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Alesi D, Bordini B, Fratini S, Ancarani C, Agostinone P, Grassi A, Marcheggiani Muccioli GM, Viceconti M, Zaffagnini S. Lateral unicompartmental knee arthroplasty (UKA) showed a lower risk of failure compared to medial unicompartmental knee arthroplasty in the Register of Prosthetic Orthopedic Implants (RIPO). Arch Orthop Trauma Surg 2022; 143:3363-3368. [PMID: 36156122 DOI: 10.1007/s00402-022-04631-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 09/18/2022] [Indexed: 02/09/2023]
Abstract
INTRODUCTION The present study aimed to investigate differences in survivorship between medial and lateral unicompartmental knee arthroplasty (UKA) by analyzing the data of an Italian regional registry. The hypothesis was that, according to recent literature, lateral implants have comparable survivorship with regard to the medial implants. MATERIALS AND METHODS The Register of Orthopaedic Prosthetic Implants (RIPO) of Emilia-Romagna (Italy) database was searched for all UKAs between July 1, 2000, and December 31, 2019. For both cohorts, subject demographics and reasons for revision were presented as a percentage of the total cohort. Kaplan-Meier survivorship analysis was performed using revision of any component as the endpoint and survival times of unrevised UKAs taken as the last observation date (December 31, 2019, or date of death). RESULTS Patients living outside the region and symmetrical implants (which do not allow the compartment operated to be traced) were excluded. 5571 UKAs implanted on 5172 patients (5215 medial UKAs and 356 lateral UKAs) were included in the study. The survivorship analysis revealed 13 failures out of 356 lateral UKAs (3.7%) at a mean follow-up of 6.3 years and 495 failures out of 5215 medial UKAs (9.5%) at a mean follow-up of 6.7 years. The medial UKAs had a significantly higher risk of failure, with a Hazard Ratio of 2.6 (CI 95% 1.6-4.8; p < 0.001), adjusted for age, gender, weight, and mobility of the insert. Both the groups revealed a good survival rate, with 95.2% of lateral implants and 87.5% of medial implants still in situ at 10 years of follow-up. CONCLUSIONS Lateral UKA is a safe procedure showing longer survivorship than medial UKAs (95.2% and 87.5% at 10 years, respectively) in the present study. LEVEL OF EVIDENCE Level 3, therapeutic study.
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Affiliation(s)
- Domenico Alesi
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy.
| | - Barbara Bordini
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy
| | - Stefano Fratini
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | - Cristina Ancarani
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy
| | - Piero Agostinone
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | - Alberto Grassi
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
| | | | - Marco Viceconti
- Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, Via di Barbiano 1/10, 40136, Bologna, BO, Italy
| | - Stefano Zaffagnini
- Clinica Ortopedica e Traumatologica II, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, BO, Italy
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Khalid N, Pandey Y, Khalid U, Kamran H, Wermers JP, Chhabra L, Alam M, Jneid H, Kayani WT. Modes of failure with fractional flow reserve guidewires: Insights from the manufacturer and user facility device experience database. World J Cardiol 2021; 13:223-229. [PMID: 34367506 PMCID: PMC8326154 DOI: 10.4330/wjc.v13.i7.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/26/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Fractional flow reserve (FFR) measurement is commonly used in the cardiac catheterization laboratory to assess the functional significance of coronary arterial plaques. Robust real-world data on complications and modes of failure of FFR guidewires are limited.
AIM To characterize these outcomes by analyzing the post-marketing surveillance data from the United States Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database for commonly used FFR guidewires.
METHODS The MAUDE database was queried from January 2010 through April 2020 for 3 FFR guidewires [PressureWireTM X (Abbott), CometTM (Boston Scientific), and VerrataTM (Philips)] by searching for the following events: “Injury”, “malfunction”, “death”, and “other”. This yielded 544 reports. After excluding incomplete reports, 486 reports were analyzed.
RESULTS Guidewire tip fracture was the most commonly reported mode of failure, in 174 (35.8%) cases followed by guidewire kinking (n = 152, 31.3%), communication failure (n = 141, 29.0%), and shaft fracture (n = 67, 13.8%). In total, 133 (27.4%) device failures resulted in patient adverse events. The most common adverse event was retained guidewire tip, in 71 (53.4%) cases, followed by freshly deployed stent dislodgment (n = 26, 19.6%) and coronary artery dissection (n = 23, 17.3%). Seven deaths were reported.
