessment report

    SciTech Connect

    Mayberry, J.L.; Feizollahi, F.; Del Signore, J.C.

    1991-10-01

    The System Design Study (SDS), part of the Waste Technology Development Department of the Idaho National Engineering Laboratory (INEL), examined techniques available for the remediation of hazardous and transuranic waste stored at the Radioactive Waste Management Complex's Subsurface Disposal Area at the INEL. Using specific technologies, system concepts for treating the buried waste and the surrounding contaminated soil were evaluated. Evaluation included implementability, effectiveness, and cost. The SDS resulted in the development of technology requirements including demonstration, testing, and evaluation activities needed for implementing each concept. The SDS results are published in eight volumes. Volume I contains an executive summary. The SDS summary and analysis of results are presented in Volume II. Volumes III through VII contain descriptions of twelve system and four subsystem concepts. Volume VIII contains the appendixes.

  1. Preliminary Systems Design Study assessment report

    SciTech Connect

    Mayberry, J.L.; Quapp, W.J.; Feizollahi, F.; Del Signore, J.C.

    1991-07-01

    The System Design Study (SDS), part of the Waste Technology Development Department at the Idaho National Engineering Laboratory (INEL), examined techniques available for the remediation of hazardous and transuranic waste stored at the Radioactive Waste Management Complex's Subsurface Disposal Area at the INEL. Using specific technologies, system concepts for treating the buried waste and the surrounding contaminated soil were evaluated. Evaluation included implementability, effectiveness, and cost. SDS resulted in the development of technology requirements including demonstration, testing, and evaluation activities needed for implementing each concept. The SDS results are published in eight volumes. Volume 1 contains an executive summary. The SDS summary and analysis of results are presented in Volume 2. Volumes 3 through 7 contain detailed descriptions of twelve system and four subsystem concepts. Volume 8 contains the appendixes. 23 refs., 23 figs., 16 tabs.

  2. Preliminary study of disc hydrodynamic polishing.

    PubMed

    Li, Yan; Lin, Bin; Zhang, XiaoFeng; Liu, PengFei

    2016-10-01

    In this paper, a developed polishing method based on elastic emission machining and Jules Verne-a variation on fluid jet polishing-is presented. This method is named disc hydrodynamic polishing (DHDP). A computational fluid dynamics (CFD)-based model that consists of a CFD model and an erosion model is introduced to predict the surface roughness obtained by DHDP. The performance of DHDP is studied by experiments. The slurry used in the experiments comprises 95% deionized water and 5% cerium oxide particles. Fused-silica glass is chosen as the workpiece. After the experiments, an ultrasmooth surface without cracks is obtained. The simulation results principally coincide with the experimental results. The experimental results show that the actual roughness is slightly less than the prediction and smaller particles are more favorable for obtaining a better surface roughness.

  3. PRELIMINARY PHYTOCHEMICAL STUDIES ON THE ROOTS OF COCCULUS HIRSUTUS, LINN.

    PubMed Central

    Jain, Sourabh; Lavhale, Manish; Nayak, S.

    2004-01-01

    The roots of Cocculus hirsutus (Linn) Diels was analyzed for preliminary phytochemical studies including physical constant (total ash, acid soluble and insoluble ash and moisture content), extractive values in different solvents (petroleum ether, benzene, chloroform, methanol and water), and phytochemical tests. The plant is well reputed in traditional system of medicine, present studies will help in further validation and standardization of the plant. PMID:22557132

  4. Ceramic Femoral Components in Total Knee Arthroplasty - Two Year Follow-Up Results of an International Prospective Multi-Centre Study

    PubMed Central

    Bergschmidt, Philipp; Bader, Rainer; Ganzer, Dirk; Hauzeur, Christian; Lohmann, Christoph; Rüther, Wolfgang; Tigani, Domenico; Rani, Nicola; Prats, Fernando Lopez; Zorzi, Claudio; Madonna, Vincenzo; Rigotti, Stefano; Benazzo, Francesco; Rossi, Stefano Marco Paolo; Kundt, Guenther; Bloch, Hans Rudolf; Mittelmeier, Wolfram

    2012-01-01

    Background: Total knee arthroplasty can be considered as a reliable surgical procedure with a good long-term clinical result. However, implant failure due to particle induced aseptic loosening as well as the aspect of hypersensitivity to metal ions still remains an emerging issue. Methods: The purpose of this prospective international multi-centre study was to evaluate the clinical and radiological outcomes and the reliability of the unconstrained Multigen Plus Total Knee System with a new BIOLOX® delta ceramic femoral component. Cemented total knee arthroplasty was performed on 108 patients (110 knees) at seven hospitals in three countries. Clinical and radiological evaluations were performed preoperatively, and after 3, 12 and 24 months postoperatively using the HSS-, WOMAC-, SF-36-score and standardised X-rays. Results: The mean preoperative HSS-Score amounted to 55.5 ± 11.5 points and improved significantly in all postoperative evaluations (85.7 ± 11.7 points at 24 months). Furthermore, improvements in WOMAC- and SF-36-score were evaluated as significant at all points of evaluation. Radiolucent lines around the femoral ceramic component at 24 months were found in four cases. Progression of radiolucent lines was not seen and no implant loosening was observed. During the 24 month follow-up eight patients underwent subsequent surgery due to reasons unrelated to the implant material. Conclusions: The observed clinical and radiological results are encouraging for a long-term survival of the ceramic femoral component. Therefore, ceramic implants could be a promising solution not only for patients with allergies against metallic implant materials, but also for the osteoarthritic knee joint. Long-term follow-up is necessary to draw conclusions regarding the superiority of the ceramic knee implants concerning in vivo wear and long-term survivorship. PMID:22582104

  5. Preliminary Photomicrographic Studies of Fuel Sprays

    NASA Technical Reports Server (NTRS)

    Lee, Dana W; Spencer, Robert C

    1932-01-01

    Photomicrographs were taken of fuel sprays injected into air at various densities for the purpose of studying the spray structure and the stages in the atomization of the fuel. The photomicrographs were taken at magnifying powers of 2.5, 3.25, and 10, using a spark discharge of very short duration for illumination. The results indicate that the theory advanced by Dr. R. A. Castleman, Jr., on the atomization of fuel in carburetors may also be applied to the atomization of fuel sprays of the solid-injection type. The fuel leaves the nozzle as a solid column, is ruffled and then torn into small, irregular ligaments by the action of the air. These ligaments are then quickly broken up into drops by the surface tension of the fuel. The photomicrographs also show that the dispersion of a fuel spray at a given distance from the nozzle increases with an increase in the jet velocity or an increase in the air density. The first portions of fuel sprays injected from an automatic injection valve into air at atmospheric density have a much greater dispersion than the later portions, but this difference decreases rapidly as the air density is increased.

  6. Helicopter pilot back pain: a preliminary study.

    PubMed

    Shanahan, D F; Reading, T E

    1984-02-01

    Because of the high prevalence of back pain experienced by U.S. Army helicopter pilots, a study was conducted to ascertain the feasibility of reproducing these symptoms in the laboratory. A mock-up of a UH-1H seat and control configuration was mounted to a multi-axis vibration simulator (MAVS). Eleven subjects were tested on the apparatus for two 120-min periods. During one period, the MAVS was programmed to reproduce vibrations recorded from a UH-1H in cruise flight. The subjects received no vibration during the other test period. All subjects reported back pain which they described as identical to the pain they experience during flight, during one or more of their test periods. There was no statistical difference between the vibration and nonvibration test conditions (p greater than 0.05) in terms of time of onset of pain or intensity of pain as measured by a visual analog scale. It appears the vibration at the frequencies and amplitudes tested plays little or no role in the etiology of the back symptoms reported by these pilots. It is proposed that the primary etiological factor for these symptoms is the poor posture pilots are obliged to assume for extended periods while operating helicopters.

  7. Arthroplasty of a Charcot knee

    PubMed Central

    Babazadeh, Sina; Stoney, James D.; Lim, Keith; Choong, Peter F.M.

    2010-01-01

    The Charcot knee - or neuropathic arthropathy - presents a considerable challenge to the orthopaedic surgeon. Caused by a combination of sensory, motor and autonomic neuropathy, it was originally described as an arthritic sequelae of neurosyphilis. In today's western orthopaedics it is more often caused by diabetes. A Charcot knee is often symptomatically painful and unstable. Traditional management has usually been conservative or arthrodesis, with limited success. Arthroplasty of a Charcot joint has commonly been avoided at all costs. However, in the right patient, using the right technique, arthroplasty can significantly improve the symptoms of a Charcot joint. This article explores the evidence surrounding the role of arthroplasty in the management of a Charcot knee. Arthroplasty is compared to other forms of treatment and specific patient demographics and surgical techniques are explored in an attempt to define the role of arthroplasty in the management of a Charcot knee. PMID:21808708

  8. Does tranexamic acid reduce blood transfusion cost for primary total hip arthroplasty? A case-control study.

    PubMed

    Harris, Ryan N; Moskal, Joseph T; Capps, Susan G

    2015-02-01

    Peri-operative tranexamic acid (TXA) significantly reduces the need for allogeneic blood transfusion in total hip arthroplasty (THA) and thus hospital costs are reduced. Before employing TXA in primary THA at our institution, facility costs were $286.90/THA for blood transfusion and required 0.45 man-hours/THA (transfusion rate 19.87%). After incorporating TXA, the cost for intravenous application was $123.38/THA for blood transfusion and TXA medication and 0.07 man-hours/THA (transfusion rate 4.39%) and the cost for topical application was $132.41/THA for blood transfusion and TXA and 0.14 man-hours/THA (transfusion rate 12.86%). TXA has the potential to reduce the facility cost per THA and the man-hours/THA from blood transfusions.

  9. Template-Directed Instrumentation Reduces Cost and Improves Efficiency for Total Knee Arthroplasty: An Economic Decision Analysis and Pilot Study.

    PubMed

    McLawhorn, Alexander S; Carroll, Kaitlin M; Blevins, Jason L; DeNegre, Scott T; Mayman, David J; Jerabek, Seth A

    2015-10-01

    Template-directed instrumentation (TDI) for total knee arthroplasty (TKA) may streamline operating room (OR) workflow and reduce costs by preselecting implants and minimizing instrument tray burden. A decision model simulated the economics of TDI. Sensitivity analyses determined thresholds for model variables to ensure TDI success. A clinical pilot was reviewed. The accuracy of preoperative templates was validated, and 20 consecutive primary TKAs were performed using TDI. The model determined that preoperative component size estimation should be accurate to ±1 implant size for 50% of TKAs to implement TDI. The pilot showed that preoperative template accuracy exceeded 97%. There were statistically significant improvements in OR turnover time and in-room time for TDI compared to an historical cohort of TKAs. TDI reduces costs and improves OR efficiency.

  10. How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A cadaveric study.

    PubMed

    Koh, In Jun; Kwak, Dai-Soon; Kim, Tae Kyun; Park, In Joo; In, Yong

    2014-12-01

    We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (E group), while the other knee underwent MNP in flexion (F group). The increased extension and 90° flexion gaps after every five needle punctures were measured until over-release occurred. The extension gap (< 4mm) and the 90° flexion gap (< 6mm) gradually increased in both groups. The 90° flexion gaps increased more selectively than did the extension gaps. MNP in the flexed knee, a narrow MCL, and severe osteoarthritis were associated with a smaller number of MNPs required to over-release.

  11. Robot-assisted total knee arthroplasty accurately restores the joint line and mechanical axis. A prospective randomised study.

    PubMed

    Liow, Ming Han Lincoln; Xia, Zhan; Wong, Merng Koon; Tay, Keng Jin; Yeo, Seng Jin; Chin, Pak Lin

    2014-12-01

    Robot-assisted Total Knee Arthroplasty (TKA) improves the accuracy and precision of component implantation and mechanical axis (MA) alignment. Joint-line restoration in robot-assisted TKA is not widely described and joint-line deviation of>5mm results in mid-flexion instability and poor outcomes. We prospectively randomised 60 patients into two groups: 31 patients (robot-assisted), 29 patients (conventional). No MA outliers (>±3° from neutral) or notching was noted in the robot-assisted group as compared with 19.4% (P=0.049) and 10.3% (P=0.238) respectively in the conventional group. The robot-assisted group had 3.23% joint-line outliers (>5mm) as compared to 20.6% in the conventional group (P=0.049). Robot-assisted TKA produces similar short-term clinical outcomes when compared to conventional methods with reduction of MA alignment and joint-line deviation outliers.

  12. Preliminary 2D design study for A&PCT

    SciTech Connect

    Keto, E.; Azevedo, S.; Roberson, P.

    1995-03-01

    Lawrence Livermore National Laboratory is currently designing and constructing a tomographic scanner to obtain the most accurate possible assays of radioactivity in barrels of nuclear waste in a limited amount of time. This study demonstrates a method to explore different designs using laboratory experiments and numerical simulations. In particular, we examine the trade-off between spatial resolution and signal-to-noise. The simulations are conducted in two dimensions as a preliminary study for three dimensional imaging. We find that the optimal design is entirely dependent on the expected source sizes and activities. For nuclear waste barrels, preliminary results indicate that collimators with widths of 1 to 3 inch and aspect ratios of 5:1 to 10:1 should perform well. This type of study will be repeated in 3D in more detail to optimize the final design.

  13. Intra-articular bupivacaine after joint arthroplasty: a systematic review and meta-analysis of randomised placebo-controlled studies

    PubMed Central

    Cui, Yang; Yang, Tuo; Zeng, Chao; Wei, Jie; Xie, Xi; Li, Liangjun; Ding, Xiang; Zhang, Yi; Lei, Guanghua

    2016-01-01

    Objectives To evaluate the efficacy and safety of intra-articular (IA) bupivacaine administered for pain relief after joint arthroplasty. Design Meta-analysis. Methods A systematic review was conducted to identify the randomised controlled trials using IA bupivacaine for postoperative pain relief from MEDLINE, Cochrane Library and EMBASE databases (up to October 2015). The standardised mean difference (SMD), the relative risk (RR) and their corresponding 95% CIs were calculated using the RevMan statistical software. Results A total of 11 randomised controlled trials were included. Statistically significant differences between IA bupivacaine and placebo were observed for the mean visual analogue scale (VAS) values (SMD −0.55; 95% CI −0.89 to −0.22; p<0.001) and narcotic consumption (SMD −0.32; 95% CI −0.55 to −0.08; p=0.008) during the period of 24 hours postoperatively and narcotic consumption during the period between 24 and 48 hours postoperatively (SMD −0.32; 95% CI −0.55 to −0.08; p=0.009). However, there was no significant difference in the mean VAS pain score during the period between 24  and 48 hours postoperatively (SMD −0.09, 95% CI −0.30 to 0.11; p=0.37) and in the incidence of adverse effects 24–72 hours postoperatively (RR 0.97; 95% CI 0.60 to 1.57; p=0.91). Conclusions The administration of IA bupivacaine after joint arthroplasty is effective for pain relief without increasing adverse effects. PMID:27406643

  14. Preliminary study of niobium alloy contamination by transport through helium

    NASA Technical Reports Server (NTRS)

    Scheuermann, C. M.; Moore, T. J.; Wheeler, D. R.

    1987-01-01

    Transport of gaseous contaminants through the working fluid to or from sensitive refractory alloys is theoretically possible during long time operation of Brayton and Stirling space power generation systems which use a gas as the working fluid. A test was designed which could give an answer to whether transport of contaminants through the working fluid was a potential major problem. The findings of that preliminary study are summarized.

  15. Preliminary dose comparisons for the MRS Systems Study

    SciTech Connect

    Pelto, P.J.; Lavender, J.C.

    1989-04-01

    This report provides preliminary information on the radiological doses to the public and the workers for alternative system configurations proposed in the MRS Systems Study. Information published in the MRS Environmental Assessment (DOE 1986) was used as a basis for this analysis. The risk differences between alternative configurations were found to be small and should not be viewed as a major factor in selecting alternative configurations. 1 ref.

  16. Preliminary Study of a Piston Pump for Cryogenic Fluids

    NASA Technical Reports Server (NTRS)

    Biermann, Arnold E.; Kohl, Robert C.

    1959-01-01

    Preliminary data are presented covering the performance of a low-speed, five-cylinder piston pump designed for handling boiling hydrogen. This pump was designed for a flow of 55 gallons per minute at 240 rpm with a discharge pressure of 135 pounds per square inch. Tests were made using JP-4 fuel, liquid nitrogen, and liquid hydrogen. Pump delivery and endurance characteristics were satisfactory for the range of operation covered. In connection with the foregoing pump development, the cavitation characteristics of a preliminary visual model, glass-cylinder pump and of a simple reciprocating disk were studied. Subcooling of approximately 0.60 F was obtained from the cavitation produced by reciprocating a disk in boiling nitrogen and in boiling water. The subcooling obtained in a similar manner with liquid hydrogen was somewhat less.

  17. Arthroplasty in Femoral Head Osteonecrosis

    PubMed Central

    Nam, Dong Cheol; Jung, Kwangyoung

    2014-01-01

    Osteonecrosis of the femoral head is a destructive joint disease requiring early hip arthroplasty. The polyethylene-metal design using a 22-mm femoral head component, introduced by Charnley in 1950, has been widely used for over half a century. Since then, different materials with the capacity to minimize friction between bearing surfaces and various cement or cementless insert fixations have been developed. Although the outcome of second and third generation designs using better bearing materials and technologies has been favorable, less favorable results are seen with total hip arthroplasty in young patients with osteonecrosis. Selection of appropriate materials for hip arthroplasty is important for any potential revisions that might become inevitable due to the limited durability of a prosthetic hip joint. Alternative hip arthroplasties, which include hemiresurfacing arthroplasty and bipolar hemiarthroplasty, have not been found to have acceptable outcomes. Metal-on-metal resurfacing has recently been suggested as a feasible option for young patients with extra physical demands; however, concerns about complications such as hypersensitivity reaction or pseudotumor formation on metal bearings have emerged. To ensure successful long-term outcomes in hip arthroplasty, factors such as insert stabilization and surfaces with less friction are essential. Understanding these aspects in arthroplasty is important to selection of proper materials and to making appropriate decisions for patients with osteonecrosis of the femoral head. PMID:27536561

  18. Cementless total knee arthroplasty

    PubMed Central

    Risitano, Salvatore; Sabatini, Luigi; Giachino, Matteo; Agati, Gabriele; Massè, Alessandro

    2016-01-01

    Interest for uncemented total knee arthroplasty (TKA) has greatly increased in recent years. This technique, less used than cemented knee replacement in the last decades, sees a revival thanks an advance in prosthetic design, instrumentation and operative technique. The related literature in some cases shows conflicting data on survival and on the revision’s rate, but in most cases a success rate comparable to cemented TKA is reported. The optimal fixation in TKA is a subject of debate with the majority of surgeons favouring cemented fixation. PMID:27162779

  19. Early Attempts at Hip Arthroplasty

    PubMed Central

    Gomez, Pablo F; Morcuende, Jose A

    2005-01-01

    Over the last three centuries, treatment of hip arthritides has evolved from rudimentary surgery to modern total hip arthroplasty (THA), which is considered one of the most successful surgical interventions ever developed. We here review the history of the early hip arthroplasty procedures for hip arthritis that preceded Charley total hip arthroplasty. An evaluation of such past enterprises is relevant, and reminds us of the ephemeral nature of human industriousness, and how medical research and procedures are not isolated developments, but correlate to the social, economical, and cultural framework of their time. PMID:16089067

  20. Late deep venous thrombosis and delayed weightbearing after total hip arthroplasty.

    PubMed

    Buehler, K O; D'Lima, D D; Petersilge, W J; Colwell, C W; Walker, R H

    1999-04-01

    One hundred ninety-nine patients who underwent primary total hip arthroplasty and used in hospital pneumatic compression stockings and aspirin as thromboembolic prophylaxis were screened for deep venous thrombosis using duplex ultrasonography on the fourth postoperative day. Of the initial 98 patients, 21 underwent noncemented arthroplasty, maintained touchdown weightbearing for 6 weeks after surgery, and then began progressive partial weightbearing. Of the subsequent 101 patients, 28 underwent noncemented arthroplasty and began progressive weightbearing immediately after surgery. All other patients underwent hybrid arthroplasty and began weightbearing to tolerance immediately after surgery. After duplex screening examination, patients with proximal deep venous thrombosis were given anticoagulation therapy, and patients with negative study results were observed clinically. The relative risk of proximal deep venous thrombosis after noncemented arthroplasty using delayed weightbearing was compared with that after noncemented arthroplasty using immediate progressive weightbearing. Of patients with noncemented arthroplasty, the prevalence of proximal deep venous thrombosis was significantly lower in those using progressive weightbearing immediately after surgery (none) than in those using delayed weightbearing rehabilitation (19%). This study showed that patients undergoing noncemented total hip arthroplasty with delayed weightbearing rehabilitation risk greater potential for deep venous thrombosis after hospital discharge. This study suggests consideration for continued thromboembolic prophylaxis or routine deep venous thrombosis surveillance, or both measures, after hospital discharge, unless more rapid progression of weightbearing is allowed.

  1. Preliminary Study for a Tetrahedron Formation: Quality Factors and Visualization

    NASA Technical Reports Server (NTRS)

    Guzman, Jose J.; Schiff, Conrad; Bauer, Frank (Technical Monitor)

    2002-01-01

    Spacecraft flying in tetrahedron formations are excellent for electromagnetic and plasma studies. The quality of the science recorded is strongly affected by the tetrahedron evolution. This paper is a preliminary study on the computation of quality factors and visualization for a formation of four or five satellites. Four of the satellites are arranged geometrically in a tetrahedron shape. If a fifth satellite is present, it is arbitrarily initialized at the geometric center of the tetrahedron. The fifth satellite could act as a collector or as a spare spacecraft. Tetrahedron natural coordinates are employed for the initialization. The natural orbit evolution is visualized in geocentric equatorial inertial and in geocentric solar magnetospheric coordinates.

  2. Design and cadaveric validation of a novel device to quantify knee stability during total knee arthroplasty.

    PubMed

    Siston, Robert A; Maack, Thomas L; Hutter, Erin E; Beal, Matthew D; Chaudhari, Ajit M W

    2012-11-01

    The success of total knee arthroplasty depends, in part, on the ability of the surgeon to properly manage the soft tissues surrounding the joint, but an objective definition as to what constitutes acceptable postoperative joint stability does not exist. Such a definition may not exist due to lack of suitable instrumentation, as joint stability is currently assessed by visual inspection while the surgeon manipulates the joint. Having the ability to accurately and precisely measure knee stability at the time of surgery represents a key requirement in the process of objectively defining acceptable joint stability. Therefore, we created a novel sterilizable device to allow surgeons to measure varus-valgus, internal-external, or anterior-posterior stability of the knee during a total knee arthroplasty. The device can be quickly adjusted between 0 deg and 90 deg of knee flexion. The device interfaces with a custom surgical navigation system, which records the resultant rotations or translations of the knee while the surgeon applies known loads to a patient's limb with a handle instrumented with a load cell. We validated the performance of the device by having volunteers use it to apply loads to a mechanical linkage that simulated a knee joint; we then compared the joint moments calculated by our stability device against those recorded by a load cell in the simulated knee joint. Validation of the device showed low mean errors (less than 0.21 ± 1.38 Nm and 0.98 ± 3.93 N) and low RMS errors (less than 1.5 Nm and 5 N). Preliminary studies from total knee arthroplasties performed on ten cadaveric specimens also demonstrate the utility of our new device. Eventually, the use of this device may help determine how intra-operative knee stability relates to postoperative function and could lead to an objective definition of knee stability and more efficacious surgical techniques.

  3. In vivo knee kinematics in patients with bilateral total knee arthroplasty of 2 designs.

    PubMed

    Okamoto, Nobukazu; Breslauer, Leigh; Hedley, Anthony K; Mizuta, Hiroshi; Banks, Scott A

    2011-09-01

    Many younger and highly active patients desire to achieve high flexion after total knee arthroplasty. This study's purpose was to determine if a contemporary total knee arthroplasty design improved functional knee flexion compared with a traditional total knee arthroplasty in patients living a Western lifestyle. Ten patients with bilateral total knee arthroplasty of 2 types were studied during weight-bearing lunge, kneeling, and stair activities using fluoroscopic imaging. There were no differences in maximum knee flexion during lunging or kneeling. Statistically significant differences in tibial rotation and condylar translation were observed during the 3 activities. Although several joint kinematic differences were observed, no important functional differences were observed in clinically excellent, high performing subjects with bilateral total knee arthroplasty of 2 types.

  4. Lunate implant arthroplasty. Evaluation of 19 patients.

    PubMed

    Eiken, O; Necking, L E

    1984-01-01

    The results of lunate implant arthroplasty are unpredictable and many untoward postoperative problems are encountered. A retrospective review of 19 patients operated on for lunatomalacia (Kienböck's disease) by Silastic (HP) implant arthroplasty suggests that prevention of postoperative scapholunate dissociation seems to be the key to successful results. Knowledge of the predominant role played by the palmar ulnolunate and radiolunate ligaments is important to the understanding of this mechanism. The intrinsic stability accomplished by the geometry of the carpal bones requires adequate ligamentous support. This restraint, however, may be weakened by pre-existing absence of certain palmar fibres, by the disease process or by the surgery. In the present study three operative methods have been assessed: dorsal approach and implant stem fixation; dorsal approach, removal of implant stem and Kirschner-wire fixation; volar approach, removal of implant stem, no internal fixation but palmar capsuloligamentous reinforcement. Consistently good results have been obtained using the latter technique. It seems as if most of the usual postoperative problems of lunate implant arthroplasty can be avoided by this method which warrants continued trial.

  5. Periprosthetic fractures around total knee arthroplasty

    PubMed Central

    Sarmah, SS; Patel, S; Reading, G; El-Husseiny, M; Douglas, S; Haddad, FS

    2012-01-01

    INTRODUCTION The number of total knee arthroplasties performed continues to rise annually and it would be expected that complications, which include periprosthetic fractures, will also therefore become more commonplace. This article reviews the current literature regarding this injury and identifies the treatment principles that enable patients to regain optimal function. METHODS A comprehensive search of the Pubmed and Embase™ databases was performed to identify relevant articles. Keywords and MeSH (Medical Subject Headings) terms included in the search strategy were ‘periprosthetic fracture(s)’, ‘femur’, ‘tibia’, ‘patella(r)’, ‘complication(s)’, ‘failure(s)’, ‘risk(s)’, ‘prevalence’, ‘incidence’, ‘epidemiology’ and ‘classification(s)’. The search was limited to all articles published in English and reference lists from the original articles were reviewed to identify pertinent articles to include in this review. A total number of 43 studies were identified. RESULTS Common treatment aims have been identified when managing patients with a periprosthetic fracture around total knee arthoplasty. The main criterion that determines which option to choose is the degree of remaining bone stock and the amount of fracture displacement. CONCLUSIONS Treatment of a periprosthetic fracture around total knee arthroplasty will either be non-operative, osteosynthesis or revision arthroplasty. It is imperative that a suitable option is chosen and based on the published literature, pathways are outlined to aid the surgeon. PMID:22943223

  6. Constraint choice in revision knee arthroplasty: study protocol of a randomised controlled trial assessing the effect of level of constraint on postoperative outcome

    PubMed Central

    Hommel, Hagen; Wilke, Kai; Kunze, Daniel; Hommel, Peggy

    2017-01-01

    Introduction The proper management of total knee arthroplasty (TKA) in patients with severe deformities regarding the preferable prosthetic design and the required amount of constraint is a controversial subject. In the absence of any high-level clinical evidence, we designed a randomised clinical trial to investigate if rotating hinged (RTH) and constrained condylar knee (CCK) designs yield similar outcomes. Methods and analysis This study is a multicentre, randomised clinical trial including two groups of 85 patients. Patients will be randomised to a CCK knee design group or an RTH knee design group. Patients will be followed for 2 years. The study will be designed as an equivalence trial. The primary study outcome will be the postoperative functional outcome as measured by the self-administered Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes will be postoperative joint awareness during various activities of daily living as measured by the Forgotten Joint Score-12, the Knee Society Score, along with the incidence and location of radiolucent lines using the Knee Society TKA radiographic evaluation system. Ethics and dissemination This study is approved by the ethics committee of the Landesärztekammer Brandenburg ((S 10(a)/2013) from 27.08.2013, amended on 25.04.2016) and will be conducted according to the principles of the World Medical Association Declaration of Helsinki and the ISO14155:2011. Trial registration number DRKS00010539. PMID:28348182

  7. Biocontamination Control for Spacesuit Garments - A Preliminary Study

    NASA Technical Reports Server (NTRS)

    Rhodes, Richard A.; Orndoff, Evelyne; Korona, F. Adam; Poritz, Darwin; Smith, Jelanie; Wong, Wing

    2011-01-01

    This paper outlines a preliminary study that was conducted to review, test, and improve on current space suit biocontamination control. Biocontamination from crew members can cause space suit damage and objectionable odors and lead to crew member health hazards. An understanding of the level of biocontamination is necessary to mitigate its effects. A series of tests were conducted with the intent of evaluating current suit materials, ground and on-orbit disinfectants, and potential commercial off-the-shelf antimicrobial materials. Included in this paper is a discussion of the test methodology, results, and analysis method.

  8. The lived experience of mothering after prison: the preliminary study.

    PubMed

    Hayes, Margaret O

    2008-01-01

    The purpose of this interpretive phenomenological preliminary study was to gain a better understanding of the experience of mothering after prison. In-depth interviewing was conducted with two participants for a period of 4 months after their release from prison. All interviews were focused on the research question, "What has been your experience of mothering since your release from prison?" Data were analyzed using thematic analysis. The following four themes emerged: "always the mother,"separation anxiety,"new demands: divided loyalties," and "the honeymoon is over."

  9. Energy efficient engine: Preliminary design and integration studies

    NASA Technical Reports Server (NTRS)

    Johnston, R. P.; Hirschkron, R.; Koch, C. C.; Neitzel, R. E.; Vinson, P. W.

    1978-01-01

    Parametric design and mission evaluations of advanced turbofan configurations were conducted for future transport aircraft application. Economics, environmental suitability and fuel efficiency were investigated and compared with goals set by NASA. Of the candidate engines which included mixed- and separate-flow, direct-drive and geared configurations, an advanced mixed-flow direct-drive configuration was selected for further design and evaluation. All goals were judged to have been met except the acoustic goal. Also conducted was a performance risk analysis and a preliminary aerodynamic design of the 10 stage 23:1 pressure ratio compressor used in the study engines.

  10. Experimental Studies of Ion Beam Neutralization: Preliminary Results

    SciTech Connect

    Ding, N.; Polansky, J.; Downey, R.; Wang, J.

    2011-05-20

    A testing platform is designed to study ion beam neutralization in the mesothermal, collisionless region. In the experimental setup, argon neutrals were ionized in a microwave cavity and accelerated by a plasma lens system which was biased to 2500 V above the system ground. Electrons were boiled off from two hot tungsten filaments to neutralize the ion beam. The plasma is diagnosed using Langmuir probe and Faraday probe. A 3-D traversing system and a complete data acquisition loop were developed to efficiently measure 3-D beam profile. Preliminary measurements of beam profiles are presented for different operating conditions.

  11. Preliminary Study of a Pull Plug Friction Weld

    NASA Technical Reports Server (NTRS)

    Buchanan, George R.

    1999-01-01

    A pull plug friction weld, simply defined, comprises inserting a rotating cone-shaped cylinder into a somewhat cone-shaped hole in a plate. The rotating plug makes contact with the edge of the plate and the resulting friction generates heat. The temperature of the plate material eventually reaches a magnitude that will cause the plate material at the edge of the hole to flow. This can be termed a temperature dependent plastic flow. The rotation of the plug is terminated, additional pressure is applied and the metal at the interface of the two materials cools and welding occurs. This preliminary study addresses only three aspects of a complete analysis that is multi-faceted. The transient temperature distribution for different pull plug configurations has been studied in some detail even though the initial conditions and boundary conditions may still be deemed tentative. The stress distribution within the pull plug caused by the heating pressure was studied along with a preliminary analysis of the thermoelastic stress distribution caused by friction heating. There are no definitive results for the stress analysis. Additional study will be required.

  12. Arthroplasty Utilization in the United States is Predicted by Age-Specific Population Groups.

    PubMed

    Bashinskaya, Bronislava; Zimmerman, Ryan M; Walcott, Brian P; Antoci, Valentin

    2012-01-01

    Osteoarthritis is a common indication for hip and knee arthroplasty. An accurate assessment of current trends in healthcare utilization as they relate to arthroplasty may predict the needs of a growing elderly population in the United States. First, incidence data was queried from the United States Nationwide Inpatient Sample from 1993 to 2009. Patients undergoing total knee and hip arthroplasty were identified. Then, the United States Census Bureau was queried for population data from the same study period as well as to provide future projections. Arthroplasty followed linear regression models with the population group >64 years in both hip and knee groups. Projections for procedure incidence in the year 2050 based on these models were calculated to be 1,859,553 cases (hip) and 4,174,554 cases (knee). The need for hip and knee arthroplasty is expected to grow significantly in the upcoming years, given population growth predictions.

  13. Descriptive Epidemiology of Patients Undergoing Total Hip Arthroplasty in Korea with Focus on Incidence of Femoroacetabular Impingement: Single Center Study

    PubMed Central

    2017-01-01

    We analyzed the causes leading to total hip arthroplasty (THA), aimed to clarify the incidence of femoroacetabular impingement (FAI) among the causes, and compared the incidence in Korea with those in other countries. From January 2000 to December 2014, 1,206 hips of 818 patients who underwent primary THA at our institute were reviewed retrospectively in terms of radiographs and electronic charts. The radiographs and radiographic parameters were reviewed and measured by 2 of the authors, who are orthopedic surgeons. Patients were categorized in terms of the causes leading to THA as primary osteoarthritis (OA), rheumatoid arthritis (RA), posttraumatic arthritis, post infectious arthritis, avascular necrosis (AVN) of the femoral head, fracture of the femoral head or neck, ankylosing spondylitis (AS), developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), FAI, and others. There were 32 patients (3.91%) in the primary OA group, 41 (5.01%) in the RA group, 84 (10.27%) in the posttraumatic arthritis group, 39 (4.77%) in the post infectious arthritis group, 365 (44.62%) in the AVN group, 39 (4.77%) in the fracture group, 21 (2.57%) in the AS group, 52 (6.36%) in the DDH group, 71 (8.68%) in the LCPD group, 52 (6.36%) in the FAI group, and 22 (2.69%) in the ‘other’ group. The causes leading to THA in Korea differ from those in Western countries. FAI could be causes of severe secondary OA that requires THA in Korea, therefore symptomatic FAI should not be neglected. PMID:28244282

  14. Scapular neck length and implications for reverse total shoulder arthroplasty: An anatomic study of 442 cadaveric specimens

    PubMed Central

    Fortun, Chad M.; Streit, Jonathan J.; Horton, Steven A.; Muh, Stephanie J.; Gillespie, Robert J.; Gobezie, Reuben

    2015-01-01

    Purpose: Reverse total shoulder arthroplasty (RTSA) may be used to treat a variety of pathologic shoulder conditions, but complications such as scapular notching continue raise concerns. Variable anatomy surrounding the glenoid may have implications for future RTSA design, but at present the anatomy of the scapular neck in the human population has not been clearly defined. Materials and Methods: 442 human scapulae from the Hamann-Todd Osteological Collection were measured for scapular neck length (SNL) and scapular neck angle (SNA). SNL was defined as the distance from the most lateral portion of the infraglenoid tubercle to the most inferolateral portion of the glenoid fossa. The SNA was measured according to Gerber et al. previously. The mean, standard deviation and ranges for SNL and SNA were calculated and compared based on sex and race, and interobserver variability was calculated. Results: The mean SNL was 1.06 cm ± 0.33 cm (0.37-2.43 cm). Males demonstrated a larger SNL (1.08 cm ± 0.33 cm) than females (1.01 cm ± 0.32 cm) (P < 0.12), and Caucasians (1.09 cm ± 0.33 cm) demonstrated a significantly larger SNL than African-Americans (1.00 cm ± 0.32) (P < 0.01). The mean SNA was 106.7° ± 11.0° (76.9-139.4°). No significant correlation was found between SNL and SNA (Pearson Correlation Coefficient = 0.018) (P < 0.702). Conclusion: Scapular neck length and SNA vary widely within the population but there appears to be a tendency towards increased SNL in males and Caucasians. Clinical Relevance: The anatomy of the scapular neck may have significant implications for RTSA design, surgical planning, and reduction of associated complications. PMID:25937712

  15. Radiolucent lines in low-contact-stress mobile-bearing total knee arthroplasty: a blinded and matched case control study

    PubMed Central

    2011-01-01

    Background Low-contact-stress (LCS) mobile-bearing total knee arthroplasty (TKA) (Johnson & Johnson, New Brunswick, NJ; previously: DePuy, Warsawa, USA) provides excellent functional results and wear rates in long-term follow-up analyses. Radiological analysis shows radiolucent lines (RLL) appearing immediately or two years after primary implantation, indicative of poor seat. Investigations proved RLL to be more frequent in uncemented TKA, resulting in a consensus to cement the tibial plateau, but their association with clinical findings and patients discomfort and knee pain is still unknown. Methods 553 patients with 566 low-contact-stress (LCS) total knee prostheses were screened for continuous moderate knee pain. We compared tibial stress shielding classified by Ewald in patients suffering from pain with a matched, pain-free control group on blinded X-rays. We hypothesized a positive correlation between pain and radiolucency and higher frequency of such radiolucent lines in the most medial and most lateral zones of the tibial plateau. Results Twenty-eight patients suffered from knee pain in total. Radiolucencies were detected in 27 of these cases and in six out of 28 matched controls without knee pain. We could demonstrate a significant correlation of knee pain and radiolucencies, which appeared significantly more frequently in the outermost zones of the tibial plateau. Conclusion Our findings suggest that radiolucent lines, representing poor implant seat, about the tibial plateau are associated with knee pain in LCS patients. Radiolucencies are observed more often in noncemented LCS, and cementing the tibial plateau might improve implant seat and reduce both radiolucent lines and associated knee pain. PMID:21714916

  16. Preliminary design study of the TMT Telescope structure system: overview

    NASA Astrophysics Data System (ADS)

    Usuda, Tomonori; Ezaki, Yutaka; Kawaguchi, Noboru; Nagae, Kazuhiro; Kato, Atsushi; Takaki, Junji; Hirano, Masaki; Hattori, Tomoya; Tabata, Masaki; Horiuchi, Yasushi; Saruta, Yusuke; Sofuku, Satoru; Itoh, Noboru; Oshima, Takeharu; Takanezawa, Takashi; Endo, Makoto; Inatani, Junji; Iye, Masanori; Sadjadpour, Amir; Sirota, Mark; Roberts, Scott; Stepp, Larry

    2014-07-01

    We present an overview of the preliminary design of the Telescope Structure System (STR) of Thirty Meter Telescope (TMT). NAOJ was given responsibility for the TMT STR in early 2012 and engaged Mitsubishi Electric Corporation (MELCO) to take over the preliminary design work. MELCO performed a comprehensive preliminary design study in 2012 and 2013 and the design successfully passed its Preliminary Design Review (PDR) in November 2013 and April 2014. Design optimizations were pursued to better meet the design requirements and improvements were made in the designs of many of the telescope subsystems as follows: 1. 6-legged Top End configuration to support secondary mirror (M2) in order to reduce deformation of the Top End and to keep the same 4% blockage of the full aperture as the previous STR design. 2. "Double Lower Tube" of the elevation (EL) structure to reduce the required stroke of the primary mirror (M1) actuators to compensate the primary mirror cell (M1 Cell) deformation caused during the EL angle change in accordance with the requirements. 3. M1 Segment Handling System (SHS) to be able to make removing and installing 10 Mirror Segment Assemblies per day safely and with ease over M1 area where access of personnel is extremely difficult. This requires semi-automatic sequence operation and a robotic Segment Lifting Fixture (SLF) designed based on the Compliance Control System, developed for controlling industrial robots, with a mechanism to enable precise control within the six degrees of freedom of position control. 4. CO2 snow cleaning system to clean M1 every few weeks that is similar to the mechanical system that has been used at Subaru Telescope. 5. Seismic isolation and restraint systems with respect to safety; the maximum acceleration allowed for M1, M2, tertiary mirror (M3), LGSF, and science instruments in 1,000 year return period earthquakes are defined in the requirements. The Seismic requirements apply to any EL angle, regardless of the

  17. The minimal invasive direct anterior approach in combination with large heads in total hip arthroplasty - is dislocation still a major issue? a case control study

    PubMed Central

    2014-01-01

    Background There have been increasing numbers of publications in recent years on minimally invasive surgery (MIS) for total hip arthroplasty (THA), reporting results with the use of different head sizes, tribologic and functional outcomes. This study presents the results and early complication rates after THA using the direct anterior approach (DAA) in combination with head sizes ≥ 36 mm. Methods A total of 113 patients with THA were included in the study. The Harris Hip Score (HHS) was determined, a radiographic evaluation was carried out, and complications were recorded. The minimum follow-up period was 2 years (means 35 ± 7 months). Results The HHS improved from 43.6 (± 12) to 88.2 (± 14; P < 0.01). One early infection occurred, one periprosthetic fracture, and three cases of aseptic stem loosening. No incorrect positioning of the implants was observed, and there were no dislocations. Conclusion THA with the minimally invasive DAA in combination with large heads is associated with good to very good functional results in the majority of cases. The complication rates are not increased. The rate of dislocation mainly as an complication of the first two years can be markedly reduced in particular. PMID:24621189

  18. Relationship between self-reported pain sensitivity and pain after total knee arthroplasty: a prospective study of 71 patients 8 weeks after a standardized fast-track program

    PubMed Central

    Valeberg, Berit T; Høvik, Lise H; Gjeilo, Kari H

    2016-01-01

    Background and purpose This was a prospective cohort study assessing data from 71 adult patients undergoing total knee arthroplasty (TKA) following a standardized fast-track program between January and July 2013. The objective was to examine the relationship between self-rated pain sensitivity, as measured by the Pain Sensitivity Questionnaire (PSQ), and postoperative pain after TKA. Methods The baseline questionnaires, PSQ and Brief Pain Inventory, were given to the patients for self-administration at the presurgical evaluation (1–2 weeks prior to surgery). The follow-up questionnaire, Brief Pain Inventory, was administered at the first follow-up, 8 weeks after surgery. Results A statistically significant association was found between average preoperative pain and average pain 8 weeks after surgery (P=0.001). The PSQ-minor was statistically significantly associated with average pain only for patients younger than 70 years (P=0.03). Interpretation This is the first study to examine the relationship between pain sensitivity measured by PSQ and postoperative pain in patients after TKA. We found that a lower score on the PSQ-minor was statistically significantly associated with patients’ pain 8 weeks after TKA surgery, but only for younger patients. Further research is needed to explore whether the PSQ could be a useful screening tool for patients’ pain sensitivity in clinical settings. PMID:27660489

  19. Uncemented total hip arthroplasty in osteoarthritis of hip secondary to low and high dislocated hips: A mid-term follow-up study

    PubMed Central

    Munigangaiah, Sudarshan; O’Dwyer, Sinead; Masterson, Eric

    2016-01-01

    Background: Performing successful total hip replacement (THR) in dysplastic, subluxed, and dislocated hip is a challenging task. Here, we assessed midterm clinical and radiological outcomes of uncemented total hip arthroplasty in osteoarthritis (OA) of hip secondary to Hartofilakidis low and high-dislocated hips with a mean follow-up of 8.8 years. Materials and Methods: A retrospective study of prospectively collected data was designed involving all consecutive patients who underwent uncemented THR for OA of hip secondary to developmental dysplasia of the hip and Grade II or Grade III Hartofilakidis classification. Results: Thirty-two patients underwent 45 THR, with 23 Grade II (low dislocation) and 22 Grade III (high-dislocation) of Hartofilakidis classification. Thirteen patients had bilateral hip replacements, 19 patients had unilateral THR. There was highly statistically significant difference between preoperative and postoperative HHS and SF-36v2™ at each follow-up. Survivorship of original implant was 98.88% at a mean follow-up of 8.8 years. The mean improvement in leg length in this series was 3.6 cm (1.8-4.5, 95% confidence interval). No sciatic nerve or femoral nerve palsies were observed. Conclusions: Uncemented THR provides better function and quality of life. However, longer follow-up studies are needed to assess survivorship of uncemented THR in Hartofilakidis low and high-dislocations. PMID:27433063

  20. Tissue sparing total femoral arthroplasty: technical note.

    PubMed

    Willimon, Samuel Clifton; Bolognesi, Michael P; Attarian, David E

    2011-01-01

    It is predicted that the number of revision hip and knee arthroplasties will double by the years 2026 and 2015, respectively. As the burden of end-stage prosthetic disease increases, there will be a greater potential need for total femoral arthroplasty. This report describes a patient with a femoral neck fracture nonunion with an ipsilateral multiply revised failed total knee arthroplasty treated by a tissue sparing total femoral arthroplasty. The technique is described, and potential benefits are reviewed.

  1. Algorithm of physical therapy exercises following total hip arthroplasty.

    PubMed

    Stryła, Wanda; Pogorzała, Adam M; Rogala, Piotr; Nowakowski, Andrzej

    2013-01-09

    Authors present a set of exercises for patients after total hip replacement (THR) treated due to idiopathic hip joint osteoarthritis. Outcome of surgical treatment depends largely on physical therapy conducted after the procedure. Physical therapy following total hip arthroplasty involves restoration of proper physical function. Exercises increase the strength of hip girdle muscles and stabilize the involved hip joint. Total postoperative rehabilitation improves the gait esthetics. Restoring patient's full independence in everyday and professional life after total hip arthroplasty is the best test for properly conducted rehabilitation. A rehabilitation algorithm following hip arthroplasty was established based on the data acquired from literature and authors' own studies. Methods of rehabilitation following total arthroplasty was unified with regard to the type of endoprosthesis (cemented and non-cemented). Rehabilitation after revision and cancer arthroplasties were not taken into consideration. Exercises were divided into those performed in supine and standing positions as well as resistance training (using an elastic TheraBand® tape). At a later stage of rehabilitation, marching and walking as well as cycloergometer training were included. Patient's position during the day and in the sleep for two months following THR was taken into account, including some types of exercises that are contraindicated and pose a threat of endoprosthesis luxation.

  2. Preliminary design study of advanced multistage axial flow core compressors

    NASA Technical Reports Server (NTRS)

    Wisler, D. C.; Koch, C. C.; Smith, L. H., Jr.

    1977-01-01

    A preliminary design study was conducted to identify an advanced core compressor for use in new high-bypass-ratio turbofan engines to be introduced into commercial service in the 1980's. An evaluation of anticipated compressor and related component 1985 state-of-the-art technology was conducted. A parametric screening study covering a large number of compressor designs was conducted to determine the influence of the major compressor design features on efficiency, weight, cost, blade life, aircraft direct operating cost, and fuel usage. The trends observed in the parametric screening study were used to develop three high-efficiency, high-economic-payoff compressor designs. These three compressors were studied in greater detail to better evaluate their aerodynamic and mechanical feasibility.

  3. R&D Requirements, RF Gun Mode Studies, FEL-2 Steady-StateStudies, Preliminary FEL-1 Time-Dependent Studies, and Preliminary LayoutOption Investigation

    SciTech Connect

    Byrd, John; Corlett, John; Doolittle, Larry; Fawley, William; Lidia, Steven; Penn, Gregory; Ratti, Alex; Staples, John; Wilcox Russell; Wurtele, Jonathan; Zholents, Alexander

    2005-10-01

    This report constitutes the third deliverable of LBNLs contracted role in the FERMI {at} Elettra Technical Optimization study. It describes proposed R&D activities for the baseline design of the Technical Optimization Study, initial studies of the RF gun mode-coupling and potential effects on beam dynamics, steady-state studies of FEL-2 performance to 10 nm, preliminary studies of time-dependent FEL-1 performance using electron bunch distribution from the start-to-end studies, and a preliminary investigation of a configuration with FEL sinclined at a small angle from the line of the linac.

  4. Nevada potential repository preliminary transportation strategy Study 2. Volume 1

    SciTech Connect

    1996-02-01

    The objectives of this study were to build on the findings of the Nevada Potential Repository Preliminary Transportation Strategy Study 1 (CRWMS M&O 1995b), and to provide additional information for input to the repository environmental impact statement (EIS) process. In addition, this study supported the future selection of a preferred rail corridor and/or heavy haul route based on defensible data, methods, and analyses. Study research did not consider proposed legislation. Planning was conducted according to the Civilian Radioactive Waste Management Program Plan (DOE 1994a). The specific objectives of Study 2 were to: eliminate or reduce data gaps, inconsistencies, and uncertainties, and strengthen the analysis performed in Study 1; develop a preliminary list of rail route evaluation criteria that could be used to solicit input from stakeholders during scoping meetings. The evaluation criteria will be revised based on comments received during scoping; restrict and refine the width of the four rail corridors identified in Study 1 to five miles or less, based on land use constraints and engineering criteria identified and established in Study 2; evaluate national-level effects of routing spent nuclear fuel and high-level waste to the four identified branch lines, including the effects of routing through or avoiding Las Vegas; continue to gather published land use information and environmental data to support the repository EIS; continue to evaluate heavy haul truck transport over three existing routes as an alternative to rail and provide sufficient information to support the repository EIS process; and evaluate secondary uses for rail (passenger use, repository construction, shared use).

  5. Arthroscopic bursectomy for recalcitrant trochanteric bursitis after hip arthroplasty.

    PubMed

    Van Hofwegen, Christopher; Baker, Champ L; Savory, Carlton G; Baker, Champ L

    2013-01-01

    This study evaluated the use of arthroscopic bursectomy for pain relief in patients with trochanteric bursitis after hip arthroplasty. In this retrospective case series of 12 patients undergoing arthroscopic treatment of recalcitrant trochanteric bursitis after hip arthroplasty, outcomes were assessed via phone interview with a numeric pain rating scale from 1 to 10 and were compared with preoperative pain ratings. Patients were asked the percentage of time they had painless hip function and whether they would have the surgery again. At an average 36-month follow-up (range, 4-85 months), the average numeric pain scale rating improved from 9.3 to 3.3. At an average of 62% of the time, patients had painless use of the hip. Ten of 12 patients in the study felt the pain relief gained was substantial enough to warrant having procedure again. In these patients, arthroscopic bursectomy was a viable option for patients with recalcitrant bursitis after hip arthroplasty.

  6. Bacterial Findings in Infected Hip Joint Replacements in Patients with Rheumatoid Arthritis and Osteoarthritis: A Study of 318 Revisions for Infection Reported to the Norwegian Arthroplasty Register

    PubMed Central

    Schrama, J. C.; Lutro, O.; Langvatn, H.; Hallan, G.; Espehaug, B.; Sjursen, H.; Engesaeter, L. B.; Fevang, B.-T.

