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BACKGROUND: Endoscopic rubber band ligation (ERBL) is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain. AIM: To evaluate satisfaction, long-term recurrence, and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL. METHODS: This was a prospective, multicenter, randomized study. A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding (EFSB) or an ERBL group. All patients were followed-up for 12 months. Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score (HSS) and a visual analog scale (VAS). Continuous variables were reported as medians and interquartile range. RESULTS: One hundred and ninety-five patients were enrolled, with 98 in the EFSB group. HSS was lower in the EFSB group than in the ERBL group at 8 weeks [4.0 (3.0-5.0) vs 5.0 (4.0-6.0), P = 0.003] and 12-month [2.0 (1.0-3.0) vs 3.0 (2.0-3.0), P < 0.001] of follow-up. The prolapse recurrence rate was lower in the EFSB group at 12 months (11.2% vs 21.6%, P = 0.038). Multiple linear regression analysis demonstrated that EFSB treatment [B = -0.915, 95% confidence interval (CI): -1.301 to -0.530, P = 0.001] and rubber band number (B = 0.843, 95%CI: 0.595-1.092, P < 0.001) were negatively and independently associated with the VAS score 24 hours post-procedure. The median VAS was lower in the EFSB group than in the ERBL [2.0 (1.0-3.0) vs 3.0 (2.0-4.0), P < 0.001]. CONCLUSION: Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.
Subject(s)
Hemorrhoids , Polidocanol , Recurrence , Sclerosing Solutions , Sclerotherapy , Humans , Polidocanol/administration & dosage , Polidocanol/therapeutic use , Hemorrhoids/therapy , Hemorrhoids/diagnosis , Hemorrhoids/surgery , Middle Aged , Female , Male , Prospective Studies , Sclerotherapy/methods , Treatment Outcome , Ligation/methods , Sclerosing Solutions/administration & dosage , Adult , Aged , Severity of Illness Index , Pain, Postoperative/etiology , Pain, Postoperative/diagnosis , Patient Satisfaction , Pain Measurement , Polyethylene Glycols/administration & dosage , Polyethylene Glycols/therapeutic useABSTRACT
BACKGROUND: In China, Tongluo-Qutong rubber plaster (TQRP) is commonly used for cervical spondylotic radiculopathy, but lacks high-quality trials. OBJECTIVE: This study aimed to conduct a multicenter, open-label, parallel-group, randomized controlled trial in China to investigate the practical efficacy and safety of TQRP in the treatment of CSR. METHODS: A total of 240 patients diagnosed with CSR were recruited for the investigation from multiple hospitals in Gansu province, China. The patients were randomly assigned to either an experimental or a control group. The experimental group received treatment with TQRP, whereas the control group was administered a diclofenac sodium patch (DSP) for a maximum duration of 21 days. The visual analogue scale (VAS) score for pain, the proportion of patients experiencing 50% or more pain relief, the neck disability index (NDI), changes as per the Eaton trial, and recurrence during the follow-up period were evaluated for both groups. The safety and adverse events associated with the concurrent drug therapy were also evaluated. RESULTS: At each time point, the mean VAS and NDI scores of both groups demonstrated a downward trend. The experimental group exhibited a greater decline in VAS score at each time point compared to the control group (P< 0.01). In the Eaton trial, both the percentage of patients experiencing pain relief of 50% or more and the number of abnormal results exhibited improvement. However, the outcomes in the 21 ± 3d experimental group were significantly superior to those in the control group (P< 0.01). During the follow-up period, the recurrence events in the experimental group were reduced compared to the control group. The difference between the two groups was statistically significant (P< 0.05). The incidence of adverse reactions was 1.74% for TQRP and 3.54% for DSP. CONCLUSION: TQRP is effective and safe in the treatment of CSR.
