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1.
Eur J Orthop Surg Traumatol ; 34(2): 1183-1192, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38006463

ABSTRACT

PURPOSE: To determine the survival and patient-reported outcomes in non-oncological patients treated with proximal femoral resection (PFR) using MEG for femoral reconstruction. MATERIALS AND METHODS: This retrospective study included 16 patients. Demographic variables and complications developed were analyzed. Clinical-functional outcomes were measured using the modified Harris score (mHSS), numeric Pain Rating Scale (NPRS) and Musculoskeletal Tumor Society (MSTS) score. MEG survival was estimated using a Kaplan-Meier survival analysis. RESULTS: Average follow-up was 5 years (range, 1-9). The 75% of patients were overweight and women with an average age of 74.2 ± 5.9-years (BMI of 28.5 ± 4.2 kg/m2). The main cause of MEG was periprosthetic infection (43.7%). The 50% of patients had post-surgical complications regarding with MEG, being the most frequent seromas and MEG dislocation. Implant survival was 93.4% and 80.9% at 3 and 7 years of follow-up, respectively. The functional results at the end of the follow-up with respect to the pre-surgical state improved from 9.5 ± 2.6 to 3 ± 0.9 mean NPRS and 26.5 ± 6.8 to 69.5 ± 13.5 mean mHHS, p < 0.001, respectively. The mean MSTS score was 68.1% that these results were considered excellent. CONCLUSIONS: The MEG for reconstruct III-IV femoral defects is a good therapeutic option that offers an acceptable clinical-functional result. Short-term and medium-term survival was greater than 80%. The most frequent complications are seromas and MEG dislocation. The use of constrained liner and abductor system reconstruction is essential to prevent the dislocation.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Humans , Female , Aged , Aged, 80 and over , Prosthesis Design , Follow-Up Studies , Retrospective Studies , Seroma/pathology , Seroma/surgery , Treatment Outcome , Prosthesis Failure , Femur/pathology , Reoperation , Arthroplasty, Replacement, Hip/methods
2.
Arch Orthop Trauma Surg ; 144(1): 347-355, 2024 Jan.
Article in English | MEDLINE | ID: mdl-37743356

ABSTRACT

INTRODUCTION: Few information has been published on the survival of unicompartmental knee arthroplasty (UKA) and fixed-bearing tibial components. The aim of this study is to analyze if UKA survival varies according to UKA model used and to analyze the possible risk factors for UKA revision. MATERIALS AND METHODS: A retrospective study analyzing 301 UKAs (ACCURIS, all-polyethylene tibial component, 152; Triathlon PKR, metal-backed tibial component, 149) was performed. Demographic parameters as well as implant survival and cause of prosthetic revision were analyzed. The Kaplan-Meier survival analysis, the log-rank test and the Cox multiple regression were used for the analysis. RESULTS: Average follow-up was 8.1 ± 3.08-years. Average age was 68.1 ± 8.6-years; 70.4% of subjects were women. The ACCURIS UKA group had a UKA revision rate higher compared to the Triathlon PKR group (16/152, 10.6% vs 5/149, 3.4%, respectively; p < 0.001). The main cause of prosthetic revision was aseptic loosening (5/21, 23.8%). All aseptic loosening cases and tibial component collapse were reported with the ACCURIS UKA group. Overall UKA survival was 98.01% (95% CI 95.62-99.1) at 1-year, 94.27% (95% CI 90.95-96.4) at 5-years and 92.38% (95% CI 88.48-94.99) at 10-years' follow-up. There were no differences in the Kaplan-Meier survival curves regarding operated side or affected tibiofemoral compartment (log-rank test = 0.614 and 0.763, respectively). However, Kaplan-Meier survival curve according to UKA model used was different (log-rank test = 0.033). The metal-backed component appeared to be a protector factor for UKA revision when adjusted for age, sex, operated side, and affected tibiofemoral compartment (Hazard Ratio 0.32, p = 0.031). CONCLUSION: Fixed-bearing UKAs showed excellent mid- and long-term survival rates. Aseptic loosening is the main cause of implant failure. PKR group (metal-backed component) seem to be a protector factor to UKA revision when it was compared with ACCURIS UKA group (all-polyethylene tibial component).


Subject(s)
Arthroplasty, Replacement, Knee , Knee Prosthesis , Osteoarthritis, Knee , Humans , Female , Middle Aged , Aged , Male , Arthroplasty, Replacement, Knee/adverse effects , Knee Prosthesis/adverse effects , Retrospective Studies , Reoperation/adverse effects , Prosthesis Failure , Polyethylene , Metals , Osteoarthritis, Knee/surgery , Treatment Outcome , Knee Joint/surgery
3.
PLoS One ; 6(12): e28927, 2011.
Article in English | MEDLINE | ID: mdl-22174927

ABSTRACT

Defects in the ubiquitin-proteasome system have been related to aging and the development of neurodegenerative disease, although the effects of deficient proteasome activity during early postnatal development are poorly understood. Accordingly, we have assessed how proteasome dysfunction during early postnatal development, induced by administering proteasome inhibitors daily during the first 10 days of life, affects the behaviour of adult mice. We found that this regime of exposure to the proteasome inhibitors MG132 or lactacystin did not produce significant behavioural or morphological changes in the first 15 days of life. However, towards the end of the treatment with proteasome inhibitors, there was a loss of mitochondrial markers and activity, and an increase in DNA oxidation. On reaching adulthood, the memory of mice that were injected with proteasome inhibitors postnatally was impaired in hippocampal and amygdala-dependent tasks, and they suffered motor dysfunction and imbalance. These behavioural deficiencies were correlated with neuronal loss in the hippocampus, amygdala and brainstem, and with diminished adult neurogenesis. Accordingly, impairing proteasome activity at early postnatal ages appears to cause morphological and behavioural alterations in adult mice that resemble those associated with certain neurodegenerative diseases and/or syndromes of mental retardation.


Subject(s)
Cognition Disorders/complications , Nerve Degeneration/complications , Nervous System/growth & development , Nervous System/pathology , Proteasome Inhibitors , Amygdala/drug effects , Amygdala/pathology , Amygdala/physiopathology , Animals , Animals, Newborn , Ataxia/complications , Ataxia/physiopathology , Biomarkers/metabolism , Brain/drug effects , Brain/metabolism , Brain/pathology , Cognition Disorders/physiopathology , DNA/metabolism , Depression/complications , Depression/physiopathology , Disease Models, Animal , Dopaminergic Neurons/metabolism , Enzyme Inhibitors/administration & dosage , Enzyme Inhibitors/pharmacology , Exploratory Behavior/drug effects , Hippocampus/drug effects , Hippocampus/pathology , Hippocampus/physiopathology , Leupeptins/administration & dosage , Leupeptins/pharmacology , Memory/drug effects , Mice , Mitochondria/drug effects , Mitochondria/metabolism , Motor Activity/drug effects , Nerve Degeneration/physiopathology , Nervous System/drug effects , Oxidation-Reduction/drug effects , Proteasome Endopeptidase Complex/metabolism , Ubiquitinated Proteins/metabolism
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