Increased stability of short femoral stem through customized distribution of coefficient of friction in porous coating.

Stress shielding and aseptic loosening are complications of short stem total hip arthroplasty, which may lead to hardware failure. Stems with increased porosity toward the distal end were discovered to be effective in reducing stress shielding, however, there is a lack of research on optimized porous distribution in stem's coating. This study aimed to optimize the distribution of the coefficient of friction of a metaphyseal femoral stem, aiming for reducing stress shielding in the proximal area.

Intrapelvic Cup Migration Following Revision Total Hip Arthroplasty: A Case Report and Review of the Literature.

Intrapelvic acetabular cup migration is a rare but serious complication that can occur following either primary or revision total hip arthroplasty. Medial acetabular wall weakening is considered the main predisposing factor for acetabular protrusion. A thorough preoperative plan is essential to advocate proper pelvic anatomy reconstruction, including osteosynthesis of the pelvis, if necessary, preservation of muscle and bone stock, and selection of the right prosthetic components without damaging adjacent anatomical structures.

Fracture of femoral neck in modular total hip arthroplasty: a systematic review of the literature.

Background: Modular femoral stems have the advantage of anatomic hip reconstruction by restoring the femoral offset thus minimising the bearing surface wear, implant loosening and dislocation.

Aim: This study aims to investigate the existing literature on modular neck fractures, to identify predisposing factors and guide the decision-making process in the management of these difficult cases.

Methods: A systematic literature review was conducted until July 2022.

Prevalence, Risk Factors, and Economical Cost of Work-Related Injuries Among Olive Workers in the Achaia Region, Greece.

Background Olive gathering involves tree climbing, carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injuries among olive workers. The aim of this study is to evaluate the prevalence and risk factors of occupational injuries among olive workers in a rural Greek area and to assess the financial burden on the health system and insurance funds.

Association of vitamins B12 and D3 with Balance and Falls in a sample of Greek older people.

Objectives: Balance disorders and falls are common in the elderly and have a multifactorial etiology. The purpose of the present cross-sectional study is to evaluate a possible association between vitamins D3 and B12 and impaired balance and falls.

Methods: Ninety patients, females and males, were evaluated, from December 2019 to December 2020 during their first ambulatory visit at the Prevention of Falls Clinic of the General University Hospital of Patras.

Optimizing fixation methods for stable and unstable intertrochanteric hip fractures treated with sliding hip screw or cephalomedullary nailing: A comparative biomechanical and finite element analysis study.

Background: Despite recent advances in implants and surgical techniques, catastrophic and clinical failures in the treatment of intertrochanteric fractures continue to occur, with dire consequences in an overall frail population subset. The aim of the current study is to evaluate the effect of the factors under the surgeons' control, namely fracture reduction and implant selection, on the biomechanical behavior of fracture fixation constructs.

Material-methods: An experimental protocol was conducted with the use of instrumented sawbones, in order to validate the finite element models.

Avoiding Complications of Locking Plating for Proximal Humerus Fractures.

Proximal humeral fractures are very common, especially among elderly people with osteoporosis. The treatment methods are numerous, according to the characteristics of the patient and the fracture, as well as the surgeon's preference. These fractures can be treated either conservatively or operatively with closed or open reduction and internal fixation, or arthroplasty.

Neglected Posterior Dislocation Septic Loosening and Prolonged Flexion Contracture of Total Knee Arthroplasty: A Case Report.

BACKGROUND Chronic posterior knee dislocation after total knee arthroplasty (TKA) is a rare but serious complication, especially when it coexists with septic implant loosening, flexion contracture, and extensive comorbidities. Although the severity is comparable to that in the native knee dislocation, there are few reports in the literature. When TKA dislocation is complicated with infection, bone defect, and patient's comorbidity, treatment becomes even more difficult.

Short-term clinical and radiological results of two different design metaphyseal fitting femoral stems in total hip arthroplasty: a prospective, randomized trial.