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Volatile organic compounds (VOCs) pose potential hazards to human health and contribute significantly to odor pollution. This study examined VOC emissions from a representative recycled rubber industry, evaluating the occupational health risks for frontline workers in various workshops. Variables such as gender and workshop-specific concentration variations were considered using Monte Carlo simulation methods. Employees in the five production workshops and office areas face noncarcinogenic health risks with hazard indices (HIs) greater than 1, with the rubber compounding phase presenting the highest risk. Acetaldehyde is identified as the primary noncarcinogenic health risk substance, with hazard quotient (HQ) values exceeding 1 in all workshops. Carcinogenic health risks vary by area, with the highest risks found in compounding and refining workshops. Formaldehyde poses the greatest risk in rubber grinding workshops and offices, with cumulative weights exceeding unacceptable levels of M80.58â¯% and W77.56â¯% in grinding and M94.98â¯% and W92.24â¯% in the office. Male workers face 4-7â¯% greater noncarcinogenic VOC health risks than females and 5-14â¯% greater carcinogenic risks from individual VOCs, increasing their susceptibility to health risks caused by VOCs. Additionally, our analysis of odor identification and intensity classification revealed that 53 VOCs are capable of causing odor pollution, with several substances reaching odor levels of 2 or higher. The predominant perceived odors, as reflected in the odor wheel, include categories such as "solvent/aromatic" and "sweet/fruit," with aldehydes being the primary odor-causing substances. In summary, emissions of VOCs from rubber industrial processes not only pose substantial health risks to workers but also contribute significantly to odor pollution. Consequently, enterprises must prioritize optimizing workplace conditions to ensure the occupational health and well-being of their employees.
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Triboelectric nanogenerators (TENG) are promising alternatives for clean energy harvesting. However, the material utilization in the development of TENG relies majorly on polymers derived from non-renewable resources. Therefore, minimizing the carbon footprint associated with such TENG development demands a shift toward usage of sustainable materials. This study pioneers using natural rubber (NR) as a sustainable alternative in TENG development. Infusing graphene in NR, its dielectric constant and tribonegativity are optimized, yielding a remarkable enhancement. The optimized sample exhibits a dielectric constant of 411 (at 103 Hz) and a contact potential difference (CPD) value of 1.85 V. In contrast, the pristine NR sample showed values of 6 and 3.06 V for the dielectric constant and CPD. Simulation and experimental studies fine-tune the TENG's performance, demonstrating excellent agreement between theoretical predictions and practical studies. Sensors developed via stencil printing technique possess a remarkably low layer thickness of 270 µm, and boast a power density of 420 mW m-2, a staggering 250% increase over conventional NR. Moreover, the material is pressure sensitive, enabling precise real-time human motion detection, including finger contact, finger bending, neck bending, and arm bending. This versatile sensor offers wireless monitoring, empowering healthcare monitoring based on the Internet of Things.
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Taraxacum kok-saghyz (TKS) is a natural rubber (NR)-producing plant and a model plant for studying the biosynthesis of NR. Analyzing and studying the biosynthetic mechanism of NR is an important way to cultivate high-yield rubber TKS varieties. JAZ proteins, which belong to the Jasmonate ZIM domain family, function as negative regulators in the jasmonic acid (JA) signal transduction pathway. MYC2 is typically regarded as a regulatory factor for the target genes of JAZ proteins; JAZ proteins indirectly influence the gene expression regulated by MYC2 by modulating its activity. Theoretically, JAZ is expected to participate in growth, development, and responses to environmental cues related to rubber and biomass accumulation in TKS, all of which rely on the interaction between JAZ and MYC2. In this study, we identified 11 TkJAZs through homology searching of the TKS genomes and bioinformatics analyses. Subcellular localization, Y2H, and BiFC analysis demonstrate that TkJAZs and TkMYC2 are localized in the nucleus, with all TkJAZs and TkMYC2 showing nuclear colocalization interactions. Overexpression of TkMYC2 in TKS inhibited leaf development, promoted root growth, and simultaneously increased NR production. RNA-seq and qRT-PCR analysis revealed that the TkSRPP/REF genes exhibit varying degrees of upregulation compared to the wild type, upregulating the TkREF1 gene by 3.7-fold, suggesting that TkMYC2 regulates the synthesis of NR by modulating the TkSRPP/REF genes.
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Given the friction and drag reduction effects observed in various biological hexagonal structures in nature, a new design was implemented on the rubber surface of the stator of a submersible screw pump. This design featured a multilayer concentric hexagonal groove structure. Furthermore, a composite multilayer hexagonal structure integrating grooves and pits was also developed and applied. This study investigated the influence of groove layer number, groove depth, pit depth, and multilayer hexagonal groove texture arrangement on the rubber surface flow characteristics. Additionally, the pressure field state, the degree of influence on the oil film-bearing capacity, and the biomimetic and hydrodynamic lubrication theories were tested using the finite element analysis method. Tribological experiments were conducted on nanosecond laser-processed rubber textures under simulated liquid lubrication conditions, reflecting actual shale oil well experiments. These experiments aimed to investigate the influence of multilayer hexagonal shape parameters on the tribological characteristics of the stator-rotor friction pair of a submersible screw pump. The results indicated that with a constant overall size, a multilayer hexagonal structure with ~0.1 mm groove depth enhanced the oil film-bearing capacity, providing significant friction and drag reduction. For composite textures, a deeper pit depth within the study area enhanced the oil film-bearing capacity. Furthermore, a gradient arrangement of groove textures featuring wider outer grooves and shallower depth exhibited superior performance in terms of bearing capacity.
