Base de dados : MEDLINE
Pesquisa : E07.695.400.400 [Categoria DeCS]
Referências encontradas : 20879 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 2088 ir para página                         

  1 / 20879 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28470463
[Au] Autor:Hoffmeister T; Schwarze F; Aschoff HH
[Ad] Endereço:Sana Kliniken Lübeck GmbH, Kronsforder Allee 71/73, 23560, Lübeck, Deutschland.
[Ti] Título:[The endo-exo prosthesis treatment concept : Improvement in quality of life after limb amputation].
[Ti] Título:Das Endo-Exo-Prothesen-Versorgungskonzept : Verbesserung der Lebensqualität nach Extremitätenamputation..
[So] Source:Unfallchirurg;120(5):371-377, 2017 May.
[Is] ISSN:1433-044X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions. The retrospective examination of the results concerning by now more than 100 patients provided with an endo-exo femoral prosthesis (EEFP) showed a very satisfying outcome concerning objective as well as subjective values, such as duration of daily use and wearing comfort of the exoprosthesis. Regaining the ability of osseoperception due to the intraosseous fixation is described by the patients as a great advantage. The step from a socket prosthesis to an EEP is felt to be a big increase in quality of life by nearly all patients included into the follow-up. Nearly all of the patients questioned would choose an endo-exo prosthesis again. Meanwhile, the success of the EEP resulted in the broadening of indications from above-knee amputations to transtibial as well as transhumeral amputations. The results are likewise encouraging. The use of EEP for the upper limbs leads to substantial improvement in the range of motion of the shoulder joint with the intramedullary anchored percutaneous implant. Furthermore, new pathbreaking possibilities in the fixation of myoelectrically controlled arm prostheses may arise from the EEP technique.
[Mh] Termos MeSH primário: Cotos de Amputação/cirurgia
Amputação/reabilitação
Artroplastia de Quadril/instrumentação
Exoesqueleto Energizado
Prótese de Quadril
Perna (Membro)/cirurgia
Qualidade de Vida/psicologia
[Mh] Termos MeSH secundário: Amputação/psicologia
Artroplastia de Quadril/métodos
Artroplastia de Quadril/psicologia
Membros Artificiais
Terapia Combinada/instrumentação
Terapia Combinada/métodos
Terapia Combinada/psicologia
Seres Humanos
Osseointegração
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s00113-017-0350-1


  2 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29437054
[Au] Autor:Hexter AT; Hislop SM; Blunn GW; Liddle AD
[Ad] Endereço:Institute of Orthopaedics and Musculoskeletal Science, University College London, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.
[Ti] Título:The effect of bearing surface on risk of periprosthetic joint infection in total hip arthroplasty: a systematic review and meta-analysis.
[So] Source:Bone Joint J;100-B(2):134-142, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Periprosthetic joint infection (PJI) is a serious complication of total hip arthroplasty (THA). Different bearing surface materials have different surface properties and it has been suggested that the choice of bearing surface may influence the risk of PJI after THA. The objective of this meta-analysis was to compare the rate of PJI between metal-on-polyethylene (MoP), ceramic-on-polyethylene (CoP), and ceramic-on-ceramic (CoC) bearings. PATIENTS AND METHODS: Electronic databases (Medline, Embase, Cochrane library, Web of Science, and Cumulative Index of Nursing and Allied Health Literature) were searched for comparative randomized and observational studies that reported the incidence of PJI for different bearing surfaces. Two investigators independently reviewed studies for eligibility, evaluated risk of bias, and performed data extraction. Meta-analysis was performed using the Mantel-Haenzel method and random-effects model in accordance with methods of the Cochrane group. RESULTS: Our search strategy revealed 2272 studies, of which 17 met the inclusion criteria and were analyzed. These comprised 11 randomized controlled trials and six observational studies. The overall quality of included studies was high but the observational studies were at high risk of bias due to inadequate adjustment for confounding factors. The overall cumulative incidence of PJI across all studies was 0.78% (1514/193 378). For each bearing combination, the overall incidence was as follows: MoP 0.85% (1353/158 430); CoP 0.38% (67/17 489); and CoC 0.53% (94/17 459). The meta-analysis showed no significant difference between the three bearing combinations in terms of risk of PJI. CONCLUSION: On the basis of the clinical studies available, there is no evidence that bearing choice influences the risk of PJI. Future research, including basic science studies and large, adequately controlled registry studies, may be helpful in determining whether implant materials play a role in determining the risk of PJI following arthroplasty surgery. Cite this article: 2018;100-B:134-42.
[Mh] Termos MeSH primário: Artroplastia de Quadril
Prótese de Quadril
Infecções Relacionadas à Prótese/etiologia
[Mh] Termos MeSH secundário: Cerâmica
Seres Humanos
Incidência
Metais
Polietileno
Desenho de Prótese
Infecções Relacionadas à Prótese/epidemiologia
Fatores de Risco
Propriedades de Superfície
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Metals); 9002-88-4 (Polyethylene)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0575.R1


