ABSTRACT
Aims: The purpose of this retrospective study was to evaluate the minimum five-year outcome of revision total hip arthroplasty (THA) using the Kerboull acetabular reinforcement device (KARD) in patients with Paprosky type III acetabular defects and destruction of the inferior margin of the acetabulum. Patients and Methods: We identified 36 patients (37 hips) who underwent revision THA under these circumstances using the KARD, fresh frozen allograft femoral heads, and reconstruction of the inferior margin of the acetabulum. The Merle d'Aubigné system was used for clinical assessment. Serial anteroposterior pelvic radiographs were used to assess migration of the acetabular component. Results: At a mean follow-up of 8.2 years (5 to 19.3), the mean Merle d'Aubigné score increased from 12.5 (5 to 18) preoperatively to 16.5 (10 to 18) (p < 0.0001). The survival rate at ten years was 95.3% (sd 4.5; 95% confidence interval (CI) 86.4 to 100) and 76.5% (sd 9.9, 95% CI 57.0 to 95.9) using aseptic loosening and radiological loosening as the endpoints, respectively. Conclusion: These results show that the use of the KARD with reconstruction of the inferior margin of the acetabulum in revision THA is associated with acceptable clinical results and survival at mid-term follow-up with, however, a high rate of migration of the acetabular component of 21.6%. Cite this article: Bone Joint J 2018;100-B:725-32.
Subject(s)
Acetabulum/surgery , Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Reoperation/methods , Acetabulum/pathology , Adult , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Hip/methods , Bone Transplantation/adverse effects , Bone Transplantation/methods , Female , Follow-Up Studies , Hip Joint/surgery , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Prosthesis Failure , Reoperation/adverse effects , Reoperation/instrumentation , Retrospective Studies , Survival Rate , Transplantation, Homologous , Treatment OutcomeABSTRACT
Two mitochondrial DNA segments of the bigeye tuna (Thunnus obesus) were amplified by polymerase chain reaction (PCR), and restriction fragment length polymorphism (RFLP) analyses of these segments were used for the genetic stock study. The variation in a segment flanking the ATPase and COIII genes was low; only two genotypes (alpha and beta) were detected by RsaI digestion. Yet a large difference in the genotype distribution was observed between ocean basin samples. The alpha type predominated in four Atlantic samples, where 178 of 244 individuals were the alpha type. In contrast, only one of 195 individuals collected in the Indo-Pacific was the alpha type? The frequency of the alpha type varied considerably from 0 to 80% among seven samples collected off the Cape of Good Hope. The variation found in the other segment, containing the D-loop region, was much higher; two endonucleases (DpnII and RsaI) detected five genotypes each and 15 composite genotypes. A highly significant difference in genotype frequencies was observed between the Atlantic and Indo-Pacific samples, but no heterogeneity was observed among the four Atlantic or among four Indo-Pacific samples. These results clearly indicate that not only gene flow, but also fish migration, between the Atlantic and Indian Oceans are severely restricted, and that fishes from these distinct stocks are intermingling around South Africa. The simple and diagnostic genetic marker found in this study can be used to estimate mixing ratios between Atlantic and Indian stocks around South Africa.