    2012-01-01

    High rates of Staphylococcus aureus are reported in prosthetic joint infection (PJI) in rheumatoid arthritis (RA). RA patients are considered to have a high risk of infection with bacteria of potentially oral or dental origin. One thousand four hundred forty-three revisions for infection were reported to the Norwegian Arthroplasty Register (NAR) from 1987 to 2007. For this study 269 infection episodes in 255 OA patients served as control group. In the NAR we identified 49 infection episodes in 37 RA patients from 1987 to 2009. The RA patients were, on average, 10 years younger than the OA patients and there were more females (70% versus 54%). We found no differences in the bacterial findings in RA and OA. A tendency towards a higher frequency of Staphylococcus aureus (18% versus 11%) causing PJI was found in the RA patients compared to OA. There were no bacteria of potential odontogenic origin found in the RA patients, while we found 4% in OA. The bacteria identified in revisions for infection in THRs in patients with RA did not significantly differ from those in OA. Bacteria of oral or dental origin were not found in infected hip joint replacements in RA. PMID:24977078

  7. Are Western Knee Designs Dimensionally Correct for Korean Women? A Morphometric Study of Resected Femoral Surfaces during Primary Total Knee Arthroplasty

    PubMed Central

    Lyu, Suk-Joo; Kang, Hyung Wook

    2016-01-01

    Background The purpose of this study was to determine the shape of the distal femur of Korean women compared with the prostheses currently available in Korea. Methods Morphometric data (5 parameters) were measured in 356 resected femurs of Korean women undergoing primary total knee arthroplasty (TKA) utilizing the LCS knee implant (DePuy). The data were then compared with 5 additional contemporary TKA implant systems. Results Implant designs based on Caucasian population data do not ideally match the distal femoral morphology of Korean women. Overhang at the anterior mediolateral width was observed in 84.8% for the LCS while a gender-specific implant resulted in undercoverage of the bone in 86%. Posterior overhang was observed in up to 51.2%. Most implant designs have a narrower intercondylar notch than the morphologic data of Korean women. Conclusions Since there is some difference between the shape of distal femur of Korean women and that of the implants, surgeons should have this in mind when selecting an implant for a patient. These data may also be used as a guideline for future prosthetic design options for Korean women population. PMID:27583107

  8. Tranexamic acid reduces blood loss and need of blood transfusion in total knee arthroplasty: A prospective, randomized, double-blind study in Indian population

    PubMed Central

    Shinde, Abhishek; Sobti, Anshul; Maniar, Shriji; Mishra, Amit; Gite, Raju; Shetty, Vivek

    2015-01-01

    Introduction: For quite a few years, tranexamic acid (TEA) has been used during total knee arthroplasty (TKA) to reduce blood loss. However, no consensus exits regarding its timing and doses. Materials and Methods: We conducted a prospective, randomized double-blinded study of 56 patients in the Indian population undergoing TKA from 2011 to 2012. A dose of 10 mg/kg body weight of TEA (three doses) was given in one group and normal saline was administered in the other. Results: The mean blood loss in the TEA unilateral group was 295 mL ± 218 mL and in the placebo group was 482 mL ± 186 mL (P < 0.005). In the bilateral TEA group, the mean blood loss was 596 mL ± 235 mL and in the placebo group was 1349 mL ± 41 mL (P < 0.005). Conclusion: The number of patients requiring blood transfusion reduced substantially. There was no increase in the risk of deep vein thrombosis (DVT) and pulmonary embolism. TEA reduces intraoperative and postoperative blood loss and thus reduces the need of allogenic blood transfusion. PMID:26420938

  9. Effects of rhBMP-2 on cortical strut allograft healing to the femur in revision total hip arthroplasties: an experimental study

    PubMed Central

    Wu, Li-Dong; Yu, Hua-Chen

    2006-01-01

    We have studied the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) on cortical strut allograft healing and remodelling in revision hip arthroplasty. Thirty adult New Zealand rabbits underwent bilateral onlay allograft strut procedures to the femur using wires. The left femur (experimental side) received the rhBMP-2 device (1.0-mg rhBMP-2/gelatin composites) interposed between the allograft and host bone, while the right side was grafted with an allograft strut as the control. The femurs and implants were retrieved at 4, 6, and 8 weeks postoperatively. The healing of cortical strut grafts to the femur was enhanced dramatically by the addition of the rhBMP-2 device in radiographic examination, contact radiographic examination, non-decalcification sections, fluorescence tag, and computer-aided image analysis. The remodelling of cortical strut allograft was also accelerated. The new bone formation ratio and radiographic scores of the experimental side were also much higher than the control side at all times. Strut healing with the rhBMP-2 device at 4 weeks postoperatively was superior to the healing in control sides at 8 weeks. Our findings showed that the rhBMP-2 device improved and accelerated the course of cortical strut allograft healing and remodelling with host bone. PMID:17123081

  10. Effect of Closed Suction Drain on Blood Loss and Transfusion Rates in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Study

    PubMed Central

    Shetty, Gautam M.; Gupta, Vinay; Saxena, Purvi; Singh, Nidhi

    2016-01-01

    Purpose Simultaneous bilateral total knee arthroplasty (TKA) is associated with excessive blood loss and morbidity arising from postoperative reduction in hemoglobin (Hb). The purpose of this prospective randomized study was to determine if drains have any effect on blood loss, postoperative reduction in Hb levels and transfusion rates compared to no drainage in simultaneous bilateral TKAs. Materials and Methods Two hundred and thirty patients who underwent simultaneous bilateral TKA by a single surgeon were randomly allotted to drain or no-drain group (n=115 in each group). Postoperative Hb level, blood loss volume and transfusion rate were compared between the two groups. Results The mean postoperative Hb level (p=0.38), blood loss volume (p=0.33) and transfusion rate (p=0.52) in the drain group were not significantly different compared to the no-drain group. No statistical difference was found in terms of complications, readmissions and mortality rates between the two groups. Conclusions No significant difference was observed in the two groups with respect to blood loss and blood transfusion. Non-drainage does not offer an advantage over drainage with respect to conserving blood in simultaneous bilateral TKA. PMID:27595073

  11. Intermittent pneumatic compression devices combined with anticoagulants for prevention of symptomatic deep vein thrombosis after total knee arthroplasty: a pilot study

    PubMed Central

    Liu, Pengcheng; Liu, Junfeng; Chen, Liyang; Xia, Kuo; Wu, Xing

    2017-01-01

    Objectives To investigate the effectiveness of intermittent pneumatic compression (IPC) devices combined with anticoagulants for the prevention of deep vein thrombosis (DVT) after total knee arthroplasty (TKA). Patients and methods In total 120 patients were involved in this pilot study. Patients in the control group received 10 mg of rivaroxaban per day after surgery. In addition to the prescription of rivaroxaban, IPC devices were used in the experimental group. The diagnosis of DVT was made by compression duplex ultrasound on postoperative day 9. Results The incidence rates of overall, proximal, distal, and intermuscular DVT were 8.3%, 0%, 1.67%, and 6.67% in the experimental group; and 18.3%, 0%, 5%, and 13.33% in the control group, respectively. The incidence rates of total, distal, and intermuscular DVT in TKA patients was significantly lower in the experimental group than in the control group. For patients with DVT, enoxaparin was used instead of rivaroxaban, and DVT was found to have disappeared 10–14 days postoperatively. Conclusion Compared with the use of rivaroxaban alone, IPC devices combined with anticoagulants can significantly reduce the incidence rate of distal DVT and intermuscular DVT in the early postoperative period after TKA. PMID:28243107

  12. Adjacent-level arthroplasty following cervical fusion.

    PubMed

    Rajakumar, Deshpande V; Hari, Akshay; Krishna, Murali; Konar, Subhas; Sharma, Ankit

    2017-02-01

    OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1-3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2-7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow

  13. Characterization of burns using hyperspectral imaging technique - a preliminary study.

    PubMed

    Calin, Mihaela Antonina; Parasca, Sorin Viorel; Savastru, Roxana; Manea, Dragos

    2015-02-01

    Surgical burn treatment depends on accurate estimation of burn depth. Many methods have been used to asses burns, but none has gained wide acceptance. Hyperspectral imaging technique has recently entered the medical research field with encouraging results. In this paper we present a preliminary study (case presentation) that aims to point out the value of this optical method in burn wound characterization and to set up future lines of investigation. A hyperspectral image of a leg and foot with partial thickness burns was obtained in the fifth postburn day. The image was analyzed using linear spectral unmixing model as a tool for mapping the investigated areas. The article gives details on the mathematical bases of the interpretation model and correlations with clinical examination pointing out the advantages of hyperspectral imaging technique. While the results were encouraging, further more extended and better founded studies are being prepared before recognizing hyperspectral imaging technique as an applicable method of burn wound assessment.

  14. Preliminary Studies for Three Experiments at Treiman-Yang Criterion

    NASA Astrophysics Data System (ADS)

    Kres, I. V.; Kondratyev, V. N.; Cherubini, S.; Spitaleri, C.

    2016-05-01

    Nuclear reactions with three bodies in their final state may proceed through different reaction mechanisms. The Feynman graph technique has been widely used to describe such reactions. However, it is very difficult in general to select the graphs that dominate in given process. The Treiman-Yang criterion is one of the most powerful experimental tests for verifying the pole approximation prediction when describing a quasi-free reaction mechanism. We propose the theoretical study of the H2(B10, α Be7)ns, H1(B11, α1α2)αs, He3(Be9, α1α2)αs reactions at different energies. The preliminary study helps to check the existence of a QF channel by using the TY creterion.

  15. Seeing the Heat: Preliminary Studies of Cryocrystallography Using Infrared Imaging

    NASA Technical Reports Server (NTRS)

    Snell, E. H.; Judge, R. A.; Larson, M.; vanderWoerd, M. J.; Curreri, Peter A. (Technical Monitor)

    2002-01-01

    As preparation for an extensive study imaging the cryocooling process of macromolecular crystals we have demonstrated the ability to thermally image solid objects and liquids at temperatures far below 273 K. In the case of a large lysozyme crystal qualitative measurements show the cooling process to take about 0.6s with the cooling taking place in a wave from the face of the crystal nearest to the origin of the cryostream, to the point furthest away from the origin. Annealing of this lysozyme crystal, cooled under good cryoprotectant conditions, showed cold striations formed perpendicular to the cooling stream. These striations became more pronounced after successive annealing. Cryocooling of a non-cryoprotected crystal of glucose isomerase displayed an S-shaped cold front wave traveling across the sample. These preliminary results are qualitative but show the power of infrared imaging as a new tool for fundamental and practical cryocrystallography studies.

  16. Possession experiences in dissociative identity disorder: a preliminary study.

    PubMed

    Ross, Colin A

    2011-01-01

    Dissociative trance disorder, which includes possession experiences, was introduced as a provisional diagnosis requiring further study in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Consideration is now being given to including possession experiences within dissociative identity disorder (DID) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), which is due to be published in 2013. In order to provide empirical data relevant to the relationship between DID and possession states, I analyzed data on the prevalence of trance, possession states, sleepwalking, and paranormal experiences in 3 large samples: patients with DID from North America; psychiatric outpatients from Shanghai, China; and a general population sample from Winnipeg, Canada. Trance, sleepwalking, paranormal, and possession experiences were much more common in the DID patients than in the 2 comparison samples. The study is preliminary and exploratory in nature because the samples were not matched in any way.

  17. First Breath prenatal smoking cessation pilot study: preliminary findings.

    PubMed

    Jehn, Lisette; Lokker, Nicole; Matitz, Debra; Christiansen, Bruce

    2003-01-01

    Despite the many dangers associated with smoking during pregnancy, it remains a salient public health problem for Wisconsin women. The First Breath pilot program was developed in an attempt to reduce rates of smoking during pregnancy among low-income women. Preliminary results suggest that the First Breath counseling-based approach is effective, with a quit rate of 43.8% among First Breath enrollees at 1 month postpartum. Women receiving First Breath cessation counseling also had higher quit rates at every measurement period versus women in a comparison group who were receiving whatever cessation care was available in their county in the absence of First Breath. The First Breath pilot study has demonstrated success in helping pregnant women quit smoking and in creating a model for integration of cessation services into prenatal health care service provision. It is through this success that First Breath is expanding beyond the pilot study stage to a statewide program in 2003.

  18. Reverse shoulder arthroplasty for the management of proximal humerus fractures.

    PubMed

    Jobin, Charles M; Galdi, Balazs; Anakwenze, Oke A; Ahmad, Christopher S; Levine, William N

    2015-03-01

    The use of reverse shoulder arthroplasty is becoming increasingly popular for the treatment of complex three- and four-part proximal humerus fractures in the elderly compared with the often unpredictable and poor outcomes provided by open reduction and internal fixation and by hemiarthroplasty. Inferior results with plate osteosynthesis are often a result of complications of humeral head osteonecrosis, loss of fixation, and screw penetration through the humeral head, whereas major concerns with hemiarthroplasty are tuberosity resorption, malunion, and nonunion resulting in pseudoparalysis. Comparative studies support the use of reverse shoulder arthroplasty in elderly patients with complex proximal humerus fractures because the functional outcomes and relief of pain are reliably improved. Repair and union of the greater tuberosity fragment during reverse shoulder arthroplasty demonstrates improved external rotation, clinical outcomes, and patient satisfaction compared with outcomes after tuberosity resection, nonunion, or resorption. Satisfactory results can be obtained with careful preoperative planning and attention to technical details.

  19. Oxidized Zirconium Bearing Surfaces in Total Knee Arthroplasty: Lessons Learned.

    PubMed

    Schüttler, Karl Friedrich; Efe, Turgay; Heyse, Thomas J; Haas, Steven B

    2015-10-01

    Polyethylene wear in total knee arthroplasty is a still unsolved problem resulting in osteolysis and long-term failure of knee joint replacement. To address the problem of polyethylene wear, research aimed for an optimal implant design and for an optimal combination of bearing surfaces. Oxidized zirconium was introduced to minimize surface wear and thus potentially increase long-term implant survival. This review comprises the current literature related to in vitro and in vivo studies evaluating performance of oxidized zirconium total knee arthroplasty and results from retrieval analyses.

  20. Preliminary Studies of a Phase Modulation Technique for Measuring Chromaticity

    SciTech Connect

    Tan, Cheng-Yang; /Fermilab

    2006-04-01

    The classical method for measuring chromaticity is to slowly modulate the RF frequency and then measuring the betatron tune excursion. The technique that is discussed in this paper modulates instead the phase of the RF and then the chromaticity is obtained by phase demodulating the betatron tune. However, this technique requires knowledge of the betatron frequency in real time in order for the phase to be demodulated. Fortunately, the Tevatron has a tune tracker based on the phase locked loop principle which fits this requirement. A preliminary study with this technique has showed that it is a promising method for doing continuous chromaticity measurement and raises the possibility of doing successful chromaticity feedback with it.

  1. Biased attention in childhood anxiety disorders: a preliminary study.

    PubMed

    Vasey, M W; Daleiden, E L; Williams, L L; Brown, L M

    1995-04-01

    This study provides preliminary tests of two hypotheses: (1) Anxiety-disordered children show an attentional bias toward emotionally threatening stimuli, and (2) normal controls show an attentional bias away from emotionally threatening stimuli. Twelve children, 9 to 14 years of age, with primary diagnoses of anxiety disorder were compared with 12 normal controls matched for age, gender, vocabulary level, and reading ability. Subjects completed a reaction time task that measured visual attention toward threatening versus neutral words. The anxious group showed the predicted attentional bias toward threat words. However, controls did not show the predicted bias away from threat words. These results are the first showing that biased attentional processing occurs among clinically anxious children. The potential role of such an attentional bias in childhood anxiety disorders and future direction for research are discussed.

  2. Primary versus secondary distal femoral arthroplasty for treatment of total knee arthroplasty periprosthetic femur fractures.

    PubMed

    Chen, Antonia F; Choi, Lisa E; Colman, Matthew W; Goodman, Mark A; Crossett, Lawrence S; Tarkin, Ivan S; McGough, Richard L

    2013-10-01

    Current methods of fixing periprosthetic fractures after total knee arthroplasty (TKA) are variable, and include open reduction and internal fixation (ORIF) via plating, retrograde nailing, or revision using standard revision TKA components or a distal femoral arthroplasty (DFA). The purpose of this study is to compare patients who failed plating techniques requiring subsequent revision to DFA to patients who underwent primary DFA. Of the 13 patients (9.2%) who failed primary ORIF, causes included nonunion (53.8%), infection (30.8%), loosening (7.7%), and refracture (7.7%). There were significantly more surgical procedures for ORIF revision to DFA compared to primary DFA. Complications for patients who underwent primary reconstruction with DFAs included extensor mechanism disruption (8.3%), infection (5.6%), and dislocation (2.8%). Primary reconstruction via ORIF is beneficial for preserving bone stock, but primary DFA may be preferred in osteopenic patients, or those at high risk for nonunion.

  3. Preliminaries toward studying resonant extraction from the Debuncher

    SciTech Connect

    Michelotti, Leo; Johnstone, John; /Fermilab

    2009-06-01

    A recent proposal to detect {mu} {yields} e direct conversion at Fermilab asks for slow extraction of protons from the antiproton source, specifically from the Debuncher. [1] A third-integer resonance originally was considered for this, partly because of the Debuncher's three-fold symmetry and partly because its operational horizontal tune, {nu}{sub x} {approx} 9.765, is already within 0.1 of {nu}{sub x} = 29/3. Using a half integer resonance, {nu}{sub x} = 19/2, though not part of the original proposal, has been suggested more recently because (a) Fermilab has had a good deal of experience with half-integer extraction from the Tevatron, the Main Injector and the erstwhile Main Ring, and (b) for reasons we shall examine later, it depopulates the entire bunch without an abort at the end. This memo presents considerations preliminary to studying both possibilities. It is meant only as a starting point for investigations to be carried out in the future. The working constraints and assumptions have oscillated between two extremes: (1) making minimal changes in the antiproton source to minimize cost and (2) building another machine in the same tunnel. In this memo we adopt an attitude aligned more toward the first. The assumed parameters are listed in Table 1. A few are not (easily) subject to change, such as those related to the beam's momentum and revolution frequency and the acceptance of the debuncher. Two resonance exemplars are presented in the next section, with an explanation of the analytic and semi-analytic calculations that can be done for each. Section 3 contains preliminary numerical work that was done to validate the exemplars within the context of extraction from the Debuncher. A final section contains a summary. Following the bibliography, appendices contain (a) a qualitative, conceptual discussion of extraction for the novice, (b) a telegraphic review of the perturbative incantations used to filter the exemplars as principal resonances of quadrupole

  4. Avulsive axillary artery injury in reverse total shoulder arthroplasty.

    PubMed

    Wingert, Nathaniel C; Beck, John D; Harter, G Dean

    2014-01-01

    In addition to neurologic injuries such as peripheral nerve palsy, axillary vessel injury should be recognized as a possible complication of reverse total shoulder arthroplasty. Limb lengthening associated with Grammont-type reverse total shoulder arthroplasty places tension across the brachial plexus and axillary vessels and may contribute to observed injuries. The Grammont-type reverse total shoulder arthroplasty prosthesis reverses the shoulder ball and socket, shifts the shoulder center of rotation distal and medial, and lengthens the arm. This alteration of native anatomy converts shearing to compressive glenohumeral joint forces while augmenting and tensioning the deltoid lever arm. Joint stability is enhanced; shoulder elevation is enabled in the rotator cuff–deficient shoulder. Arm lengthening associated with reverse total shoulder arthroplasty places a longitudinal strain on the brachial plexus and axillary vessels. Peripheral nerve palsies and other neurologic complications of reverse total shoulder arthroplasty have been documented. The authors describe a patient with rotator cuff tear arthropathy and a history of radioulnar synostosis who underwent reverse total shoulder arthroplasty complicated by intraoperative injury to the axillary artery and postoperative radial, ulnar, and musculocutaneous nerve palsies. Following a seemingly unremarkable placement of reverse shoulder components, brisk arterial bleeding was encountered while approximating the incised subscapularis tendon in preparation for wound closure. Further exploration revealed an avulsive-type injury of the axillary artery. After an unsuccessful attempt at primary repair, a synthetic arterial bypass graft was placed. Reperfusion of the right upper extremity was achieved and has been maintained to date. Postoperative clinical examination and electromyographic studies confirmed ongoing radial, ulnar, and musculocutaneous neuropathies.

  5. The association between component malalignment and post-operative pain following navigation-assisted total knee arthroplasty: results of a cohort/nested case-control study.

    PubMed

    Czurda, Thomas; Fennema, Peter; Baumgartner, Martin; Ritschl, Peter

    2010-07-01

    Previous studies have noted an adverse relationship between implant malalignment during total knee arthroplasty (TKA) and post-operative pain. Although some evidence exists indicating that computer-assisted surgical navigation for TKA can improve the accuracy of component alignment, its impact on clinical outcomes is currently unknown. The dual goals of the present cohort/nested case-control study were to (1) compare self-reported responses to the Western Ontario-McMaster Osteoarthritis Index (WOMAC) questionnaire between computer-assisted TKA (123 patients) using the imageless PiGalileo navigation system and conventional TKA (207 patients) [cohort analysis], and (2) to investigate a potential association between malalignment and post-operative pain in 19 painful knees and 19 asymptomatic knees obtained from the cohort analysis using matched sampling [nested case-control study]. In the cohort analysis, a relevant but non-significant (P = 0.06) difference in the occurrence of chronic pain was observed between the navigated (12%) and conventional arms (20%). Median post-operative WOMAC pain score was 100 (range, 50-100) in the conventional group and 100 (range, 65-100) in the navigated group. However, the Mann-Whitney test revealed a significant difference in favor of the navigated group (P = 0.01). In the nested case-control analysis, radiological outcomes and computer tomography (CT) measurements of femoral rotation were compared between the groups. The CT rotation measurements yielded evidence of a relationship between post-operative pain and incorrect rotational alignment of the femoral component of more than 3 degrees (OR: 7; 95% CI: 1.2-42; P = .033). In conclusion, there was no clinical benefit to computer-assisted navigation; however, a statistically significant relationship was observed between incorrect rotational alignment of the femoral component and symptoms of post-operative pain following TKA.

  6. Antibacterial activity of joint fluid in cemented total-knee arthroplasty: an in vivo comparative study of polymethylmethacrylate with and without antibiotic loading.

    PubMed

    Ueng, Steve W N; Hsieh, Pang-Hsin; Shih, Hsin-Nung; Chan, Yi-Shan; Lee, Mel S; Chang, Yuhan

    2012-11-01

    The objective of this study was to evaluate the antibacterial activities of joint fluids of patients undergoing total-knee arthroplasty (TKA). Thirty patients who were scheduled for primary cemented TKA were enrolled in the study. The patients were grouped on the basis of whether the cement was without antibiotic loading (control group) or loaded with oxacillin (oxacillin group) or vancomycin (vancomycin group). Cefazolin was administered to every patient as the perioperative prophylactic antibiotic. Samples of joint fluids were collected from the knee joints at 8, 16, 24, 32, 40, and 48 h after prosthesis implantation. We assessed the bioactivities of the joint fluids against methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA). The antibiotic contents of the joint fluid samples were further evaluated by using high-performance liquid chromatography. Against MSSA, all joint fluid samples exhibited at least 24 h of bacterial inhibition activity. The oxacillin (43.2 h ± 2 h) and vancomycin (40.8 h ± 1.8 h) groups exhibited significantly longer durations of antibacterial activities than the control group (28 h ± 1.3 h; P < 0.05). However, antibacterial activity against MRSA was observed only in the vancomycin group. In conclusion, cefazolin, which was administered as a prophylactic antibiotic in TKA, exhibited good ability for knee joint penetration and was sufficient to inhibit MSSA during its administration. The use of antibiotic-loaded cement can prolong the antibacterial activity of joint fluid in TKA. Further, vancomycin-loaded cement had antibacterial activity against MRSA superior to that of cement loaded with oxacillin or without antibiotic loading.

  7. Can consistent benchmarking within a standardized pain management concept decrease postoperative pain after total hip arthroplasty? A prospective cohort study including 367 patients

    PubMed Central

    Benditz, Achim; Greimel, Felix; Auer, Patrick; Zeman, Florian; Göttermann, Antje; Grifka, Joachim; Meissner, Winfried; von Kunow, Frederik

    2016-01-01

    Background The number of total hip replacement surgeries has steadily increased over recent years. Reduction in postoperative pain increases patient satisfaction and enables better mobilization. Thus, pain management needs to be continuously improved. Problems are often caused not only by medical issues but also by organization and hospital structure. The present study shows how the quality of pain management can be increased by implementing a standardized pain concept and simple, consistent, benchmarking. Methods All patients included in the study had undergone total hip arthroplasty (THA). Outcome parameters were analyzed 24 hours after surgery by means of the questionnaires from the German-wide project “Quality Improvement in Postoperative Pain Management” (QUIPS). A pain nurse interviewed patients and continuously assessed outcome quality parameters. A multidisciplinary team of anesthetists, orthopedic surgeons, and nurses implemented a regular procedure of data analysis and internal benchmarking. The health care team was informed of any results, and suggested improvements. Every staff member involved in pain management participated in educational lessons, and a special pain nurse was trained in each ward. Results From 2014 to 2015, 367 patients were included. The mean maximal pain score 24 hours after surgery was 4.0 (±3.0) on an 11-point numeric rating scale, and patient satisfaction was 9.0 (±1.2). Over time, the maximum pain score decreased (mean 3.0, ±2.0), whereas patient satisfaction significantly increased (mean 9.8, ±0.4; p<0.05). Among 49 anonymized hospitals, our clinic stayed on first rank in terms of lowest maximum pain and patient satisfaction over the period. Conclusion Results were already acceptable at the beginning of benchmarking a standardized pain management concept. But regular benchmarking, implementation of feedback mechanisms, and staff education made the pain management concept even more successful. Multidisciplinary teamwork

  8. Total Hip Arthroplasty Using Modular Trabecular Metal Acetabular Components for Failed Treatment of Acetabular Fractures: A Mid-term Follow-up Study

    PubMed Central

    Huang, De-Yong; Zhang, Liang; Zhou, Yi-Xin; Zhang, Chun-Yu; Xu, Hui; Huang, Yong

    2016-01-01

    Background: Porous-coated cups have been widely used in acetabular reconstruction after failed treatment of acetabular fractures, and good results have been reported with the use of these cups; however, the durability and functionality of modular trabecular metal (TM) acetabular components in acetabular reconstruction after failed treatment of acetabular fractures remain unclear. This study aimed to examine the radiographic and clinical outcomes associated with the use of modular TM acetabular components for failed treatment of acetabular fractures to assess the durability and functionality of these components in acetabular reconstruction after failed treatment of acetabular fractures. Methods: A total of 41 patients (41 hips) underwent total hip arthroplasty (THA) using modular TM acetabular components for failed treatment of acetabular fractures at our hospital between January 2007 and December 2012. Among these patients, two were lost to follow-up. Therefore, 39 patients (39 hips) were finally included in this study. The Harris hip score before and after the surgery, satisfaction level of the patients, and radiographic results were assessed. Results: The mean Harris hip score increased from 34 (range, 8–52) before surgery to 91 (range, 22–100) at the latest follow-up examination (P < 0.001). The results were excellent for 28 hips, good for six, fair for three, and poor for two. Among the 39 patients, 25 (64%) and 10 (26%) were very satisfied and somewhat satisfied, respectively. All cups were found to be fully incorporated, and no evidence of cup migration or periacetabular osteolysis was noted. Conclusions: Despite the technically demanding nature of the procedure, THA using modular TM acetabular components showed good durability and functionality and may be an effective reconstruction option for failed treatment of acetabular fractures. PMID:27064033

  9. Measured flexion following total knee arthroplasty.

    PubMed

    Mai, Kenny T; Verioti, Christopher A; Hardwick, Mary E; Ezzet, Kace A; Copp, Steven N; Colwell, Clifford W

    2012-10-01

    Postoperative flexion is an important factor in the outcome of total knee arthroplasty. Although normal activities of daily living require a minimum of 105° to 110° of flexion, patients from non-Western cultures often engage in activities such as kneeling and squatting that require higher flexion. The desire to achieve greater flexion serves as the driving force for prosthetic modifications, including high-flexion designs. Techniques used to measure knee flexion and knee position during measurement are not often described or are different depending on the examiner. The purpose of this study was to compare active (self) and passive (assisted) flexion after successful total knee arthroplasty for 5 prostheses (2 standard and 3 high-flexion) using clinical (goniometer) and radiographic (true lateral radiograph) measurement techniques by different independent examiners.At a mean follow-up of 2.7 years (range, 1-5.6 years), a total of 108 patients (144 total knee arthroplasties) had completed the study. Mean postoperative active flexion was 111° clinically and 109° radiographically for the standard designs and 114° clinically and 117° radiographically for the high-flexion designs. Adding passive flexion increased flexion to 115° clinically and 117° radiographically for the standard designs and 119° clinically and 124° radiographically for the high-flexion designs. Flexion differences between the 2 measurement techniques (active vs passive and clinically vs radiographically) were statistically significant (P<.05). These findings demonstrate the importance of describing how flexion is measured in studies and understanding how the method of measurement can affect the findings.

  10. The influence of third-body particles on wear rate in unicondylar knee arthroplasty: a wear simulator study with bone and cement debris.

    PubMed

    Schroeder, Christian; Grupp, Thomas M; Fritz, Bernhard; Schilling, Christoph; Chevalier, Yan; Utzschneider, Sandra; Jansson, Volkmar

    2013-05-01

    The reduced intraoperative visibility of minimally invasive implanted unicondylar knee arthroplasty makes it difficult to remove bone and cement debris, which have been reported on the surface of damaged and retrieved bearings. Therefore, the aim of this study was to analyze the influence of bone and cement particles on the wear rate of unicompartmental knee prostheses in vitro. Fixed bearing unicompartmental knee prostheses were tested using a knee-wear-simulator according to the ISO standard 14243-1:2002(E) for 5.0 million cycles. Afterwards bone debris (particle size 671 ± 262 μm) were added to the test fluid in a concentration of 5 g/l for 1.5 million cycles, followed by 1.5 million cycles blended with cement debris (particle size 644 ± 186 μm) in the same concentration. Wear rate, knee-kinematics and wear-pattern were analyzed. The wear rate reached 12.5 ± 1.0 mm³/million cycles in the running-in and decreased during the steady state phase to 4.4 ± 0.91 mm³/million cycles. Bone particles resulted in a wear rate of 3.0 ± 1.27 mm³/million cycles with no influence on the wear rate compared to the steady state phase. Cement particles, however, lead to a significantly higher wear rate (25.0 ± 16.93 mm³/million cycles) compared to the steady state phase. The careful removal of extruded cement debris during implantation may help in reducing wear rate. Bone debris are suggested to have less critical influence on the prostheses wear rate.

  11. Effects of a Foot Pump on the Incidence of Deep Vein Thrombosis After Total Knee Arthroplasty in Patients Given Edoxaban: A Randomized Controlled Study.

    PubMed

    Sakai, Tatsuya; Izumi, Masahiro; Kumagai, Kenji; Kidera, Kenichi; Yamaguchi, Takayuki; Asahara, Tomohiko; Kozuru, Hideko; Jiuchi, Yuka; Mawatari, Masaaki; Osaki, Makoto; Motokawa, Satoru; Migita, Kiyoshi

    2016-01-01

    We conducted a randomized clinical trial to compare the effectiveness of the A-V Impulse System foot pump for reducing the incidence of deep-vein thrombosis (DVT) after total knee arthroplasty (TKA) in patients under edoxaban thromboprophylaxis. Patients undergoing primary TKA at our institution between September 2013 and March 2015 were enrolled after obtaining informed consent. The patients were randomized to use the foot pump (n = 58) and not to use the foot pump (n = 62). Both groups were given prophylactic edoxaban. Primary outcomes were any DVT as detected by bilateral ultrasonography up to postoperative day 10 (POD10) and pulmonary embolism (PE) up to POD28. The safety outcomes were bleeding and death of any cause up to POD28. Plasma D-dimer levels were measured before TKA and on POD10 after TKA. Immunoglobulin G (IgG)-class anti-PF4/heparin antibodies were measured using an IgG-specific enzyme-linked immunosorbent assay. The incidences of any DVT up to POD28 were 31.0% and 17.7% in patients with or without the foot pump, respectively. The incidences of major bleeding up to POD28 were 5.1% and 4.8% in patients with or without the foot pump, respectively. Foot pump use did not significantly reduce the incidence of DVTs in patients undergoing TKA under edoxaban thromboprophylaxis. Although seroconversion of anti-PF4/heparin antibodies was confirmed in one-fourth of patients, the seroconversion rates did not differ between patients with (20.7%) or without (25.8%) foot pump use. This study shows that the A-V Impulse system foot pump did not affect the incidence of DVT under edoxaban thromboprophylaxis in patients undergoing TKA. Seroconversion of anti-PF4/heparin antibodies was detected in a significant number of patients who underwent TKA under antithrombotic prophylaxis using edoxaban.

  12. Preliminary Study of a Model Rotor in Descent

    NASA Technical Reports Server (NTRS)

    McAlister, K. W.; Tung, C.; Sharpe, D. L.; Huang, S.; Hendley, E. M.

    2000-01-01

    Within a program designed to develop experimental techniques for measuring the trajectory and structure of vortices trailing from the tips of rotor blades, the present preliminary study focuses on a method for quantifying the trajectory of the trailing vortex during descent flight conditions. This study also presents rotor loads and blade surface pressures for a range of tip-path plane angles and Mach numbers. Blade pressures near the leading edge and along the outer radius are compared with data obtained on the same model rotor, but in open jet facilities. A triangulation procedure based on two directable laser-light sheets, each containing an embedded reference, proved effective in defining the spatial coordinates of the trailing vortex. When interrogating a cross section of the flow that contains several trailing vortices, the greatest clarity was found to result when the flow is uniformly seeded. Surface pressure responses during blade-vortex interactions appeared equally sensitive near the leading edge and along the outer portion of the blade, but diminished rapidly as the distance along the blade chord increased. The pressure response was virtually independent of whether the tip-path plane angle was obtained through shaft tilt or cyclic pitch. Although the shape and frequency of the pressure perturbations on the advancing blade during blade-vortex interaction are similar to those obtained in open-jet facilities, the angle of the tip-path plane may need to be lower than the range covered in this study.

  13. Preliminary studies to determine the shelf life of HEPA filters

    SciTech Connect

    Gilbert, H.; Fretthold, J.K.; Rainer, F.

    1995-02-01

    We have completed a preliminary study using filter media tests and filter qualification tests to investigate the effect of shelf-life on HEPA filter performance. Our media studies showed that the tensile strength decreased with age, but the data were not sufficient to establish a shelf-life. Thermogravimetric analyses demonstrated that one manufacturer had media with low tensile strength due to insufficient binder. The filter qualification tests (heated air and overpressure) conducted on different aged filters showed that filter age is not the primary factor affecting filter performance; materials and the construction design have a greater effect. An unexpected finding of our study was that sub-standard HEPA filters have been installed in DOE facilities despite existing regulations and filter qualification tests. We found that the filter with low tensile strength failed the overpressure test. The same filter had passed the heated air test, but left the filter so structurally weak, it was prone to blow-out. We recommend that DOE initiate a filter qualification program to prevent this occurrence.

  14. Medial pivot knee in primary total knee arthroplasty.

    PubMed

    Atzori, Francesco; Salama, Wael; Sabatini, Luigi; Mousa, Shazly; Khalefa, Abdelrahman

    2016-01-01

    Total knee arthroplasty (TKA) with a medial pivot design was developed in order to mimic normal knee kinematics; the highly congruent medial compartment implant should improve clinical results and decrease contact stresses. Clinical and radiographic mid-term outcomes are satisfactory, but we need other studies to evaluate long-term results and indications for unusual cases.

  15. Archaeoastronomical Information in the Study of Cremation Necropolis: Preliminary Study

    NASA Astrophysics Data System (ADS)

    Mejuto, J.; Cerde, M. L.; Rodríguez, C.

    2009-08-01

    This work remarks the significance that archaeoastronomical studies have for archaeological research. These studies provide us data about the perception that ancient societies had about astronomical events and how these facts were added to their religious and ideological world. Thus, archaeoastronomy become a valuable source of information when aimed to solve any question involving the ancient societies. We take as reference in this work some of the Late Bronze Age{'}s cremation necropolis, representatives of usually called Urnfields, to check if their design can be related to some celestial phenomena: Can Bech de Baix (Gerona), Can Pitieu-Can Roqueta(Barcelona), Molá (Tarragona), Can Missert (Tarragona), Les Obagues (Tarragona), La Colomina (Lleida) and La Torraza (Navarra). Likewise a new standard in archaeological excavations maps is proposed. This will allow getting the information more available and improving further studies.

  16. Energy efficient engine preliminary design and integration study

    NASA Technical Reports Server (NTRS)

    Gray, D. E.

    1978-01-01

    The technology and configurational requirements of an all new 1990's energy efficient turbofan engine having a twin spool arrangement with a directly coupled fan and low-pressure turbine, a mixed exhaust nacelle, and a high 38.6:1 overall pressure ratio were studied. Major advanced technology design features required to provide the overall benefits were a high pressure ratio compression system, a thermally actuated advanced clearance control system, lightweight shroudless fan blades, a low maintenance cost one-stage high pressure turbine, a short efficient mixer and structurally integrated engine and nacelle. A conceptual design analysis was followed by integration and performance analyses of geared and direct-drive fan engines with separate or mixed exhaust nacelles to refine previously designed engine cycles. Preliminary design and more detailed engine-aircraft integration analysis were then conducted on the more promising configurations. Engine and aircraft sizing, fuel burned, and airframe noise studies on projected 1990's domestic and international aircraft produced sufficient definition of configurational and advanced technology requirements to allow immediate initiation of component technology development.

  17. Physico-Chemical profile of Puga Khanda: A Preliminary Study

    PubMed Central

    Baragi, Pramod C.; Baragi, Umapati C.; Bhat, Sathyanarayana; Prajapati, Pradeep Kumar

    2014-01-01

    Background: Herbal medicines are the oldest known form of medicine in the world. However, the quality control and the assurance still remains a challenge because of the high variability of chemical components. Herbal drugs, singlely or in combinations, contain numerous compounds in complex matrices in which no single active constituent is responsible for the overall efficacy. This creates a challenge in establishing quality control standards and the standardization of finished herbal products. Many formulations have been mentioned in Ayurvedic text for Vrushyatwa (aphrodisiac). Puga Khanda is one among such formulations. Aim: To develop preliminary physico-chemical profile of Puga Khanda. Materials and Methods: Puga Khanda was prepared in three batches as per the classical reference mentioned in Bhaishajya Ratnavali. The formulation was subjected for physico-chemical analysis, phytochemical analysis and Thin Layer Chromatography (TLC). Results and Conclusion: The study revealed that organoleptic characters, pH and extractive values of all 3 samples were almost equal. All the samples had 60% of sugar needed for preservation and 2/3rd of it was non reducing sugar. The total alkaloids ranged from 0.002 to 0.004% w/w. In TLC study the entire samples showed similar pattern except the 2nd sample of Puga Khanda. PMID:25364209

  18. Intraarterial Ultrasound in Pancreatic Cancer: Feasibility Study and Preliminary Results

    SciTech Connect

    Larena-Avellaneda, Axel; Timm, Stephan; Kickuth, Ralph; Kenn, Werner; Steger, Ulrich; Jurowich, Christian; Germer, Christoph-Thomas

    2010-08-15

    Despite technological advances in computed tomography (CT) and magnetic resonance imaging, the involvement of the celiac or mesenteric artery in pancreatic cancer remains uncertain in many cases. Infiltration of these vessels is important in making decisions about therapy choices but often can only be definitively determined through laparotomy. Local (intraarterial) ultrasound may increase diagnostic accuracy. Using the Volcano intravascular ultrasound (IVUS) system, we applied a transfemoral method to scan the celiac and mesenteric arteries directly intraarterial. This technique was used in five patients with suspected pancreatic cancer. Technical success was achieved in all cases. In one case, a short dissection of the mesenteric artery occurred but could be managed interventionally. In tumors that did not contact with the vessels, IVUS was unable to display the tissue pathology. Our main interest was the infiltration of the arteries. In one case, infiltration was certain in the CT scan but uncertain in two patients. In the latter two cases, IVUS correctly predicted infiltration in one and freedom from tumor in the other case. In our preliminary study, IVUS correctly predicted arterial infiltration in all cases. IVUS did not provide new information when the tumor was far away from the vessel. Compared with IVUS in the portal vein, the information about the artery is more detailed, and the vessel approach is easier. These results encouraged us to design a prospective study to evaluate the sensitivity and specificity of this method.

  19. Laboratory study of corrosion of steam generator tubes: Preliminary results

    SciTech Connect

    Sala, B.; Organista, M.; Henry, K.; Erre, R.; Gelpi, A.; Cattant, F.; Dupin, M.

    1995-12-31

    The secondary side intergranular attack (IGA) and intergranular stress corrosion cracking (IGSCC) of steam generator tubes often occurs in crevices where impurities are concentrated, due to local elevated temperatures and restricted water flow. From the analysis of tubes pulled from plants, it is believed that alumino-silicates deposits and/or organic species may play a role in the development of IGA in near neutral environments. New observations suggest that similar environments and similar processes are operative inside the corroded grain boundaries. A former study using autoclave tests was mainly devoted to the formation of alumino-silicate deposits similar to those observed in plants. The present work pursued the study of local environments responsible for IGA/SC. It confirms former results on the catalytic decomposition of organic species into acetates and presents more details on the mechanism of formation of alumino-silicate deposits on alloy 600, particularly on the role of iron and, to a lesser extent, nickel cations. It was showed that, under the alumino-silicate deposits and in the presence of some organic species, a non-protective chromium rich layer may grow instead of the usual protective spinel oxide. The mechanism responsible for the formation of this layer is believed to involve interaction between iron and, to a lesser extent, nickel with silica and/or possible interaction between chromium and acetates. Preliminary capsule tests indicate that these conditions may induce the initiation of IGA.

  20. Thulium-170-labeled microparticles for local radiotherapy: preliminary studies.

    PubMed

    Polyak, Andras; Das, Tapas; Chakraborty, Sudipta; Kiraly, Reka; Dabasi, Gabriella; Joba, Robert Peter; Jakab, Csaba; Thuroczy, Julianna; Postenyi, Zita; Haasz, Veronika; Janoki, Gergely; Janoki, Gyozo A; Pillai, Maroor R A; Balogh, Lajos

    2014-10-01

    The present article describes the preparation, characterization, and biological evaluation of Thulium-170 ((170)Tm) [T1/2 = 128.4 days; Eβmax = 968 keV; Eγ = 84 keV (3.26%)] labeled tin oxide microparticles for its possible use in radiation synovectomy (RSV) of medium-sized joints. (170)Tm was produced by irradiation of natural thulium oxide target. 170Tm-labeled microparticles were synthesized with high yield and radionuclidic purity (> 99%) along with excellent in vitro stability by following a simple process. Particle sizes and morphology of the radiolabeled particles were examined by light microscope, dynamic light scattering, and transmission electron microscope and found to be of stable spherical morphology within the range of 1.4-3.2 μm. The preparation was injected into the knee joints of healthy Beagle dogs intraarticularly for biological studies. Serial whole-body and regional images were taken by single-photon-emission computed tomography (SPECT) and SPECT-CT cameras up to 9 months postadministration, which showed very low leakage (< 8% of I.D.) of the instilled particles. The majority of leaked radiocolloid particles were found in inguinal lymph nodes during the 9 months of follow-up. All the animals tolerated the treatment well; the compound did not show any possible radiotoxicological effect. These preliminary studies showed that 170Tm-labeled microparticles could be a promising nontoxic and effective radiopharmaceutical for RSV applications or later local antitumor therapy.

  1. Duloxetine in OsteoArthritis (DOA) study: study protocol of a pragmatic open-label randomised controlled trial assessing the effect of preoperative pain treatment on postoperative outcome after total hip or knee arthroplasty

    PubMed Central

    Blikman, T; Rienstra, W; van Raaij, T M; ten Hagen, A J; Dijkstra, B; Zijlstra, W P; Bulstra, S K; van den Akker-Scheek, I; Stevens, M

    2016-01-01

    Introduction Residual pain is a major factor in patient dissatisfaction following total hip arthroplasty or total knee arthroplasty (THA/TKA). The proportion of patients with unfavourable long-term residual pain is high, ranging from 7% to 34%. There are studies indicating that a preoperative degree of central sensitisation (CS) is associated with poorer postoperative outcomes and residual pain. It is thus hypothesised that preoperative treatment of CS could enhance postoperative outcomes. Duloxetine has been shown to be effective for several chronic pain syndromes, including knee osteoarthritis (OA), in which CS is most likely one of the underlying pain mechanisms. This study aims to evaluate the postoperative effects of preoperative screening and targeted duloxetine treatment of CS on residual pain compared with care-as-usual. Methods and analysis This multicentre, pragmatic, prospective, open-label, randomised controlled trial includes patients with idiopathic hip/knee OA who are on a waiting list for primary THA/TKA. Patients at risk for CS will be randomly allocated to the preoperative duloxetine treatment programme group or the care-as-usual control group. The primary end point is the degree of postoperative pain 6 months after THA/TKA. Secondary end points at multiple time points up to 12 months postoperatively are: pain, neuropathic pain-like symptoms, (pain) sensitisation, pain catastrophising, joint-associated problems, physical activity, health-related quality of life, depressive and anxiety symptoms, and perceived improvement. Data will be analysed on an intention-to-treat basis. Ethics and dissemination The study is approved by the local Medical Ethics Committee (METc 2014/087) and will be conducted according to the principles of the Declaration of Helsinki (64th, 2013) and the Good Clinical Practice standard (GCP), and in compliance with the Medical Research Involving Human Subjects Act (WMO). Trial registration number 2013-004313-41; Pre

  2. A preliminary study of Mars rover/sample return missions

    NASA Technical Reports Server (NTRS)

    1987-01-01

    The Solar System Exploration Committee (SSEC) of the NASA Advisory Council recommends that a Mars Sample Return mission be undertaken before the year 2000. Comprehensive studies of a Mars Sample Return mission have been ongoing since 1984. The initial focus of these studies was an integrated mission concept with the surface rover and sample return vehicle elements delivered to Mars on a single launch and landed together. This approach, to be carried out as a unilateral U.S. initiative, is still a high priority goal in an Augmented Program of exploration, as the SSEC recommendation clearly states. With this background of a well-understood mission concept, NASA decided to focus its 1986 study effort on a potential opportunity not previously examined; namely, a Mars Rover/Sample Return (MRSR) mission which would involve a significant aspect of international cooperation. As envisioned, responsibility for the various mission operations and hardware elements would be divided in a logical manner with clearly defined and acceptable interfaces. The U.S. and its international partner would carry out separately launched but coordinated missions with the overall goal of accomplishing in situ science and returning several kilograms of surface samples from Mars. Important considerations for implementation of such a plan are minimum technology transfer, maximum sharing of scientific results, and independent credibility of each mission role. Under the guidance and oversight of a Mars Exploration Strategy Advisory Group organized by NASA, a study team was formed in the fall of 1986 to develop a preliminary definition of a flight-separable, cooperative mission. The selected concept assumes that the U.S. would undertake the rover mission with its sample collection operations and our international partner would return the samples to Earth. Although the inverse of these roles is also possible, this study report focuses on the rover functions of MRSR because rover operations have not

  3. ECG Response of Koalas to Tourists Proximity: A Preliminary Study

    PubMed Central

    Ropert-Coudert, Yan; Brooks, Lisa; Yamamoto, Maki; Kato, Akiko

    2009-01-01

    Koalas operate on a tight energy budget and, thus, may not always display behavioral avoidance reaction when placed in a stressful condition. We investigated the physiological response of captive koalas Phascolarctos cinereus in a conservation centre to the presence of tourists walking through their habitat. We compared, using animal-attached data-recorders, the electrocardiogram activity of female koalas in contact with tourists and in a human-free area. One of the koalas in the tourist zone presented elevated heart rate values and variability throughout the recording period. The remaining female in the exhibit area showed a higher field resting heart rates during the daytime than that in the isolated area. In the evening, heart rate profiles changed drastically and both the koalas in the exhibit and in the tourist-free zones displayed similar field resting heart rates, which were lower than those during the day. In parallel, the autonomic nervous systems of these two individuals evolved from sympathetic-dominant during the day to parasympathetic-dominant in the evening. Our results report ECG of free-living koalas for the first time. Although they are preliminary due to the difficulty of having sufficient samples of animals of the same sex and age, our results stress out the importance of studies investigating the physiological reaction of animals to tourists. PMID:19823679

  4. Real-time trichromatic holographic interferometry: preliminary study

    NASA Astrophysics Data System (ADS)

    Albe, Felix; Bastide, Myriam; Desse, Jean-Michel; Tribillon, Jean-Louis H.

    1998-08-01

    In this paper we relate our preliminary experiments on real- time trichromatic holographic interferometry. For this purpose a CW `white' laser (argon and krypton of Coherent- Radiation, Spectrum model 70) is used. This laser produces about 10 wavelengths. A system consisting of birefringent plates and polarizers allows to select a trichromatic TEM00 triplet: blue line ((lambda) equals 476 nm, 100 mW), green line ((lambda) equals 514 nm, 100 mW) and red line ((lambda) equals 647 nm, 100 mW). In a first stage we recorded a trichromatic reflection hologram with a separate reference beam on a single-layer silver-halide panchromatic plate (PFG 03C). After processing, the hologram is put back into the original recording set-up, as in classical experiments on real-time monochromatic holographic interferometry. So we observe interference fringes between the 3 reconstructed waves and the 3 actual waves. The interference fringes of the phenomenon are observed on a screen and recorded by a video camera at 25 frames per second. A color video film of about 3 minutes of duration is presented. Some examples related to phase objects are presented (hot airflow from a candle, airflow from a hand). The actual results show the possibility of using this technique to study, in real time, aerodynamic wakes and mechanical deformation.

  5. Textual appropriation in engineering master's theses: a preliminary study.

    PubMed

    Eckel, Edward J

    2011-09-01

    In the thesis literature review, an engineering graduate student is expected to place original research in the context of previous work by other researchers. However, for some students, particularly those for whom English is a second language, the literature review may be a mixture of original writing and verbatim source text appropriated without quotations. Such problematic use of source material leaves students vulnerable to an accusation of plagiarism, which carries severe consequences. Is such textual appropriation common in engineering master's writing? Furthermore, what, if anything, can be concluded when two texts have been found to have textual material in common? Do existing definitions of plagiarism provide a sufficient framework for determining if an instance of copying is transgressive or not? In a preliminary attempt to answer these questions, text strings from a random sample of 100 engineering master's theses from the ProQuest Dissertations and Theses database were searched for appropriated verbatim source text using the Google search engine. The results suggest that textual borrowing may indeed be a common feature of the master's engineering literature review, raising questions about the ability of graduate students to synthesize the literature. The study also illustrates the difficulties of making a determination of plagiarism based on simple textual similarity. A context-specific approach is recommended when dealing with any instance of apparent copying.

