ABSTRACT
Background: Femoral neck fracture is a common posttraumatic injury in the elderly. Currently, orthopedic surgeons conducting total hip arthroplasty (THA) for hip fractures have various prosthetic alternatives. Dual-mobility cup THA is recommended for hip fracture patients to reduce prosthesis dislocation. Therefore, the goal of this research is to evaluate the effectiveness of conventional prostheses against dual-mobility prostheses in treating femoral neck fractures in two groups of patients. Materials and Methods: The current clinical investigation involved patients with femoral neck fractures. Among approved 84 patients, 44 and 40 were undergoing conventional THA (group A) and dual-mobility THA (group B), respectively. Patients were observed regularly after surgeries, and the same measurements were performed. The data were assembled and entered into SPSS software (version 25, IBM Corporation, Armonk, NY, USA) and analyzed. In all analyses, a P value of less than 0.05 was considered significant. Results: Eighty-four cases with an average age of 63.97 years were evaluated. In postoperative follow-up, there were no statistically significant differences between the groups in terms of Harris hip score, SF-36, and infection (P > 0.05). However, patients who received conventional implants had more dislocation postoperatively (P = 0.045). Regarding the rehabilitation costs, there were no statistically significant differences between the groups, so the group using the conventional implants incurred a higher cost (P = 0.041). Conclusion: According to the results, both dual mobility and conventional implants had optimal functional outcomes in patients with femoral neck fractures.
ABSTRACT
BACKGROUND: Increases in intracranial pressure (ICP) require a rapid recognition to allow for adequate treatments. The aim of this study was to determine whether transocular Doppler and optic nerve sheath diameter (ONSD) monitoring could reliably identify increases in ICP. MATERIALS AND METHODS: This is a cross-sectional case-control study, which was carried out on 2013. Subjects were chosen from patients who admitted to the neurology and neurosurgery departments and the intensive care unit of Alzahra Hospital (Isfahan, Iran). To measure the ICP, the authors used ultrasound to measure the diameter of the optic nerve sheath and transocular Doppler (TOD) to measure blood flew velocity in ophthalmic artery (OA) and ophthalmic vein (OV) in both groups. RESULTS: The mean of ONSD was 4.8 mm (SD 0.77) in patients with raised ICP and 3.2 mm (SD 0.3) in healthy volunteers which was significant (P < 0.001). The mean (SD) of TOD parameters were also significantly more in OA and OV of patients with raised ICP. CONCLUSION: Ultrasound methods has been proposed as an alternative safe technique for invasive ICP measuring methods.
ABSTRACT
BACKGROUND: Knee replacement is one of the most frequently performed surgical procedures in the world. Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the rates and causes of revision TKA in Kashani Hospital (Isfahan, Iran) from 2011 to 2013. MATERIALS AND METHODS: We assessed all primary TKA and revision TKA procedures performed from 2011 to 2013 for the rate and causes of failures. Demographic data, duration from primary TKA to revision TKA and underlying diagnosis for primary TKA were also assessed. RESULTS: Overall, 353 primary TKA procedures carried out in this period. The overall revisions following primary TKA in this period was 24 cases, indicating a revision burden of 6.8%. The most common cause of revision TKA was infection, which was in 16 cases (44.4%). Other causes included patellar complications, mechanical loosening of both tibia and femur, mechanical loosening of tibia, instability, and periprosthetic fracture. The main revision procedures were all component revision, tibial component revision, isolated tibial insert exchange and patellar tendon repair. The most common revision procedure was two stage all component revision, which was carried out in 13 subjects (36.1%). CONCLUSION: Local indications for revision TKA are mainly similar to those in other large centers. As compared with other centers, with considering the follow-up time, revision burden is relatively higher in this center.
