RESUMO
The aim of the present in vitro study was to evaluate migrational characteristics of cementless primary hip arthroplasty stems in combination with a diameter 50 mm head (hemiarthroplasty) and a diameter 28 mm head in and with a polyethylene cup (total hip arthroplasty) in fresh-frozen human specimens. Two different types (Endo SL, FMT) were implanted into seven pairs of fresh-frozen human femoral specimens. The implanted stems were combined with a diameter 50 mm head (hemiarthroplasty) on one side and with a polyethylene cup and a 28 mm head (total hip arthroplasty) on the other side. Dynamic mechanical loading was applied for 50,000 cycles while recording relative motions between stem and bone stock using a 3-D motion analysis system. The Endo SL stem showed a significantly higher amplitude of relative motion in all translational and rotational components regardless of the head used. In both stem types a strong tendency for higher axial migration with the diameter 50 mm head in comparison to the THA head was found. The lowest axial migration was found in the FMTstem in combination with the small head and a PE cup. The highest axial migration was found in the Endo SL stem combined with the diameter 50 mm head. Our results indicate that the head might play an important role for axial migration of cementless stems.
Assuntos
Artroplastia de Quadril/instrumentação , Prótese de Quadril , Falha de Prótese , Fenômenos Biomecânicos , Humanos , Técnicas In Vitro , Movimento (Física) , Desenho de PróteseRESUMO
Symptoms, Effects on Quality of Life, Judgement and Expectations of Treatment in Active Ankylosing Spondylitis: The Patient's View.In ankylosing spondylitis uncertainty prevails among rheumatologists on how to define and measure activity. In the present study the patient's view of activity was evaluated. What does active ankylosing spondylitis mean for the patient? In a standardized interview the patient was asked to describe, from his own experience, what active ankylosing spondylitis means, what bothers him most, what helps most, and what he expects from therapy. For the patient, active ankylosing spondylitis means pain (99 responses), mobility restriction (19), muscle tension (10), inability to stay supine (6), restriction in chest mobility (5) and dyspnea (5). Fatigue was mentioned by two patients. In active states patients are mainly bothered by pain (77), mobility restriction (55), consequences for social life (20) and work (18), disturbed sleep (17) and difficult breathing (16). Drugs (84) and physical activity (42) were judged the best treatments during active ankylosing spondylitis. It was no surprise that pain and mobility restriction were cited most often by the patients. Breathing difficulties were cited rather often, whereas fatigue seems not to play an important role for most patients. The results suggest that modern rheumatology may have underestimated the relevance of difficult breathing and paid too much attention to fatigue.
Assuntos
Satisfação do Paciente , Qualidade de Vida , Espondilite Anquilosante/reabilitação , Atividades Cotidianas/psicologia , Adulto , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Medição da Dor , Espondilite Anquilosante/psicologiaRESUMO
OBJECTIVE: A large share of rheumatism patients who are treated by rheumatologists use unconventional therapies additionally. What is the frequency in patients with ankylosing spondylitis who present for treatment at a radon spa? PATIENTS: 75 patients with ankylosing spondylitis presenting for treatment at the Gasteiner Heilstollen Hospital agreed to participate in the study (6 refused). DESIGN: In an open interview a research assistant asked the patients to name all interventions which they have used for the treatment of ankylosing spondylitis. RESULTS: Unconventional therapies (beside treatment at the Gasteiner Heilstollen) were used by 39 patients. Most frequently cited were acupuncture (15x), diet (8x), herbal therapy (7x), and homeopathy (6x). In total 40 different forms of unconventional therapies were mentioned. All patients claimed to have used at least two conventional therapies. CONCLUSION: Patients presenting for treatment at a radon spa claim to have used conventional therapies more frequently than unconventional forms of treatment.
