Notes

Acoustically induced mechanotherapy employing genetically secured fuel vesicles.
During the last century, total hip arthroplasties have become more popular. They have had a huge impact on the quality of life, pain, range of motion, social interaction, and psychological well-being. A number of studies have emphasized the importance of using templates to choose the appropriate implant size when planning the surgery. Our aim is to use MediCad
software to analyze the ability of the digital template system MediCad
to predict the size of the implant needed in total hip arthroplasties.

An arthroplasty preoperative plan was created according to the MediCad
software guidelines, on anteroposterior hip X-ray by one junior resident, one senior resident, and three experienced hip surgeons.

The median size accuracy was 0.7 (range 0.27-0.87) for the cup, 0.73 (range 0.36-0.83) for the stem, and 0.28 (range -0.14-0.69) for the neck. Interobserver reliability was good (kappa > 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.
 0.4) and stronger when measuring the stem than when doing so with the cup. Conclusion Digital preoperative total hip arthroplasty planning is a good method for predicting component size, restoring hip anatomy (vertical offset and horizontal offset), with good interobserver reliability.
Uncemented total hip arthroplasty (THA) with large size femoral heads have shown greater advantage with good stability, range of motion and decreased dislocation rate in ankylosing spondylitis (AS). Meticulous planning is needed to address the unique surgical challenges in such patients with fused hip and spinal deformity.

Thirty fivefused hip joints in twenty-five AS patients who underwent uncemented THA (April 2014 to December 2016) were included in our prospective study and were followed up for a minimum period of 36months. #link# Pain relief, functional improvement and patient satisfaction were statistically assessed using "Visual Analogue Score" (VAS), "Harris Hip Score" (HHS) and "AJRI 10-Point Satisfaction Score" (A10PSS), respectively.

The overall mean preoperative VAS improved from 6.9 ± 1.5 to 1.5 ± 1, HHS improved from 50.0 ± 12 to 88.4 ± 7.8 and A10PSS improved from 2.2 ± 1.2 to 7.6 ± 0.8. Our study results were significant with zero dislocation and good functional score in comparison to the other available studies in literature. First subdivision study in AS patients with bilateral THA performed better than unilateral THA. Second subdivision study showed no significant statistical difference in terms of VAS, HHS, A10PSS and dislocation rate in relation to femoral head size between 32mm, 36mm and 40mm.

Uncemented THA with large size femoral head equal or greater than 32mm provides better stability and good functional outcome with less dislocation rate in comparison to older studies of literature with femoral head size less than 32mm.

read more study. (Data collected from the ongoing prospective study) (https//www.spine.org/Documents/LevelsofEvidenceFinal.pdf).
A Level II study. (Data collected from the ongoing prospective study) (https//www.spine.org/Documents/LevelsofEvidenceFinal.pdf).
The present study aimed to evaluate the effect of a longer interval between the first and second stages of infected total knee arthroplasty (TKA) revision on the clinical and functional outcome.

This study included a total of 56 patients who underwent two-stage revision TKA with a dynamic spacer with a minimum of 2years of follow-up. Patients were categorized into two groups according to time with the spacer < 3months (Group 1, 31 patients) or > 3months (Group 2, 25 patients). Clinical outcome and quality of life were assessed by knee range of motion (ROM), Knee Society Score for Knee (KSS-K), Knee Society Score for Function (KSS-F) and Short Form 36 (SF-36).

The mean follow-up period was 48 ± 19.1months (range, 24-84months). The KSS-K, KSS-F, and ROM values were significantly higher in Group 1 than in Group 2 (
 < 0.05). The SF-36 scores for general health, physical function, and bodily pain were significantly higher in Group 1 (
 < 0.05). Re-infection occurred in 10 patients (17.8%). Time with spacer was not associated with re-infection development (Group 1,
 = 6, 19% vs. Group 2,
 = 4, 16%;
 > 0.05).

Increased duration with a spacer is associated with poorer clinical and functional outcomes as well as higher treatment costs in two-stage revision knee arthroplasty. Surgeons can attempt to reduce the time patients spend in a spacer to obtain better postoperative functional outcomes, as well as a better quality of life.

3.
3.
Pain control after total knee replacement (TKR) is of primary importance to joint replacement surgeons to achieve good functional outcome post-surgery. This becomes even more challenging when these major procedures are done in immunocompromised patients like rheumatoid arthritis. Good peri-operative analgesia facilitates early rehabilitation, improves patient satisfaction, and reduces the hospital stay. The adverse effects caused by epidural analgesia or parenteral opioids can be avoided by replacing it with an analgesic cocktail locally. Our prospective study was to evaluate the benefits of a periarticular cocktail injection which was given in rheumatoid patients undergoing bilateral TKR in single sitting with respect to pain and knee motion recovery.

Sixty-four rheumatoid arthritis patients undergoing simultaneous primary total knee replacement were included in the study. A total of 128 knees were randomized either to receive a periarticular intra-operative injection containing ropivacaine, fentanyl, clrative analgesia and also improves patient satisfaction, with no apparent risks, following total knee arthroplasty in rheumatoid arthritis.
Periarticular cocktail injection significantly reduces the requirements for post-operative analgesia and also improves patient satisfaction, with no apparent risks, following total knee arthroplasty in rheumatoid arthritis.
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