1,720,965 research outputs found
ANTERIOR LONGITUDINAL OSTEOTOMY OF THE GREATER TROCHANTER IN TOTAL HIP ARTHROPLASTY: SHORT-TERM FOLLOW-UP
No full textBACKGROUND Early dislocation is a foremost complication of total hip arthroplasty through a postero-lateral approach. The extra-articular impingement of the anterior part of the great trochanter with ileum bone, with or without soft tissue interposition is a well recognized but underestimated etiopathogenetic cause reported in literature. In this retrospective study through the assessment of clinical and radiographic follow-up at a minimum of six months, the effectiveness of an antero- longitudinal osteotomy of the great trochanter for early dislocation prevention is evaluated.
MATERIALS AND METHODS 209 patients (48.3% males and 51,7% females) underwent a total hip arthroplasty from June 2011 to September 2015, with surgery being performed by the same surgeon. A modified posterolateral approach was used according to the tissue-sparing criteria, in all the cases an anterior longitudinal osteotomy of the great trochanter has been performed at 90° to the antiversion angle of the implant and aligned posteriorly with the prosthesis. All the patients underwent a clinical and radiological follow up at one, three, and six months.
RESULTS In this study, only one patient reported dislocation of THA. One patient suffered from a wound infection which was subsequently treated with antibiotics and had complete remission. All patients demonstrated a fast recovery of ROM and walking, starting from pre-op Harris Hip Score 42.24pts and obtaining a score of 81.52pts at three months, and 92.03 at six months post-op. After surgery and during the follow up period, there were no trochanteric fractures detected.
DISCUSSION The correct positioning of the implants, the head diameter, offset, soft tissues repair, absence of impingement, and patients compliance are all elements that define the prosthetic stability. Literature shows and incidence of primary total hip arthroplasty dislocation between 0.80% to 10%. The incidence of dislocation reported in a preliminary study in our Institute is 0.48%, demonstrating the effectiveness of the trochanteric osteotomy.
CONCLUSIONS The osteotomy of the great trochanter is an effective surgical technique used to decrease the anterior impingement and early dislocation incidence. It is particularly effective on patients with good compliance and correctly implanted prosthetic components
Anterior Longitudinal Osteotomy of greater trochanter and prevention of early dislocation in total hip arthroplasty: updated results
No full textActive septic arthritis of the hip in adults: what's new in the treatment? A narrative review
No full textSeptic arthritis of the hip in adults is a rare disease with important and serious sequalae if not immediately and correctly treated. An early diagnosis is essential in order to avoid complications that could invalidate patients quality of life: a multidisciplinary approach is usually requested and recommended. Staphylococcus aureus is the most common finding among the different bacteria identified, and the clinical presentation is extremely aspecific. Based on symptoms, radiological signs, serum tests, synovial aspirates and bacterial cultures, different treatment could be performed. The surgical treatment goal should be to wash the hip joint with high volume of saline solution in addition to a specific antibiotic therapy. Different techniques and strategies are described in literature: arthroscopic surgery allows a direct visualization of the joint and a synovial debridement, as well as washing the joint with very high volume of fluid. Other open techniques with more extensive debridement are described, but in case of bone destruction an open two-stage technique is indicated with the cement spacer implant. No statistically significant differences have been demonstrated in the scientific literature between open or arthroscopic techniques in terms of infection recurrence. Each technique has advantages and disadvantages that the surgeon should take into account in order to offer the best treatment to the patient. The antibiotic-loaded cement spacer is strongly recommended during the two-stage open arthroplasty and Girdlestone technique remains a valid option in selected patient, both as primary or salvage treatment
Hallux rigidus: are only injections worth it?—a systematic review