CONCLUSION FFR guidewire failures can occur because of various mechanisms and cause patient adverse events. The MAUDE database serves as an important platform for improved collaboration among clinicians, device manufacturers, and regulators to improve device performance and optimize patient outcomes. Our analysis provides mechanistic insights of FFR guidewire failure and associated adverse events but cannot verify causality or provide a comparison among different guidewires.
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Affiliation(s)
- Nauman Khalid
- Department of Interventional Cardiology, St. Francis Medical Center, Monroe, LA 71201, United States
| | - Yagya Pandey
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States
| | - Umair Khalid
- Department of Interventional Cardiology, Michael E. DeBakey VA Medical Center, Houston, TX 77030, United States
| | - Hassan Kamran
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Jason P Wermers
- Health Sciences, University of Maryland Graduate School, Baltimore, MD 21201, United States
| | - Lovely Chhabra
- Department of Cardiology, Westchester Medical Center Network Advanced Physician Services, New York, NY 12601, United States
| | - Mahboob Alam
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Hani Jneid
- Department of Interventional Cardiology, Michael E. DeBakey VA Medical Center, Houston, TX 77030, United States
| | - Waleed Tallat Kayani
- Department of Interventional Cardiology, Baylor College of Medicine, Houston, TX 77030, United States
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Di Martino A, Bordini B, Barile F, Ancarani C, Digennaro V, Faldini C. Unicompartmental knee arthroplasty has higher revisions than total knee arthroplasty at long term follow-up: a registry study on 6453 prostheses. Knee Surg Sports Traumatol Arthrosc 2021; 29:3323-9. [PMID: 32740877 DOI: 10.1007/s00167-020-06184-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/23/2020] [Indexed: 01/29/2023]
Abstract
PURPOSE The purpose of this study is to analyse long-term unicompartmental knee arthroplasty (UKA) focusing on survivorship, causes of failure and revision strategy. METHODS This study is a retrospective analysis of data from a regional arthroplasty registry for cases performed between 2000 and 2017. A total of 6453 UKAs were identified and the following information was analysed: demographic data, diagnosis leading to primary implant, survivorship, complication rate, causes of failure, revision strategies. UKA registry data were compared with total knee arthroplasty (TKA) registry data of 54,012 prostheses, which were implanted in the same time period. RESULTS 6453 UKAs were included in the study: the vast majority of them (84.4%) were implanted due to primary osteoarthritis followed by deformity (7.1%) and necrosis of the condyle (5.1%). When compared to TKA, UKA showed lower perioperative complication rate (0.3% compared to 0.6%) but higher revision rate (18.2% at 15 years, compared to 6.2% for TKA). No correlation was found between diagnosis leading to primary implant and prosthesis survival. The most frequent cause of failure was total aseptic loosening (37.4%), followed by pain without loosening (19.8%). Of the 620 UKAs requiring revision, 485 were revised with a TKA and 61 of them required a re-revision; on the other hand, of the 35 cases where another UKA was implanted, 16 required a re-revision. CONCLUSION UKA is associated with fewer perioperative complications but higher revision rates when compared to TKA. Its survivorship is not affected by the diagnosis leading to primary implant. Revision surgery of a failed UKA should be performed implanting a TKA, which is associated with a lower re-revision rate when compared to another UKA. LEVEL OF EVIDENCE Level 3, therapeutic study.