  3 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29252750
[Au] Autor:Runner RP; Bellamy JL; Roberson JR
[Ad] Endereço:Department of Orthopaedics, Emory University, Atlanta, Georgia.
[Ti] Título:Gross Trunnion Failure of a Cobalt-Chromium Femoral Head on a Titanium Stem at Midterm Follow-up: A Report of 3 Cases.
[So] Source:JBJS Case Connect;6(4):e96, 2016 Oct-Dec.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: Three patients underwent uncomplicated primary total hip arthroplasty with cobalt-chromium femoral heads (36+5 mm) on titanium V40 tapers. At 6 to 9 years of follow-up, severe effects of corrosion at the trunnion were noted in all 3 patients, along with elevated levels of serum cobalt ions and normal levels of serum chromium ions. Gross trunnion failure, apparently caused by corrosion, required femoral stem revision in all of the patients. CONCLUSION: Decreased neck diameter, longer trunnion length, and large-sized cobalt-chromium heads are possible contributors to early failure after primary total hip arthroplasty due to trunnionosis. Surgeons should be mindful of trunnionosis as a cause of pain and a mechanism of failure following total hip arthroplasty, and serum metal ions should be monitored in these patients.
[Mh] Termos MeSH primário: Artroplastia de Quadril/instrumentação
Prótese de Quadril/efeitos adversos
Falha de Prótese/etiologia
[Mh] Termos MeSH secundário: Idoso
Corrosão
Seres Humanos
Masculino
Metais/sangue
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Metals)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.16.00054


  4 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29350891
[Au] Autor:Mladenovic M; Micic I; Stojiljkovic P; Milenkovic S; Mladenovic D
[Ti] Título:First experiences with the Fitmore® hip stem: Early results of the 16-month monitoring.
[So] Source:Vojnosanit Pregl;74(1):51-3, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Fitmore® hip stem belongs to the group of short stem prostheses with the metaphysar stabilization, with its shape and form that protects the bone mass in the greater trochanter region and the distal part of the femur. The aim of this paper was to present the early postoperative results in patients with implanted Fitmore® hip stem and point out some of the advantages. Methods: A series of 10 patients with implanted Fitmore® hip stem, was included in this study. The average age of the patients was 54.5 (48­65) years. There were 5 women and 5 men. The total monitoring time was 16 months. To rate the condition of the hip joint we used The Western Ontario and Mc Master Universities Arthritis Index (WOMAC) score. We also monitored the degree of hip pain, hip flexion, heterotopic ossification and indentation in the stem of the prosthesis. Results: After 12 months of monitoring 9 (90%) of the patients had no pain in the thigh region, and only 1 (10%) experienced mild pain. The hip flexion rose from the average 89° to postoperative 114°. WOMAC score rose as well, from 49 to 94 average points. Indentation in the stem was registered 3 months after the operation in 2 (20%) of the patients ­ in one of the patients the indentation was 3 mm and in the other patient 5 mm. After the 16-month monitoring, the results were excellent. The monitoring period was short though it should be continued and the results should be presented after 5 and then after 10 years. Conclusion: Early results of the implantation Fitmore stem showed good bone ingrowth with excellent functional result.
[Mh] Termos MeSH primário: Artroplastia de Quadril/instrumentação
Articulação do Quadril/cirurgia
Prótese de Quadril
[Mh] Termos MeSH secundário: Idoso
Artroplastia de Quadril/efeitos adversos
Fenômenos Biomecânicos
Avaliação da Deficiência
Feminino
Articulação do Quadril/diagnóstico por imagem
Articulação do Quadril/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/etiologia
Desenho de Prótese
Amplitude de Movimento Articular
Recuperação de Função Fisiológica
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150514145M


