Hip Resurfacing: A Single Surgeon U.S. Series With Minimum Ten-Year Follow-up
Background: Metal-on-metal hip resurfacing is an alternative to total hip arthroplasty (THA). The aim of this study was to determine implant survivorship, analyze patient-reported outcomes measures and to determine patient satisfaction for patients who underwent metal-on-metal hip resurfacing at a large US academic institution by a single surgeon with a minimum of 10-year follow-up.
Methods: Patients who underwent hip resurfacing from September 2006 through November 2009 were included. Patient demographics and variables were collected from a prospectively maintained institutional database and patients completed an additional questionnaire with patient-reported outcomes measures.
Results: A total of 350 patients (389 hips) out of 371 (433 hips) with a minimum 10-year follow-up were successfully contacted (94.3% follow-up). Mean age was 53 years, 258 were male (73%). 377 out of 389 hips (96.9%) did not require additional surgery. Gender was significantly related to implant survivorship (males 99.0%, females 90.9%; P < .001). 330 patients (369 hips, 94.8%) were satisfied with their surgery. Males had higher proportion of satisfaction scores (P = .02) and higher modified Harris Hip Score (odds ratio = 2.63 (1.39, 4.98), P = .003). Median modified Harris Hip Score score for non-revised hips was 84.0 [80.0; 86.0] versus those requiring revision, 81.5 [74.0; 83.0], (P = .009).
Conclusion: At a minimum 10-year follow-up, hip resurfacing, using an implant with a good track record, demonstrates 99.0% survivorship in male patients with an average age of 52 years. We believe that the continued use of metal-on-metal hip resurfacing arthroplasty in this population is justified by both positive patient reported outcomes and survivorship.
Linsen T Samuel
William A Zuke
Sania Mahmood
Mohammed A Munim
Peter B Alamir
Peter J Brooks
J Arthroplasty
. 2022 Sep;37(9):1799-1808. doi: 10.1016/j.arth.2022.04.008. Epub 2022 Apr 14.
2022
English
Traction Spica Cast For Femoral-shaft Fractures In Children
closed reduction; external; fixation; immobilization; long-term; nails; Orthopedics; pediatric femur fractures; skeletal traction; supracondylar kirschner wires
We treated 20 children for an isolated femoral shaft fracture using distal tibial traction incorporated into a spica cast with the knee in full extension. Patients were discharged from the hospital at a mean of 5.1 days following injury. All fractures healed, and there were four minor complications. At a mean follow-up of 35 (13-72) months, all patients were asymptomatic with normal function. All but one fracture healed in acceptable alignment, and there was no clinically significant leg-length discrepancy. The method is relatively simple to employ and may be advantageous in a setting of limited resources.
Gracilla R V; Diaz H M; Penaranda N R; Pagsisilgan J M; Spiegel D A; Quirapas D; Reyes E R
International Orthopaedics
2003
2003-06
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1007/s00264-003-0443-z" target="_blank" rel="noreferrer noopener">10.1007/s00264-003-0443-z</a>
Duration Of Anticoagulant Therapy After Initial Idiopathic Venous Thromboembolism
anticoagulation; antiphospholipid syndrome; deep-vein thrombosis; duration of therapy; factor-v-leiden; first episode; heterozygous carriers; idiopathic venous thromboembolism; intensity warfarin therapy; long-term; medical progress; Pharmacology & Pharmacy; pulmonary-embolism; risk; warfarin
Frazee L A; Chomo D L
Annals of Pharmacotherapy
2003
2003-10
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1345/aph.1C486" target="_blank" rel="noreferrer noopener">10.1345/aph.1C486</a>
Immune response to CMV in solid organ transplant recipients: current concepts and future directions
adaptive immunity; antibody; cd4(+) t-cells; cell-mediated-immunity; CMV; human cytomegalovirus-infection; Immunology; innate immunity; kidney-transplantation; liver-transplantation; long-term; lung transplantation; preemptive therapy; receptor repertoire; recipient; renal-transplant; Toll-like receptor; transplantation; vaccine
Despite advances in immunosuppression and antiviral therapy, CMV continues to be a significant opportunistic pathogen adversely affecting the outcome of solid organ transplantation (SOT) recipients. While a significant proportion of CMV disease is caused by reactivation of latent virus, the risk is highest among CMV donor+ and recipient- SOT patients. CMV is responsible for both direct (e.g., pneumonitis, colitis) and indirect (e.g., rejection, atherosclerosis) morbidity and mortality. Healthy CMV-seropositive individuals have a high frequency of CMV-specific CD4(+) and CD8(+) T cells that provide immune protection by limiting CMV reactivation and replication. Changes to the innate and adaptive immune system from immunosuppressive therapy following SOT contribute to CMV disease pathogenesis. CMV disease after SOT is associated with poorer outcomes, thus novel strategies to prevent it are an area of active research. In this article, we review the current state of knowledge on the immune response to CMV following SOT.
Watkins R R; Lemonovich T L; Razonable R R
Expert Review of Clinical Immunology
2012
2012-05
Journal Article
<a href="http://doi.org/10.1586/eci.12.25" target="_blank" rel="noreferrer noopener">10.1586/eci.12.25</a>