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Van Hove B, Caekebeke P, Duerinckx J. Does trapezium remodeling correlate with cup shape? Hand Surg Rehabil 2024; 43:101618. [PMID: 37977284 DOI: 10.1016/j.hansur.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/19/2023]
Abstract
We investigated whether trapezium bone reaction was different following implantation of a trapeziometacarpal total joint replacement with a hemispheric or a conical cup. Fifty-three Keri Medical Touch implants with hemispheric cup and 53 with conical cup were prospectively followed up radiographically. We compared radiographs taken immediately and one year after surgery for cup subsidence, tilt, heterotopic ossification and loosening. Cup subsidence of at least 1 mm was detected in 4% of cases for both cup types. Additive bone reaction around the cup of more than 1 mm was present in 62% of conical cups and 47% of hemispheric cups. These were minor and there were no large ossifications with risk of impingement. Minor radiolucency was seen superficially at the implant-bone interface of 13% of the hemispheric cups and 9% of the conical cups. None of these bone reactions differed significantly according to cup design.
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Affiliation(s)
- Bram Van Hove
- Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
| | - Pieter Caekebeke
- Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium
| | - Joris Duerinckx
- Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600 Genk, Belgium; Hasselt University, Faculty of Rehabilitation Sciences, Agoralaan 5, 3590 Diepenbeek, Belgium.
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McKenna DP, Price A, McAleese T, Dahly D, McKenna P, Cleary M. Acetabular cup size trends in total hip arthroplasty. World J Orthop 2024; 15:39-44. [PMID: 38293257 PMCID: PMC10824062 DOI: 10.5312/wjo.v15.i1.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND Total hip arthroplasty (THA) is a common procedure for end stage osteoarthritis. The learning curve for THA is complex and challenging. One of the most difficult skills to master is acetabular reaming. We wish to identify if experience in arthroplasty leads to preservation of more bone stock. AIM To investigate if increasing surgeon experience will predict an ever decreasing acetabular cup size. METHODS A retrospective case series of four attending orthopaedic surgeons was completed. All uncemented elective total hip arthroplasties since appointment were selected for inclusion. The size of acetabular cup used was noted and logistic regression was used to identify if a trend to smaller cups existed. RESULTS A total of 1614 subjects were included with a mean age of 64 years. Overall cups were on average 0.18mm smaller per year (95% confidence interval -0.25 to -0.11, P < 0.001). Individual surgeon trends showed cup sizes to decrease 0.27 mm/year for surgeon A, 0.02 mm/year for surgeon B, 0.15 mm/year for surgeon C and 0.29 mm/year for surgeon D. Three of the four surgeons had a more pronounced trend to smaller cups for male subjects than their female counterparts. CONCLUSION We found increasing surgeon experience to be associated with an ever-decreasing acetabular cup size. Smaller acetabular cup size may act as a surrogate marker of surgical proficiency by virtue of decreased acetabular reaming.
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Affiliation(s)
- Daniel Patrick McKenna
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Alex Price
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Timothy McAleese
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - Darren Dahly
- Department of Epidemiology and Public Health, University College Cork, Cork T12 XF62, Ireland
| | - Paul McKenna
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
| | - May Cleary
- Department of Trauma and Orthopaedics, University Hospital Waterford, Waterford X91 ER8E, Ireland
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Afghanyar Y, Möller JH, Wunderlich F, Dargel J, Rehbein P, Gercek E, Drees P, Kutzner KP. An isoelastic monoblock cup versus a modular metal-back cup: a matched-pair analysis of clinical and radiological results using Einzel-Bild-Röntgen-Analyse software. Arch Orthop Trauma Surg 2024; 144:493-500. [PMID: 37740060 PMCID: PMC10774207 DOI: 10.1007/s00402-023-05058-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/01/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION Bone preservation and long-term survival are the main challenges in cementless total hip arthroplasty (THA). A good bone stock is especially important for adequate anchorage of the cup in revision cases. However, the optimal acetabular cup design for preserving good bone stock is still unclear. We aimed to compare clinical outcome, radiological alterations, migration, and wear at mid-term for two different cup types. MATERIALS AND METHODS This retrospective matched-pair study was performed using the data for 98 THA cases treated with a monoblock cup composed of vitamin E-blended highly cross-linked polyethylene (VEPE; monoblock group) or a modular cup composed of a highly cross-linked polyethylene (HXLPE) without an antioxidant (modular group). Clinical results were evaluated using the Harris Hip Score (HHS). The obtained radiographs were analyzed for radiological alterations, migration, and wear using Einzel-Bild-Röntgen-Analyse (EBRA) software. RESULTS The mean follow-up duration was 73.2 ± 19.2 months (range: 32-108 months) and 60.5 ± 12.2 months (range: 20-84 months) in the monoblock and modular groups, respectively. HHS improved to 95.7 points in the monoblock group and 97.6 points in the modular group, without significant differences (p = 0.425). EBRA measurements were obtained in all cases. Acetabular bone alterations were not detected on radiological assessments. Mean cup migration was 1.67 ± 0.92 mm (range: 0.46-3.94 mm) and 1.24 ± 0.87 mm (range: 0.22-3.62 mm) in the monoblock and modular groups. The mean wear rate was 0.21 ± 0.18 mm (range: 0.00-0.70 mm) and 0.20 ± 0.13 mm (range: 0.00-0.50 mm) in the monoblock and modular groups. Both migration and wear pattern showed no significant differences (p = 0.741 and 0.243). None of the cases required revision surgery, yielding an implant survival rate of 100% in both groups. CONCLUSION The isoelastic press-fit monoblock VEPE cup and modular metal-back HXLPE cup showed equivalent mid-term wear and cup migration. Long-term studies are required to determine the effects of modularity, isoelasticity, and polyethylene stabilization with vitamin E on cup loosening and survival rates.
