We hypothesized that the formation and differentialtion of osteoclasts are accelerated and the potential of bone resorption is increased in the hemiplegic bone marrow in the early stage of stroke. We randomly divided white female Sprague-Dawley (SD) rats (n = 30) into two groups, stroke (n = 15) and sham ...

BACKGROUND: Chronic low bone mineral density is associated with an increased risk of stroke. However, little is known about the influence of bone mineral density at the time of stroke on clinical outcome. We investigated the association between bone mineral density and functional disability at three-months in patients with acute ...

Physical inactivity contributes to accelerated bone loss after stroke, leading to heightened fracture risk, increased mortality, and reduced independence. This paper sought to summarise the evidence for the use of physical activity to protect bone in healthy adults and adults with stroke, and to identify international recommendations regarding any means ...

Abstract Bone loss after stroke is pronounced, and contributes to increased fracture risk. People who fracture after stroke experience reduced mobility and increased mortality. Physical activity can maintain or improve bone mineral density and structure in healthy older adults, likely reducing fracture risk. The purpose of this systematic review was ...

ABSTRACT: BACKGROUND: Approximately 70,000 patients / year undergo surgery for repair of a fractured hip in the United Kingdom. This is associated with 30-day mortality of 9% and survivors have a considerable length of acute hospital stay postoperatively (median 26 days). Use of oesophageal Doppler monitoring to guide intra-operative fluid ...

Carotid artery stenting (CAS) is a developing intervention for carotid artery stenosis, and long-term outcomes remain unclear. We examined the prevalence and clinical significance of carotid stent fractures or deformations following CAS. Two hundred thirty-one CAS performed in 219 patients at one academic institution between August 2000 and March 2009 ...

Fractures are increased among men with prostate cancer, especially those on androgen-deprivation therapy (ADT), but few data are available on men with localized prostate cancer. The purpose of this investigation was to estimate fracture risk among unselected community men with prostate cancer and systematically assess associations with ADT and other ...

BACKGROUND: Osteoporosis is generally thought of as a "woman's disease" because the prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older men. However, the absolute number of men affected by osteoporosis and fractures is large, as at least 2.8 million men in ...

Iwamoto J, Takeda T, Matsumoto H. Sunlight exposure is important for preventing hip fractures in patients with Alzheimer's disease, Parkinson's disease, or stroke. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01555.x. © 2011 John Wiley & Sons A/S. Objectives -  Hypovitaminosis D as a result of malnutrition or sunlight deprivation, increased bone resorption, low ...

By understanding the normal humeral and scapular kinematics during the kayak stroke, inferences about the relationship of kayaking technique and shoulder injury may be established. The purpose of this study was to describe scapular and humeral kinematics and to compare dominant versus nondominant symmetry in healthy whitewater kayakers performing the ...

Femoral neck fracture in hip resurfacing has been attributed to technical error during femoral head preparation. In the absence of fracture, several radiographic findings have been speculated to increase the risk of femoral component failure. We examined whether (1) the use of navigation to reduce technical errors during femoral head ...

ABSTRACT: BACKGROUND: In general there is a lack of data on osteoporosis and fracture in men; this also includes low-energy distal radius fractures. The objectives of this study were to examine BMD and identify factors associated with distal radius fractures in male patients compared with controls recruited from the background ...

Failure of internal fixation of intertrochanteric fractures is associated with delayed union or malunion resulting in persistent pain and diminished function. We evaluated 15 elderly patients treated with a tapered, fluted, modular, distally fixing cementless stem. At an average follow-up of 2.86 years, mean Harris hip score improved from 35.90 ...

Alternative bearing materials in THA have been developed to reduce the incidence of osteolysis. Alumina-on-alumina bearings exhibit extremely low wear rates in vitro, but concerns exist regarding component impingement with the potential for dislocation and the occurrence of noise. We determined generation of squeaking and the relationship between squeaking and ...

Modular femoral stems are one option for revision THA surgeons and allow offset restoration, leg length discrepancy correction, and stability independent of distal stem fixation. The complexity of revision THA usually leads surgeons to use multiple revision hip designs to address these issues. We evaluated functional outcomes with a revision ...

Interprosthetic femoral fractures, ones occurring between ipsilateral total hip and total knee arthroplasties, are an increasingly common and challenging problem for orthopaedic surgeons. The purpose of this study was to report specific fracture locations and treatment outcomes associated with a protocol of femoral plate fixation that spanned the interprosthetic zone ...

Despite stem subsidence being a major complication of femoral impaction bone grafting in cemented revision hip arthroplasty, few studies have distinguished subsidence at the prosthesis-cement interface from that at the cement-bone interface. It is unknown how technique developments intended to improve the procedure influence stability of the stem. We used ...