Background: There is great design variability on short femoral stems available on the market. This study aims to evaluate the short-term clinical and radiological results of two different design short femoral stems, both classified as shortened tapered stems.

Methods: From March 2016 to March 2018, a prospective, randomized, parallel-group design study was conducted to compare functional and radiological outcomes of 45 patients underwent THA using the Tri-Lock Bone Preservation Stem and 45 patients underwent THA with the Minima S stem at a minimum 2 years of follow-up.

Multimodal analgesia protocol for pain management after total knee arthroplasty: comparison of three different regional analgesic techniques.

Objectives: To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total knee arthroplasty (TKA).

Methods: Seventy-two patients undergoing TKA were randomly allocated into three groups according to the analgesic technique used for postoperative pain management. Group EA patients received epidural analgesia (control group), group IA received intra-articular infusion and group FNB received femoral nerve block.

Comparative analysis of the biomechanical behavior of two different design metaphyseal-fitting short stems using digital image correlation.

Background: The progressive evolution in hip replacement research is directed to follow the principles of bone and soft tissue sparing surgery. Regarding hip implants, a renewed interest has been raised towards short uncemented femoral implants. A heterogeneous group of short stems have been designed with the aim to approximate initial, post-implantation bone strain to the preoperative levels in order to minimize the effects of stress shielding.

Reliability and validity of the mCTSIB dynamic platform test to assess balance in a population of older women living in the community.

Objectives: Test the reliability and validity of the modified Clinical test of Sensory Interaction in Balance (mCTSIB) of the Balance Platform Biodex Balance System (BBS) in a female community dwelling population.

Method: 100 women over 65 years community dwellers mean age 71.8 (SD±6, ranging from 65 to 91) years, were examined using the posturography modified Clinical test of Sensory Interaction on Balance (mCTSIB) protocol of the Biodex Balance system SD and the Greek Mini-Best Test (miniBESTest-GR) to assess concurrent validity, with 24 undergoing a second measurement after one week to test the reliability of the method.

Design of Improved Intertrochanteric Fracture Treatment (DRIFT) Study: Protocol for Biomechanical Testing and Finite Element Analysis of Stable and Unstable Intertrochanteric Fractures Treated With Intramedullary Nailing or Dynamic Compression Screw.

Background: Intertrochanteric hip fractures rank in the top 10 of all impairments worldwide in terms of loss in disability-adjusted years for people aged older than 60 years. The type of surgery is usually carried out with dynamic hip screw (DHS) devices or cephalomedullary nails (CMN). Cut-out of the hip screw is considered the most frequent mechanical failure for all implants with an estimated incidence ranging from 2% to 16.

Comparison of two metaphyseal-fitting (short) femoral stems in primary total hip arthroplasty: study protocol for a prospective randomized clinical trial with additional biomechanical testing and finite element analysis.

Background: Total hip replacement has recently followed a progressive evolution towards principles of bone- and soft-tissue-sparing surgery. Regarding femoral implants, different stem designs have been developed as an alternative to conventional stems, and there is a renewed interest towards short versions of uncemented femoral implants. Based on both experimental testing and finite element modeling, the proposed study has been designed to compare the biomechanical properties and clinical performance of the newly introduced short-stem Minima S, for which clinical data are lacking with an older generation stem, the Trilock Bone Preservation Stem with an established performance record in short to midterm follow-up.

Can a surgeon predict the longevity of a total hip replacement?

Introduction: The purpose of this study was to examine the ability of a surgeon to predict survival of a total hip replacement (THR) based on the patient's diagnosis, demographics, postoperative activity level and the surgical technique.

Methods: 4 experienced hip surgeons were asked to predict the longevity of 131 Charnley THRs, performed by the senior author (GH) 22-35 years ago, by providing them with pre- and postoperative radiographs, and data concerning patient's diagnosis, demographics, postoperative activity level and the surgical technique. This process was repeated 3 months later.

