The evolution of functional bracing of fractures.
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Biomedical subjects
Publications and source records attributed to A Sarmiento.
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The long-term radiologically interpreted results of low-friction Charnley hip arthroplasties have been previously suggested to be influenced by surgical details, such as orientation of the femoral component, degree of coverage of the plastic acetabulum and other features. We carefully analyzed the radiographs of 135 Charnley arthroplasties that had remained functional, had not been revised and had follow-ups between 15 and 35 years. Several common denominators were identified amongst these radiographs: 93.5% arthroplasties had 100% coverage of the acetabular component; 88% had acetabular inclination between 40-45 degrees ; 84.5% had a proximal/medial column of cement between 3 and 5 millimeters at the level of femoral head resection; 81% had a femoral canal/stem ratio more than 50%; and 84% had a column of cement that extended below the tip of the prosthesis. This study supports the importance of technical surgical details that enhance the chances of long-term survival of cemented total hip arthroplasties.
We carry out a numerical study of the asymptotic dynamics of breathers in finite Fermi-Pasta-Ulam chains at zero and nonzero temperatures. While at zero temperature such breathers remain essentially stationary and decay extremely slowly over wide parameter ranges, thermal fluctuations tend to lead to breather motion and more rapid decay. In both cases the decay is essentially exponential over long time intervals.
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We study energy relaxation in thermalized one-dimensional nonlinear arrays of the Fermi-Pasta-Ulam type. The ends of the thermalized systems are placed in contact with a zero-temperature reservoir via damping forces. Harmonic arrays relax by sequential phonon decay into the cold reservoir, the lower-frequency modes relaxing first. The relaxation pathway for purely anharmonic arrays involves the degradation of higher-energy nonlinear modes into lower-energy ones. The lowest-energy modes are absorbed by the cold reservoir, but a small amount of energy is persistently left behind in the array in the form of almost stationary low-frequency localized modes. Arrays with interactions that contain both a harmonic and an anharmonic contribution exhibit behavior that involves the interplay of phonon modes and breather modes. At long times relaxation is extremely slow due to the spontaneous appearance and persistence of energetic high-frequency stationary breathers. Breather behavior is further ascertained by explicitly injecting a localized excitation into the thermalized arrays and observing the relaxation behavior.
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We use temperature tuning to control signal propagation in simple one-dimensional arrays of masses connected by hard anharmonic springs and with no local potentials. In our numerical model a sustained signal is applied at one site of a chain immersed in a thermal environment and the signal-to-noise ratio is measured at each oscillator. We show that raising the temperature can lead to enhanced signal propagation along the chain, resulting in thermal resonance effects akin to the resonance observed in arrays of bistable systems.
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To investigate the effect of instability on the remodelling of a minor articular surface offset, we created a 0.5 mm coronal step-off of the medial femoral condyle in 12 New Zealand white rabbits and transected the anterior cruciate ligament (ACL). A control group of 12 rabbits had only ACL resection and the opposite knee was used as the non-operated control. The osteoarthritic changes at 6, 12 and 24 weeks after surgery were evaluated histologically. In addition, changes in the immunological detection of 3-B-3(-) and 7-D-4 chondroitin-6-sulphate epitopes were determined because of the previous association of such changes with repair of cartilage and early osteoarthritis. In the instability/step-off group there was rapidly progressing focal degeneration of cartilage on the high side of the defect, not seen in previous step-off studies in stable knees. The rest of the femoral condyles and the tibial plateaux of the instability/step-off group had moderate osteoarthritis similar to that of the instability group. 3-B-3(-) was detectable in the early and the intermediate stages of osteoarthritis but no staining was seen in the severely damaged cartilage zones. Immunoreactivity with 7-D-4 increased as degeneration progressed.
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A nineteen-year-old otherwise healthy woman is seen in the emergency room after being struck by a car. The patient reports left lower extremity pain and has no other injuries. Exam shows a Tscherne grade I soft tissue injury with otherwise normal motor and sensory exam. There are no signs of compartment syndrome. A closed reduction was performed.
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