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IntroductionThe aim of this study was to evaluate the clinical and radiological outcomes of total hip arthroplasty (THA) in patients with Ankylosing Spondylitis (AS).Patients and methodsOne hundred five hips of 61 AS patients (mean age: 41.3 ± 10.2 years) who underwent THA between 1997 and 2012 were included into the study. Dorr's classification of proximal femoral geometry, acetabular protrusio, bone ankylosis, acetabular protrusion, Brooker classification of heterotopic ossification (HO), Gruen and Charnley classifications of implant loosening were used in radiographic assessments. Patients were called back to return for an additional long-term follow-up for functional assessment.ResultsCementless total hip arthroplasty was used in 83 hips (79%) and cemented TKA was used in 22 hips (21%). The overall rate of aseptic loosening was 7.6% at a mean follow-up of 5.4 years. Femoral loosening was statistically similar in cemented and cementless femoral components (14% vs. 8%, p = 0.089). Acetabular component loosening was statistically higher in patients with any degree of HO (p = 0.04). Regardless of the type of femoral implant (cemented or cementless), femoral component loosening was higher in Dorr's type C patients (p = 0.005). The average pre-operative HSS was 46.6 ± 16.3, and it improved to 80.7 ± 18.7 at last follow-up (p < 0.01).ConclusionRevision incidence was similar in between ankylosed and non-ankylosed hips. While complication rates are high, significant functional improvement can be achieved after THA in patients with AS.

HighlightsFemoral neck stress fractures are not uncommon.Osteomalacia is a common cause of insufficiency fractures.Coxa vara is a rare cause of femoral neck stress fractures.Co-existence of osteomalacia and coxa vara is a rare condition.

The aim of this in vitro study was to compare the microleakage of Er:YAG laser and diamond bur on different bonding systems in class V restorations. Class V cavities were prepared with Er:YAG laser or diamond bur on 80 intact human molars. Teeth were randomly distributed into ten groups and cavities were restored with CeramX duo (DENTSPLY) or Filtek Silorane (3M/ESPE) using different bonding materials (One Coat 7.0 (Coltène), XP Bond (DENTSPLY), Clearfil Protect Bond (Kuraray), AdperSE (3M/ESPE), and Silorane System Adhesive (3M/ESPE). All specimens were subjected to thermocycling and load cycling. After being immersed in silver nitrate dye, the specimens were sectioned. Microleakage was evaluated by stereomicroscope and SEM. Data were statistically analyzed by one-way ANOVA, Kruskal-Wallis, and Mann-Whitney tests. Statistically differences were found between groups (p > 0.05) and cavities prepared with the Er:YAG laser showed higher microleakage than diamond bur. The microleakage of different bonding systems was influenced by the choice of diamond bur or Er:YAG laser for class V composite cavity preparation.