Health-Related Quality-of-Life and Functional Outcomes in Short-Stem Versus Standard-Stem Total Hip Arthroplasty: An 18-Month Follow-Up Cohort Study.

BACKGROUND Osteoarthritis (OA) progressively produces symptoms and disability that may significantly reduce health-related quality of life (HRQoL). Total hip arthroplasty (THA) is an important treatment for symptomatic OA. An alternative to standard-stem THA for younger patients is short-stem THA. The aim of this study was to investigate potential HRQoL and functional outcome differences between these patient groups to provide additional data that will be clinically useful in the decision making between the types of prosthesis. MATERIAL AND METHODS In an 18-month follow-up longitudinal cohort study, we conducted Harris Hip Score (HHS) evaluations and SF-36 questionnaires in a study group and a control group undergoing short-stem and standard-stem THA preoperatively and during follow-up at 1, 3, 6, 12, and 18 months. Effect size was calculated to estimate the size of changes in scores during follow-up between chosen time intervals. RESULTS A total of 168 patients were included in the study. The total HHS score was significantly increased postoperatively from 46.9 to 87.0 in the standard-stem group, and from 42.7 to 85.1 in the short-stem group. All SF-36 scores improved after THA in both groups. No HRQoL or functional differences were found in the use of either surgical option in the HHS or SF-36 score results (all p>0.05). CONCLUSIONS As there were no differences in HRQoL in the two groups, we strongly recommend considering short-stem THA, especially in younger patients, due to the benefit of future revision options and a minimally invasive approach.

Low-frequency, low-magnitude vibrations (LFLM) enhances chondrogenic differentiation potential of human adipose derived mesenchymal stromal stem cells (hASCs).

The aim of this study was to evaluate if low-frequency, low-magnitude vibrations (LFLM) could enhance chondrogenic differentiation potential of human adipose derived mesenchymal stem cells (hASCs) with simultaneous inhibition of their adipogenic properties for biomedical purposes. We developed a prototype device that induces low-magnitude (0.3 g) low-frequency vibrations with the following frequencies: 25, 35 and 45 Hz. Afterwards, we used human adipose derived mesenchymal stem cell (hASCS), to investigate their cellular response to the mechanical signals. We have also evaluated hASCs morphological and proliferative activity changes in response to each frequency. Induction of chondrogenesis in hASCs, under the influence of a 35 Hz signal leads to most effective and stable cartilaginous tissue formation through highest secretion of Bone Morphogenetic Protein 2 (BMP-2), and Collagen type II, with low concentration of Collagen type I. These results correlated well with appropriate gene expression level. Simultaneously, we observed significant up-regulation of α3, α4, ß1 and ß3 integrins in chondroblast progenitor cells treated with 35 Hz vibrations, as well as Sox-9. Interestingly, we noticed that application of 35 Hz frequencies significantly inhibited adipogenesis of hASCs. The obtained results suggest that application of LFLM vibrations together with stem cell therapy might be a promising tool in cartilage regeneration.

"Pros and cons" of total hip arthroplasty with metaphyseal Proxima endoprosthesis.

The authors present their own experience concerning total hip arthroplasty with the metaphyseal prosthesis Proxima. Proxima, a metaphyseal prosthesis, provides an innovative supplement to total hip arthroplasty. In this study, the authors present their own experience using Proxima in patients with hip osteoarthritis. This study was performed between 2008 to 2013 and comprised of 62 patients, of which 38 were male (61.3%) and 24 female (38.7%). All patients were operated on due to hip osteoarthritis using total hip arthroplasty with the metaphyseal prosthesis Proxima. The age of patients included into the study ranged from 23 years to 62 years with the mean age of 46 years. The authors paid close attention to the "pros and cons" of surgical techniques and assessed clinical and radiological results in both the short and long-term observation periods. The clinical evaluation was based on the Harris Hip Score and radiological assessment of fixation of the acetabular cup of the endoprosthesis was based on Pradhan's criteria. The endoprosthesis Proxima stem was positioned using the manufacturer's recommended method, evaluating the direction, scope and duration of the displacement in the marrow cavity of the proximal stump of the femur. According to the authors' analysis, the surgery gives good functional and radiological results both in the short- and long-term observation periods. The effectiveness depends on precise qualification for surgery, proper surgical techniques and specific anatomical conditions of the proximal femur stump. The most common reasons for primary and secondary dislocations of the metaphyseal endoprosthesis Proxima stem occur during the first three months post surgery. This is due to incorrect surgical techniques, which disregard the importance of specific anatomical conditions of the proximal femoral stump, which affects Proxima implantation, and cause deviations towards a varus or valgus orientation.