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Affiliation(s)
- Yama Afghanyar
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany.
- Department of Orthopaedics and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany.
| | - Jens Hendrik Möller
- Department of Orthopaedics and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany
| | - Felix Wunderlich
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Jens Dargel
- Department of Orthopaedics and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany
| | - Philipp Rehbein
- Department of Orthopaedics and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany
| | - Erol Gercek
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Philipp Drees
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Karl Philipp Kutzner
- Department of Orthopaedics and Traumatology, University Medical Centre of the Johannes Gutenberg-University of Mainz, Mainz, Germany
- Department of Orthopaedics and Traumatology, St. Josefs Hospital Wiesbaden, Wiesbaden, Germany
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Bayer LV, Milano S, Formel SK, Kaur H, Ravichandran R, Cambeiro JA, Slinko L, Catrina IE, Bratu DP. Cup is essential for oskar mRNA translational repression during early Drosophila oogenesis. RNA Biol 2023; 20:573-587. [PMID: 37553798 PMCID: PMC10413924 DOI: 10.1080/15476286.2023.2242650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/27/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023] Open
Abstract
Study of the timing and location for mRNA translation across model systems has begun to shed light on molecular events fundamental to such processes as intercellular communication, morphogenesis, and body pattern formation. In D. melanogaster, the posterior mRNA determinant, oskar, is transcribed maternally but translated only when properly localized at the oocyte's posterior cortex. Two effector proteins, Bruno1 and Cup, mediate steps of oskar mRNA regulation. The current model in the field identifies Bruno1 as necessary for Cup's recruitment to oskar mRNA and indispensable for oskar's translational repression. We now report that this Bruno1-Cup interaction leads to precise oskar mRNA regulation during early oogenesis and, importantly, the two proteins mutually influence each other's mRNA expression and protein distribution in the egg chamber. We show that these factors stably associate with oskar mRNA in vivo. Cup associates with oskar mRNA without Bruno1, while surprisingly Bruno1's stable association with oskar mRNA depends on Cup. We demonstrate that the essential factor for oskar mRNA repression in early oogenesis is Cup, not Bruno1. Furthermore, we find that Cup is a key P-body component that maintains functional P-body morphology during oogenesis and is necessary for oskar mRNA's association with P-bodies. Therefore, Cup drives the translational repression and stability of oskar mRNA. These experimental results point to a regulatory feedback loop between Bruno 1 and Cup in early oogenesis that appears crucial for oskar mRNA to reach the posterior pole and its expression in the egg chamber for accurate embryo development.
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Affiliation(s)
- Livia V. Bayer
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
- Program in Molecular, Cellular, and Developmental Biology, the Graduate Center, City University of New York, New York, NY, USA
| | - Samantha Milano
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
- Program in Molecular, Cellular, and Developmental Biology, the Graduate Center, City University of New York, New York, NY, USA
| | - Stephen K. Formel
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Harpreet Kaur
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Rishi Ravichandran
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Juan A. Cambeiro
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Lizaveta Slinko
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
| | - Irina E. Catrina
- Department of Chemistry and Biochemistry, Yeshiva University, New York, NY, USA
| | - Diana P. Bratu
- Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA
- Program in Molecular, Cellular, and Developmental Biology, the Graduate Center, City University of New York, New York, NY, USA
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Innmann MM, Verhaegen J, Merle C, Beaulé PE, Meermans G, Grammatopoulos G. Cup orientation following posterior approach THA - the effect of different visual aids and pelvic supports. BMC Musculoskelet Disord 2022; 23:881. [PMID: 36138377 PMCID: PMC9502576 DOI: 10.1186/s12891-022-05820-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction This study aims to compare cup inclination achieved (1) Using two orientation guides, whilst using the same 3-point pelvic positioner and (2) Using two types of pelvic positioners, whilst measuring intra-operative cup inclination with an inclinometer. Materials and methods This is a prospective, diagnostic cohort study of a consecutive series of 150 THAs performed through a posterior approach. Two types of 3-point pelvic positioners were used (Stulberg and modified Capello Hip Positioners) and the cup was positioned freehand using one of two orientation guides (mechanical guide or digital inclinometer). Intra-operative inclination was recorded, radiographic cup inclination and anteversion were measured from radiographs. The differences in inclination due to pelvic position (ΔPelvicPosition) and orientation definitions (ΔDefinition) were calculated. Target radiographic inclination and anteversion was 40/20° ± 10°. Results There was no difference in radiographic cup inclination/ (p = 0.63) using a mechanical guide or digital inclinometer. However, differences were seen in ΔPelvicPosition between the positioners ((Stulberg: 0° ± 5 vs. Capello: 3° ± 6); p = 0.011). Intra-operative inclination at implantation was different between positioners and this led to equivalent cases within inclination/anteversion targets (Stulberg:84%, Capello:80%; p = 0.48). Conclusions With the pelvis securely positioned with 3-point supports, optimum cup orientation can be achieved with both alignment guides and inclinometer. Non-optimal cup inclinations were seen when intra-operative inclinations were above 40° and below 32°, or the ΔPelvicPosition was excessive (> 15°; n = 2). We would thus recommend that the intra-operative cup inclination should be centered strictly between 30° and 35° relative to the floor. Small differences exist between different type of pelvic positioners that surgeons need to be aware off and account for.