No full textBackground: The term hallux rigidus describes the painful condition of the metatarsophalangeal joint of the great toe, characterized by restricted motion and proliferative osteophytosis. Conservative treatments are typically used. In certain cases, a carefully administered intra-articular steroid injection may provide temporary relief. Very few studies have been reported in the literature; thus, data on the efficacy of these injections are limited. For this systematic review of the literature, we asked: (I) what injection treatment options are available for hallux rigidus? (II) What are the success rates and outcomes of these treatments? (III) Which factors influence the outcomes? (IV) How long have the effects of the injection lasted? Methods: In January 2025 a search was conducted on the electronic databases PubMed, Scopus, and Embase using the search terms: “hallux rigidus” or “hallux limitus” and “injection” or “steroid” or “ialuronic” or “platetel-rich plasma”. Inclusion (English language, treatment of hallux rigidus/limitus with injections) and exclusion criteria (injection involving other joints, descriptive or epidemiological studies, and systematic reviews) were determined a priori. The ROBINS-I was used to assess the risk of bias in each report. In addition, studies with injections after hallux surgery were excluded, aiming to understand whether injections for the hallux rigidus are truly. Results: The final review included thirteen studies, whose quality was rated as moderate. High success rates for pain relief (84–92%) and movement restoration have been reported; the reduction in visual analogic score (VAS) scores after injection was statistically significant, regardless of the substance used (P<0.05). Some factors may influence the effectiveness of injections: the severity of osteoarthritis and imaging guidance are demonstrated to be significant; contrarily, the type of injection is not crucial, even if hyaluronic acid may provide better long-term benefits. The duration of efficacy has been reported to be less than one-year in 50% of patients. Conclusions: Intra-articular injections of hallux rigidus are effective and safe for conservative treatment of hallux rigidus, particularly in the early stages of osteoarthritis
Active septic arthritis of the hip in adults: what's new in the treatment? A systematic review
Full text linkTreatment of bacterial septic arthritis in the native adult hip joint can be challenging. Prompt diagnosis and treatment decisions can reduce the associated morbidity and mortality.
For this systematic review of the literature, we asked: (1) What are the treatment options? (2) What are the success rates and the outcomes after treatment? (3) Which antibiotic and duration of therapy are optimal?
We searched the electronic databases PubMed, Scopus, and Embase using the search terms "hip" or "native hip" and "septic arthritis" or "coxitis". Studies were included if they reported on: (1) bacterial infection of the hip, (2) treatment, (3) success rate/outcomes, (4) follow-up. The final review included 19 studies. The quality of study reporting was evaluated with the Methodological Index for Non-randomized Studies (MINORS) questionnaire.
Three treatment options are: arthroscopy, single open surgery, and two-stage total hip arthroplasty (THA). A high success rate in infection eradication was reported for all three. Intravenous antibiotic therapy should be promptly initiated to eradicate septic arthritis and minimize potential sequelae and complications.
Arthroscopy, single open or two-stage THA were reported to be effective in treating bacterial septic arthritis of the native hip. The key to optimal outcome is early diagnosis and timely treatment
CONVENTIONAL VERSUS CROSS-LINKED POLYETHYLENE FOR TOTAL HIP ARTHROPLASTY: CLINICAL AND RADIOGRAPHIC OUTCOMES AT A MEAN OF NINE YEARS
No full textPolyethylene wear is the main factor leading to periprosthetic osteolysis, aseptic loosening and long-term failure of the implant in total hip arthroplasty (THA). The present study compares the clinical and radiographic outcomes of 88 patients who underwent primary THA with either conventional polyethylene or cross-linked polyethylene (XLPE) from the same manufacturer (Zimmer®, Warsaw, IN, USA). There were no significant differences between the two sub-populations in average age, gender, side affected and prosthetic stem and cup size. The average follow-up was 104 months, ranging from 55 to 131 months: to our knowledge this is the longest follow-up for this particular insert. Clinical and x-ray evaluation was obtained at 1, 3, 6 and 12 months and yearly thereafter. Our results showed that cross-linked polyethylene has a significantly greater wear reduction than that of standard polyethylene
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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