Analysis of body composition among children and adolescents - a cross-sectional study of the Polish population and comparison of body fat measurement methods.

OBJECTIVE: The first aim of the present study was to analyze the body composition of Polish children ages 7-17 years old to add to the current body of literature. The second aim was to compare two body fat measurement methods (bioimpedance vs. Slaughter equation) on the abovementioned population. METHODS: Height (cm) and weight (kg) of 308 (161 males and 147 females) participants, ages 7-17, were measured, and body mass index (BMI) scores were calculated. Skinfold thickness (SFT) was measured for the triceps, subscapular, abdominal, suprailiac, thigh, and medial thigh skin folds on the left side of the body. Fat mass, fat percentage in the whole body (%BF), fat-free mass, and total body water were assessed using bioelectrical impedance analysis (BIA). RESULTS: In the present sample, 29.5% of males were overweight, and 11.3% of these were obese. Among females, 27.2% were classified as overweight, and 6.8% of these were obese. Males had a higher total body water (median=27.25 vs. 24.8 kg, p<0.001) and fat-free mass (median=37.25 vs. 33.90 kg, p<0.001), while females showed a higher total body fat percentage (median=22 vs. 14.55%, p<0.001) and fat mass (median=9.1 vs. 5.9 kg, p<0.001). %BF calculated using Slaughter equations overestimated those obtained by BIA in both genders (p<0.0001). CONCLUSIONS: The percent of youths classified as overweight and obese has increased in Krakow (Poland). Calculation of body fat percent derived from bioimpedance provides better estimates than the use of Slaughter equations, which tended to overestimates the values.

Plutonium, 90Sr and 241Am in human bones from southern and northeastern parts of Poland.

The paper presents the results of our study on 238Pu, 239Pu, 240Pu, 241Am and 90Sr concentration in human bones carried out on a set of 88 individual samples of central Europe origin. Bone tissue samples were retrieved under surgery while introducing hip joint implants. The conducted surgeries tend to cover either southern or northeastern parts of Poland. While for the southern samples only global fallout was expected to be seen, a mixed global and Chernobyl fallout were to be reflected in the others. Alpha spectrometry was applied to obtain activity concentration for 238Pu, 239+240Pu, 241Am, while liquid scintillation spectrometry for 90Sr and mass spectrometry to receive 240Pu/239Pu mass ratio. Surprisingly enough, and to the contrary to our expectations we could not see any significant differences in either Pu activity or Pu mass ratio between the studied populations. In both populations Chernobyl fraction proved marginal. The results on 90Sr and 241Am confirm similarities between the two examined groups.

Preliminary psychometric validation of the Polish version of the EORTC elderly module (QLQ-ELD14).

AIM: The aim of our study was to report preliminary validation data on the EORTC translated, Polish version of the EORTC QLQ-ELD14 questionnaire to show that this tool is an acceptable and psychometrically robust measure to collect HRQoL data in Polish elderly patients with cancer. MATERIALS AND METHODS: Patients with histological confirmation of primary cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-ELD14 module in addition to EORTC QLQ-C30 and a demographic questionnaire. Standardized validity and reliability analyses were performed. RESULTS: Sixty-five patients (41 females - 63.1%) were enrolled into the study, with a mean age of 76.4 ± 5.7 years. Cronbach alpha coefficients, range 0.70-0.84, showed positive internal consistency. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. Strong correlations were observed between the EORTC QLQ-ELD14 (especially mobility and burden of illness), and the EORTC QLQ-C30 (r = -0.30-(-0.83); p <0.001). CONCLUSIONS: Basing on the preliminary data from this study, the Polish version of the EORTC QLQ-ELD14 module is a reliable and valid tool for measuring HRQoL in elderly cancer patients. However further research is needed to establish the full psychometric properties of the described module, especially in regards to test-retest and responsiveness over time.

