PubMed · 14927962
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A B HIRSCHTICK. 1952. A utility shoulder splint.. https://pubmed.ncbi.nlm.nih.gov/14927962/
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COX-2 inhibitors have come under a lot of scrutiny lately, with questions raised regarding class effects and the risk-benefit of these pharmaceuticals. From 1999 to 2003 the New Zealand Pharmaceutical Management Agency (PHARMAC) evaluated the evidence on COX-2 inhibitors, including their efficacy, cost-effectiveness and budgetary impact. In September 2003 PHARMAC decided not to list celecoxib, rofecoxib and meloxicam on the Pharmaceutical Schedule. This decision meant that at least 18 other pharmaceuticals were able to be funded or have access extended, resulting in 437 'statistical lives' saved per year, with net health gains, and savings for District Health Boards. Had PHARMAC funded COX-2 inhibitors at the same time as Australia, it is estimated that this may have resulted in approximately 740 to 4220 excess myocardial infarctions (MIs) and approximately 330 to 1900 excess deaths from MI.
Inevitable complications after total shoulder replacements, mainly due to wear and loosening of glenoid components, have stimulated research on a new glenoid implant design. The aim of this study is to analyse a new design concept of the glenoid component with the articular surface made of artificial cartilage-specifically a poly(vinyl-alcohol)cryogel (PVA-c). Based on the performed experiments and hyperelasticity law the material model of the PVA-c is defined. Mechanical effects of using a cryogel layer with different geometries in glenoid components are analysed using a finite element method. The analysis allows for identification of design solutions with reduced, lower than failure, strains and stresses in the cryogel. The layer shape similar to the glenoid cartilage shows the most favourable mechanical effects. This indicates a high potential of using this soft material for the articular surface. Replacing the polyethylene with a cryogel layer results in a significant reduction in contact stresses together with the growth in contact area. This can promote fluid film lubrication and lower the wear, thus lower implant failure. Moreover, soft cryogel, having shock absorbing properties, may result in lower stresses at the implant-bone, thus lowering the risk of implant loosening. This study indicates a high importance of an elastic implant for restoring full function of the articular surface in a glenoid component.