scholarly journals 3D Printed Guides and Preoperative Planning for Uncemented Stem Anteversion Reconstruction during Hip Arthroplasty: A Pilot Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yingqi Zhang ◽  
Zhitao Rao ◽  
Jincheng Zhang ◽  
Shijie Li ◽  
Shimin Chang ◽  
...  
Keyword(s):  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Femoral Stem ◽  
Study Groups ◽  
Femoral Anteversion ◽  
Neck Fracture ◽  
Group A ◽  
3D Printed ◽  
Group B

Objective. To investigate if 3D printed guides and preoperative planning can accurately control femoral stem anteversion. Methods. A prospective comparative study was carried out from 2018 to 2020, including 53 patients who underwent hip arthroplasty for femoral neck fracture. The target rotation center of the femoral head is determined by three-dimensional planning. In group A, planning was made by 2D templates. In group B, preoperative 3D planning and 3D printed osteotomy/positioning guides were performed. After the operation, 3D model registration was performed to calculate the accuracy of anteversion restoration. Results. We screened 60 patients and randomized a total of 53 to 2 parallel study arms: 30 patients to the group A (traditional operation) and 23 patients to the group B (3D preoperative planning and 3D printed guide). There were no significant differences in demographic or perioperative data between study groups. The restoration accuracy of group A was 5.42 ° ± 3.65 ° and of group B was 2.32 ° ± 1.89 ° . The number and rate of abnormal cases was 15 (50%) and 2 (8.7%), respectively. Significant statistical differences were found in angle change, restoration accuracy, and number of abnormal cases. Conclusion. Three-dimensional preoperative planning and 3D printed guides can improve the accuracy of the restoration of femoral anteversion during hip arthroplasty.

scholarly journals Predictive factor for bone cement implantation syndrome in osteoporotic femoral neck fracture undergoing cemented hip arthroplasty: a retrospective review of 142 cases

2020 ◽  
Author(s):  
Kulapat Chulsomlee ◽  
Sasichol Prukviwat ◽  
Noratep Kulachote ◽  
Norachart Sirisreetreeux ◽  
Sorawut Thamyongkit ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Femoral Stem ◽  
Ambulatory Status ◽  
Neck Fracture ◽  
Patients At Risk ◽  
Group A ◽  
Bone Cement Implantation Syndrome ◽  
Group B

Abstract Background: Bone cement implantation syndrome (BCIS) is a serious and potentially fatal complication in cemented hip arthroplasty (CHA). Although previous studies have identified patients at risk for BCIS, few studies have reported on the association between BCIS and perioperative surgical factors in patients with osteoporotic femoral neck fracture (OFNF) undergoing CHA. This study aimed to identify the prevalence of BCIS and its related outcomes, correlating between BCIS and perioperative surgical factors in these patients. Methods: A single-centred, retrospective study was conducted between 2015 and 2018 with patients who sustained OFNF and underwent CHA. Perioperative data and BCIS-related outcomes were reviewed using electronic database and telephone interview. BCIS grading was classified according to the Donaldson classification. All patients were allocated into 2 groups: Group A (BCIS grade 0 or 1: BCIS-gr0/1) and Group B (BCIS grade 2 or 3: BCIS-gr2/3). Multiple logistic regression analysis was used to identify predictive factors for BCIS-gr2/3. Results: A total of 142 OFNF patients were included. The prevalence of BCIS-gr2/3 was 6.4% (n=9). Group B showed a significantly higher major complication rate than Group A (44.4% vs. 8.3%, respectively, p<0.01). The in-hospital and 1-year mortality rates in Group B were also higher than in Group A, but non-significantly different (p=0.12 and p=0.32, respectively). Multivariate analysis showed that preinjury non-ambulatory status (odds ratio [OR] 11.83; 95% confidence interval [CI], 1.06–131.8, p=0.04), arrhythmia (OR 5.65; 95% CI, 1.13–28.93, p=0.04) and shape-closed femoral stem type (OR 9.78; 95% CI, 1.65–57.80, p=0.01) were the significant independent predictors for BCIS-gr2/3 in these patients. Conclusion: BCIS in OFNF patients undergoing CHA is common and associates with a high major perioperative complication rate. The patients at risk for BCIS-gr2/3 are those with poor preinjury ambulatory status, those with an underlying cardiac arrhythmia, and those whose CHA procedures use a shape-closed femoral stem design.

scholarly journals Predictive factor for bone cement implantation syndrome in osteoporotic femoral neck fracture undergoing cemented hip arthroplasty: a retrospective review of 142 cases