  5 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29381984
[Au] Autor:Yan SG; Li D; Yin S; Hua X; Tang J; Schmidutz F
[Ad] Endereço:Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University of Munich (LMU), Munich, Germany.
[Ti] Título:Periprosthetic bone remodeling of short cementless femoral stems in primary total hip arthroplasty: A systematic review and meta-analysis of randomized-controlled trials.
[So] Source:Medicine (Baltimore);96(47):e8806, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Short-stem total hip arthroplasty (SHA) has been increasingly used in the treatment of hip arthroplasty. However, it is unclear whether there is a superiority of SHA in periprosthetic bone remodeling over standard stem total hip arthroplasty (THA). This meta-analysis of randomized-controlled trials (RCTs) compared the periprosthetic bone remodeling after SHA and THA. METHODS: PubMed and Embase were screened for relevant publications up to May 2017. RCTs that compared periprosthetic bone remodeling with bone mineral density (BMD) changes between SHA and THA were included. Meta-analysis was conducted to calculate weighted mean differences (WMDs) and 95% confidence intervals (CIs) using Stata version 12.0. Quality appraisal was performed by 2 independent reviewers using RevMan 5.3 software and Grades of Recommendation Assessment, Development, and Evaluation criteria. RESULTS: Seven studies involving 910 patients and 5 SHA designs (Proxima, Fitmore, Microplasty short, Unique custom, and Omnifit-HA 1017) were included for meta-analysis. The pooled data showed no significant differences in the percentage BMD changes in all Gruen zones, with Gruen zone 1 [mean difference (MD) = 11.33, 95% CI, -1.67 to 24.33; P = .09] and Gruen zone 7 (MD = 8.46, 95% CI, -1.73 to 18.65; P = .10). Subgroup analysis of short SHA stems with lateral flare showed a significant less percentage BMD changes compared with standard THA in Gruen zone 1 (MD = 27.57, 95% CI, 18.03-37.12; P < .0001) and Gruen zone 7 (MD = 18.54, 95% CI, 8.27-28.81; P < .0001). CONCLUSION: The study shows moderate-quality evidence that periprosthetic bone remodeling around the analyzed SHA stems was similar to standard THA stems. However, short SHA stems with lateral flare revealed a moderate- to low-quality evidence for superiority over the standard THA and highlighted the importance of the different SHA designs. Besides, it has to be noticed that despite a similar pattern of periprosthetic bone remodeling, the femoral length where periprosthetic bone remodeling occurs is clearly shorter in SHA. Due to the moderate- to low-quality evidence and the limited stem designs analyzed, the further large-scale multicenter RCTs including the most recent SHA designs are required. However, the current findings should be considered by surgeons for counseling patients regarding total hip replacement.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Remodelação Óssea
Fêmur/fisiopatologia
[Mh] Termos MeSH secundário: Densidade Óssea
Fêmur/cirurgia
Prótese de Quadril
Seres Humanos
Período Pós-Operatório
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008806