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Affiliation(s)
- Moritz M Innmann
- Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care Wing, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada. .,Department of Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.
| | - Jeroen Verhaegen
- Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care Wing, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.,Department of Orthopaedics and Traumatology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Antwerp, Belgium.,Orthopedic Center Antwerp, Kielsevest 14, 2018, Antwerp, Belgium
| | - Christian Merle
- Department of Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany
| | - Paul E Beaulé
- Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care Wing, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
| | - Geert Meermans
- Department of Orthopaedics, Bravis Hospital, Boerhaavelaan 25, 4708 AE, Roosendaal, The Netherlands
| | - George Grammatopoulos
- Division of Orthopaedic Surgery, The Ottawa Hospital, Critical Care Wing, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada
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Athlani L, Motte D, Bergere M, Mottet J, Beaulieu JY, Moissenet F. Assessment of trapezial prosthetic cup migration: A biomechanical study. Hand Surg Rehabil 2021; 40:754-759. [PMID: 34391955 DOI: 10.1016/j.hansur.2021.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/06/2021] [Indexed: 11/29/2022]
Abstract
We performed a biomechanical study using 60 Sawbones® rigid foam blocks of two simulated densities (osteoporotic, n = 30 and non-osteoporotic, n = 30) and 10 cadaveric trapezium bones from fresh-frozen, unembalmed adult cadaver hands to assess the trapezial prosthetic cup migration with progressively greater compression loads (10-40 kg). Two cups from the Touch® prosthesis were compared: 9-mm conical cup and 9-mm spherical cup. Uniaxial compression tests were carried out using an MTS Criterion® Series 40 Electromechanical Testing System. Cup migration was measured in millimeters (mm) at 10, 20, and 40 kg of compression load. Median cup migration values were similar in the cadaveric trapezium bones and Sawbones® non-osteoporotic blocks, and higher in the Sawbones® osteoporotic blocks. In the cadaveric trapezium bones and the Sawbones® non-osteoporotic blocks, migration values were less than or equal to 0.1 mm for 10 and 20 kg loads; it was 0.2 mm for 40 kg load. In the Sawbones® osteoporotic blocks, migration values were less than or equal to 0.3 mm for 10 and 20 kg loads; it was 0.4-0.5 mm for 40 kg load. There was no significant difference between the two cup shapes in both cadaveric trapezium bones and Sawbones® non-osteoporotic blocks. In Sawbones® osteoporotic blocks, the largest difference between the two cup shapes was 0.1 mm for loads up to 40 kg, which corresponded to our measurement accuracy. Our findings indicate that the trapezial component of total trapeziometacarpal joint arthroplasty undergoes very weak migration for axial compression loads up to 40 kg, presumably below the threshold of clinical relevance. The cup shape did not have an obvious influence; however, low bone mineral density may result in greater cup migration.
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Affiliation(s)
- L Athlani
- Department of Hand Surgery, Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland; Department of Anatomy, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Geneva, Switzerland.
| | - D Motte
- KeriMedical SA, Route des Acacias 45A, 1227 Geneva, Switzerland.
| | - M Bergere
- KeriMedical SA, Route des Acacias 45A, 1227 Geneva, Switzerland.
| | - J Mottet
- KeriMedical SA, Route des Acacias 45A, 1227 Geneva, Switzerland.
| | - J-Y Beaulieu
- Department of Hand Surgery, Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland; Department of Anatomy, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Geneva, Switzerland.
| | - F Moissenet
- Department of Anatomy, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Geneva, Switzerland; Biomechanics Laboratory (B-LAB), Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva 14, Switzerland.