  6. Studying the anthropogenic radionuclides in Puerto Rico: Preliminary Result

    NASA Astrophysics Data System (ADS)

    Ithier-Guzmán, W.; Pyrtle, A. J.; Smoak, J.

    2004-12-01

    Local introduction of anthropogenic radionuclides to Puerto Rico's terrestrial and aquatic environments began in 1962 as a result of US government-sponsored research activities. Some of the earlier experiments examined the effects of radiation in tropical rainforests and the potential of superheated boiling nuclear reactor technology. More recent activities involved the use of depleted uranium during military exercises on Vieques. While the presence of radionuclides in Puerto Rico is documented, little research has been done to assess the environmental impact of this anthropogenic material. After entering Puerto Rico's environment, it is likely that some radionuclides are transported away from initial introduction sites. It is important that the distributions and behavior of radionuclides in Puerto Rico be determined. As such an investigation of this material throughout Puerto Rico was initiated. Sediment Cs-137 and Pb-210 activities, as well as ancillary geochemistry data are presented. These preliminary findings will be utilized as part of an ongoing study to determine radionuclide distributions and behaviors, with respect to aquatic geochemistry and dominant transport processes.

  7. A Preliminary Study of Functional Connectivity in Comorbid Adolescent Depression

    PubMed Central

    Cullen, Kathryn R.; Gee, Dylan G.; Klimes-Dougan, Bonnie; Gabbay, Vilma; Hulvershorn, Leslie; Mueller, Bryon A.; Camchong, Jazmin; Bell, Christopher J.; Houri, Alaa; Kumra, Sanjiv; Lim, Kelvin O.; Castellanos, F. Xavier; Milham, Michael P.

    2009-01-01

    Major Depressive Disorder (MDD) begins frequently in adolescence and is associated with severe outcomes, but the developmental neurobiology of MDD is not well understood. Research in adults has implicated fronto-limbic neural networks in the pathophysiology of MDD, particularly in relation to the subgenual anterior cingulate cortex (ACC). Developmental changes in brain networks during adolescence highlight the need to examine MDD-related circuitry in teens separately from adults. Using resting state functional magnetic resonance imaging (fMRI), this study examined functional connectivity in adolescents with MDD (n=12) and healthy adolescents (n=14). Seed-based connectivity analysis revealed that adolescents with MDD have decreased functional connectivity in a subgenual ACC-based neural network that includes the supragenual ACC (BA 32), the right medial frontal cortex (BA 10), the left inferior (BA 47) and superior frontal cortex (BA 22), superior temporal gyrus (BA 22), and the insular cortex (BA 13). These preliminary data suggest that MDD in adolescence is associated with abnormal connectivity within neural circuits that mediate emotion processing. Future research in larger, un-medicated samples will be necessary to confirm this finding. We conclude that hypothesis-driven, seed-based analyses of resting state fMRI data hold promise for advancing our current understanding of abnormal development of neural circuitry in adolescents with MDD. PMID:19446602

  8. Lymphangiogenesis in Classical Hodgkin Lymphoma - Preliminary Study with Clinicopathological Correlations

    PubMed Central

    Benharroch, Daniel; Prinsloo, Isebrand; Gopas, Jacob; Lazarev, Irena

    2016-01-01

    A role for lymphangiogenesis in metastatic breast and prostate cancers has been suggested recently. The relevance of lymphangiogenesis in cancer as a rule, and more specifically in classical Hodgkin lymphoma, is poorly understood in comparison with that of angiogenesis. In a preliminary (pilot) study we have investigated the role of lymphatic vessels growth in 19 cases of classical Hodgkin lymphoma stained with the D2-40 (podoplanin) antibody. In each case, three lymphatic vessels hot spots were scrutinized twice. Of the 57 hot spots thus identified, we chose 15 at random for photography, microvessel counting and image analysis. We determined the mean perimeter, surface area, major axis length and complexity factor for each hot spot and correlated them with clinical and biological features of classical Hodgkin lymphoma. No correlations were found with clinical features. No associations were noted with the standard immuno-markers of classical Hodgkin lymphoma. However, significant inverse correlations were shown with pRb, BAX and IκB-α expression. The mean lymphatic major axis length was inversely correlated with the complexity factor. Last, we carried out an additional clinicopathological correlation of the expression of pRb, BAX and IκB-α in a cohort of classical Hodgkin lymphoma patients previously published. PMID:27877228

  9. Preliminary design studies on a nuclear seawater desalination system

    SciTech Connect

    Wibisono, A. F.; Jung, Y. H.; Choi, J.; Kim, H. S.; Lee, J. I.; Jeong, Y. H.; No, H. C.

    2012-07-01

    Seawater desalination is one of the most promising technologies to provide fresh water especially in the arid region. The most used technology in seawater desalination are thermal desalination (MSF and MED) and membrane desalination (RO). Some developments have been done in the area of coupling the desalination plant with a nuclear reactor to reduce the cost of energy required in thermal desalination. The coupling a nuclear reactor to a desalination plant can be done either by using the co-generation or by using dedicated heat from a nuclear system. The comparison of the co-generation nuclear reactor with desalination plant, dedicated nuclear heat system, and fossil fueled system will be discussed in this paper using economical assessment with IAEA DEEP software. A newly designed nuclear system dedicated for the seawater desalination will also be suggested by KAIST (Korea Advanced Inst. of Science and Technology) research team and described in detail within this paper. The suggested reactor system is using gas cooled type reactor and in this preliminary study the scope of design will be limited to comparison of two cases in different operating temperature ranges. (authors)

  10. Calibration Study and Preliminary Results of PRad Experiment

    NASA Astrophysics Data System (ADS)

    Levillain, Maxime; PRad Collaboration

    2016-09-01

    The latest measurements of the proton radius through muonic hydrogen Lamb shift show a discrepancy of 7 σ from a global analysis of standard hydrogen Lamb shift and elastic ep -scattering. In order to understand this proton radius puzzle, the PRad experiment successfully took in last June some elastic ep -scattering data at very low Q2 (2 .10-4 to 10-1 GeV2) with very accurate angle and energy measurements to minimize the systematic uncertainties. Before measuring the cross-sections that will be used to extract the electromagnetic form factor GE(Q2) and the proton radius, a very careful calibration of the electromagnetic calorimeter (HyCal) must be performed to get a good energy resolution and separate ep -events from M øller events especially at low angle. We will present an extended study of the electromagnetic calorimeter calibration of this experiment as well as some preliminary results on ep - and ee -scattering processes extracted from the data. The PRad experiment is supported in part by NSF MRI Award PHY-1229153.

  11. Cementless acetabular revision arthroplasty

    PubMed Central

    Jain, Rina; Schemitsch, Emil H.; Waddell, James P.

    2000-01-01

    Objective To evaluate the effects of clinical factors on outcome after acetabular revision with a cementless beaded cup. Design Retrospective case series. Setting Tertiary care referral centre. Patients Forty-one patients who underwent acetabular revision with a cementless cup were followed up for a mean of 3.4 years. Interventions Acetabular revision with a beaded cementless cup in all patients. A morcellized allograft was used in 10 patients. Outcome measures A modified Harris hip score (range of motion measurement omitted), the SF-36 health survey, and the Western Ontario McMaster (WOMAC) osteoarthritis index. Multivariate analysis was used to evaluate the effects of age, gender, morcellized allografting, time to revision from the previous operation, acetabular screw fixation and concurrent femoral revision on outcome. Results Gender accounted for a significant portion of the variation seen in the SF-36 physical component scores (r = 0.36, p = 0.02), with women tending to have worse results. Increasing age was associated with lower WOMAC index function scores (r = 0.36, p = 0.03), whereas concurrent femoral revision tended to have a positive effect on WOMAC index function (r = 0.39, p = 0.01). None of the potential clinical predictors had any significant effect on the SF-36 mental component scores, or WOMAC index pain and stiffness scores. Conclusions In cementless acetabular revision arthroplasty, physical function, as measured by generic and limb-specific scales, may be affected by gender, age and the presence of a concurrent femoral revision. Time to revision from the previous operation, morcellized allografting and screw fixation of the acetabulum did not affect outcomes. This information may provide some prognostic value for patients’ expectations. PMID:10948687

  12. Bio-Contamination Control for Spacesuit Garments - A Preliminary Study

    NASA Technical Reports Server (NTRS)

    Rhodes, Richard; Korona, Adam; Orndoff, Evelyn; Ott, Mark; Poritz, Darwin

    2010-01-01

    This paper outlines a preliminary study to review, test, and improve upon the current state of spacesuit bio-contamination control. The study includes an evaluation of current and advanced suit materials, ground and on-orbit cleaning methods, and microbial test and analysis methods. The first aspect of this study was to identify potential anti-microbial textiles and cleaning agents, and to review current microbial test methods. The anti-microbial cleaning agent and textile market survey included a review of current commercial-off-the-shelf (COTS) products that could potentially be used as future space flight hardware. This review included replacements for any of the softgood layers that may become contaminated during an extravehicular activity (EVA), including the pressure bladder, liquid cooling garment, and ancillary comfort undergarment. After a series of COTS anti-microbial textiles and clean ing agents were identified, a series of four tests were conducted: (1) a stacked configuration test that was conducted in order to review how bio-contamination would propagate through the various suit layers, (2) a individual materials test that evaluated how well each softgood layer either promoted or repressed growth, (3) a cleaning agent test that evaluated the efficacy on each of the baseline bladders, and (4) an evaluation of various COTS anti-microbial textiles. All antimicrobial COTS materials tested appeared to control bacteria colony forming unit (CFU) growth better than the Thermal Comfort Undergarment (TCU) and ACES Liquid Cooling Garment (LCG)/EMU Liquid Cooling Ventilation Garment (LCVG) materials currently in use. However, a comparison of fungi CFU growth in COTS to current suit materials appeared to vary per material. All cleaning agents tested in this study appeared to inhibit the level of bacteria and fungi growth to acceptable levels for short duration tests. While several trends can be obtained from the current analysis, a series of test improvements are

  13. [Peritoneal equilibration test: Conventional versus adapted. Preliminary study].

    PubMed

    Zaloszyc, Ariane; Schmitt, Claus Peter; Schaefer, Betti; Doutey, Armelle; Terzic, Joëlle; Menouer, Soraya; Higel, Laetitia; Fischbach, Michel

    2017-02-01

    Conventional automated peritoneal dialysis (APD) is prescribed as a repetition of cycles with the same dwell time and the same fill volume. Water and sodium balance remains a common problem among patients on peritoneal dialysis. More recently, adapted automated peritoneal dialysis was described, as a combination of short dwells with a low volume, in order to enhance ultrafiltration, followed by long dwells with a large fill volume to favor solute removal. We performed a preliminary crossover study on 4 patients. The total amount of dialysate was the same, i.e. 2L/m(2) as well as the total duration of the test, i.e. 150 minutes. The conventional test was made with two identical cycles, each cycle had a fill volume of 1L/m(2) and a duration of 75 minutes, while the adapted test was performed with one short cycle, i.e. 30 minutes with a low fill volume, i.e. 0.6L/m(2), followed by a long cycle, i.e. 120 minutes, with a large fill volume, i.e. 1.4L/m(2). Sodium extraction was improved by 29.3mmol/m(2) (169%) in the adapted test in comparison to the conventional test. Ultrafiltration was enhanced by 159mL/m(2) (128%) in the adapted test compared to the conventional one. Glucose absorption was decreased by 35% in the adapted test in comparison to the conventional test and osmotic conductance was also improved. In conclusion, adapted dialysis may allow for a better volume and sodium balance, since we observed an improvement in sodium extraction and ultrafiltration. This pre-study authorizes an improvement of the European Pediatric Study's protocol on Adapted APD, already started and which will continue in the next months.

  14. Progress in preliminary studies at Ottana Solar Facility

    NASA Astrophysics Data System (ADS)

    Demontis, V.; Camerada, M.; Cau, G.; Cocco, D.; Damiano, A.; Melis, T.; Musio, M.

    2016-05-01

    The fast increasing share of distributed generation from non-programmable renewable energy sources, such as the strong penetration of photovoltaic technology in the distribution networks, has generated several problems for the management and security of the whole power grid. In order to meet the challenge of a significant share of solar energy in the electricity mix, several actions aimed at increasing the grid flexibility and its hosting capacity, as well as at improving the generation programmability, need to be investigated. This paper focuses on the ongoing preliminary studies at the Ottana Solar Facility, a new experimental power plant located in Sardinia (Italy) currently under construction, which will offer the possibility to progress in the study of solar plants integration in the power grid. The facility integrates a concentrating solar power (CSP) plant, including a thermal energy storage system and an organic Rankine cycle (ORC) unit, with a concentrating photovoltaic (CPV) plant and an electrical energy storage system. The facility has the main goal to assess in real operating conditions the small scale concentrating solar power technology and to study the integration of the two technologies and the storage systems to produce programmable and controllable power profiles. A model for the CSP plant yield was developed to assess different operational strategies that significantly influence the plant yearly yield and its global economic effectiveness. In particular, precise assumptions for the ORC module start-up operation behavior, based on discussions with the manufacturers and technical datasheets, will be described. Finally, the results of the analysis of the: "solar driven", "weather forecasts" and "combined storage state of charge (SOC)/ weather forecasts" operational strategies will be presented.

  15. A preliminary magnetic study of Sawa lake sediments, Southern Iraq

    NASA Astrophysics Data System (ADS)

    Ameen, Nawrass

    2016-04-01

    A preliminary magnetic study combined with chemical analyses was carried out in Sawa Lake in Al-Muthanna province, southern Iraq, about 22 km south west of Samawa city (31°18'48.80"N, 45°0'25.25"E). The lake is about 4.74 km length, 1.75 km width and 5.5 m height, it is surrounded by a salt rim which is higher than the lake water by about 2.8 m and sea water by about 18.5 m (Naqash et al., 1977 in Hassan, 2007). The lake is an elongated closed basin with no surface water available to it, it may be fed by groundwater of the Euphrates and Dammam aquifers through system of joints and cracks. This study aims to investigate the concentrations of selected heavy metals as pollutants and magnetic susceptibility (MS) and other magnetic properties of sediment samples from fifty sites collected from the bottom of the lake, the study area lies in an industrial area. The results show spatial variations of MS with mean value of about 4.58 x 10-8 m3 kg-1. Scanning electron microscopy and magnetic mineralogy parameters indicate the dominance of soft magnetic phase like magnetite and presence of hard magnetic phase like hematite. Spatial variations of MS combined with the concentrations of heavy metals suggests the efficiency of magnetic methods as effective, inexpensive and non-time consuming method to outlining the heavy metal pollution. References: Hassan W.F., 2007. The Physio-chemical characteristic of Sawa lake water in Samawa city-Iraq. Marine Mesopotamica, 22(2), 167-179.

  16. Nationwide trends in total shoulder arthroplasty and hemiarthroplasty for osteoarthritis.

    PubMed

    Trofa, David; Rajaee, Sean S; Smith, Eric L

    2014-04-01

    Recent literature reports an increase in the rate of shoulder arthroplasties, particularly total shoulder arthroplasties (TSAs), being performed in the United States. However, the national epidemiology of use of hemiarthroplasty (HA) and TSA as treatments for glenohumeral osteoarthritis has not been elucidated. We conducted a study to analyze trends in using HA and TSA as treatments for glenohumeral osteoarthritis from 2000 to 2010, and to compare patient characteristics and inpatient complications. US Nationwide Inpatient Sample patients with a primary inpatient diagnosis of shoulder arthritis and a principal procedure of HA or TSA were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural codes. From 2000 to 2010 the nationally adjusted population rate of shoulder arthroplasty performed for osteoarthritis increased 3.7-fold. Specifically, the population rate of TSA increased 5.0-fold, and that of HA increased 1.9-fold. In 2010, 80.3% of patients having shoulder arthroplasty for arthritis underwent TSA. TSA patients were older (P < .0001) and had a higher mean number of chronic illnesses (P = .034). TSA-associated discharges had a higher rate of surgical and medical care complications (P = .011) and blood transfusions (P = .041) after adjusting for comorbidities.

  17. Total Arthroplasty in Ankylosed Knees: A Case Series

    PubMed Central

    Camanho, Gilberto Luiz

    2009-01-01

    OBJECTIVE To present nine patients with ankylosis in their knees that were submitted to a total arthroplasty to lessen their pain and improve their functional limitation. For these patients, arthrodesis remained a possibility in the event of arthroplasty failure. INTRODUCTION Ankylosis of the knee is a severe functional limitation that becomes worse when pain is present. Arthrodesis of the knee is a classical indication for such patients, since it resolves the pain; however, the severe functional limitation remains. METHODS In the present study, we evaluated the clinical course of nine patients who underwent total arthroplasty of the knee, and were followed up for at least five years. RESULTS The results demonstrate that all of the patients experienced a significant reduction in pain and some improvement in the degree of knee flexion and extension. CONCLUSION Based on the latest follow-up, there has been no need to perform arthrodesis for any of our patients, showing that a total arthroplasty could be a option for treatment in knee ankylosis. PMID:19330242

  18. How Perceived Pain Influence Sleep and Mood More Than The Reverse: A Novel, Exploratory Study with Patients Awaiting Total Hip Arthroplasty.

    PubMed

    Blågestad, Tone; Pallesen, Ståle; Grønli, Janne; Tang, Nicole K Y; Nordhus, Inger H

    2016-01-01

    Objectives: Attributions about how comorbid symptoms worsen or improve each other are central cognitive components of chronic pain that are shown to facilitate or impede the recovery process. Still, these attributions have been poorly illuminated in chronic pain patients. The present study explored perceptions of how sleep, pain, and mood influence each other in patients awaiting total hip arthroplasty (THA). Design and Methods: In this cross-sectional study, 291 patients (mean age 67.8, 65.3% female) rated 12 statements about how much a given symptom (pain, sleep, mood) changed when another symptom (pain, sleep, mood) worsened or improved on a response scale ranging from much worse (-2) via no change (0) to much better (2). Sleep (Bergen Insomnia Scale), pain (McGill Pain Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale) were assessed as background variables. Results: Of the patients in the study, 56% reported symptoms indicating insomnia. Anxiety and depression were indicated in 16 and 10%, respectively. Over 80% rated their pain as horrible/unbearable and reported that pain occurred always/daily. When experiencing increased pain, a majority perceived that sleep (90%) and mood (70%) worsened, whilst experiencing reduced pain improved sleep and mood in 50%. Poor sleep increased pain and worsened mood in 45 and 60% of the patients, respectively. Better sleep was perceived to reduce pain and improve mood in 50%. Worsened mood increased pain (46%) and worsened sleep (52%). Improved mood decreased pain and improved sleep in 25 and 35%, respectively. Discussion: In this study, a novel approach was used to investigate perceptions of reciprocal relationships between symptoms. We found that THA patients perceived interrelationships between pain, sleep and mood. These perceived interrelations were stronger when symptoms worsened than when symptoms improved. They also held stronger beliefs about the effect of pain on sleep and mood, than the

  19. How Perceived Pain Influence Sleep and Mood More Than The Reverse: A Novel, Exploratory Study with Patients Awaiting Total Hip Arthroplasty

    PubMed Central

    Blågestad, Tone; Pallesen, Ståle; Grønli, Janne; Tang, Nicole K. Y.; Nordhus, Inger H.

    2016-01-01

    Objectives: Attributions about how comorbid symptoms worsen or improve each other are central cognitive components of chronic pain that are shown to facilitate or impede the recovery process. Still, these attributions have been poorly illuminated in chronic pain patients. The present study explored perceptions of how sleep, pain, and mood influence each other in patients awaiting total hip arthroplasty (THA). Design and Methods: In this cross-sectional study, 291 patients (mean age 67.8, 65.3% female) rated 12 statements about how much a given symptom (pain, sleep, mood) changed when another symptom (pain, sleep, mood) worsened or improved on a response scale ranging from much worse (-2) via no change (0) to much better (2). Sleep (Bergen Insomnia Scale), pain (McGill Pain Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale) were assessed as background variables. Results: Of the patients in the study, 56% reported symptoms indicating insomnia. Anxiety and depression were indicated in 16 and 10%, respectively. Over 80% rated their pain as horrible/unbearable and reported that pain occurred always/daily. When experiencing increased pain, a majority perceived that sleep (90%) and mood (70%) worsened, whilst experiencing reduced pain improved sleep and mood in 50%. Poor sleep increased pain and worsened mood in 45 and 60% of the patients, respectively. Better sleep was perceived to reduce pain and improve mood in 50%. Worsened mood increased pain (46%) and worsened sleep (52%). Improved mood decreased pain and improved sleep in 25 and 35%, respectively. Discussion: In this study, a novel approach was used to investigate perceptions of reciprocal relationships between symptoms. We found that THA patients perceived interrelationships between pain, sleep and mood. These perceived interrelations were stronger when symptoms worsened than when symptoms improved. They also held stronger beliefs about the effect of pain on sleep and mood, than the

  20. Assessing hospital cost of joint arthroplasty

    PubMed Central

    BONIFORTI, FILIPPO

    2015-01-01

    Purpose total joint replacement is one of the most successful procedures in medicine and cost reimbursements to hospitals for the joint arthroplasty diagnosis-related group are among the largest payments made by a Regional Health Service. Despite the popularity of these procedures, there are few high-quality cost-effectiveness studies on this topic. This study evaluates the cost of total joint arthroplasty performed in a district hospital. Methods direct and indirect costs have been measured and patient procedure pathway was analyzed subdivided into three stages: surgical procedure, inpatient care and outpatient clinic. Results the cost of the surgical procedure stage was calculated as 3,798 euros, while that of the inpatient stage was 2,924 euros. The mean hospital costs per procedure amounted to 6,952 euros. Conclusions although the Health Service tariffs fully reimburse the cost of providing a joint replacement, our data contribute to point out the role of hospital staff’s organization to support sustainable improvements on health care for joint replacement surgery. Level of evidence Level VI, single economic evaluation. PMID:26904524

  1. UNICOMPARTMENTAL KNEE ARTHROPLASTY: CURRENT PERSPECTIVES AND TRENDS IN BRAZIL

    PubMed Central

    Arliani, Gustavo Gonçalves; Júnior, João Alberto Yazigi; Angelini, Felipe Bertelli; Ferlin, Fernando; Hernandes, Andrea Canizares; Astur, Diego da Costa; Cohen, Moises

    2015-01-01

    Objective: The aim of this study was to evaluate the approaches and procedures used by Brazilian orthopedic surgeons for treating osteoarthrosis by means of unicompartmental knee arthroplasty and high tibial osteotomy of the knee. Methods: A questionnaire with 14 closed questions was developed and applied to Brazilian knee surgeons during the three days of the 43rd Brazilian Congress of Orthopedics and Traumatology. Results: A total of 113 surgeons filled out the questionnaire completely and became part of the sample analyzed. In this study, the majority of the surgeons performed fewer than five unicompartmental knee arthroplasty procedures/year (61.1%) and between 5 and 15 high tibial osteotomy procedures/year (37.2%). Use of computerized navigation systems during surgery remains uncommon in our environment, since only 0.9% of the specialists were using it. 65.5% of the surgeons reported that they had chosen to use total knee arthroplasty rather than partial arthroplasty due to lack of familiarity with the surgical technique. When asked about the possibility that the number of unicompartmental prostheses used in Brazil would grow as surgeons in this country become increasingly familiar with the technique, 80.5% of the respondents believed in this hypothesis. In this sample, we found that the greater the surgeon's experience was, the greater the numbers of unicompartmental prostheses and tibial osteotomies performed annually were (r = 0.550 and r = 0.465, respectively; p < 0.05). Conclusions: There is a clear evolutional trend towards treatment of unicompartmental osteoarthritis using partial knee arthroplasty in Brazil. However, further prospective controlled studies are needed in order to evaluate the clinical and scientific benefits of these trends. PMID:27047891

  2. Chemical components of shredded paper insulation: a preliminary study.

    PubMed

    Kelman, B J; Swenson, L J; Uppala, L V; Cohen, J M; Millette, J R; Mueller, W F

    1999-03-01

    We conducted an evaluation of shredded paper insulation to identify potentially toxic components. The study was to provide a preliminary characterization of a few samples of insulation currently in use. The following samples were analyzed: previously produced insulation (PPI) containing fire retardants, shredded recycled paper (PPI feedstock), freshly produced insulation (FPI), and insulation which had been installed in a residence (II). Volatile constituents were analyzed by GC-MS from headspace air of samples held at room temperature or heated to 90 degrees C. Extractable constituents were sampled by extracting with methylene chloride, and analyzing by GC-MS. Formaldehyde analysis was done according to EPA Method TO11. Headspace air at room temperature contained no detectable quantities of volatile constituents for any sample measured. In headspace air at 90 degrees C, only PPI contained traces of aliphatic and aromatic hydrocarbons and higher aldehydes, and FPI traces of toluene. Extracts of PPI contained traces of octadecadienoic acid methyl ester and aliphatic and aromatic hydrocarbons and higher aldehydes. Extracts of PPI feedstock contained traces of a substituted cyclohexenecarboxylic acid. FPI contained extractable diethyl phthalate (30-50 micrograms/g). Extracts of II contained traces of methyl palmitate, an octadecenoic acid methyl ester, and a phthalate plasticizer. No formaldehyde was detected. PPI was composed of approximately 98 percent paper fiber and 2 percent pre-gelatinized starch. PPI samples agglomerated together with less than 0.01 percent separating from clumps as fine dust. Boron and sodium were expected and confirmed because they were added to PPI and FPI as fire retardants. Chromium, copper, iron, potassium, magnesium, manganese, phosphorus, and silicon were present at detectable concentrations. Study calculations indicate that an occupant would have to completely consume all the fine particles produced from 3.3 kg of insulation per day to

  3. Preliminary study of the CRRES magnetospheric barium releases

    NASA Technical Reports Server (NTRS)

    Huba, J. D.; Bernhardt, P. A.; Lyon, J. G.

    1992-01-01

    Preliminary theoretical and computational analyses of the Combined Release and Radiation Effects Satellite (CRRES) magnetospheric barium releases are presented. The focus of the studies is on the evolution of the diamagnetic cavity which is formed by the barium ions as they expand outward, and on the structuring of the density and magnetic field during the expansion phase of the releases. Two sets of simulation studies are discussed. The first set is based upon a 2D ideal MHD code and provides estimates of the time and length scales associated with the formation and collapse of the diamagnetic cavity. The second set uses a nonideal MHD code; specifically, the Hall term is included. This additional term is critical to the dynamics of sub-Alfvenic plasma expansions, such as the CRRES barium releases, because it leads to instability of the expanding plasma. Detailed simulations of the G4 and G10 releases were performed. In both cases the expanding plasma rapidly structured: the G4 release structured at time t less than about 3 s and developed scale sizes of about 1-2 km, while the G10 release structured at time t less than about 22 s and developed scale sizes of about 10-15 km. It is also found that the diamagnetic cavity size is reduced from those obtained from the ideal MHD results because of the structure. On the other hand, the structuring allows the formation of plasma blobs which appear to free stream across the magnetic field; thus, the barium plasma can propagate to larger distances traverse to the magnetic field than the case where no structuring occurs. Finally, a new normal mode of the system was discovered which may be excited at the leading edge of the expanding barium plasma.

  4. Nevada potential repository preliminary transportation strategy: Study 1

    SciTech Connect

    None,

    1995-04-01

    Limited feasible options exist when considering the shipment of spent nuclear fuel and high-level radioactive waste. These options are rail or truck; because of the weight associated with transportation casks (68.0 to 113.4 tonnes/75 to 125 tons), heavy-haul trucks are also considered. Yucca Mountain currently lacks rail service or an existing right-of-way for rail; it also lacks a dedicated highway suitable for heavy-haul trucks. Approximately 11,230 shipments by rail are planned from waste producer sites to Nevada, with an additional 1,041 shipments by legal-weight truck from four reactor sites not capable of upgrading for rail shipment. This study identifies the reasonable alternatives for waste transport to the potential repository site, describes the evaluation process performed to identify those alternatives, and discusses the reasons for elimination of transportation routes deemed to be not reasonable. The study concluded that heavy haul truck transportation is feasible-cost is very favorable when compared to rail-but route restrictions must be further evaluated. In addition to restrictions due to seasonal weather conditions, specific routes have additional restrictions, including no travel on holidays or weekends, and travel during daylight hours only. Further restrictions will be imposed by the U.S. Department of Transportation based on routing of radioactive materials by highway. Operation and maintenance costs for heavy-haul over a 24-year period, based on preliminary information, were calculated on an estimated operational cost of $15,000 per trip, with an estimated 468 trips per year average (11,230 total trips), for an estimated cost of $171 million to $173 million, depending on the route used. Because the initial costs and the total system life cycle costs of heavy-haul are approximately 50 percent lower than the lowest rail cost, this option will continue to be evaluated.

  5. In vivo radioprotection by alpha-TMG: preliminary studies.

    PubMed

    Satyamitra, M; Devi, P U; Murase, H; Kagiya, V T

    2001-08-08

    alpha-TMG is a novel water-soluble derivative of Vitamin E that has shown excellent antioxidant activity. The parent compound has demonstrated protection against radiation induced chromosomal damage in vivo. Hence, the preliminary experiments to determine the radioprotective activity of alpha-TMG were carried out in adult Swiss albino mice. Acute toxicity of the drug was studied taking 24h, 72 h and 30 day mortality after a single intraperitoneal injection of 500-2000 mg/kg body weight of the drug. The drug LD(50) for 24h and 72 h/30 day survival were found to be 1120 and 1000 mg/kg body weight, respectively. The optimum time of drug administration and drug dose-dependent effect on in vivo radiation protection of bone marrow chromosomes was studied in mice. Injection of 600 mg/kg of the drug 15 min before or within 5, 15 or 30min after 3Gy whole body gamma radiation resulted in a significant decrease in the aberrant metaphases percent at 24h post-irradiation; the maximum effect was seen when the drug was given immediately after irradiation. Injection of 200-800 mg/kg TMG within 5 min of irradiation with 3 Gy produced a significant dose-dependent reduction in the radiation induced percent aberrant metaphases and in the frequency of micronucleated erythrocytes at 24h after exposure, with a corresponding decrease in the different types of aberrations. The optimum dose for protection without drug toxicity was 600 mg/kg body weight. At this dose, TMG produced 70 and >60% reduction in the radiation induced percent aberrant metaphases and micronucleated erythrocytes, respectively. The high water solubility and effectiveness when administered post-irradiation favor TMG as a likely candidate for protection in case of accidental exposures.

  6. The role of surgeon volume on patient outcome in total knee arthroplasty: a systematic review of the literature

    PubMed Central

    2012-01-01

    Background A number of factors have been identified as influencing total knee arthroplasty outcomes, including patient factors such as gender and medical comorbidity, technical factors such as alignment of the prosthesis, and provider factors such as hospital and surgeon procedure volumes. Recently, strategies aimed at optimizing provider factors have been proposed, including regionalization of total joint arthroplasty to higher volume centers, and adoption of volume standards. To contribute to the discussions concerning the optimization of provider factors and proposals to regionalize total knee arthroplasty practices, we undertook a systematic review to investigate the association between surgeon volume and primary total knee arthroplasty outcomes. Methods We performed a systematic review examining the association between surgeon volume and primary knee arthroplasty outcomes. To be included in the review, the study population had to include patients undergoing primary total knee arthroplasty. Studies had to report on the association between surgeon volume and primary total knee arthroplasty outcomes, including perioperative mortality and morbidity, patient-reported outcomes, or total knee arthroplasty implant survivorship. There were no restrictions placed on study design or language. Results Studies were variable in defining surgeon volume (‘low’: <3 to <52 total knee arthroplasty per year; ‘high’: >5 to >70 total knee arthroplasty per year). Mortality rate, survivorship and thromboembolic events were not found to be associated with surgeon volume. We found a significant association between low surgeon volume and higher rate of infection (0.26% - 2.8% higher), procedure time (165 min versus 135 min), longer length of stay (0.4 - 2.13 days longer), transfusion rate (13% versus 4%), and worse patient reported outcomes. Conclusions Findings suggest a trend towards better outcomes for higher volume surgeons, but results must be interpreted with caution. PMID

  7. In vivo knee kinematics during stair and deep flexion activities in patients with bicruciate substituting total knee arthroplasty.

    PubMed

    Kuroyanagi, Yuji; Mu, Shang; Hamai, Satoshi; Robb, William J; Banks, Scott A

    2012-01-01

    Orthopedic surgeons and their patients continue to seek better functional outcomes after total knee arthroplasty. The bicruciate substituting (BCS) total knee arthroplasty design has been introduced to achieve more natural knee mechanics. The purpose of this study was to characterize kinematics in knees with BCS arthroplasty during deep flexion and stair activities using fluoroscopy and model-image registration. In 20 patients with 25 BCS knees, we observed average implant flexion of 128° during kneeling and consistent posterior condylar translations with knee flexion. Tibial rotations were qualitatively similar to those observed in the arthritic natural knee. Knee kinematics with BCS arthroplasty were qualitatively more similar to arthritic natural knees than knees with either posterior cruciate-retaining or posterior-stabilized arthroplasty.

  8. Unicompartmental Knee Osteoarthritis (UKOA): Unicompartmental Knee Arthroplasty (UKA) or High Tibial Osteotomy (HTO)?

    PubMed Central

    Rodriguez-Merchan, E. Carlos

    2016-01-01

    The aim of this review article is to analyze the results of high tibial osteotomy compared to unicompartmental knee arthroplasty in patients with unicompartmental knee osteoarthritis. The search engine used was PubMed. The keywords were: “high tibial osteotomy versus unicompartmental knee arthroplasty”. Twenty-one articles were found on 28 February 2015, but only eighteen were selected and reviewed because they strictly focused on the topic. In a meta-analysis the ratio for an excellent outcome was higher in unicompartmental knee arthroplasty than high tibial osteotomy and the risks of revision and complications were lower in the former. A prospective comparative study showed that unicompartmental knee arthroplasty offers better long-term success (77% for unicompartmental knee arthroplasty and 60% for high tibial osteotomy at 7-10 years). However, a review of the literature showed no evidence of superior results of one treatment over the other. A multicenter study stated that unicompartmental knee osteoarthritis without constitutional deformity should be treated with unicompartmental knee arthroplasty while in cases with constitutional deformity high tibial osteotomy should be indicated. A case control study stated that unicompartmental knee arthroplasty offers a viable alternative to high tibial osteotomy if proper patient selection is done. The literature is still controversial regarding the best surgical treatment for unicompartmental knee osteoarthritis (high tibial osteotomy or unicompartmental knee arthroplasty). However, unicompartmental knee arthroplasty utilization is increasing, while high tibial osteotomy utilization is decreasing, and a meta-analysis has shown better outcomes and less risk of revision and complications in the former. A systematic review has found that with correct patient selection, both procedures show effective and reliable results. However, prospective randomized studies are needed in order to answer the question of this article

  9. Different incidences of knee arthroplasty in the Nordic countries

    PubMed Central

    NiemeläInen, Mika J; MäKelä, Keijo T; Robertsson, Otto; W-Dahl, Annette; Furnes, Ove; Fenstad, Anne M; Pedersen, Alma B; Schrøder, Henrik M; Huhtala, Heini; Eskelinen, Antti

    2017-01-01

    Background and purpose The annual number of total knee arthroplasties (TKAs) has increased worldwide in recent years. To make projections regarding future needs for primaries and revisions, additional knowledge is important. We analyzed and compared the incidences among 4 Nordic countries Patients and methods Using Nordic Arthroplasty Register Association (NARA) data from 4 countries, we analyzed differences between age and sex groups. We included patients over 30 years of age who were operated with TKA or unicompartmental knee arthroplasty (UKA) during the period 1997–2012. The negative binomial regression model was used to analyze changes in general trends and in sex and age groups. Results The average annual increase in the incidence of TKA was statistically significant in all countries. The incidence of TKA was higher in women than in men in all 4 countries. It was highest in Finland in patients aged 65 years or more. At the end of the study period in 2012, Finland’s total incidence was double that of Norway, 1.3 times that of Sweden and 1.4 times that of Denmark. The incidence was lowest in the youngest age groups (< 65 years) in all 4 countries. The proportional increase in incidence was highest in patients who were younger than 65 years. Interpretation The incidence of knee arthroplasty steadily increased in the 4 countries over the study period. The differences between the countries were considerable, with the highest incidence in Finland. Patients aged 65 years or more contributed to most of the total incidence of knee arthroplasty. PMID:28056570

  10. Comparison of Clinical and Radiological Results according to Glenosphere Position in Reverse Total Shoulder Arthroplasty: A Short-term Follow-up Study

    PubMed Central

    Choi, Chang Hyuk; Kim, Sung Guk; Lee, Jae Jun

    2017-01-01

    Background In a previous biomechanical study, eccentric glenospheres with more inferior position of the center of rotation were shown to improve range of motion and reduce the incidence of scapular notching after reverse total shoulder arthroplasty (RSA). The purpose of this study was to compare the clinical and radiological results of RSA using an eccentric glenosphere to those using a concentric glenosphere and to determine the usefulness of the eccentric glenosphere. Methods From 2009 to 2015, we performed a retrospective review of 20 consecutive patients who underwent RSA using a deltopectoral approach. Nine patients underwent RSA using a concentric glenosphere (group A) while 11 had an eccentric glenosphere (group B). The average follow-up period was 13.9 months (range, 12 to 18 months). All glenoid components were placed with 15° of inferior tilt. Clinical results were assessed using the visual analog pain scale score (VAS), the American Shoulder and Elbow Surgeon (ASES) score, the Korean shoulder scoring system (KSS), and the Constant score. On radiological evaluation, prosthesisscapular neck angle (PSNA), peg-glenoid rim distance (PGRD), scapular neck-inferior glenoshere rim distance (inferior glenoshpere overhang), acromion-greater tuberosity (AT) distance, glenoid-greater tuberosity (GT) distance, and severity of notching according to the Nerot-Sirveaux classification were assessed. Results The clinical results improved significantly in both groups, but there was no statistically significant difference between the two groups. A significant intergroup difference was observed with regard to PGRD (24.8 ± 1.6 mm for group A vs. 22.2 ± 1.9 mm for group B; p = 0.002) and inferior glenosphere overhang (2.0 ± 1.7 mm for group A vs. 5.8 ± 1.6 mm for group B; p = 0.000). Seven of 9 patients in group A developed notching compared with 2 of 11 patients in group B (p = 0.022). The other radiological parameters such as inferior tilt and AT and GT distances were

  11. A Preliminary Study of the Burgers Equation with Symbolic Computation

    NASA Astrophysics Data System (ADS)

    Derickson, Russell G.; Pielke, Roger A.

    2000-07-01

    A novel approach based on recursive symbolic computation is introduced for the approximate analytic solution of the Burgers equation. Once obtained, appropriate numerical values can be inserted into the symbolic solution to explore parametric variations. The solution is valid for both inviscid and viscous cases, covering the range of Reynolds number from 500 to infinity, whereas current direct numerical simulation (DNS) methods are limited to Reynolds numbers no greater than 4000. What further distinguishes the symbolic approach from numerical and traditional analytic techniques is the ability to reveal and examine direct nonlinear interactions between waves, including the interplay between inertia and viscosity. Thus, preliminary efforts suggest that symbolic computation may be quite effective in unveiling the “anatomy” of the myriad interactions that underlie turbulent behavior. However, due to the tendency of nonlinear symbolic operations to produce combinatorial explosion, future efforts will require the development of improved filtering processes to select and eliminate computations leading to negligible high order terms. Indeed, the initial symbolic computations present the character of turbulence as a problem in combinatorics. At present, results are limited in time evolution, but reveal the beginnings of the well-known “saw tooth” waveform that occurs in the inviscid case (i.e., Re=∞). Future efforts will explore more fully developed 1-D flows and investigate the potential to extend symbolic computations to 2-D and 3-D. Potential applications include the development of improved subgrid scale (SGS) parameterizations for large eddy simulation (LES) models, and studies that complement DNS in exploring fundamental aspects of turbulent flow behavior.

  12. Byssinosis in a textile factory in Cameroon: a preliminary study.

    PubMed Central

    Takam, J; Nemery, B

    1988-01-01

    To assess the risk of byssinosis in a cotton textile factory in Cameroon a preliminary study was conducted on a random sample of 125 men from production areas and 68 men from non-production areas. Symptoms were assessed by a questionnaire, which also included questions regarding sleep; peak expiratory flow rate (PEF) was measured with a miniature peak flow meter at the end of a working day and total dust concentrations were assessed by static and personal sampling with Casella dust samplers giving values of 6.4 +/- 2.6 mg/m3 (m +/- SD) in production areas and 1.7 +/- 0.7 mg/m3 in control areas. Exposed subjects had significantly more symptoms (particularly in smokers) and lower PEF values than controls (408 +/- 961/min v 468 +/- 701/min, p less than 0.001). Twenty three exposed subjects (18%) reported chest tightness on returning to work after the weekly break (compared with one control, p less than 0.01). Subjects with byssinosis had lower PEF values than those without chest tightness (356 +/- 501/min v 426 +/- 951/min, p less than 0.01), more chronic bronchitis (52% v 6%, p less than 0.001), they were more often smokers (61% v 31%, p less than 0.05), and came generally, though not exclusively, from the opening carding spinning department with the highest concentrations of total dust (8 +/- 2 mg/m3) and an estimated prevalence of byssinosis of 28%. There were no significant differences in sleep related symptoms between the exposed and controls, though the 23 subjects with byssinosis tended to report more snoring (48%), early morning headache (48%), and sleep improvement over the working week (44%) than all the other subjects (28%, 24%, and 24% respectively, p less than 0.1). PMID:3219305

  13. Infrared laser sealing of porcine tissues: preliminary in vivo studies

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Hutchens, Thomas C.; Kerr, Duane; Latimer, Cassandra; Rosenbury, Sarah B.; Giglio, Nicholas C.; Schweinsberger, Gino R.; Perkins, William C.; Wilson, Christopher R.; Ward, Arlen; Nau, William H.; Fried, Nathaniel M.

    2015-02-01

    We are exploring infrared (IR) lasers as an alternative energy modality to radiofrequency (RF) and ultrasonic (US) devices intended to provide rapid surgical hemostasis with minimal collateral zones of thermal damage and tissue necrosis. Previously, a 1470-nm IR laser sealed and cut ex vivo porcine renal arteries of 1-8 mm in 2 s, yielding burst pressures < 1200 mmHg (compared to normal systolic blood pressure of 120 mmHg) and thermal coagulation zones < 3 mm (including the seal). This preliminary study describes in vivo testing of a laser probe in a porcine model. A prototype, fiber optic based handheld probe with vessel/tissue clasping mechanism was tested on blood vessels < 6 mm diameter using incident 1470-nm laser power of 35 W for 1-5 s. The probe was evaluated for hemostasis after sealing isolated and bundled vasculature of abdomen and hind leg, as well as liver and lung parenchyma. Sealed vessel samples were collected for histological analysis of lateral thermal damage. Hemostasis was achieved in 57 of 73 seals (78%). The probe consistently sealed vasculature in small bowel mesentery, mesometrium, and gastro splenic and epiploic regions. Seal performance was less consistent on hind leg vasculature including saphenous arteries and bundles and femoral and iliac arteries. Collagen denaturation averaged 1.6 mm in 8 samples excised for histologic examination. A handheld laser probe sealed porcine vessels in vivo. With further improvements in probe design and laser parameter optimization, IR lasers may provide an alternative to RF and US vessel sealing devices.

  14. Preliminary study for small animal preclinical hadrontherapy facility

    NASA Astrophysics Data System (ADS)

    Russo, G.; Pisciotta, P.; Cirrone, G. A. P.; Romano, F.; Cammarata, F.; Marchese, V.; Forte, G. I.; Lamia, D.; Minafra, L.; Bravatá, V.; Acquaviva, R.; Gilardi, M. C.; Cuttone, G.

    2017-02-01

    Aim of this work is the study of the preliminary steps to perform a particle treatment of cancer cells inoculated in small animals and to realize a preclinical hadrontherapy facility. A well-defined dosimetric protocol was developed to explicate the steps needed in order to perform a precise proton irradiation in small animals and achieve a highly conformal dose into the target. A precise homemade positioning and holding system for small animals was designed and developed at INFN-LNS in Catania (Italy), where an accurate Monte Carlo simulation was developed, using Geant4 code to simulate the treatment in order to choose the best animal position and perform accurately all the necessary dosimetric evaluations. The Geant4 application can also be used to realize dosimetric studies and its peculiarity consists in the possibility to introduce the real target composition in the simulation using the DICOM micro-CT image. This application was fully validated comparing the results with the experimental measurements. The latter ones were performed at the CATANA (Centro di AdroTerapia e Applicazioni Nucleari Avanzate) facility at INFN-LNS by irradiating both PMMA and water solid phantom. Dosimetric measurements were performed using previously calibrated EBT3 Gafchromic films as a detector and the results were compared with the Geant4 simulation ones. In particular, two different types of dosimetric studies were performed: the first one involved irradiation of a phantom made up of water solid slabs where a layer of EBT3 was alternated with two different slabs in a sandwich configuration, in order to validate the dosimetric distribution. The second one involved irradiation of a PMMA phantom made up of a half hemisphere and some PMMA slabs in order to simulate a subcutaneous tumour configuration, normally used in preclinical studies. In order to evaluate the accordance between experimental and simulation results, two different statistical tests were made: Kolmogorov test and

  15. Adsorption of Roxarsone onto Drinking Water Treatment Residuals: Preliminary Studies

    NASA Astrophysics Data System (ADS)

    Salazar, J.; Sarkar, D.; Datta, R.; Sharma, S.

    2006-05-01

    above parameters were varied one at a time to study their effects on roxarsone adsorption. Desorption studies were carried out using 125 mg/L phosphorous at predetermined interval of time. In addition to analyzing for total As by an ICP-MS, aqueous speciation of As was performed using a coupled HPLC-ICP-MS system. Preliminary studies show significant roxarsone adsorption capacity of the WTRs.

  16. Comparison of total hip arthroplasty in osteoarthritis of mechanical and rheumatologic causes

    PubMed Central

    Ejnisman, Leandro; Leonhardt, Nathalia Zalc; Fernandes, Laura Fillipini Lorimier; Leonhardt, Marcos de Camargo; Vicente, José Ricardo Negreiros; Croci, Alberto Tesconi

    2014-01-01

    Objective: To compare the use of uncemented implants in total hip arthroplasty in patients with rheumathologic diseases and mechanical osteoarthrosis. Methods: We retrospectively evaluated 196 patients who were operated by the Hip and Arthroplasty Surgery Group of the IOT-HCFMUSP between 2005 and 2009. Patients were divided into two groups: mechanical causes (165 patients) and rheumathologic causes (31 patients). Groups were compared between each other in age, gender and follow-up time. Osseointegration rate and percentage of failure in arthroplasty were evaluated. Results: No statistically significant difference was found in osseointegration rates (in both femoral and acetabular components) in both groups. The rates of revision surgery and implant survival also did not show statistically significant differences. Conclusion: The use of uncemented total hip arthroplasty did not show worse results in rheumathologic patients. Level of Evidence III, Retrospective Case Control Study. PMID:24644419

  17. A Preliminary Outcome Study of Response Ability Pathways Training

    ERIC Educational Resources Information Center

    Forthun, Larry F.; McCombie, Jeff W.

    2007-01-01

    Approximately 68 classroom teachers participated in a preliminary evaluation of Response Ability Pathways (RAP), a reclaiming training course for adults who work with children and youth. RAP offers basic training in the Circle of Courage Model and provides participants with general strategies for assisting youth who are experiencing challenges.…

  18. Orofacial Muscle Activity of Children Who Stutter: A Preliminary Study.

    ERIC Educational Resources Information Center

    Kelly, Ellen M.; And Others

    1995-01-01

    This preliminary investigation of stuttering development and maturation of speech motor processes recorded the electromyographic activity of the orofacial muscles of nine children who stuttered. Results suggest that the emergence of tremor-like instabilities in the speech motor processes of stuttering children may coincide with aspects of general…

  19. Technology User Groups and Early Childhood Education: A Preliminary Study

    ERIC Educational Resources Information Center

    Parette, Howard P.; Hourcade, Jack J.; Blum, Craig; Watts, Emily H.; Stoner, Julia B.; Wojcik, Brian W.; Chrismore, Shannon B.

    2013-01-01

    This article presents a preliminary examination of the potential of Technology User Groups as a professional development venue for early childhood education professionals in developing operational and functional competence in using hardware and software components of a Technology toolkit. Technology user groups are composed of varying numbers of…

  20. Use of tranexamic acid in total knee arthroplasty

    PubMed Central

    MARRA, FRANCESCO; ROSSO, FEDERICA; BRUZZONE, MATTEO; BONASIA, DAVIDE EDOARDO; DETTONI, FEDERICO; ROSSI, ROBERTO

    2016-01-01

    Purpose different strategies have been developed to reduce blood loss in total knee arthroplasty (TKA). The efficacy of both systemic and local tranexamic acid (TXA) administration is demonstrated in the literature. The aim of the present study was to compare the efficacy of systemic, local and combined (systemic + local) administration of TXA in reducing blood loss after TKA. Methods we enrolled all patients submitted to a primary TKA in our department between November 2014 and August 2015. They were divided into three groups corresponding to the method of TXA administration used: intravenous (IV), intra-articular (IA), and a combination of the two. Demographic data, as well as preoperative hemoglobin and platelet levels, were collected. The primary outcome was the maximum hemoglobin loss, while the secondary outcomes were the amount of blood in the drain (cc/hour) and the rate of transfusions; postoperative pain was also assessed. Student’s t-test or a χ2 test was used to evaluate between-group differences, using p<0.05 as the cut-off for statistically significant differences. Results the sample comprised 34 patients: IV, 10 cases; IA, 15 cases, and combined (IV + IA), 9 cases. The average age of the patients was 71.1±6.4 years. No significant differences in the outcome measures were found between the groups, with the exception of a significantly lower maximum hemoglobin loss in the combined versus the IV group (p=0.02). There were no differences between the groups in the amount of blood in the drain or the rate of transfusions. Conclusions the data from this preliminary study, as well as data from the literature, confirm that TXA administration is safe and effective in reducing total blood loss in TKA, and no administration protocol seems to be superior to the others. Level of evidence Level II, prospective comparative study. PMID:28217656

  1. Qualifying CT for wrist arthroplasty: extending techniques for total hip arthroplasty to total wrist arthroplasty

    NASA Astrophysics Data System (ADS)

    Alcala, Yvonne; Olivecrona, Henrik; Olivecrona, Lotta; Noz, Marilyn E.; Maguire, Gerald Q., Jr.; Zeleznik, Michael P.; Sollerman, Christer

    2005-04-01

    The purpose of this study was to extend previous work to detect migration of total wrist arthroplasty non-invasively, and with greater accuracy. Two human cadaverous arms, each with a cemented total wrist implant, were used in this study. In one of the arms, 1 mm tantalum balls were implanted, six in the carpal bones and five in the radius. Five CT scans of each arm were acquired, changing the position of the arm each time to mimic different positions patients might take on repeated examinations. Registration of CT volume data sets was performed using an extensively validated, 3D semi-automatic volume fusion tool in which co-homologous point pairs (landmarks) are chosen on each volume to be registered. Three sets of ten cases each were obtained by placing landmarks on 1) bone only (using only arm one), 2) tantalum implants only, and 3) bone and tantalum implants (both using only arm two). The accuracy of the match was assessed visually in 2D and 3D, and numerically by calculating the distance difference between the actual position of the transformed landmarks and their ideal position (i.e., the reference landmark positions). All cases were matched visually within one width of cortical bone and numerically within one half CT voxel (0.32 mm, p = 0.05). This method matched only the bone/arm and not the prosthetic component per se, thus making it possible to detect prosthetic movement and wear. This method was clinically used for one patient with pain. Loosening of the carpal prosthetic component was accurately detected and this was confirmed at surgery.

