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  • Karstensen Egan heeft een update geplaatst 1 week, 1 dag geleden

    Normalisation of echogenicity to muscle thickness may help delineate between regions of contractile and non-contractile tissue and provide a useful measure of muscle echogenicity when comparing muscles of different cross-sectional dimensions. We recommend that researchers consider controlling for muscle size-dependent effects on echogenicity, by normalising EI and EV to muscle thickness, or including the latter as a covariate when comparing between groups.

    The Metasul articular interface was a second-generation metal-on-metal (MoM) total hip arthroplasty (THA) that was introduced as a promising interface with improved manufacturing technology, better clearances, and enhanced metal hardness. In December 2001, the manufacturer recalled these implants due to the failure of cup osseointegration.

    Between 1997 and 2004, 168 consecutive primary Metasul THAs were performed in 144 patients. Most patients received a cementless femoral and porous-coated acetabular component with 28 mm head. A competing risk analysis was performed for determination separately for bearing surface-related, recalled bearing failure, and end point revision for any reason. For clinical patient evaluation, we used Harris hip score and University of California at Los Angeles scores. Cobalt and chromium ion level measurement and standard radiographic assessment was performed.

    Of the 168 THAs, 19 hips were revised at a mean period of 15 years as follows 12 of them were due to recalled acetabular component, five hips had noninterface-related complication, and two true interface surface failure. The survival distribution function of all hips with revision for any reason was 88.4%, for bearing interface relation 98.8%, and 92.6% for recalled cups. The mean Harris hip score and University of California at Los Angeles scores were 85 and 6, respectively, and the median Co and Cr blood levels were 1.0 and 0.91 μg/L.

    Excluding the recalled components, Metasul articular interface has performed extremely well at a minimum follow-up of 15 years in this relatively young population. There were two interface-related revisions in the entire cohort.

    Excluding the recalled components, Metasul articular interface has performed extremely well at a minimum follow-up of 15 years in this relatively young population. There were two interface-related revisions in the entire cohort.

    Higher body mass index (BMI) is a well-known risk factor for the development of hip and knee osteoarthritis and predicts total hip arthroplasty (THA) and total knee arthroplasty (TKA) at an earlier age. The purpose of this study is to document the nationwide trends in age and obesity in primary THA and TKA throughout the obesity epidemic.

    A retrospective analysis of the National Inpatient Sample database was conducted on patients undergoing primary THA and TKA for primary OA between 2002 and 2017. Analysis of variance and chi-square tests were performed to examine changes in age and obesity percentage over time, respectively. Pearson correlations were used to assess the relationship between patient age, BMI, and year of surgery.

    A total of 688,371 THA and 1,556,651 TKA were identified over the sixteen-year period. Between 2002 and 2017, the proportion of obese patients increased for both THA (7.0% to 22.7%, P < .001) and TKA (10.7% to 30.4%, P < .001). Mean age significantly decreased for both THA (66.7 to 65.9 years, P < .001) and TKA (67.6 to 66.8 years; P < .001). Over time, BMI significantly increased (THA r= 0.221 vs. #link# TKA r= 0.272) and patient age decreased (THA r= -0.031 vs. TKA r= -0.137) for both procedures (P < .001 for all).

    THA and TKA patients have become younger and increasingly more obese throughout the obesity epidemic, as obesity rates have tripled over this time period. The current investigation is the first to demonstrate significant trends in both age and obesity in the THA and TKA populations on a national level.

    III.

    III.

    Hip hemiarthroplasty is the most common arthroplasty option for fractured neck of femur (FNOF). Revision to total hip arthroplasty (THA) is occasionally required. This study aimed to assess the outcome of hemiarthroplasty revised to THA and to assess the impact of femoral head size, dual mobility (DM), and constrained liners.

    All aseptic 1

    revisions reported to the Australian Joint Replacement Registry after hemiarthroplasty performed for FNOF when a THA was used as the revision procedure were included from September 1999 to December 2019. AP20187 cost was the cumulative percent revision for all-causes and dislocation. The impact of prosthesis factors on revision THA was assessed standard head THA (≤32 mm), large head THA (≥36 mm), DM, and constrained liners. Outcomes were compared using Kaplan Meyer and competing risk.

    There were 96,861 hemiarthroplasties performed, with 985 revised to THA. The most common reasons for 1

    revision were loosening (49.3%), fracture (17.7%), and dislocation (11.0%). Of the hemiarthroplasty procedures revised to THA, 76 had a 2

    revision. The most common reasons for 2

    revision were fracture (27.6%), dislocation (26.3%), loosening (23.7%), and infection (18.4%). Femoral head size, DM, or constrained liner use did not alter the incidence of all-cause 2

    revision. This did not change when solely looking at patients still alive. A 2

    revision was more likely in patients aged <75 years.

    The outcome of hemiarthroplasty performed for FNOF revised to THA is influenced by patient age, not by the articulation used.

    The outcome of hemiarthroplasty performed for FNOF revised to THA is influenced by patient age, not by the articulation used.Hypersensitivity Pneumonitis (HP) is a common immune-mediated interstitial lung disease (ILD) induced by repeated exposure to environmental antigens in susceptible individuals. The most commonly known forms are bird fancier’s disease and farmer’s lung. However, the antigens involved are widely diverse. Therefore, the list of causes of HP is frequently expanding. HP seems to be under-diagnosed owing to its highly heterogeneous presentation in both the non-fibrotic and fibrotic subtypes and could represent up to 15% of all ILDs encountered in clinical practice. However, the recognition of HP cases is essential to ensure appropriate therapy for the patient. Home health care workers’ intervention is sometimes critical in this context. In case of confirmed exposure, the diagnosis could be considered with high confidence if the high-resolution computed tomography (HR-CT) shows a typical HP pattern associated with a lymphocytosis over 30% in the broncho-alveolar lavage (BAL). In all other situations, the patients should undergo further investigations and additional histopathological sampling should be considered and submitted to a multidisciplinary team discussion.

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