  6 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29201293
[Au] Autor:Tetsunaga T; Fujiwara K; Endo H; Tetsunaga T; Shiota N; Sato T; Ozaki T
[Ad] Endereço:Department of Orthopaedic Surgery, Okayama University, Okayama, Japan.
[Ti] Título:Calcar Femorale in Patients with Osteoarthritis of the Hip Secondary to Developmental Dysplasia.
[So] Source:Clin Orthop Surg;9(4):413-419, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: We investigated whether the calcar femorale, a cortical septum in the region of the lesser trochanter of the femur, correlates with results of femoral stem implantation in patients with osteoarthritis of the hip secondary to developmental dysplasia using computed tomography. Methods: This retrospective study included 277 hips (41 males and 236 females; age, 37 to 92 years) of patients who had presented to Okayama Medical Center with hip pain. Of these, a total of 219 hips (31 males and 188 females) had previously undergone total hip arthroplasty. According to the Crowe classification, 147 hips were classified as Crowe grade I, 72 hips as Crowe grade II-IV, and 58 hips as normal. Results: The calcar femorale was identified in 267 hips (96.4%). The calcar femorale was significantly shorter and more anteverted in Crowe grade II-IV hips than in Crowe grade I or normal hips. Significant differences in the shape of the calcar femorale were found according to the severity of hip deformity. Three stem designs were analyzed: single-wedge (59 hips), double-wedge metaphyseal filling (147 hips), and modular (13 hips). Single-wedge stems were inserted more parallel to the calcar femorale rather than femoral neck anteversion, while other types of stems scraped the calcar femorale. Conclusions: The angle of the calcar femorale differs according to the severity of hip deformity, and the calcar femorale might thus serve as a more useful reference for stem insertion than femoral neck anteversion in total hip arthroplasty using a single-wedge stem.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Fêmur/anatomia & histologia
Luxação Congênita de Quadril/complicações
Osteoartrite do Quadril/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/instrumentação
Feminino
Fêmur/diagnóstico por imagem
Prótese de Quadril
Seres Humanos
Masculino
Meia-Idade
Osteoartrite do Quadril/cirurgia
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.413


  7 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29305446
[Au] Autor:Sabah SA; Moon JC; Jenkins-Jones S; Morgan CL; Currie CJ; Wilkinson JM; Porter M; Captur G; Henckel J; Chaturvedi N; Kay P; Skinner JA; Hart AJ; Manisty C
[Ad] Endereço:Royal National Orthopaedic Hospital, Stanmore, Middlesex and University College London, London, UK.
[Ti] Título:The risk of cardiac failure following metal-on-metal hip arthroplasty.
[So] Source:Bone Joint J;100-B(1):20-27, 2018 01.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to determine whether patients with metal-on-metal (MoM) arthroplasties of the hip have an increased risk of cardiac failure compared with those with alternative types of arthroplasties (non-MoM). PATIENTS AND METHODS: A linkage study between the National Joint Registry, Hospital Episodes Statistics and records of the Office for National Statistics on deaths was undertaken. Patients who underwent elective total hip arthroplasty between January 2003 and December 2014 with no past history of cardiac failure were included and stratified as having either a MoM (n = 53 529) or a non-MoM (n = 482 247) arthroplasty. The primary outcome measure was the time to an admission to hospital for cardiac failure or death. Analysis was carried out using data from all patients and from those matched by propensity score. RESULTS: The risk of cardiac failure was lower in the MoM cohort compared with the non-MoM cohort (adjusted hazard ratio (aHR) 0.901; 95% confidence interval (CI) 0.853 to 0.953). The risk of cardiac failure was similar following matching (aHR 0.909; 95% CI 0.838 to 0.987) and the findings were consistent in subgroup analysis. CONCLUSION: The risk of cardiac failure following total hip arthroplasty was not increased in those in whom MoM implants were used, compared with those in whom other types of prostheses were used, in the first seven years after surgery. Cite this article: 2018;100-B:20-7.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Insuficiência Cardíaca/etiologia
Prótese de Quadril/efeitos adversos
Próteses Articulares Metal-Metal/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/instrumentação
Artroplastia de Quadril/mortalidade
Feminino
Insuficiência Cardíaca/epidemiologia
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Registro Médico Coordenado
Meia-Idade
Desenho de Prótese
Sistema de Registros
Estudos Retrospectivos
Fatores de Risco
Reino Unido/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-1065.R1


