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Review of mid-term results (five years) for tumour and revision arthroplasty surgery using the Stanmore METS® distal femoral replacement.
Data were collected retrospectively for 90 patients for procedures performed between 2002 and 2019. Kaplan-Meier survivorship for implant was estimated at five years post-op. Endpoints for survivorship analysis included revision for any cause and as per Henderson classification. Log rank test was used to compare implant survival for different categorical variables. Musculo-Skeletal Tumour Society (MSTS) score was used to estimate function.
Overall implant survival at five years was 76% (95% CI 66-86). Implants with a short body (<= 45mm) had significantly better implant survival [87% (95% CI 78-99)] compared to those with larger bodies [63% (95% CI 48-82)] (logrank test, p=0.031). There was no significant difference in implant survival for tumour and revision arthroplasty patients (logrank test, p=0.61). Mean MSTS scores (median follow-up=3.5years) for tumour and revision arthroplasty patient were 71% and 63% respectively (Wilcoxon rank test, p<0.05). Higher total number of surgeries was a significant predictor of patient mortality [HR=0.7 (95% CI 0.49-0.99)]. Longer bodies were a significant predictor of implant failure [HR=3.2 (95% CI 1.05-10.53), p<0.05].
Overall outcome of Stanmore METS® distal femoral replacement at five years following tumour and revision arthroplasty reconstruction is comparable to the other implants.
Overall outcome of Stanmore METS® distal femoral replacement at five years following tumour and revision arthroplasty reconstruction is comparable to the other implants.
The purpose of this study was to compare implant migration and tibiofemoral contact kinematics of a cementless primary total knee arthroplasty (TKA) implanted using either a gap balancing (GB) or measured resection (MR) surgical technique.
Thirty-nine patients underwent TKA via a GB (n=19) or a MR (n=20) surgical technique. Dihexa concentration Patients received an identical fixed-bearing, cruciate-retaining cementless implant. Patients underwent a baseline radiostereometric analysis (RSA) exam at two weeks post-operation, with follow-up visits at six weeks, three months, six months, and one year post-operation. Migration including maximum total point motion (MTPM) of the femoral and tibial components was calculated over time. At the one year visit patients also underwent a kinematic exam via RSA.
Mean MTPM of the tibial component at one year post-operation was not different (mean difference=0.09mm, p=0.980) between the GB group (0.85±0.37mm) and the MR group (0.94±0.41mm). Femoral component MTPM at one year post-operation was also not different (mean difference=0.27mm, p=0.463) between the GB group (0.62±0.34mm) and the MR group (0.89±0.44mm). Both groups displayed similar kinematic patterns.
There was no difference in implant migration and kinematics of a single-radius, cruciate retaining cementless TKA performed using a GB or MR surgical technique. The magnitude of migration suggests there is low risk of early loosening. The results provide support for using the cementless implant with either a GB or MR technique.
There was no difference in implant migration and kinematics of a single-radius, cruciate retaining cementless TKA performed using a GB or MR surgical technique. The magnitude of migration suggests there is low risk of early loosening. The results provide support for using the cementless implant with either a GB or MR technique.A study was undertaken of 51 cases where barbiturates were detected in post-mortem blood samples from 2000 to 2019 at Forensic Science South Australia, Adelaide, Australia. The cause of death was drug toxicity in only 27 (53%) (MF = 198; age range 19-74yrs, mean 46yrs). In 17 cases, barbiturate toxicity was the primary cause of death, 14 due to pentobarbitone and 3 to phenobarbitone. All were suicides. Barbiturates were obtained by online purchase from overseas sources in 9 cases (33%), and through veterinary practice in 2 cases (7%). Drug toxicity deaths where barbiturates were detected rose from 1 in 2000-2004 to 11 in 2015-2019, and those where deaths were primarily due to barbiturate toxicity rose from 1 in 2000-2004 to 9 in 2015-2019. However, the mere detection of barbiturates in post mortem samples did not equate with illicit use, as 23 of the deaths (45%) were due to natural causes in individuals prescribed barbiturates for epilepsy. The usefulness of examining subset populations separate from accrued national data is also demonstrated in the significantly younger age of decedents in South Australia dying from deliberately administered barbiturates (46 yrs) compared to the national average of 57.9 yrs. The reasons for this difference will require further investigation as this may impact upon local suicide prevention strategies.Nonpoint source (NPS) water quality trading (WQT) has been lauded as a way to reduce water pollution while mitigating costs, but NPS WQT programs often do not account for cumulative landscape-scale impacts to hydrological and ecological processes. In this work, we parameterize the landscape-scale patterns of an emerging NPS WQT market in Virginia (n = 606 transactions) and describe potential tradeoffs and synergies. We also examine program outcomes in the context of Virginia's spatially-explicit conservation and restoration priorities, and discuss ways in which NPS WQT integrates or fails to integrate with these state-level watershed management goals. These spatial and policy analyses demonstrate novel ways to evaluate NPS WQT programs. Our results reveal how NPS WQT has influenced Virginia land management patterns in practice. Specifically, we show that this program has encouraged the transfer of water quality Best Management Practices (BMPs) from urban to rural areas. Impact sites are often far from mitigation sites, at an average of 164.6 km apart measured along the stream network and most often migrated outside the 8-digit Hydrologic Unit Code watershed boundaries. We also find opportunity for improved integration with the state-level management priorities, including that an estimated 22% of the NPS WQT mitigation site area works against state priorities (for example by converting prime farmland to forest), 9% supports state priorities, and 69% neither negates nor supports state priorities. We suggest policy and management actions that can increase the integration of NPS WQT with statewide watershed management goals, and could ultimately improve environmental returns from this fast-growing program.
Homepage: https://www.selleckchem.com/products/dihexa.html
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