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The goal of this work was to develop acrylonitrile-butadiene (NBR) elastomer composites filled with hydroxyapatite (HAP) characterized by improved cure characteristics and resistance to burning. Silane, i.e., (3-aminopropyl)-triethoxysilane, ionic liquid, i.e., 1-decyl-3-methylimidazolium bromide and surfactant, i.e., cetyltrimethylammonium bromide, were used to improve the filler's dispersibility in the elastomer matrix and to reduce the time and temperature of vulcanization. The effects of HAP and dispersants on the cure characteristics, crosslink density and physico-chemical properties of NBR composites were explored. The additives used, especially the ionic liquid and surfactant, effectively improved the dispersion of HAP in the NBR matrix. The amount of HAP and the dispersant used strongly affected the cure characteristics and crosslink density of NBR. The optimal vulcanization time significantly increased with HAP content and was pronouncedly reduced when ionic liquid and surfactant were applied. In addition, ionic liquid and surfactant significantly lowered the onset vulcanization temperature and improved the crosslink density and hardness of the vulcanizates while impairing their elasticity. HAP and dispersants did not significantly affect the damping properties or chemical resistance of NBR vulcanizates. Above all, application of HAP considerably enhanced the resistance of vulcanizates to thermo-oxidative aging and reduced their flammability compared with the unfilled NBR.
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WO3 and silicone rubber (SR)-based gasochromic composites were fabricated to detect hydrogen leaks at room temperature. WO3 rod-like nanostructures were uniformly distributed in the SR matrix, with a particle size of 60-100 nm. The hydrogen permeability of these composites reached 1.77 cm3·cm/cm2·s·cmHg. At a 10% hydrogen concentration, the visible light reflectance of the composite decreased 49% during about 40 s, with a color change rate of 6.4% s-1. Moreover, the composite detected hydrogen concentrations as low as 0.1%. And a color scale was obtained for easily assessing hydrogen concentrations in the environment based on the color of composites. Finally, the composite materials as disposable sensors underwent testing at several Sinopec hydrogen refueling stations.
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The comprehensive performance of rubber products could be significantly improved by the addition of functional fillers. To improve research efficiency and decrease the experimental cost, the mechanical and thermal properties of carbon-fiber-reinforced rubber were investigated using finite element simulations and theoretical modeling. The simplified micromechanical model was constructed through the repeatable unit cell with periodic boundary conditions, and the corresponding theoretical models were built based on the rule of mixture (ROM), which can be treated as the mutual verification. The simulation results suggest that, in addition to the fiber volume fraction Vfc increasing from 10% to 70%, the longitudinal Young's modulus, transversal Young's modulus, in-plane shear modulus, longitudinal thermal expansion coefficient, and transversal thermal expansion coefficient changed from 2.31 × 1010 Pa to 16.09 × 1010 Pa, from 0.54 × 107 Pa to 2.59 × 107 Pa, from 1.66 × 106 Pa to 10.11 × 106 Pa, from -4.98 × 10-7 K-1 to -5.89 × 10-7 K-1, and from 5.72 × 10-4 K-1 to 1.66 × 10-4 K-1, respectively. The mechanism by which Vfc influences the properties of carbon-fiber-reinforced rubber was revealed through the distribution of Von Mises stress. This research will contribute to improving the performance of carbon-fiber-reinforced rubber and promote its application.
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This study involved the preparation of natural rubber-based composites incorporating varying proportions of heavy metals and rare earth oxides (Sm2O3, Ta2O5, and Bi2O3). The investigation analyzed several parameters of the samples, including mass attenuation coefficients (general, photoelectric absorption, and scattering), linear attenuation coefficients (µ), half-value layers (HVLs), tenth-value layers (TVLs), mean free paths (MFPs), and radiation protection efficiencies (RPEs), utilizing the Monte Carlo simulation software Geant4 and the WinXCom database across a gamma-ray energy spectrum of 40-150 keV. The study also compared the computational discrepancies among these measurements. Compared to rubber composites doped with single-component fillers, multi-component mixed shielding materials significantly mitigate the shielding deficiencies observed with single-component materials, thereby broadening the γ-ray energy spectrum for which the composites provide effective shielding. Subsequently, the simulation outcomes were juxtaposed with experimental data derived from a 133Ba (80 keV) γ-source. The findings reveal that the simulated results align closely with the experimental observations. When compared to the WinXCom database, the Geant4 software demonstrates superior accuracy in deriving radiation shielding parameters and notably enhances experimental efficiency.
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A previous related paper dealing with the density relaxation of polystyrene (PS) has shown that the equilibrium relaxation time (τeq) has a purely exponential temperature dependence (ETD) below ≈100 °C. Such an ETD is now also confirmed based upon available dielectric spectra data for PS. By combining the ETD behavior of τeq (or aT) at low temperatures with a VFTH behavior at higher temperatures (based mainly on available recoverable shear compliance data), a composite correlation for τeq (or aT) is developed, which is continuous with continuous slope at a crossover temperature that is found to be 99.22 °C, where τeq = 92.15 s. This composite representation is shown to describe (without any adjustable parameters) available independent data for the segmental relaxation time over a finite range both above and below Tcrossover (i.e., the glass transition temperature).
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In order to improve the basic pavement performance of high-elastic asphalt concrete filled in the expansion longitudinal joints of seamless bridges, rubber particles and polyester fibers were added to optimize the mix proportion of elastic asphalt concrete, and the optimal asphalt-aggregate ratio was determined. The influence of rubber particles and polyester fibers on the basic pavement performance of high-elastic asphalt concrete was studied. The results show that when the dosage of polyester fiber is not more than 0.6%, the optimal asphalt-aggregate ratio is 1:5, and when it exceeds 0.6%, the optimal asphalt-aggregate ratio is 1:4. The incorporation of rubber particles reduces the compressive strength of high-elastic asphalt concrete but enhances its high-temperature stability, fracture performance, and deformation recovery ability. The incorporation of polyester fibers improves its compressive strength, high-temperature stability, fracture performance, and deformation recovery ability. In addition, the incorporation of rubber granules and polyester fibers promotes the use of green building materials and provides strong support for sustainable building practices.
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In practical applications, polyurethane (PU) foam must be rigid to meet the demands of various industries and provide comfort and protection in everyday life. PU foam components are extensively used in structural foam, thermal insulation, decorative panels, packaging, imitation wood, and floral foam, as well as in models and prototypes. Conventional technology for producing PU foam parts often leads to defects such as deformation, short shots, entrapped air, warpage, flash, micro-bubbles, weld lines, and voids. Therefore, the development of rigid PU foam parts has become a crucial research focus in the industry. This study proposes an innovative manufacturing process for producing rigid PU foam parts using silicone rubber molds (SRMs). The deformation of the silicone rubber mold can be predicted based on its wall thickness, following a trend equation with a correlation coefficient of 0.9951. The volume of the PU foam part can also be predicted by the weight of the PU foaming agent, as indicated by a trend equation with a correlation coefficient of 0.9824. The optimal weight ratio of the foaming agent to water, yielding the highest surface hardness, was found to be 5:1. The surface hardness of the PU foam part can also be predicted based on the weight of the water used, according to a proposed prediction equation with a correlation coefficient of 0.7517. The average surface hardness of the fabricated PU foam part has a Shore O hardness value of approximately 75. Foam parts made with 1.5 g of water added to 15 g of a foaming agent have the fewest internal pores, resulting in the densest interior. PU foam parts exhibit excellent mechanical properties when 3 g of water is added to the PU foaming agent, as evidenced by their surface hardness and compressive strength. Using rigid PU foam parts as a backing material in the proposed method can reduce rapid tool production costs by about 62%. Finally, an innovative manufacturing process for creating large SRMs using rigid PU foam parts as backing material is demonstrated.
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The forest industry produces several low-value by-products, such as bark, sawdust, limbs, and leaves, that are not ultimately disposed of and remain in the forests and sawmill facilities. Among these by-products are leaves, which contain not only cellulose fibers and lignin but also essential oils such as terpenes. These are biosynthesized in a similar way as cis-1,4-polyisoprene. In this context, this work evaluates the use of screened and unscreened dried Eucalyptus nitens leaves in natural rubber. Among the most relevant results of this work is a significant increase in mechanical properties, such as tensile strength and elongation at break, reaching values of 9.45 MPa and 649% of tensile strength and elongation at break, respectively, for a sample of natural rubber containing sieved dried leaves of Eucalyptus nitens. In addition, it is observed that the content of this vegetable filler allows for inhibiting the antibacterial effect of vulcanized rubber against several bacteria, such as Bacillus subtilis, Staphylococcus aureus, Escherichia coli K 12, Escherichia coli FT 17 and Pseudomonas fluorescens. These results are promising because they not only add value to a by-product of the forestry industry, improving the mechanical properties of natural rubber from a sustainable approach but also increase the affinity of rubber with bacterial microorganisms that may play a role in certain ecosystems.
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Distinguished from traditional vulcanized rubber, which is not reusable, thermoplastic elastomer (TPV) is a material that possesses both the excellent resilience of traditional vulcanized rubber and the recyclability of thermoplastic, and TPVs have been widely studied in both academia and industry because of their outstanding green properties. In this study, new thermoplastic elastomers based on solution polymerized styrene butadiene rubber (SSBR) and thermoplastic elastomers (SEPSs/SEBSs) were prepared by the first dynamic vulcanization process. The high slip resistance and abrasion resistance of SSBR are utilized to improve the poor slip resistance of SEPSs/SEBSs, which provides a direction for the recycling of shoe sole materials. In this paper, the effects of different ratios of the rubber/plastic phase (R/P) on the mechanical properties, rheological properties, micro-morphology, wear resistance, and anti-slip properties of SSBR/TPE TPVs are investigated. The results show that the SSBR/TPE TPVs have good mechanical properties. The tensile strength, tear strength, hardness, and resilience of the TPVs decrease slightly with an increasing R/P ratio. Still, TPVs have a tensile strength of 18.1 MPa when the ratio of R/P is 40/100, and this reaches the performance of the vulcanized rubber sole materials commonly used in the market. In addition, combined with microscopic morphology analysis (SEM), it was found that, with the increase in the R/P ratio, the size of the rubber particles gradually increased, forming a stronger crosslinking network, but the rheological properties of TPVs gradually decreased; crosslinking network enhancement led to the increase in the size of the rubber particles, and the increase in the size of rubber particles made the material in the abrasion of rubber particles fall easily, thus increasing its abrasion volume. Through dynamic mechanical analysis and anti-slip tests, when the R/P ratio was 40/100, the tan δ of TPVs at 0 °C was 0.35, which represents an ordinary vulcanized rubber sole material in the market. The viscoelasticity of TPVs increased with the increase in the R/P ratio, which improved the anti-slip performance of TPVs. SSBR/TPE TPVs are expected to be used in footwear and automotive fields due to their excellent abrasion resistance and anti-slip performance.
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Aim The aim of this study was to evaluate the effectiveness of 5% eutectic mixture of local anesthetics (EMLA) cream and 20% benzocaine gel in reduction of pain during rubber dam clamp placement in the treatment of non-carious cervical lesions (NCCLs). Methodology In this split-mouth single-blind randomized clinical trial, 50 adult participants were selected from the outpatient department. The test group was treated using 5% EMLA cream for three minutes, and visual analog scale (VAS) scores were recorded. The comparison group was treated using 20% benzocaine gel and procedure was repeated as that in the test group. After recording the VAS scores, NCCLs in both the groups were restored using composite restoration. Results In the included 50 participants, 70% were males, with an age group of 31-67 years. The mean VAS score at 3 minutes in EMLA group was significantly lower than that in benzocaine group. Conclusion Application of 5% EMLA cream for 3 minutes showed greater pain reduction during rubber dam clamp placement as compared to 20% benzocaine gel in adult patients with NCCLs.
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The Oomycetes fungus Phytophthora spp. which causes Abnormal leaf fall (ALF) disease poses a significant threat as one of the most devastating diseases affecting rubber trees in India. A total of 30 Phytophthora isolates were obtained from ALF-affected samples collected during the Southwest monsoon season of Kerala. The colony morphology of Phytophthora isolates revealed eight different types of growth patterns, with stellate, stellate striated, and petaloid patterns growing rapidly, whereas chrysanthemum pattern grew slowly. Sporangia were papillate to non-papillate in various shapes, and sporangiophores exhibited simple, simple sympodial, or irregularly branching patterns. Highly virulent isolates exhibited petaloid morphology and rapid growth rates. Regardless of their virulence, all isolates showed susceptibility to the fungicide metalaxyl. Under in vitro conditions, the highly virulent isolate (R17) from rubber caused severe infections in chili, brinjal, and tomato with brown water-soaked lesions. Sequence analysis and multi-locus phylogeny of Internal transcribed spacer (ITS), cCytochrome c oxidase 1 (COX 1), Heat shock protein 90 (HSP 90), and Ribosomal protein L10 (RPL 10) confirmed the pathogen as Phytophthora meadii. A comprehensive understanding of both morphological and molecular traits of P. meadii is crucial for precise identification and future genetic variability studies.
Subject(s)
Hevea , Phylogeny , Phytophthora , Plant Diseases , India , Phytophthora/genetics , Phytophthora/classification , Plant Diseases/microbiology , Plant Diseases/parasitology , Hevea/microbiology , Hevea/parasitology , Multilocus Sequence Typing , Plant Leaves/microbiology , Plant Leaves/parasitology , Sequence Analysis, DNA , Virulence , DNA, Ribosomal Spacer/genetics , Prevalence , Cluster Analysis , Fungicides, Industrial/pharmacology , Alanine/analogs & derivativesABSTRACT
Recent years have witnessed the explosive development of highly sensitive smart sensors based on conductive polymer foam materials. However, the design and development of multifunctional polymeric foam composites as smart sensors applied in complex solvent and oil environments remain a critical challenge. Herein, we design and synthesize vinyl-terminated polytrifluoropropylmethylsiloxane through anionic ring-opening polymerization to fabricate fluorosilicone rubber foam (FSiRF) materials with nanoscale wrinkled surfaces and reactive Si-H groups via a green and rapid chemical foaming strategy. Based on the strong adhesion between FSiRF materials and consecutive oxidized ketjen black (OKB) nano-network, multifunctional FSiRF nanocomposites were prepared by a dip-coating strategy followed by fluoroalkylsilane modification. The optimized F-OKB@FSiRF nanocomposites exhibit outstanding mechanical flexibility in wide-temperature range (100 cycle compressions from -20 to 200 °C), structure stability (no detached particles after being immersed into various aqueous solutions for up to 15 days), surface superhydrophobicity (water contact angle of 154° and sliding angle of â¼7°), and tunable electrical conductivity (from 10-5 to 10-2 S m-1). Additionally, benefiting from the combined actions of multiple lines of defense (low surface energy groups, physical barriers, and "shielding effect"), the F-OKB@FSiRF sensor presents excellent anti-swelling property and high sensitivity in monitoring both large-deformation and tiny vibrations generated by knocking the beaker, ultrasonic action, agitating, and sinking objects in weak-polar or nonpolar solvents. This work conceivably provides a chemical strategy for the fabrication of multifunctional polymeric foam nanocomposite materials as smart sensors for broad applications.
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After ingestion rubber gloves harden and can produce dangerous complications. Therefore the choice of treatment is of utmost importance. Aside from a surgical approach, endoscopy should also be considered as a treatment option on a case-to-case basis or if not applicable as a useful diagnostic tool.
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Introduction: Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital vascular disorder that affects the venous system. Lesions are multiple and involved not only the skin and subcutaneous tissue but also muscles, joints and organs such as the gastrointestinal tract. At present, little is known regarding its potential orthopedic complications. Case Report: We present a unique case of a patient with BRBNS displaying both intra-articular and extra-articular severe venous malformation (VM) of the hip. This extensive VM caused severe deformities in bone growth, mainly affecting the proximal femur, and impacted the muscular development of the gluteus medius and gluteus maximus. Its intra-articular extension, along with repeated secondary hemarthrosis, led to cartilaginous destruction. Consequently, the patient presented with significant coxa valga and developed acetabular dysplasia and subluxation of femoral head, during growth. In order to restore hip function and alleviate pain, the patient underwent a total hip arthroplasty (THA) at the age of 18. Discussion: The dysplastic changes in the hip joint observed in this case are attributed to the deleterious effects of VMs and coxa valga on joint anatomy and biomechanics. VMs induce recurrent hemarthrosis, leading to cartilage destruction and hip instability. Additionally, coxa valga alters hip biomechanics, exacerbating joint instability and accelerating wear. Surgical intervention with THA aimed to restore joint stability and function, although challenges arose due to anatomical complexities and limited prosthetic options. Conclusion: This is the first reported case of hip dysplasia associated with BRBNS. This case shows the involvement of vascular malformation in the development of hip dysplasia leading to total hip arthroplasty. The surgical planning and technique must take the specificity of this pathology into account to get the best result possible for the patient. This case illustrates the importance of a multidisciplinary approach to treat patients with this specific syndrome and adds valuable information to the limited literature on orthopedic complications in BRBNS.