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Athlani L, Auberson L, Motte D, Moissenet F, Beaulieu JY. Comparison of two radiographic landmarks for centering the trapezial component in total trapeziometacarpal arthroplasty. Hand Surg Rehabil 2021; 40:609-613. [PMID: 33992819 DOI: 10.1016/j.hansur.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
We performed a retrospective review of standard anteroposterior and lateral radiographs of the thumb in 80 patients, to compare two radiographic landmarks, in terms of mediolateral bone support, for centering the trapezial component in total joint arthroplasty. On anteroposterior view, we identified the distal articular surface of the trapezium and trapezium width, and defined the two midpoints as radiographic landmarks for positioning a 9-mm trapezial cup. Mean trapezium width was significantly greater than the distal articular surface of the trapezium, and the midpoints did not match. Thus, after positioning simulated 9-mm prosthetic cups centered on each landmark, the residual radial bone distance was significantly greater using the landmark based on trapezium width. The mean value was 33% greater with this landmark, and the minimum value was 2.1 mm, compared to 0.2 mm using the landmark based on the distal articular surface. Our study thus suggested that the midpoint of the trapezium width is the more relevant radiographic landmark for centering the trapezial prosthetic cup in total joint arthroplasty, by preserving better bone stock on the radial side without depleting the ulnar side. On an intraoperative anteroposterior fluoroscopic view, this landmark could be used to check cup positioning.
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Affiliation(s)
- L Athlani
- Department of Hand Surgery, Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland; Department of Anatomy, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Geneva, Switzerland.
| | - L Auberson
- Department of Hand Surgery, Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland.
| | - D Motte
- KeriMedical SA, Route des Acacias 45A, 1227 Geneva, Switzerland.
| | - F Moissenet
- Biomechanics Laboratory (B-LAB), Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland.
| | - J-Y Beaulieu
- Department of Hand Surgery, Division of Orthopedics and Trauma Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland; Department of Anatomy, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Geneva, Switzerland.
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Cao WX, Kabelitz S, Gupta M, Yeung E, Lin S, Rammelt C, Ihling C, Pekovic F, Low TCH, Siddiqui NU, Cheng MHK, Angers S, Smibert CA, Wühr M, Wahle E, Lipshitz HD. Precise Temporal Regulation of Post-transcriptional Repressors Is Required for an Orderly Drosophila Maternal-to-Zygotic Transition. Cell Rep 2021; 31:107783. [PMID: 32579915 PMCID: PMC7372737 DOI: 10.1016/j.celrep.2020.107783] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/06/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022] Open
Abstract
In animal embryos, the maternal-to-zygotic transition (MZT) hands developmental control from maternal to zygotic gene products. We show that the maternal proteome represents more than half of the protein-coding capacity of Drosophila melanogaster’s genome, and that 2% of this proteome is rapidly degraded during the MZT. Cleared proteins include the post-transcriptional repressors Cup, Trailer hitch (TRAL), Maternal expression at 31B (ME31B), and Smaug (SMG). Although the ubiquitin-proteasome system is necessary for clearance of these repressors, distinct E3 ligase complexes target them: the C-terminal to Lis1 Homology (CTLH) complex targets Cup, TRAL, and ME31B for degradation early in the MZT and the Skp/Cullin/F-box-containing (SCF) complex targets SMG at the end of the MZT. Deleting the C-terminal 233 amino acids of SMG abrogates F-box protein interaction and confers immunity to degradation. Persistent SMG downregulates zygotic re-expression of mRNAs whose maternal contribution is degraded by SMG. Thus, clearance of SMG permits an orderly MZT. Cao et al. show that 2% of the proteome is degraded in early Drosophila embryos, including a repressive ribonucleoprotein complex. Two E3 ubiquitin ligases separately act on distinct components of this complex to phase their clearance. Failure to degrade a key component, the Smaug RNA-binding protein, disrupts an orderly maternal-to-zygotic transition.
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Affiliation(s)
- Wen Xi Cao
- Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Sarah Kabelitz
- Institute of Biochemistry and Biotechnology and Charles Tanford Protein Center, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3, 06099 Halle, Germany
| | - Meera Gupta
- Department of Molecular Biology and the Lewis-Sigler Institute, Princeton University, Washington Road, Princeton, NJ 08544, USA
| | - Eyan Yeung
- Department of Molecular Biology and the Lewis-Sigler Institute, Princeton University, Washington Road, Princeton, NJ 08544, USA
| | - Sichun Lin
- Department of Pharmaceutical Sciences, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada
| | - Christiane Rammelt
- Institute of Biochemistry and Biotechnology and Charles Tanford Protein Center, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3, 06099 Halle, Germany
| | - Christian Ihling
- Institute of Pharmacy and Charles Tanford Protein Center, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3, 06099 Halle, Germany
| | - Filip Pekovic
- Institute of Biochemistry and Biotechnology and Charles Tanford Protein Center, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3, 06099 Halle, Germany
| | - Timothy C H Low
- Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Najeeb U Siddiqui
- Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Matthew H K Cheng
- Department of Biochemistry, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Stephane Angers
- Department of Pharmaceutical Sciences, University of Toronto, 144 College Street, Toronto, ON M5S 3M2, Canada; Department of Biochemistry, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Craig A Smibert
- Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada; Department of Biochemistry, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada
| | - Martin Wühr
- Department of Molecular Biology and the Lewis-Sigler Institute, Princeton University, Washington Road, Princeton, NJ 08544, USA
| | - Elmar Wahle
- Institute of Biochemistry and Biotechnology and Charles Tanford Protein Center, Martin Luther University Halle-Wittenberg, Kurt-Mothes-Str. 3, 06099 Halle, Germany.
