PubMed · 15487415
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John J Callaghan, Michael R O'Rourke. 2004. Avoiding dislocation: but when it happens!. https://doi.org/10.3928/0147-7447-20040901-27
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Minimally invasive (MI) total hip replacement (THR) supposedly provides improved ambulation in the immediate post-operative period. This study used a prospective blinded design to analyse early post-operative walking ability using gait analysis. Seventeen patients were available for full analysis with nine having had the MI technique and eight having the standard incision (SI) technique. Patients were blinded as to the incision used, as were all physiotherapists and assessors. Differences in temporal-spatial variables and joint kinematics measured 1 day pre-operatively, 2 days post-operatively and 42 days (6 weeks) post-operatively were compared between groups. There was no significant difference in velocity, step length of the affected or unaffected leg, stride length or stance phase duration between the MI and SI groups between any of the timepoints tested. There was no significant improvement in the gait kinematics of the MI group compared to the SI group either 2 days post-operatively or 6 weeks post-operatively. Contrary to previous studies, there was no improvement in early post-operative gait for those patients who received THR using the minimally invasive technique.
Hydroxyapatite [HA, Ca10(PO4)6(OH)2] coatings on polymer composite substrates were investigated for their bioactivity and their physicochemical and mechanical characteristics. HA holds key characteristics for use in orthopedic applications, such as for coating of the femoral stem in a hip replacement device. The plasma-spray technique was used to project HA onto a carbon fiber/polyamide 12 composite substrate. The resulting HA coatings exhibited mechanical adhesion as high as 23 MPa, depending on the surface treatment of the composite substrate. The purpose of this investigation was to evaluate the bioactivity of an HA-coated composite substrate. HA- coated samples have been immersed in simulated body fluid (SBF) and maintained within a shaker bath for periods of 1, 7, 14, 21, and 28 days at 37 degrees C. Scanning electron microscopy, energy dispersive X-ray spectroscopy, and X-ray diffraction techniques were performed on the samples before and after immersion into SBF. SBF was analyzed using inductively coupled plasma atomic emission spectrometry for element concentration and evaluation of the solution's purity. SBF conditioning led to the deposition of crystalline HA onto the surface of the coatings. The calcium-to-phosphorous ratios of initial HA coating and of newly deposited HA were respectively 1.72 and 1.65, close to the HA theoretical calcium/phosphorous value of 1.67. Results demonstrated that bioactive HA coatings were produced by plasma spraying, because SBF conditioning induced newly formed HA with high crystallinity. Mechanical adhesion of the HA coatings was not significantly affected upon SBF conditioning.
In a postal survey of all orthopaedic surgery departments performing total hip or knee replacements in Norway, we inquired about the use of hip or knee scoring systems and their impact. All 63 eligible hospitals responded to the questionnaire. Thirteen (21%) reported routine use of hip clinical scoring systems, and five (9%) used knee clinical scoring systems. The Harris hip score and The Knee Society clinical rating system were the most prevalent. We received five different versions of the Harris hip score. The regional/university hospitals most commonly used clinical scoring systems. The adoption of clinical scoring systems did not differ with the annual procedure volumes of the hospitals.