Strategies for revising a ceramic-on-ceramic total hip prosthesis are controversial. Some consider reimplantation of a ceramic head on a well-fixed femoral stem inadvisable as it may lead to a fracture of the newly implanted head. We assessed (1) the risk of fracture when a new ceramic head was placed on ...

Since the early 1980s, research on the modification of bone implant surfaces by applying coatings has mainly focused on the application of inorganic calcium phosphate (CaP) coatings using physical deposition techniques. Organic components of the extracellular bone matrix, on the other hand, play an essential role in the process of ...

Allograft-prosthesis composite (APC) for proximal femur reconstruction have shown favorable longevity and functional outcome compared to endoprosthesis, owing to restoration of bone stock, load-sharing property, and biological attachment of abductors and iliopsoas tendons. This study examined whether a pasteurized-prosthesis composite (PPC) is comparable to APC regarding implant survival, functional outcome, ...

The interfacial micromotion is closely associated to the long-term success of cementless hip prostheses. Various techniques have been proposed to measure them, but only a few number of points over the stem surface can be measured simultaneously. In this paper, we propose a new technique based on micro-Computer Tomography (μCT) ...

Compared to fully textured prosthetic stems, partial texturing lessens bone loss due to stress shielding and makes removal easier. However, initial press-fit stability is necessary for bone ingrowth. There is no significant difference in the initial stability of radial head prostheses that are partially grit-blasted compared to those that are ...

Revision surgery of the hip was performed on 114 hips using an extensively porous-coated femoral component. Of these, 95 hips (94 patients) had a mean follow-up of 10.2 years (5 to 17). No cortical struts were used and the cortical index and the femoral cortical width were measured at different ...

Securing femoral offset should in theory improve hip stability and abductor muscles moment arms. As problems arise mainly in case of originally increased offset (>40mm), a range of extra-offset stems is available; the exact impact in terms of fixation, however, is not known. Extra-offset stems should more reliably reestablish original ...

We report on a prospective series of 201 primary uncemented total hip arthroplasties with a Bicontact prosthesis at a mean follow-up of 12.9 years. The mean Harris hip score improved from 41 before surgery to 89 at final follow-up. Two femoral stems, one each for infection and fracture, and 12 cups ...

Early aseptic loosening is a major complication in revision total knee arthroplasty (TKA). It is well accepted that intramedullary stems improve the anchoring of the prosthetic components; however, controversy still exists about the optimal fixation technique of the stems (cementless, hybrid, cemented). A literature review was carried out in the ...

Traditional techniques for the insertion of femoral stems in arthroplasty of the hip in osteopetrosis carry a considerable risk of penetration of the femoral cortex and intra-operative fractures, due to obliteration of the intramedullary cavity and greatly increased stiffness and brittleness of the bone. In order to reduce the risk ...

Intraoperative proximal femoral fracture is a risk in total hip arthroplasty (THA) with cementless stems with reported rates of 1.5-27.8%. Certain designs or designs associated with certain types of instrumentation may have higher rates. We compared the incidence of proximal femoral fracture with two stem and instrument design systems. We ...

OBJECTIVE: To compare an electron beam melting-processed (EBMP) low-modulus titanium alloy mesh stem with a commercial cobalt-chromium (CC) stem in a canine cadaver model. SAMPLE POPULATION: 9 pairs of cadaver femora. PROCEDURES: EBMP stems of 3 sizes were placed in randomly chosen sides of femora (left or right) and CC ...

Bone deficiency represents a common theme in revision total knee arthroplasty (TKA). The etiology of bone deficiency may be aseptic loosening resulting in direct mechanical bone loss, osteolysis, stress shielding, septic loosening, or iatrogenic resulting from implant removal. Not all revisions are created equal. The surgeon must assess the degree ...

Bone preservation and physiological distribution of forces on the proximal femur are key elements in introducing a successful uncemented total hip replacement. In order to achieve this, in the mid 1990s, we developed an ultra short proximal loading custom-made component with a lateral flare, a high femoral neck osteotomy and ...

The effect of a short-stem femoral resurfacing component on load transfer and potential failure mechanisms has rarely been studied. The stem length has been reduced by approximately 50% as compared to the current long-stem design. Using 3-D FE models of natural and resurfaced femurs, the study is aimed at investigating ...

It has been suggested that the use of a short-stem prosthesis could conserve proximal bone by proximal load transfer. Proximal stress shielding should be reduced, a phenomenon that has been associated with bone resorption around traditional stems. Bone remodelling of a metaphyseal fixed stem (Nanos, Smith & Nephew Int.) was ...