| | - Howard D Lipshitz
- Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, ON M5G 1M1, Canada.
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Schiffner E, Latz D, Jungbluth P, Grassmann JP, Tanner S, Karbowski A, Windolf J, Schneppendahl J. Is computerised 3D templating more accurate than 2D templating to predict size of components in primary total hip arthroplasty? Hip Int 2019; 29:270-275. [PMID: 29781288 DOI: 10.1177/1120700018776311] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The aim of this study was to compare the accuracy of preoperative templating in total hip arthroplasty (THA) using conventional 2-dimensional (2D) and computed tomography (CT)-based 3-dimensional (3D) measures. METHODS One hundred and sixteen consecutive primary THAs were analysed. The preoperative diagnosis was primary osteoarthritis in all cases. The 2D templating and the 3D templating were performed by two different residents. All templating results were available for the orthopaedic surgeon performing the procedure. Accuracies with regard to the predicted and actual implant sizes were determined for each procedure. Implantation of the size as planned was defined as "exact", whereas the use of components within one size larger or smaller (±1) as planned were defined as "accurate." RESULTS The 3D templating was significantly more accurate in predicting implant sizing compared to 2D templating for primary total hip arthroplasty (THA). The difference was statistically significant for the cup templating (''exact'' p = 0.02; ''accurate'' p = 0.01) and for the stem templating (''exact'' p = 0.04; ''accurate'' p = 0.01). CONCLUSION Our results support the superiority of 3D templating over 2D templating in predicting implant size.
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Affiliation(s)
- Erik Schiffner
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - David Latz
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - Pascal Jungbluth
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - Jan P Grassmann
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - Stephan Tanner
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - Alfred Karbowski
- 2 Department of Orthopaedic Surgery, Hospital of the Augustinians, Cologne, Germany
| | - Joachim Windolf
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
| | - Johannes Schneppendahl
- 1 Department of Trauma and Hand Surgery, Heinrich Heine University Hospital, Duesseldorf, Germany
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Gkolfakis P, Tziatzios G, Spartalis E, Papanikolaou IS, Triantafyllou K. Colonoscopy attachments for the detection of precancerous lesions during colonoscopy: A review of the literature. World J Gastroenterol 2018; 24:4243-4253. [PMID: 30310257 PMCID: PMC6175757 DOI: 10.3748/wjg.v24.i37.4243] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/06/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
Although colonoscopy has been proven effective in reducing the incidence of colorectal cancer through the detection and removal of precancerous lesions, it remains an imperfect examination, as it can fail in detecting up to almost one fourth of existing adenomas. Among reasons accounting for such failures, is the inability to meticulously visualize the colonic mucosa located either proximal to haustral folds or anatomic curves, including the hepatic and splenic flexures. In order to overcome these limitations, various colonoscope attachments aiming to improve mucosal visualization have been developed. All of them - transparent cap, Endocuff, Endocuff Vision and Endorings - are simply mounted onto the distal tip of the scope. In this review article, we introduce the rationale of their development, present their mode of action and discuss in detail the effect of their implementation in the detection of lesions during colonoscopy.
