RESUMO
PURPOSE OF THE STUDY Cementless stems in highly dysplastic hips are considered to increase the risk of femoral fracture and associated morbidity. Several authors speculated to use prophylactic cabling in this patient group to prevent intraoperative fractures. This study aims to reveal objective results regarding the perioperative complications in a large and consecutive patient group with respect to use of prophylactic cabling. MATERIAL AND METHODS A retrospective comparative study was planned. A total of 122 consecutive patients with dysplastic hips of Crowe type 3 or 4, operated on with total hip arthroplasty (THA) and shortening osteotomy using a rectangular femoral stem were included. Patients were stratified according to use of a diaphyseal prophylactic cerclage cable. Perioperative complications were recorded. Clinical outcome was measured in terms of Harris Hip Score and Visual Analog Scale (VAS) for pain. All results were compared between the groups. RESULTS The mean follow-up time was 27 months. Two (2%) versus five (14%) patients had a fracture at the diaphyseal level in cabled versus non-cabled groups. Difference between groups was statistically significant (p=0.01). Relative risk of fracture in case of a non-cabling was 5.8 (p=0.03). Eleven (9%) patients had a non-displaced fracture at the metaphyseal level. No significant differences were detected with respect to preoperative clinical outcome scores or change in these scores between groups. CONCLUSIONS Femoral diaphyseal fracture rates are low when cementless, rectangular stems are used in dysplastic high riding hips. Prophylactic cerclage cabling further decreases the fracture risk and eases treatment in case of a fracture without causing additional complications and therefore is recommended. Key words: intraoperative fracture, periprosthetic fracture, total hip arthroplasty, cerclage cabling, developmental hip dysplasia, transverse shortening osteotomy.
Assuntos
Artroplastia de Quadril , Displasia do Desenvolvimento do Quadril , Fraturas do Fêmur , Fraturas Periprotéticas , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Cimentos Ósseos , Fraturas do Fêmur/etiologia , Fraturas do Fêmur/prevenção & controle , Fraturas do Fêmur/cirurgia , Humanos , Fraturas Periprotéticas/etiologia , Fraturas Periprotéticas/prevenção & controle , Fraturas Periprotéticas/cirurgia , Estudos RetrospectivosRESUMO
PURPOSE: To compare the length, thickness, and elasticity of the patellar tendon between operated and non-operated knees following closed wedge high tibial osteotomy (CWHTO). METHODS: Three men and 17 women aged 52 to 75 (mean, 64.8) years who underwent unilateral CWHTO by a single surgeon and were followed up for a mean of 11 (range, 5-22) years were included, as were 3 male and 17 female healthy controls aged 35 to 61 (mean, 47.9) years. The length, thickness, and elasticity of the bilateral patellar tendons in the patients and healthy controls were measured using shear wave elastography. RESULTS: In the CWHTO patients, the patellar tendon on the operated side was thicker (4.4 vs. 3.3 mm, p=0.001) and stiffer (74.1 vs. 47.7 kPa, p<0.001) than on the non-operated side. CONCLUSION: Patellar tendon contracture (thickening and stiffening) is associated with CWHTO.
Assuntos
Contratura/diagnóstico por imagem , Osteotomia/efeitos adversos , Ligamento Patelar/diagnóstico por imagem , Ligamento Patelar/fisiopatologia , Tíbia/cirurgia , Idoso , Contratura/etiologia , Elasticidade , Técnicas de Imagem por Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-OperatórioRESUMO
Color removal from neutralized sunflower oil was studied with different kinds of commercial bleaching earths. The effect of changes in time (25 and 35 min), temperature (80-125 degrees C), and bleaching earth dosage (0.1-0.9% by weight) on color, chlorophyll and carotene concentrations, and oxidation degree were investigated. To obtain adsorption curves from coloring compounds adsorbed onto activated bleaching earths, the Langmuir and Freundlich equations was used, the constant parameters and correlation coefficient R were calculated for each type of bleaching earth, and color changes were explained by both adsorption isotherms. It was observed that an increase in bleaching earth dosage decreases color. Its effect on oxidation state, however, is complex and related to both primary and secondary oxidation products. In addition, an increase in temperature seems to decrease chlorophyll and carotene adsorptions. Generally, time beyond equilibrium is considered useless for the removal of unwanted components. This study also confirms this claim and reveals that the peroxide value does not indicate the oxidation state of the oil completely.