Purpose The aim of this study was to evaluate early results of acetabular revisions of total hip replacement using fully cementless trabecular titanium (TT) acetabular modular implants (Delta Trabecular Titanium, Limacorporate, Udine, Italy). Methods Between March 2009 and May 2012 TT was used in 81 revisions. The mean age at the time of revision was 68 years (32-84 years). There were nine patients revised for type 1, 11 for type 2A, 27 for type 2B, six for type 2C, 15 for type 3A and 13 for type 3B acetabular defects according to the Paprosky classification. Frozen morselised bone allografts were used in 53 cases and bulk structural allografts in three cases. Clinical evaluations were made using a modified functional Merle d'Aubigné-Postel score. The mean follow-up period was 38.14 months (24-62 months). Results The mean pre-operative Merle d'Aubigné-Postel functional score was 4.7 and 9.8 at the time of last followup. There was one revision due to instability of the acetabular component. A cage system-Delta Revision TT-was successfully used in this case. Three cases with Paprosky type 3B defect showed cranial migration of the acetabular component by 6 mm, but stabilised after six months. No dislocations associated with acetabular surgery have occurred in the cohort. There have been no dissociations of the modular component. A fatigue fracture of the hemispherical module occurred in the revised case. No other hardware mechanical failures have been recorded. Conclusions TT cups, hemispherical modules and augments facilitate reliable and reproducible biological fixation in acetabular revision surgery with excellent results. Extended follow-up is necessary to evaluate the long-term performance of TT modular implants.
Osteoarthritis (OA) is characterized by deterioration of the joints and associated with considerable pain and disability. OA is a chronic disease that requires intervention with both non-pharmacological and pharmacological treatment modalities and, inevitably, disease progression may necessitate successive treatments throughout the course of the disease. There is increasing data on the shortfalls of current pharmacological treatment of OA, and safety concerns associated with analgesic therapy use in OA arising from increasing evidence of gastrointestinal, cardiovascular, hepatic and renal adverse events with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). Consequently, symptomatic slow-acting drugs for OA (SYSADOAs) may now be considered as a first-line treatment for knee OA, with a particular emphasis placed on the outstanding benefit: risk ratio of pharmaceutical-grade glucosamine and chondroitin sulfate formulations. In this short communication we review recent publications concerned with the safety of paracetamol, NSAIDs and SYSADOAs. Greater understanding of the benefits and limitations of current medications will lead to better disease management in OA. Furthermore, adherence to guideline recommendations across Europe and internationally, such as those from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), will promote evidence-based medicine and patient-centric care, ultimately leading to greater physician and patient satisfaction.
A 62-year-old man presented with diabetes insipidus, pulmonary fibrosis, right atrial tumor and bilateral knee osteoarthritis with cystic lesions of distal femur and proximal tibia. Scintigraphy and histological examination of right femur bone biopsy revealed changes characterized for Paget's disease. Re-evaluation of the computer tomography (CT) scans and histological samples revealed diffuse infiltrates of foamy histiocytes in the bone marrow what was consistent with Erdheim-Chester disease. Positron emission tomography/computed tomography (PET/CT) was performed to access the activity and extent of disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.