2020 ◽  
Author(s):  
Kulapat Chulsomlee ◽  
Sasichol Prukviwat ◽  
Noratep Kulachote ◽  
Norachart Sirisreetreeux ◽  
Sorawut Thamyongkit ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Femoral Stem ◽  
Ambulatory Status ◽  
Neck Fracture ◽  
Patients At Risk ◽  
Group A ◽  
Bone Cement Implantation Syndrome ◽  
Group B

Abstract Background Bone cement implantation syndrome (BCIS) is a serious and potentially fatal complication in cemented hip arthroplasty (CHA). Although previous studies have identified patients at risk for BCIS, few studies have reported on the association between BCIS and perioperative surgical factors in patients with osteoporotic femoral neck fracture (OFNF) undergoing CHA. This study aimed to identify the prevalence of BCIS and its related outcomes, correlating between BCIS and perioperative surgical factors in these patients. Materials and methods A single-centred, retrospective study was conducted between 2015 and 2018 with patients who sustained OFNF and underwent CHA. Perioperative data and BCIS-related outcomes were reviewed using electronic database and telephone interview. BCIS grading was classified according to the Donaldson classification. All patients were allocated into 2 groups: Group A (BCIS grade 0 or 1: BCIS-gr0/1) and Group B (BCIS grade 2 or 3: BCIS-gr2/3). Multiple logistic regression analysis was used to identify predictive factors for BCIS-gr2/3. Results A total of 142 OFNF patients were included. The prevalence of BCIS-gr2/3 was 6.4% (n=9). Group B showed a significantly higher major complication rate than Group A (44.4% vs. 8.3%, respectively, p<0.01). The in-hospital and 1-year mortality rates in Group B were also higher than in Group A, but non-significantly different ( p =0.12 and p =0.32, respectively). Multivariate analysis showed that preinjury non-ambulatory status (odds ratio [OR] 11.83; 95% confidence interval [CI], 1.06–131.8, p =0.04), arrhythmia (OR 5.65; 95% CI, 1.13–28.93, p =0.04) and shape-closed femoral stem type (OR 9.78; 95% CI, 1.65–57.80, p =0.01) were the significant independent predictors for BCIS-gr2/3 in these patients. Conclusion BCIS in OFNF patients undergoing CHA is common and associates with a high major perioperative complication rate. The patients at risk for BCIS-gr2/3 are those with poor preinjury ambulatory status, those with an underlying cardiac arrhythmia, and those whose CHA procedures use a shape-closed femoral stem design.

scholarly journals Value of preoperative three-dimensional planning software (AI-HIP) in primary total hip arthroplasty: a retrospective study

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110588
Author(s):  
Xuzhuang Ding ◽  
Bingshi Zhang ◽  
Wenao Li ◽  
Jia Huo ◽  
Sikai Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Femoral Stem ◽  
Stem Size ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

Objective We performed a retrospective study to compare the accuracy of preoperative planning using three-dimensional AI-HIP software and traditional two-dimensional manual templating to predict the size and position of prostheses. The purpose of this study was to evaluate the accuracy of AI-HIP in preoperative planning for primary total hip arthroplasty. Methods In total, 316 hips treated from April 2019 to June 2020 were retrospectively reviewed. A typical preoperative planning process for patients was implemented to compare the accuracy of the two preoperative planning methods with respect to prosthetic size and position. Intraclass correlation coefficients (ICCs) were used to evaluate the homogeneity between the actual prosthetic size and position and the preoperative planning method. Results When AI-HIP software and manual templating were used for preoperative planning, the stem agreement was 87.7% and 58.9%, respectively, and the cup agreement was 94.0% and 65.2%, respectively. The results showed that when AI-HIP software was used, an extremely high level of consistency (ICC > 0.95) was achieved for the femoral stem size, cup size, and femoral osteotomy level (ICC = 0.972, 0.962, and 0.961, respectively). Conclusion AI-HIP software showed excellent reliability for predicting the component size and implant position in primary total hip arthroplasty.

scholarly journals Comparison of Efficacy between Three-Dimensional Printing and Manual-Bending Implants for Inferomedial Orbital Fracture: A Retrospective Study

2021 ◽  
Vol 11 (17) ◽  
pp. 7971
Author(s):  
Jun-Hyeok Kim ◽  
Chae-Rim Lee ◽  
Deuk-Young Oh ◽  
Young-Joon Jun ◽  
Suk-Ho Moon
Keyword(s):  
Retrospective Study ◽  
Three Dimensional ◽  
Normal Structure ◽  
Orbital Fracture ◽  
Three Dimensional Printing ◽  
Normal Side ◽  
Lesion Side ◽  
Group A ◽  
3D Printed ◽  
Group B