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Affiliation(s)
- Paraskevas Gkolfakis
- Hepato-gastroenterology Unit, Second Department of Internal Medicine -Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ‘‘Attikon” University General Hospital, Athens 12462, Greece
| | - Georgios Tziatzios
- Hepato-gastroenterology Unit, Second Department of Internal Medicine -Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ‘‘Attikon” University General Hospital, Athens 12462, Greece
| | - Eleftherios Spartalis
- Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens, Athens 12462, Greece
| | - Ioannis S Papanikolaou
- Hepato-gastroenterology Unit, Second Department of Internal Medicine -Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ‘‘Attikon” University General Hospital, Athens 12462, Greece
| | - Konstantinos Triantafyllou
- Hepato-gastroenterology Unit, Second Department of Internal Medicine -Propaedeutic, Research Institute and Diabetes Center, Medical School, National and Kapodistrian University of Athens, ‘‘Attikon” University General Hospital, Athens 12462, Greece
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Mandal PR, Das S. Leachable lead and cadmium in microwave-heated ceramic cups: possible health hazard to human. Environ Sci Pollut Res Int 2018; 25:28954-28960. [PMID: 30109678 DOI: 10.1007/s11356-018-2944-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/08/2018] [Indexed: 06/08/2023]
Abstract
In this study, we assessed the leachability as well as health risk associated with the consumption from glazed, colourful, ceramic cups, containing lead and cadmium. Both metals leached into the 2.5-min microwave-heated (convection mode, at 140 °C) double-distilled water in concentrations above 0.5 mg/L, the permissible limits of leachable Pb and Cd in ceramic mugs set by United States Food and Drug Administration (US FDA). On an average, significantly higher Pb leached in new cups, 7.69 ± 0.56 mg/L, compared to that in old cups, 3.15 ± 0.15 mg/L. Cd leached similarly in both old (1.97 ± 0.14 mg/L) and new cups (1.57 ± 0.005 mg/L). The chronic daily intake of Pb by children and adults, respectively, consuming from new cups were 1.3-5× and 1.28-6× more than that from old cups. In both the cases, intake values far exceeded WHO reference dose of 0.0006 mg Pb/kg bw/day in children (< 11 years) and 0.0013 mg Pb/kg bw/day in adults. Such levels of Pb consumption in children might be predicted to be associated with decrement in IQ by at least 1 point and adverse effects in adults, especially, women of childbearing age. The daily intake of Cd from these cups ranged from 0.002-0.049 mg/kg bw/day, which was also above permissible limit. Consequently, high hazard quotient and hazard index (both more than 1) were observed for these metals, which might impart individual as well as cumulative effects on the health. Thus, apart from other dietary as well as inhalation sources of contaminants (which were not studied here), regular consumption of beverages alone in glazed, ceramic cups increased chances of Pb- and Cd-related health risks to humans.
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Affiliation(s)
- Priyanka Rani Mandal
- Aquatic Toxicology and Remediation Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, India
| | - Suchismita Das
- Aquatic Toxicology and Remediation Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, India.
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Zhao JX, Su XY, Zhao Z, Xiao RX, Zhang LC, Tang PF. Three-dimensional orientation and location-dependent varying rules of radiographic angles of the acetabular cup. Int Orthop 2018; 42:1819-1825. [PMID: 29453586 DOI: 10.1007/s00264-018-3809-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/23/2018] [Indexed: 10/18/2022]
Abstract
AIM The aim of this study is to demonstrate the varying rules of radiographic angles following varying three-dimensional (3D) orientations and locations of cup using an accurate mathematical model. METHODS A cone model is established to address the quantitative relationship between the opening circle of cup and its ellipse projection on radiograph. The varying rules of two-dimensional (2D) radiographic anteversion (RA) and inclination (RI) angles can be analyzed. RESULTS When the centre of cup is located above X-ray source, with proper 3D RI/RA angles, 2D RA angle can be equal to its 3D counterpart, and 2D RI angle is usually greater than its 3D counterpart. Except for the original point on hip-centered anterior-posterior radiograph, there is no area on radiograph where both 2D RA and RI angles are equal to their 3D counterparts simultaneously. DISCUSSION This study proposes an innovative model for accurately explaining how 2D RA/RI angles of cup are varying following different 3D RA/RI angles and location of cup. The analysis results provide clinicians an intuitive grasp of knowledge about 2D RA/RI angles greater or smaller than their 3D counterparts post-operatively. The established model may allow determining the effects of pelvic rotations on 2D radiographic angles of cup.
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Affiliation(s)
- Jing-Xin Zhao
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiu-Yun Su
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhe Zhao
- Department of Orthopaedics, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, China
| | - Ruo-Xiu Xiao
- School of Computer and Communication Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Li-Cheng Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Pei-Fu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China.
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Lazarinis S, Mäkelä KT, Eskelinen A, Havelin L, Hallan G, Overgaard S, Pedersen AB, Kärrholm J, Hailer NP. Does hydroxyapatite coating of uncemented cups improve long-term survival? An analysis of 28,605 primary total hip arthroplasty procedures from the Nordic Arthroplasty Register Association (NARA). Osteoarthritis Cartilage 2017; 25:1980-7. [PMID: 28802851 DOI: 10.1016/j.joca.2017.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/23/2017] [Accepted: 08/03/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. METHOD We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n = 28,605). Cumulative survival rates and adjusted hazard ratios (HRs) for the risk of revision were calculated. RESULTS Unadjusted 13-year survival for cup revision due to aseptic loosening was 97.9% (CI: 96.5-99.4) for uncoated and 97.8% (CI: 96.3-99.4) for HA-coated cups. Adjusted HRs were 0.66 (CI 0.42-1.04) for the presence of HA coating during the first 10 years and 0.87 (CI 0.14-5.38) from year 10-13, compared with uncoated cups. When considering the endpoint cup revision for any reason, unadjusted 13-year survival was similar for uncoated (92.5% [CI: 90.1-94.9]) and HA-coated (94.7% [CI: 93.2-96.3]) cups. The risk of revision of any component due to infection was higher in THA with HA-coated cups than in THA with uncoated cups (adjusted HR 1.4 [CI 1.1-1.9]). CONCLUSIONS HA-coated cups have a similar risk of aseptic loosening as uncoated cups, thus the use of HA coating seems to not confer any added value in terms of implant stability. The risk of infection seemed higher in THA with use of HA-coated cups, an observation that must be investigated further.
