Migration and clinical outcomes of a novel cementless hydroxyapatite-coated titanium acetabular shell: two-year follow-up of a randomized controlled trial using radiostereometric analysis.

Aims: The objective of this study was to compare the two-year migration and clinical outcomes of a new cementless hydroxyapatite (HA)-coated titanium acetabular shell with its previous version, which shared the same geometrical design but a different manufacturing process for applying the titanium surface.

Methods: Overall, 87 patients undergoing total hip arthroplasty (THA) were randomized to either a Trident II HA or Trident HA shell, each cementless with clusterholes and HA-coating. All components were used in combination with a cemented Exeter V40 femoral stem.

Strategic complements: Poverty-targeted subsidy programs show additive benefits on household toilet purchases in rural Cambodia when coupled with sanitation marketing.

While poverty-targeted subsidies have shown promise as a means of reducing financial constraints on low-income populations to invest in new latrines, concerns have been raised about whether they may reduce demand for new latrines among non-eligible, non-poor populations, especially in geographically limited or closed markets. Using quasi experimental methods, we investigate the interaction effects of the "CHOBA" subsidy, a partial poverty-targeted monetary incentive to build a toilet, and a sanitation marketing program (SanMark) on new latrine uptake among households from different income segments in 110 rural villages across six Cambodian provinces. These programs were implemented either jointly with or independently.

Globe Browsing: Contextualized Spatio-Temporal Planetary Surface Visualization.

Results of planetary mapping are often shared openly for use in scientific research and mission planning. In its raw format, however, the data is not accessible to non-experts due to the difficulty in grasping the context and the intricate acquisition process. We present work on tailoring and integration of multiple data processing and visualization methods to interactively contextualize geospatial surface data of celestial bodies for use in science communication.

Total intravenous general anaesthesia vs. spinal anaesthesia for total hip arthroplasty: a randomised, controlled trial.

Background: The choice of anaesthetic technique for patients undergoing joint arthroplasty is debatable. The hypothesis of this study was that general anaesthesia would generate a more favourable recovery profile than spinal anaesthesia.

Methods: We randomly allocated 120 patients to either intrathecal bupivacaine or general anaesthesia with target-controlled infusion of remifentanil and propofol.

Does a new knee design perform as well as the design it replaces?

Objectives: The objective of this study was to compare the early migration characteristics and functional outcome of the Triathlon cemented knee prosthesis with its predecessor, the Duracon cemented knee prosthesis (both Stryker).

Methods: A total 60 patients were prospectively randomised and tibial component migration was measured by radiostereometric analysis (RSA) at three months, one year and two years; clinical outcome was measured by the American Knee Society score and the Knee Osteoarthritis and Injury Outcome Score.

Results: There were no statistically significant differences in rotation or translation around or along the three coordinal axes, or in the maximum total point motion (MTPM) during the two-year follow-up.

State-of-the-art of visualization in post-mortem imaging.

Autopsies constitute a valuable feedback to the healthcare chain to achieve improvements in quality of care and cost effectiveness. This review describes post-mortem imaging, which has emerged as an important part of the pathology toolbox. A broad range of visualization aspects within post-mortem imaging are covered.

Efficient visibility encoding for dynamic illumination in direct volume rendering.

We present an algorithm that enables real-time dynamic shading in direct volume rendering using general lighting, including directional lights, point lights, and environment maps. Real-time performance is achieved by encoding local and global volumetric visibility using spherical harmonic (SH) basis functions stored in an efficient multiresolution grid over the extent of the volume. Our method enables high-frequency shadows in the spatial domain, but is limited to a low-frequency approximation of visibility and illumination in the angular domain.

Spatial conditioning of transfer functions using local material distributions.

In many applications of Direct Volume Rendering (DVR) the importance of a certain material or feature is highly dependent on its relative spatial location. For instance, in the medical diagnostic procedure, the patient's symptoms often lead to specification of features, tissues and organs of particular interest. One such example is pockets of gas which, if found inside the body at abnormal locations, are a crucial part of a diagnostic visualization.

Advancing the state-of-the-art for Virtual Autopsies--initial forensic workflow study.

There are numerous advantages described of how imaging technology can support forensic examinations. However, postmortem examinations of bodies are mainly performed to address demands which differ from those of traditional clinical image processing. This needs to be kept in mind when gathering information from image data sets for forensic purposes.

Local ambient occlusion in direct volume rendering.

This paper presents a novel technique to efficiently compute illumination for Direct Volume Rendering using a local approximation of ambient occlusion to integrate the intensity of incident light for each voxel. An advantage with this local approach is that fully shadowed regions are avoided, a desirable feature in many applications of volume rendering such as medical visualization. Additional transfer function interactions are also presented, for instance, to highlight specific structures with luminous tissue effects and create an improved context for semitransparent tissues with a separate absorption control for the illumination settings.

Uncertainty visualization in medical volume rendering using probabilistic animation.

Direct Volume Rendering has proved to be an effective visualization method for medical data sets and has reached wide-spread clinical use. The diagnostic exploration, in essence, corresponds to a tissue classification task, which is often complex and time-consuming. Moreover, a major problem is the lack of information on the uncertainty of the classification, which can have dramatic consequences for the diagnosis.

