The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Martyn J. Parker - One of the best experts on this subject based on the ideXlab platform.
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Cemented versus unCemented hemiarthroplasty for hip fractures a systematic review of randomised controlled trials
Hip International, 2011Co-Authors: Shin Azegami, Kurinchi Selvan Gurusamy, Martyn J. ParkerAbstract:We performed a systematic review of randomised controlled trials in order to identify the best available evidence to compare the outcome between Cemented and unCemented hemiarthroplasty for treatment of intracapsular hip fractures. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, MEDLINE and the National Research Register (UK) to retrieve all of the published randomised controlled trials designed to address these issues, in order to perform a meta-analysis. Eight studies involving 1169 patients were determined to be appropriate for meta-analysis. The following statistically significant differences were found between the Cemented and unCemented prostheses: (1) longer operative time for Cemented Prosthesis; (2) lower reduction in mobility score for those treated with Cemented Prosthesis; (3) fewer patients with residual pain in the hip and lower pain score (signifying less pain) for those treated with a Cemented Prosthesis. Our meta-analysis has shown that there is good evidence that the use of cement during hemiarthroplasty will reduce the amount of residual hip pain and also allow better restoration of function. There is no evidence of significant adverse effects of cement on mortality or other complications encountered. These observations apply to older designs, and there is a need for randomised trials comparing hydroxyapatite-coated modern stems with Cemented prostheses.
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Stability of hip hemiarthroplasties
International Orthopaedics, 2004Co-Authors: James Varley, Martyn J. ParkerAbstract:It has been stated in the literature that a bipolar hemiarthroplasty has a lower risk of dislocation compared to a unipolar hemiarthroplasty. As this statement has not been substantiated we undertook a systematic review of the literature of published articles from the last 40 years. In addition we used our own database of hip fractures. One hundred and thirty-three published articles were included in the review to give a total of 23,107 cases. The overall dislocation rate for all types of hemiarthroplasty was 791/23,107 (3.4%). An increased risk of dislocation was associated with a posterior surgical approach and the use of a Cemented Prosthesis. After adjustment for surgical approach and the use of cement there was no difference in risk of dislocation between unipolar and bipolar hemiarthroplasties. There was an increased risk of open reduction for a bipolar hemiarthroplasty.
Kurinchi Selvan Gurusamy - One of the best experts on this subject based on the ideXlab platform.
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Cemented versus unCemented hemiarthroplasty for hip fractures a systematic review of randomised controlled trials
Hip International, 2011Co-Authors: Shin Azegami, Kurinchi Selvan Gurusamy, Martyn J. ParkerAbstract:We performed a systematic review of randomised controlled trials in order to identify the best available evidence to compare the outcome between Cemented and unCemented hemiarthroplasty for treatment of intracapsular hip fractures. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, MEDLINE and the National Research Register (UK) to retrieve all of the published randomised controlled trials designed to address these issues, in order to perform a meta-analysis. Eight studies involving 1169 patients were determined to be appropriate for meta-analysis. The following statistically significant differences were found between the Cemented and unCemented prostheses: (1) longer operative time for Cemented Prosthesis; (2) lower reduction in mobility score for those treated with Cemented Prosthesis; (3) fewer patients with residual pain in the hip and lower pain score (signifying less pain) for those treated with a Cemented Prosthesis. Our meta-analysis has shown that there is good evidence that the use of cement during hemiarthroplasty will reduce the amount of residual hip pain and also allow better restoration of function. There is no evidence of significant adverse effects of cement on mortality or other complications encountered. These observations apply to older designs, and there is a need for randomised trials comparing hydroxyapatite-coated modern stems with Cemented prostheses.
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Cemented versus unCemented hemiarthroplasty for intracapsular hip fractures a randomised controlled trial in 400 patients
Journal of Bone and Joint Surgery-british Volume, 2010Co-Authors: M I Parker, G Pryor, Kurinchi Selvan GurusamyAbstract:We undertook a prospective randomised controlled trial involving 400 patients with a displaced intracapsular fracture of the hip to determine whether there was any difference in outcome between treatment with a Cemented Thompson hemiarthroplasty and an unCemented Austin-Moore Prosthesis. The surviving patients were followed up for between two and five years by a nurse blinded to the type of Prosthesis used. The mean age of the patients was 83 years (61 to 104) and 308 (77%) were women. The degree of residual pain was less in those treated with a Cemented Prosthesis (p < 0.0001) three months after surgery. Regaining mobility was better in those treated with a Cemented implant (p = 0.005) at six months after operation. No statistically significant difference was found between the two groups with regard to mortality, implant-related complications, re-operations or post-operative medical complications. The use of a Cemented Thompson hemiarthroplasty resulted in less pain and less deterioration in mobility than an unCemented Austin-Moore Prosthesis with no increase in complications.
Jangwon Park - One of the best experts on this subject based on the ideXlab platform.