Validation of the Polish version of the EORTC QLQ-BM22 module for the assessment of health-related quality of life in patients with bone metastases.

PURPOSE: The aim of our study was to undertake a prospective validation study of the Polish version of the European Organization for Research and Treatment of Cancer (EORTC) bone metastases (QLQ-BM22) module used alongside the EORTC core measure. METHODS: The translated module was pilot-tested according to the established EORTC guidelines. Patients with histological confirmation of malignancy and bone metastases, diagnosed by imaging studies, were eligible for the study. All patients filled out the Polish version of the QLQ-BM22 module in addition to QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. RESULTS: One hundred and fifty-five patients were enrolled into the study, including 94 women (60.7 %) and 61 men (mean age ± SD; 59.1 ± 12.1). Cronbach's alpha coefficients, range 0.68-0.93, showed positive internal consistency. Re-test was undertaken with fifty patients (32.3 %). Interclass correlations for the EORTC QLQ-BM22 ranged from 0.91 to 0.93 and proved sufficient test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. CONCLUSIONS: Our study provides new and robust evidence which shows that the Polish version of the QLQ-BM22 module is a valid and reliable instrument for measuring health-related quality of life in patients with bone metastases. It is suitable for use in clinical trials and in research.

Validation of the Polish version of the EORTC QLQ-OV28 module for the assessment of health-related quality of life in women with ovarian cancer.

The aim of our study was to undertake a prospective validation study of the Polish version of the EORTC ovarian cancer (EORTC QLQ-OV28) module used together with the EORTC QLQ-C30. The translated module was pilot-tested according to the EORTC guidelines. Patients with histological confirmation of ovarian cancer were eligible for the study. All patients filled out the Polish version of the EORTC QLQ-OV28, the EORTC QLQ-C30 and a demographic questionnaire. Standard validity and reliability analyses were performed. One-hundred and forty patients agreed to take part in the study (mean age ± standard deviation: 63.3 ± 10.2 years). Cronbach's alpha coefficients showed positive internal consistency (0.78-0.91). Interclass correlations for the EORTC QLQ-OV28 ranged from 0.77 to 0.93 and proved appropriate test-retest reliability. Satisfactory convergent and discriminant validity in multi-trait scaling analyses was seen. The Polish version of the EORTC QLQ-OV28 module proved to be a reliable and valid tool for measuring health-related quality of life in patients with ovarian cancer.

Human bones obtained from routine joint replacement surgery as a tool for studies of plutonium, americium and 9°Sr body-burden in general public.

The paper presents a new sampling method for studying in-body radioactive contamination by bone-seeking radionuclides such as (90)Sr, (239+240)Pu, (238)Pu, (241)Am and selected gamma-emitters, in human bones. The presented results were obtained for samples retrieved from routine surgeries, namely knee or hip joints replacements with implants, performed on individuals from Southern Poland. This allowed to collect representative sets of general public samples. The applied analytical radiochemical procedure for bone matrix is described in details. Due to low concentrations of (238)Pu the ratio of Pu isotopes which might be used for Pu source identification is obtained only as upper limits other then global fallout (for example Chernobyl) origin of Pu. Calculated concentrations of radioisotopes are comparable to the existing data from post-mortem studies on human bones retrieved from autopsy or exhumations. Human bones removed during knee or hip joint surgery provide a simple and ethical way for obtaining samples for plutonium, americium and (90)Sr in-body contamination studies in general public.