Full body virtual autopsies using a state-of-the-art volume rendering pipeline.

This paper presents a procedure for virtual autopsies based on interactive 3D visualizations of large scale, high resolution data from CT-scans of human cadavers. The procedure is described using examples from forensic medicine and the added value and future potential of virtual autopsies is shown from a medical and forensic perspective. Based on the technical demands of the procedure state-of-the-art volume rendering techniques are applied and refined to enable real-time, full body virtual autopsies involving gigabyte sized data on standard GPUs.

Local histograms for design of transfer functions in direct volume rendering.

Direct Volume Rendering (DVR) is of increasing diagnostic value in the analysis of data sets captured using the latest medical imaging modalities. The deployment of DVR in everyday clinical work, however, has so far been limited. One contributing factor is that current Transfer Function (TF) models can encode only a small fraction of the user's domain knowledge.

Interposition arthroplasty of the elbow with rheumatoid arthritis.

Radiographic bone loss and clinical outcome were evaluated at a median of 6 years after interposition arthroplasty was performed in 35 elbows with rheumatoid arthritis. Seven early postoperative complications, two major and five minor, occurred. Three elbows subsequently required total elbow replacement.

Short-term complications of the lateral approach for non-constrained elbow replacement. Follow-up of 50 rheumatoid elbows.

We reviewed 50 capitellocondylar elbow replacements performed by the lateral approach in 42 rheumatoid patients, at a median follow-up of three years. There were two major and 17 minor complications; 18 were early and one was late. Eight elbows required reoperation: soft-tissue surgery was performed in seven and prosthesis removal in one because of a deep infection.

Intraoperative monitoring of ulnar nerve function during replacement of the rheumatoid elbow via the lateral approach.

Neurography of the ulnar nerve was performed pre-, intra- and postoperatively in 8 arms of 7 patients with rheumatoid arthritis operated on with total elbow replacement via the lateral approach. Ulnar nerve decompression was performed in 4 elbows before implantation. A reduction in the amplitude of compound muscle action potential (CMAP) recorded from the abductor digiti minimi on stimulation of the ulnar nerve in the axilla, was observed during elbow dislocation at surgery in all patients, in 5 cases transiently and in 3 cases until the end of surgery.

Wound healing after total elbow replacement in rheumatoid arthritis. Wound complications in 50 cases and laser-Doppler imaging of skin microcirculation.

Wound healing complications, predisposing to deep infection, are common following prosthetic surgery of the elbow. 50 capitellocondylar elbow prostheses were inserted, using a lateral approach, in 42 patients with rheumatoid arthritis. The first 5 elbows were immobilized postoperatively for 5 days and the following 45 elbows for 12 days, because of delayed wound healing in 2 of the first 5 elbows.

Comparison of talonavicular dowel arthrodesis utilizing autogenous bone versus defatted bank bone.

A simple dowel arthrodesis of the talonavicular joint in an early stage of destruction can reduce pain and prevent the development of valgus deformity in the rheumatoid hindfoot. Previously, we used autogenous dowels made from the iliac crest. In order to facilitate the operation and to get a better fitting dowel, we tried defatted cancellous allograft dowels from which marrow tissue had been removed.

Talonavicular arthrodesis in the rheumatoid foot.

Arthrodesis of the talonavicular joint with a cylindrical dowel was performed in 19 feet in 17 rheumatoid patients with arthritic destruction of the talonavicular joint, but without fixed hindfoot deformity. Osseous union was achieved in 12 feet, but all patients experienced pain relief and no foot showed progressive valgus deformity of the hindfoot during follow-up. Staple fixation seemed to promote osseous union.

Fracture of the tibial tray of the PCA knee. A case report of early failure caused by improper design.

Knee prostheses with metal backing of the polyethylene tibial component are nowadays used almost universally. Eight cases of fracture of the metal tray are reported in the literature. We present a case in which the failure could be expected because of improper design of the tibial tray.

Failure of the Wadsworth elbow. Nineteen cases of rheumatoid arthritis followed for 5 years.

Nineteen Wadsworth elbow prostheses were inserted in 15 patients with rheumatoid arthritis during the 4 years 1979-1982. The patients were followed prospectively for an average of 5.7 years.

Hip socket wear due to component mismatch. A case report.

A total hip replacement with loosening of the femoral component was revised. The original femoral component with a 35-mm head was exchanged for one with a 32-mm head. The mismatch caused extensive wear of the acetabular component.

Nerve lesions after total hip replacement.

In a prospective study 50 extremities in 46 patients with total hip replacement (THR) were examined clinically and with EMG preoperatively and 4 weeks postoperatively. Four patients with normal preoperative findings had electromyographical evidence of nerve lesions postoperatively and three of these had clinical symptoms; one patient had no clinical symptoms. Ten patients with normal pre- and postoperative findings were re-examined 1 year after the operation and still found to be normal.

Pre-operative and postoperative scintimetry after femoral neck fracture.

In 22 patients with femoral neck fractures 99mTc-MDP scintimetry was performed before operation and again shortly after operation; in 17 of these patients the investigation was repeated after four months. Six patients with increased uptake in the femoral head before operation and eight with decreased uptake had similar results at the first postoperative investigation. Of eight patients with an intermediate uptake before operation, two showed increased and six decreased femoral head uptake after operation.