Background: As total hip replacement cases increase year after year, registry-wide data becomes increasingly important in order to assess pathology distribution, reimbursement efficiency as well as physician performance. In order to assess all these factors patient evolution needs to be documented after surgery as well, but the main impediment to doing this is losing patients to follow-up. For this reason, the present study aims to perform a descriptive analysis of the hospital’s internal registry data as well as to determine what percentage of patients can be expected to return to follow-up after total hip replacement. Methods: A query of the hospital’s internal registry data in the last years was performed. Patient demographics, county distribution as well as ICD-10 code usage were documented. Data standardization was performed to determine the probability and cumulative distribution of the patient’s age. The chi2 test of independence was used to assess whether there is a correlation between the patient’s gender and ICD-10 codes. Pot hoc power analysis was performed to assess the accuracy of correlation analysis. Results: Only 29.6% of the patients undergoing total hip replacement are from the county within which the hospital is located. 25% of the patients were under 60 years old. Conclusions: Current registry data reveals that most patients undergoing total hip replacement are around 67.5 ± 11 years old, suffer from unilateral or bilateral primary or secondary hip osteoarthritis and only 29.6% of them are likely to return to follow-up.
Background: Rotator cuff tendinopathy is most often described as a continuum between the normal cuff and rotator cuff tears with calcific tendinitis having its place along this continuum. Although many studies have focused on the role of magnetic resonance imagining (MRI) in diagnosing the extent of rotator cuff tears and their associated findings with good interobserver reliability, the same cannot be stated about MRI tendinopathy findings. Because of this discrepancy in diagnostic reliability, tendinopathy tends to be overtreated with injections when associated with symptoms, thus potentially increasing the risk of calcific tendinitis and progression toward rotator cuff tears. This study aims to assess whether diagnosing shoulder MRI tendinopathy patterns through dichotomization can accelerate clinical progress toward consensus. Methods: This study is a large retrospective cohort of 184 patients that underwent a 1.5T shoulder MRI for shoulder pain. Inclusion criteria were acromioclavicular arthrosis diagnosed in patients of any age. Exclusion criteria were partial or complete rotator cuff tears. Tendinopathy was considered the dependent variable and registered as a dichotomous variable while acromioclavicular joint arthrosis together with gender was categorical and age was the continuous variable. An attempt was made to generate a clinically significant binary logistic regression to assess the odds ratio of diagnosing tendinopathy based on age, gender, and acromioclavicular joint arthrosis status. Results: An overwhelming proportion of patients was positive for tendinopathy findings (95.11%). 64.12% of patients were within the active age group with patients within the 50-59 group being diagnosed the most with rotator cuff tendinopathy. Conclusions: Due to the high variability of MRI findings that can be considered positive for rotator cuff tendinopathy, an overwhelming skew toward a positive diagnosis was observed, thus dichotomizing tendinopathy diagnosis is not appropriate for clinically relevant conclusion-making.
Leiomyosarcoma is a rare type of smooth muscle cell tumor, with an incidence of 7-10% compared to other types of sarcomas. It develops primarily in the retroperitoneal cavity, the genital tract and extremities. Leiomyosarcoma can also affect the bone, either as a primary tumor or as metastasis. Primary osseus leiomyosarcoma is a rare finding in patients with radiologically identified osteolytic lesions having an incidence of <1% of total primary bone tumors.Due to its low incidence patients with primary osseous leiomyosarcoma are never diagnosed before immunohistochemical analysis and case management is difficult because of the lack of specific indications pertaining to primary osseus leiomyosarcoma. Data on age specific incidence is scarce but there seems to be a tendency towards a higher incidence with advanced age. The purpose of this work is to discuss the complete management of primary osseus leiomyosarcomas based on interdisciplinary medical teams’ indications in a Romanian hospital setting.
Magnesium alloys represent a new research direction in the field of orthopedic resorbable metal materials, because it has several important properties that recommend it as an excellent resorbable biomaterial for implants. From in vitro studies, Magnesium has osteoconductive properties, promoting the formation of new bone by stimulating the adhesion of osteoblastic cells, this leading to the idea that it will induce formation of hard callous at fracture site. The present study followed the in vivo evaluation of the biodegradation of pins made of Mg-1Ca alloy introduced centromedulary in rabbit tibiae, with previously induced experimental fractures. The influence of the biodegradation process on the formation of the bone callus was evaluated through radiological images and histopathological examinations. At the same time, we evaluated the function of vital organs through histopathological examinations and blood tests. We chose intramedulary nailing (IMN) with pins, because in orthopaedic surgery this is the golden standard for fractures of tibia or femur. In the radiological images obtained, we notice callus formation at the level of the experimental fracture at 6 weeks after surgery. The histological sections made from the samples collected from the fracture zone adjacent to the Mg1Ca alloy implant, confirm the formation of the bony callus. The trichrome Masson sections show a normal bone development with newly formed bone tissue at the tissue - alloy interface. In the sections harvested from the vital organs, no pathological changes are observed. These observations suggest that the biodegradation process of the Mg-1Ca alloy do not interfere negatively with the biological process of bone formation, allowing the formation of the bone callus and do not confirm the suspicion of pathological changes induced by systemically released corrosion products and gas embolism in vital organs.
The current paper describes the protocol used in our clinic for 3D imaging, reconstruction and printing of complex acetabular defects that are used for surgical planning of complex acetabular defects. Surgical guides have also been developed to aid optimal acetabular reamer placement in order to recreate the optimal hip rotation centre for each patient undergoing revision hip arthroplasty that has impaired acetabular bone stock.