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Abstract
Objective WHO and UNICEF recommend cup feeding for neonates unable to breastfeed in low-resource settings. In developed countries, cup feeding in lieu of bottle feeding in the neonatal period is hypothesized to improve breastfeeding outcomes for those initially unable to breastfeed. Our aim was to synthesize the entire body of evidence on cup feeding. Methods We searched domestic and international databases for original research. Our search criteria required original data on cup feeding in neonates published in English between January 1990 and December 2014. Results We identified 28 original research papers. Ten were randomized clinical trials, 7 non-randomized intervention studies, and 11 observational studies; 11 were conducted in developing country. Outcomes evaluated included physiologic stability, safety, intake, duration, spillage, weight gain, any and exclusive breastfeeding, length of hospital stay, compliance, and acceptability. Cup feeding appears to be safe though intake may be less and spillage greater relative to bottle or tube feeding. Overall, slightly higher proportions of cup fed versus bottle fed infants report any breastfeeding; a greater proportion of cup fed infants reported exclusive breastfeeding at discharge and beyond. Cup feeding increases breastfeeding in subgroups (e.g. those who intend to breastfeed or women who had a Caesarean section). Compliance and acceptability is problematic in certain settings. Conclusions Further research on long-term breastfeeding outcomes and in low-resource settings would be helpful. Research data on high risk infants (e.g. those with cleft palates) would be informative. Innovative cup feeding approaches to minimize spillage, optimize compliance, and increase breastfeeding feeding are needed.
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Affiliation(s)
- Christy M McKinney
- Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195, USA.
- Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Robin P Glass
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | | | - Tessa Rue
- Institute of Translation Health Sciences, University of Washington, Seattle, WA, USA
| | - Matthew G Vaughn
- Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, Seattle, WA, 98195, USA
| | - Michael Cunningham
- Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
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Zhao JX, Su XY, Xiao RX, Zhao Z, Zhang LH, Zhang LC, Tang PF. A mathematical method for precisely calculating the radiographic angles of the cup after total hip arthroplasty. Med Eng Phys 2016; 38:1376-1381. [PMID: 27720337 DOI: 10.1016/j.medengphy.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 08/18/2016] [Accepted: 09/23/2016] [Indexed: 11/19/2022]
Abstract
We established a mathematical method to precisely calculate the radiographic anteversion (RA) and radiographic inclination (RI) angles of the acetabular cup based on anterior-posterior (AP) pelvic radiographs after total hip arthroplasty. Using Mathematica software, a mathematical model for an oblique cone was established to simulate how AP pelvic radiographs are obtained and to address the relationship between the two-dimensional and three-dimensional geometry of the opening circle of the cup. In this model, the vertex was the X-ray beam source, and the generatrix was the ellipse in radiographs projected from the opening circle of the acetabular cup. Using this model, we established a series of mathematical formulas to reveal the differences between the true RA and RI cup angles and the measurements results achieved using traditional methods and AP pelvic radiographs and to precisely calculate the RA and RI cup angles based on post-operative AP pelvic radiographs. Statistical analysis indicated that traditional methods should be used with caution if traditional measurements methods are used to calculate the RA and RI cup angles with AP pelvic radiograph. The entire calculation process could be performed by an orthopedic surgeon with mathematical knowledge of basic matrix and vector equations.
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Affiliation(s)
- Jing-Xin Zhao
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
| | - Xiu-Yun Su
- Department of Orthopaedics, Affiliated Hospital of the Academy of Military Medical Sciences, No. 8 Dongdajie Road, Beijing 100071, People's Republic of China; Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
| | - Ruo-Xiu Xiao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, People's Republic of China.
| | - Zhe Zhao
- Department of Orthopaedics, Beijing Tsinghua Chang Gung Hospital, No. 1 Block Tiantongyuan North, Beijing 102218, People's Republic of China; Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
| | - Li-Hai Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
| | - Li-Cheng Zhang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
| | - Pei-Fu Tang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.
