Age and muscle strength mediate the age-related biomechanical plasticity of gait.

Purpose: Old compared with young adults walk with reduced ankle and increased hip mechanical output. We examined the idea that age, leg strength, or both are related to the age-related changes in mechanical output during gait.

Methods: Healthy young (n = 32, age 21.

Pharmacologic Prophylaxis for Venous Thromboembolism Among Patients With Total Joint Replacement: An Electronic Medical Records Study.

Patients who have total hip (THR) or knee (TKR) replacement have an elevated risk of venous thromboembolism (VTE). The American College of Chest Physicians guidelines recommend prophylactic anticoagulation. The aim of the study was to examine pharmacologic prophylaxis against VTE among patients with THR or TKR and to assess demographic and clinical correlates related to VTE prophylaxis.

Early Experience with a New Porous Hemispheric Acetabular Component.

A third-generation cementless acetabular system has been designed, building on the successes of a second-generation system that featured good congruity between the liner and hemispheric shell, and proven porous plasma-sprayed coating on titanium alloy substrate, by designing a ringless barb and groove locking mechanism and optimizing range of motion. These design features are amenable to modern, highly crosslinked polyethylenes. A retrospective review was performed to assess early outcomes.

Switching to Tenofovir Alafenamide, Coformulated With Elvitegravir, Cobicistat, and Emtricitabine, in HIV-Infected Patients With Renal Impairment: 48-Week Results From a Single-Arm, Multicenter, Open-Label Phase 3 Study.

Background: Tenofovir alafenamide (TAF) is a novel tenofovir prodrug with improved renal and bone safety compared with TDF-containing regimens. We report the 48 week safety and efficacy of a once-daily single tablet regimen of elvitegravir 150 mg (E), cobicistat 150 mg (C), emtricitabine 200 mg (F), and TAF 10 mg (E/C/F/TAF) in HIV-1-infected patients with mild to moderate renal impairment.

Methods: We enrolled virologically suppressed HIV-1-infected subjects with estimated creatinine clearance (CrCl) 30-69 mL/min in a single-arm, open-label study to switch regimens to E/C/F/TAF.

Effects of exercise and manual therapy on pain associated with hip osteoarthritis: a systematic review and meta-analysis.

Aim: To explore the effects of exercise (water-based or land-based) and/or manual therapies on pain in adults with clinically and/or radiographically diagnosed hip osteoarthritis (OA).

Methods: A systematic review and meta-analysis was performed, with patient reported pain assessed using a visual analogue scale (VAS) or the Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain subscale. Data were grouped by follow-up time (0-3 months=short term; 4-12 months=medium term and; >12 months=long term), and standardised mean differences (SMD) with 95% CIs were used to establish intervention effect sizes.

Analysis of a Standardized Perioperative Pain Management Order Set in Highly Opioid-Tolerant Patients.

Objective: The aim was to assess a standardized order set for perioperative pain management in highly opioid-tolerant patients undergoing elective orthopedic surgery.

Methods: This retrospective chart review evaluated a pain order set in highly opioid-tolerant patients undergoing elective total knee or total hip arthroplasty from January 2010 through August 2012. Based on the date of the surgery, patients were allocated into preimplementation or postimplementation order set groups.

Large Metal Heads and Vitamin E Polyethylene Increase Frictional Torque in Total Hip Arthroplasty.

Purpose: Trunnionosis has reemerged in modern total hip arthroplasty for reasons that remain unclear. Bearing frictional torque transmits forces to the modular head-neck interface, which may contribute to taper corrosion. The purpose of this study is to compare frictional torque of modern bearing couples in total hip arthroplasty.

Health benefits of seated speed, resistance, and power training for an individual with spastic quadriplegic cerebral palsy: A case report.

Children with moderate to severe cerebral palsy are at risk for low bone mass for chronological age, which compounds risk in adulthood for progressive deformity and chronic pain. Physical activity and exercise can be a key component to optimizing bone health. In this case report we present a young adult male with non-ambulatory, spastic quadriplegia CP whom began a seated speed, resistance, and power training exercise program at age 14.

Effect of aerobic exercise training on cardiometabolic risk factors among professional athletes in the heaviest-weight class.

Background: High prevalence of metabolic diseases among young professional athletes with large body sizes has raised growing attention. However, few studies specifically examined whether additional aerobic exercise provides cardiometabolic beneficial effect among these young athletes under regularly intensive strength training.

Objective: We conducted a pilot trial to evaluate the effects of aerobic exercise on overall metabolic syndrome (MetS), individual MetS components, and aerobic capacity among metabolically unhealthy athletes in the heaviest-weight class.

Elevated incidence of fractures in women with invasive breast cancer.

Unlabelled: This study evaluates the incidence of bone fractures in women with BC.We found that women with invasive breast cancer are at an increased risk for bone fractures, with fractures most commonly occurring at lower extremity and vertebral sites. The risk is further increased in women undergoing cancer therapy.

Caffeine Intake, Coffee Consumption, and Risk of Cutaneous Malignant Melanoma.

Background: Caffeine has been shown to prevent ultraviolet radiation-induced carcinogenesis and to inhibit growth of melanoma cells in experimental studies. We evaluated the association among caffeine intake, coffee consumption, and melanoma risk among three large cohort studies.

Methods: The analysis used data from 89,220 women in the Nurses' Health Study II (1991-2009), 74,666 women in the Nurses' Health Study (1980-2008), and 39,424 men in the Health Professionals Follow-up Study (1986-2008).

Midterm Results of Delta Ceramic-on-Ceramic Total Hip Arthroplasty.