The purpose of reconstruction of an orbital fracture is restoration of normal structure and volume without visible or functional complications. In a previous study, orbital implants were created using three-dimensional (3D) printing technology to restore orbital fractures. In the present study, the authors compared the efficacy of the conventional manual-bending implant and the 3D-printed standardized implant in order to verify the clinical utility of the fabricated 3D printed orbital implant. In this single-center, retrospective study, the authors evaluated medical records and 3D-CT scans of patients with inferomedial orbital fracture. Selected patients were divided into two groups. Group A underwent surgery with the 3D-printed standardized implant, while group B was treated using a manual technique to mold and trim the implant. A total of 32 patients was included in this study, 16 in each group. The volume of the preoperative lesion side was significantly different from that of the normal side or postoperative lesion side within each group. The volume of the postoperative lesion side was not statistically different from that of the normal side in Group A, but this volume was significantly different from that of the normal side in Group B. The 3D-printed standardized implant provides surgical efficacy to restore inferomedial orbital fracture and has superior surgical outcomes to the manual-bending implant.

scholarly journals Osteogenesis of 3D-Printed PCL/TCP/bdECM Scaffold Using Adipose-Derived Stem Cells Aggregates; An Experimental Study in the Canine Mandible

2021 ◽  
Vol 22 (11) ◽  
pp. 5409
Author(s):  
Joon Seok Lee ◽  
Tae Hyun Park ◽  
Jeong Yeop Ryu ◽  
Dong Kyu Kim ◽  
Eun Jung Oh ◽  
...  
Keyword(s):  
Stem Cells ◽  
Intervention Group ◽  
Three Dimensional ◽  
Artificial Organs ◽  
Adipose Derived Stem Cells ◽  
Gene Expressions ◽  
Group A ◽  
3D Printed ◽  
Group B ◽  
Tissue Recovery

Three-dimensional (3D) printing is perceived as an innovative tool for change in tissue engineering and regenerative medicine based on research outcomes on the development of artificial organs and tissues. With advances in such technology, research is underway into 3D-printed artificial scaffolds for tissue recovery and regeneration. In this study, we fabricated artificial scaffolds by coating bone demineralized and decellularized extracellular matrix (bdECM) onto existing 3D-printed polycaprolactone/tricalcium phosphate (PCL/TCP) to enhance osteoconductivity and osteoinductivity. After injecting adipose-derived stem cells (ADSCs) in an aggregate form found to be effective in previous studies, we examined the effects of the scaffold on ossification during mandibular reconstruction in beagle dogs. Ten beagles were divided into two groups: group A (PCL/TCP/bdECM + ADSC injection; n = 5) and group B (PCL/TCP/bdECM; n = 5). The results were analyzed four and eight weeks after intervention. Computed tomography (CT) findings showed that group A had more diffuse osteoblast tissue than group B. Evidence of infection or immune rejection was not detected following histological examination. Goldner trichrome (G/T) staining revealed rich ossification in scaffold pores. ColI, Osteocalcin, and Runx2 gene expressions were determined using real-time polymerase chain reaction. Group A showed greater expression of these genes. Through Western blotting, group A showed a greater expression of genes that encode ColI, Osteocalcin, and Runx2 proteins. In conclusion, intervention group A, in which the beagles received the additional ADSC injection together with the 3D-printed PCL/TCP coated with bdECM, showed improved mandibular ossification in and around the pores of the scaffold.

CONVENTIONAL VERSUS THREE-DIMENSIONAL CONFORMAL EXTERNAL RADIOTHERAPY IN CANCER CERVIX: A COMPARATIVE STUDY FOR COMPLIANCE, RESPONSE AND TOXICITY

2016 ◽  
Vol 1 (2) ◽  
Author(s):  
Richa Gupta ◽  
Piyush Kumar ◽  
D. P. Singh ◽  
Arvind Kumar Chauhan ◽  
Kamal Sahni
Keyword(s):  
Clinical Response ◽  
Three Dimensional ◽  
Common Side Effect ◽  
P Value ◽  
High Dose ◽  
Cancer Cervix ◽  
Conventional Radiotherapy ◽  
Radiation Fields ◽  
Group A ◽  
Group B