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Fernández-Valencia JÁ, Gallart X, Bori G, Rodríguez-Roiz JM, Combalia A. The use of a "rim cutter" device and a flanged cup for improving the mantle of the acetabular component of a cemented Exeter total hip arthroplasty. Eur J Orthop Surg Traumatol 2016; 26:891-4. [PMID: 27549660 DOI: 10.1007/s00590-016-1838-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/11/2016] [Indexed: 10/21/2022]
Abstract
A retrospective study was performed to evaluate the cement mantle in two groups of patients treated with the acetabular components of cemented Exeter total hip arthroplasties (THAs). Two groups of 20 patients were compared: Group 1 received non-flanged acetabular cemented cups (Contemporary, Stryker) and Group 2 received flanged acetabular cemented cups (X3 Rim Fit, Stryker). Cups in Group 2 were implanted after using a rim cutter device. Group 2 showed better penetration of cement in zone 1 (10.76 mm compared with 2.93 mm; p = 0.008) and a thicker cement mantle in zone 1 (3.57 mm compared with 2.89 mm; p = 0.04). More cups in Group 2 had a cement mantle thickness less than 3 mm (30 % in Group 1 compared with 70 % in Group 2; p = 0.0039). No other radiological differences were observed. These results favor the use of a rim cutter device and flanged cup to improve the cement mantle for the acetabular components of cemented Exeter THAs. However, the improvements were less than expected. In view of the results of previous studies, further research is therefore needed to assess the value of this approach in improving the acetabular cement mantle.
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McGonagle L, Siney PD, Raut VV. Fate of the unrevised cemented stem following cup only revision: 227 hips at an average of 6 years follow-up. Orthop Traumatol Surg Res 2015; 101:781-4. [PMID: 26498884 DOI: 10.1016/j.otsr.2015.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 08/10/2015] [Accepted: 08/29/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND After primary total hip replacement, aseptic loosening of the acetabular cup is more common than loosening of the femoral stem. Removal of a well-fixed stem adds to operative time, blood loss, risk of bone loss and fracture. There is limited evidence that isolated cup revision can be a safe option in revision hip arthroplasty. We question the following regarding the unrevised cemented stem after isolated cup revision: 1) Does the unrevised stem require revision after isolated cup revision? 2) When is the stem subsequently revised? 3) Why is the stem subsequently revised? 4) Do unrevised stems exhibit radiographic loosening? HYPOTHESIS We hypothesise that after isolated cup revision most unrevised stems do not need subsequent revision, and that most do not exhibit evidence of radiographic loosening. PATIENTS AND METHODS A retrospective analysis of all patients who underwent revision of the acetabular component only during revision hip arthroplasty between March 1970 and July 2013 was carried out. We assessed survival of the unrevised stem, reasons for subsequent revision, plus radiographic analysis for stem loosening. RESULTS Two hundred and twenty-seven hips were included [215 patients with an average age at the time of primary surgery was 47 (13-70) years]. The Charnley stem was used in 161 cases; C-stem 65, Howse 1. Average time between primary surgery and cup revision was 15.9 (1.6-33.4) years. Average follow-up for all stems post-isolated cup revision was 6.1 (0.1-30.7) years. Twenty-eight stems (12.3%) were subsequently revised 5.1 (0.1-12.6) years after the isolated cup revision. Reasons for subsequent revision were: aseptic loosening (10); infection (8); dislocation (6); unreconstructable joint post-loose cup removal (2); fracture (2). Radiographic review was possible on 140 cases. Five femoral stems were revised and 2 others showed evidence of possible radiological loosening but were not revised. CONCLUSION To our knowledge this is the largest series showing that isolated cup revision in the place of a well-fixed cemented stem is safe and is associated with ongoing good long-term survival of the stem. LEVEL OF EVIDENCE Level IV, retrospective case series.
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Mierzwa AJ, Zhou YX, Hibbits N, Vana AC, Armstrong RC. FGF2 and FGFR1 signaling regulate functional recovery following cuprizone demyelination. Neurosci Lett 2013; 548:280-5. [PMID: 23684572 DOI: 10.1016/j.neulet.2013.05.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 04/16/2013] [Accepted: 05/03/2013] [Indexed: 12/16/2022]
Abstract
In demyelinating diseases, such as multiple sclerosis, remyelination offers the potential to recover function of viable denuded axons by restoring saltatory conduction and/or protecting from further damage. Mice with genetic reduction of fibroblast growth factor 2 (Fgf2) or Fgf receptor 1 (Fgfr1) exhibit dramatically improved remyelination following experimental demyelination with cuprizone. The current studies are the first to test neurobehavioral outcomes with these gene deletions that improved remyelination. The cuprizone protocols used did not produce overt abnormalities but did reduce bilateral sensorimotor coordination (complex wheel task) and increase sociability (two chamber apparatus with novel mouse). A significant effect of genotype was observed on the complex wheel task but not in the sociability apparatus. Specifically, complex wheel velocities for Fgf2 nulls improved significantly after removal of cuprizone from the diet. This improvement in Fgf2 null mice occurred following either acute (6 weeks) or chronic (12 weeks) demyelination. Plp/CreERT:Fgfr1(fl/fl) mice administered tamoxifen at 10 weeks of cuprizone treatment to induce Fgfr1 knockdown also showed improved recovery of running velocities on the complex wheels. Therefore, constitutive deletion of Fgf2 or Fgfr1 knockdown in oligodendrocyte lineage cells is sufficient to overcome impairment of sensorimotor coordination after cuprizone demyelination.
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Affiliation(s)
- Amanda J Mierzwa
- Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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