Long-term outcome of cementless total hip arthroplasty with threaded Tropic® acetabular cup and Corail® femoral stem.

This study investigates the clinical and radiological results of a tapered femoral stem (Corail®) and uncemented threaded acetabular cups (Tropic®) and in addition an analysis of the complications and retrieved implants was conducted. Between January 1990 and September 1998, 301 total hips arthroplasties in 268 patients were implanted. 78 patients (87 hips) had died and 9 patients (12 hips) had been lost to follow-up, leaving at the time of the latest follow-up 180 patients (202 hips). The mean age at surgery was 56,1 (27-75) years. Of the 154 unrevised hips, the median Harris and Merle d'Aubigne and Postel hip scores were 83,3 points and 15,3 points respectively at the latest follow-up. The median follow-up time was 16.9 years (10,4-25). No femoral component was revised for aseptic loosening ; osteolysis was observed in the 9,5% of the implants (13 stems). 48 hips (23%) were revised and 27 cups (56,2%) needed revision surgery because of massive polyethylene wear. Pelvic osteolysis was found out in 80 cups (58,8%). 87 hips (63,9%) showed signs of a progressive wear of the liner, more than 2mm in 48 hips. Kaplan-Meier survivorship analysis at 15 years follow-up was 81.2% with revision for any reason (85.8% for mechanical or radiographic loosening). High rates of polyethylene wear and the high prevalence of pelvic osteolysis are serious matters in these types of implants with high rates of revision at 15 years follow-up so we decided to abandon the concept of a threaded cup design in favor of a press-fit acetabular cup.

Mastocitosis cutánea: revisión de 10 años de experiencia en el Servicio de Dermatología del Hospital General de Niños Pedro de Elizalde / Cutaneous mastocytosis: 10-years experience review at the Dermatology Department, Hospital General de Niños Pedro de Elizalde

Introducción. La mastocitosis representa un espectro de trastornos clínicos con un fenotipo común correspondiente a una hiperplasia de los mastocitos tisulares. Objetivo. Presentar la experiencia del Servicio de Dermatología del Hospital General de Niños Pedro de Elizalde en mastocitosis cutánea en los últimos 10 años. Diseño. Estudio retrospectivo y descriptivo, de corte transversal. Material y método. Se revisaron los archivos histológicos correspondientes al período que va de marzo de 1999 a marzo de 2099 del Servicio de Dermatología del Hospital General de Niños Pedro de Elizalde. Se consideraron como variables de estudio la edad al momento de la consulta, sexo, presencia de antecedentes personales y familiares, tipo clínico, localización, presencia de síntomas al examen físico, así como hallazos patológicos en los estudios complementarios. Los resultados se expresaron en promedios y porcentajes. Resultados. Presentamos 49 casos con diagnóstico clínico e histológico de mastocitosis cutánea; 33 pacientes (67,3%) de sexo masculino y 16 (32,7%) de sexo femenino. En cuanto al tipo clínico de mastocitosis, se encontraron 36 casos de urticaria pigmentosa (73,4%), 6 casos de mastocitoma solitario (12,2%), 5 casos de telangiectasia macularis eruptiva perstans (10,2%) y 2 casos donde coexistía mastocitoma solitario y urticaria pigmentosa (4%). No se encontraron casos de mastocitosis cutánea difusa. Las lesiones se distribuyen en tronco 25 casos (51%), en tronco y miembros 17 casos (34,6%), en cabeza, tronco y miembros 3 casos (6,1%), en miembros 3 casos (6,1%), en cabeza y tronco un caso (2,04%). Conclusión. En nuestra casuística, la manifestación clínica más frecuente fue la urticaria pigmentosa, similar a lo señalado en la bibliografía. Encontramos, a diferencia de lo publicado en la literatura, un predominio de sexo masculino y un alto porcentaje (10,2%) de pacientes pediátricos con la forma de telangiectasia macularis eruptiva perstans.

IntroductionMastocytosis represents a spectrum of clinical disorders with a common phenotype correspondingto hyperplasia of mast cells on tissues.ObjectiveTo present the experience of the Department of Dermatology, Hospital General de Niños Pedro deElizalde in cutaneous mastocytosis during the past 10 years.DesignRetrospective and descriptive, cross sectional study.Material and methodsHistological records were reviewed for the period March 1999-March 2009 at the Department ofDermatology, Hospital General de Niños Pedro de Elizalde.The variables considered were: age at time of consultation, gender, presence of personal andfamily history, clinical type, location, presence of symptoms by physical examination andabnormal findings on complementary studies.The results were expressed as averages and percentages.ResultsForty nine patients with clinical and histological diagnosis of cutaneous mastocytosis arepresented, 33 of them were male (67.3%) and 16 were female (32.7%).As regards to the clinical type of mastocytosis, 36 patients presented urticaria pigmentosa(73.4%), 6 had solitary mastocytoma (12.2%), 5 presented telagiectasia macularis eruptivaperstans (10.2%) and 2 patients presented solitary mastocytoma combined with urticariapigmentosa (4%). Diffuse cutaneous mastocytosis was not found.Twenty five patients had lesions distributed on the trunk (51%), trunk and limbs on 17 (34.6%),head, trunk and limbs 3 patients (6.1%), on limbs only 3 patients (6.1%), while head and trunktogether were affected on 1 patient (2.04%).ConclusionIn our caseload, the most frequent clinical manifestation was urticaria pigmentosa, similar tofindings in the literature.As opposed to published data we found predominance in males, and a high incidence (10.2%)of pediatric patients with telangiectasia macularis eruptiva perstans.