INTRODUCTION: Cervical cancer is the second most frequent cancer among Indian women. Radiotherapy is the cornerstone of treatment in all its stages. Three-dimensional conformal radiotherapy (3DCRT) combines multiple radiation fields to deliver precise dose of radiation to the affected area. Tailoring each of the radiation fields to focus on the tumor delivers a high dose of radiation to the tumor and avoids nearby healthy tissue. The present study is done to compare conventional radiotherapy versus 3DCRT in cancer cervix for compliance, clinical response and toxicity. MATERIAL AND METHODS: Fifty patients were enrolled and randomised into two radiotherapy plans with radical intent - Group A treated by conventional radiotherapy and group B treated by 3DCRT. Concurrent cisplatin was delivered on weekly (35mg/m2) or tri-weekly (75mg/m2) basis during external beam Radiotherapy and was followed by High Dose Radiotherapy Brachytherapy. Clinical response and complication assessment were evaluated.Collected data was analyzed using standard statistical methods and softwares to calculate level of significance using “p” value by chi square test. RESULTS: In this study mean age of the patients was 48 years (26-67 years). The anemia was the most common side effect seen in both groups (96% vs 88%, p=0.29). Neutropenia was more in group B (36% vs 44%, p= 0.56). Lower GI toxicity was seen only in patients in group A (20% vs 0%, p=0.018). In follow up there were no significant early rectal and bladder reactions in both groups and 2 patients in each group had late rectal reactions of grade I and II (p= 0.312). No significant skin, bladder and small intestinal toxicity were seen in both groups. CONCLUSION: Conventional radiotherapy gives equally efficacious response though accompanied by toxicities which were acceptable.

scholarly journals Value of 3D Preoperative Planning for Primary Total Hip Arthroplasty Based on Biplanar Weightbearing Radiographs

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Y. Knafo ◽  
F. Houfani ◽  
B. Zaharia ◽  
F. Egrise ◽  
I. Clerc-Urmès ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Planning ◽  
Femoral Stem ◽  
Leg Length ◽  
Femoral Offset ◽  
Postoperative Result ◽  
Total Hip ◽  
Planning Software ◽  
Navigated Surgery

Two-dimensional (2D) planning on standard radiographs for total hip arthroplasty may not be sufficiently accurate to predict implant sizing or restore leg length and femoral offset, whereas 3D planning avoids magnification and projection errors. Furthermore, weightbearing measures are not available with computed tomography (CT) and leg length and offset are rarely checked postoperatively using any imaging modality. Navigation can usually achieve a surgical plan precisely, but the choice of that plan remains key, which is best guided by preoperative planning. The study objectives were therefore to (1) evaluate the accuracy of stem/cup size prediction using dedicated 3D planning software based on biplanar radiographic imaging under weightbearing and (2) compare the preplanned leg length and femoral offset with the postoperative result. This single-centre, single-surgeon prospective study consisted of a cohort of 33 patients operated on over 24 months. The routine clinical workflow consisted of preoperative biplanar weightbearing imaging, 3D surgical planning, navigated surgery to execute the plan, and postoperative biplanar imaging to verify the radiological outcomes in 3D weightbearing. 3D planning was performed with the dedicated hipEOS® planning software to determine stem and cup size and position, plus 3D anatomical and functional parameters, in particular variations in leg length and femoral offset. Component size planning accuracy was 94% (31/33) within one size for the femoral stem and 100% (33/33) within one size for the acetabular cup. There were no significant differences between planned versus implanted femoral stem size or planned versus measured changes in leg length or offset. Cup size did differ significantly, tending towards implanting one size larger when there was a difference. Biplanar radiographs plus hipEOS planning software showed good reliability for predicting implant size, leg length, and femoral offset and postoperatively provided a check on the navigated surgery. Compared to previous studies, the predictive results were better than 2D planning on conventional radiography and equal to 3D planning on CT images, with lower radiation dose, and in the weightbearing position.

scholarly journals The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Serdar Sahin ◽  
Havva Sezer ◽  
Ebru Cicek ◽  
Yeliz Yagız Ozogul ◽  
Murat Yildirim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Health Care Providers ◽  
Study Groups ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Care Providers ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

