Radiographic Characteristics of the Femoral Nutrient Artery Canals in Total Hip Arthroplasty using Cementless Femoral Stem

@#Introduction: Accurate diagnosis of undisplaced periprosthetic femoral fracture (PFF) after hip arthroplasty is crucial, as overlooked PFF may affect its treatment and prognosis. The undisplaced PFF is often difficult to distinguish from radiolucent lines of nutrient artery canal (NAC) of the femur present on post-operative radiographs. We aimed to identify the radiographic features of NAC to distinguish them from PFFs. Materials and methods: In this retrospective radiological study, a total of 242 cases in 215 patients with hip arthroplasty were analysed using pre-operative and postoperative anteroposterior (AP) and translateral (TL) radiographs. Interobserver agreement of the measurements was assessed by two independent experienced orthopaedic surgeons. The kappa value ranged from 0.83 to 0.87, indicating strong agreement according to the Landis and Koch criteria. Results: The NACs were found pre-operatively in 94 (39.8%) cases on AP views and in 122 cases (50.4%) on TL views. The radiolucent lines were observed post-operatively in 42 (17.4%) on AP views and 122 (50.4%) on the TL views. three cases (1.2%) had a fracture around the stem that were detected on radiographs. One case with PFF presented simultaneously with NAC on the immediate post-operative radiographs. All patients were treated by conservative measures, and the radiolucent lines did not appear on followup radiographs. Conclusion: It is not easy to differentiate undisplaced PFFs that can occur after hip arthroplasty operation from NACs. However, accurate diagnosis is possible through careful observation and comparison of pre-operative and postoperative radiologic images

A preliminary study on bacterial composition in the subgingival plaque of woman with periodontitis during pregnancy and menopause

Aim: The aim of the present study was to explore the bacterial composition in subgingival plaque of females with periodontitis during pregnancy and menopause stages using 16S ribosomal RNA (rRNA) gene pyrosequencing approach.Methodology: Subgingival plaque was collected from four woman volunteers (healthy, periodontitis, periodontitis at pregnancy and periodontitis at menopause). The microbial community composition was analyzed by 454/Roche GS FLX chemistry pyrosequencing approach using the variable (V1-V3) region of the 16S rRNA gene. Pyrosequencing reads were sorted to get the clean reads that were annotated against the EzBioCloud data base for taxonomic classification. Operational Taxonomic Units (OTUs) were assigned and shared, and subsequently identified using CLCOMMUNITY software. Results: Pyrosequencing yielded 13,939 sequences comprising of 13 phyla, 124 genera, and 372 species. The predominant microbial phyla in subgingival plaque of all woman volunteers included Firmicutes, Actinobacteria, Fusobacteria, Bacteroidetes, and Proteobacteria. In the healthy volunteer, Streptococcus (52.4%) formed the predominant genus while in woman with periodontitis Streptococcus (24.6%) and Fusobacterium (11.7%) predominated. In the periodontitis volunteer with pregnancy, the predominant genus included Streptococcus (25.8%) and Fusobacterium (22.4%), whereas volunteer with menopause, the gingivitis was associated with genus Alloprevotella (19.5%), Leptotrichia (14.3%), Fusobacterium (12.3%), and Porphyromonas (12.0%). Interpretation: This study proves on preliminary basis that the subgingival microbiome of woman with periodontitis at pregnancy or menopause tend to differ from that of healthy woman, and these species included certain periodontal pathogens such as Fusobacterium nucleatum and Porphyromonas gingivalis

Effects of Inflammatory Disease on Clinical Progression and Treatment of Ischiogluteal Bursitis: A Retrospective Observational Study

@#Introduction: The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment. Materials and Methods: Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention. Results: The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups. Conclusion: The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.