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simultaneous Cemented and cementless total knee replacement in the same patients a prospective comparison of long term outcomes using an identical design of nexgen Prosthesis
Journal of Bone and Joint Surgery-british Volume, 2011Co-Authors: Jangwon ParkAbstract:The purpose of this prospective, randomised study was to evaluate the clinical and radiological results comparing the identical Cemented or cementless NexGen total knee prostheses implanted bilaterally in the same patient. Sequential simultaneous bilateral total knee replacements were performed in 50 patients (100 knees). There were 39 women and 11 men with a mean age of 58.4 years (51 to 67) who received a Cemented Prosthesis in one knee and a cementless Prosthesis in the other. The mean follow-up was 13.6 years (13 to 14). At final review, the mean Knee Society scores (96.2 (82 to 100) versus 97.7 (90 to 100)), the mean Western Ontario and McMaster Universities osteoarthritis index (34.5 (4 to 59) versus 35.6 (5 to 51)), the mean ranges of knee movement (124° (100° to 140°) versus 128° (110° to 140°)), mean patient satisfaction (8.1 (sd 1.9) versus 8.3 (sd 1.7)), and radiological results were similar in both groups. The rate of survival of the femoral components was 100% in both groups at 14 years. The rate of survival of the Cemented tibial component was 100% and 98% in the cementless tibial component. No osteolysis was identified in either group. Our data have shown no advantage of cementless over Cemented components in total knee replacement.
Mario Cannas - One of the best experts on this subject based on the ideXlab platform.
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Ultrastructural analysis of nanoparticles and ions released in periprosthetic membranes
Journal of applied biomaterials & functional materials, 2014Co-Authors: Maurizio Sabbatini, Filippo Renò, Michela Bosetti, Giorgio Gatti, Leonardo Marchese, Mario CannasAbstract:The distribution and relationship of hydroxyapatite debris, nanometric organic and metal wear particles and metal ions on periimplant interface membranes following aseptic and septic arthroplastic loosening were investigated. Scanning electron microscopy and X-ray spectroscopic analysis were used to analyze debris and ion distribution. Hydroxyapatite debris appeared with different morphology in a particular distribution among several membranes. These differences may reflect the occurrence of different friction forces taking place between Prosthesis and bone interface in the several types of prostheses studied. Metal wear particles were detected in greater numbers in membranes from nonCemented prostheses compared with those from Cemented ones. In contrast, more organic particles were present in membrane from Cemented Prosthesis. No differences were observed between aseptic and septic membranes. Our findings support the need to evaluate the occurrence of friction forces that periprosthetic bone debris production may induce to exacerbate cellular reactivity. Furthermore, cellular engulfment of debris and the high level of different ions released indicate the occurrence of a toxic environment that may induce failure of any reparative pathways.
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Biochemical and histological evaluation of human synovial-like membrane around failed total hip replacement prostheses during in vitro mechanical loading.
Journal of materials science. Materials in medicine, 2001Co-Authors: Michela Bosetti, Alessandro Massè, Roberto Navone, Mario CannasAbstract:The biochemical role of the synovial-like membrane formed at the interface of eight aseptic failed total hip Prosthesis has been investigated during in vitro mechanical loading. The study was carried out on four membranes from Cemented Prosthesis and four titanium alloy unCemented ones. Intermittent positive pressure leading to 20% deformation of the membrane (100 g/cm2)was applied to the membrane fragments in cycles (300 cycles/15 min) repeated three times at thirty minutes intervals in which interleukin-6 (IL6), prostaglandin-E2 (PGE2) and interleukin-1β (IL1β) levels were quantified both in culture media and in tissue extracts. Histological, morphometrical and immunohistochemical studies were also carried out on the same membranes.
J Schmitt - One of the best experts on this subject based on the ideXlab platform.
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analyses of Prosthesis stem failures in nonCemented modular hip revision prostheses
Journal of Arthroplasty, 2011Co-Authors: Turgay Efe, J SchmittAbstract:In recent years, hip Prosthesis stem revision by means of modular revision systems has reached an essential role in revision prosthetics. It is an extremely successful technique. Reports about mechanical failure in nonmodular revision stems have already been published. This complication is rare, but feared. We report about mechanical failure of four non-Cemented modular revision stems over a period of 28 months. All failures became clinically apparent because of severe inguinal or thigh pain and were confirmed by conventional x-ray imaging. All stem failures occurred just below the interface between Prosthesis stem and neck, which is a biomechanically stressed area. Distal of the failure, all stems were still firmly fixed. In all cases, there was obvious evidence of loosening at the proximal component. Metallographic and energy-dispensive x-ray analysis of one stem showed a fatigue fracture due to dynamic stress. If new pain arises after revision surgery with modular non-Cemented Prosthesis systems, the possibility of an implant failure should be kept in mind. Patients should be informed accordingly about the risk of implant failure.