  2. Outcomes following cervical disc arthroplasty: a retrospective review.

    PubMed

    Cody, John P; Kang, Daniel G; Tracey, Robert W; Wagner, Scott C; Rosner, Michael K; Lehman, Ronald A

    2014-11-01

    Cervical disc arthroplasty has emerged as a viable technique for the treatment of cervical radiculopathy and myelopathy, with the proposed benefit of maintenance of segmental range of motion. There are relatively few, non-industry sponsored studies examining the outcomes and complications of cervical disc arthroplasty. Therefore, we set out to perform a single center evaluation of the outcomes and complications of cervical disc arthroplasty. We performed a retrospective review of all patients from a single military tertiary medical center undergoing cervical disc arthroplasty from August 2008 to August 2012. The clinical outcomes and complications associated with the procedure were evaluated. A total of 219 consecutive patients were included in the review, with an average follow-up of 11.2 (±11.0)months. Relief of pre-operative symptoms was noted in 88.7% of patients, and 92.2% of patients were able to return to full pre-operative activity. There was a low rate of complications related to the anterior cervical approach (3.2% with recurrent laryngeal nerve injury, 8.9% with dysphagia), with no device/implant related complications. Symptomatic cervical radiculopathy is a common problem in both the civilian and active duty military populations and can cause significant disability leading to loss of work and decreased operational readiness. There exist several surgical treatment options for appropriately indicated patients. Based on our findings, cervical disc arthroplasty is a safe and effective treatment for symptomatic cervical radiculopathy and myelopathy, with a low incidence of complications and high rate of symptom relief.

  3. PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of total knee replacement: A preliminary study

    PubMed Central

    Cowie, Raelene M; Briscoe, Adam; Fisher, John; Jennings, Louise M

    2016-01-01

    PEEK-OPTIMA™ (Invibio Ltd, UK) has been considered as an alternative joint arthroplasty bearing material due to its favourable mechanical properties and the biocompatibility of its wear debris. In this study, the potential to use injection moulded PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of a total knee replacement was investigated in terms of its wear performance. Experimental wear simulation of three cobalt chrome and three PEEK-OPTIMA™ femoral components articulating against all-polyethylene tibial components was carried out under two kinematic conditions: 3 million cycles under intermediate kinematics (maximum anterior-posterior displacement of 5 mm) followed by 3 million cycles under high kinematic conditions (anterior-posterior displacement 10 mm). The wear of the GUR1020 ultra-high-molecular-weight polyethylene tibial components was assessed by gravimetric analysis; for both material combinations under each kinematic condition, the mean wear rates were low, that is, below 5 mm3/million cycles. Specifically, under intermediate kinematic conditions, the wear rate of the ultra-high-molecular-weight polyethylene tibial components was 0.96 ± 2.26 mm3/million cycles and 2.44 ± 0.78 mm3/million cycle against cobalt chrome and PEEK-OPTIMA™ implants, respectively (p = 0.06); under high kinematic conditions, the wear rates were 2.23 ± 1.85 mm3/million cycles and 4.44 ± 2.35 mm3/million cycles, respectively (p = 0.03). Following wear simulation, scratches were apparent on the surface of the PEEK-OPTIMA™ femoral components. The surface topography of the femoral components was assessed using contacting profilometry and showed a statistically significant increase in measured surface roughness of the PEEK-OPTIMA™ femoral components compared to the cobalt chrome implants. However, this did not appear to influence the wear rate, which remained linear over the duration of the study. These

  4. Pyrocarbon Interposition Wrist Arthroplasty in the Treatment of Failed Wrist Procedures

    PubMed Central

    Bellemère, Philippe; Maes-Clavier, Catherine; Loubersac, Thierry; Gaisne, Etienne; Kerjean, Yves; Collon, Sylvie

    2012-01-01

    Treatment of failures after prior wrist surgeries with major articular destruction is challenging. In most cases, total wrist fusion is the only possible salvage procedure. We propose a new interposition arthroplasty with a pyrocarbon implant called Amandys. A total of 16 patients, 14 men and 2 women, with a mean age of 56 years were operated on for a failure of wrist surgery performed previously, with an average time lapse of 12 years. The prior surgeries were partial wrist arthrodesis in seven cases, silicone implant interpositions in five cases, advanced Kienböck disease (Lichtman IV) treatment in two cases, proximal row carpectomy in one case, and an isolated scaphoidectomy in one case. A prospective study with clinical and radiological evaluation was performed with a mean follow-up of 24 months (6 to 41 months). Pain and function showed significant improvement. The mean pain score decreased from 7 of 10 to 4 of 10, postoperatively. The mean grip strength was 19 kg (53% of the contralateral side), and the mean range of motion in flexion extension was 68 degrees. Mean strength and range of motion did not change significantly with the operation. The mean QuickDASH (Disability Arm Shoulder and Hand) score decreased from 59 of 100 to 39 of 100. The mean Patient-Rated Wrist Evaluation decreased from 57 of 100 to 33. Two patients (12.5%) required revision for implant repositioning. No dislocation or subsidence of the implant was noted. Pyrocarbon interposition arthroplasty is a new option for treatment of advanced wrist destruction. Preliminary short-term results suggest that it may be a reliable alternative to total wrist fusion. The level of evidence of this study is IV (therapeutic case series). PMID:23904977

  5. [Winter sports and shoulder arthroplasty].

    PubMed

    Kirchhoff, C; Imhoff, A B; Hinterwimmer, S

    2008-09-01

    Nowadays, a general negative evaluation of sportive activity regarding different kinds of sport following arthroplasty is at present no more scientifically supported. However, at present no valid guidelines regarding sportive activity of patients after implantation of shoulder joint arthroplasty exist. The question regarding the ability of performing winter sports activities of patients treated with shoulder joint endoprothesis has not been answered so far. Therefore the aim of the presented work was to identify winter sports-specific risks for patients treated with shoulder joint endoprothesis as well as to critically discuss the actual literature in refer to winter sport activities. Criteria for the education of patients with shoulder joint endoprothesis as well as consultation regarding winter sport activities will be provided for the orthopaedic surgeon.

  6. NAVIGATION IN TOTAL KNEE ARTHROPLASTY

    PubMed Central

    da Mota e Albuquerque, Roberto Freire

    2015-01-01

    Navigation was the most significant advance in instrumentation for total knee arthroplasty over the last decade. It provides surgeons with a precision tool for carrying out surgery, with the possibility of intraoperative simulation and objective control over various anatomical and surgical parameters and references. Since the first systems, which were basically used to control the alignment of bone cutting referenced to the mechanical axis of the lower limb, many other surgical steps have been incorporated, such as component rotation, ligament balancing and arranging the symmetry of flexion and extension spaces, among others. Its efficacy as a precision tool with an effective capacity for promoting better alignment of the lower-limb axis has been widely proven in the literature, but the real value of optimized alignment and the impact of navigation on clinical results and the longevity of arthroplasty have yet to be established. PMID:27026979

  7. The Swedish Knee Arthroplasty Register

    PubMed Central

    Robertsson, O.; Ranstam, J.; Sundberg, M.; W-Dahl, A.; Lidgren, L.

    2014-01-01

    We are entering a new era with governmental bodies taking an increasingly guiding role, gaining control of registries, demanding direct access with release of open public information for quality comparisons between hospitals. This review is written by physicians and scientists who have worked with the Swedish Knee Arthroplasty Register (SKAR) periodically since it began. It reviews the history of the register and describes the methods used and lessons learned. Cite this article: Bone Joint Res 2014;3:217–22. PMID:24986492

  8. Preliminary design studies for the DESCARTES and CIDER codes

    SciTech Connect

    Eslinger, P.W.; Miley, T.B.; Ouderkirk, S.J.; Nichols, W.E.

    1992-12-01

    The Hanford Environmental Dose Reconstruction (HEDR) project is developing several computer codes to model the release and transport of radionuclides into the environment. This preliminary design addresses two of these codes: Dynamic Estimates of Concentrations and Radionuclides in Terrestrial Environments (DESCARTES) and Calculation of Individual Doses from Environmental Radionuclides (CIDER). The DESCARTES code will be used to estimate the concentration of radionuclides in environmental pathways, given the output of the air transport code HATCHET. The CIDER code will use information provided by DESCARTES to estimate the dose received by an individual. This document reports on preliminary design work performed by the code development team to determine if the requirements could be met for Descartes and CIDER. The document contains three major sections: (i) a data flow diagram and discussion for DESCARTES, (ii) a data flow diagram and discussion for CIDER, and (iii) a series of brief statements regarding the design approach required to address each code requirement.

  9. Preliminary experimental study of a carbon fiber array cathode

    NASA Astrophysics Data System (ADS)

    Li, An-kun; Fan, Yu-wei

    2016-08-01

    The preliminary experimental results of a carbon fiber array cathode for the magnetically insulated transmission line oscillator (MILO) operations are reported. When the diode voltage and diode current were 480 kV and 44 kA, respectively, high-power microwaves with a peak power of about 3 GW and a pulse duration of about 60 ns were obtained in a MILO device with the carbon fiber array cathode. The preliminary experimental results show that the shot-to-shot reproducibility of the diode current and the microwave power is stable until 700 shots. No obvious damage or deterioration can be observed in the carbon fiber surface morphology after 700 shots. Moreover, the cathode performance has no observable deterioration after 700 shots. In conclusion, the maintain-free lifetime of the carbon fiber array cathode is more than 700 shots. In this way, this carbon fiber array cathode offers a potential replacement for the existing velvet cathode.

  10. Preliminary Fatigue Studies on Aluminum Alloy Aircraft Engines

    NASA Technical Reports Server (NTRS)

    1938-01-01

    Preliminary information on the complex subject of the fatigue strength of fabricated structural members for aircraft is presented in the test results obtained on several different types of airship girders subjected to axial tension and compression in a resonance fatigue machine. A description of this machine as well as numerous photographs of the fatigue failures are given. There is also presented an extended bibliography on the subject of fatigue strength.

  11. Which patients need critical care intervention after total joint arthroplasty? : a prospective study of factors associated with the need for intensive care following surgery.

    PubMed

    Courtney, P M; Melnic, C M; Gutsche, J; Hume, E L; Lee, G-C

    2015-11-01

    Older patients with multiple medical co-morbidities are increasingly being offered and undergoing total joint arthroplasty (TJA). These patients are more likely to require intensive care support, following surgery. We prospectively evaluated the need for intensive care admission and intervention in a consecutive series of 738 patients undergoing elective hip and knee arthroplasty procedures. The mean age was 60.6 years (18 to 91; 440 women, 298 men. Risk factors, correlating with the need for critical care intervention, according to published guidelines, were analysed to identify high-risk patients who would benefit from post-operative critical care monitoring. A total of 50 patients (6.7%) in our series required critical care level interventions during their hospital stay. Six independent multivariate clinical predictors were identified (p < 0.001) including a history of congestive heart failure (odds ratio (OR) 24.26, 95% confidence interval (CI) 9.51 to 61.91), estimated blood loss > 1000 mL (OR 17.36, 95% CI 5.36 to 56.19), chronic obstructive pulmonary disease (13.90, 95% CI 4.78 to 40.36), intra-operative use of vasopressors (OR 8.10, 95% CI 3.23 to 20.27), revision hip arthroplasty (OR 2.71, 95% CI 1.04 to 7.04) and body mass index > 35 kg/m(2) (OR 2.70, 95% CI 123 to 5.94). The model was then validated against an independent, previously published data set of 1594 consecutive patients. The use of this risk stratification model can be helpful in predicting which high-risk patients would benefit from a higher level of monitoring and care after elective TJA and aid hospitals in allocating precious critical care resources.

  12. Computing and information sciences preliminary engineering design study

    SciTech Connect

    Schroeder, J O; Pearson, E W; Thomas, J J; Brothers, J W; Campbell, W K; DeVaney, D M; Jones, D R; Littlefield, R J; Peterson, M J

    1991-04-01

    This document presents the preliminary design concept for the integrated computing and information system to be included in the Environmental and Molecular Sciences Laboratory (EMSL) at the Pacific Northwest Laboratory, Richland, Washington, for the US Department of Energy (DOE). The EMSL is scheduled for completion and occupancy in 1994 or 1995 and will support the DOE environmental mission, in particular hazardous waste remediation. The focus of the report is on the Computing and Information Sciences engineering task of providing a fully integrated state-of-the-art computing environment for simulation, experimentation and analysis in support of molecular research. The EMSL will house two major research organizations, the Molecular Sciences Research Center (MSRC) and part of the Environmental Sciences Research Center (ESRC). Included in the report is a preliminary description of the computing and information system to be included. The proposed system architecture is based on a preliminary understanding of the EMSL users' needs for computational resources. As users understand more about the scientific challenges they face, the definition of the functional requirements will change. At the same time, the engineering team will be gaining experience with new computing technologies. Accordingly, the design architecture must evolve to reflect this new understanding of functional requirements and enabling technologies. 3 figs., 2 tabs.

  13. Humeral windows in revision total elbow arthroplasty.

    PubMed

    Peach, Chris A; Salama, Amir; Stanley, David

    2016-04-01

    The use of cortical windows for revision elbow arthroplasty has not previously been widely reported. Their use aids safe revision of a well fixed humeral prosthesis and can be used in the setting of dislocation, periprosthetic fracture or aseptic loosening of the ulnar component. We describe our technique and results of cortical windows in the distal humerus for revision elbow arthroplasty surgery.

  14. Reducing arthroplasty costs via vendor contracts

    PubMed Central

    Johnston, D. William C.; Beaupré, Lauren A.; Davies, Donna M.; Hessels, Rick

    1999-01-01

    Objective To describe a method of reducing the costs of implants in hip and knee arthroplasty. Design Implant costs were compared before and after the implementation of a 2-year contract with implant vendors, providing increased volume for decreased implant cost. An additional 20% of arthroplasties could be done outside the contract for research or special purposes. Setting A regional health authority involving 2 acute care hospitals. Method Costs were obtained for 942 hip and knee arthroplasties performed in 1993/94 and compared with costs of 1656 hip and knee arthroplasties performed in 1996/97. Outcome Measures Implant cost and number of joint arthroplasty procedures performed. Results A 40% decrease in the cost per implant for primary knee arthroplasty and an 18% decrease in the cost per implant for primary hip arthroplasty were achieved. A rebate, calculated as a percentage of volume used, was received from the vendor to support general orthopedic research and education. A new contract for 3 years has recently been signed with 3 vendors designated as primary vendors for 80% of the volume. Conclusion The vendor-contract economic strategy effectively reduced the cost of hip and knee arthroplasty and may be useful at other centres looking for cost reduction methods that maintain adequate patient care and support clinical research and education. PMID:10593246

  15. Characterization of hip and knee arthroplasties and factors associated with infection☆

    PubMed Central

    da Silva Pinto, Cibele Zdebsky; Alpendre, Francine Taporosky; Stier, Christiane Johnscher Niebel; Maziero, Eliane Cristina Sanches; de Alencar, Paulo Gilberto Cimbalista; de Almeida Cruz, Elaine Drehmer

    2015-01-01

    Objective To characterize arthroplasty procedures, calculate the surgical infection rate and identify related risk factors. Methods This was a retrospective cohort study. Data on operations performed between 2010 and 2012 were gathered from documental sources and were analyzed with the aid of statistical software, using Fisher's exact test, Student's t test and the nonparametric Mann–Whitney and Wilcoxon tests. Results 421 total arthroplasty procedures performed on 346 patients were analyzed, of which 208 were on the knee and 213 on the hip. It was found that 18 patients (4.3%) were infected. Among these, 15 (83.33%) were reoperated and 2 (15.74%) died. The prevalence of infection in primary total hip arthroplasty procedures was 3%; in primary total knee arthroplasty, 6.14%; and in revision of total knee arthroplasty, 3.45%. Staphylococcus aureus was prevalent. The length of the surgical procedure showed a tendency toward being a risk factor (p = 0.067). Conclusion The prevalence of infection in cases of primary total knee arthroplasty was greater than in other cases. No statistically significant risk factors for infection were identified. PMID:27218082

  16. Repeat Manipulation Under Anesthesia For Persistent Stiffness After Total Knee Arthroplasty Achieves Functional Range of Motion.

    PubMed

    Ferrel, Jason R; Davis, Richard L; Agha, Obiajulu A J C; Politi, Joel R

    2015-05-01

    Poor range of motion may decrease a patient's ability to participate in activities of daily living after total knee arthroplasty. Manipulation under anesthesia has been shown to improve range of motion; however, some patients have persistent stiffness even after manipulation. The goal of this study was to evaluate the outcomes and complications of patients who underwent a second manipulation under anesthesia for persistent stiffness after total knee arthroplasty. The review of surgical records of two joint arthroplasty surgeons identified 226 knees in 210 patients who underwent a manipulation under anesthesia for poor range of motion after total knee arthroplasty. Of these patients, 16 patients underwent a second manipulation under anesthesia. For patients undergoing two manipulations under anesthesia procedures, at latest follow up (mean 539 days), mean extension improved from 10.50° to 2.50° (p=0.001) and mean flexion improved from 87.50° to 112.69° (p=0.001) respectively. SF-12 scores were available for 12 of 16 knees with a mean score of 34.42. Two of 16 patients (12.5%) experienced a complication. Three of 16 (18.8%) patients who underwent a second manipulation required a revision arthroplasty procedure. In conclusion, a second manipulation under anesthesia can achieve functional range of motion that is sustained after total knee arthroplasty.

  17. In Situ Oxidation of Liquid Trichloroethylene by Permanganate Solutions: Preliminary Results of Column Studies

    SciTech Connect

    Schroth, Martin H.; Oostrom, Mart; Wietsma, Thomas W.; Istok, Jonathan D.; H.J. Morel-Seytoux

    2000-01-11

    In situ oxidation of liquid trichloroethylene by permanganate solutions: Preliminary results of column studies. In: Proceedings of the 19th American Geophysical Union Hydrology Days, H. J. Morel-Seytoux, ed., pp. 411-420. Hydrology Days Pub., Atherton, Ca.

  18. Summary of the Preliminary Optical ICHMI Design Study: A Preliminary Engineering Design Study for a Standpipe Viewport

    SciTech Connect

    Anheier, Norman C.; Qiao, Hong; Berglin, Eric J.; Hatchell, Brian K.

    2013-12-26

    This summary report examines an in-vessel optical access concept intended to support standoff optical instrumentation, control and human-machine interface (ICHMI) systems for future advanced small modular reactor (AdvSMR) applications. Optical-based measurement and sensing systems for AdvSMR applications have several key benefits over traditional instrumentation and control systems used to monitor reactor process parameters, such as temperature, flow rate, pressure, and coolant chemistry (Anheier et al. 2013). Direct and continuous visualization of the in-vessel components can be maintained using external cameras. Many optical sensing techniques can be performed remotely using open optical beam path configurations. Not only are in-vessel cables eliminated by these configurations, but also sensitive optical monitoring components (e.g., electronics, lasers, detectors, and cameras) can be placed outside the reactor vessel in the instrument vault, containment building, or other locations where temperatures and radiation levels are much lower. However, the extreme AdvSMR environment present challenges for optical access designs and optical materials. Optical access is not provided in any commercial nuclear power plant or featured in any reactor design, although successful implementation of optical access has been demonstrated in test reactors (Arkani and Gharib 2009). This report outlines the key engineering considerations for an AdvSMR optical access concept. Strict American Society of Mechanical Engineers (ASME) construction codes must be followed for any U.S. nuclear facility component (ASME 2013); however, the scope of this study is to evaluate the preliminary engineering issues for this concept, rather than developing a nuclear-qualified design. In addition, this study does not consider accident design requirements. In-vessel optical access using a standpipe viewport concept serves as a test case to explore the engineering challenges and performance requirements

  19. L5 – S1 Segmental Kinematics After Facet Arthroplasty

    PubMed Central

    Voronov, Leonard I.; Havey, Robert M.; Rosler, David M.; Sjovold, Simon G.; Rogers, Susan L.; Carandang, Gerard; Ochoa, Jorge A.; Yuan, Hansen; Webb, Scott

    2009-01-01

    Background Facet arthroplasty is a motion restoring procedure. It is normally suggested as an alternative to rigid fixation after destabilizing decompression procedures in the posterior lumbar spine. While previous studies have reported successful results in reproducing normal spine kinematics after facet replacement at L4-5 and L3-4, there are no data on the viability of facet replacement at the lumbosacral joint. The anatomy of posterior elements and the resulting kinematics at L5-S1 are distinctly different from those at superior levels, making the task of facet replacement at the lumbosacral level challenging. This study evaluated the kinematics of facet replacement at L5-S1. Methods Six human cadaveric lumbar spines (L1-S1, 46.7 ± 13.0 years) were tested in the following sequence: (1) intact (L1-S1), (2) complete laminectomy and bilateral facetectomy at L5-S1, and (3) implantation of TFAS-LS (Lumbosacral Total Facet Arthroplasty System, Archus Orthopedics, Redmond, Washington) at L5-S1 using pedicle screws. Specimens were tested in flexion (8Nm), extension (6Nm), lateral bending (LB, ± 6Nm), and axial rotation (AR, ± 5Nm). The level of significance was α = .017 after Bonferroni correction for three comparisons: (1) intact vs. destabilized, (2) destabilized vs. reconstructed, and (3) intact vs. reconstructed. Results Laminectomy-facetectomy at L5-S1 increased the L5-S1 angular range of motion (ROM) in all directions. Flexion-extension (F-E) ROM increased from 15.3 ± 2.9 to 18.7 ± 3.5 degrees (P < .017), LB from 8.2 ± 1.8 to 9.3 ± 1.6 degrees (P < .017), and AR from 3.7 ± 2.0 to 5.9 ± 1.8 degrees (P < .017). The facet arthroplasty system decreased ROM compared to the laminectomy-facetectomy condition in all tested directions (P < .017). The facet arthroplasty system restored the L5-S1 ROM to its intact levels in LB and AR (P > .017). F-E ROM after the facet arthroplasty system implantation was smaller than the intact value (10.1 ± 2.2 vs. 15.3 ± 2

  20. Transplacental transfer of cobalt and chromium in patients with metal-on-metal hip arthroplasty: a controlled study.

    PubMed

    Ziaee, H; Daniel, J; Datta, A K; Blunt, S; McMinn, D J W

    2007-03-01

    Metal-on-metal bearings are being increasingly used in young patients. The potential adverse effects of systemic metal ion elevation are the subject of ongoing investigation. The purpose of this study was to investigate whether cobalt and chromium ions cross the placenta of pregnant women with a metal-on-metal hip resurfacing and reach the developing fetus. Whole blood levels were estimated using high-resolution inductively-coupled plasma mass spectrometry. Our findings showed that cobalt and chromium are able to cross the placenta in the study patients with metal-on-metal hip resurfacings and in control subjects without any metal implants. In the study group the mean concentrations of cobalt and chromium in the maternal blood were 1.39 microg/l (0.55 to 2.55) and 1.28 microg/l (0.52 to 2.39), respectively. The mean umbilical cord blood concentrations of cobalt and chromium were comparatively lower, at 0.839 microg/l (0.42 to 1.75) and 0.378 microg/l (0.14 to 1.03), respectively, and this difference was significant with respect to chromium (p < 0.05). In the control group, the mean concentrations of cobalt and chromium in the maternal blood were 0.341 microg/l (0.18 to 0.54) and 0.199 microg/l (0.12 to 0.33), and in the umbilical cord blood they were 0.336 microg/l (0.17 to 0.5) and 0.194 microg/l (0.11 to 0.56), respectively. The differences between the maternal and umbilical cord blood levels in the controls were marginal, and not statistically significant (p > 0.05). The mean cord blood level of cobalt in the study patients was significantly greater than that in the control group (p < 0.01). Although the mean umbilical cord blood chromium level was nearly twice as high in the study patients (0.378 microg/l) as in the controls (0.1934 microg/l), this difference was not statistically significant. (p > 0.05) The transplacental transfer rate was in excess of 95% in the controls for both metals, but only 29% for chromium and 60% for cobalt in study patients

  1. Clinical outcomes of remote asynchronous telerehabilitation are equivalent to traditional therapy following total knee arthroplasty: A randomized control study.

    PubMed

    Bini, S A; Mahajan, J

    2017-02-01

    Introduction Successful post-operative telerehabilitation following total knee replacement (TKR) has been documented using synchronous (real-time) video. Bandwidth and the need for expensive hardware are cited as barriers to implementation. Web-based asynchronous visual platforms promise to address these problems but have not been evaluated. We performed a randomized control study comparing an asynchronous video-based software platform to in-person outpatient physical therapy visits following TKR. Materials and methods Fifty-one patients were randomized to either the intervention group, using an asynchronous video application on a mobile device, or the traditional group undergoing outpatient physical therapy. Outcome data were collected using validated instruments prior to surgery and at a minimum three-month follow-up. Results Twenty-nine patients completed the study. There were no statistically significant differences in any clinical outcome between groups. The satisfaction with care was equivalent between groups. Overall utilization of hospital-based resources was 60% less than for the traditional group. Discussion We report that clinical outcomes following asynchronous telerehabilitation administered over the web and through a hand-held device were not inferior to those achieved with traditional care. Outpatient resource utilization was lower. Patient satisfaction was high for both groups. The results suggest that asynchronous telerehabilitation may be a more practical alternative to real-time video visits and are clinically equivalent to the in-person care model.

  2. Preliminary results from a shallow water benthic grazing study

    USGS Publications Warehouse

    Jones, N.L.; Monismith, Stephen G.; Thompson, Janet K.

    2005-01-01

    Despite great improvements in our knowledge on the effects of benthic grazers on seston concentrations in water columns, the effects of different hydrodynamic conditions on grazing rates has not been formulated. This makes it difficult to assess the system-wide effect of the benthic ecosystem on phytoplankton concentrations. Furthermore, it affects our ability to predict the potential success of a benthic species, such as the invasive clams Corbicula fluminea and Potamocorbula amurensis. This paper presents the preliminary results of a control volume approach to elucidate the effect of different hydrodynamic conditions on the grazing rates of Corbicula fluminea.

  3. Decontamination of Johnston Island Coral: a preliminary study

    SciTech Connect

    Kochen, R.L.

    1986-02-17

    A preliminary investigation was completed on the characterization and decontamination of coral samples from Johnston Island. These samples were found to contain individual particles (2 to 0.25 mm) of contaminated coral as well as a piece of contaminated magnetic metal. They ranged in activity from about 70 to 811 nCi Am-241. The decontamination methods investigated were froth flotation, ferrite treatment, attrition scrubbing, ultrasonic treatment and dry sieving. Dry sieving, the more effective technique, separated about 42 wt % of the coral into a decontaminated fraction. This fraction (>4 mm) contained about 0.5% of the total activity. 7 refs., 3 tabs.

  4. Preliminary Studies on Pulsed Electric Field Breakdown of Lead Azide

    DTIC Science & Technology

    1976-10-01

    subjected to combinations of 400.0 nm irradiation (strongly absorbed by Pb(N_)-) and strong field, for both polarities, again with no effect . It has...II n»Kt*tmy mad I4mtlty by MeeM mmt»mr) .± Lead Azide Electric Field Initiation Contact Effects Surface Effects Radiation Effect ! A9STMACT...reported. Specifically, ws-d4*eu«s the effects of contacts on the initiation of explosives by electric fields, and present preliminary weaouresents

  5. Safety and efficacy of multimodal thromboprophylaxis following total knee arthroplasty: a comparative study of preferential aspirin vs. routine coumadin chemoprophylaxis.

    PubMed

    Gesell, Mark W; González Della Valle, Alejandro; Bartolomé García, Sergio; Memtsoudis, Stavros G; Ma, Yan; Haas, Steven B; Salvati, Eduardo A

    2013-04-01

    Multimodal thromboprophylaxis encompasses preoperative VTE risk stratification, regional anesthesia, mechanical prophylaxis, and early mobilization. We determined if aspirin can be safely used for adjuvant chemoprophylaxis in patients who have a low thromboembolic risk. 1016 consecutive patients undergoing TKA received multimodal thromboprophylaxis. Aspirin was used in 67% of patients and Coumadin 33% (high risk patients, or who were on Coumadin before surgery). This study group was compared to 1001 consecutive patients who received multimodal thromboprophylaxis and routine Coumadin chemoprophylaxis. There was no significant difference in rates of VTE, PE, bleeding, complications, readmission and 90-day mortality between the two groups. There was a significantly higher rate of wound related complications in the control group (p=0.03). Multimodal thromboprophylaxis with aspirin given to the majority of patients at a low VTE risk is safe and effective in patients undergoing primary TKA.

  6. Impact of Preemptive Analgesia on inflammatory responses and Rehabilitation after Primary Total Knee Arthroplasty: A Controlled Clinical Study

    PubMed Central

    Jianda, Xu; Yuxing, Qu; Yi, Gao; Hong, Zhao; Libo, Peng; Jianning, Zhao

    2016-01-01

    The aim of this study was to investigate the effects of preemptive analgesia on the inflammatory response and rehabilitation in TKA. 75 patients with unilateral primary knee osteoarthritis were conducted in this prospective study. All patients were randomly divided into two groups (MMA with/without preemptive analgesia group). The following parameters were used to evaluate analgesic efficacy: knee flexion, pain at rest and walking, functional walking capacity (2 MWT and 6 MWT), WOMAC score, and hs-CRP level. Patients in MMA with preemptive analgesia group had lower hs-CRP level and less pain at rest and walking during the first week postoperatively (P < 0.05). The 2 MWT was significantly better in MMA with preemptive analgesia group (17.13 ± 3.82 VS 14.19 ± 3.56, P = 0.001). The 6 MWT scores and WOMAC scores increased significantly within Groups (P = 0.020, 0.000), but no difference between groups postoperatively (P > 0.05). Less cumulative consumption of morphine was found in MMA with preemptive analgesia group at 48 h (P = 0.017, 0.023), but no difference at total requirement (P = 0.113). Preemptive analgesia added to a multimodal analgesic regime improved analgesia, reduced inflammatory reaction and accelerated functional recovery at the first week postoperatively, but not improved long-term function. PMID:27578313

  7. Mixing and matching in ceramic-on-metal hip arthroplasty: an in-vitro hip simulator study.

    PubMed

    Affatato, Saverio; Spinelli, Michele; Squarzoni, Stefano; Traina, Francesco; Toni, Aldo

    2009-11-13

    The clinical success of second-generation metal-on-metal hip replacement and the good tribological performance of alumina ceramic revived an interest in hip articulation as a solution to reduce wear. This study was aimed at characterizing the wear behaviour of new hybrid ceramic-on-metal bearings. In particular, this study investigated the wear behaviour of ceramic-on-metal hip components (three different diameters configurations: 28, 32 and 36 mm), not specifically proposed to be coupled, in order to compare them with ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. For this purpose, the weight loss over a standard wear simulation was monitored. Moreover, scanning electronic microscope observations were used to verify if any carbides removal, for the metallic components, triggered wears debris production promoting abrasive third-body wear. After five million cycles, our results showed significantly greater wear-in ceramic-on-metal compared with ceramic-on-ceramic, and significant greater wear for the 32-mm diameter compared with the 36-mm one. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones confirming that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behaviour, not even comparable with that of the ceramic-on-ceramic gold standard. Wear patterns and roundness tolerances certainly discourage the coupling of components not specifically intended to be coupled. Unsuitable geometrical conformity could, in fact, result in a poor dynamic behaviour and lead to clinical failure.

  8. Incidence and natural history of deep-vein thrombosis after total hip arthroplasty. A prospective and randomised clinical study.

    PubMed

    Kim, Young-Hoo; Oh, S H; Kim, J S

    2003-07-01

    There are many reports concerning the aetiology and prophylaxis of deep-vein thrombosis (DVT) but little is known about its natural history. The purpose of our study was to identify the incidence and site of DVT, the risk factors for pulmonary embolism and the natural history of DVT after total hip replacement (THR) in patients who do not receive any form of prophylactic or therapeutic treatment for DVT. Two hundred patients who had a primary THR were included: 100 had one-staged bilateral THR and 100 had unilateral THR and 150 implants were cemented and 150 cementless. Coagulation assays, a full blood count, blood typing and serum chemical profile tests were performed for all patients on three separate occasions. Bilateral simultaneous or unilateral venograms were performed on the sixth or seventh postoperative day and perfusion lung scans preoperatively and on the seventh or eighth postoperative day. Further venograms were performed in all patients who had thrombi six months later. In the patients with bilateral THR, 52 (26%) venograms were positive for thrombi, while in the patients with unilateral THR 20 (20%) were positive (p = 0.89). In the patients with a cemented THR, 31 venograms (20.7%) were positive for thrombi, while in those with a cementless THR 41 (27.3%) were positive (p = 0.654). Further venograms in all 72 patients who had thrombi at six months after operation showed that they resolved completely and spontaneously regardless of their site and size. No patients had symptoms of pulmonary emboli and none were seen on the perfusion lung scans. Two patients died from unrelated causes. Although the prevailing opinion is that patients with proximal venous thrombosis should be treated with anticoagulants, our study has shown that all thrombi regardless of their site and size resolve spontaneously without associated pulmonary embolism.

  9. Incidence and natural history of deep-vein thrombosis after total knee arthroplasty. A prospective, randomised study.

    PubMed

    Kim, Young-Hoo; Kim, J S

    2002-05-01

    We have evaluated prospectively the incidence and location of deep-vein thrombosis (DVT), the risk factors for pulmonary embolism, and the natural history of thrombosis after total knee replacement (TKR) in patients who did not receive prophylactic or therapeutic treatment for DVT. We studied 227 patients who underwent primary TKR; 116 had one-stage bilateral and 111 unilateral procedures. Coagulation assays, the full blood count and blood typing tests for the serum chemical profile were undertaken in all patients on three separate occasions. Bilateral simultaneous or unilateral venograms were carried out at six or seven days after operation. Perfusion lung scanning was undertaken before and at seven or eight days after operation. Bilateral simultaneous or unilateral venograms were repeated six months after operation in all patients who had thrombi. In the 116 patients with a bilateral replacement, 97 of 232 venograms (41.8%) were positive for fresh thrombi while there were 46 positive venograms (41.4%) in the 111 patients with a unilateral replacement (p = 1.000). Of the 116 venograms in knees with a cemented replacement, 45 (38.8%) were positive for thrombi while 52 of the 116 venograms (44.8%) were positive in those with a cementless replacement (p = 0.675). Further venograms at six months after operation in all 143 limbs which had thrombi showed that all had completely resolved regardless of the size or location. No pulmonary embolism occurred as shown by negative perfusion lung scans and the absence of symptoms. Although the current prevailing opinion is that patients with thrombosis in the proximal veins should receive anticoagulant treatment, our study has shown that all thrombi regardless of their size or location resolved without causing pulmonary embolism.

  10. In vivo determination of total knee arthroplasty kinematics

    SciTech Connect

    Komistek, Richard D; Mahfouz, Mohamed R; Bertin, Kim; Rosenberg, Aaron; Kennedy, William

    2008-01-01

    The objective of this study was to determine if consistent posterior femoral rollback of an asymmetrical posterior cruciate retaining (PCR) total knee arthroplasty was mostly influenced by the implant design, surgical technique, or presence of a well-functioning posterior cruciate ligament (PCL). Three-dimensional femorotibial kinematics was determined for 80 subjects implanted by 3 surgeons, and each subject was evaluated under fluoroscopic surveillance during a deep knee bend. All subjects in this present study having an intact PCL had a well-functioning PCR knee and experienced normal kinematic patterns, although less in magnitude than the normal knee. In addition, a surprising finding was that, on average, subjects without a PCL still achieved posterior femoral rollback from full extension to maximum knee flexion. The findings in this study revealed that implant design did contribute to the normal kinematics demonstrated by subjects having this asymmetrical PCR total knee arthroplasty.

  11. Environmental Stability and Residual Stresses in Zirconia Femoral Head for Total Hip Arthroplasty: In Vitro Aging versus Retrieval Studies

    PubMed Central

    Arita, Masanori; Takahashi, Yasuhito; Pezzotti, Giuseppe; Shishido, Takaaki; Masaoka, Toshinori; Sano, Keiji; Yamamoto, Kengo

    2015-01-01

    The objective of this study was to compare the low temperature degradation (LTD) behavior of femoral heads made of 3Y-TZP as observed on retrievals with that induced in vitro upon prolonged exposures to a hydrothermal environment. The time-dependent evolution of tetragonal-to-monoclinic transformation and the related residual stresses were nondestructively monitored by Raman microspectroscopy. An increasing intensification of tensile and compressive stresses was detected with increasing hydrothermal aging duration in tetragonal and monoclinic phases, respectively. The dependence of monoclinic fraction upon exposure time was rationalized through the Mehl-Avrami-Johnson (MAJ) formalism in order to interpret the LTD process according to a two-step mechanism of formation and growth of monoclinic nuclei. In vitro results were compared to in vivo monoclinic contents in the same type of 3Y-TZP head retrievals after implantation periods of 1.6–16.6 y, also including literature data previously reported by other authors. One-hour exposure under the selected aging condition is estimated to correspond to in vivo exposures of 4 and 2 years according to ISO and ASTM criteria, respectively. A critical review of these two criteria according to the present analyses revealed that the ASTM simulation predicts more closely the in vivo results as compared to the ISO one. PMID:26146624

  12. Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency

    PubMed Central

    RANDELLI, PIETRO; RANDELLI, FILIPPO; COMPAGNONI, RICCARDO; CABITZA, PAOLO; RAGONE, VINCENZA; PULICI, LUCA; BANFI, GIUSEPPE

    2015-01-01

    Purpose the aim of this systematic literature review is to report clinical outcomes of reverse shoulder arthroplasty (RSA) used as a revision surgery following failure of the primary implant due to rotator cuff insufficiency. Methods a systematic review was performed using the following key words: revision, shoulder, rotator cuff deficiency, outcome assessment, treatment outcome, complications. Studies eligible for inclusion in the review were clinical trials investigating patients in whom a primary shoulder arthroplasty implant with an incompetent rotator cuff was replaced with a reverse shoulder prosthesis. Results nine articles were identified and further reviewed. The results refer to a total of 226 shoulders that were treated with RSA as revision surgery. The patients in the studies had a mean age ranging from 64 to 72 years and the longest follow-up was 3.8 years. Improvements in function and reduction of pain were shown by many studies, but the mean Constant score ranged from 44.2 to 56. High complication rates (of up to 62%) were recorded, and a mean reoperation rate of 27.5%. Conclusions RSA as revision surgery for patients with rotator cuff deficiency is a valid option, and often the only solution available, but it should be limited to elderly patients with poor function and severe pain. Level of evidence level IV, systematic review of level I–IV studies. PMID:26151037

  13. Restoring the femoral offset prevent early migration of the stem in total hip arthroplasty: an EBRA-FCA study.

    PubMed

    Vicenti, G; Solarino, G; Spinarelli, A; Carrozzo, M; Picca, G; Maddalena, R; Rifino, F; Moretti, B

    2016-01-01

    The use of modular stems is still debated and controversial. Some authors have highlighted a number of disadvantages of modular prostheses including high costs, the tendency to fracture, the fretting and corrosion and the increased production of debris. Other authors have emphasized several advantages to adapt the prosthesis to the morphometric differences of patients, to allow better accuracy in restoring the anatomy and biomechanics of hip joint. The advantages of the modular devices appear to be more evident in patients with developmental dysplasia of the hip (DDH). In our study we compared 96 patients, operated for arthritis of the hip with 55 modular neck prostheses (PROFEMUR®, Wright® Arlington, Tennesse, USA) and 41 standard femoral stems (SYMAX®, Striker® Kalamazoo, Michigan, USA). The precision of restoring the natural offset during surgery was correlated with the clinical outcome and the radiological early migration of each stem measured using the computer-assisted EBRA-FCA method. The average preoperative HHS (Harris Hip Score) was 44 (23-66); the postoperative 86.56 in the 55 patients operated with modular prostheses and 81.70 in the 41 patients with monoblock stem. The worst HH Scores were seen in patients in whom the offset was not restored properly. On the contrary, the best scores have been reached in patients in which that value is closer to the “target” value (offset value of the contralateral hip). Restoring the proper offset seems to determine an appropriate tension of the abductor muscles of the hip and implies a better functioning of the joint and a better primary stability of the implant, with less early migration. This has to be a primary objective of THA surgery.

  14. Anatomic Versus Mechanically Aligned Total Knee Arthroplasty for Unicompartmental Knee Arthroplasty Revision

    PubMed Central

    Toliopoulos, Panagiota; LeBlanc, Marc-Andre; Hutt, Jonathan; Lavigne, Martin; Desmeules, Francois; Vendittoli, Pascal-Andre

    2016-01-01

    Objectives: The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA. Methods: Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs. The need for augments, stems, and constrained inserts was compared between groups. Clinical outcomes were compared using the WOMAC score along with maximum distance walked as well as knee range of motion obtained prior to discharge. All data was obtained by a retrospective review of patient files. Results: The kinematic group required less augments, stems, and constrained inserts than the mechanical group and thinner polyethylene bearings. There were significant differences in the lateral distal femoral angle (LDFA) and the medial proximal tibial angle (MPTA) between the two groups (p<0.05). The mean WOMAC score obtained at discharge was better in the kinematic group as was mean knee flexion. At last follow up of 34 months for the kinematic group and 58 months for the mechanical group, no orthopedic complications or reoperations were recorded. Conclusion: Although this study has a small patient cohort, our results suggest that kinematic alignment for TKA after UKA revision is an attractive method. Further studies are warranted. PMID:27563365

  15. A Preliminary Case Study for Rectenna Sites in Indonesia

    NASA Astrophysics Data System (ADS)

    Purwanto, Y.; Collins, P.

    2004-12-01

    Electricity power generation using alternative energy sources in Indonesia has become an important policy. Until now, the contribution from alternative energy sources (especially from renewable energy sources) is very small, only about 1% of the total energy supply. It is expected that in the next 10 years this contribution will be raised to 20%. The development of renewable energy sources is primarily performed in remote areas, that are poor in infrastructure facilities. This is considered to be a good policy since there are many such remote areas in Indonesia that need development programs. The existence of Solar Power Satellite system will open a new horizon in alternative energy supply, including Indonesia, because of its higher efficiency compared to conventional terrestrial solar cells, with almost no influence from either climate or solar position. Like other countries in the world, Indonesia, although one of the largest mineral energy producers in the world (i.e. oil, coal, and natural gas), still gives attention to energy diversification programs, including solar energy utilization. SPS, being based on solar energy, could be a good choice. The Indonesian archipelago consists of thousands of islands (more than 13,000) and is the equatorial country with the longest equatorial extent (more than 5000 km). This condition is very good for energy reception from the SPS 2000 pilot plant since the energy transmitting system (spacetenna) will orbit above the equator. Along the equator there could be placed more than four receiving stations (rectenna), especially in remote areas. Thus, it is very important to consider the involvement of Indonesia in SPS energy reception research. This paper describes a preliminary study of the development possibilities in SPS energy reception in Indonesia. To define the rectenna sites and physical development aspect, this study considers some major aspects: environmental, technical, social, and economic aspects. Environmental aspects

  16. Comparison of Head Center Position and Screw Fixation Options Between a Jumbo Cup and an Offset Center of Rotation Cup in Revision Total Hip Arthroplasty: A Computer Simulation Study.

    PubMed

    Faizan, Ahmad; Black, Brandon J; Fay, Brian D; Heffernan, Christopher D; Ries, Michael D

    2016-01-01

    Jumbo acetabular cups are commonly used in revision total hip arthroplasty (THA). A straightforward reaming technique is used which is similar to primary THA. However, jumbo cups may also be associated with hip center elevation, limited screw fixation options, and anterior soft tissue impingement. A partially truncated hemispherical shell was designed with an offset center of rotation, thick superior rim, and beveled anterior and superior rims as an alternative to a conventional jumbo cup. A three dimensional computer simulation was used to assess head center position and safe screw trajectories. Results of this in vitro study indicate that a modified hemispherical implant geometry can reduce head center elevation while permitting favorable screw fixation trajectories into the pelvis in comparison to a conventional jumbo cup.

  17. Dermabond wound closure in primary hip arthroplasty.

    PubMed

    Khurana, Ashish; Parker, Salim; Goel, Vivek; Alderman, Phillip M

    2008-06-01

    Cyanoacrylate glues have been used in various surgical specialties for primary wound closure or as a supplement to other methods. We assessed the overall results and safety of this technique following primary hip arthroplasty. Ninety-three patients undergoing primary total hip replacement were studied. The surgical wound had been closed with subcuticular vicryl followed by the application of topical dermabond adhesive, without any additional dressings. The mean follow-up was 7.2 months. One patient suffered wound dehiscence on the third post operative day. Two patients had serous oozing from the wound for the initial 3-4 days. This technique provides an immediate water tight seal in a sterile operative environment and provides a barrier to micro organisms. It has good tensile strength, aesthetic value and patient satisfaction.

  18. Total knee arthroplasty closure with barbed sutures.

    PubMed

    Eickmann, Tom; Quane, Erika

    2010-09-01

    Bidirectional barbed sutures, which do not require the tying of knots, have the potential to reduce closure times of total knee arthroplasty (TKA) wounds without adverse effect to wound security, cosmesis, or infection risk. In this retrospective study, data were reviewed from TKAs performed between January 2007 and September 2008. For 88 of these procedures, conventional absorbable sutures were used for interrupted closure of the retinacular and subcutaneous layers and for running closure of the subcuticular layer. For 90 procedures, bidirectional barbed absorbable sutures were used for running closure of the retinacular and subcutaneous layers. Surgeries performed with barbed sutures were significantly faster than those performed with conventional sutures (mean times of 74.3 minutes and 85.8 minutes, respectively, p < 0.001) with no detrimental clinical effects.

  19. The trochanter slide osteotomy approach for resurfacing hip arthroplasty.

    PubMed

    Pitto, Rocco P

    2009-04-01

    The aim of this prospective study was to assess the safety and efficacy of the greater trochanter slide osteotomy approach for resurfacing hip arthroplasty. Fifty consecutive hips (47 patients) with degenerative joint disease were enrolled in the study. Serial clinical and radiological assessments were performed after the index operation. At 1-year follow-up, the clinical outcome and patient satisfaction were rated excellent or good in all hips. The radiological assessment showed signs of satisfactory implant alignment. Periprosthetic fractures and non-unions of the greater trochanter were not observed. The greater trochanter slide osteotomy approach for resurfacing hip arthroplasty is a safe procedure and provides optimal exposure of the acetabulum and proximal femur, maintaining the soft-tissue integrity of the hip joint. Blood supply of the proximal femur is not violated using this approach.

  20. Preliminary study of niobium alloy contamination by transport through helium

    NASA Technical Reports Server (NTRS)

    Scheuermann, Coulson M.; Moore, Thomas J.; Wheeler, Donald R.

    1987-01-01

    Preliminary tests were conducted to determine if interstitial element transport through a circulating helium working fluid was a potential problem in Brayton and Stirling space power systems. Test specimens exposed to a thermal gradient for up to 3000-hr included Nb-1%Zr, a Sm-Co alloy (referred to as SmCo in this paper), Hiperco 50 steel, and alumina to simulate various engine components of the Brayton and Stirling systems. Results indicate that helium transport of interstitial contaminants can be minimized over a 7-yr life with a monometallic Nb-1%Zr design. Exposure with other materials indicated a potential for interstitial contaminant transport. Determination of contamination kinetics and the effects on structural integrity will require additional testing.

  1. Characterization and subsequent utilization of microbially solubilized coal: Preliminary studies

    SciTech Connect

    Davison, B.H.; Nicklaus, D.M.; Woodward, C.A.; Lewis, S.N.; Faison, B.D.

    1989-01-01

    The solubilization of low-ranked coals by fungi, such as Paecilomyces and Candida, in defined submerged culture systems has been demonstrated. Current efforts focus on the characterization of the aqueous solubilized coal products and the development of technologies for their subsequent utilization. Solubilized coal products have been fractionated, and preliminary characterizations performed. Differences in product composition have been detected with respect to the organism used in culture duration. Prospects for the conversion of the aerobically-solubilized coal into less-oxidized products have been developed which can remain active and viable in the presence of the aqueous coal product or vanillin, a coal model compound. The results suggest that a methanogenic consortium was able to produce methane and carbon dioxide from the product of coal biosolubilization by Paecilomyces as a sole carbon source. Work continues on the development of cultures able to convert the aqueous coal product and its various fractions into methane or fuel alcohols. 17 refs., 8 figs.

  2. Total Hip Arthroplasty in Paget's Disease A Review.

    PubMed

    Tyagi, Vineet; Lajam, Claudette; Deshmukh, Ajit J

    2016-11-01

    Paget's disease of the bone is a chronic osteopathy that leads to structural weakness, hypervascularity, and bone deformities. Rapid bone turnover in patients with Paget's disease may affect outcomes following total hip arthroplasty (THA). Most literature on THA in the setting of Paget's disease is limited to isolated case reports or case series documenting a single institution experience. By completing a comprehensive analysis of the available cases, this study aims to investigate the outcomes and complications of THA in patients with Paget's disease.