Addressing severe proximal femoral bone loss in revision hip surgery is a challenging reconstructive problem. The use of modular proximal femoral megaprostheses is one of many available options to address this. This is a retrospective review of 15 patients who had undergone limb salvage at our institution using a modular ...

The goal of the study was to evaluate the long-term results of a metal-on-metal articulation. We evaluated the results and histologic findings in patients who had undergone revision. One hundred total hip arthroplasties with a Lubrimet metal-on-metal articulation (Smith and Nephew, Rotkreuz, Switzerland) were implanted in 99 consecutive unselected patients ...

BACKGROUND AND PURPOSE: We have developed an individually designed, uncemented femoral component for achievement of improved strain distribution and fixation to the bone, to make uncemented stems more applicable in femurs of abnormal size and shape, and to improve the joint mechanics. Here we describe the design of the implant ...

Abstract: Objective: To investigate the biocompatibility of diamond-like carbon (DLC) coated nickel-titanium shape memory alloy (NiTi SMA) in vitro and in vivo. Methods: The in vitro study was carried out by co-culturing the DLC coated and uncoated NiTi SMA with bone marrow mesenchymal stem cells (MSCs), respectively, and the in ...

We describe a case of successful revision total hip arthroplasty for a Vancouver type B3 periprosthetic femoral fracture with extensive bone stock deficiency and osteoporotic diaphyseal bone. The femur was reconstructed with an allograft-cemented stem composite using a telescoping technique and a drainage hole for surplus cement. This procedure facilitated ...

Treating senile osteoporotic patients with unstable hip fractures remains a challenge. We evaluated the results of 87 cementless bipolar hemiarthroplasties using an extensively hydroxyapatite-coated long stem for unstable intertrochanteric fractures in senile patients. Sixty-one hips were followed for a minimum of 2 years (mean, 36 months) postoperatively. The mean Merle ...

We report a novel technique for the treatment of a fractured fully porous-coated modular stem. The fracture of the stem occurred at the taper of the stem-body junction. In both cases, the stem was well-fixed distally making the reconstruction difficult. Previously, authors have reported the use of an extended trochanteric ...

The purpose of this study was to evaluate the effects of partial and full weightbearing after cementless total hip arthroplasty over a two year follow-up period. Fifty-nine women and 41 men (average age 61 years) received an uncemented Spotorno stem and were randomised into a full and a partial weightbearing ...

During revision of a failed acetabular component with well-fixed antiquated femoral stem, the same variant of metal head is usually not available in the inventory production. We gathered the stems retrieved from revision surgeries and tried to reassemble with the commercially available femoral heads. This study reports the results of ...

BACKGROUND: Conversion of a failed femoral resurfacing component is reportedly a straightforward procedure; however, little has been published regarding the functional results following revision. Our primary aim was to compare the functional results for a group of patients who had had isolated femoral component revision after a failed hip resurfacing ...

A quantitative analysis of the response of proximal femur bone to implantation of revision stems with distal fixation and of the factors that affect that response has not previously been published. A prospective study of 138 stem revision operations involving replacement with cementless, modular, titanium revision stems with distal fixation ...

This work presents an analysis of a total hip prosthesis that failed in service prematurely within 5 years. The prosthesis presented a fractured stem that was extracted from a 46 year old male patient, 75 kg weight and 1.76 m height. In order to determine the origin of the failure, ...

The IMAGE prosthesis was developed with the objective of proximal load induction to avoid stress shielding and proximal bone resorption. In this study patients were followed clinically and radiologically with a special emphasis on osteointegration of the shaft in the proximal and distal regions. In addition, the reconstruction of the ...

Adequate stem alignment is essential for the success of Total Hip Arthroplasty (THA) to avoid dislocation and impingement. One factor that has not been sufficiently investigated so far is the stem tilting in the sagittal plane, which has an influence on the position of the centre of the femoral head ...

We report on 13 cases of periprosthetic stress fracture at the sleeve/stem junction using the Sivash-Range of Motion femoral prosthesis. Radioisotope bone scans confirmed the incidence of fracture, and review of the lateral radiographs revealed anteromedial notching of the distal sleeve on the metaphyseal throat of the femur. Treatment in ...

Femoral stem fracture is reported as an uncommon late complication of cemented total hip replacement in two dogs. In each case surgical salvage was achieved by extirpation of the proximal unstable component of the femoral stem, resulting in acceptable limb function. To the authors' knowledge, intramedullary femoral stem failure has ...

Biologic augmentation of orthopaedic procedures is a time-tested useful adjunct. The ability to predictably heal all fractures and arthrodesis procedures is still elusive because of multiple factors. The next frontier in musculoskeletal medicine and surgery will involve increasing biologic manipulation of the healing environment. Mesenchymal stem cell allograft is viable ...