This study reports mid-term results of Delta ceramic on ceramic (COC) in total hip arthroplasty (THA). Subjects received Delta COC THA in a prospective multi-center study with either 28 mm (n=177) or 36 mm (n=168) articulations. Annual clinical and radiographic evaluations were performed, and patients were asked about hip noises.

Yoga leads to multiple physical improvements after stroke, a pilot study.

Objective: To assess change in physical functioning (pain, range of motion (ROM), strength, and endurance) after 8 weeks of therapeutic-yoga.

Design: Planned analyses of data from a randomized pilot study of yoga after stroke.

Setting: University-based research laboratory.

The impact of total joint arthroplasty on sexual function in young, active patients.

There is limited information regarding sexual function following total hip (THA) and knee arthroplasty (TKA). A multicenter study of 806 THA, 542 TKA, and 181 control patients less than 60 years of age was conducted using an independent survey center to question subjects about their sexual function. Only 1.

Musculoskeletal healthcare disparities: influence of patient sex, race, and ethnicity on utilization of total joint arthroplasty.

Total joint arthroplasty is an effective treatment of musculoskeletal diseases including osteoarthritis, rheumatoid arthritis, trauma, and other diseases of the major joints. Based on data obtained from the National Inpatient Survey from 2000 through 2010, substantial differences in the rates of utilization of total hip, knee, and shoulder arthroplasty were detected with respect to race, ethnicity, and gender/sex. The results of this study support the likelihood that it is the interaction between multiple factors (patient, physician, and system/institutional) that contributes to musculoskeletal health disparities.

Barefoot running and hip kinematics: good news for the knee?

Purpose: Patellofemoral pain and iliotibial band syndromes are common running injuries. Excessive hip adduction (HADD), hip internal rotation (HIR), and contralateral pelvic drop (CLPD) during running have been suggested as causes of injury in female runners. This study compared these kinematic variables during barefoot and shod running.

Does increasing steps per day predict improvement in physical function and pain interference in adults with fibromyalgia?

Objective: To examine the concurrent and predictive associations between the number of steps taken per day and clinical outcomes in patients with fibromyalgia (FM).

Methods: A total of 199 adults with FM (mean age 46.1 years, 95% women) who were enrolled in a randomized clinical trial wore a hip-mounted accelerometer for 1 week and completed self-report measures of physical function (Fibromyalgia Impact Questionnaire-Physical Impairment [FIQ-PI], Short Form 36 [SF-36] health survey physical component score [PCS], pain intensity and interference (Brief Pain Inventory [BPI]), and depressive symptoms (Patient Health Questionnaire-8 [PHQ-8]) as part of their baseline and followup assessments.

Reproducibility of femoral offset following short stem and straight stem total hip arthroplasty.

Bone stock-preserving short stem prostheses have gained importance in total hip arthroplasty (THA) with the use of minimally invasive surgical procedures. Because of their metaphyseal fixation and their dependency on the calcar radius, it is unknown whether the femoral offset can be reproduced with the same accuracy following short stem vs standard stem THA. This study clarifies whether it is possible to restore the femoral offset using a short stem prosthesis (Fitmore; Zimmer, Warsaw, Indiana) compared with a conventional straight stem prosthesis (CLS; Zimmer) following minimally invasive implantation using an anterolateral approach.

Associations of MTHFR gene polymorphisms with hypertension and hypertension in pregnancy: a meta-analysis from 114 studies with 15411 cases and 21970 controls.

Background: Several epidemiological studies have investigated the associations of methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms with hypertension (H) or hypertension in pregnancy (HIP). However, the results were controversial. We therefore performed a comprehensive meta-analysis to provide empirical evidences on the associations.

Concerns of an itinerant surgeon: results of a Guatemalan surgical aid trip.

Over the past decade the popularity of foreign medical aid has increased and gained notoriety. Operation Walk is a philanthropic organization dedicated to improving the ambulatory potential of patients in developing countries by providing free surgical treatment for patients who otherwise lack access to care of debilitating bone and joint conditions. During Operation Walk Mooresville's 2013 trip to Guatemala 40 patients prospectively completed a Likert Scale style survey.

Redesigning a joint replacement program using Lean Six Sigma in a Veterans Affairs hospital.

Importance: In April 2009, an analysis of joint replacement surgical procedures at the Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, Indiana, revealed that total hip and knee replacements incurred $1.4 million in non-Veterans Affairs (VA) care costs with an average length of stay of 6.

Determining the cost-effectiveness of hospital nursing interventions for patients undergoing a total hip replacement.

Aim: The purposes of the study were to (i) identify the types and amounts of nursing interventions and (ii) estimate the cost-effectiveness of nursing interventions for complications the patients experienced when undergoing a total hip replacement (THR).

Background: There has been little cost-effectiveness research into nursing interventions in hospitals, resulting in an inability to explain the economic value of hospital nursing interventions.

Method: The direct effects of nursing interventions on hospital direct costs and complication rates were analysed using path modelling, controlling for multiple factors (patient characteristics and nursing contexts) influencing nursing care.

Evaluation and treatment of painful total hip arthroplasties with modular metal taper junctions.

Modern primary total hip arthroplasty femoral components have evolved to include modular necks. Subsequently, the additional taper junction provides another interface as a potential source for mechanically assisted crevice corrosion, which is a complex process involving fretting and crevice corrosion. Furthermore, it is becoming evident that an adverse local tissue reaction may result in some patients due to the mechanically assisted crevice corrosion.

A Prospective, Randomized Study of Component Position in Two-Incision MIS Total Hip Arthroplasty: A Preliminary Study.

Controversy exists regarding the ability to position the implants reliably in minimally invasive surgery (MIS) total hip arthroplasty (THA). This study compared the ability to accurately position components in the MIS two-incision versus single-incision approaches. Twenty-four patients were randomized to THA through one of three approaches, including the two-incision approach.