  3. Total Ankle Arthroplasty: An Imaging Overview

    PubMed Central

    Kim, Da-Rae; Potter, Hollis G.; Li, Angela E.; Chun, Ka-Young; Jung, Yoon Young; Kim, Jin-Su; Young, Ki-Won

    2016-01-01

    With advances in implant technology, total ankle arthroplasty (TAA) has become an increasingly popular alternative to arthrodesis for the management of end-stage ankle arthritis. However, reports in the literature do not focus on the imaging features of TAA. Through a literature review, we demonstrate basic design features of the current ankle arthroplasty system, and the normal and abnormal postoperative imaging features associated with such devices. Pre- and postoperative evaluations of ankle arthroplasty mainly include radiography; in addition, computed tomography and magnetic resonance imaging provide further characterization of imaging abnormalities. Familiarization with multimodal imaging features of frequent procedural complications at various postoperative intervals is important in radiological practice. PMID:27134529

  4. Total knee arthroplasty in vascular malformation

    PubMed Central

    Bhende, Harish; Laud, Nanadkishore; Deore, Sandeep; Shashidhar, V

    2015-01-01

    In Klippel–Trenaunay syndrome, vascular malformations are not only in skin and superficial soft tissues but also in deep tissues like muscles bones and joints. It is well documemted that these recurrent intraarticular bleeds can cause early arthritis and joint pain. Performing arthroplasty in such patients is difficult and fraught with complications. We describe such a case where navigated total knee arthroplasty was performed with success to avoid the problems of intra medullary alignment used in the presence of intra medullary vascular malformations. We also suggest certain measures when knee arthroplasty is considered in such patients. PMID:26538765

  5. Improved radiographic outcomes with patient-specific total knee arthroplasty.

    PubMed

    Ivie, Conrad B; Probst, Patrick J; Bal, Amrit K; Stannard, James T; Crist, Brett D; Sonny Bal, B

    2014-11-01

    Patient-specific guides can improve limb alignment and implant positioning in total knee arthroplasty, although not all studies have supported this benefit. We compared the radiographs of 100 consecutively-performed patient-specific total knees to a similar group that was implanted with conventional instruments instead. The patient-specific group showed more accurate reproduction of the theoretically ideal mechanical axis, with fewer outliers, but implant positioning was comparable between groups. Our odds ratio comparison showed that the patient-specific group was 1.8 times more likely to be within the desired +3° from the neutral mechanical axis when compared to the standard control group. Our data suggest that reliable reproduction of the limb mechanical axis may accrue from patient-specific guides in total knee arthroplasty when compared to standard, intramedullary instrumentation.

  6. Changes in knee kinematics following total knee arthroplasty.

    PubMed

    Akbari Shandiz, Mohsen; Boulos, Paul; Saevarsson, Stefan Karl; Yoo, Sam; Miller, Stephen; Anglin, Carolyn

    2016-04-01

    Total knee arthroplasty (TKA) changes the knee joint in both intentional and unintentional, known and unknown, ways. Patellofemoral and tibiofemoral kinematics play an important role in postoperative pain, function, satisfaction and revision, yet are largely unknown. Preoperative kinematics, postoperative kinematics or changes in kinematics may help identify causes of poor clinical outcome. Patellofemoral kinematics are challenging to record since the patella is obscured by the metal femoral component in X-ray and moves under the skin. The purpose of this study was to determine the kinematic degrees of freedom having significant changes and to evaluate the variability in individual changes to allow future study of patients with poor clinical outcomes. We prospectively studied the 6 degrees of freedom patellofemoral and tibiofemoral weightbearing kinematics, tibiofemoral contact points and helical axes of rotation of nine subjects before and at least 1 year after total knee arthroplasty using clinically available computed tomography and radiographic imaging systems. Normal kinematics for healthy individuals were identified from the literature. Significant differences existed between pre-TKA and post-TKA kinematics, with the post-TKA kinematics being closer to normal. While on average the pre-total knee arthroplasty knees in this group displayed no pivoting (only translation), individually only five knees displayed this behaviour (of these, two showed lateral pivoting, one showed medial pivoting and one showed central pivoting). There was considerable variability postoperatively as well (five central, two lateral and two medial pivoting). Both preop and postop, flexion behaviour was more hinge-like medially and more rolling laterally. Helical axes were more consistent postop for this group. An inclusive understanding of the pre-TKA and post-TKA kinematics and changes in kinematics due to total knee arthroplasty could improve implant design, patient diagnosis and

  7. It’s not just a knee, but a whole life: A qualitative descriptive study on patients’ experiences of living with knee osteoarthritis and their expectations for knee arthroplasty

    PubMed Central

    Nyvang, Josefina; Hedström, Margareta; Gleissman, Sissel Andreassen

    2016-01-01

    Aim Knee arthroplasties are an increasingly common treatment for osteoarthritis (OA) and the main indication is pain. Previous research states, however, that 15–20% of the operated patients are dissatisfied and 20–30% have persistent pain after surgery. This study is aimed at describing patients’ experiences of living with knee OA when scheduled for surgery and further their expectations for future life after surgery. Methods We interviewed 12 patients with knee OA scheduled for arthroplasty, using semi-structured qualitative interviews. The interviews were recorded and transcribed verbatim and analyzed using qualitative thematic analysis. Findings Three categories were formulated with an overriding theme: “It's not just a knee, but a whole life.” The three categories were “Change from their earlier lives,” “Coping with knee problems,” and “Ultimate decision to undergo surgery.” The main finding was that knee OA affects the whole body and self, ultimately affecting the patients’ lives on many levels. Further findings were that knee OA was considered to be the central focus in the participants’ lives, which limited their level of activity, their ability to function as desired, their quality of life, and their mental well-being. Although surgery was considered to be the only solution, the expectations regarding the outcome differed. Conclusions The participants were forced to change how they previously had lived their lives resulting in a feeling of loss. Thus, the experienced loss and expectations for future life must be put into the context of the individual's own personality and be taken into account when treating individuals with knee OA. The experience of living with knee OA largely varies between individuals. This mandates that patients’ assessment should be considered on individual basis with regard to each patient. PMID:27036130

  8. Validation of primary metal-on-metal hip arthroplasties on the National Joint Registry for England, Wales and Northern Ireland using data from the London Implant Retrieval Centre: a study using the NJR dataset.

    PubMed

    Sabah, S A; Henckel, J; Cook, E; Whittaker, R; Hothi, H; Pappas, Y; Blunn, G; Skinner, J A; Hart, A J

    2015-01-01

    Arthroplasty registries are important for the surveillance of joint replacements and the evaluation of outcome. Independent validation of registry data ensures high quality. The ability for orthopaedic implant retrieval centres to validate registry data is not known. We analysed data from the National Joint Registry for England, Wales and Northern Ireland (NJR) for primary metal-on-metal hip arthroplasties performed between 2003 and 2013. Records were linked to the London Implant Retrieval Centre (RC) for validation. A total of 67,045 procedures on the NJR and 782 revised pairs of components from the RC were included. We were able to link 476 procedures (60.9%) recorded with the RC to the NJR successfully. However, 306 procedures (39.1%) could not be linked. The outcome recorded by the NJR (as either revised, unrevised or death) for a primary procedure was incorrect in 79 linked cases (16.6%). The rate of registry-retrieval linkage and correct assignment of outcome code improved over time. The rates of error for component reference numbers on the NJR were as follows: femoral head category number 14/229 (5.0%); femoral head batch number 13/232 (5.3%); acetabular component category number 2/293 (0.7%) and acetabular component batch number 24/347 (6.5%). Registry-retrieval linkage provided a novel means for the validation of data, particularly for component fields. This study suggests that NJR reports may underestimate rates of revision for many types of metal-on-metal hip replacement. This is topical given the increasing scope for NJR data. We recommend a system for continuous independent evaluation of the quality and validity of NJR data.

  9. Debridement with prosthesis retention and antibiotherapy vs. two-stage revision for periprosthetic knee infection within 3 months after arthroplasty: a case-control study.

    PubMed

    Lizaur-Utrilla, A; Gonzalez-Parreño, S; Gil-Guillen, V; Lopez-Prats, F A

    2015-09-01

    Sixty-four patients with periprosthetic infection within 3 months of index arthroplasty, of whom 39 underwent debridement with prosthesis retention and antibiotherapy (DPRA), and 25 underwent two-stage revision (2SR), were compared regarding control of infection and functional outcomes by use of Knee Society scores. Failure was defined as the need for subsequent surgery to control infection. The failure rate after DPRA was 61.5%, and that after 2SR was 12.0% (p 0.001). The failure risk was not significantly associated with the duration of symptoms (≤4 weeks). The only predictor of failure was isolation of Staphylococcus aureus or Staphylococcus epidermidis. Treatment with 2SR required fewer surgical operations, a shorter duration of hospitalization, and a shorter duration of treatment. All patients who required a second debridement ultimately underwent prosthesis removal. The functional outcome was significantly better for 2SR at the last follow-up.

  10. Patient and health professional views on rehabilitation practices and outcomes following total hip and knee arthroplasty for osteoarthritis:a focus group study

    PubMed Central

    2010-01-01

    Background There is worldwide variation in rehabilitation practices after total hip arthroplasty (THA) and total knee arthroplasty (TKA) and no agreement on which interventions will lead to optimal short and long term patient outcomes. As a first step in the development of clinical practice guidelines for post-acute rehabilitation after THA and TKA, we explored experiences and attitudes about rehabilitation practices and outcomes in groups of individuals identified as key stakeholders. Methods Separate focus groups and interviews were conducted with patients (THA or TKA within past year) and three health professional groups: allied health professionals (AHPs), orthopaedic surgeons, and other physicians, in Canada and the United States. Pairs of moderators led the focus groups using a standardized discussion guide. Discussions were audiotaped and transcribed verbatim. A content analysis within and across groups identified key themes. Results Eleven focus groups and eight interviews took place in six sites. Patients (n = 32) varied in age, stage of recovery, and surgical and rehabilitation experiences. Health professionals (n = 44) represented a range of disciplines, practice settings and years of experience. Six key themes emerged: 1) Let's talk (issues related to patient-health professional and inter-professional communication); 2) Expecting the unexpected (observations about unanticipated recovery experiences); 3) It's attitude that counts (the importance of the patient's positive attitude and participation in recovery); 4) It takes all kinds of support (along the continuum of care); 5) Barriers to recovery (at patient, provider and system levels), and 6) Back to normal (reflecting diversity of expected outcomes). Patients offered different, but overlapping views compared to health professionals regarding rehabilitation practices and outcomes following THA and TKA. Conclusion Results will inform subsequent phases of guideline development and ensure stakeholders

  11. Intraoperative Hypothermia in Total Hip and Knee Arthroplasty.

    PubMed

    Frisch, Nicholas B; Pepper, Andrew M; Rooney, Edward; Silverton, Craig

    2016-10-25

    Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes. The clinical records of 2580 consecutive patients who underwent TKA or THA at a single institution between January 1, 2011, and December 31, 2013 were reviewed. After excluding patients with complex or revision procedures, a total of 2397 patients comprised the study population. Patient demographic data, surgery-specific data, postoperative complications, length of hospital stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis evaluated associations with hypothermia and the effect on complications and outcomes. The incidence of mean intraoperative hypothermia was 37%, 43.9%, and 32.6% for arthroplasty, THA, and TKA, respectively. General anesthesia was significantly associated with hypothermia (P<.001). Women and THA patients were at higher risk for hypothermia. In the arthroplasty and THA cohorts, longer operating room time and re-warmer use were associated with hypothermia (P=.010). Overall, hypothermia was associated with increased estimated blood loss, but no increase in associated transfusion was demonstrated (P=.006). Hypothermia was not associated with postoperative complications. [Orthopedics. 201x; xx(x):xx-xx.].

  12. Utilization of optimal study design for maternal and fetal sheep propofol pharmacokinetics study: a preliminary study.

    PubMed

    Sherwin, Catherine M T; Ngamprasertwong, Pornswan; Sadhasivam, Senthilkumar; Vinks, Alexander A

    2014-02-01

    Multiple blood samples are generally required for measurement of pharmacokinetic (PK) parameters. D-optimal design is a popular and frequently used approach for determination of sampling time points in order to minimize the number of samples, while optimizing the estimation of PK parameters. Optimal design utilizing ADAPT (v5, BSR, University of Southern California, Los Angeles) developed a sparse sampling strategy to determine measurement of propofol in pregnant sheep. Propofal was administered as supplemental anesthetic agent to inhalation anesthesia to mimic anesthesia for open fetal surgery. In our preliminary study, propofol 3 mg/kg was given as a bolus to the ewe, followed by propofol infusion at rate 450 mcg/kg/min for 60 minutes, then decreased to 75 mcg/kg/min for 90 more minutes and then ceased. A three compartment model described the PK parameters with the fetus assumed as the third compartment. Initially, sampling times were chosen from thirteen time points as previously stated in the literature. Using priori propofol PK estimates, the final 9 sample time points were proposed in an optimal design with a change in infusion rate occurring between 65 and 75 minutes and sampling proposed at 5, 15, 25, 65, 75, 100, 110, 150, and 180 minutes. D-optimal design optimized the number and timing of samplings, which led to a reduction of cost and man power in the study protocol while preserving the ability to estimate propofol PK parameters in the maternal and fetal sheep model. Initial evaluation of samples collected from three sheep using the optimal design strategy confirmed the performance of the design in obtaining effective PK parameter estimates.

  13. Contamination of individuals by radon daughters: a preliminary study

    SciTech Connect

    Stebbings, J.H.; Dignam, J.J.

    1988-03-01

    Body radon daughter contamination reflects relative individual respiratory exposures to radon daughters; counts can be related both to household radon levels and to lung cancer risk factors such as sex and tobacco smoking. Radon daughters were counted by gamma spectroscopy from 180 adult residents of eastern Pennsylvania. A seven-position, 35-min scan was conducted in a mobile body counter, generally during afternoon or evening hours. Track-etch detectors for household radon were distributed, and were recovered from 80% of the subjects. Over 75% of the population had environmentally enhanced radon daughter contamination. House radon levels were strongly related, as anticipated, to radon daughter contamination in the 112 subjects for whom both sets of measurements were available (p less than .001); basement measurements were as strongly related to personal contamination as were living area measurements; bedroom measurements were slightly more strongly correlated. Both sex (p less than .02) and cigarette smoking (p less than .01) significantly modified the relationships, after nonlinear adjustment for travel times. Using a logarithmic model, a given house living-area radon level was associated in females with body contamination by radon daughters 2-3 times that in males. Nonsmokers had 2-4 times higher levels of contamination than smokers. Results are for the total of internal and external contamination, these being highly correlated in preliminary experiments. Time usage and activity patterns of the subjects are believed to be important in explaining these findings, and may become important variables in radon risk assessment.

  14. Laparoscopic Herniorrhaphy with Porcine Small Intestinal Submucosa: A Preliminary Study

    PubMed Central

    2002-01-01

    Introduction: Using mesh or a synthetic prosthesis during the laparoscopic repair of inguinal hernias has been demonstrated to be safe and effective. A new material, porcine small intestinal submucosa (SIS mesh), has been successfully used in canine and rodent animal models with excellent results. This mesh is degradable and resorbable with a marked decrease in the possibility of becoming infected. However, the amount of fibroblast ingrowth is equal to that with polypropylene mesh. Methods: A comparison was made between this new SIS mesh to repair 15 inguinal hernias in 12 patients and polypropylene mesh used in 12 similar patients. A preperitoneal approach with balloon dissection was used in all patients. Results: Demographics were similar in both groups. The results were excellent and compared equally. Complications (seroma, discomfort) were minimal in both groups and were similar. Conclusions: Porcine small intestinal submucosa, SIS mesh, can be used for laparoscopic repair of inguinal hernias. Long-term follow-up will be necessary to confirm these preliminary results. PMID:12166756

  15. The Myres Hill remote sensing intercomparison study: preliminary results

    NASA Astrophysics Data System (ADS)

    Clive, P. J. M.; Chindurza, I.; Ravey, I.; Bass, J.; Boyle, R. J.; Jones, P.; Lang, S. J.; Bradley, S.; Hay, L.; Oldroyd, A.; Stickland, M.

    2008-05-01

    Two remote sensing techniques (SODAR and LIDAR) have been developed for measuring wind speed and turbulence from ground level up to altitudes of 300 m or higher. Although originally developed in the defence sector, these techniques are now generating considerable interest in the renewable energy and meteorological sectors. Despite the benefits of these instruments they are not yet generally accepted for due diligence measurements by wind energy developers and financial institutions. There is a requirement for a series of independent assessments of these new metrology techniques, comparing their measurements with the approved cup-type anemometer readings. This is being addressed at TUV NEL's Myres Hill wind turbine test site in a measurement programme supported by the DIUS National Measurement Systems Measurement for Innovators scheme and a consortium of 21 industrial collaborators. Data from SODAR and LIDAR systems are being compared with results from cup-type anemometers mounted at different heights on an 80m meteorological mast. An ultrasonic sensor is also mounted on the mast. The objective of the test programme is to assess the effectiveness of SODAR and LIDAR wind speed measurement techniques under different operating regimes and atmospheric conditions. Results from the measurements will provide definitive data on the performance of the remote wind speed sensing techniques under test on complex terrain typical of many wind farm sites. Preliminary measurements based on data acquired during the initial measurement campaign are presented.

  16. Implications for rehabilitation after total wrist arthroplasty.

    PubMed

    Lockard, Margery A

    2004-09-01

    Achieving satisfactory, long-term functional outcomes after total wrist arthroplasty surgery has proved more complicated than with arthroplasties in joints such as the hip or knee. However, improvements in implant design and surgical technique have resulted in recent successes and evidence that wrist arthroplasty may be an appropriate choice to improve function in select patients. This article reviews factors that therapists must consider in planning, implementing, and progressing individual patients' rehabilitation programs after wrist arthroplasty surgery. Therapists must be knowledgeable about the specifics of each patient's surgery so that the rehabilitation program can be customized appropriately and can contribute to achieving pain-free stable wrist movement that allows patients to perform their desired functional activities.

  17. [What's new about total knee arthroplasty].

    PubMed

    Dao Trong, Mai Lang; Helmy, Näder

    2013-10-30

    Osteoarthritis of the knee is one of the most common problems in the orthopedic practice and its surgical technique is still challenging. This Mini-Review presents patient specific cutting blocks for the implantation of a total knee arthroplasty.

  18. [Recovery from total knee arthroplasty through continuous passive motion].

    PubMed

    Sánchez Mayo, B; Rodríguez-Mansilla, J; González Sánchez, B

    2015-01-01

    The purpose of this study was to know the effects of continuous passive mobilization in patients who underwent total knee arthroplasty. A search strategy was developed to retrieve all clinical trials, written in English and/or Spanish, published in the electronic search databases PubMed, Cochrane Library Plus, Dialnet, CSIC and PEDro. The inclusion criteria were: clinical trials published from January 2000 until November 2014 in English or Spanish. Out of 537 clinical trials that were potentially relevant, a total of 12 were included in this review. The evaluation of 1,153 patients shows that there is no significant difference in improving the range of the joint, pain, balance, motion, healing and hospital stay using continuous passive mobilization against the regular physiotherapy treatment for total knee arthroplasty. The application of continuous passive mobilization in the long-term does not provide any benefit in terms of the breadth of the range of the joint, pain and improvement of standing and motion in comparison with conventional postoperative physiotherapy treatment in total knee arthroplasty. In the short term an improvement is obtained in the range of joint motion in knee flexion.

  19. Cost analyses of extended prophylaxis with enoxaparin after hip arthroplasty.

    PubMed

    Friedman, R J; Dunsworth, G A

    2000-01-01

    Venous thromboembolic complications occur in 50% to 70% of patients undergoing total hip arthroplasty if no prophylactic regimen is used. Because enoxaparin and warfarin are useful for extended outpatient prophylaxis, the objective of this study was to determine which of these agents is most cost effective in preventing venous thromboembolic complications. A decision tree analysis was developed to simulate a hypothetical cohort of patients with total hip arthroplasty. The analysis considered home health care services to perform monitoring and compliance verification. Accounting for prophylactic failures and treatment complications, results showed that enoxaparin maintained a cost effective advantage over warfarin for extended prophylaxis in the time after discharge and total hip arthroplasty ranging from 19 to 31 days after the patient was discharged from the hospital. The duration of cost effectiveness of enoxaparin was reduced to 14 to 17 days when home care services were excluded. These results indicated that approximately 3 weeks of outpatient therapy with enoxaparin is cost effective. With the cornerstone of managed care being cost efficiency in the provision of quality care, this conclusion warrants the development of integrated care strategies for the patient having orthopaedic surgery to achieve cost effective patient management.

  20. Metallic radial head arthroplasty improves valgus stability of the elbow.

    PubMed

    King, G J; Zarzour, Z D; Rath, D A; Dunning, C E; Patterson, S D; Johnson, J A

    1999-11-01

    The stabilizing influence of radial head arthroplasty was studied in eight medial collateral ligament deficient anatomic specimen elbows. An elbow testing apparatus, which used computer controlled pneumatic actuators to apply tendon loading, was used to simulate active elbow flexion. The motion pathways of the elbow were measured using an electromagnetic tracking device, with the forearm in supination and pronation. As a measure of stability, the maximum varus to valgus laxity over the range of elbow flexion was determined from the difference between varus and valgus gravity loaded motion pathways. After transection of the medial collateral ligament, the radial head was excised and replaced with either a silicone or one of three metallic radial head prostheses. Medial collateral ligament transection caused a significant increase in the maximum varus to valgus laxity to 18.0 degrees +/- 3.2 degrees. After radial head excision, this laxity increased to 35.6 degrees +/- 10.3 degrees. The silicone implant conferred no increase in elbow stability, with a maximum varus to valgus laxity of 32.5 degrees +/- 15.5 degrees. All three metallic implants improved the valgus stability of the medial collateral ligament deficient elbow, providing stability similar to the intact radial head. The use of silicone arthroplasty to replace the radial head in the medial collateral ligament deficient elbow must be questioned. Metallic radial head arthroplasty provides improved valgus stability, approaching that of an intact radial head.

  1. Tantalum Cones in Revision Total Knee Arthroplasty.

    PubMed

    Kim, Eric G; Patel, Nirav K; Chughtai, Morad; Elmallah, Randa D K; Delanois, Ronald E; Harwin, Steven F; Mont, Michael A

    2016-11-01

    The best strategy to address large bony defects in revision total knee arthroplasty has yet to be determined. The relatively recent development of porous tantalum cones and their use to address massive bone loss in knee arthroplasty has shown promising short- and intermediate-term results. The purpose of this review is to present the current literature on: (1) basic science of porous tantalum, (2) classification and treatment for bone loss, (3) clinical results, and (4) evolution of newer generation cones.

  2. CMC Arthroplasty of the Thumb: A Review

    PubMed Central

    Ilyas, Asif; Thoder, Joseph J.

    2007-01-01

    Arthritis of the first carpometacarpal (CMC) joint of the hand is a common and often debilitating disease. Diagnosis can be readily made with history, physical exam, and radiographic evaluation. Patients with advanced disease who have failed conservative treatment modalities have multiple surgical options including ligament reconstruction, resection arthroplasty, silicone implantation, tendon interposition, or total joint arthroplasty. This article will describe the variety of approaches to treatment as well as the author’s preferred method. PMID:18780059

  3. Reverse Shoulder Arthroplasty – A Literature Review

    PubMed Central

    Mahmood, Aatif; Malal, Joby Jacob George; Waseem, Mohammed

    2013-01-01

    Professor Grammont revolutionised shoulder surgery with his reverse shoulder arthroplasty design. Patients who had poor results from a conventional shoulder replacement because of cuff deficiency can now be treated effectively. Although designed for cuff tear arthropathy, indications continue to evolve and broaden. The initial results look very promising and the implant has gained much popularity over the years. The article provides an extensive literature review of the indications, results and complications for reverse shoulder arthroplasty. PMID:24082977

  4. Reverse shoulder arthroplasty - a literature review.

    PubMed

    Mahmood, Aatif; Malal, Joby Jacob George; Waseem, Mohammed

    2013-01-01

    Professor Grammont revolutionised shoulder surgery with his reverse shoulder arthroplasty design. Patients who had poor results from a conventional shoulder replacement because of cuff deficiency can now be treated effectively. Although designed for cuff tear arthropathy, indications continue to evolve and broaden. The initial results look very promising and the implant has gained much popularity over the years. The article provides an extensive literature review of the indications, results and complications for reverse shoulder arthroplasty.

  5. Research evidence for the use of preoperative exercise in patients preparing for total hip or total knee arthroplasty.

    PubMed

    Barbay, Kathryn

    2009-01-01

    Preoperative exercise/rehabilitation is currently being considered to improve outcomes for orthopaedic surgery. This article presents an evidence-based practice review of the current research literature from 1998 to 2008 to determine whether preoperative exercise alone will be beneficial to patients preparing for total knee or hip arthroplasty. Only 3 studies met the inclusion criteria of preoperative exercise as the sole intervention. Each of these studies indicated that preoperative exercise had some postoperative benefit to total knee or hip arthroplasty patients. In general, the results are inconclusive due to the lack of strong research evidence, and only a pragmatic recommendation for preoperative exercise prior to total hip or knee arthroplasty is supported. More research is needed in the area of preoperative exercise for persons preparing for total hip or knee arthroplasty.

  6. Preliminary Studies of a Pulsed Detonation Rocket Engine

    NASA Technical Reports Server (NTRS)

    Cambier, Jean-Luc; Adelman, H. G.; Menees, G. P.; Edwards, Thomas A. (Technical Monitor)

    1995-01-01

    In the new era of space exploration, there is a strong need for more efficient, cheaper and more reliable propulsion devices. With dramatic increase in specific impulse, the overall mass of fuel to be lifted into orbit is decreased, and this leads, in turn, to much lower mass requirements at lift-off, higher payload ratios and lower launch costs. The Pulsed Detonation engine (PDE) has received much attention lately due to its unique combination of simplicity, light-weight and efficiency. Current investigations focus principally on its use as a low speed, airbreathing engine, although other applications have also been proposed. Its use as a rocket propulsion device was first proposed in 1988 by the present authors. The superior efficiency of the Pulsed Detonation Rocket Engine (PDRE) is due to the near constant volume combustion process of a detonation wave. Our preliminary estimates suggest that the PDRE is theoretically capable of achieving specific impulses as high as 720 sec, a dramatic improvement over the current 480 sec of conventional rocket engines, making it competitive with nuclear thermal rockets. In addition to this remarkable efficiency, the PDRE may eliminate the need for high pressure cryogenic turbopumps, a principal source of failures. The heat transfer rates are also much lower, eliminating the need for nozzle cooling. Overall, the engine is more reliable and has a much lower weight. This paper will describe in detail the operation of the PDRE and calculate its performance, through numerical simulations. Engineering issues will be addressed and discussed, and the impact on mission profiles will also be presented. Finally, the performance of the PDRE using in-situ resources, such as CO and O2 from the martian atmosphere, will also be computed.

  7. A Preliminary Study of Seismicity at Ceboruco, Volcano, Nayarit, Mexico

    NASA Astrophysics Data System (ADS)

    Sanchez, J. J.; Nunez-Cornu, F. J.; Suarez-Plascencia, C.; Trejo-Gomez, E.

    2007-12-01

    Ceboruco Volcano is located northwestern of Tepic-Zacoalco graben (Jalisco, Mexico). Its volcanic activity can be divided in four eruptive cycles differentiated by their volcano explosivity index (VEI) and chemical variations as well. As a result of andesitic effusive activity, during the first cycle the "paleo-Ceboruco" edifice was constructed. The end of this cycle is defined by a plinian eruption (VEI is estimated between 3 and 4) which occurred some 1020 years ago and formed the external caldera. During the second cycle an andesitic dome extruded in the interior of the caldera. The dome, called Dos Equis, collapsed and formed the internal caldera. The third cycle is represented by andesitic lava flows which partially cover the northern and south-southwestern part of the edifice. The last cycle is represented by historic andesitic lava flows located in the southwestern flank of the volcano. In February 2003 as part of an agreement with Nayarit Civil Defense a seismic station was installed in the SW flank of the volcano. The station is equipped with a Marslite (lennartz) digitizer with a 3DLe 1Hz. seismic sensor. Detection system is based on a STA/LTA recording algorithm. More than 2000 small earthquakes have been attributed to various local sources, and some of this earthquakes are possibly located beneath Ceboruco volcano. A preliminary classification separates high frequency and low frequency seismic events. The sources of high frequency earthquakes appear to be distributed as evidenced from waveforms variety and changing S-P arrivals separations. The low frequency seismic events also show varying signatures and some of them exhibit extended coda, including some monochromatic character.

  8. The relationship between knee arthroplasty and foot loading.

    PubMed

    Voronov, Michael L; Pinzur, Michael S; Havey, Robert M; Carandang, Gerard; Gil, Joseph A; Hopkinson, William J

    2012-02-01

    Surgeons have questioned whether foot deformity applies abnormal loading on a knee implant. A total of 24 patients with mild knee deformity underwent a static recording of foot loading prior to and at 3 months following knee replacement. Of these patients, 13 had a preoperative varus deformity. The recorded postoperative to preoperative loading in all 6 geographic sites was decreased by an average of 10%. The largest changes were observed in the hallux and lesser toe masks, whereas the postoperative to preoperative foot pressure ratio in the metatarsal head (lateral and medial), heel, and midfoot masks was 0.94. This preliminary investigation reveals a minimal change in geographic foot loading following total knee arthroplasty in patients with mild knee deformity.

  9. Pseudotumor due to metallosis after total elbow arthroplasty

    PubMed Central

    Rotini, Roberto; Bettelli, Graziano; Cavaciocchi, Michele; Savarino, Lucia

    2017-01-01

    The incidence of primary total elbow arthroplasty (TEA) in young patients is increasing. The indications for revision surgery are also rising. Here, we report a rare case of pseudotumor detected in a patient 16 years after TEA. Intraoperative findings revealed a necrotic mass characterized by a conspicuous metallosis in the soft tissues around the prosthesis, which caused ulnar nerve dislocation. Due to this anatomical change, a lesion of the nerve was accidentally produced during revision surgery. The case report emphasizes that the indications for elbow replacement, as well as the patient education about the permanent physical limitations, should be carefully considered. Moreover, the high risks of complications related to the revision procedure and pseudotumor removal need to be addressed before surgery. The technique should be done carefully and a preliminary thorough imaging should be performed, since a newly formed mass can cause significant distortion of the anatomy. PMID:28216759

  10. Bilateral custom-fit total knee arthroplasty in a patient with poliomyelitis.

    PubMed

    Tardy, Nicolas; Chambat, Pierre; Murphy, Colin G; Fayard, Jean-Marie

    2014-09-01

    In limbs affected by poliomyelitis, total knee arthroplasty results in satisfactory pain relief. However, the risk of failure is high, especially if the preoperative quadriceps power is low. Therefore, treating osteoarthritis in the current patient represented a challenging procedure. A 66-year-old man presented with tricompartmental osteoarthritis of both knees, with valgus deformity of 14° on the left knee and 11° on the right knee. He walked with a bilateral knee recurvatum of 30° and a grade 1 quadriceps power. The authors treated both knees with cemented custom-fit hinged total knee arthroplasty with 30° of recurvatum in the tibial keel. Clinical scores showed good results 1 year postoperatively, especially on the subjective data of quality of life and function. At follow-up, radiographs showed good total knee arthroplasty positioning on the right side and a small mechanical loosening at the end of the tibial keel on the left side. Only 5 studies (Patterson and Insall; Moran; Giori and Lewallen; Jordan et al; and Tigani et al) have reported total knee arthroplasty results in patients with poliomyelitis. This study reports an original case of bilateral custom-fit hinged total knee arthroplasty in a patient with poliomyelitis. To the authors' knowledge, this is the first report of this type of procedure in the literature. The key point is the degree of recurvatum that is needed to allow walking, avoiding excessive constraints on the implants that can lead to early mechanical failure.

  11. Lubrication regimes in lumbar total disc arthroplasty.

    PubMed

    Shaheen, A; Shepherd, D E T

    2007-08-01

    A number of total disc arthroplasty devices have been developed. Some concern has been expressed that wear may be a potential failure mode for these devices, as has been seen with hip arthroplasty. The aim of this paper was to investigate the lubrication regimes that occur in lumbar total disc arthroplasty devices. The disc arthroplasty was modelled as a ball-and-socket joint. Elastohydrodynamic lubrication theory was used to calculate the minimum film thickness of the fluid between the bearing surfaces. The lubrication regime was then determined for different material combinations, size of implant, and trunk velocity. Disc arthroplasties with a metal-polymer or metal-metal material combination operate with a boundary lubrication regime. A ceramic-ceramic material combination has the potential to operate with fluid-film lubrication. Disc arthroplasties with a metal-polymer or metal-metal material combination are likely to generate wear debris. In future, it is worth considering a ceramic-ceramic material combination as this is likely to reduce wear.

  12. Preliminary Design Study of a National Program for Training Skilled Aviation Personnel.

    ERIC Educational Resources Information Center

    Arizona State Univ., Tempe.

    This study supplementing a 1967 study of Arizona State University, recommends preliminary plans for the design of a national training center capable of accommodating 2,200 fliers and aviation technicians and the steps that should be taken to complete the facility by September 1972. Specific recommendations are: (1) negotiations between the…

  13. Identification of Emerging Self-Injurious Behavior in Young Children: A Preliminary Study

    ERIC Educational Resources Information Center

    Kurtz, Patricia F.; Chin, Michelle D.; Huete, John M.; Cataldo, Michael F.

    2012-01-01

    Self-injurious behavior (SIB) is a chronic disorder that often begins in early childhood; however, few studies have examined the onset of SIB in young children. This preliminary study reports on the identification, assessment, and observation of SIB in 32 children who had begun to engage in SIB within the previous 6 months. Participants were under…

  14. Joint Line Reconstruction in Navigated Total Knee Arthroplasty Revision

    ClinicalTrials.gov

    2012-05-16

    Revision Total Knee Arthroplasty Because of; Loosening; Instability; Impingement; or Other Reasons Accepted as Indications for TKA Exchange.; The Focus is to Determine the Precision of Joint Line Restoration in Navigated vs. Conventional Revision Total Knee Arthroplasty

  15. Can tranexamic acid change preoperative anemia management during total joint arthroplasty?

    PubMed Central

    Phan, Duy L; Rinehart, Joseph B; Schwarzkopf, Ran

    2015-01-01

    AIM: To investigate the postoperative transfusion and complication rates of anemic and nonanemic total joint arthroplasty patients given tranexamic acid (TXA). METHODS: A cross-sectional prospective study was conducted of primary hip and knee arthroplasty cases performed from 11/2012 to 6/2014. Exclusion criteria included revision arthroplasty, bilateral arthroplasty, acute arthroplasty after fracture, and contraindication to TXA. Patients were screened prior to surgery, with anemia was defined as hemoglobin of less than 12 g/dL for females and of less than 13 g/dL for males. Patients were divided into four different groups, based on the type of arthroplasty (total hip or total knee) and hemoglobin status (anemic or nonanemic). Intraoperatively, all patients received 2 g of intravenous TXA during surgery. Postoperatively, allogeneic blood transfusion (ABT) was directed by both clinical symptoms and relative hemoglobin change. Complications were recorded within the first two weeks after surgery and included thromboembolism, infection, and wound breakdown. The differences in transfusion and complication rates, as well as the relative hemoglobin change, were compared between anemic and nonanemic groups. RESULTS: A total of 232 patients undergoing primary joint arthroplasty were included in the study. For the total hip arthroplasty cohort, 21% (18/84) of patients presented with preoperative anemia. Two patients in the anemic group and two patients in the nonanemic group needed ABTs; this was not significantly different (P = 0.20). One patient in the anemic group presented with a deep venous thromboembolism while no patients in the nonanemic group had an acute complication; this was not significantly different (P = 0.21). For nonanemic patients, the average change in hemoglobin was 2.73 ± 1.17 g/dL. For anemic patients, the average change in hemoglobin was 2.28 ± 0.96 g/dL. Between the two groups, the hemoglobin difference of 0.45 g/dL was not significant (P = 0

  16. Patient expectation is the most important predictor of discharge destination after primary total joint arthroplasty.

    PubMed

    Halawi, Mohamad J; Vovos, Tyler J; Green, Cindy L; Wellman, Samuel S; Attarian, David E; Bolognesi, Michael P

    2015-04-01

    The purpose of this study was to identify preoperative predictors of discharge destination after total joint arthroplasty. A retrospective study of three hundred and seventy-two consecutive patients who underwent primary total hip and knee arthroplasty was performed. The mean length of stay was 2.9 days and 29.0% of patients were discharged to extended care facilities. Age, caregiver support at home, and patient expectation of discharge destination were the only significant multivariable predictors regardless of the type of surgery (total knee versus total hip arthroplasty). Among those variables, patient expectation was the most important predictor (P < 0.001; OR 169.53). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a high concordance index of 0.969.

  17. Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty.

    PubMed

    Soni, Ashwani; Saini, Raghav; Gulati, Anmol; Paul, Rajesh; Bhatty, Shiraj; Rajoli, Sreekanth Reddy

    2014-08-01

    Tranexamic acid is an antifibrinolytic drug used widely to prevent bleeding. Its use in reducing bleeding during total knee arthroplasty surgery is well proven but there is no final consensus regarding the regimen. The purpose of our study was to compare the effectiveness of intravenous and intra-articular regimen of tranexamic acid during the total knee arthroplasty surgery. A total of 40 patients were received three doses of intravenous tranexamic acid during total knee arthroplasty surgery. Intra-articular tranexamic acid was used in 40 patients during the surgery. We concluded that intra-articular tranexamic acid is equally effective as three dose intravenous regimen in reducing blood loss during total knee arthroplasty surgery.

  18. Severe Pelvic Obliquity Affects Femoral Offset in Patients with Total Hip Arthroplasty but Not Leg-Length Inequality.

    PubMed

    Zhou, Xiaoxiao; Wang, Qi; Zhang, Xianlong; Chen, Yunsu; Peng, Xiaochun; Mao, Yuanqing; Yang, Yang; Fu, Beigang; Wang, Xiuhui; Tang, Tingting

    2015-01-01

    Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthroplasty were correlated with pelvic obliquity. This prospective study divided 98 patients into six groups based on the inclination of pelvic obliquity before total hip arthroplasty. Leg-length inequality, variation of pelvic obliquity, offset, and vertical offset were measured after total hip arthroplasty. Leg-length inequality and vertical offset were not significantly different among groups, whereas the variation of pelvic obliquity was significantly higher in type IIC pelvic obliquity than in other groups. Type IC pelvic obliquity had a significantly shorter offset than did the other groups, which may have been an important factor leading to type IC pelvic obliquity. Pelvic obliquity exhibited no significant effect on leg-length inequality in patients with total hip arthroplasty. A shorter offset may be caused by the higher tension of the abductor in the operated hip, which may result in the formation of type IC pelvic obliquity. Releasing the abductor contracture and restoring femoral offset are important for increasing hip stability and maintaining pelvic balance following total hip arthroplasty.

  19. Severe Pelvic Obliquity Affects Femoral Offset in Patients with Total Hip Arthroplasty but Not Leg-Length Inequality

    PubMed Central

    Zhou, Xiaoxiao; Wang, Qi; Zhang, Xianlong; Chen, Yunsu; Peng, Xiaochun; Mao, Yuanqing; Yang, Yang; Fu, Beigang; Wang, Xiuhui; Tang, Tingting

    2015-01-01

    Leg-length inequality is an extensively studied complication of total hip arthroplasty in normal patients. However, few studies have focused on the pelvic obliquity of coronal pelvic malrotation. We hypothesized that pelvic obliquity with a fixed abduction/adduction contracture deformity of the hip may intraoperatively affect the release of soft tissues, ultimately resulting in a leg-length inequality. This study also investigated whether the femoral and vertical offsets of total hip arthroplasty were correlated with pelvic obliquity. This prospective study divided 98 patients into six groups based on the inclination of pelvic obliquity before total hip arthroplasty. Leg-length inequality, variation of pelvic obliquity, offset, and vertical offset were measured after total hip arthroplasty. Leg-length inequality and vertical offset were not significantly different among groups, whereas the variation of pelvic obliquity was significantly higher in type IIC pelvic obliquity than in other groups. Type IC pelvic obliquity had a significantly shorter offset than did the other groups, which may have been an important factor leading to type IC pelvic obliquity. Pelvic obliquity exhibited no significant effect on leg-length inequality in patients with total hip arthroplasty. A shorter offset may be caused by the higher tension of the abductor in the operated hip, which may result in the formation of type IC pelvic obliquity. Releasing the abductor contracture and restoring femoral offset are important for increasing hip stability and maintaining pelvic balance following total hip arthroplasty. PMID:26673427

  20. General Compared with Spinal Anesthesia for Total Hip Arthroplasty

    PubMed Central

    Basques, Bryce A.; Toy, Jason O.; Bohl, Daniel D.; Golinvaux, Nicholas S.; Grauer, Jonathan N.

    2015-01-01

    Background: Total hip arthroplasty may be performed under general or spinal anesthesia. The purpose of the current study was to compare perioperative outcomes between anesthetic types for patients undergoing primary elective total hip arthroplasty. Methods: Patients who had undergone primary elective total hip arthroplasty from 2010 to 2012 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Operating room times, length of stay, thirty-day adverse events, and readmission were compared between patients who had received general anesthesia and those who had received spinal anesthesia. Propensity-adjusted multivariate analysis was used to control for selection bias and baseline patient characteristics. Results: A total of 20,936 patients who had undergone total hip arthroplasty met inclusion criteria for this study. Of these, 12,752 patients (60.9%) had received general anesthesia and 8184 patients (39.1%) had received spinal anesthesia. On propensity-adjusted multivariate analyses, general anesthesia for total hip arthroplasty was associated with increased operative time (+12 minutes [95% confidence interval, +11 to +13 minutes]; p < 0.001) and postoperative room time (+5 minutes [95% confidence interval, +4 to +6 minutes]; p < 0.001). General anesthesia was also associated with the occurrence of any adverse event (odds ratio, 1.31 [95% confidence interval, 1.23 to 1.41]; p < 0.001), prolonged postoperative ventilator use (odds ratio, 5.81 [95% confidence interval, 1.35 to 25.06]; p = 0.018), unplanned intubation (odds ratio, 2.17 [95% confidence interval, 1.11 to 4.29]; p = 0.024), stroke (odds ratio, 2.51 [95% confidence interval, 1.02 to 6.20]; p = 0.046), cardiac arrest (odds ratio, 5.04 [95% confidence interval, 1.15 to 22.07]; p = 0.032), any minor adverse event (odds ratio, 1.35 [95% confidence interval, 1.25 to 1.45]; p = 0.001), and blood transfusion (odds ratio, 1.34 [95% confidence interval, 1.25 to

  1. Total hip arthroplasty after lower extremity amputation.

    PubMed

    Amanatullah, Derek F; Trousdale, Robert T; Sierra, Rafael J

    2015-05-01

    There are approximately 1.6 million lower extremity amputees in the United States. Lower extremity amputees are subject to increased physical demands proportional to their level of amputation. Lower extremity amputees have a 6-fold higher risk of developing radiographic osteoarthritis in the ipsilateral hip and a 2-fold risk of developing radiographic osteoarthritis in contralateral hip when compared with the non-amputee population. Additionally, there is a 3-fold increased risk of developing radiographic osteoarthritis in the ipsilateral hip after an above knee amputation when compared with a below knee amputation. The authors retrospectively reviewed 35 total hip arthroplasties after lower extremity amputation. The mean clinical follow-up was 5.3±4.0 years. The mean time from lower extremity amputation to total hip arthroplasty was 12.2±12.8 years after a contralateral amputation and 5.4±6.0 years after an ipsilateral amputation (P=.050). The mean time to total hip arthroplasty was 15.6±15.4 years after an above knee amputation and 6.4±6.1 years after a below knee amputation (P=.021). There was a statistically significant improvement in the mean Harris Hip Score from 35.9±21.8 to 76.8±12.8 with total hip arthroplasty after a contralateral amputation (P<.001). There also was a statistically significant improvement in the mean Harris Hip Score from 25.4±21.7 to 78.6±17.1 with total hip arthroplasty after an ispilateral amputation (P<.001). Three (17.7%) total hip arthroplasties after a contralateral amputation and 2 (11.1%) total hip arthroplasties after an ipsilateral amputation required revision total hip arthroplasty. Patients with an ipsilateral amputation or a below knee amputation progress to total hip arthroplasty faster than those with a contralateral amputation or an above knee amputation, respectively. Lower extremity amputees experience clinically significant improvements with total hip arthroplasty after lower extremity amputation.

  2. Changes in foot function, disease activity, and disability after forefoot resection arthroplasty in patients with rheumatoid arthritis.

    PubMed

    Sawachika, Fusakazu; Uemura, Hirokazu; Katsuura-Kamano, Sakurako; Yamaguchi, Miwa; Bahari, Tirani; Miki, Keisuke; Todo, Satoshi; Inoo, Masayuki; Onishi, Ikuko; Kurata, Noriyuki; Arisawa, Kokichi

    2016-01-01

    The purpose of this study was to investigate the changes in foot function, disease activity, and disability in patients with RA after resection arthroplasty of the forefoot (arthroplasty). Arthroplasty was performed on 11 patients with RA. All study patients underwent clinical assessment to measure disease activity (Disease Activity Score in 28 Joints-C-reactive protein, DAS28-CRP), disability (Health Assessment Questionnaire-Disability Index, HAQ-DI) and foot function (Foot Function Index, FFI) at the following stages: preoperatively and 1, 3, and 12 months after surgery. Following arthroplasty, foot function improved significantly, as assessed by FFI total and subscales (pain, disability, and limitation of activity) (P<0.001, P<0.001, P<0.001, and P=0.002, respectively). Disease activity was significantly improved in relation to DAS28-CRP and its subscales of number of swollen joints and patient global assessment (PtGA) (P=0.033, P=0.008, and P=0.038, respectively). There was no significant difference in disability, as assessed by the HAQ-DI and its subscale, HAQ-walking (P=0.150 and P=0.597, respectively). Foot function improved significantly after arthroplasty, and was maintained at 12 months postoperatively. Additionally, our study showed that disease activity and its subscale PtGA improved after arthroplasty.

  3. A Preliminary Field Study of Turbulent Flow Over and Inside a Forest Edge.

    DTIC Science & Technology

    2014-09-26

    anemometer , and x-hot wire and hot film anemometers . tThis report documents the results of these preliminary tudies of turbulent flow over and inside the...Calibration of a Miniature Octant Wind Direction Sensor 20 Correction of the Gill Anemometer Cosine Response Error 22 V. Preliminary Study of the...As Figure 3.1 for the temperature sensors Figure 3.3 As Figure 3.1 for the cup anemometers Figure 3.4 As Figure 3.1 for the thermal anemometers Figure

  4. Systems design study of the Pioneer Venus spacecraft. Volume 2. Preliminary program development plan

    NASA Technical Reports Server (NTRS)

    1973-01-01

    The preliminary development plan for the Pioneer Venus program is presented. This preliminary plan treats only developmental aspects that would have a significant effect on program cost. These significant development areas were: master program schedule planning; test planning - both unit and system testing for probes/orbiter/ probe bus; ground support equipment; performance assurance; and science integration Various test planning options and test method techniques were evaluated in terms of achieving a low-cost program without degrading mission performance or system reliability. The approaches studied and the methodology of the selected approach are defined.

  5. PRELIMINARY EXPOSURE ASSESSMENT FINDINGS FROM THE TAMPA ASTHMATIC CHILDREN'S STUDY

    EPA Science Inventory

    The Tampa Asthmatic Children's Study (TACS) was a pilot study that focused on developing and evaluating air pollution exposure assessment methods and participant recruiting tools. The four-week study was performed in October and November, 2003. The study involved repeated daily...

  6. Instability following total knee arthroplasty.

    PubMed

    Rodriguez-Merchan, E Carlos

    2011-10-01

    Background Knee prosthesis instability (KPI) is a frequent cause of failure of total knee arthroplasty. Moreover, the degree of constraint required to achieve immediate and long-term stability in total knee arthroplasty (TKA) is frequently debated. Questions This review aims to define the problem, analyze risk factors, and review strategies for prevention and treatment of KPI. Methods A PubMed (MEDLINE) search of the years 2000 to 2010 was performed using two key words: TKA and instability. One hundred and sixty-five initial articles were identified. The most important (17) articles as judged by the author were selected for this review. The main criteria for selection were that the articles addressed and provided solutions to the diagnosis and treatment of KPI. Results Patient-related risk factors predisposing to post-operative instability include deformity requiring a large surgical correction and aggressive ligament release, general or regional neuromuscular pathology, and hip or foot deformities. KPI can be prevented in most cases with appropriate selection of implants and good surgical technique. When ligament instability is anticipated post-operatively, the need for implants with a greater degree of constraint should be anticipated. In patients without significant varus or valgus malalignment and without significant flexion contracture, the posterior cruciate ligament (PCL) can be retained. However, the PCL should be sacrificed when deformity exists particularly in patients with rheumatoid arthritis, previous patellectomy, previous high tibial osteotomy or distal femoral osteotomy, and posttraumatic osteoarthritis with disruption of the PCL. In most cases, KPI requires revision surgery. Successful outcomes can only be obtained if the cause of KPI is identified and addressed. Conclusions Instability following TKA is a common cause of the need for revision. Typically, knees with deformity, rheumatoid arthritis, previous patellectomy or high tibial osteotomy, and

  7. PRELIMINARY HEALTH BURDEN ANALYSIS FOR EPIDEMIOLOGIC RECREATIONAL WATER STUDY

    EPA Science Inventory

    Introduction: The National Epidemiological and Environmental Assessment of Recreational Water Study (NEEAR) offers a rare opportunity for researchers. The study's design involves the collection of health data before and after visiting the beach in conjunction with water quality...

  8. Developing Parenting Skills through Health Visitors: Preliminary Results from an Evaluation Study.

    ERIC Educational Resources Information Center

    Stevenson, Jim

    Preliminary results of a study of the extent to which training health visitors in behavior modification techniques improves the effectiveness of their work with families of young children are presented. A total of 14 health visitors were recruited and assigned to training and delay-of-training groups. Selected from case loads, participating…

  9. Early Language and Literacy Development among Young English Language Learners: Preliminary Insights from a Longitudinal Study

    ERIC Educational Resources Information Center

    Roessingh, Hetty; Elgie, Susan

    2009-01-01

    This article reports on the preliminary findings of a two-staged empirical study aimed at gaining insights into the variables salient in the early language and literacy development of young English language learners (ELL). Increasingly, young ELL, whether foreign-born or Canadian-born, arrive at school with little developed English-language…

  10. Work Experiences of People with Mental Illness in Malaysia: A Preliminary Qualitative Study

    ERIC Educational Resources Information Center

    Boo, Su-Lyn; Loong, Jaymee; Ng, Wai-Sheng

    2011-01-01

    This is a preliminary qualitative study, using a basic interpretive approach, to investigate the work experiences of people with mental illness in Malaysia. Six females and four males (aged 30-70) from a residential home for the mentally ill participated in semi-structured interviews. Three inter-relating themes emerged, namely the experience of…

  11. Preliminary Study of Coupling Electrical Energy to Detonation Reaction Zone of Primasheet-1000 Explosive

    DTIC Science & Technology

    2013-05-01

    Preliminary Study of Coupling Electrical Energy to Detonation Reaction Zone of Primasheet-1000 Explosive by Thuvan Piehler, Charles Hummer...1000 Explosive Thuvan Piehler, Charles Hummer, Richard Benjamin, Eugene Summers, and Kevin McNesby Weapons and Materials Research Directorate...5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Thuvan Piehler, Charles Hummer, Richard Benjamin, Eugene Summers, Kevin McNesby

  12. Zero-gravity cloud physics laboratory: Experiment program definition and preliminary laboratory concept studies

    NASA Technical Reports Server (NTRS)

    Eaton, L. R.; Greco, E. V.

    1973-01-01

    The experiment program definition and preliminary laboratory concept studies on the zero G cloud physics laboratory are reported. This program involves the definition and development of an atmospheric cloud physics laboratory and the selection and delineations of a set of candidate experiments that must utilize the unique environment of zero gravity or near zero gravity.

  13. Correlates of Cigarette Smoking among Male Chinese College Students in China--A Preliminary Study

    ERIC Educational Resources Information Center

    Li, Kaigang; Kay, Noy S.

    2009-01-01

    The main purpose of this preliminary study was to examine the association between four constructs of the Health Belief Model (HBM) (i.e. perceived severity of smoking-related health problems, perceived susceptibility to smoking-health related problems, perceived barriers to non-smoking and perceived benefits of non-smoking) and cigarette smoking …

  14. Validity and Reliability of Turkish Version of Gilliam Autism Rating Scale-2: Results of Preliminary Study

    ERIC Educational Resources Information Center

    Diken, Ibrahim H.; Diken, Ozlem; Gilliam, James E.; Ardic, Avsar; Sweeney, Dwight

    2012-01-01

    The purpose of this preliminary study was to explore the validity and reliability of Turkish Version of the Gilliam Autism Rating Scale-2 (TV-GARS-2). Participants included 436 children diagnosed with autism (331 male and 105 female, mean of ages was 8.01 with SD = 3.77). Data were also collected from individuals diagnosed with intellectual…

  15. Individual and Family Factors Impacting Diabetic Control for the Adolescent: A Preliminary Study.

    ERIC Educational Resources Information Center

    Lawler, Mary; And Others

    Sixteen adolescents between the ages of 15 and 18 years and their parents participated in a preliminary study on the impact of family and individual factors on diabetes control for the adolescent. It was hypothesized that there was a relationship between the adolescent's perception of adolescent development, social support, depression, family…

  16. Factorial Structure of the Pain Rehabilitation Expectations Scale: A Preliminary Study

    ERIC Educational Resources Information Center

    Cheing, Gladys L. Y.; Lai, Amy K. M.; Vong, Sinfia K. S.; Chan, Fong H.

    2010-01-01

    The aim of this study was to report the preliminary validation results for the Pain Rehabilitation Expectations Scale (PRES). The PRES is a clinical tool developed to measure the expectations about rehabilitation treatment and outcome for people with back pain. Fifty people with chronic back pain were recruited from 11 physiotherapy outpatient…

  17. School Library Support of Health Education in China: A Preliminary Study

    ERIC Educational Resources Information Center

    Liu, Geoffrey Z.; Zhang, Wuhong

    2008-01-01

    This preliminary study investigates the current situation of school library support of K-12 health education in China. A survey of 42 school librarians and 115 K-12 teachers from selected schools was conducted to find out their views about school library's role in school health education and their current practice of library use in health…

  18. Nd:YAG laser treatment of herpes and aphthous ulcers: a preliminary study

    NASA Astrophysics Data System (ADS)

    Parkins, Frederick M.; O'Toole, Thomas J.; Yancey, John M.

    2000-06-01

    Previously herpes labialis and recurrent aphthous ulcers have not been successfully treated. A preliminary study with a pulsed Nd:YAG laser evaluated the results with a protocol of four minute non-contact exposures for both types of lesions. Most patients experienced relief of symptoms. The progress of herpes lesion was halted and aphthous lesions became desensitized.

  19. Occupational Therapy in the Context of Head Start: A Preliminary Survey Study

    ERIC Educational Resources Information Center

    Bowyer, Patricia; Moore, Cary C.; Thom, Carly

    2016-01-01

    This preliminary, descriptive study yields information on the utilization of occupational therapy services within Head Start programs. Participants completed an Internet-based survey of 25 questions pertaining to the understanding, scope, and utilization of occupational therapy services. Surveys were completed by 35 respondents nationwide. A total…

  20. Factors affecting weight gain and dietary intake in Latino males residing in Mississippi: A preliminary study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Research indicates that as Latinos become more acculturated to the United States, their diet changes and they experience weight gain. There is also a high incidence of depression in this population. The purpose of this preliminary study was to examine the correlations between sociodemographic factor...

  1. Comparison of Brain Activity during Drawing and Clay Sculpting: A Preliminary qEEG Study

    ERIC Educational Resources Information Center

    Kruk, Kerry A.; Aravich, Paul F.; Deaver, Sarah P.; deBeus, Roger

    2014-01-01

    A preliminary experimental study examined brain wave frequency patterns of female participants (N = 14) engaged in two different art making conditions: clay sculpting and drawing. After controlling for nonspecific effects of movement, quantitative electroencephalographic (qEEG) recordings were made of the bilateral medial frontal cortex and…

  2. Gap Arthroplasty versus Interpositional Arthroplasty for Temporomandibular Joint Ankylosis: A Meta-Analysis

    PubMed Central

    Ma, Junli; Liang, Limin; Jiang, Hua; Gu, Bin

    2015-01-01

    Gap arthroplasty (GA) and interpositional arthroplasty (IA) are widely used for the treatment of temporomandibular joint ankylosis (TMJA). However, controversy remains as to whether IA is superior to GA. PubMed, EMBASE, the Cochrane Library, the Web of science and the China National Knowledge Infrastructure were searched for literature regarding these procedures (published from 1946 to July 28, 2014). A study was included in this analysis if it was: (1) a randomized controlled trial or non-randomized observational cohort study; (2) comparing the clinical outcomes between GA and IA with respect to the maximal incisal opening (MIO) and reankylosis; (3) with a follow-up period of at least 12 months. The methodological quality of the included studies was evaluated according to the Newcastle-Ottawa Scale Eight non-randomized observational cohort studies with 272 patients were included. All the statistical analyses were performed using the RevMan 5.3 and Stat 12. The pooled analysis showed no significant difference in the incidence of reankylosis between the IA group (13/120) and the GA group (29/163) (RR= 0.67, 95% CI=0.38 to 1.16; Z=1.43, p=0.15). The IA group showed a significantly larger MIO than the GA group (MD=1.96, 95% CI=0.21 to 3.72, Z=2.19, p=0.03, I2=0%). In conclusion, patients with TMJA could benefit more from IA than GA, with a larger MIO and a similar incidence of reankylosis. IA shows to be an adequate option in the treatment of TMJA based on the results of maximal incisal opening. PMID:26010224

  3. The Status of Women in Alaska, 1977. A Preliminary Study.

    ERIC Educational Resources Information Center

    Jones, Dorothy M.; And Others

    To determine the precise nature and extent of the problem confronting Alaskan women, the Legislature in 1976 directed the Human Rights Commission to conduct a study on the status of women in education, employment, health, and the justice system. This publication contains the results of that study. Data for the study were secured through interviews…

  4. Preliminary study of Kelso Dunes using AVIRIS, TM, and AIRSAR

    NASA Technical Reports Server (NTRS)

    Xu, Pung; Blumberg, Dan G.; Greeley, Ronald

    1995-01-01

    Remote sensing of sand dunes helps in the understanding of aeolian process and provides important information about the regional geologic history, environmental change, and desertification. Remotely sensed data combined with field studies are valuable in studying dune morphology, regional aeolian dynamics, and aeolian depositional history. In particular, active and inactive sands of the Kelso Dunes have been studied using landsat TM and AIRSAR. In this report, we describe the use of AVIRIS data to study the Kelso dunes and to compare the AVIRIS information with that from TM and AIRSAR.

  5. Comparison of arthroplasty trial publications after registration in ClinicalTrials.gov.

    PubMed

    Smith, Holly N; Bhandari, Mohit; Mahomed, Nizar N; Jan, Meryam; Gandhi, Rajiv

    2012-08-01

    In 2005, the International Committee of Medical Journal Editors established a mandatory trial registration before study enrollment for publication in member journals. Our primary objective was to evaluate the publication rates of arthroplasty trials registered with ClinicalTrials.gov (CTG). We further aimed to examine the consistency of registration summaries with that of final publications. We searched CTG for all trials related to joint arthroplasty and conducted a thorough search for publications resulting from registered closed trials. Of 101 closed and completed trials, we found 23 publications, for an overall publication rate of 22.8%. Registration of arthroplasty trials in CTG does not consistently result in publication or disclosure of results. In addition, changes are frequently made to the final presentation of the data that are not reflected in the trial registry.

  6. Two-Stage Cementless Revision Total Hip Arthroplasty for Infected Primary Hip Arthroplasties.

    PubMed

    Camurcu, Yalkin; Sofu, Hakan; Buyuk, Abdul Fettah; Gursu, Sarper; Kaygusuz, Mehmet Akif; Sahin, Vedat

    2015-09-01

    The main purpose of the present study was to analyze the clinical features, the most common infective agents, and the results of two-stage total hip revision using a teicoplanin-impregnated spacer. Between January 2005 and July 2011, 41 patients were included. At the clinical status analysis, physical examination was performed, Harris hip score was noted, isolated microorganisms were recorded, and the radiographic evaluation was performed. The mean Harris hip score was improved from 38.9 ± 9.6 points to 81.8 ± 5.8 points (P<0.05). Infection was eradicated in 39 hips. Radiographic evidence of stability was noted in 37 acetabular revision components, and all femoral stems. Two-stage revision of the infected primary hip arthroplasty is a time-consuming but a reliable procedure with high rates of success.

  7. Young Children's Perceptions of Scientists: A Preliminary Study

    ERIC Educational Resources Information Center

    Buldu, Mehmet

    2006-01-01

    Background: Since the 1950s, there has been a growing body of research dealing with perceptions children have of scientists. Typically, research studies in this area have utilized children's drawings in an effort to discern what those perceptions are. Studies assessing perceptions children have of scientists have shown that children have…

  8. Citations to Wikipedia in Chemistry Journals: A Preliminary Study

    ERIC Educational Resources Information Center

    Brazzeal, Bradley

    2011-01-01

    Wikipedia has been the subject of an increasing number of studies. Many of these have focused on the quality of Wikipedia articles and the use of Wikipedia by students. Little research has focused on the use of Wikipedia by scholars. This study helps to fill that gap by examining citations to Wikipedia in chemistry journals from three major…

  9. Personality Study of Hawaii Japanese Nonagenarians: Preliminary Findings. Technical Report.

    ERIC Educational Resources Information Center

    Izutsu, Satoru; Rose, Charles L.

    As part of a larger study of the demographics, family, household, health, diet, activity, functioning, and mental ability of older Japanese people living in Hawaii which will be compared to similar studies conducted in Japan, personality data were obtained from 101 noninstitutionalized Japanese with an average age of 92 years, residing in Hawaii.…

  10. Assessment of asymmetric leg loading before and after total hip arthroplasty using instrumented shoes

    PubMed Central

    2014-01-01

    Background Total hip arthroplasty is a successful surgical treatment in patients with osteoarthritis of the hip. Different questionnaires are used by the clinicians to assess functional capacity and the patient's pain, despite these questionnaires are known to be subjective. Furthermore, many studies agree that kinematic and kinetic parameters are crucial to evaluate and to provide useful information about the patient’s evolution for clinicians and rehabilitation specialists. However, these quantities can currently only be obtained in a fully equipped gait laboratory. Instrumented shoes can quantify gait velocity, kinetic, kinematic and symmetry parameters. The aim of this study was to investigate whether the instrumented shoes is a sufficiently sensitive instrument to show differences in mobility performance before and after total hip arthroplasty. Methods In this study, patients undergoing total hip arthroplasty were measured before and 6–8 months after total hip arthroplasty. Both measurement sessions include 2 functional mobility tasks while the subject was wearing instrumented shoes. Before each measurement the Harris Hip Score and the Traditional Western Ontario and McMaster Universities osteoarthritis index were administered as well. Results The stance time and the average vertical ground reaction force measured with the instrumented shoes during walking, and their symmetry index, showed significant differences before and after total hip arthroplasty. However, the data obtained with the sit to stand test did not reveal this improvement after surgery. Conclusions Our results show that inter-limb asymmetry during a walking activity can be evaluated with the instrumented shoes before and after total hip arthroplasty in an outpatient clinical setting. PMID:24581227

  11. [Design of an unconventional interlocked hip arthroplasty system (RIMAG) from Mexican femoral measurement].

    PubMed

    Martínez, Genaro Rico; Domínguez, Víctor H; Muller, José Antonio; Cedillo, Ernesto A Delgado; Roa, Josué Antonio Miranda; Montoya, Roberto C

    2008-01-01

    The need in resolving massive bone losses in hip region caused by tumors, infections, trauma or failed arthroplasties in 17 years of the Bone Tumors Department of the National Rehabilitation Institute, Mexico City, and data obtained from different studies: 1) Biomechanic study of an unconventional hip arthroplasty system, 2) Tridimensional model of a human femur by the finite element method, 3) Biomechanical analysis of a system bone-implant for reconstruction of the proximal third of the femur by the finite element method, 4) Incidence of tumor and pseudotumor bone and soft tissue lesions of the hip, generated the project of designing an unconventional interlocked hip arthroplasty system for femur reconstruction. Two processes were done for adequate manufacturing and dimensioning: Anthropomorphometric study of Mexican femora; 2) Design of an unconventional hip arthroplasty system with the following characteristics: first, the arthroplasty system is constituted by an intramedullar stem, is fixated to femur with interlocking screws, this fixation method was inspired from the design of intramedullar nails of Dr. Fernando Colchero Rosas. The system has a second fixation system in the femur cut region, resolved by a fenestrated support introduced in the cortical wall. Once data was processed, the need for manufacturing 2 models was determined: 1) One for the proximal 11 cm of the femur and 2) other for the 12 distal cm. The height of interlocking screws, 2 models of intracortical proximal support (one fixated and one fixable with an expansible screw), were designed. Diameter, length of the stems, size of spacers and supports were determined for adequate interlocking fixation. We designed the instruments for assembling, impaction and orientation of the arthroplasty system. The system was presented to the Mexican Institute of Industrial Property, at March 15, 1996 and the patent was conceded April 19, 2007 (#245717).

  12. Biofeedback relaxation for pain associated with continuous passive motion in Taiwanese patients after total knee arthroplasty.

    PubMed

    Wang, Tsae-Jyy; Chang, Ching-Fen; Lou, Meei-Fang; Ao, Man-Kuan; Liu, Chiung-Chen; Liang, Shu-Yuan; Wu, Shu-Fang Vivienne; Tung, Heng-Hsing

    2015-02-01

    Effective pain management is crucial for patient recovery after total knee arthroplasty (TKA). Biofeedback therapy, which encourages relaxation and helps alleviate various conditions associated with stress, may help to decrease postoperative pain in patients undergoing TKA. A quasi- experimental design was used to investigate the efficacy of a biofeedback relaxation intervention in reducing pain associated with postoperative continuous passive motion (CPM) therapy. Sixty-six patients admitted to a general hospital in Taiwan for TKA were recruited and randomly assigned to the intervention or control group. The intervention group received biofeedback training twice daily for 5 days, concurrent with CPM therapy, whereas the control group did not receive the biofeedback intervention. Pain was measured using a numeric rating scale before and after each CPM therapy session on postoperative days 1 through 5. The CPM-elicited pain score was calculated by subtracting the pre-CPM pain score from the post-CPM pain score. Results of repeated-measures analysis of variance showed intervention group reported significantly less pain caused by CPM than did the control group (f = 29.70, p < 0.001). The study results provide preliminary support for biofeedback relaxation, a non-invasive and non-pharmacological intervention, as a complementary treatment option for pain management in this population.

  13. Smart instrumentation for determination of ligament stiffness and ligament balance in total knee arthroplasty.

    PubMed

    Hasenkamp, W; Villard, J; Delaloye, J R; Arami, A; Bertsch, A; Jolles, B M; Aminian, K; Renaud, P

    2014-06-01

    Ligament balance is an important and subjective task performed during total knee arthroplasty (TKA) procedure. For this reason, it is desirable to develop instruments to quantitatively assess the soft-tissue balance since excessive imbalance can accelerate prosthesis wear and lead to early surgical revision. The instrumented distractor proposed in this study can assist surgeons on performing ligament balance by measuring the distraction gap and applied load. Also the device allows the determination of the ligament stiffness which can contribute a better understanding of the intrinsic mechanical behavior of the knee joint. Instrumentation of the device involved the use of hall-sensors for measuring the distractor displacement and strain gauges to transduce the force. The sensors were calibrated and tested to demonstrate their suitability for surgical use. Results show the distraction gap can be measured reliably with 0.1mm accuracy and the distractive loads could be assessed with an accuracy in the range of 4N. These characteristics are consistent with those have been proposed, in this work, for a device that could assist on performing ligament balance while permitting surgeons evaluation based on his experience. Preliminary results from in vitro tests were in accordance with expected stiffness values for medial collateral ligament (MCL) and lateral collateral ligament (LCL).

  14. Pulmonary functions in petrol pump workers: a preliminary study.

    PubMed

    Singhal, Mayank; Khaliq, Farah; Singhal, Siddarth; Tandon, O P

    2007-01-01

    Occupational exposures to petrol/diesel vapors have been shown to affect functioning of different systems of the body. The present study was planned to assess the pulmonary functions in petrol pump workers (filling attendants) who are continuously exposed to petrol/diesel vapors during duty hours. Thirty healthy non-smoker males working in petrol pump for more than one year formed the study group, while thirty healthy non-smoker males from hospital staff served as control group. The pulmonary functions were assessed using computerized spirometer. The FVC and FEV1 were decreased in the study group while their ratio did not differ much. Both the inspiratory and expiratory flow rates were also decreased in the study group. These findings point towards adverse effects of petrol/diesel fumes mainly on lower airways with restrictive pattern of disease.

  15. Numerical aerodynamic simulation facility preliminary study, volume 2 and appendices

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Data to support results obtained in technology assessment studies are presented. Objectives, starting points, and future study tasks are outlined. Key design issues discussed in appendices include: data allocation, transposition network design, fault tolerance and trustworthiness, logic design, processing element of existing components, number of processors, the host system, alternate data base memory designs, number representation, fast div 521 instruction, architectures, and lockstep array versus synchronizable array machine comparison.

  16. Protocol Development and Preliminary Toxicity Study of CBRN Nanomaterials

    DTIC Science & Technology

    2013-12-05

    Program Army Institute of Public Health Specialty: 500C, Toxicity Tests Toxicology Study No. 87-XE-0EJ5-11 (FY12 Continuation) Use of trademarked name(s...toxicity by Microtox test and human cytotoxicity by NRU assay. These studies fill the data gaps and provide toxicity information useful in risk...Transepithelial Permeability (TEP) assays were developed and tested on EpiAirway. a 3-D human tracheal/bronchial epithelial equivalent. Further evaluation of the

  17. Hydrogen Gas Retention and Release from WTP Vessels: Summary of Preliminary Studies

    SciTech Connect

    Gauglitz, Phillip A.; Bontha, Jagannadha R.; Daniel, Richard C.; Mahoney, Lenna A.; Rassat, Scot D.; Wells, Beric E.; Bao, Jie; Boeringa, Gregory K.; Buchmiller, William C.; Burns, Carolyn A.; Chun, Jaehun; Karri, Naveen K.; Li, Huidong; Tran, Diana N.

    2015-07-01

    The Hanford Waste Treatment and Immobilization Plant (WTP) is currently being designed and constructed to pretreat and vitrify a large portion of the waste in the 177 underground waste storage tanks at the Hanford Site. A number of technical issues related to the design of the pretreatment facility (PTF) of the WTP have been identified. These issues must be resolved prior to the U.S. Department of Energy (DOE) Office of River Protection (ORP) reaching a decision to proceed with engineering, procurement, and construction activities for the PTF. One of the issues is Technical Issue T1 - Hydrogen Gas Release from Vessels (hereafter referred to as T1). The focus of T1 is identifying controls for hydrogen release and completing any testing required to close the technical issue. In advance of selecting specific controls for hydrogen gas safety, a number of preliminary technical studies were initiated to support anticipated future testing and to improve the understanding of hydrogen gas generation, retention, and release within PTF vessels. These activities supported the development of a plan defining an overall strategy and approach for addressing T1 and achieving technical endpoints identified for T1. Preliminary studies also supported the development of a test plan for conducting testing and analysis to support closing T1. Both of these plans were developed in advance of selecting specific controls, and in the course of working on T1 it was decided that the testing and analysis identified in the test plan were not immediately needed. However, planning activities and preliminary studies led to significant technical progress in a number of areas. This report summarizes the progress to date from the preliminary technical studies. The technical results in this report should not be used for WTP design or safety and hazards analyses and technical results are marked with the following statement: “Preliminary Technical Results for Planning – Not to be used for WTP Design

  18. [Omeprazole: a new treatment for paranasal sinus polyps in Widal syndrome. Preliminary study].

    PubMed

    Serra, J; Piñas, J; Arnaiz, J A; Quesada, P; Naches, S; Lorente, J; Carne, X

    1998-05-01

    A preliminary report is made of the potential therapeutic effect of omeprazol in reducing nasosinusal polyps. This study is based on the empirical observation of nasal airflow improvement in patients suffering from nasosinusal polyposis after administering omeprazol. Different phases of the study suggested that patients with Widal's syndrome benefited the most. Based on the results of this study, we have undertaken a randomized, parallel, double-blind, placebo-controlled clinical trial.

  19. Assessing interpersonal aspects of schizoid personality disorder: preliminary validation studies.

    PubMed

    Kosson, David S; Blackburn, Ronald; Byrnes, Katherine A; Park, Sohee; Logan, Caroline; Donnelly, John P

    2008-03-01

    In 2 studies, we examined the reliability and validity of an interpersonal measure of schizoid personality disorder (SZPD) based on nonverbal behaviors and interpersonal interactions occurring during interviews. A total of 556 male jail inmates in the United States participated in Study 1; 175 mentally disordered offenders in maximum security hospitals in the United Kingdom participated in Study 2. Across both samples, scores on the Interpersonal Measure of Schizoid Personality Disorder (IM-SZ) exhibited adequate reliability and patterns of correlations with other measures consistent with expectations. The scale displayed patterns of relatively specific correlations with interview and self-report measures of SZPD. In addition, the IM-SZ correlated in an expected manner with features of psychopathy and antisocial personality and with independent ratings of interpersonal behavior. We address implications for assessment of personality disorder.

  20. [Sport activity after hip and knee arthroplasty].

    PubMed

    Keren, Amit; Berkovich, Yaron; Berkovitch, Yaron; Soudry, Michael

    2013-11-01

    Joint arthroplasty is one of the commonest surgical procedures in orthopedic surgery. In recent years there was an increase in the number of procedures, patient satisfaction and implant survival. Originally, these operations were designed for old patients in order to relieve pain and to enable ambulation. Over the past few years, these operations have become common in younger patients which desire to return to activity, including sports activities. The importance of physical activity is a well known fact. In recent years it became clear that with the proper physical activity the outcomes of the operations are better. There are several types of arthroplasty. Many factors influence the outcome of the operation apart from the post-surgery physical activity. These factors include patient factors, surgical technique and type of arthroplasty. This review summarizes the recommendations for sports activities after hip and knee arthroplasties. These activities are evaluated according to surgeons' recommendations, stress applied on the implant and long term outcomes. The recommended sports activities after joint arthroplasties are walking, swimming and cycling. Soccer, basketball and jogging are not advised. Tennis, downhill skiing and horse riding are recommended with previous experience. There are many more sports activities that patients can participate in, and it is important that the patient discuss the different options prior to the operation. Since these operations are so common, many non-orthopedic physicians encounter these patients in their practice. They should be acquainted with the recommendations for sports activities and encourage them.

  1. Arthroplasty for tenosynovial giant cell tumors

    PubMed Central

    Verspoor, Floortje G M; Hannink, Gerjon; Scholte, Anouk; Van Der Geest, Ingrid C M; Schreuder, H W Bart

    2016-01-01

    Background and purpose Tenosynovial giant cell tumors (t-GCTs) can behave aggressively locally and affect joint function and quality of life. The role of arthroplasty in the treatment of t-GCT is uncertain. We report the results of arthroplasty in t-GCT patients. Patients and methods t-GCT patients (12 knee, 5 hip) received an arthroplasty between 1985 and 2015. Indication for arthroplasty, recurrences, complications, quality of life, and functional scores were evaluated after a mean follow-up time of 5.5 (0.2–15) years. Results 2 patients had recurrent disease. 2 other patients had implant loosening. Functional scores showed poor results in almost half of the knee patients. 4 of the hip patients scored excellent and 1 scored fair. Quality of life was reduced in 1 or more subscales for 2 hip patients and for 5 knee patients. Interpretation In t-GCT patients with extensive disease or osteoarthritis, joint arthroplasty is an additional treatment option. However, recurrences, implant loosening, and other complications do occur, even after several years. PMID:27357329

  2. Preliminary studies of combustor sensitivity to alternative fuels

    NASA Technical Reports Server (NTRS)

    Humenik, F. M.

    1980-01-01

    Combustion problems associated with using alternative fuels ground power and aeropropulsion applications were studied. Rectangular sections designed to simulate large annular combustor test conditions were examined. The effects of using alternative fuels with reduced hydrogen content, increased aromatic content, and a broad variation in fuel property characteristics were also studied. Data of special interest were collected which include: flame radiation characteristics in the various combustor zones; the correponding increase in liner temperature from increased radiant heat flux; the effect of fuel bound nitrogen on oxides of nitrogen (NO sub x) emissions; and the overall total effect of fuel variations on exhaust emissions.

  3. Durability of highly cross-linked polyethylene in total hip and total knee arthroplasty.

    PubMed

    Dion, Neil T; Bragdon, Charles; Muratoglu, Orhun; Freiberg, Andrew A

    2015-07-01

    This article reviews the history of the development of highly cross-linked polyethylene and provides an in-depth review of the clinical results regarding the durability of highly cross-linked polyethylene (HXLPE) used in total hip arthroplasty (THA) and total knee arthroplasty (TKA). The use of polyethylene as a bearing surface has contributed to the success of THA and TKA; however, polyethylene wear and osteolysis can lead to failure. Ongoing clinical and retrieval studies are required to analyze outcomes at longer-term follow-up.

  4. [Recurrent effusion and granulomatous synovitis following total knee arthroplasty in association with latex allergy].

    PubMed

    Schuh, A; Thomas, P; Hönle, W; Schmickal, T

    2008-02-01

    An increasing number of articles report about allergic reactions in association with total knee arthroplasty. While most studies focus on allergic reactions to metallic components, few reports exist about reactions to bone cement or its ingredients. Allergy to natural rubber latex is a major occupational problem in the health care sector and a problem even in other occupations in which protective gloves are used. The allergic reaction to latex ranges from a minor skin rash to anaphylactic shock. Preventing exposure to latex is the key to managing and preventing this allergy. We report about a patient who developed recurrent effusion and granulomatous synovitis following total knee arthroplasty in association with latex allergy.

  5. Computer-Generated Geometry Instruction: A Preliminary Study

    ERIC Educational Resources Information Center

    Kang, Helen W.; Zentall, Sydney S.

    2011-01-01

    This study hypothesized that increased intensity of graphic information, presented in computer-generated instruction, could be differentially beneficial for students with hyperactivity and inattention by improving their ability to sustain attention and hold information in-mind. To this purpose, 18 2nd-4th grade students, recruited from general…

  6. A Normative Study of Children's Drawings: Preliminary Research Findings

    ERIC Educational Resources Information Center

    Deaver, Sarah P.

    2009-01-01

    This paper describes methodology, data analysis, and initial results of a research study with the long-term goal of establishing contemporary normative data on drawings from children living in the United States. The pool of participants was composed of 316 fourth graders (mean age 9.69 years) and 151 second graders (mean age 7.56 years) who each…

  7. Theoretical Evaluation Self-Test (Test): A Preliminary Validation Study

    ERIC Educational Resources Information Center

    Coleman, Daniel

    2004-01-01

    Over nearly 40 years, several scales have been developed to measure therapist theoretical orientation (Poznanski & McLennan, 1995). This study, unlike previous efforts, focuses on "community clinicians"--social workers and other mental health professionals (such as psychologists, counselors, psychiatrists, and psychiatric nurses) who…

  8. Functional Communication Training in Rett Syndrome: A Preliminary Study

    ERIC Educational Resources Information Center

    Byiers, Breanne J.; Dimian, Adele; Symons, Frank J.

    2014-01-01

    Rett syndrome (RTT) is associated with a range of serious neurodevelopmental consequences including severe communicative impairments. Currently, no evidence-based communication interventions exist for the population (Sigafoos et al., 2009). The purpose of the current study was to examine the effectiveness of functional assessment (FA) and…

  9. Problems of Eskimo Relocation for Industrial Employment. A Preliminary Study.

    ERIC Educational Resources Information Center

    Stevenson, D. S.

    A study was conducted to determine the reasons for variable success in relocating Eskimo families from rural areas of the northern territories of Canada to southern centers of industrial employment (railways, mining centers). The data were collected by interviewing 105 Eskimos, both male and female, married and single, who had migrated south. The…

  10. Violence Prevention in Middle School: A Preliminary Study

    ERIC Educational Resources Information Center

    KIllam, Wendy K.; Roland, Catherine B.; Weber, Bill

    2014-01-01

    Violence in schools continues reflecting violence within society. There is a growing need for violence prevention programs within the schools that provide students with the skills needed to cope with interpersonal and relationship is-sues effectively. This study was conducted at a middle school and there were 345 middle school students (6th to 8th…

  11. Preliminary Systems Design Study assessment report. Volume 8, Appendixes

    SciTech Connect

    Mayberry, J.L.; Feizollahi, F.; Del Signore, J.C.

    1992-01-01

    The System Design Study (SDS), part of the Waste Technology Development Department at the Idaho National Engineering Laboratory (INEL), examined techniques available for the remediation of hazardous and transuranic waste stored at the Radioactive Waste Management Complex`s Subsurface Disposal Area at the INEL. Using specific technologies, system concepts for treating the buried waste and the surrounding contaminated soil were evaluated. Evaluation included implementability, effectiveness, and cost. The SDS resulted in the development of technology requirements including demonstration, testing, and evaluation activities needed for implementing each concept. This volume of the Systems Design Study contain four Appendixes that were part of the study. Appendix A is an EG&G Idaho, Inc., report that represents a review and compilation of previous reports describing the wastes and quantities disposed in the Subsurface Disposal Area of the Idaho National Engineering Laboratory. Appendix B contains the process flowsheets considered in this study, but not selected for detailed analysis. Appendix C is a historical tabulation of radioactive waste incinerators. Appendix D lists Department of Energy facilities where cementation stabilization systems have been used.

  12. Learning Disabilities in Alcohol-Dependent Adults: A Preliminary Study.

    ERIC Educational Resources Information Center

    Rhodes, Sharyn S.; Jasinski, Donald R.

    1990-01-01

    The study found that 40 percent of 25 adult alcoholics were found to have had special education, remedial services, or repeated grade failure concurrent with a familial history of alcoholism and current discrepancies indicative of learning disabilities. Results suggest that childhood learning disorders may be related to the development of…

  13. Preliminary study of NAVSTAR/GPS for general aviation

    NASA Technical Reports Server (NTRS)

    Alberts, R. D.; Ruedger, W. H.

    1976-01-01

    The activities conducted as a planning effort to focus attention on the applicability of the global positioning system for general aviation are described. The description of GPS, its impact on economic and functional aspects of general aviation avionics, as well as a declaration of potential extensions of the basic concept have been studied in detail.

  14. Renal denervation by intravascular ultrasound: Preliminary in vivo study

    NASA Astrophysics Data System (ADS)

    Sinelnikov, Yegor; McClain, Steve; Zou, Yong; Smith, David; Warnking, Reinhard

    2012-10-01

    Ultrasound denervation has recently become a subject of intense research in connection with the treatment of complex medical conditions including neurological conditions, development of pain management, reproduction of skin sensation, neuropathic pain and spasticity. The objective of this study is to investigate the use of intravascular ultrasound to produce nerve damage in renal sympathetic nerves without significant injury to the renal artery. This technique may potentially be used to treat various medical conditions, such as hypertension. The study was approved by the Institutional Animal Care and Use Committee. Ultrasound was applied to renal nerves of the swine model for histopathological evaluation. Therapeutic ultrasound energy was delivered circumferentially by an intravascular catheter maneuvered into the renal arteries. Fluoroscopic imaging was conducted pre-and post-ultrasound treatment. Animals were recovered and euthanized up to 30 hours post procedure, followed by necropsy and tissue sample collection. Histopathological examination showed evidence of extensive damage to renal nerves, characterized by nuclear pyknosis, hyalinization of stroma and multifocal hemorrhages, with little or no damage to renal arteries. This study demonstrates the feasibility of intravascular ultrasound as a minimally invasive renal denervation technique. Further studies are necessary to evaluate the long-term safety and efficacy of this technique and its related clinical significance.

  15. Burnout among Special Education Administrators: A Preliminary Study

    ERIC Educational Resources Information Center

    Carter, Susan J.

    2011-01-01

    Research on the extent of stress and burnout among special education administrators is not as well developed as research on the extent of stress and burnout among teachers. This study utilized the Maslach Burnout Inventory to determine levels of stress and burnout among administrators of special education. Results indicated administrators of…

  16. Preliminary study of ceramic-metal interface in thermal boundaries

    NASA Astrophysics Data System (ADS)

    Tremouilles, G.; Derep, J. Luc

    1987-10-01

    The interface of yttrium doped zircon ceramic on NiCrAlY alloy is studied. The different phases in the zircon are examined with electron microscopy. The presence of alumina in the interface is demonstrated. The possibility of damaging the NiCrAlY substrate when using a plasma gun is discussed.

  17. Landmarks in the World Wide Web: A Preliminary Study.

    ERIC Educational Resources Information Center

    Heffron, Jennifer K.; Dillon, Andrew; Mostafa, Javed

    1996-01-01

    Outlines results of a pilot study examining what constitutes a landmark in hypertext. Seven subjects began a search task from the same Indiana University School of Library and Information Science Homepage; searches had to be conducted without the use of search engines, and strictly following hypertext links. (Author/AEF)

  18. No statistically significant kinematic difference found between a cruciate-retaining and posterior-stabilised Triathlon knee arthroplasty: a laboratory study involving eight cadavers examining soft-tissue laxity.

    PubMed

    Hunt, N C; Ghosh, K M; Blain, A P; Rushton, S P; Longstaff, L M; Deehan, D J

    2015-05-01

    The aim of this study was to compare the maximum laxity conferred by the cruciate-retaining (CR) and posterior-stabilised (PS) Triathlon single-radius total knee arthroplasty (TKA) for anterior drawer, varus-valgus opening and rotation in eight cadaver knees through a defined arc of flexion (0º to 110º). The null hypothesis was that the limits of laxity of CR- and PS-TKAs are not significantly different. The investigation was undertaken in eight loaded cadaver knees undergoing subjective stress testing using a measurement rig. Firstly the native knee was tested prior to preparation for CR-TKA and subsequently for PS-TKA implantation. Surgical navigation was used to track maximal displacements/rotations at 0º, 30º, 60º, 90º and 110° of flexion. Mixed-effects modelling was used to define the behaviour of the TKAs. The laxity measured for the CR- and PS-TKAs revealed no statistically significant differences over the studied flexion arc for the two versions of TKA. Compared with the native knee both TKAs exhibited slightly increased anterior drawer and decreased varus-valgus and internal-external roational laxities. We believe further study is required to define the clinical states for which the additional constraint offered by a PS-TKA implant may be beneficial.

  19. Advanced Analysis of Finger-Tapping Performance: A Preliminary Study

    PubMed Central

    Barut, Çağatay; Kızıltan, Erhan; Gelir, Ethem; Köktürk, Fürüzan

    2013-01-01

    Background: The finger-tapping test is a commonly employed quantitative assessment tool used to measure motor performance in the upper extremities. This task is a complex motion that is affected by external stimuli, mood and health status. The complexity of this task is difficult to explain with a single average intertap-interval value (time difference between successive tappings) which only provides general information and neglects the temporal effects of the aforementioned factors. Aims: This study evaluated the time course of average intertap-interval values and the patterns of variation in both the right and left hands of right-handed subjects using a computer-based finger-tapping system. Study Design: Cross sectional study. Methods: Thirty eight male individuals aged between 20 and 28 years (Mean±SD = 22.24±1.65) participated in the study. Participants were asked to perform single-finger-tapping test for 10 seconds of test period. Only the results of right-handed (RH) 35 participants were considered in this study. The test records the time of tapping and saves data as the time difference between successive tappings for further analysis. The average number of tappings and the temporal fluctuation patterns of the intertap-intervals were calculated and compared. The variations in the intertap-interval were evaluated with the best curve fit method. Results: An average tapping speed or tapping rate can reliably be defined for a single-finger tapping test by analysing the graphically presented data of the number of tappings within the test period. However, a different presentation of the same data, namely the intertap-interval values, shows temporal variation as the number of tapping increases. Curve fitting applications indicate that the variation has a biphasic nature. Conclusion: The measures obtained in this study reflect the complex nature of the finger-tapping task and are suggested to provide reliable information regarding hand performance. Moreover, the

  20. Depressed patients’ preferences for type of psychotherapy: a preliminary study

    PubMed Central

    Yrondi, Antoine; Rieu, Julie; Massip, Claire; Bongard, Vanina; Schmitt, Laurent

    2015-01-01

    Background The treatment recommendations for depressed patients by the American Psychiatric Association encourage a focus on the patient’s preferences. The focus of this study was the preference of depressed inpatients for the type of psychotherapy. Methods Twenty-nine subjects of both sexes who were hospitalized with a major depressive episode were interviewed at 5-day intervals with the same questions after the depressive episode resolved, as indicated by a score less than 7 on the Hamilton Depression Rating Scale (HDRS). The selection of items was performed by expert consensus. Results The supportive psychotherapy scores were the highest, followed by psychodynamic psychotherapy and cognitive behavioral therapy. The two sessions conducted at 5-day intervals showed no significant difference, which reflected the stability of choices and preferences of patients. Conclusion In this study, the patients preferred supportive psychotherapy as first-line therapy compared to psychodynamic psychotherapy and cognitive behavioral therapy. PMID:26491265

  1. Preliminary report of an immunological study in urological cancer.

    PubMed

    Serrallach, N; Jimenez, J F; Aguiló, F; Anguera, A; Clavo, M; Orejas, V; Torner, V; Serrate, R

    1975-01-01

    In this study, 32 cases of cancer of the genito-urinary tract are discussed from the viewpoint of immunology. In eight cases treated surgically, there has been no evidence of recurrence over a period of 1-4 years. Those with a good immunological response have a satisfactory course. Patients with a good response have been treated by radical surgery depending on the stage of the tumour, whilst those with a poor response have been treated less radically by reduction of the tumour mass in the hope that a better response may develop. The authors of this report feel that the 'inhibition of the lymphocyte migration test' is a very important factor to evaluate in the study and immunological evolution of the patient. Also, and concerning cases with good immunological response, the poor results after surgery makes us consider the importance and value of blocking factors of the serum closely related to the B type lymphocytes.

  2. Dissociation and fantasy proneness in psychiatric patients: a preliminary study.

    PubMed

    Merckelbach, Harald; à Campo, Joost; Hardy, Solange; Giesbrecht, Timo

    2005-01-01

    Nonclinical studies found that dissociative experiences are intimately linked to a trait known as fantasy proneness. We examined the links among dissociative symptoms, fantasy proneness, and impulsivity in psychiatric outpatients. Our sample consisted of 22 patients with schizophrenia, 20 patients with a diagnosis of borderline personality disorder, and 19 patients with a major depressive disorder. For the whole sample, levels of dissociation were found to be related to fantasy proneness and impulsivity. There were group differences in dissociative symptoms, with patients with borderline personality disorder reporting more such symptoms than patients with either schizophrenia or major depressive disorder. The overlap between dissociation and fantasy proneness may have important ramifications for studies addressing comorbid phenomena of dissociative symptoms.

  3. Gravity of the New Madrid seismic zone; a preliminary study

    USGS Publications Warehouse

    Langenheim, V.E.

    1995-01-01

    In the winter of 1811-12, three of the largest historic earthquakes in the United States occurred near New Madrid, Mo. Seismicity continues to the present day throughout a tightly clustered pattern of epicenters centered on the bootheel of Missouri, including parts of northeastern Arkansas, northwestern Tennessee, western Kentucky, and southern Illinois. In 1990, the New Madrid seismic zone/Central United States became the first seismically active region east of the Rocky Mountains to be designated a priority research area within the National Earthquake Hazards Reduction Program (NEHRP). This Professional Paper is a collection of papers, some published separately, presenting results of the newly intensified research program in this area. Major components of this research program include tectonic framework studies, seismicity and deformation monitoring and modeling, improved seismic hazard and risk assessments, and cooperative hazard mitigation studies.

  4. Sleep habits and patterns of college students: a preliminary study.

    PubMed

    Buboltz, W C; Brown, F; Soper, B

    2001-11-01

    The negative effects of sleep difficulties have been well documented. However, the prevalence of such problems among US college students has not been well studied. Design difficulties are common in the limited number of existing investigations, making it difficult to estimates the prevalence and types of disturbance studied. The authors describe the use of a quantitative-based assessment instrument to provide an initial indication of students' sleep problems and to serve as a means of addressing some of the deficiencies in the literature. In their sample of 191 undergraduates at a rural southern university, they found that most of the students exhibited some form of sleep disturbance and that women, in general, reported more sleep disturbances than men did. They suggest how colleges and university officials can alter procedures to minimize students' sleep disturbances and reduce the deleterious effects of sleep problems on academic performance.

  5. Preliminary space station solar array structural design study

    NASA Technical Reports Server (NTRS)

    Dorsey, J. T.; Bush, H. G.; Mikulas, M. M., Jr.

    1984-01-01

    Structurally efficient ways to support the large solar arrays (3,716 square meters which are currently considered for space station use) are examined. An erectable truss concept is presented for the on orbit construction of winged solar arrays. The means for future growth, maintenance, and repair are integrally designed into this concept. Results from parametric studies, which highlight the physical and structural differences between various configuration options are presented. Consideration is given to both solar blanket and hard panel arrays.

  6. Energy efficient engine: Preliminary design and integration studies

    NASA Technical Reports Server (NTRS)

    Gray, D. E.

    1978-01-01

    A mixed exhaust, direct drive fan turbofan configuration was selected from four candidates. This choice was based on its ability to exceed study goals of 12% lower thrust specific fuel consumption and 5% lower direct operating cost by the 1990's with commercially acceptable technical risk and relative mechanical simplicity. The evaluation leading to configuration selection is discussed. Necessary technology advancements are identified and related to the goals.

  7. Preliminary studies on antipyretic and analgesic properties of Taverniera abyssinica.

    PubMed

    Dagne, E; Yenesew, A; Capasso, F; Mascolo, N; Pinto, A

    1990-10-01

    In an attempt to ascertain the pharmacological basis of the use of the marketed traditional drug Taverniera abyssinica A. Rich. (Amharic name Dingetegna), crude extracts as well as purified substances of this plant were tested for their antipyretic and analgesic properties. Antipyretic activity was determined on rats made hyperthermic by yeast injection and analgesic activity was determined by the hot plate, as well as the acetic acid induced writhing, methods. The study showed that the plant possesses significant antipyretic and analgesic activities.

  8. Preliminary results from two international pluvial flood event studies

    NASA Astrophysics Data System (ADS)

    Roezer, Viktor; Spekkers, Matthieu; Kreibich, Heidi

    2016-04-01

    Pluvial floods have caused severe damages to urban dwellings in Europe and elsewhere in recent years. With a predicted increase in extreme weather events as well as an ongoing urbanization, pluvial flood damage is expected to increase in the future. These type of flood events, caused by stormwater being unable to enter urban drainage systems or flowing out of urban drainage systems when capacity is exceeded, often happen with little warning and in areas which are often not obviously prone to flooding. Up to now little research was done on the adverse consequences of pluvial floods, as empirical damage data of pluvial flooding is scarce. In this study, results of two telephone surveys are discussed. The surveys comprise interviews with more than 500 flood-affected households in Germany (Münster and Greven) and the Netherlands (Amsterdam), related to the severe rain event of July 28th 2014. Respondents were asked a series of questions about the damage to their building structure and contents, as well as on topics such as early warning, emergency and precautionary measures, building properties and hazard characteristics. The questionnaire was developed with the aim to create a harmonized transnational pluvial flood damage survey that can potentially be extended to other European countries. New indicator variables have been developed to account for different national and regional standards in building structure, early warning, socio-economic data and recovery. The survey data from the German and Dutch case studies are compared with the goal to identify similarities and differences in damage reducing factors and recovery. Water level data and other hazard characteristics are used to form comparable groups out of the German and Dutch sample. Within these groups, regional distinctions in building topology and use are expected to have the strongest impact on differences between reported damage amounts of the two case studies. The newly collected data will be used in

  9. A Preliminary Study of 3D Printing on Rock Mechanics

    NASA Astrophysics Data System (ADS)

    Jiang, Chao; Zhao, Gao-Feng

    2015-05-01

    3D printing is an innovative manufacturing technology that enables the printing of objects through the accumulation of successive layers. This study explores the potential application of this 3D printing technology for rock mechanics. Polylactic acid (PLA) was used as the printing material, and the specimens were constructed with a "3D Touch" printer that employs fused deposition modelling (FDM) technology. Unconfined compressive strength (UCS) tests and direct tensile strength (DTS) tests were performed to determine the Young's modulus ( E) and Poisson's ratio ( υ) for these specimens. The experimental results revealed that the PLA specimens exhibited elastic to brittle behaviour in the DTS tests and exhibited elastic to plastic behaviour in the UCS tests. The influence of structural changes in the mechanical response of the printed specimen was investigated; the results indicated that the mechanical response is highly influenced by the input structures, e.g., granular structure, and lattice structure. Unfortunately, our study has demonstrated that the FDM 3D printing with PLA is unsuitable for the direct simulation of rock. However, the ability for 3D printing on manufactured rock remains appealing for researchers of rock mechanics. Additional studies should focus on the development of an appropriate substitution for the printing material (brittle and stiff) and modification of the printing technology (to print 3D grains with arbitrary shapes).

  10. Assessment and attitude of university students about elderly: Preliminary Study

    PubMed Central

    Tabari, ZA; Ghaedi, FB; Hamissi, JH; Eskandari, S

    2015-01-01

    Aims: The aim of this study was to evaluate the attitude of dental students towards elderly patients. This approach might increase the responsiveness and need of the geriatric dental education within the undergraduate dental students curriculum, which is the persistent necessity for today communities. Methods & Materials: A cross–sectional study was conducted on 201 students who were randomly selected. The investigation was carried out in Qazvin University of Medical Sciences. The attitude of dental students towards elderly was measured with a self-administered questionnaire consisting of an Aging Semantic Differential scale (ASD), which was developed by Rozencranz and Mc Nevin. Results: According to the findings of this study, the students’ attitude remained very positive towards the elderly patients as they showed a strong demand to work with elderly patients. This consisted of a 24 bipolar pair of adjectives that described the attributes of behavioral characteristics thought to be applicable to persons of all ages. Conclusion: According to our finding, the future geriatric dentistry is not towards a weak point in Iran as compared with the undesirable attitudes of dental students in the developed countries.

  11. Parkinson's disease and forced exercise: a preliminary study.

    PubMed

    Qutubuddin, Abu; Reis, Timothy; Alramadhani, Raed; Cifu, David X; Towne, Alan; Carne, William

    2013-01-01

    Objective. The concept of forced exercise has drawn attention for the treatment of Parkinson's disease symptoms with anecdotal reports of success. This study sought to ascertain any significant effect of forced exercise using a motorized stationary bicycle when compared to controls on Parkinson's disease symptoms in a blinded, randomized, and controlled setting. Setting. Parkinson's disease outpatient clinic, Veterans Administration Medical Center. Method. We assessed 23 patients (13 experimental and 10 controls) on a number of standard Parkinson's measures at baseline, after participation in eight weeks of twice weekly forced exercise or eight weeks of conventional clinic care, and then after a three-month period had elapsed. Dependent measures were UPDRS-III, Berg Balance Scale, finger taping test, and the PDQ-39. Results. Results did not demonstrate any main effect differences between the exercise and control groups on any measure at any point in time. A within subjects effect was demonstrated for the forced exercise group on overall UPDRS-III scores at the three-month end point. No other within group effects were noted. Results suggest that early enthusiasm for forced exercise may need tempering. Limitations of the study are discussed as well as numerous logistical challenges to this type of study.

  12. A preliminary study to Assess Model Uncertainties in Fluid Flows

    SciTech Connect

    Marc Oliver Delchini; Jean C. Ragusa

    2009-09-01

    The goal of this study is to assess the impact of various flow models for a simplified primary coolant loop of a light water nuclear reactor. The various fluid flow models are based on the Euler equations with an additional friction term, gravity term, momentum source, and energy source. The geometric model is purposefully chosen simple and consists of a one-dimensional (1D) loop system in order to focus the study on the validity of various fluid flow approximations. The 1D loop system is represented by a rectangle; the fluid is heated up along one of the vertical legs and cooled down along the opposite leg. A pressurizer and a pump are included in the horizontal legs. The amount of energy transferred and removed from the system is equal in absolute value along the two vertical legs. The various fluid flow approximations are compressible vs. incompressible, and complete momentum equation vs. Darcy’s approximation. The ultimate goal is to compute the fluid flow models’ uncertainties and, if possible, to generate validity ranges for these models when applied to reactor analysis. We also limit this study to single phase flows with low-Mach numbers. As a result, sound waves carry a very small amount of energy in this particular case. A standard finite volume method is used for the spatial discretization of the system.

  13. Parkinson's Disease and Forced Exercise: A Preliminary Study

    PubMed Central

    Reis, Timothy; Alramadhani, Raed; Cifu, David X.; Towne, Alan; Carne, William

    2013-01-01

    Objective. The concept of forced exercise has drawn attention for the treatment of Parkinson's disease symptoms with anecdotal reports of success. This study sought to ascertain any significant effect of forced exercise using a motorized stationary bicycle when compared to controls on Parkinson's disease symptoms in a blinded, randomized, and controlled setting. Setting. Parkinson's disease outpatient clinic, Veterans Administration Medical Center. Method. We assessed 23 patients (13 experimental and 10 controls) on a number of standard Parkinson's measures at baseline, after participation in eight weeks of twice weekly forced exercise or eight weeks of conventional clinic care, and then after a three-month period had elapsed. Dependent measures were UPDRS-III, Berg Balance Scale, finger taping test, and the PDQ-39. Results. Results did not demonstrate any main effect differences between the exercise and control groups on any measure at any point in time. A within subjects effect was demonstrated for the forced exercise group on overall UPDRS-III scores at the three-month end point. No other within group effects were noted. Results suggest that early enthusiasm for forced exercise may need tempering. Limitations of the study are discussed as well as numerous logistical challenges to this type of study. PMID:23853722

  14. Mesiodistal odontometrics as a distinguishing trait: A comparative preliminary study

    PubMed Central

    Sravya, Taneeru; Dumpala, Rakesh Kumar; Guttikonda, Venkateswara Rao; Manchikatla, Praveen Kumar; Narasimha, Vanajakshi China

    2016-01-01

    Introduction: Sex determination is a vital step in reconstructing an individual profile from unidentified skeletal remnants. Variations in tooth size are influenced by genetic and environmental factors. Tooth size variations have been reported among different populations. Aim: To identify the sex by determining the mesiodistal (MD) dimensions of maxillary canines. Objectives: (1) To compare the MD diameter of all maxillary canines — (a) in the entire urban and tribal population, (b) in urban male and urban female populations, (c) in tribal male and tribal female populations, and (d) in the entire male and female populations and (2) To estimate the percentage of sexual dimorphism individually in urban and tribal populations. Materials and Methods: Fifty subjects each from urban and tribal populations in equal gender ratio were selected in Khammam district, Telangana, for the purpose of this study. After obtaining informed consent, maxillary study models of the selected subjects were made. MD diameters of left and right maxillary canines were measured on casts using vernier calipers. The obtained data were subjected to statistical analysis. Results: (1) The total tribal population showed a greater MD diameter of maxillary canines than the total urban population, (2) Urban males showed a greater MD diameter of maxillary canines than urban females, (3) Tribal males showed a greater MD diameter of maxillary canines than tribal females, (4) The entire male population showed a greater MD diameter of maxillary canines than the entire female population, and (5) The percentage of dimorphism between males and females in individual groups was found to be significant. Conclusion: The study showed maxillary canines exhibiting significant sexual dimorphism and can be used as a distinguishing trait for sex determination along with other procedures. PMID:27555727

  15. [Animal health policies and practices in the Americas: preliminary study].

    PubMed

    Rojas, H; Stuardo, L; Benavides, D

    2005-08-01

    The Americas have a large population of farm animals, mostly for export. There are diverse production systems distributed over an extensive and varied geography, which hampers efforts to respond to the demands of the different markets. This study provides an overview of the elements influencing animal welfare implementation, such as the requirements of importing countries, the requirements of private agents, the demands of producers and manufacturers, quality promotion policies, the demands of the community, the recommendations of reference bodies and the results of applied research. To explore the level of animal welfare development in the countries of the region, a detailed case study was made of Chile, in addition to a survey of the Member Countries of the World Organisation for Animal Health (OIE) in the Americas. An analysis was made of progress with the issues considered by the OIE as priorities, namely humane slaughter for human consumption, transport and killing for disease control purposes. Furthermore, the study considers various aspects of production which the OIE has not included up to now. It also explores the status of research and producer and consumer perceptions of the issue. The results reveal that the level of development and implementation of animal welfare differs from one country to another. While the adoption of animal welfare regulations certainly relates to all the above-mentioned aspects, the one which appears to have the most impact is the export of livestock products to certain markets. Although there is great interest in improving animal welfare conditions, this calls for the general characteristics of animal husbandry in the various countries to be taken into account. While some livestock production in the Americas follows world patterns, many countries still find it difficult to integrate good animal welfare practices, owing to specific geographical, social and cultural situations that are reflected in local livestock development

  16. Long head of the biceps pathology as a cause of anterior shoulder pain after shoulder arthroplasty.

    PubMed

    Tuckman, David V; Dines, David M

    2006-01-01

    The use of shoulder arthroplasty has been increasing over the last decade, with nearly 20,000 shoulder arthroplasties being performed each year. Although many patients have excellent results, there exists a subset of patients in whom anterior catching shoulder pain develops after arthroplasty. The purpose of this study was to examine this group of patients and explore treatment options and outcomes for this condition. We undertook a review of 8 shoulders in 7 patients who were treated for anterior shoulder pain radiating into the biceps muscle after shoulder arthroplasty. Three patients had a hemiarthroplasty for fracture, and five had a total shoulder arthroplasty. All patients had anterior shoulder pain with physical examination findings consistent with biceps tendon pathology. Definitive diagnosis and treatment consisted of either arthroscopy, in 7 of 8 shoulders, or an open procedure, in 1 of 8 shoulders. The range of motion improved in all shoulders. The hemiarthroplasty group showed an increase in flexion of 36 degrees (range, 68 degrees -104 degrees ), external rotation of 23 degrees (range, 11 degrees -34 degrees ), and internal rotation to L4. The total shoulder group demonstrated an increase in flexion of 50 degrees (range, 66 degrees -166 degrees ), external rotation of 27 degrees (range, 22 degrees -39 degrees ), and internal rotation to L3. The Hospital for Special Surgery score improved in all shoulders, with all patients being satisfied with their final outcome. Pain scores improved from a mean of 6.9 (range, 4-9) preoperatively to 1.4 (range, 0.5-2) postoperatively on a scale of 1 to 10, with 10 indicating the most pain. The role of the biceps tendon in the pathology of anterior shoulder pain after shoulder arthroplasty appears to be consistent with fibrosis and inflammation. Initial results, achieved with arthroscopic debridement or tenodesis, were encouraging.

  17. Conditioning arbitrary stimuli to cigarette smoke intake: a preliminary study.

    PubMed

    Payne, T J; Etscheidt, M; Corrigan, S A

    1990-01-01

    This study represents an attempt to classically condition arbitrary stimuli to cigarette smoke intake. A smoker either smoked or mock-smoked a cigarette in two discriminative contexts for 20 sessions. The contingencies were reversed during an additional last two sessions. Measures of heart rate, skin temperature, and puff duration were monitored during all sessions. Results suggested that both manipulations of smoke delivery and context cues were related to puff duration. The pattern of psychophysiological reactivity was mixed and not easily interpreted. This experimental paradigm may be useful in the investigation of conditioning factors underlying addictive behaviors.

  18. Preliminary Study of Uranium Oxide Dissolution in Simulated Lung Fluid

    DTIC Science & Technology

    1985-01-01

    34 Eidson attributed the initial dissolution phase to the ammyiium diuranate component of the yellow cake. 19Follow-up animal inhalation studies, using... Sodium chloride 6.019 " Potassium chloride 0.298 Sodium phosphate, dibasic, anhydrous 0.142 Sodium sulfate, anhydrous 0.071 Calcium chloride, dih•,drate...0.368 Sodium acetate, trihydrate 0.953 ’ Sodium bicarbonate 2.604 Sodium citrate, dihydrate 0.097 6 A ".d increase the rate of solution, 95 per cent of

  19. A preliminary phenomenological study of being hypnotized and hypnotizing.

    PubMed

    Woodard, Fredrick James

    2005-10-01

    This paper presents phenomenological research conducted following Woodard's phenomenological and perceptual research methodology for understanding hypnotic experiencing. The research emphasizes examining the internal experiencings of individuals involved in hypnotic experiencing. Examples are presented of Individual Situated Structures and the General Structures from both a group of 8 participants who hypnotized their clients and another group of 17 individuals who volunteered to be hypnotized. The explicated themes identified in hypnotic experiencing (the hypnotic relationship, phenomenology of trance, use of imagination, problem with psychic energy, a gestalt of experiencing, and linear-nonlinear experiencing) are discussed. The author discusses limitations of this study and suggestions for further work.

  20. Preliminary noise tradeoff study of a Mach 2.7 cruise aircraft

    NASA Technical Reports Server (NTRS)

    Mascitti, V. R.; Maglieri, D. J. (Editor); Raney, J. P. (Editor)

    1979-01-01

    NASA computer codes in the areas of preliminary sizing and enroute performance, takeoff and landing performance, aircraft noise prediction, and economics were used in a preliminary noise tradeoff study for a Mach 2.7 design supersonic cruise concept. Aerodynamic configuration data were based on wind-tunnel model tests and related analyses. Aircraft structural characteristics and weight were based on advanced structural design methodologies, assuming conventional titanium technology. The most advanced noise prediction techniques available were used, and aircraft operating costs were estimated using accepted industry methods. The 4-engines cycles included in the study were based on assumed 1985 technology levels. Propulsion data was provided by aircraft manufacturers. Additional empirical data is needed to define both noise reduction features and other operating characteristics of all engine cycles under study. Data on VCE design parameters, coannular nozzle inverted flow noise reduction and advanced mechanical suppressors are urgently needed to reduce the present uncertainties in studies of this type.

  1. Sexual hormone serum levels and temporomandibular disorders. A preliminary study.

    PubMed

    Landi, Nicola; Lombardi, Ilaria; Manfredini, Daniele; Casarosa, Elena; Biondi, Katya; Gabbanini, Massimo; Bosco, Mario

    2005-02-01

    The aim of the present study was to investigate the role of sexual hormones in a young adult population affected by articular forms of temporomandibular disorders (TMD), measuring 17beta-estradiol and progesterone serum levels. In the study, we included 40 patients (20 males and 20 females) with a Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) axis I group II diagnosis of disk displacement and/or group III diagnosis of arthralgia, osteoarthritis or osteoarhrosis, and 32 healthy controls. In female patients, blood samples were collected in follicular and luteal phases of the same menstrual cycle, while only one blood sample was drawn in male patients. Serum levels of estradiol and progesterone were determined using a radioimmunoassay and the comparison between the two groups was performed using a t test. Regarding estradiol, our results showed significantly higher serum levels in patients affected by TMD than in healthy controls, both in males (p < 0.01) and in the luteal phase of the menstrual cycle in females (p < 0.05), while no difference was found for progesterone serum levels. Considering the multifactorial etiology of TMD and the hypothesis that some joint tissues (e.g., bone, cartilage, collagen, proteins) could be a target for sexual hormones, these data suggest that high serum estrogen levels might be implicated in the physiopathology of TMD.

  2. Ultrasonic nebulization atmospheric pressure glow discharge - Preliminary study

    NASA Astrophysics Data System (ADS)

    Greda, Krzysztof; Jamroz, Piotr; Pohl, Pawel

    2016-07-01

    Atmospheric pressure glow microdischarge (μAPGD) generated between a small-sized He nozzle jet anode and a flowing liquid cathode was coupled with ultrasonic nebulization (USN) for analytical optical emission spectrometry (OES). The spatial distributions of the emitted spectra from the novel coupled USN-μAPGD system and the conventional μAPGD system were compared. In the μAPGD, the maxima of the intensity distribution profiles of the atomic emission lines Ca, Cd, In, K, Li, Mg, Mn, Na and Sr were observed in the near cathode region, whereas, in the case of the USN-μAPGD, they were shifted towards the anode. In the novel system, the intensities of the analytical lines of the studied metals were boosted from several to 35 times. As compared to the conventional μAPGD-OES with the introduction of analytes through the sputtering and/or the electrospray-like nebulization of the flowing liquid cathode solution, the proposed method with the USN introduction of analytes in the form of a dry aerosol provides improved detectability of the studied metals. The detection limits of metals achieved with the USN-μAPGD-OES method were in the range from 0.08 μg L- 1 for Li to 52 μg L- 1 for Mn.

  3. Preliminary studies on immobilization of lipase using chicken eggshell

    NASA Astrophysics Data System (ADS)

    Salleh, S.; Serri, N. A.; Hena, S.; Tajarudin, H. A.

    2016-06-01

    A few advantages of enzyme immobilization are reusability of expensive enzyme, improvement of stability and activity compared to crude enzyme. Various organic components can be used as carrier for enzyme immobilization such as chicken eggshell. It can be used as a carrier for immobilization as its mineral component mostly contains of calcium carbonate. In the present study, Tributyrin method was used to test enzyme activity of Rhizomucour Miehei, Candida Antarctica and Candida Rugosa. Rhizomucour Miehei shows the highest enzyme activity (360.8 mol/min/mL lipase) and was used in further experiment. Experiment was continued to study incubation time for lipase immobilization on eggshell (1-4 hours) and reaction time of esterification of sugar ester (0-72 hours). Two hours incubation time for lipase immobilization was observed and gives the highest yield of sugar ester (78.13%). Fructose and stearic acid as substrate was used for the production of sugar ester. The highest percentage of sugar ester production was shown at 36 hours of reaction time.

  4. Spherical Cryogenic Hydrogen Tank Preliminary Design Trade Studies

    NASA Technical Reports Server (NTRS)

    Arnold, Steven M.; Bednarcyk, Brett A.; Collier, Craig S.; Yarrington, Phillip W.

    2007-01-01

    A structural analysis, sizing optimization, and weight prediction study was performed by Collier Research Corporation and NASA Glenn on a spherical cryogenic hydrogen tank. The tank consisted of an inner and outer wall separated by a vacuum for thermal insulation purposes. HyperSizer (Collier Research and Development Corporation), a commercial automated structural analysis and sizing software package was used to design the lightest feasible tank for a given overall size and thermomechanical loading environment. Weight trade studies were completed for different panel concepts and metallic and composite material systems. Extensive failure analyses were performed for each combination of dimensional variables, materials, and layups to establish the structural integrity of tank designs. Detailed stress and strain fields were computed from operational temperature changes and pressure loads. The inner tank wall is sized by the resulting biaxial tensile stresses which cause it to be strength driven, and leads to an optimum panel concept that need not be stiffened. Conversely, the outer tank wall is sized by a biaxial compressive stress field, induced by the pressure differential between atmospheric pressure and the vacuum between the tanks, thereby causing the design to be stability driven and thus stiffened to prevent buckling. Induced thermal stresses become a major sizing driver when a composite or hybrid composite/metallic material systems are used for the inner tank wall for purposes such as liners to contain the fuel and reduce hydrogen permeation.

  5. Preliminary study on hydrogeology in tectonically active areas.

    SciTech Connect

    Lowry, Thomas Stephen; Lappin, Allen R.; Gettemy, Glen L.; Jensen, Richard Pearson; Arnold, Bill Walter; James, Scott Carlton; Lee, Moo Yul; Meier, Diane A.

    2006-09-01

    This report represents the final product of a background literature review conducted for the Nuclear Waste Management Organization of Japan (NUMO) by Sandia National Laboratories, Albuquerque, New Mexico, USA. Internationally, research of hydrological and transport processes in the context of high level waste (HLW) repository performance, has been extensive. However, most of these studies have been conducted for sites that are within tectonically stable regions. Therefore, in support of NUMO's goal of selecting a site for a HLW repository, this literature review has been conducted to assess the applicability of the output from some of these studies to the geological environment in Japan. Specifically, this review consists of two main tasks. The first was to review the major documents of the main HLW repository programs around the world to identify the most important hydrologic and transport parameters and processes relevant in each of these programs. The review was to assess the relative importance of processes and measured parameters to site characterization by interpretation of existing sensitivity analyses and expert judgment in these documents. The second task was to convene a workshop to discuss the findings of Task 1 and to prioritize hydrologic and transport parameters in the context of the geology of Japan. This report details the results and conclusions of both of these Tasks.

  6. Preliminary Attitude Control Studies for the ASTER Mission

    NASA Astrophysics Data System (ADS)

    Victorino Sarli, Bruno; Luís da Silva, André; Paglione, Pedro

    2013-10-01

    This work discusses an attitude control study for the ASTER mission, the first Brazilian mission to the deep space. The study is part of a larger scenario that is the development of optimal trajectories to navigate in the 2001 SN263 asteroid system, together with the generation of orbit and attitude controllers for autonomous operation. The spacecraft attitude is defined from the orientation of the body reference system to the Local Vertical Local Horizontal (LVLH) of a circular orbit around the Alpha asteroid. The rotational equations of motion involve the dynamic equations, where the three angular speeds are generated from a set of three reaction wheels and the gravitational torque. The rotational kinematics is represented in the Euler angles format. The controller is developed via the linear quadratic regulator approach with output feedback. It involves the generation of a stability augmentation (SAS) loop and a tracking outer loop, with a compensator of desired structure. It was chosen the feedback of the p, q and r angular speeds in the SAS, one for each reaction wheel. In the outer loop, it was chosen a proportional integral compensator. The parameters are tuned using a numerical minimization that represents a linear quadratic cost, with weightings in the tracking error and controls. Simulations are performed with the nonlinear model. For small angle manoeuvres, the linear results with reaction wheels or thrusters are reasonable, but, for larger manoeuvres, nonlinear control techniques shall be applied, for example, the sliding mode control.

  7. Preliminary 1H NMR study on archaeological waterlogged wood.

    PubMed

    Maccotta, Antonella; Fantazzini, Paola; Garavaglia, Carla; Donato, Ines D; Perzia, Patrizia; Brai, Maria; Morreale, Filippa

    2005-01-01

    Magnetic Resonance Relaxation (MRR) and Magnetic Resonance Imaging (MRI) are powerful tools to obtain detailed information on the pore space structure that one is unlikely to obtain in other ways. These techniques are particularly suitable for Cultural Heritage materials, because they use water 1H nuclei as a probe. Interaction with water is one of the main causes of deterioration of materials. Porous structure in wood, for example, favours the penetration of water, which can carry polluting substances and promote mould growth. A particular case is waterlogged wood from underwater discoveries and moist sites; in fact, these finds are very fragile because of chemical, physical and biological decay from the long contact with the water. When wood artefacts are brought to the surface and directly dried in air, there is the collapse of the cellular structures, and wood loses its original form and dimensions and cannot be used for study and museum exhibits. In this work we have undertaken the study of some wood finds coming from Ercolano's harbour by MRR and MRI under different conditions, and we have obtained a characterization of pore space in wood and images of the spatial distribution of the confined water in the wood.

  8. Psychophysiological patterns during cell phone text messaging: a preliminary study.

    PubMed

    Lin, I-Mei; Peper, Erik

    2009-03-01

    This study investigated the psychophysiological patterns associated with cell phone text messaging (texting). Twelve college students who were very familiar with texting were monitored with surface electromyography (SEMG) from the shoulder (upper trapezius) and thumb (abductor pollicis brevis/opponens pollicis); blood volume pulse (BVP) from the middle finger, temperature from the index finger, and skin conductance (SC) from the palm of the non-texting hand; and respiration from the thorax and abdomen. The counter-balanced procedure consisted of a 2 min pre-baseline, 1 min receiving text messages, 2 min middle baseline, 1 min sending text messages and 2 min post-baseline. The results indicated that all subjects showed significant increases in respiration rate, heart rate, SC, and shoulder and thumb SEMG as compared to baseline measures. Eighty-three percentage of the participants reported hand and neck pain during texting, and held their breath and experienced arousal when receiving text messages. Subjectively, most subjects were unaware of their physiological changes. The study suggests that frequent triggering of these physiological patterns (freezing for stability and shallow breathing) may increase muscle discomfort symptoms. Thus, participants should be trained to inhibit these responses to prevent illness and discomfort.

  9. Reverse total shoulder arthroplasty: research models

    PubMed Central

    PETRILLO, STEFANO; LONGO, UMILE GIUSEPPE; GULOTTA, LAWRENCE V.; BERTON, ALESSANDRA; KONTAXIS, ANDREAS; WRIGHT, TIMOTHY; DENARO, VINCENZO

    2016-01-01

    Purpose the past decade has seen a considerable increase in the use of research models to study reverse total shoulder arthroplasty (RTSA). Nevertheless, none of these models has been shown to completely reflect real in vivo conditions. Methods we performed a systematic review of the literature matching the following key words: “reverse total shoulder arthroplasty” or “reverse total shoulder replacement” or “reverse total shoulder prosthesis” and “research models” or “biomechanical models” or “physical simulators” or “virtual simulators”. The following databases were screened: Medline, Google Scholar, EMBASE, CINAHIL and Ovid. We identified and included all articles reporting research models of any kind, such as physical or virtual simulators, in which RTSA and the glenohumeral joint were reproduced. Results computer models and cadaveric models are the most commonly used, and they were shown to be reliable in simulating in vivo conditions. Bone substitute models have been used in a few studies. Mechanical testing machines provided useful information on stability factors in RTSA. Conclusion because of the limitations of each individual model, additional research is required to develop a research model of RTSA that may reduce the limitations of those presently available, and increase the reproducibility of this technique in the clinical setting. PMID:28217660

  10. Optimization of ultrasound scanner characteristics: a preliminary study.

    PubMed

    Metcalfe, S C; Evans, J A

    1993-07-01

    It is generally accepted that different transducer characteristics are optimal for different examinations, but it is not always obvious which other scanner/transducer parameters, e.g. signal processing should be selected for a given examination. We have examined noise and grey-level parameters for two specific anatomical sections (one showing the liver and right kidney and one showing the uterus) using a combination of subjective and objective assessment. The results confirm that the images chosen for this study have different requirements in terms of noise and grey-scale processing. The uterus image requires a large range of greys assigned to the lower level echoes and requires low noise levels. The liver/kidney image was not affected by noise levels in the systems used and required the lower amplitude grey-levels to be compressed, liberating a greater range of greys for the higher amplitude echoes.

  11. Functional communication training in rett syndrome: a preliminary study.

    PubMed

    Byiers, Breanne J; Dimian, Adele; Symons, Frank J

    2014-07-01

    Rett syndrome (RTT) is associated with a range of serious neurodevelopmental consequences including severe communicative impairments. Currently, no evidence-based communication interventions exist for the population ( Sigafoos et al., 2009 ). The purpose of the current study was to examine the effectiveness of functional assessment (FA) and functional communication training (FCT) methods for teaching 3 individuals (ages 15-47 years) with classic RTT novel communicative behaviors. Using single-case experimental designs, functional reinforcers were identified (FA) and each participant quickly learned to activate a voice-output switch to obtain a reinforcer (FCT). These results suggest that individuals with classic RTT can learn novel communicative responses, which has important implications for future intervention research.

  12. Preliminary Design Study for a National Digital Seismograph Network

    USGS Publications Warehouse

    Peterson, Jon; Hutt, Charles R.

    1981-01-01

    Introduction Recently, the National Research Council published a report by the Panel on National, Regional, and Local Seismograph Networks of the Committee on Seismology in which the principal recommendation was for the establishment of a national digital seismograph network (NDSN). The Panel Report (Bolt, 1980) addresses both the need and the scientific requirements for the new national network. The purpose of this study has been to translate the scientific requirements into an instrumentation concept for the NSDS. There are literally hundreds, perhaps thousands, of seismographs in operation within the United States. Each serves an important purpose, but most have limited objectives in time, in region, or in the types of data that are being recorded. The concept of a national network, funded and operated by the Federal Government, is based on broader objectives that include continuity of time, uniform coverage, standardization of data format and instruments, and widespread use of the data for a variety of research purposes. A national digital seismograph network will be an important data resource for many years to come; hence, its design is likely to be of interest to most seismologists. Seismologists have traditionally been involved in the development and field operation of seismic systems and thus have been familiar with both the potential value and the limitations of the data. However, in recent years of increasing technological sophistication, the development of data sstems has fallen more to system engineers, and this trend is likely to continue. One danger in this is that the engineers may misinterpret scientific objectives or subordinate them to purely technological considerations. Another risk is that the data users may misuse or misinterpret the data because they are not aware of the limitations of the data system. Perhaps the most important purpose of a design study such as this is to stimulate a dialogue between system engineers and potential data users

  13. Shuttle infrared telescope facility (SIRTF) preliminary design study

    NASA Technical Reports Server (NTRS)

    1976-01-01

    An overall picture of the SIRTF system is first presented, including the telescope, focal plane instruments, cryogen supply, shuttle and spacelab support subsystems, mechanical and data interfaces with the vehicles, ground support equipment, and system requirements. The optical, mechanical, and thermal characteristics of the telescope are then evaluated, followed by a description of the SIRTF internal stabilization subsystem and its interface with the IPS. Expected performance in the shuttle environment is considered. Tradeoff studies are described, including the Gregorian versus the Cassegrain telescope, aperture diameter tradeoff, a CCD versus an image dissector for the star tracker, the large ambient telescope versus the SIRTF, and a dedicated gimbal versus the IPS. Operations from integration through launch and recovery are also discussed and cost estimates for the program are presented.

  14. A preliminary study of pulse-laser powered orbital launcher

    NASA Astrophysics Data System (ADS)

    Katsurayama, Hiroshi; Komurasaki, Kimiya; Arakawa, Yoshihiro

    2009-10-01

    An air-breathing pulse-laser powered orbital launcher has been proposed as an alternative to conventional chemical launch systems. The aim of the present study is to assess its feasibility through the estimation of its achievable payload mass per unit beam power and launch cost. A transfer trajectory from the ground to a geosynchronous Earth orbit (GEO) is proposed, and the launch trajectory to its geosynchronous transfer orbit (GTO) is computed using the realistic performance modeled in the pulsejet, ramjet, and rocket flight modes of the launcher. Results show that the launcher can transfer 0.084 kg of payload per 1 MW beam power to a geosynchronous earth orbit. The cost becomes a quarter of existing systems if one can divide a single launch into 24,000 multiple launches.

  15. [Effectiveness of magnetotherapy in optic nerve atrophy. A preliminary study].

    PubMed

    Zobina, L V; Orlovskaia, L S; Sokov, S L; Sabaeva, G F; Kondé, L A; Iakovlev, A A

    1990-01-01

    Magnetotherapy effects on visual functions (vision acuity and field), on retinal bioelectric activity, on conductive vision system, and on intraocular circulation were studied in 88 patients (160 eyes) with optic nerve atrophy. A Soviet Polyus-1 low-frequency magnetotherapy apparatus was employed with magnetic induction of about 10 mT, exposure 7-10 min, 10-15 sessions per course. Vision acuity of patients with its low (below 0.04 diopters) values improved in 50 percent of cases. The number of patients with vision acuity of 0.2 diopters has increased from 46 before treatment to 75. Magnetotherapy improved ocular hemodynamics in patients with optic nerve atrophy, it reduced the time of stimulation conduction along the vision routes and stimulated the retinal ganglia cells. The maximal effect was achieved after 10 magnetotherapy sessions. A repeated course carried out in 6-8 months promoted a stabilization of the process.

  16. PRELIMINARY STUDY OF METHODS TO CHEMICALLY BIND ZINC

    SciTech Connect

    Korinko, P.

    2011-06-10

    To address the {sup 65}Zn contamination issue in the TEF, a multi-task experimental program was initiated. The first two experimental tasks were completed. The results of the third experimental task are reported here. This task was conducted to determine if the zinc vapors could be chemically bound on two non hydrogen active substrates. Based on a thermodynamic study copper and cobalt were the most favorable for capturing zinc without forming hydrides. Within the experimental parameters tested, which include temperatures of 350, 400, and 450 C at pressures of nominally 20-40 millitorr, the zinc deposited on the both copper screen and cobalt rods but did not react to form a compound. The conditions that were tested are not prototypic and additional testing under higher vacuum conditions, i.e., .01 millitorr, may enhance the reactivity of the surfaces and is recommended.

  17. Psychological Preparation for Paralympic Athletes: A Preliminary Study.

    PubMed

    Blumenstein, Boris; Orbach, Iris

    2015-07-01

    Since the first Paralympics in 1960 there has been an increase in social and scientific interest in Paralympic athletes' personality, their preparation, and their sport results. During the last 20 yr, researchers and practitioners have been focused on psychological-skills programs for athletes with disabilities. The purpose of this article was to describe a psychological-preparation program for Israeli Paralympic athletes. Two subprograms, the learning-modification-application approach and the Simulation Training Exercise Program, were adapted to athletes' disability and sport demands. Two case studies, from table tennis and sailing (Sonar 3-person keelboat), are described to demonstrate how systematic sport psychology preparation can be effectively integrated into the training process of Paralympic athletes. Some recommendations for Paralympic athletes are presented.

  18. A Preliminary Study of Surface Temperature Cold Bias in COAMPS

    SciTech Connect

    Chin, H-N S; Leach, M J; Sugiyama, G A; Aluzzi, F J

    2001-04-27

    It is well recognized that the model predictability is more or less hampered by the imperfect representations of atmospheric state and model physics. Therefore, it is a common problem for any numerical models to exhibit some sorts of biases in the prediction. In this study, the emphasis is focused on the cold bias of surface temperature forecast in Naval Research Laboratory's three-dimensional mesoscale model, COAMPS (Coupled Ocean/Atmosphere Mesoscale Prediction System). Based on the comparison with the ground station data, there were two types of ground temperature cold biases identified in LLNL (Lawrence Livermore National Laboratory) operational forecasts of COAMPS over the California and Nevada regions during the 1999 winter and the 2000 spring. The first type of cold bias appears at high elevation regions covered by snow, and its magnitude can be as large as 30 F - 40 F lower than observed. The second type of cold bias mainly exists in the snow-free clear-sky regions, where the surface temperature is above the freezing point, and its magnitude can be up to 5 F - 10 F lower than observed. These cold biases can affect the low-level stratification, and even the diurnal variation of winds in the mountain regions, and therefore impact the atmospheric dispersion forecast. The main objective of this study is to explore the causes of such cold bias, and to further the improvement of the forecast performance in COAMPS. A series of experiments are performed to gauge the sensitivity of the model forecast due to the physics changes and large-scale data with various horizontal and vertical resolutions.

  19. Wind energy in electric power production, preliminary study

    NASA Astrophysics Data System (ADS)

    Lento, R.; Peltola, E.

    1984-01-01

    The wind speed conditions in Finland have been studied with the aid of the existing statistics of the Finnish Meteorological Institute. With the aid of the statistics estimates on the available wind energy were also made. Eight hundred wind power plants, 1.5 MW each, on the windiest west coast would produce about 2 TWh energy per year. Far more information on the temporal, geographical and vertical distribution of the wind speed than the present statistics included is needed when the available wind energy is estimated, when wind power plants are dimensioned optimally, and when suitable locations are chosen for them. The investment costs of a wind power plant increase when the height of the tower or the diameter of the rotor is increased, but the energy production increases, too. Thus, overdimensioning the wind power plant in view of energy needs or the wind conditions caused extra costs. The cost of energy produced by wind power can not yet compete with conventional energy, but the situation changes to the advantage of wind energy, if the real price of the plants decreases (among other things due to large series production and increasing experience), or if the real price of fuels rises. The inconvinience on the environment caused by the wind power plants is considered insignificant. The noise caused by the plant attenuates rapidly with distance. No harmful effects to birds and other animals caused by the wind power plants have been observed in the studies made abroad. Parts of the plant getting loose during an accident, or ice forming on the blades are estimated to fly even from a large plant only a few hundred meters.

  20. A preliminary study on the dielectric constant of WPC based on some tropical woods

    NASA Astrophysics Data System (ADS)

    Chia, L. H. L.; Chua, P. H.; Hon, Y. S.; Lee, E.

    The use of WPC as an important insulating material is studied by determining its dielectric constant. The variation of dielectric constant with moisture content is also investigated. Preliminary results show that all untreated woods studied have a higher dielectric constant than their polymer composites with the exception of Kapur and Keruing. It is therefore postulated that the presence of polymers has led to a decrease in the number of polarizable units. Such a material may be useful commercially.

  1. Preliminary study of a wing-tip vortex using laser velocimetry

    NASA Technical Reports Server (NTRS)

    Takahashi, R. K.; Mcalister, K. W.

    1987-01-01

    Measurements have been made in the wake of a semi-span NACA 0015 airfoil with emphasis on the region of the wing tip vortex. The spanwise and streamwise velocity components were measured using a two-component laser Doppler velocimeter. The purpose of the study was to initiate the operation of a laser velocimeter system and to perform preliminary wake measurements in preparation for a more extensive study of the structure and near field development of a tip vortex.

  2. Preliminary study of application of Moringa oleifera resin as polymer electrolyte in DSSC solar cells

    NASA Astrophysics Data System (ADS)

    Saehana, Sahrul; Darsikin, Muslimin

    2016-04-01

    This study reports the preliminary study of application of Moringa oleifera resin as polymer electrolyte in dye-sensitized solar cell (DSSC). We found that polymer electrolyte membrane was formed by using solution casting methods. It is observed that polymer electrolyte was in elastic form and it is very potential to application as DSSC component. Performance of DSSC which employing Moringa oleifera resin was also observed and photovoltaic effect was found.

  3. Preliminary Hydrogeologic Characterization Results from the Wallula Basalt Pilot Study

    SciTech Connect

    B.P. McGrail; E. C. Sullivan; F. A. Spane; D. H. Bacon; G. Hund; P. D. Thorne; C. J. Thompson; S. P. Reidel; F. S. Colwell

    2009-12-01

    The DOE's Big Sky Regional Carbon Sequestration Partnership has completed drilling the first continental flood basalt sequestration pilot borehole to a total depth (TD) of 4,110 feet on the Boise White Paper Mill property at Wallula, Washington. Site suitability was assessed prior to drilling by the 2007-2008 acquisition, processing and analysis of a four-mile, five-line three component seismic swath, which was processed as a single data-dense line. Analysis of the seismic survey data indicated a composite basalt formation thickness of {approx}8,000 feet and absence of major geologic structures (i.e., faults) along the line imaged by the seismic swath. Drilling of Wallula pilot borehole was initiated on January 13, 2009 and reached TD on April 6, 2009. Based on characterization results obtained during drilling, three basalt breccia zones were identified between the depth interval of 2,716 and 2,910 feet, as being suitable injection reservoir for a subsequent CO2 injection pilot study. The targeted injection reservoir lies stratigraphically below the massive Umtanum Member of the Grande Ronde Basalt, whose flow-interior section possesses regionally recognized low-permeability characteristics. The identified composite injection zone reservoir provides a unique and attractive opportunity to scientifically study the reservoir behavior of three inter-connected reservoir intervals below primary and secondary caprock confining zones. Drill cuttings, wireline geophysical logs, and 31one-inch diameter rotary sidewall cores provided geologic data for characterization of rock properties. XRF analyses of selected rock samples provided geochemical characterizations of the rocks and stratigraphic control for the basalt flows encountered by the Wallula pilot borehole. Based on the geochemical results, the pilot borehole was terminated in the Wapshilla Ridge 1 flow of the Grande Ronde Basalt Formation. Detailed hydrologic test characterizations of 12 basalt interflow reservoir

  4. Preliminary Study of Methods for Upgrading USGS Antarctic Seismological Capability

    USGS Publications Warehouse

    Holcomb, L. Gary

    1982-01-01

    Purpose The purpose of this study is to evaluate potential methods for obtaining higher quality seismic data from Antarctica. Currently, USGS-sponsored WWSSN stations are located at Scott Base, Sanae Base, and at South Pole Station. Scott and Sanae Stations are located near the coast; data obtained from coastal installations are normally degraded by noise generated by ocean wave action on the coast. Operations at South Pole are rather difficult because of the severe environmental characteristics and the extended logistics which are required to provide supplies and operating personnel to its remote location. Short-period data quality from Pole Station has been moderately high with a short-period magnification of 100K at 1Hz. Long-period magnifications have been rather low (<1K @ 15 s period). Recent relocation of the seismic recording facilities at South Pole Station as a result of the construction of a completely new station facility has caused serious degradation of the data quality due to faulty installation techniques. Repairs have been implemented to remedy these deficiencies and to regain the data quality which existed before the move to new facilities. However, the technology being used at South Pole Station is of WWSSN vintage; as a result it is about 20 years old. Much has been learned about achieving higher magnifications since the WWSSN was designed. This study will evaluate the feasibility of applying recent technological advances to Antarctic seismology. Seismological data from the Antarctic Continent is important to the world's seismological community because of the Antarctic's unique geographic position on the globe. Land masses are scarce in that part of the world; the Antarctic sits right in the middle of the void. Therefore, its data are important for completing the data set for the southern hemisphere. Upgrading the USGS seismic capability in the Antarctic should also prove to be a wise investment from another point of view. Although the initial

  5. Acute arterial occlusion after total knee arthroplasty.

    PubMed

    Gregory, Patricia C; Rogic, Roselyn; Eddington, Carolyn

    2006-11-01

    There are a number of complications associated with total knee-joint arthroplasty. These include deep venous thromboses, peroneal palsy, infection, anemia, and Ogilvie's syndrome. An uncommon but potentially limb-threatening complication is acute arterial occlusion. Approximately 35 cases have been reported in the orthopedic literature. Prompt recognition and treatment intervention are the keys to successful outcome. We describe the case of one patient who had mild peroneal palsy and developed acute arterial occlusion 9 days postoperatively while on the inpatient rehabilitation service. Prompt aggressive management restored arterial circulation to the lower limb. Careful management of patients after total knee arthroplasty requires an understanding that arterial occlusion is a rare limb-threatening complication of surgery, but that it is treatable with prompt, deliberate management. Physiatrists should be aware that this condition exists in postoperative knee-joint arthroplasty patients. They should pay careful attention to any patient with a history of peripheral vascular disease or postoperative peroneal palsy.

  6. Uncommon indications for reverse total shoulder arthroplasty.

    PubMed

    Hyun, Yoon Suk; Huri, Gazi; Garbis, Nickolas G; McFarland, Edward G

    2013-12-01

    Total shoulder arthroplasty and shoulder hemiarthroplasty have been the traditional method for treating a variety of shoulder conditions, including arthritis, cuff tear arthropathy, and some fracture types. However, these procedures did not provide consistently good results for patients with torn rotator cuffs. The development of the reverse prosthesis by Grammont in the late 20th century revolutionized the treatment of the rotator-cuff-deficient shoulder with arthritis. The main indication for the reverse prosthesis remains the patient with cuff tear arthropathy who has pain and loss of motion. Because the reverse total shoulder arthroplasty produced such good results in these patients, the indications for the reverse prosthesis have expanded to include other shoulder conditions that have previously been difficult to treat successfully and predictably. This review discusses and critically reviews these newer indications for the reverse total shoulder arthroplasty.

  7. Uncommon Indications for Reverse Total Shoulder Arthroplasty

    PubMed Central

    Hyun, Yoon Suk; Huri, Gazi; Garbis, Nickolas G.

    2013-01-01

    Total shoulder arthroplasty and shoulder hemiarthroplasty have been the traditional method for treating a variety of shoulder conditions, including arthritis, cuff tear arthropathy, and some fracture types. However, these procedures did not provide consistently good results for patients with torn rotator cuffs. The development of the reverse prosthesis by Grammont in the late 20th century revolutionized the treatment of the rotator-cuff-deficient shoulder with arthritis. The main indication for the reverse prosthesis remains the patient with cuff tear arthropathy who has pain and loss of motion. Because the reverse total shoulder arthroplasty produced such good results in these patients, the indications for the reverse prosthesis have expanded to include other shoulder conditions that have previously been difficult to treat successfully and predictably. This review discusses and critically reviews these newer indications for the reverse total shoulder arthroplasty. PMID:24340143

  8. Weldon Spring, Missouri, Raffinate Pits 1, 2, 3, and 4: Preliminary grout development screening studies for in situ waste immobilization

    SciTech Connect

    McDaniel, E.W.; Gilliam, T.M.; Dole, L.R.; West, G.A.

    1987-04-01

    Results of Oak Ridge National Laboratory's initial support program to develop a preliminary grout formula to solidify in situ the Weldon Spring waste are presented. The screening study developed preliminary formulas based on a simulated composite waste and then tested the formulas on actual waste samples. Future data needs are also discussed. 1 ref., 6 figs., 9 tabs.

  9. A Preliminary Study of CO2 Flux Measurements by Lidar

    NASA Technical Reports Server (NTRS)

    Gibert, Fabien; Koch, Grady J.; Beyon, Jeffrey Y.; Hilton, T.; Davis, Kenneth J.; Andrews, Arlyn; Ismail, Syed; Singh, Upendra N.

    2008-01-01

    A mechanistic understanding of the global carbon cycle requires quantification of terrestrial ecosystem CO2 fluxes at regional scales. In this paper, we analyze the potential of a Doppler DIAL system to make flux measurements of atmospheric CO2 using the eddy-covariance and boundary layer budget methods and present results from a ground based experiment. The goal of this study is to put CO2 flux point measurements in a mesoscale context. In June 2007, a field experiment combining a 2-m Doppler Heterodyne Differential Absorption Lidar (HDIAL) and in-situ sensors of a 447-m tall tower (WLEF) took place in Wisconsin. The HDIAL measures simultaneously: 1) CO2 mixing ratio, 2) atmosphere structure via aerosol backscatter and 3) radial velocity. We demonstrate how to synthesize these data into regional flux estimates. Lidar-inferred fluxes are compared with eddy-covariance fluxes obtained in-situ at 396m AGL from the tower. In cases where the lidar was not yet able to measure the fluxes with acceptable precision, we discuss possible modifications to improve system performance.

  10. An automatic tooth preparation technique: A preliminary study

    NASA Astrophysics Data System (ADS)

    Yuan, Fusong; Wang, Yong; Zhang, Yaopeng; Sun, Yuchun; Wang, Dangxiao; Lyu, Peijun

    2016-04-01

    The aim of this study is to validate the feasibility and accuracy of a new automatic tooth preparation technique in dental healthcare. An automatic tooth preparation robotic device with three-dimensional motion planning software was developed, which controlled an ultra-short pulse laser (USPL) beam (wavelength 1,064 nm, pulse width 15 ps, output power 30 W, and repeat frequency rate 100 kHz) to complete the tooth preparation process. A total of 15 freshly extracted human intact first molars were collected and fixed into a phantom head, and the target preparation shapes of these molars were designed using customised computer-aided design (CAD) software. The accuracy of tooth preparation was evaluated using the Geomagic Studio and Imageware software, and the preparing time of each tooth was recorded. Compared with the target preparation shape, the average shape error of the 15 prepared molars was 0.05–0.17 mm, the preparation depth error of the occlusal surface was approximately 0.097 mm, and the error of the convergence angle was approximately 1.0°. The average preparation time was 17 minutes. These results validated the accuracy and feasibility of the automatic tooth preparation technique.

  11. Preliminary hydrochemical study of Ronda ultramafic massif (South Spain)

    NASA Astrophysics Data System (ADS)

    Vadillo, Iñaki; Urresti, Begoña; Jiménez, Pablo; Martos, Sergio; José Durán, Juan; Benavente, José; Carrasco, Francisco; Pedrera, Antonio

    2016-04-01

    During 2015 more than 70 springs related to the peridotite outcrops of the Ronda mountainous massif, South Spain, have been identified. The field work included "in situ" measurements of physical-chemical parameters (T, EC, pH), and water sampling for major components and stable isotopes of water and DIC. The hydrogeochemical study allowed us to characterize different flow systems: (1) springs with very low to medium electrical conductivities (200-700 μS/cm) and pH below 9.0, and (2) springs with EC above 700 μS/cm and pH above 9.0. The first group of springs are supposed to be linked with surface and subsurface flows. The hydrogeochemical reactions that determine their composition are characterized by the low solubility of minerals, atmospheric CO2 (open system) and active serpentinization reactions that supplies hundreds of ppm of Mg2+. All of them are waters of HCO3-Mg or HCO3-Mg-Na type. The second group of springs drains water with EC above 700 μS/cm and pH over 9. In general, these springs are associated to deep flows connected to regional faults or major tectonic features. Deeper flow enhances water-rock interaction and time of contact, so this system evolves towards a closed system to O2 and CO2. All these waters are old or older than the first group and show reducing features and are of Na-Cl or OH-Ca type.

  12. A preliminary study of patient comfort associated with customised mouthguards

    PubMed Central

    McClelland, C.; Kinirons, M.; Geary, L.

    1999-01-01

    OBJECTIVE: To compare patient perception of custom made mouthguards of ideal and less than ideal designs in terms of their comfort and "wearability". METHOD: A mouthguard of ideal design (A) and one incorporating common design faults of underextension and unadjusted occlusion (B) were provided for 22 active sportsmen and women. They were not informed of the details of the design or the status of the protector. Half the participants were asked to wear mouthguard A first and the other half wore B first, each worn for one hour on two consecutive nights. Questionnaires were used to evaluate and rate the comfort and wearability of each mouthguard. RESULTS: Eighteen people completed the study. The ideal appliance was rated as significantly more retentive and comfortable overall and specifically was more comfortable to lips, gums, and tongue. It was also recognised as being less bulky, less likely to keep the teeth apart, or to cause pain in the jaw muscles. CONCLUSIONS: Comfort is likely to be increased if mouthguards are extended labially to within 2 mm of the vestibular reflection, adjusted to allow even occlusal contact, rounded at the buccal peripheries, and tapered at the palatal edges. 


 PMID:10378071

  13. Preliminary Study of Advanced Turboprops for Low Energy Consumption

    NASA Technical Reports Server (NTRS)

    Kraft, G. A.; Strack, W. C.

    1975-01-01

    The fuel savings potential of advanced turboprops (operational about 1985) was calculated and compared with that of an advanced turbofan for use in an advanced subsonic transport. At the design point, altitude 10.67 km and Mach 0.80, turbine-inlet temperature was fixed at 1590 K while overall pressure ratio was varied from 25 to 50. The regenerative turboprop had a pressure ratio of only 10 and an 85 percent effective rotary heat exchanger. Variable camber propellers were used with an efficiency of 85 percent. The study indicated a fuel savings of 33 percent, a takeoff gross weight reduction of 15 percent, and a direct operating cost reduction of 18 percent was possible when turboprops were used instead of the reference turbofan at a range of 10 200 km. These reductions were 28, 11, and 14 percent, respectively, at a range of 5500 km. Increasing overall pressure ratio from 25 to 50 saved little fuel and slightly increased takeoff gross weight.

  14. Firearm fatalities. A preliminary study report from Iran.

    PubMed

    Amiri, A; Sanaei-Zadeh, H; Towfighi Zavarei, H; Rezvani Ardestani, F; Savoji, N

    2003-09-01

    During the one-year period from March 2002 to March 2003 there were 89 firearm fatalities investigated by the Legal Medicine Organization of Iran in Tehran. We determined the characteristics of these 89 firearm deaths which comprised 0.83% of all postmortem examinations. Of these, 60.7% were homicides, 30.3% suicides, 4.5% accidental, and 4.5% unclassifiable. Most victims were young male. Military rifles were responsible for almost all suicides, whereas in homicide handguns were the preferred weapons. The most common site of entrance wounds in suicides were the under the chin (37%) and chest (25.9%). In homicide group, 42.6% of entrance wounds were located in the head. The suicidal gunshots were fired from contact/near contact range in 84.6% while this was the case in only two cases of the homicides. All but one of the suicides were committed at the garrisons or police stations. The unique pattern of suicide that was found in this series was not similar to that reported in earlier studies. We believe our pattern of firearm fatalities must be in great part due to the Iran's strict gun control regulations and cultural background.

  15. Preliminary study of visual effect of multiplex hologram

    NASA Astrophysics Data System (ADS)

    Fu, Huaiping; Xiong, Bingheng; Yang, Hong; Zhang, Xueguo

    2004-06-01

    The process of any movement of real object can be recorded and displayed by a multiplex holographic stereogram. An embossing multiplex holographic stereogram and a multiplex rainbow holographic stereogram have been made by us, the multiplex rainbow holographic stereogram reconstructs the dynamic 2D line drawing of speech organs, the embossing multiplex holographic stereogram reconstructs the process of an old man drinking water. In this paper, we studied the visual result of an embossing multiplex holographic stereogram made with 80 films of 2-D pictures. Forty-eight persons of aged from 13 to 67 were asked to see the hologram and then to answer some questions about the feeling of viewing. The results indicate that this kind of holograms could be accepted by human visual sense organ without any problem. This paper also discusses visual effect of the multiplex holography stereograms base on visual perceptual psychology. It is open out that the planar multiplex holograms can be recorded and present the movement of real animal and object. Not only have the human visual perceptual constancy for shape, just as that size, color, etc... but also have visual perceptual constancy for binocular parallax.

  16. An automatic tooth preparation technique: A preliminary study

    PubMed Central

    Yuan, Fusong; Wang, Yong; Zhang, Yaopeng; Sun, Yuchun; Wang, Dangxiao; Lyu, Peijun

    2016-01-01

    The aim of this study is to validate the feasibility and accuracy of a new automatic tooth preparation technique in dental healthcare. An automatic tooth preparation robotic device with three-dimensional motion planning software was developed, which controlled an ultra-short pulse laser (USPL) beam (wavelength 1,064 nm, pulse width 15 ps, output power 30 W, and repeat frequency rate 100 kHz) to complete the tooth preparation process. A total of 15 freshly extracted human intact first molars were collected and fixed into a phantom head, and the target preparation shapes of these molars were designed using customised computer-aided design (CAD) software. The accuracy of tooth preparation was evaluated using the Geomagic Studio and Imageware software, and the preparing time of each tooth was recorded. Compared with the target preparation shape, the average shape error of the 15 prepared molars was 0.05–0.17 mm, the preparation depth error of the occlusal surface was approximately 0.097 mm, and the error of the convergence angle was approximately 1.0°. The average preparation time was 17 minutes. These results validated the accuracy and feasibility of the automatic tooth preparation technique. PMID:27125874

  17. An automatic tooth preparation technique: A preliminary study.

    PubMed

    Yuan, Fusong; Wang, Yong; Zhang, Yaopeng; Sun, Yuchun; Wang, Dangxiao; Lyu, Peijun

    2016-04-29

    The aim of this study is to validate the feasibility and accuracy of a new automatic tooth preparation technique in dental healthcare. An automatic tooth preparation robotic device with three-dimensional motion planning software was developed, which controlled an ultra-short pulse laser (USPL) beam (wavelength 1,064 nm, pulse width 15 ps, output power 30 W, and repeat frequency rate 100 kHz) to complete the tooth preparation process. A total of 15 freshly extracted human intact first molars were collected and fixed into a phantom head, and the target preparation shapes of these molars were designed using customised computer-aided design (CAD) software. The accuracy of tooth preparation was evaluated using the Geomagic Studio and Imageware software, and the preparing time of each tooth was recorded. Compared with the target preparation shape, the average shape error of the 15 prepared molars was 0.05-0.17 mm, the preparation depth error of the occlusal surface was approximately 0.097 mm, and the error of the convergence angle was approximately 1.0°. The average preparation time was 17 minutes. These results validated the accuracy and feasibility of the automatic tooth preparation technique.

