Acetabular revision arthroplasty using press-fitted jumbo cups: an average 10-year follow-up study.

INTRODUCTION: Acetabular revision arthroplasty using jumbo cups for moderate-to-severe acetabular defects has varied outcomes. We evaluated the clinical and radiological outcomes of acetabular revision arthroplasty using a press-fitted jumbo cup and sought to identify factors that influence outcomes during intermediate follow-up. MATERIALS AND METHODS: Eighty patients (47 men, 33 women; 80 hips) who underwent acetabular revision arthroplasty using press-fitted jumbo cups were included. The mean follow-up period was 10.4 years. Harris hip score (HHS), presence of groin pain, radiographic results, and Kaplan-Meier survival curves were evaluated. Implant design and surgery-related and patient-related factors were assessed to identify influential factors for cup loosening. Migration and wear analyses were performed using Einzel-Bild-Röntgen-Analyse software. RESULTS: The mean preoperative HHS of 53 had improved to 77 at the final follow-up (p = 0.005). Nine patients experienced groin pain. Acetabular cup loosening was observed in seven cups (8.7%), and one jumbo cup was replaced with a reinforcement cage. The survival rate of the acetabular cup was 91% at 16 years according to the Kaplan-Meier analysis. Osteolysis was identified around the cup in six cases (7.5%). Acetabular cup loosening occurred more frequently in patients with conventional polyethylene liners than in those with highly cross-linked polyethylene liners (p = 0.045). The mean total migration was 1.52 mm, and the mean total wear was 0.98 mm. There was a positive correlation between total migration and total wear (p = 0.023; Spearman's rho = 0.388). The mean wear rate of the patients with the cup inclination angle < 50° was significantly lower than those with the cup inclination angle > 50° (p = 0.001). There were four cases of complications (three dislocations and one infection) that did not require revision surgery. CONCLUSION: Press-fitted jumbo cups for acetabular revision arthroplasty exhibited encouraging results during follow-up for an average of 10 years. Use of highly cross-linked polyethylene liners and proper placement of the acetabular component with an inclination angle < 50° may contribute to better clinical outcomes after acetabular revision arthroplasty with jumbo cups.

Candida albicans protein analysis during hyphal differentiation using an integrative HA-tagging method.

In order to understand the biological complexity inherent to the pathogenicity of Candida albicans, gene expressions need to be analyzed at the protein level. We employed an epitope-tagging technique in a set of C. albicans ORF, and constructed fifteen strains which expressed HA-tagged proteins. These efforts permitted us to identify differentially synthesized proteins during the hyphal differentiations. ICL1, MLS1, and WAP1, all of which are known to be hypha-induced at the transcript level, were indeed found to be up-regulated at the protein level. We also identified CaeIF4G, CaTPO5, and CaZRT1, the protein levels of which were increased during hyphal transition, and CaERB1, the protein level of which was reduced consistently. The hypha-induced protein level of CaeIF4G was closely associated with the cellular hyphal phenotype. CaeIF4G overexpression was shown to result in hyperfilamentation in C. albicans. CaeIF4E, which was constitutively expressed during the hyphal development, exhibited no overexpression phenotype. HA-tagged strains were also utilized in our analysis of C. albicans proteins in a co-culture of macrophage and C. albicans. Five genes were found to be expressed differentially during the macrophage co-cultures. Our approaches proved to be rather useful under yeast culture conditions as well as in co-cultures of macrophage and C. albicans.