Immunohistochemical evaluation of periprosthetic membrane from loose cemented and uncemented total hip arthroplasty

Evaluate the cellular mechanisms responsible for the aseptic loosening of total hip replacements. Twenty periprosthetic membranes were collected during revision procedures at the Department of Orthopedics, Hacettepe University, Ankara, Turkey, during 1998 to 1999. Arthroplasties with polyethylene components and without polyethylene components were examined under light microscopy and immunohistochemically using the indirect immunoperoxidase technique into 2 different groups. Immunohistochemical analysis with monoclonal antibodies reactive to certain cell surface antigens [CD45, CD44, CD98, CD31, CD26, CD71] revealed different morphological characteristics regarding the adjacent fibrosis, leukocyte activation, and immunologic response. These findings suggested the role of different cellular mechanisms in each group

High independence level in functional activities reduced hospital stay after total hip arthroplasty regardless of pain intensity

The purpose of this study is to investigate the relationship between independence level in functional activities and pain, and length of hospital stay in the early postoperative period in patients with total hip arthroplasty [THA]. The study was performed over 26 end stage hip arthritis patients who were hospitalized in the Department of Orthopedics and Traumatology, Hacettepe University Hospital, Ankara, Turkey, between January 2000 and July 2003 for THA and operated with the same surgical technique by the same surgeon. All patients were mobilized in the first postoperative day and a standard rehabilitation protocol was applied to all patients. The independence level in functional activities of the cases was assessed with Iowa Level of Assistance Scale [ILAS]. Iowa Ambulation Speed Scale [IASS] was used to evaluate the speed of ambulation in the early postoperative period. Pain was assessed with visual analogue scale [VAS]. There was no statistically significant relation between pain intensity and independence level in functional activities on the second and sixth postoperative days [p>0,05], but independence level scores in functional activities on the second and sixth days were correlated with hospital stay length [p<0.05]. The results of this study indicate that in patients with THA, pain does not affect the independence level in functional activities in the early postoperative period. In the same period as the independence level improves, the hospital stay length decreases. This is an important factor that may reduce both the hospital costs and the possible complications due to prolonged hospital stay