  8 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:29205219
[Au] Autor:Vogel D; Rathay A; Teufel S; Ellenrieder M; Zietz C; Sander M; Bader R
[Ad] Endereço:Biomechanics and Implant Technology Research Laboratory, Department of Orthopaedics, University of Rostock, Rostock, Germany.
[Ti] Título:Experimental analysis of insertion torques and forces of threaded and press-fit acetabular cups by means of ex vivo and in vivo measurements.
[So] Source:Acta Bioeng Biomech;19(3):155-163, 2017.
[Is] ISSN:1509-409X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: In THA a sufficient primary implant stability is the precondition for successful secondary stability. Industrial foams of different densities have been used for primary stability investigations. The aim of this study was to analyse and compare the insertion behaviour of threaded and press-fit cups in vivo and ex vivo using bone substitutes with various densities. METHODS: Two threaded (Bicon Plus®, Trident® TC) and one press-fit cup (Trident PSL®) were inserted by orthopaedic surgeons (S1, S2) into 10, 20 and 31 pcf blocks, using modified surgical instruments allowing measurements of the insertion forces and torques. Furthermore, the insertion behaviour of two cups were analysed intraoperatively. RESULTS: Torques for the threaded cups increased while bone substitute density increased. Maximum insertion torques were observed for S2 with 102 Nm for the Bicon Plus® in 20 pcf blocks and 77 Nm for the Trident® TC in 31 pcf blocks, which compares to the in vivo measurement (85 Nm). The average insertion forces for the press-fit cup varied from 5.2 to 6.8 kN (S1) and 7.2-11.5 kN (S2) ex vivo. Intraoperatively an average insertion force of 8.0 kN was determined. CONCLUSIONS: Implantation behaviour was influenced by acetabular cup design, bone substitute and experience of the surgeon. No specific density of bone substitute could be favoured for ex vivo investigations on the implantation behaviour of acetabular cups. The use synthetic bone blocks of high density (31 pcf) led to problems regarding cup orientation and seating. Therefore, bone substitutes used should be critically scrutinized in terms of the comparability to the in vivo situation.
[Mh] Termos MeSH primário: Acetábulo/fisiologia
Acetábulo/cirurgia
Artroplastia de Quadril/métodos
Parafusos Ósseos
Prótese de Quadril
[Mh] Termos MeSH secundário: Desenho de Equipamento
Análise de Falha de Equipamento
Fricção
Pressão
Estresse Mecânico
Torque
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