<b><i>Introduction:</i></b> The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. <b><i>Methods:</i></b> We included the patients &#x3e;18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight &#x3c;25 kg/m<sup>2</sup> (Group A), overweight from 25 to &#x3c;30 kg/m<sup>2</sup> (Group B), Class I obesity 30 to &#x3c;35 kg/m<sup>2</sup> (Group C), and ≥35 kg/m<sup>2</sup> (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. <b><i>Results:</i></b> There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [<i>p</i> = 0.017], Group D vs. Group A [<i>p</i> = 0.001], and Group D vs. Group C [<i>p</i> = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [<i>p</i> = 0.025], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> = 0.006], and Group D vs. Group C [<i>p</i> = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [<i>p</i> &#x3c; 0.001], Group C vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group A [<i>p</i> &#x3c; 0.001], Group D vs. Group B [<i>p</i> &#x3c; 0.001], and Group D vs. Group C [<i>p</i> = 0.010]). <b><i>Conclusion:</i></b> COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

scholarly journals Antibiotic use and other risk factors at hospital level for outbreaks with Clostridium difficile PCR ribotype 027

2008 ◽  
Vol 57 (6) ◽  
pp. 709-716 ◽  
Author(s):  
T. I. I. van der Kooi ◽  
M. Koningstein ◽  
A. Lindemans ◽  
D. W. Notermans ◽  
E. Kuijper ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Antibiotic Use ◽  
Study Groups ◽  
Ribotype 027 ◽  
Defined Daily Doses ◽  
Hygiene Measures ◽  
Epidemic Period ◽  
Group A ◽  
Group B ◽  
The Relationship

The first Dutch outbreak due to Clostridium difficile ribotype 027 was observed in mid-2005; by the end of that year, eight hospitals were affected. To study the relationship between hospital-wide antibiotic use and the incidence of 027-linked C. difficile-associated disease (CDAD) three study groups were made: group A, all eight hospitals with an 027-associated epidemic; group B, five of a total of six hospitals with occasional 027 cases, without an increase in CDAD; and group C, ten randomly selected hospitals with no reported 027 epidemics or isolated 027 cases. Quarterly data on CDAD incidences, hygiene measures and the use of fluoroquinolones, second- and third-generation cephalosporins, extended-spectrum penicillins, penicillins with beta-lactamase inhibitors, carbapenems, lincomycins and macrolides were collected for 2004 and 2005, and divided into pre-epidemic and epidemic periods. Using a multilevel Poisson regression analysis, CDAD incidence was linked to antibiotic use in the previous quarter and to certain hygiene measures. In the pre-epidemic period, the total use of the studied antibiotics was comparable between affected and unaffected hospitals. Higher use of second-generation cephalosporins, macrolides and all of the studied antibiotics were independently associated with a small increase in CDAD incidence [relative risk (95 % confidence interval): 1.14 per increase of 100 defined daily doses per 10 000 bed days (1.06–1.23), 1.10 (1.01–1.19) and 1.02 (1.01–1.03), respectively]. However the effect was too small to predict which hospitals might be more prone to 027-associated outbreaks.

scholarly journals The effects of pulsed low frequency magnetic field in early rehabilitation of patients with cementless total hip arthroplasty

2006 ◽  
Vol 134 (9-10) ◽  
pp. 414-419
Author(s):  
Aleksandar Djurovic ◽  
Mirjana Zivotic-Vanovic ◽  
Dejan Popovic
Keyword(s):  
Magnetic Field ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Low Frequency ◽  
Early Rehabilitation ◽  
Cementless Total Hip Arthroplasty ◽  
Frequency Magnetic Field ◽  
Group A ◽  
High Doses ◽  
Group B

Introduction: Early rehabilitation of patients with cementless total hip arthroplasty (cTHA) includes different physical modalities and pulsed low frequency magnetic field (PLFMF), which effects have not been explored yet. Objective: To investigate the effects of PLFMF which was applied in different doses in early rehabilitation of patients with cTHA. Method: Prospective, controlled, clinical study included 90 patients, divided in three groups with 30 patients each. First two groups were treated with high (group A) or low (group B) doses of PLFMF, in addition to kinesitherapy. Control group C was treated only with kinesitherapy. Study was completed in three weeks. Results: Subjects of group A had significantly lower pain than group B (p<0.01) and group C (p<0.001) subjects in the first postoperative week. Pain in group B subjects was significantly lower than in group C in all three postoperative weeks (p<0.01). In relation to other two groups, subjects of group A had higher hip Harris score values at the end of the third postoperative week (p<0.05), and they were faster on 10-meter distance at the end of the first postoperative week (p<0.01). Conclusion: PLFMF used in low and high doses for patients with cTHA had significant effects on pain abatement, especially at higher doses. Improvement of function was earlier and more manifested in the group treated with high doses of PLFMF.

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