  18. Preliminary Study for Designing a Novel Vein-Visualizing Device

    PubMed Central

    Kim, Donghoon; Kim, Yujin; Yoon, Siyeop; Lee, Deukhee

    2017-01-01

    Venipuncture is an important health diagnosis process. Although venipuncture is one of the most commonly performed procedures in medical environments, locating the veins of infants, obese, anemic, or colored patients is still an arduous task even for skilled practitioners. To solve this problem, several devices using infrared light have recently become commercially available. However, such devices for venipuncture share a common drawback, especially when visualizing deep veins or veins of a thick part of the body like the cubital fossa. This paper proposes a new vein-visualizing device applying a new penetration method using near-infrared (NIR) light. The light module is attached directly on to the declared area of the skin. Then, NIR beam is rayed from two sides of the light module to the vein with a specific angle. This gives a penetration effect. In addition, through an image processing procedure, the vein structure is enhanced to show it more accurately. Through a phantom study, the most effective penetration angle of the NIR module is decided. Additionally, the feasibility of the device is verified through experiments in vivo. The prototype allows us to visualize the vein patterns of thicker body parts, such as arms. PMID:28178227

  19. Preliminary piloted simulation studies of the HL-20 lifting body

    NASA Astrophysics Data System (ADS)

    Rivers, Robert A.; Jackson, E. Bruce; Ragsdale, W. A.

    1994-05-01

    NASA Langley Research Center is developing a lifting body vehicle, designated the HL-20, as one option of the proposed Personnel Launch System for NASA's future manned access to space requirements. Data derived from wind-tunnel and computational fluid dynamics analyses of the conceptual design led to the derivation of a flight simulator model to investigate the potential flight characteristics of the HL-20. A simulation investigation was initiated to determine if satisfactory unpowered horizontal landings could be accomplished. Control law design and trajectory development were directed toward this end. The study uncovered several deficiencies subsequently corrected through design changes, and it validated the predicted subsonic aerodynamic properties. Expanding the investigation to the Mach 4 to Mach 1 regime revealed flight characteristics necessitating the development of innovative control techniques. This article will present the significant results uncovered to date by flight simulator evaluations of a lifting body class of vehicle, and will demonstrate the effectiveness of flight simulation as an integrated part of the conceptual design phase.

  20. Segmentation and quantification for Alzheimer's disease (AD): a preliminary study

    NASA Astrophysics Data System (ADS)

    Lei, Tianhu; Udupa, Jayaram K.; Zhuge, Ying; Moonis, Gul; Clark, Christopher

    2003-05-01

    Alzheimer's is a progressive brain disease and is clinically characterized by cognitive symptoms that, in combination with behavioral disturbances, significantly interfere with activities of daily living. The purpose of this study is to investigate the possibility of developing volumetric measures of the structural damage and atrophy of brain derived from multiprotocol MR imaging. Our approach first applies intensity inhomogeneity correction and intensity standardization to PD and T2 weighted MR images to create base images for quantitative image analysis. Then, vectorial scale-based fuzzy connectedness segmentation (VSFCS) and morphological operations are applied to the base images to extract masks of cerebrospinal fluid (CSF), grey matter (GM), and white matter (WM), and further to create a clean and accurate intracranial (IC) mask. After separating CSF from brain parenchyma (BP), VSFCS is applied to BP (PD and T2) images to generate pure GM and WM masks, and then subtracting these pure from the BP mask to detect AD lesions. This method was applied to a set of conventional PD and T2 weighted MR images that were obtained from 5 patients with probable AD and 5 healthy normal control subjects. The segmented images of individual brain tissue regions (CSF, GM, WM, and AD lesion) are consistent with a Neuroradiologist's examination. The quantitative analysis shows that patients with AD have more atrophy. The mean value of the volume of brain parenchyma of patients with AD is about 10% less than that of healthy controls.

  1. Preliminary Study for Designing a Novel Vein-Visualizing Device.

    PubMed

    Kim, Donghoon; Kim, Yujin; Yoon, Siyeop; Lee, Deukhee

    2017-02-07

    Venipuncture is an important health diagnosis process. Although venipuncture is one of the most commonly performed procedures in medical environments, locating the veins of infants, obese, anemic, or colored patients is still an arduous task even for skilled practitioners. To solve this problem, several devices using infrared light have recently become commercially available. However, such devices for venipuncture share a common drawback, especially when visualizing deep veins or veins of a thick part of the body like the cubital fossa. This paper proposes a new vein-visualizing device applying a new penetration method using near-infrared (NIR) light. The light module is attached directly on to the declared area of the skin. Then, NIR beam is rayed from two sides of the light module to the vein with a specific angle. This gives a penetration effect. In addition, through an image processing procedure, the vein structure is enhanced to show it more accurately. Through a phantom study, the most effective penetration angle of the NIR module is decided. Additionally, the feasibility of the device is verified through experiments in vivo. The prototype allows us to visualize the vein patterns of thicker body parts, such as arms.

  2. Robotic consolle for ocular surgery: a preliminary study

    NASA Astrophysics Data System (ADS)

    Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Lenzetti, Ivo; Russo, Sheila; Menciassi, Arianna; Fortuna, Damiano

    2014-02-01

    Minimally invasive surgery has recently been improved by the use of robot-assisted procedures in several medical fields. Among the ocular surgeries there are a few examples of sophisticated vitreoretinal procedures, while robotic-assisted surgery of the anterior eye segment is still under study. In this paper we propose a new approach to the robotic assisted ocular surgery: a CO2 laser system is equipped with a micromanipulator and scanner, and it is proposed to induce photothermal effects for the removal of neoformations. A sensorized tool is connected to the patient eye and to the robotic arm. This tool is equipped with force and position sensors: by the use of the spatial information from the robotic console and from the patient it is possible to control the position of the target itself and to block it in the correct position for performing surgery. The system is provided by a feedback alarm that remove the block of the patient head in any moment. The optimized robotic consolle can be used in performing scleral cuts and in the treatment of pterigium or neoformations.

  3. NEOWISE STUDIES OF ASTEROIDS WITH SLOAN PHOTOMETRY: PRELIMINARY RESULTS

    SciTech Connect

    Mainzer, A.; Masiero, J.; Bauer, J.; Hand, E.; Grav, T.; Mo, W.; Tholen, D. J.; McMillan, R. S.; Maleszewski, C.; Wright, E.; Watkins, J.; Spahr, T.; Cutri, R. M.; Walker, R.

    2012-01-20

    We have combined the NEOWISE and Sloan Digital Sky Survey data to study the albedos of 24,353 asteroids with candidate taxonomic classifications derived using Sloan photometry. We find a wide range of moderate to high albedos for candidate S-type asteroids that are analogous to the S complex defined by previous spectrophotometrically based taxonomic systems. The candidate C-type asteroids, while generally very dark, have a tail of higher albedos that overlaps the S types. The albedo distribution for asteroids with a photometrically derived Q classification is extremely similar to those of the S types. Asteroids with similar colors to (4) Vesta have higher albedos than the S types, and most have orbital elements similar to known Vesta family members. Finally, we show that the relative reflectance at 3.4 and 4.6 {mu}m is higher for D-type asteroids and suggest that their red visible and near-infrared spectral slope extends out to these wavelengths. Understanding the relationship between size, albedo, and taxonomic classification is complicated by the fact that the objects with classifications were selected from the visible/near-infrared Sloan Moving Object Catalog, which is biased against fainter asteroids, including those with lower albedos.

  4. Social network analysis in identifying influential webloggers: A preliminary study

    NASA Astrophysics Data System (ADS)

    Hasmuni, Noraini; Sulaiman, Nor Intan Saniah; Zaibidi, Nerda Zura

    2014-12-01

    In recent years, second generation of internet-based services such as weblog has become an effective communication tool to publish information on the Web. Weblogs have unique characteristics that deserve users' attention. Some of webloggers have seen weblogs as appropriate medium to initiate and expand business. These webloggers or also known as direct profit-oriented webloggers (DPOWs) communicate and share knowledge with each other through social interaction. However, survivability is the main issue among DPOW. Frequent communication with influential webloggers is one of the way to keep survive as DPOW. This paper aims to understand the network structure and identify influential webloggers within the network. Proper understanding of the network structure can assist us in knowing how the information is exchanged among members and enhance survivability among DPOW. 30 DPOW were involved in this study. Degree centrality and betweenness centrality measurement in Social Network Analysis (SNA) were used to examine the strength relation and identify influential webloggers within the network. Thus, webloggers with the highest value of these measurements are considered as the most influential webloggers in the network.

  5. Preliminary Study on Water Filled Tank Perforation by Rod Projectiles

    NASA Astrophysics Data System (ADS)

    Xiao, Xin-Ke; Guo, Zi-Tao; Mu, Zhong-Cheng; Zhang, Wei

    2009-06-01

    The effects of fluid structure interactions resulting from the impact of a fluid filled tank is of the interests for engineers from both the military and civilian field, where hydrodynamic-ram (HRAM) phenomena is well known. And it is believed HRAM is responsible for the vulnerability and the possible catastrophic failure of the whole tank. Thus HRAM is related to the majority concerns on this topic, where the targets were usually assumed to be thin. In order to investigate the influence of water on the crashworthiness of a tank with relatively thick walls, 3 ballistic shots on the water filled tank with two 3 mm 2A12 aluminum plates as front and back target and 4 shots on the tank without any water by 12.7 mm rods were conducted. The failure patterns were indentified from the tests and the difference in the failure mechanism was further studied by a series of detailed numerical simulations on the corresponding tests in hydro-code AUTODYN-2D by using both the coupled Lagrange-Euler technology and the SPH method. And also, the challenge of numerical simulation in this field is addressed.

  6. Magnetic field studies at jupiter by voyager 2: preliminary results.

    PubMed

    Ness, N F; Acuna, M H; Lepping, R P; Burlaga, L F; Behannon, K W; Neubauer, F M

    1979-11-23

    Data from the Goddard Space Flight Center magnetometers on Voyager 2 have yielded on inbound trajectory observations of multiple crossings of the bow shock and magnetosphere near the Jupiter-sun line at radial distances of 99 to 66 Jupiter radii (RJ) and 72 to 62 RJ, respectively. While outbound at a local hour angle of 0300, these distances increase appreciably so that at the time of writing only the magnetopause has been observed between 160 and 185 RJ. These results and the magnetic field geometry confirm the earlier conclusion from Voyager I studies that Jupiter has an enormous magnetic tail, approximately 300 to 400 RJ in diameter, trailing behind the planet with respect to the supersonic flow of the solar wind. Addi- tional observations of the distortion of the inner magnetosphere by a concentrated plasma show a spatial merging of the equatorial magnetodisk current with the cur- rent sheet in the magnetic tail. The spacecraft passed within 62,000 kilometers of Ganymede (radius = 2,635 kilometers) and observed characteristic fluctuations in- terpreted tentatively as being due to disturbances arising from the interaction of the Jovian magnetosphere with Ganymede.

  7. Preliminary study of synergism of acid rain and diflubenzuron

    SciTech Connect

    Martin, P.J.S.; Clark, J.M.; Edman, J.D.

    1995-06-01

    Diflubenzuron{sup 1} (Dimilin{reg_sign}) was used on over 7 million acres in the U.S. in 1990 to control forest pests, particularly the gypsy moth. This chitin synthesis inhibitor affects insects and other anthropods. It is a restricted use pesticide due to its nontarget effects on aquatic macroinvertebrates. The effects of a single aerial application on nontarget aquatic macroinvertebrate communities were reviewed by Eisler (1992). Crustacea and immature insects (especially the true flies, mosquitoes, midges and black flies) are the most sensitive nontarget aquatic organisms to diflubenzuron. Diflubenzuron, N-[[4-(chlorophenyl)amino]carbonyl]-2,6-difluorobenzamide, is not the only mortality factor aquatic organisms face from human pollution. Acid deposition is a frequent stress factor in freshwater habitats in the Northeast USA. Acidic pulses can drop vernal pools (e.g., temporary, springtime, snowmelt pools) to pH levels below 3.0. Aquatic invertebrates vary in their tolerance to acidification. Reduced pH completely eliminates some species. A combination of stress factors could lead to synergistic effects, over and above the impact seen with a single stressor. The purpose of this study was to determine if there are synergist effects of diflubenzuron and lowered pH on the mortality of a nontarget aquatic organism. 11 refs., 1 fig.

  8. A preliminary study of CO2 sequestration of cement paste

    NASA Astrophysics Data System (ADS)

    Choi, Y.; Lee, H.; Hwang, J.; Oh, J.; Lee, J.

    2013-12-01

    Recently, CO2 capture and storage technologies to reduce CO2 concentration in the atmosphere have been extensively studied because global warming is a worldwide issue. Waste cement is a potential raw material for mineral carbonation. In general, carbonation refers a calcite forming reaction in hydrated cement. The carbonation of portlandite in hydrated cement is very straightforward. However, the carbonation of CSH (calcium silicate hydrate: CaO-SiO2-H2O) composing the largest portion of hydrated cement involved in complex reactions and is a key to increase the carbonation efficiency of waste cement. The present study was conducted to have basic information for utilizing waste cement as a raw material for CO2 sequestration. Cement paste was made with W:C= 6:4 and stored for 28 days in water bath. The prepared cement paste was pulverized, and fine grains sizing less than 0.15mm was used for experiment. For the direct aqueous carbonation experiment, 15g of sample is reacted with 200 ml of 1M NaHCO3 in 500ml HDPE bottle. 1M NaCl and 0.25 M MgCl2 was used for additives after leaching test with 0.25, 0.5, 1.0 and 1.5M NaCl and MgCl2 solutions, and the carbonation efficiency of these additives was evaluated. After reaction, the reacted cement paste and supernatant solution were separated from centrifuging at 5000rpm. The reacted cement paste was analyzed with XRD, DSC/TGA and SEM/EDS. The supernatant solution was filtered with 0.45um membrane filter, and nitric acid was added to lower 2 for preventing calcite precipitation. Then, chemical composition of solution was analyzed with ICP-OES. The leaching of Ca ion is increased with increasing NaCl concentration and is maximized at 1M solution. Extremely small leaching of Si ion indicates that NaCl feebly affect on the carbonation of CSH. The leaching of Ca ion in MgCl2 solution is 10 times greater than in NaCl solution and is maximized at 0.5M solution. The increased Ca leaching is probably caused by the decalcification of

  9. NEOWISE STUDIES OF SPECTROPHOTOMETRICALLY CLASSIFIED ASTEROIDS: PRELIMINARY RESULTS

    SciTech Connect

    Mainzer, A.; Masiero, J.; Hand, E.; Bauer, J.; Grav, T.; Mo, W.; Tholen, D.; McMillan, R. S.; Maleszewski, C.; Spahr, T.; Cutri, R. M.; Wright, E.; Watkins, J.

    2011-11-10

    The NEOWISE data set offers the opportunity to study the variations in albedo for asteroid classification schemes based on visible and near-infrared observations for a large sample of minor planets. We have determined the albedos for nearly 1900 asteroids classified by the Tholen, Bus, and Bus-DeMeo taxonomic classification schemes. We find that the S-complex spans a broad range of bright albedos, partially overlapping the low albedo C-complex at small sizes. As expected, the X-complex covers a wide range of albedos. The multiwavelength infrared coverage provided by NEOWISE allows determination of the reflectivity at 3.4 and 4.6 {mu}m relative to the visible albedo. The direct computation of the reflectivity at 3.4 and 4.6 {mu}m enables a new means of comparing the various taxonomic classes. Although C, B, D, and T asteroids all have similarly low visible albedos, the D and T types can be distinguished from the C and B types by examining their relative reflectance at 3.4 and 4.6 {mu}m. All of the albedo distributions are strongly affected by selection biases against small, low albedo objects, as all objects selected for taxonomic classification were chosen according to their visible light brightness. Due to these strong selection biases, we are unable to determine whether or not there are correlations between size, albedo, and space weathering. We argue that the current set of classified asteroids makes any such correlations difficult to verify. A sample of taxonomically classified asteroids drawn without significant albedo bias is needed in order to perform such an analysis.

  10. Iontophoretic delivery of terbinafine in onychomycosis: a preliminary study.

    PubMed

    Amichai, B; Nitzan, B; Mosckovitz, R; Shemer, A

    2010-01-01

    Background Onychomycosis is a common disease; topical treatment is usually poorly effective, while systemic treatment is more effective but may be associated with side-effects. Iontophoretic drug delivery may improve drug penetration through the nail and lead to better therapeutic results. Objectives To evaluate the efficacy, safety and tolerability of topical treatments with terbinafine HCl delivered with or without an iontophoretic patch in patients with onychomycosis of the toenails. Methods Patients enrolled into the study were divided randomly into two groups. Group A was treated with terbinafine and an iontophoretic patch (at a constant current density of 100 microA cm(-2)). Group B was treated with terbinafine without iontophoresis. Treatment was overnight wear, every day, 5 days per week, for 4 weeks. Follow-up period was 8 weeks from the end of treatment. Results A significant clinical response was recorded in patients of group A (active group). The percentage of patients having healthy toenail growth of more than 1.5 mm at the end of treatment was 40% compared with 11% in patients treated with terbinafine without current (passive group). The percentage of patients having fungal elements (KOH) in nail specimens decreased significantly at 8 weeks following the completion of treatment: 16% in the active group vs. 53% in the passive group. Patients in the active group reported a tingling sensation that is expected when using an iontophoretic drug delivery treatment. Conclusions The delivery of terbinafine under an electrical current of 100 microA cm(-2) appears to be efficacious and safe and is well tolerated for the treatment of nail onychomycosis.

  11. Optical Quality and Related Factors in Ocular Hypertension: Preliminary Study.

    PubMed

    Wang, Yu-Jing; Yang, Yan-Ning; Huang, Lin-Ying; Wang, Bo; Han, Yu-Can; Yan, Jiang-Bo

    2016-01-01

    Background. To evaluate the optical quality and related factors in patients with ocular hypertension (OHT). Methods. This was a prospective case-control study. A total of 12 eyes with OHT and 20 control eyes underwent testing with Optical Quality Analysis System II (OQAS II) to evaluate the modulation transfer function cut off frequency (MTF cutoff), the Strehl 2D ratio (SR), objective scatter index (OSI), tear-film mean OSI (TFOSI), and the OQAS values (OV100%,OV20%, and OV9%). Results. The optical quality of patients with OHT declined, with lower MTF cutoff (OHT 36.86 ± 7.11 cpd , controls 48.50 ± 4.04 cpd, t = -4.60, P < 0.05), lower SR (OHT 0.22 ± 0.04, controls 0.27 ± 0.05, t = -2.72, P < 0.05), lower OV100% (OHT 1.26 ± 0.25, controls 1.61 ± 0.14, t = -4.03, P < 0.05), lower OV20% (OHT 1.27 ± 0.27, controls 1.72 ± 0.20, t = -4.00, P < 0.05), and lower OV9% (OHT 1.30 ± 0.25, controls 1.69 ± 0.32, t = -2.28, P < 0.05). There were not any statistically significant differences in OSI and TFOSI. The MTF cutoff in patients with OHT was correlated significantly with age (r = -0.59, P < 0.05). Conclusions. Optical quality of patients with OHT is reduced, with lower MTF cutoff, SR, OV100%, OV20%, and OV9%. MTF cutoff is negatively related to age.

  12. Wing design for a civil tiltrotor transport aircraft: A preliminary study

    NASA Technical Reports Server (NTRS)

    Rais-Rohani, Masoud

    1993-01-01

    A preliminary study was conducted on the design of the wing-box structure for a civil tiltrotor transport aircraft. The wing structural weight is to be minimized subject to structural and aeroelastic constraints. The composite wing-box structure is composed of skin, stringers, ribs, and spars. The design variables include skin ply thicknesses and orientations and spar cap and stringer cross-sectional areas. With the total task defined, an initial study was conducted to learn more about the intricate dynamic and aeroelastic characteristics of the tiltrotor aircraft and their roles in the wing design. Also, some work was done on the wing finite-element modeling (via PATRAN) which would be used in structural analysis and optimization. Initial studies indicate that in order to limit the wing/rotor aeroelastic and dynamic interactions in the preliminary design, the cruise speed, rotor system, and wing geometric attributes must all be held fixed.

  13. Densitometric evaluation of bone-prosthetic counterface in hip and knee arthroplasty with modern implants

    PubMed Central

    Lepri, Andrea Cozzi; Giorgini, Marco; Signorini, Carla; Carulli, Christian; Civinini, Roberto; Brandi, Maria Luisa; Innocenti, Massimo

    2016-01-01

    Summary Introduction Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA). Materials and methods Thirty patients undergoing THA and nineteen undergoing rTKA were included in this study. In fifteen cases of THA a standard cementless stem was used; in the other fifteen a short cementless stem was chosen. In all cases a cementless cup was implanted. In all patients undergoing rTKA, all implants had pressfit femoral and tibial diaphyseal stems; only the femoral component and the tibial plateau were cemented. DEXA evaluation was performed preoperatively, and at 3, 6, 12, and 24 months postoperatively for rTKA, and at 6 and 12 months for THA. Results DEXA in THA showed a significant decrease at the femoral ROIs 1 and 7, and an increase in ROI 4. In rTKA a reduction of femoral BMD in R1, R7, and R4 was found, with maximum values of −13.6% in R1 and −11.89% in R7 at 24 months and a value of −2.55% in R4 at 12 months. On the tibial side, an increase in BMD R4 (with values of 2.18% still at 24 months), and a reduction in R7 (progressively lesser over the time) and in R1 (progressively higher) were found. Conclusions After a joint replacement a full adhesion of the prosthetic surface to the host bone should be achieved through a local biological process named osseointegration. In some cases this process may not fully realize, so the secondary stability of the implant may

  14. Shock absorption in lumbar disc prosthesis: a preliminary mechanical study.

    PubMed

    LeHuec, J C; Kiaer, T; Friesem, T; Mathews, H; Liu, M; Eisermann, L

    2003-08-01

    Lumbar disc prostheses have been used in treating symptomatic degenerative disc diseases. A few prostheses of the ball-socket design are currently available for clinical use, the joint mechanism being materialized either with a hard polymer core or a metal-to-metal couple. Other prostheses of "shock absorber" design were not available at the time of the study. The objective of this work was to establish whether there was a difference in the shock absorption capacity between a device having an ultra-high-molecular-weight polyethylene center core and a device having a metal-on-metal bearing. Vibration and shock loading were applied to two lumbar total disc prostheses: PRODISC, manufactured by Spine Solutions, and MAVERICK Total Disc Replacement, manufactured by Medtronic Sofamor Danek. The shock absorption capacity of the device was evaluated by comparing the input and the output force measurements. The disc prosthesis was mounted onto a test apparatus. Each side of the device was equipped with a force sensor. The input shock load and the output resulting forces were simultaneously measured and recorded. The loading force pattern included 1). a static preload of 350 N plus an oscillating vibration of 100 N with frequency sweeping from 0 to 100 Hz and 2). a sudden shock load of 250 N applied over a 0.1-second interval. Both input and output signal data were processed and were transformed into their frequency spectrums. The vibration and shock transmissibility of the device, defined as the ratio of the output spectrum over the input spectrum, were calculated in sweeping the frequency from 0 to 100 Hz. The phase deviation was calculated to characterize the shock absorber effects. For both tested devices under vibration and shock loading, the phase angle displacement between the input and the output signals was 10 degrees. Under oscillating vibration loading, both tested devices had a transmission ratio higher than 99.8%. Over the frequency interval 1-100 Hz, the

  15. Metal Hypersensitivity and Total Knee Arthroplasty.

    PubMed

    Lachiewicz, Paul F; Watters, Tyler Steven; Jacobs, Joshua J

    2016-02-01

    Metal hypersensitivity in patients with a total knee arthroplasty (TKA) is a controversial topic. The diagnosis is difficult, given the lack of robust clinical validation of the utility of cutaneous and in vitro testing. Metal hypersensitivity after TKA is quite rare and should be considered after eliminating other causes of pain and swelling, such as low-grade infection, instability, component loosening or malrotation, referred pain, and chronic regional pain syndrome. Anecdotal observations suggest that two clinical presentations of metal hypersensitivity may occur after TKA: dermatitis or a persistent painful synovitis of the knee. Patients may or may not have a history of intolerance to metal jewelry. Laboratory studies, including erythrocyte sedimentation rate, C-reactive protein level, and knee joint aspiration, are usually negative. Cutaneous and in vitro testing have been reported to be positive, but the sensitivity and specificity of such testing has not been defined. Some reports suggest that, if metal hypersensitivity is suspected and nonsurgical measures have failed, then revision to components fabricated of titanium alloy or zirconium coating can be successful in relieving symptoms. Revision should be considered as a last resort, however, and patients should be informed that no evidence-based medicine is available to guide the management of these conditions, particularly for decisions regarding revision. Given the limitations of current testing methods, the widespread screening of patients for metal allergies before TKA is not warranted.

  16. Extensor tendon ruptures after total knee arthroplasty.

    PubMed

    Bonnin, M; Lustig, S; Huten, D

    2016-02-01

    Extensor tendon rupture is a rare but serious complication after total knee arthroplasty (TKA) that impairs active knee extension, thereby severely affecting knee function. Surgery is usually required. Surgical options range from simple suturing to allograft reconstruction of the entire extensor mechanism and include intermediate methods such as reconstruction using neighbouring tendons or muscles, synthetic ligament implantation, and partial allograft repair. Simple suturing carries a high failure rate and should therefore be routinely combined with tissue augmentation using a neighbouring tendon or a synthetic ligament. After allograft reconstruction, outcomes are variable and long-term complications common. Salvage procedures for managing the most severe cases after allograft failure involve reconstruction using gastrocnemius or vastus flaps. Regardless of the technique used, suturing must be performed under tension, with the knee fully extended, and rehabilitation must be conducted with great caution. Weaknesses of available case-series studies include small sample sizes, heterogeneity, and inadequate follow-up duration. All treatment options are associated with substantial failure rates. The patient should be informed of this fact and plans made for a salvage option. Here, the main techniques and their outcomes are discussed, and a therapeutic strategy is suggested.

  17. Emerging technologies in arthroplasty: additive manufacturing.

    PubMed

    Banerjee, Samik; Kulesha, Gene; Kester, Mark; Mont, Michael A

    2014-06-01

    Additive manufacturing is an industrial technology whereby three-dimensional visual computer models are fabricated into physical components by selectively curing, depositing, or consolidating various materials in consecutive layers. Although initially developed for production of simulated models, the technology has undergone vast improvements and is currently increasingly being used for the production of end-use components in various aerospace, automotive, and biomedical specialties. The ability of this technology to be used for the manufacture of solid-mesh-foam monolithic and coated components of complex geometries previously considered unmanufacturable has attracted the attention of implant manufacturers, bioengineers, and orthopedic surgeons. Currently, there is a paucity of reports describing this fabrication method in the orthopedic literature. Therefore, we aimed to briefly describe this technology, some of the applications in other orthopedic subspecialties, its present use in hip and knee arthroplasty, and concerns with the present form of the technology. As there are few reports of clinical trials presently available, the true benefits of this technology can only be realized when studies evaluating the clinical and radiographic outcomes of cementless implants manufactured with additive manufacturing report durable fixation, less stress shielding, and better implant survivorship. Nevertheless, the authors believe that this technology holds great promise and may potentially change the conventional methods of casting, machining, and tooling for implant manufacturing in the future.

  18. Metal Hypersensitivity and Total Knee Arthroplasty

    PubMed Central

    Lachiewicz, Paul F.; Watters, Tyler Steven; Jacobs, Joshua J.

    2015-01-01

    Metal hypersensitivity in patients with a total knee arthroplasty (TKA) is a controversial topic. The diagnosis is difficult, given the lack of robust clinical validation of the utility of cutaneous and in vitro testing. Metal hypersensitivity after TKA is quite rare and should be considered after eliminating other causes of pain and swelling, such as low-grade infection, instability, component loosening or malrotation, referred pain, and chronic regional pain syndrome. Anecdotal observations suggest that two clinical presentations of metal hypersensitivity may occur after TKA: dermatitis or a persistent painful synovitis of the knee. Patients may or may not have a history of intolerance to metal jewelry. Laboratory studies, including erythrocyte sedimentation rate, C-reactive protein level, and knee joint aspiration, are usually negative. Cutaneous and in vitro testing have been reported to be positive, but the sensitivity and specificity of such testing has not been defined. Anecdotal reports suggest that, if metal hypersensitivity is suspected and nonsurgical measures have failed, then revision to components fabricated of titanium alloy or zirconium coating can be successful in relieving symptoms. Revision should be considered as a last resort, however, and patients should be informed that no evidence-based medicine is available to guide the management of these conditions, particularly for decisions regarding revision. Given the limitations of current testing methods, the widespread screening of patients for metal allergies before TKA is not warranted. PMID:26752739

  19. Acetabular blood flow during total hip arthroplasty

    PubMed Central

    ElMaraghy, Amr W.; Schemitsch, Emil H.; Waddell, James P.

    2000-01-01

    Objective To determine the immediate effect of reaming and insertion of the acetabular component with and without cement on periacetabular blood flow during primary total hip arthroplasty (THA). Design A clinical experimental study. Setting A tertiary referral and teaching hospital in Toronto. Patients Sixteen patients (9 men, 7 women) ranging in age from 30 to 78 years and suffering from arthritis. Intervention Elective primary THA with a cemented (8 patients) and noncemented (8 patients) acetabular component. All procedures were done by a single surgeon who used a posterior approach. Main outcome measure Acetabular bone blood-flow measurements made with a laser Doppler flowmeter before reaming, after reaming and after insertion of the acetabular prosthesis. Results Acetabular blood flow after prosthesis insertion was decreased by 52% in the noncemented group (p < 0.001) and 59% in the cemented group (p < 0.001) compared with baseline (prereaming) values. Conclusion The significance of these changes in periacetabular bone blood flow during THA may relate to the extent of bony ingrowth, periprosthetic remodelling and ultimately the incidence of implant failure because of aseptic loosening. PMID:10851413

  20. Pneumatic compression hemodynamics in total hip arthroplasty.

    PubMed

    Westrich, G H; Specht, L M; Sharrock, N E; Sculco, T P; Salvati, E A; Pellicci, P M; Trombley, J F; Peterson, M

    2000-03-01

    A crossover study was performed to evaluate the effect of several pneumatic compression devices and active dorsoplantar flexion in 10 patients who underwent total hip arthroplasty. Using the Acuson 128XP/10 duplex ultrasound unit with a 5-MHz linear array probe, peak venous velocity and venous volume were assessed above and below the greater saphenous vein and common femoral vein junction. A computer generated randomization table was used to determine the order of the test conditions. The pneumatic compression devices evaluated included two foot pumps, one foot and calf pump, one calf pump, and three calf and thigh pumps. Statistical analyses included analysis of variance and analysis of variance with covariance between devices and patients. The covariates tested were the baseline measurements and the order in which the devices were tested. Differences between devices relate in part to the frequency and rate of inflation and the location and type of compression. Pulsatile calf and foot and calf pneumatic compression with a rapid inflation time produced the greatest increase in peak venous velocity, whereas compression of the calf and thigh showed the greatest increase in venous volume. Because patient and nursing compliance is essential to the success of mechanical prophylaxis for thromboembolic disease, the more simple, yet efficacious, devices that are easier to apply and less cumbersome appear to have a greater likelihood of success. In the active and alert patient, active dorsoplantar flexion should be encouraged.

  1. Definitive Treatment of Infected Shoulder Arthroplasty With a Cement Spacer.

    PubMed

    Mahure, Siddharth A; Mollon, Brent; Yu, Stephen; Kwon, Young W; Zuckerman, Joseph D

    2016-09-01

    Infection in the setting of shoulder arthroplasty can result in significant pain, loss of function, and the need for additional surgery. As the use of shoulder arthroplasty increases, the medical and economic burdens of periprosthetic joint infection increase as well. The ideal management of infected shoulder prostheses has not been established. This report describes 9 patients from a single institution who had an infected shoulder arthroplasty that was definitively managed with a cement spacer. All patients had a minimum of 2 years of follow-up. Of the 9 patients in this study, 6 were men. Mean age was 73±9 years. Of the study patients, 1 had diabetes, 2 presented with Parkinson's disease, and 5 had a history of tobacco use. Average body mass index was 27.9±7 kg/m(2). After mean follow-up of 4 years, none of the patients had clinical or radiographic evidence of infection. Functional outcomes, as measured by American Shoulder and Elbow Surgeons scores, were good or fair in 89% of patients, and the average American Shoulder and Elbow Surgeons score was 57. A review of recent literature suggested that the current findings were similar to those in studies reporting 1- or 2-stage revision procedures. Although cement spacers are typically used as part of a 2-stage revision procedure, the current findings suggest that cement spacers can be used effectively to eradicate infection and allow for acceptable functional recovery and range of motion in patients who have severe medical comorbidities and cannot tolerate additional surgery. [Orthopedics. 2016; 39(5):e924-e930.].

  2. Overcoming boundaries of worldwide joint arthroplasty registers: the European Arthroplasty Register minimal dataset.

    PubMed

    Sadoghi, Patrick; Leithner, Andreas; Labek, Gerold

    2013-09-01

    Worldwide joint arthroplasty registers are instrumental to screen for complications or implant failures. In order to achieve comparable results a similar classification dataset is essential. The authors therefore present the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) European Arthroplasty Register (EAR) minimal dataset for primary and revision joint arthroplasty. Main parameters include the following: date of operation, country, hospital ID-code, patient's name and prename, birthday, identification code of the implant, gender, diagnosis, preoperations, type of prosthesis (partial, total), side, cementation technique, use of antibiotics in the cement, surgical approach, and others specifically related to the affected joint. The authors believe that using this minimal dataset will improve the chance for a worldwide comparison of arthroplasty registers and ask future countries for implementation.

  3. PERIPROSTHETIC FRACTURES IN TOTAL KNEE ARTHROPLASTY

    PubMed Central

    de Alencar, Paulo Gilberto Cimbalista; De Bortoli, Giovani; Ventura Vieira, Inácio Facó; Uliana, Christiano Saliba

    2015-01-01

    The increasing number of total knee arthroplasties, in combination with the population's longer life expectancy, has led to a greater number of long-term complications. These add to the poor bone quality of elderly patients and often culminate in periprosthetic fractures. This complex orthopedic problem has a great diversity of clinical presentation. It may affect any of the bones in the knee and, because of the difficulty in finding solutions, may lead to disastrous outcomes. Its treatment requires that orthopedists should have broad knowledge both of arthroplasty techniques and of osteosynthesis, as well as an elaborate therapeutic arsenal including, for example, access to a bone bank. PMID:27022546

  4. Total Elbow Arthroplasty for Distal Humerus Fractures.

    PubMed

    Harmer, Luke S; Sanchez-Sotelo, Joaquin

    2015-11-01

    Total elbow arthroplasty is a good treatment alternative for selected patients with distal humerus fractures. Its attractiveness is related to several factors, including the possibility of performing the procedure; leaving the extensor mechanism intact; faster, easier rehabilitation compared with internal fixation; and overall good outcomes reported in terms of both pain relief and function. Implant failure leading to revision surgery does happen, and patients must comply with certain limitations to extend the longevity of their implant. Development of high-performance implants may allow expanding the indications of elbow arthroplasty for fractures.

  5. Gap balancing in total knee arthroplasty.

    PubMed

    Bottros, John; Gad, Bishoy; Krebs, Viktor; Barsoum, Wael K

    2006-06-01

    It is well known that the success of total knee arthroplasty is collectively dependent on the proper recreation of the joint line, appropriate soft tissue balancing, and respectful management of the extensor mechanism. One of the most decisive factors within the surgeon's control is the reestablishment of proper knee kinematics through both medial-lateral and flexion-extension ligamentous balancing. This can be accomplished only by a comprehensive intraoperative evaluation in full flexion, mid flexion, and full extension to minimize potential gap mismatches. Most of the discussion will focus on this aspect of soft tissue balancing, but this does not undermine the importance of the other aforementioned principles of successful knee arthroplasty.

  6. Biomechanics of reverse total shoulder arthroplasty.

    PubMed

    Berliner, Jonathan L; Regalado-Magdos, Ashton; Ma, C Benjamin; Feeley, Brian T

    2015-01-01

    Reverse total shoulder arthroplasty is an effective procedure for treatment of glenohumeral joint disease among patients with severe rotator cuff deficiency. Improvements in prosthetic design are the result of an evolved understanding of both shoulder and joint replacement biomechanics. Although modern generations of the reverse shoulder prosthesis vary in specific design details, they continue to adhere to Grammont's core principles demonstrated by his original Delta III prosthesis. This review article discusses the biomechanics of reverse total shoulder arthroplasty with a focus on elements of implant design and surgical technique that may affect stability, postoperative complications, and functional outcomes.

  7. Proprioception and Knee Arthroplasty: A Literature Review.

    PubMed

    Wodowski, Andrew J; Swigler, Colin W; Liu, Hongchao; Nord, Keith M; Toy, Patrick C; Mihalko, William M

    2016-04-01

    Proprioceptive mechanoreceptors provide neural feedback for position in space and are critical for three-dimensional interaction. Proprioception is decreased with osteoarthritis of the knees, which leads to increased risk of falling. As the prevalence of osteoarthritis increases so does the need for total knee arthroplasty (TKA), and knowing the effect of TKA on proprioception is essential. This article reviews the literature regarding proprioception and its relationship to balance, aging, osteoarthritis, and the effect of TKA on proprioception. Knee arthroplasty involving retention of the cruciate ligaments is also reviewed, as well the evidence of proprioception in the posterior cruciate ligament after TKA.

  8. Identification and preliminary SAR studies of (+)-Geodin as a glucose uptake stimulator for rat adipocytes.

    PubMed

    Sato, Seiichi; Okusa, Noriyuki; Ogawa, Akiyo; Ikenoue, Takao; Seki, Tetsuya; Tsuji, Takashi

    2005-09-01

    (+)-Geodin (1) was isolated from Penicillium glabrum AJ117540 with activity that stimulates glucose uptake by rat adipocytes. Unlike insulin it is active in the presence of wortmannin. Dihydrogeodin (2) and sulochrin (3) which are the precursors of (+)-geodin biosynthesis were also isolated from the same fungus. Preliminary SAR studies of 1 showed some analogues had enhanced activity. Especially, the activities of racemic geodin and dibromo analogue (7a) were comparable to that of the natural product. Geodin (1), a known fungal metabolite, was isolated from Penicillium glabrum AJ117540 as an active substance (Fig. 1). Dihydrogeodin (2) and sulochrin (3), the precursors of 1, were also isolated from the same fungal extract. In this study, preliminary mechanistic insight and SAR are reported.

  9. Manual lymph drainage attenuates frontal EEG asymmetry in subjects with psychological stress: a preliminary study.

    PubMed

    Shim, Jung-Myo; Kim, Sung-Joong

    2014-04-01

    [Purpose] The purpose of this preliminary study was to investigate the effect of manual lymph drainage (MLD) of the neck on frontal electroencephalogram (EEG) asymmetry in subjects with psychological stress. [Subjects] Thirteen subjects with psychological stress participated in the study. [Methods] Subjects received MLD of the neck for 15 min. [Results] Analysis of the frontal asymmetry index showed that the energy shift in the alpha frequency band from the left hemisphere to the right hemisphere after MLD resulted in greater left-side activation (positive asymmetry values), which could be related to the positive emotional state observed particularly in the F7-F8 area. [Conclusion] These preliminary findings suggest that frontal EEG asymmetry was significantly attenuated after MLD.

  10. Resection arthroplasty of the hip in paralytic dislocations.

    PubMed

    Kalen, V; Gamble, J G

    1984-06-01

    The chronically dislocated paralytic hip causes postural difficulties, nursing and hygiene problems, and pain. Therapeutic options are limited. This study reviews the results of resection arthroplasty on 18 hips of 15 such patients. This procedure has many complications, including hip ankylosis, heterotopic ossification, abduction contracture and bony overgrowth. Despite this, all of the nursing goals were achieved and most patients had relief of pain. The operation is most successful in the skeletally mature patients, and it relies on soft-tissue interposition between the bony fragments and postoperative positioning to ensure optimum posture.

  11. PAIN FOLLOWING TOTAL KNEE ARTHROPLASTY – A SYSTEMATIC APPROACH

    PubMed Central

    Alves, Wilson Mello; Migon, Eduardo Zaniol; Zabeu, Jose Luis Amim

    2015-01-01

    Total knee arthroplasty (TKA) is known to be a successful procedure. The aging of the population and the growing demand for quality of life have greatly increased the indications for the procedure. Nonetheless, TKA presents some complications that still lack definitive resolution. Pain after TKA is caused by a myriad of reasons that need to be systematically studied in order to reach the correct diagnosis and treatment. History, physical examination, laboratory tests and imaging examinations must all be included in the workup and repeated until a plausible reason has been identified, since if pain is the only indication for TKA revision, the results may be catastrophic. PMID:27022583

  12. Medialized Versus Lateralized Center of Rotation in Reverse Shoulder Arthroplasty.

    PubMed

    Streit, Jonathan J; Shishani, Yousef; Gobezie, Reuben

    2015-12-01

    Reverse shoulder arthroplasty may be performed using components that medialize or lateralize the center of rotation. The purpose of this prospective study was to directly compare 2 reverse shoulder arthroplasty designs. Two treatment groups and 1 control group were identified. Group I comprised 9 patients using a medialized Grammont-style (GRM) prosthesis with a neck-shaft angle of 155°. Group II comprised 9 patients using a lateralized (LAT) prosthesis with a neck-shaft angle of 135°. Pre- and postoperative assessment of range of motion, American Shoulder and Elbow Surgeons score, and visual analog scale pain score were performed. Radiographic measurements of lateral humeral offset and acromiohumeral distance were compared. The GRM prosthesis achieved greater forward flexion (143.9° vs 115.6°; P=.05), whereas the LAT achieved greater external rotation (35.0° vs 28.3°; P=.07). The lateral humeral offset was greater for the LAT prosthesis compared with the GRM prosthesis, but this distance was not significantly different from that found in the control group. The acromiohumeral distance was significantly greater in the GRM prosthesis group compared with both the LAT and the control groups. The results of this study confirm that different reverse shoulder arthroplasty designs produce radiographically different anatomy. Whereas the GRM prosthesis significantly alters the anatomy of the shoulder, the LAT design can preserve some anatomic relationships found in the normal shoulder. The clinical outcomes indicate that this may have an effect on range of motion, with traditional designs achieving greater forward flexion and lateralized designs achieving greater external rotation.

  13. Should a Patients BMI Status be Used to Restrict Access to Total Hip and Knee Arthroplasty? Functional Outcomes of Arthroplasty Relative to BMI - Single Centre Retrospective Review

    PubMed Central

    Lash, H.; Hooper, G.; Hooper, N.; Frampton, C.

    2013-01-01

    We reviewed the experience of a dedicated orthopaedic elective service to determine whether we could establish a BMI group where arthroplasty was no longer effective as assessed by the patient’s functional outcome. This was a prospective observational study with retrospective analysis of data collected on 1439 total hip arthroplasty, 934 total knee arthroplasty and 326 unicompartment knee arthroplasty patients. Functional scores (WOMAC, Oxford hip and knee scores and HAAS) were obtained preoperatively and at 12 months post op. Patients had their BMI recorded at the preoperative assessment and were divided into BMI groups (BMI<25, BMI 25-30, BMI 30-35 and BMI > 35). Patients with a BMI of ≤ 30 had significantly better functional scores at 12 months post op compared to those with a BMI of > 35. The absolute gain in functional scores from pre op to 12 months post op did not differ significantly between BMI groups, the only significant difference we found for absolute gain showed patients with a BMI of > 35 have a greater increase in HAAS scores following total hip arthroplasty compared to patients with a BMI of 30 or less (p = 0.0435). Our patients with higher BMI’s had worse preoperative and post operative functional scores but their benefit from surgery measured by the change in functional scores showed no difference compared to patients with lower BMI. We could find no reason on the basis of the 12-month results to limit surgery to obese patients because of an expected poorer functional outcome. PMID:24155808

  14. Kinetic Studies on Photodeposition of Polydiacetylene Thin Film from Solution: Preliminary Determination of the Rate Law

    NASA Technical Reports Server (NTRS)

    Paley, M. S.; Armstrong, S.; Witherow, W. K.; Frazier, D. O.

    1996-01-01

    Preliminary kinetic studies were undertaken on the photodeposition of thin films of a polydiacetylene derivative of 2-methyl-4-nitroaniline from monomer solutions onto quartz substrates. Solutions of the monomer, DAMNA, in 1,2-dichloroethane at various concentrations were irradiated at 364 nm using an argon-ion laser at several intensities. It was found that the rate of polydiacetylene (PDAMNA) film photodeposition varies linearly with UV light intensity and as the square root of monomer concentration.

  15. Relationship between Improvements in Physical Measures and Patient Satisfaction in Rehabilitation after Total Knee Arthroplasty

    ERIC Educational Resources Information Center

    Nazzal, Mahmoud I.; Bashaireh, Khaldoon H.; Alomari, Mahmoud A.; Nazzal, Mohammad S.; Maayah, Mikhled F.; Mesmar, Mohammad

    2012-01-01

    The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per…

  16. Lower Limbs Function and Pain Relationships after Unilateral Total Knee Arthroplasty

    ERIC Educational Resources Information Center

    Tali, Maie; Maaroos, Jaak

    2010-01-01

    The aim of the study was to evaluate gait characteristics, lower limbs joint function, and pain relationships associated with knee osteoarthritis of female patients before and 3 months after total knee arthroplasty at an outpatient clinic rehabilitation department. Gait parameters were registered, the active range of lower extremity joints was…

  17. Gelatin matrix use reduces postoperative bleeding after total knee arthroplasty.

    PubMed

    Velyvis, John H

    2015-02-01

    Bleeding after total knee arthroplasty can result in significant morbidity and increases the need for blood transfusion. The proper use of intraoperative adjunctive topical hemostatic agents can enhance hemostasis perioperatively, potentially reducing blood transfusions. In this prospective study, 157 consecutive patients undergoing primary total knee arthroplasty received FLOSEAL (FLOSEAL Hemostatic Matrix; Baxter Healthcare Corporation, Hayward, California), a gelatin thrombin hemostatic matrix, 5 mL (74 patients) or 10 mL (83 patients). All patients received warfarin as thromboprophylaxis starting the day after surgery. Data were extracted via hospital chart review from 100 consecutive patients who underwent total knee arthroplasty and immediately preceded the FLOSEAL groups and did not receive FLOSEAL (control group). Postoperative drainage was significantly lower in the FLOSEAL 5 mL (236.9 mL) and 10 mL (120.5 mL) groups compared with the control group (430.8 mL; P<.0001 for both). The FLOSEAL 10 mL group had significantly less drainage than the FLOSEAL 5 mL group (P<.0001). The predicted probability of transfusion in the FLOSEAL 5 mL group was not significantly different compared with the control group (6.0% vs 7.6%, P=.650). The predicted probability of transfusion was lower in the FLOSEAL 10 mL group compared with the control group (0.5% vs 5.5%; P=.004). Within the FLOSEAL 10 mL group, application of FLOSEAL either before or after tourniquet release had a similarly significant effect on drainage volume and predicted probability of blood transfusion. No differences in outcomes were observed by type of anesthesia used. No adverse events occurred related to FLOSEAL use.

  18. Compartment syndrome after total knee arthroplasty: regarding a clinical case☆

    PubMed Central

    Pinheiro, Ana Alexandra da Costa; Marques, Pedro Miguel Dantas Costa; Sá, Pedro Miguel Gomes; Oliveira, Carolina Fernandes; da Silva, Bruno Pombo Ferreira; de Sousa, Cristina Maria Varino

    2015-01-01

    Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury. PMID:26401507

  19. Compartment syndrome after total knee arthroplasty: regarding a clinical case.

    PubMed

    Pinheiro, Ana Alexandra da Costa; Marques, Pedro Miguel Dantas Costa; Sá, Pedro Miguel Gomes; Oliveira, Carolina Fernandes; da Silva, Bruno Pombo Ferreira; de Sousa, Cristina Maria Varino

    2015-01-01

    Although compartment syndrome is a rare complication of total knee arthroplasty, it is one of the most devastating complications. It is defined as a situation of increased pressure within a closed osteofascial space that impairs the circulation and the functioning of the tissues inside this space, thereby leading to ischemia and tissue dysfunction. Here, a clinical case of a patient who was followed up in orthopedic outpatient consultations due to right gonarthrosis is presented. The patient had a history of arthroscopic meniscectomy and presented knee flexion of 10° before the operation, which consisted of total arthroplasty of the right knee. The operation seemed to be free from intercurrences, but the patient evolved with compartment syndrome of the ipsilateral leg after the operation. Since compartment syndrome is a true surgical emergency, early recognition and treatment of this condition through fasciotomy is crucial in order to avoid amputation, limb dysfunction, kidney failure and death. However, it may be difficult to make the diagnosis and cases may not be recognized if the cause of compartment syndrome is unusual or if the patient is under epidural analgesia and/or peripheral nerve block, which thus camouflages the main warning sign, i.e. disproportional pain. In addition, edema of the limb that underwent the intervention is common after total knee arthroplasty operations. This study presents a review of the literature and signals that the possible rarity of cases is probably due to failure to recognize this condition in a timely manner and to placing these patients in other diagnostic groups that are less likely, such as neuropraxia caused by using a tourniquet or peripheral nerve injury.

  20. Outcome Assessment after Aptis Distal Radioulnar Joint (DRUJ) Implant Arthroplasty

    PubMed Central

    Kachooei, Amir Reza; Chase, Samantha M; Jupiter, Jesse B

    2014-01-01

    Background: Conventional treatments after complicated injuries of the distal radioulnar joint (DRUJ) such as Darrach and Kapandji-Sauvé procedures have many drawbacks, which may eventually lead to a painful unstable distal ulna. The development of DRUJ prosthesis has significantly evolved over the past years. In this study, we assessed the outcome results of patients after DRUJ implant arthroplasty using the Aptis (Scheker) prosthesis. Methods: We identified 13 patients with 14 prosthesis during the past 10 years. Patients underwent DRUJ arthroplasty due to persistent symptoms of instability, chronic pain, and stiffness. Records and follow-up visits were reviewed to find the final post-operative symptoms, pain, range of motion, and grip strength with a mean follow-up of 12 months (range: 2-25 months). Also, patients were contacted prospectively by phone in order to administer the disabilities of the arm shoulder and hand (DASH), patient rated wrist evaluation (PRWE), and visual analogue scale (VAS), and to interview regarding satisfaction and progress in daily activities. Eleven patients out of 13 could be reached with a median follow-up time of 60 months (range: 2 to 102 months). Results: No patient required removal of the prosthesis. Only two patients underwent secondary surgeries in which both required debridement of the screw tip over the radius. The median DASH score, PRWE score, VAS, and satisfaction were 1.3, 2.5, 0, and 10, respectively. The mean range of flexion, extension, supination, and pronation was 62, 54, 51, and 64, respectively. Conclusions: Distal radioulnar joint injuries are disabling and patients usually undergo one or more salvage surgeries prior to receiving an arthroplasty. The Scheker prosthesis has shown satisfactory results with 100% survival rate in all reports. The constrained design of this prosthesis gives enough stability to prevent painful subluxation. PMID:25386579