Accuracy and early outcomes in medial unicompartmental knee arthroplasty performed using patient specific instrumentation.

Unicompartmental knee arthroplasty (UKA) is a technically demanding procedure and poor implant positioning has been identified as a factor in early failure. The aim of this study was to evaluate the accuracy and clinical outcomes of the patient specific instrumentation implementation technique with a fixed bearing UKA. We carried out a prospective study of 41 patients (44 procedures) between December 2011 and April 2013.

Midterm Outcomes and Predictors of Clinical Success With the KineSpring Knee Implant System.

The purpose of this study was to (1) evaluate joint pain and function in knee osteoarthritis (OA) patients treated with a joint-sparing, extracapsular implant and (2) identify patient characteristics that influenced clinical outcomes. This study included 99 patients with symptomatic medial knee OA refractory to conservative care who were treated with the KineSpring Knee Implant System and followed for a mean of 17 months (range, 1.5 to 48 months).

A prospective randomised study of minimally invasive midvastus total knee arthroplasty compared with standard total knee arthroplasty.

Introduction: Proposed advantages of minimally invasive surgery include shorter hospital stay, less blood loss, and a greater range of motion but potential concerns are raised about both prolonged learning curves and a compromise in exposure leading to implant malposition.

Patients And Methods: This powered study evaluates the outcomes of 80 patients randomised to have mini-midvastus (MMV) approach or standard medial parapatellar (MPP) approach. Rehabilitation protocols and discharge criteria were standardised.

Clinical and economic consequences of the treatment gap in knee osteoarthritis management.

Osteoarthritis affects 27 million American adults of all ages and is a leading cause of disability in middle-aged and older adults. Initial management of knee osteoarthritis symptoms utilizes conservative care although long-term efficacy is poor. Arthroplasty and high tibial osteotomy may be considered for patients with severe pain or disability.

Unload it: the key to the treatment of knee osteoarthritis.

Osteoarthritis (OA) of the knee is a major public health problem whose prevalence is expected to grow dramatically commensurate with the aging of the population and increasing rates of obesity. Unfortunately, little progress has been made therapeutically to avert this epidemic. We hypothesize that the lack of effective interventions is due, in large part, to an overemphasis on pharmacotherapy and direct chondral repair.

Association between the coronary artery disease risk locus on chromosome 9p21.3 and abdominal aortic aneurysm.

Background: Recent genome-wide studies have shown a significant association of a locus on chromosome 9p21.3 and coronary artery disease. We performed a case-control study to investigate the association between this locus and abdominal aortic aneurysm (AAA).

The interleukin-10-1082 'A' allele and abdominal aortic aneurysms.

Background: Abdominal aortic aneurysms (AAA) are caused by inflammatory processes in the wall of the aorta resulting in degradation of structural proteins. This inflammatory process is mediated, in part, by cytokines, and interleukin-10 (IL-10) is a predominantly anti-inflammatory cytokine. A single nucleotide polymorphism in the promoter region of the IL-10 gene that affects transcription has been associated with AAA in a small study.

The value of urgent carotid surgery for crescendo transient ischemic attacks.

Objective: This study audited operative risk in patients undergoing urgent carotid surgery for crescendo transient ischemic attacks (TIAs).

Methods: Interrogation of the vascular unit database (January 1992 to July 2004) identified 42 patients operated on urgently for crescendo TIAs, which were defined as>or=3 TIAs within the preceding 7 days. Stroke, death, and any major cardiac events were analyzed.

The pro-inflammatory and chemotactic cytokine microenvironment of the abdominal aortic aneurysm wall: a protein array study.

Objective: Cytokines are inflammatory mediators implicated in abdominal aortic aneurysm (AAA) pathogenesis. The cytokine expression profile of the AAA is poorly defined and has focused on the expression of pro-inflammatory cytokines, at the expense of chemokines and growth factors. This study aims to investigate the cytokine expression profile of the established AAA wall.

Subintimal recanalization of the femoropopliteal segment to promote healing of an ulcerated below-knee amputation stump.

Purpose: To describe the use of the subintimal technique to revascularize an ulcerated below-knee amputation stump.

Case Report: A 64-year-old man with persistent ulceration of a below-knee amputation stump underwent attempted percutaneous revascularization. Via antegrade puncture, the femoropopliteal occlusion was recanalized subintimally and eventually opened into a large medial geniculate collateral branch, improving the stump flow.

Simultaneous superficial venous surgery and on-table subintimal angioplasty in the treatment of venous leg ulcers with arterial compromise.

Purpose: To determine the feasibility of synchronous superficial venous surgery and on-table subintimal angioplasty in the treatment of venous ulcers with arterial compromise.

Methods: Between January 1992 and December 2004, 9 patients (8 women; median age 83 years, range 72-92) underwent the synchronous procedure. No patient had deep venous reflux; 4 patients presented with rest pain and 2 were diabetic.

Does carotid endarterectomy lead to a decline in cognitive function or health related quality of life?

Carotid endarterectomy has been shown to reduce the long-term risk of stroke in selected patients. The present study was designed to examine cognitive function and health related quality of life in a series of carotid endarterectomy patients. One hundred and nine patients undergoing carotid endarterectomy were assessed before surgery and at 6 months post op (n = 100) on standard cognitive function tests and quality of life surveys.

Randomized trial of vein versus dacron patching during carotid endarterectomy: long-term results.

Background And Purpose: Overviews of randomized patch trials by the Cochrane Collaboration suggest that a policy of routine patching is preferable to routine primary closure. However, there is no systematic evidence that patch type, whether prosthetic or vein, influences outcome after carotid endarterectomy (CEA).

Methods: Two hundred seventy-three patients were randomized to vein or thin-walled Dacron patch (Hemashield Finesse) closure of the arteriotomy after 276 CEA procedures.

Beneficial effects of clopidogrel combined with aspirin in reducing cerebral emboli in patients undergoing carotid endarterectomy.

Background: Postoperative thromboembolic stroke affects 2% to 3% of patients undergoing carotid endarterectomy (CEA) and is preceded by 1 to 2 hours of increasing cerebral embolization. Previous work has demonstrated that high rates of postoperative embolization are associated with increased platelet reactivity to adenosine 5'-diphosphate (ADP). Our hypothesis was that preoperative administration of the platelet ADP antagonist clopidogrel could reduce postoperative embolization.

Post-traumatic hepatic artery aneurysm--surgical treatment: report of a case.

Hepatic artery aneurysms (HAAs) are uncommon. We present the diagnosis and surgical treatment of a post-traumatic, extrahepatic artery aneurysm.

Simvastatin inhibits human saphenous vein neointima formation via inhibition of smooth muscle cell proliferation and migration.

Objective: Migration and proliferation of vascular smooth muscle cells (SMCs) contributes to intimal hyperplasia in saphenous vein (SV) bypass grafts, which leads to patency-threatening stenosis. Evidence for the involvement of basement membrane-degrading matrix metalloproteinases (MMPs) and growth factors in mediating SMC migration and proliferation has been presented in a number of in vitro and in vivo models. 3-Hydroxy-3 methylglutaryl CoA reductase inhibitors (statins) are widely used in patients with atherosclerosis and are claimed to have additional effects beyond cholesterol reduction.