The Evolution of Computer-Assisted Total Hip Arthroplasty and Relevant Applications / 대한고관절학회지

In total hip arthroplasty (THA), the accurate positioning of implants is the key to achieve a good clinical outcome. Computer-assisted orthopaedic surgery (CAOS) has been developed for more accurate positioning of implants during the THA. There are passive, semi-active, and active systems in CAOS for THA. Navigation is a passive system that only provides information and guidance to the surgeon. There are 3 types of navigation: imageless navigation, computed tomography (CT)-based navigation, and fluoroscopy-based navigation. In imageless navigation system, a new method of registration without the need to register the anterior pelvic plane was introduced. CT-based navigation can be efficiently used for pelvic plane reference, the functional pelvic plane in supine which adjusts anterior pelvic plane sagittal tilt for targeting the cup orientation. Robot-assisted system can be either active or semi-active. The active robotic system performs the preparation for implant positioning as programmed preoperatively. It has been used for only femoral implant cavity preparation. Recently, program for cup positioning was additionally developed. Alternatively, for ease of surgeon acceptance, semi-active robot systems are developed. It was initially applied only for cup positioning. However, with the development of enhanced femoral workflows, this system can now be used to position both cup and stem. Though there have been substantial advancements in computer-assisted THA, its use can still be controversial at present due to the steep learning curve, intraoperative technical issues, high cost and etc. However, in the future, CAOS will certainly enable the surgeon to operate more accurately and lead to improved outcomes in THA as the technology continues to evolve rapidly.

Comparative assessment of chlamydia trachomatis infection in Iranian women with cervicitis: a cross-sectional study

Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections [STI] recognized throughout the world. The aim of this study was to determine the prevalence of Chlamydia trachomatis among a randomized statistical group of women suffering from cervicitis in Tehran- Iran. During a 12- month- period, Jan 2003 to Jan 2004, 142 endocervical samples were taken from women suffering from cervicitis attending to Mirzakoochakkhan Women Hospital in Tehran, Iran. Direct fluorescent antibody [DFA] and PCR techniques were used to detect Chlamydia trachomatis in endocervical samples. Twenty two [15.5%] [95% CI, 9.54-21.4] of 142 samples were diagnosed as Chlamydia positive according to PCR results, while DFA diagnosed 20 [14.1%] positive cases [95% CI, 8.37-19.8]. No statistically significant difference was found between two diagnosis methods applied in this study. The prevalence was the highest [25%] among women aged 25 to 29 yr and 35 to 39 yr. The x 2 test showed a significant relationship between positive test result and bearing a history of STI [P= 0]. The results of this study showed high prevalence of C. trachomatis infection among women suffering from cervicitis and suggested that patients diagnosed with genital Chlamydia infection should be referred to the genitourinary medicine clinic for further STI screening and partner notification

Detection of chlamydia trachomatis from urine specimens by pcr inwomen with cervicitis

Chlamydia trachomatis is the most common agent of urogenital infections in both men and women. Diagnosis of chlamy-dial infections is based on isolation of bacteria in tissue culture media that requires at least 48 to 72h. Polymerase chain reaction [PCR] is a sensitive and specific method for detection of small quantity of bacterial DNA in clinical samples. The first goal of this study was to perform a PCR testing for detecting of C. trachomatis from urine samples and after that to identify the frequency of C. trachomatis among cervicitis women and at the end, to identify the potential risk factors for chlamydial genital infection. From August to October 2002, a total of 122 consecutive women with cervicitis who attended Obstetric and Gynecology Clinic of Shoosh, Tehran-Iran were involved into the study. After DNA extraction from urine specimens, PCR tests were performed. C. trachomatis genome was detected in 14 of 94 [14/9%] urine specimens. The highest C. trachomatis cervical infection frequency was found in women with 28 to 38 years old group, elementary education level group, and in users IUD for contraception. The results of this study indicate that PCR technique is a useful method for detecting C. trachomatis in urine