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Alqerban A. Lithium di silicate ceramic surface treated with Er,Cr:YSGG and other conditioning regimes bonded to orthodontic bracket. Saudi Dent J 2019; 33:188-193. [PMID: 34025080 PMCID: PMC8117366 DOI: 10.1016/j.sdentj.2019.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/25/2019] [Accepted: 11/25/2019] [Indexed: 11/28/2022] Open
Abstract
Aim To assess bond integrity and modes of failure of metallic brackets to lithium disilicate ceramics (LDC) conditioned with Er,Cr:YSGG laser (ECL). Material and methods Sixty LDC were arbitrarily allocated into six groups (n = 15) according to the type of ceramic surface conditioning treatment. Group 1 surface treated with silane (S) only, group 2 surface etched with hydrofluoric acid (HF)+ S, group 3 surface conditioned with HF+ ultrasonic bath (UB)+ S, group 4 sand blasting (SB) of glass ceramic surface with 50 µm Al2O3, group 5 surface conditioned with self-etch ceramic primer (SECP) and in group 6 surface treated with ECL + S. After conditioning, the specimens were positioned in a universal testing device for shear bond strength (SBS) testing. Adhesive Remnant Index (ARI) was used to determine sites of bond failure. Among experimental groups analysis of variance (ANOVA) and Tukey multiple comparison test was used at a significance level of (p < 0.05). Results The highest SBS values were observed in group 3 HF+ UB + S (18.21 ± 1.241) and the lowest SBS values were displayed group 1 surface treated with S only (5.21 ± 0.23). Specimens surface conditioned in group 2 with HF+ S (17.85 ± 1.25), group 3 HF+ UB + S (18.21 ± 1.241) and group 6 ECL + S (17.09 ± 1.114) unveiled comparable SBS values (p > 0.05). Conclusion LDC conditioned with ECL at (4.5 W and 30 Hz) has a potential to be used in clinical settings alternate to HF acid.
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Affiliation(s)
- Ali Alqerban
- Department of Preventive Dental Sciences College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Preventive Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
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Abstract
Quantitative landslide risk analysis is a key step in creating appropriate land use policies. However, regional scale landslide hazard and risk studies are traditionally based on a single, infinite-slope style of failure, belying the differing consequences of a diverse range of failure modes. In this paper we expand an existing multimodal coseismic landslide hazard model to create a method for multimodal, multi-trigger quantitative landslide risk analysis and apply it to the country of Lebanon. Physics-based, mode-specific models for coseismic and precipitation-induced landslides capture the effects of multiple failure types and triggering scenarios. A new model for analyzing slope stability against rotational failures allows for efficient, regional scale assessments. Open-source mapping of built-up area is used to identify elements at risk.
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Affiliation(s)
- William Pollock
- Dept. of Civil and Environmental Engineering, University of Washington, 201 More Hall, Seattle, WA 98195, United States
| | - Alex Grant
- Dept. of Civil and Environmental Engineering, University of Washington, 201 More Hall, Seattle, WA 98195, United States
| | - Joseph Wartman
- Dept. of Civil and Environmental Engineering, University of Washington, 201 More Hall, Seattle, WA 98195, United States
| | - Grace Abou-Jaoude
- Dept. of Civil Engineering, Lebanese American University, 304 Bassil Bldg., Byblos, Lebanon
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Chin KR, Cumming VB, Henson M, Murrell B, Chan FW. Effects of misalignment on static torsional strength of anterior cervical plate systems. Spine J 2013; 13:1544-8. [PMID: 23800821 DOI: 10.1016/j.spinee.2013.05.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 02/07/2013] [Accepted: 05/04/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT There is little understanding of cervical plate misalignment as a risk factor for plate failure at the plate-screw-bone interface. PURPOSE To assess the torsional strength and mode of failure of cervical plates misaligned relative to the midsagittal vertical axis. STUDY DESIGN Plastic and foam model spine segments were tested using static compression and torsion to assess effects of misaligned and various lengths anterior cervical plate (ACPs). METHODS Different length ACPs and cancellous fixed angle screws underwent axial torsional testing on a servo-hydraulic test frame at a rate of 0.5°/s. A construct consisted of one ACP, four screws, one ultrahigh-molecular weight polyethylene inferior block, and one polyurethane foam superior block. Group 1 had ACPs aligned in the midsagittal vertical axis, group 2 plates were positioned 20° offset from the midline, and group 3 had the ACP shifted 5 mm away and 20° offset from midline. Torques versus angle data were recorded. The failure criterion was the first sign of pullout determined visually and graphically. RESULTS Group 1 had a more direct screw pullout during failure. For the misaligned plates, failure was a combination of the screws elongating the holes and shear forces acting between the plate and block. The misaligned plates needed more torque to failure. The failure torque was 50% reduced for the longer versus the shorter plates in the neutral position. Graphically shown initial screw slippage inside the block preceded visual identification of slippage in some cases. CONCLUSIONS We observed different failure mechanisms for neutral versus misaligned plates. Clinically, misalignment may have the benefit of needing more torque to fail. Misalignment was a risk factor for failure of the screw-bone interface, especially in longer plate constructs. These comparisons of angulations may be a solid platform for expansion toward a more applicable in vivo model.
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