The impact of femoral bone quality on cementless total hip pre-operative templating.

Introduction: Accurate templating is an integral part of pre-operative planning for total hip arthroplasty (THA). Templating of cementless implant accuracy has been average. The aim of this study was to assess the impact of Dorr femoral classification on the accuracy of pre-operative digital templating.

Total Knee Arthroplasty for Valgus Deformity via a Lateral Approach: Clinical Results, Comparison to Medial Approach, and Review of Recent Literature.

Background: Total knee arthroplasty (TKA) for valgus deformity is a challenge. The standard medial parapatellar approach may not be universally useful for this. We have adopted the lateral approach to valgus knees.

Informal (Hallway) medical consultation in orthopedics-is it as common as it seems?

Introduction: Informal (hallway) medical consultation is an integral part of the physician's work. As musculoskeletal complaints are very common, orthopedic surgeons stand in the frontline of this practice. Many of these consultations are poorly, if at all, documented, thus imposing a potential medical danger to the patient and a medicolegal danger to the surgeon.

A Practical Tool for Surveillance of Surgical-Site Infections: A 5-Year Experience in Orthopedic Surgeries.

Continuous surveillance of surgical-site infection (SSI) is labor intensive. We developed a semiautomatic surveillance system partly assisted by surgeons. Most patients who developed postdischarge SSI were readmitted, which allowed us to limit postdischarge surveillance to this group.

Long Term Results of Liner Polyethylene Cementation Technique in Revision for Peri-acetabular Osteolysis.

Patients with peri-acetabular osteolysis around a well fixed cementless acetabular component may be treated with liner exchange. When the locking mechanism is unreliable or unavailable, cementing the liner into the fixed acetabular component is a feasible option. The purpose of this study was to evaluate the clinical and radiographic long term results of this technique.

Improving compliance to osteoporosis workup and treatment in postmenopausal patients after a distal radius fracture.

Objective: Distal radius fracture (DRF) in postmenopausal women is often the first clinical sign of osteoporosis (OP). Despite the availability of effective treatments, only a minority of patients who sustain a fragility fracture are tested for OP. The purpose of this study was to examine whether a simple intervention by the hospital staff increases rates of OP workup.

Set7/9 impacts COL2A1 expression through binding and repression of SirT1 histone deacetylation.

Type II collagen is a key cartilaginous extracellular protein required for normal endochondral development and cartilage homeostasis. COL2A1 gene expression is positively regulated by the NAD-dependent protein deacetylase Sirtuin 1 (SirT1), through its ability to bind chromatin regions of the COL2A1 promoter and enhancer. Although SirT1/Sox9 binding on the enhancer site of COL2A1 was previously demonstrated, little is known about its functional role on the gene promoter site.

A simple intervention for improving the implementation rate of a recommended osteoporosis treatment after hip fracture.

Objective: Osteoporosis is often under-treated, and hip fracture is frequently its first manifestation. Hospitalization for a hip fracture is an opportunity to initiate osteoporosis treatment. The aim of this study was to investigate whether a simple intervention improves the implementation rate of a recommended osteoporosis treatment.

Balance is an important predictive factor for quality of life and function after primary total knee replacement.

We investigated the extent to which improved balance relative to pain relief correlates with the success of total knee replacement (TKR). A total of 81 patients were recruited to the study: 16 men (19.8%) and 65 women (80.

Polyethylene liner cementation technique in asymptomatic versus symptomatic osteolysis.

Osteolysis around a cementless acetabular component can lead to severe bone loss. This study examined whether osteolysis should be treated while still asymptomatic. Thirty-seven liner cementation revisions were performed in 34 patients.

Bipolar hip hemiarthroplasty in a patient with an above knee amputation: a case report.

The treatment of an above knee amputee who has sustained a fracture of femoral neck is a challenge for both the orthopaedic surgeon and the rehabilitation team. We present a case of such a patient and discuss different difficulties in his treatment.

Effect of severe aortic stenosis on the outcome in elderly patients undergoing repair of hip fracture.

Background: The perioperative assessment and management of elderly patients with hip fracture and significant aortic stenosis (AS) is an increasingly common clinical problem with little data available to guide perioperative management.

Objectives: It was the aim of this study to examine the incidence of perioperative events in an elderly population of patients with severe AS undergoing repair of hip fracture as compared with controls without severe AS.

