What Are Normal Metal Ion Levels After Total Hip Arthroplasty? A Serologic Analysis of Four Bearing Surfaces.

Background: The recent experiences with adverse local tissue reactions have highlighted the need to establish what are normal serum levels of cobalt (Co), chromium (Cr), and titanium (Ti) after hip arthroplasty.

Methods: Serum Co, Cr, and Ti levels were measured in 80 nonconsecutive patients with well-functioning unilateral total hip arthroplasty and compared among 4 bearing surfaces: ceramic-on-ceramic (CoC); ceramic-on-polyethylene (CoP); metal-on-polyethylene (MoP), and dual mobility (DM). The preoperative and most recent University of California, Los Angeles (UCLA) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were compared among the different bearing surfaces.

Short-Term Outcomes and Complications After Rejuvenate Modular Total Hip Arthroplasty Revision.

Background: The early short-term outcomes and complications after revision of the recalled Rejuvenate modular neck hip arthroplasty have not been previously reported. This study's purpose is to describe the early outcomes and complications after revision of the Rejuvenate modular femoral neck.

Methods: A retrospective cohort included 92 patients with 92 Rejuvenate modular neck total hip arthroplasty (THA) who underwent revision surgery between July 2011 and April 2014.

A Novel Assessment of Braking Reaction Time Following THA Using a New Fully Interactive Driving Simulator.

Background: After total hip replacement surgery, patients are eager to resume the activities of daily life, particularly driving. Most surgeons recommend waiting 6 weeks after surgery to resume driving; however, there is no evidence to indicate that patients cannot resume driving earlier.

Questions/purposes: Our purpose was to evaluate when in the recovery period following THA that patients regain or improve upon their preoperative braking reaction time, allowing them to safely resume driving.

Two Year Clinical Outcomes of Total Hip Arthroplasty Are Not Dependent on Femoral Head Composition.

Background: Assessment of clinical outcomes and patient quality of life after total hip arthroplasty continues to grow in importance with the focus on how bearing surfaces affect long-term survival, wear, and cost. Further, as quality measures have become incorporated into reimbursement, there is a need to quantify factors which may influence these outcomes. Currently, there is a paucity of literature regarding the effects of the femoral head composition on clinical outcomes or quality of life.

Short-Term Metal Ion Trends Following Removal of Recalled Modular Neck Femoral Stems.

Elevated serum metal ions have been well documented with the Rejuvenate modular neck femoral stem (Stryker, Mahwah, NJ); however, the rate at which ion levels decline following revision is less clear. This study included fifty-nine consecutive revisions of Rejuvenate stems for symptomatic ALTR. Blood tests prior to revision and postoperatively at 6weeks, 3months, 6months, and 1year measured serum cobalt and chromium concentrations, ESR, and CRP.

Revision total hip arthroplasty with modular femoral stems.

As the rate of revision total hip arthroplasty (THA) rises, attention must be paid to potential complications relating to bone loss, soft tissue deficiencies, and loss of tissue planes. Using modular femoral stems in revision surgery allows for varying amounts of bone loss in the proximal and distal femur while letting the surgeon adjust rotation, leg length, and offset. We retrospectively reviewed 125 patients that underwent revision THA with a modular femoral component system and had minimum 2 year follow-up.

Epigenesis in acute myeloid leukemia: an update.

Acute myeloid leukemia (AML) is a hematological malignancy characterized by uncontrolled proliferation of clonal neoplastic hematopoietic precursor cells leading to the disruption of normal hematopoiesis and bone marrow failure. While about 45% of AML cases show a normal karyotype with mutations detectable only at the molecular level, 55% display chromosomal rearrangements including deletions, insertions, segmental and complete monosomy/trisomy, and gene fusions created by translocations. However, AML is not induced by cytogenetic abnormalities and gene mutations alone: the current body of literature implicates abnormal epigenetics-specifically, abnormal levels of DNA methylation, chemical modification of histones, and non-coding RNA expression-in the flawed regulation of the fundamental genes of hematopoiesis.

A Chronic Myelogenous Leukemia (CML) Case with a Cryptic Insertion of the ABL1 Gene of Chromosome 9 into 22 Resulting in a Fusion Signal on the Derivative 22: 46,XY.ish ins(22;9)(q11.2;q34q34)BCR+,ABL1.

Chronic myelogenous leukemia (CML) is characterized by the specific cytogenetic translocation t(9;22)(q34;q11.2), also called the Philadelphia (Ph) chromosome. We present a case of a cryptic BCR/ABL1 fusion, which was not originally detected by standard karyotyping.