Strut Onlay Allograft in Revision Arthroplasty: Osseous Union and Clinical Outcome.

AIM: To evaluate the clinical outcome and the osseous union of strut onlay allografts (SOAs) used as adjunct in revision total joint arthroplasty (TJA). PATIENTS AND METHODS: Patients that had previously undergone SOA augmentation were considered for inclusion. Patients were invited to provide information for the following: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQol five dimension score (EQ-5D) and Parker mobility score. Osseous union rates between SOA and the host bone were determined by radiograph with the Emerson classification system. Bone mineral density was measured via quantitative computed tomography. RESULTS: Seventeen patients were identified, at a mean follow-up of 2.8 years. The median total WOMAC score was 22 [interquartile range (IQR)=21]. The median EQ-5D score was 0.887 (IQR=0.350) (time trade-off). The Parker Mobility Score was 8.0 (IQR=3.5). Emerson stages of radiographic graft to host union were 'rounding off' in one case, 'partial bridging' in three and 'complete bridging' in 13. Quantitative computed tomography showed an average bone mineral density of approximately 1,300 mg/cm3. CONCLUSION: From our findings, it is concluded that SOAs used in revision total joint arthroplasty provide promising results and are recommended for broader clinical use. A complete osseous union between host and graft bone was observed in the majority of cases.

Effects of a heat and moisture exchanger on respiratory function and symptoms post-cold air exercise.

PURPOSE: Exercise at temperatures below -15°C induces drying and cooling of lung airways which causes exercise-induced bronchoconstriction (EIB) and respiratory symptoms, especially in winter sport athletes. The objective of this study was to evaluate whether a heat and moisture exchanger (HME) worn during intense cold air exercise improves lung function and reduces respiratory symptoms in healthy winter sport athletes. METHODS: Seven active males and six active females (maximum oxygen uptake 61.9 ± 6.9 and 52.2 ± 5.3 mL/kg/min), all active or former winter sport athletes, completed running trials with and without HME in random order on 2 days in an environmental chamber (-20°C temperature, humidity 46.2%). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1 ), forced expiratory flow at 25%-75% (FEF25%-75% ), and FEF at 50% (FEF50% ) were measured pre- and post-exercise (3, 6, 10, 15, and 20 minutes). Respiratory symptoms were reported after exercise. RESULTS: Significant interaction effects were observed for FEV1 and FEF25%-75% . Mean decrease of FVC (-5.9%, P ≤ .001) and FEV1 (-4.2%, P = .003) was largest 3 minutes post-exercise without HME. There was an increase of FEV1 , FEF25%-75% , and FEF50% post-exercise compared to pre-exercise with HME. More respiratory symptoms overall were reported without HME (P = .046). CONCLUSION: Intense cold air exercise likely causes transient acute bronchoconstriction and symptoms of cough in individuals participating in winter sports. However, this study finds that the application of an HME during intense cold air exercise improves lung function and reduces prevalence of EIB-associated symptoms compared to unprotected intense cold air exercise.