  9 / 20879 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29305447
[Au] Autor:Goodnough LH; Bala A; Huddleston J; Goodman SB; Maloney WJ; Amanatullah DF
[Ad] Endereço:Stanford University, 450 Broadway Street, Redwood City, California, 94063, USA.
[Ti] Título:Metal-on-metal total hip arthroplasty is not associated with cardiac disease.
[So] Source:Bone Joint J;100-B(1):28-32, 2018 01.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Many case reports and small studies have suggested that cobalt ions are a potential cause of cardiac complications, specifically cardiomyopathy, after metal-on-metal (MoM) total hip arthroplasty (THA). The impact of metal ions on the incidence of cardiac disease after MoM THA has not been evaluated in large studies. The aim of this study was to compare the rate of onset of new cardiac symptoms in patients who have undergone MoM THA with those who have undergone metal-on-polyethylene (MoP) THA. PATIENTS AND METHODS: Data were extracted from the Standard Analytics Files database for patients who underwent MoM THA between 2005 and 2012. Bearing surface was selected using International Classification of Diseases ninth revision codes. Patients with a minimum five-year follow-up were selected. An age and gender-matched cohort of patients who underwent MoP THA served as a comparison group. New diagnoses of cardiac disease were collected during the follow-up period. Comorbidities and demographics were identified and routine descriptive statistics were used. RESULTS: We identified 29 483 patients who underwent MoM THA and 24 175 matched patients who underwent MoP THA. Both groups had a mean Charlson comorbidity index score of 4. There were no statistically significant differences in 30 of 31 pre-existing comorbidities. Patients undergoing MoM THA had a slightly lower incidence of cardiac failure compared with those undergoing MoP THA at three years (6.60% 7.06%, odds ratio (OR) 0.93, 95% confidence interval (CI) 0.87 to 0.99) and four years (8.73% 9.49%, OR 0.91, 95% CI 0.86 to 0.97) postoperatively, with no difference in the incidence of new cardiac failure in between the groups at five years. There was no statistically significant difference in the incidence of arrhythmia, myocardial infarction and cardiomyopathy at any time between the two groups. CONCLUSION: MoM THA is not associated with cardiac complications. Initial reports may have represented individual instances of cardiac disease in patients with a failing MoM articulation rather than an emerging epidemiological trend. Cite this article: 2018;100-B:28-32.
[Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos
Cardiopatias/etiologia
Prótese de Quadril/efeitos adversos
Próteses Articulares Metal-Metal/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/instrumentação
Comorbidade
Bases de Dados Factuais
Feminino
Cardiopatias/epidemiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Polietileno
Desenho de Prótese
Falha de Prótese/etiologia
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
9002-88-4 (Polyethylene)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0366.R1


  10 / 20879 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28464821
[Au] Autor:Leijtens B; Elbers JBW; Sturm PD; Kullberg BJ; Schreurs BW
[Ad] Endereço:Department of Orthopaedic Surgery, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. borg.leijtens@radboudumc.nl.
[Ti] Título:Clindamycin-rifampin combination therapy for staphylococcal periprosthetic joint infections: a retrospective observational study.
[So] Source:BMC Infect Dis;17(1):321, 2017 05 02.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Staphylococcal species account for more than 50% of periprosthetic joint infections (PJI) and antimicrobial therapy with rifampin-based combination regimens has been shown effective. The present study evaluates the safety and efficacy of clindamycin in combination with rifampin for the management of staphylococcal PJI. METHODS: In this retrospective cohort study, patients were included who received clindamycin-rifampin combination therapy to treat a periprosthetic hip or knee infection by Staphylococcus aureus or coagulase-negative staphylococci. Patients were treated according to a standardized treatment algorithm and followed for a median of 54 months. Of the 36 patients with periprosthetic staphylococcal infections, 31 had an infection of the hip, and five had an infection of the knee. Eighteen patients underwent debridement and retention of the implant (DAIR) for an early infection, the other 18 patients underwent revision of loose components in presumed aseptic loosening with unexpected positive cultures. RESULTS: In this study, we report a success rate of 86%, with five recurrent/persistent PJI in 36 treated patients. Cure rate was 78% (14/18) in the DAIR patients and 94% (17/18) in the revision group. Five patients (14%) discontinued clindamycin-rifampin due to side effects. Of the 31 patients completing the clindamycin-rifampin regimen 29 patients (94%) were cured. CONCLUSION: Combined therapy with clindamycin and rifampin is a safe, well tolerated and effective regimen for the treatment of staphylococcal periprosthetic infection.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Clindamicina/uso terapêutico
Infecções Relacionadas à Prótese/tratamento farmacológico
Rifampina/uso terapêutico
Infecções Estafilocócicas/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/efeitos adversos
Terapia Combinada
Desbridamento
Quimioterapia Combinada
Feminino
Prótese de Quadril
Seres Humanos
Prótese do Joelho
Masculino
Meia-Idade
Estudos Retrospectivos
Staphylococcus/patogenicidade
Staphylococcus aureus/patogenicidade
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 3U02EL437C (Clindamycin); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2429-2



página 1 de 2088 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde