Neuromonitoring in pre-post and intraoperative total hip replacement surgery in type 4 high-riding developmental dysplasia of the hip.

OBJECTIVE: The choice approach to treating congenital dislocation of the hip joint is total hip replacement (THR). One of the severe but uncommon complications of THR is nerve damage. The most common nerve injury associated with total hip arthroplasty (THA) is sciatic nerve palsy, and the second typical nerve damage with THA is femoral nerve paralysis. PATIENTS AND METHODS: In this prospective cohort study, 35 patients with type 4 high riding developmental dysplasia of the hip (DDH) who were candidates for THA were enrolled. The somatosensory evoked potential (SSEP), motor evoked potential (MEP), and electromyography (EMG) were measured pre-post and intraoperatively to check the status of the sciatic and femoral nerves. After collecting the mentioned information, the data was analyzed by SPSS V. 26 software. RESULTS: Out of 35 patients with DDH type 4 who were candidates for THR, nine patients showed a 50 percent decrease in SSEP amplitude, and six patients showed a 10 percent decrease in SSEP latency. One patient during and two patients after the surgery showed more than an 80 percent decrease in MEP amplitude. Meanwhile, 14 patients showed abnormal spikes during and two patients after surgery regarding EMG. All patients with disturbed neurophysiological findings reverted to normal in the further investigation during follow-up. No correlation was found between increasing limb shortness and these modalities. CONCLUSIONS: Using neuromonitoring techniques during Total Hip Arthroplasty (THA) can help identify potential early nerve damage, prevent post-surgical complications, and improve high-riding DDH patient outcomes.

Probing nanoliposomes using single particle analytical techniques: effect of excipients, solvents, phase transition and zeta potential.

There has been a steady increase in the interest towards employing nanoliposomes as colloidal drug delivery systems, particularly in the last few years. Their biocompatibility nature along with the possibility of encapsulation of lipid-soluble, water-soluble and amphipathic molecules and compounds are among the advantages of employing these lipidic nanocarriers. A challenge in the successful formulation of nanoliposomal systems is to control the critical physicochemical properties, which impact their in vivo performance, and validating analytical techniques that can adequately characterize these nanostructures. Of particular interest are the chemical composition of nanoliposomes, their phase transition temperature, state of the encapsulated material, encapsulation efficiency, particle size distribution, morphology, internal structure, lamellarity, surface charge, and drug release pattern. These attributes are highly important in revealing the supramolecular arrangement of nanoliposomes and incorporated drugs and ensuring the stability of the formulation as well as consistent drug delivery to target tissues. In this article, we present characterization of nanoliposomal formulations as an example to illustrate identification of key in vitro characteristics of a typical nanotherapeutic agent. Corresponding analytical techniques are discussed within the context of nanoliposome assessment, single particle analysis and ensuring uniform manufacture of therapeutic formulations with batch-to-batch consistency.