Methods: Patients over the age of 70 with an echocardiographic diagnosis of severe AS defined as an aortic valve area View Article and Find Full Text PDF

A prospective, randomised study comparing the percutaneous compression plate and the compression hip screw for the treatment of intertrochanteric fractures of the hip.

Limited access surgery is thought to reduce post-operative morbidity and provide faster recovery of function. The percutaneous compression plate (PCCP) is a recently introduced device for the fixation of intertrochanteric fractures with minimal exposure. It has several potential mechanical advantages over the conventional compression hip screw (CHS).

A short plate compression screw with diagonal bolts--a biomechanical evaluation performed experimentally and by numerical computation.

Introduction: Decreasing the length of the side plate of the dynamic hip screw would theoretically allow a smaller surgical incision, a shorter surgical time, decreased operative blood loss and minimal periosteal stripping. A new design of a very short plate dynamic hip screw based on two diagonal screws has been developed. Our study compares the new design and the four-hole side plate in respect to mechanical properties and bio-mechanical outcomes utilizing the Finite Element Analysis method.

Sciatic nerve palsy due to hematoma after thrombolysis therapy for acute pulmonary embolism after total hip arthroplasty.

Sciatic nerve paralysis as a complication of bleeding due to hip surgery is a rare entity. The use of thrombolysis and full-dose heparin administration for the treatment of massive pulmonary embolism increase the risk for developing major bleeding. Prompt recognition and intervention in this condition are warranted.

Navigation-assisted minimally invasive two-incision total hip arthoplasty.

Flouroscopy-based navigation can increase accuracy in two-incision minimally invasive THA, a novel technique develop for promoting fast recovery.

Early diagnosis of occult hip fractures MRI versus CT scan.

Objective: We compared Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI) in diagnosis of a painful hip in elderly patients after trauma. We report on accuracy, efficiency and benefits.

Design: We assessed 13 patients, average age 73 years, after fall with plain X-rays showing no evidence of fracture.

Revision total knee arthroplasty.

Background: Revision total knee arthroplasties are performed with increasing frequency due to the increasing numbers of primary arthroplasties.

Objectives: To retrospectively analyze 71 patients who underwent 78 revision total knee arthroplasties during the years 1991 to 1999

Methods: We evaluated the revised knees using the Knee Society Clinical Rating System after an average follow-up period of 3 years and 9 months (2-10 years). The indications for revision included pain and instability, deep infection of the joint, complaints linked to the patella, or post-trauma to the operated knee.

Brucella prosthetic joint infection: a report of 3 cases and a review of the literature.

We report 3 cases of Brucella melitensis infection of prosthetic hips and knees, and we summarize data about 4 cases reported in the literature. Six of the 7 affected patients were men. The median duration from prosthesis implantation to the onset of symptoms was 38.

Avascular necrosis and related complications following healed osteoporotic intertrochanteric fractures.

Background: Femoral hip fractures are a common occurrence in the elderly. Of the various fracture patterns, intertrochanteric injuries have the lowest rate of complications. Case reports of ensuing subcapital fracture have all been linked to incorrect placement of fixation devices or to osteomyelitis, white cases of avascular necrosis have only been reported rarely in the literature and are considered to occur at the rare rate of 0.

Bell's palsy and herpes viruses: to (acyclo)vir or not to (acyclo)vir?

The majority of peripheral seventh cranial nerve palsy cases remain without an identified etiology and will eventually be diagnosed as idiopathic or Bell's palsy. Some features of this condition may be characteristic of a viral infection. Indeed, several herpes viruses have been implicated as potential causative pathogens.

Do axial dynamic fixators really produce axial dynamization?

The use of dynamic external fixators for the treatment of long bone fracture is widespread and well accepted. It is claimed that dynamization, i.e.

Preadmission screening of patients scheduled for hip and knee replacement: impact on length of stay.

Objective: An evaluation of the impact of a social work preadmission program on length of stay (LOS) of orthopedic patients undergoing elective total hip or total knee replacement surgeries (under diagnosis-related groups [DRGs]) at the Hadassah Ein-Kerem Hospital in Jerusalem is Israel.

Intervention: The social work interventions included preadmission psychosocial evaluation and preliminary discharge planning, coordination of nursing and physiotherapy evaluations, ensuring completion of all medical tests prior to admission, and additional psychosocial follow-up during hospitalization to carry out the original discharge plan or prepare alternatives.

Patients: The intervention patients were divided into two groups in order to see changes over time: May through December 1994 (n = 48), and January through December 1995 (n = 81).