Solitary Metastatic Lesion of the Tibia from Clear Cell Renal Carcinoma: A Case Report of Segmental Skeletal Resection, Intercalary Allograft Over Reamed Nailing and Soleus Flap Interposition.

BACKGROUND Renal cell carcinoma (RCC) is the most common malignancy of the kidney, with clear cell (ccRCC) subtype identified in 85% of the cases; one-third of these patients experience synchronous metastatic disease, while 20-30% of the remaining patients develop metachronous metastatic RCC. The axial skeleton (pelvis and sacrum) is the second most common location (following the lungs), with a reported incidence of 35%. Diaphysis of the long bones is rarely involved, with the tibia being an even rarer site of metastasis.

The relationship between isokinetic strength and functional performance tests in patients with knee osteoarthritis.

[Purpose] The main purpose of the study was to examine the relationship of a battery of frequently used functional assessment tests with quadriceps and hamstrings isokinetic strength in Knee-osteoarthritis (OA) patients. Secondarily, the predictability of isokinetic strength on these performance variables was also assessed. [Subjects and Methods] Seventeen males and 23 females with Knee-OA, were assessed via a) the common functional tests: 6-minute walk test, Timed up-and-go test, 30-second chair test and 12-stair test and b) isokinetic concentric extension-flexion at 120°/s and 180°/s.

Osteolytic lesions (brown tumors) of primary hyperparathyroidism misdiagnosed as multifocal giant cell tumor of the distal ulna and radius: a case report.

Background: Brown tumors represent a rare clinical manifestation reported in approximately 3% of patients with primary hyperparathyroidism and correspond to radiologically osteolytic lesions with well-defined borders in different parts of the skeleton.

Case Presentation: We report the case of a 53-year-old white man who presented to our hospital with osteolytic lesions of his distal ulna and radius, causing pain and swelling of 2-month duration. A subsequent biopsy revealed histological features consistent with giant cell tumor and a complete resection of his distal ulna was followed, along with curettage and cementoplasty of the distal radial metaphysis.

Long Term Survivorship of a Severely Notched Femoral Stem after Replacing the Fractured Ceramic head with a Cobalt-Chromium Head.

Background: Although ceramic head fracture occurs infrequently today, in the event of a fracture, the resulting revision surgery can prove very challenging, since the ceramic particles lodge into the surrounding soft tissue and can cause rapid implant failure.

Case Presentation: A case of long term survivorship of a severed notched femoral stem after replacing the fractured femoral head with a cobalt-chromium one is reported in a 40-year old woman with hip dysplasia who underwent an uncomplicated total hip arthroplasty. The incident of ceramic femoral head fracture occurred 14 months postoperatively without reporting any significant trauma.

Modified porous tantalum rod technique for the treatment of femoral head osteonecrosis.

Aim: To study a modified porous tantalum technique for the treatment of osteonecrosis of the femoral head.

Methods: The porous tantalum rod was combined with endoscopy, curettage, autologous bone grafting and use of bone marrow aspirates from iliac crest aspiration in 49 patients (58 hips) with a mean age of 38 years. The majority of the patients had idiopathic osteonecrosis, followed by corticosteroid-induced osteonecrosis.

Removal of well-fixed components in femoral revision arthroplasty with controlled segmentation of the proximal femur.

Background: The transfemoral and the extended trochanteric osteotomies are the most common osteotomies used in femoral revision, both when proximal or diaphyseal fixation of the new component has been decided. We present an alternative approach to the trochanteric osteotomies, most frequently used with distally fixated stems, to overcome their shortcomings of osteotomy migration and nonunion, but, most of all, the uncontrollable fragmentation of the femur.

Methods: The procedure includes a complete circular femoral osteotomy just below the stem tip to prevent distal fracture propagation and a subsequent preplanned segmentation of the proximal femur for better exposure and fast removal of the old prosthesis.